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Organising general practice for care homes: a multi-method study
Barbara Hanratty1, Rachel Stocker1, David Sinclair1
1Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Health and Social Care Delivery Research
|April 15, 2025
Summary
Trusting relationships and adequate resources are key for effective primary care in nursing homes. Larger practices or those with more care home residents showed better quality care, but flexibility in national initiatives is crucial.
Area of Science:
- Healthcare Delivery Research
- Primary Care Management
- Geriatric Health Services
Background:
- General practice is the primary point of contact for National Health Service (NHS) care for approximately 400,000 care home residents.
- Effective primary care enhances resident well-being and optimizes hospital service utilization.
Purpose of the Study:
- To investigate the links between general practice organization and resident/staff experiences, outcomes, and costs.
- To explore the impact of primary care service delivery models on care home residents.
Main Methods:
- A mixed-methods approach combining a national survey of general practices (2018), qualitative interviews (2019), and analysis of primary care data (2019-21).
- Data collected from 150 general practices, 101 healthcare professionals and care home staff, and over 100,000 care home residents aged 75+.
Main Results:
- Qualitative analysis revealed the importance of relational continuity, communication, and organizational factors in general practitioner (GP) services to care homes.
- Larger practices or those with more care home residents reported higher quality care, increased primary care contacts, and fewer urgent referrals.
- Implementation of new initiatives like telemedicine requires careful consideration of care home staff burden and acceptance.
Conclusions:
- Trusting relationships and a motivated, well-resourced primary care workforce are paramount for enhancing care home primary care.
- While practice size and resident volume correlate with better care, local flexibility in implementing national initiatives is essential for success.
- Further research is needed on promoting trusting relationships and evaluating the system-wide impact of initiatives like Enhanced Health in Care Homes.
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