GP Tutorial 5 - health inequalities and care home

Question 1

How to investigate and influence planning of local services for falls?

Answer 1

• Gather data on who referred and where from
• Assess transport links
• Ask local patient and carer groups
• Present evidence to local health comissioners/PH teams
• New ideas inc: mobile clinics, local community centre clinics, home services and integrate into GP/physio clinic

Question 2

Falls prevention in Leicester - services

Answer 2

• Strength and balance training - programs eg Steady steps is 24 week post fall to help balance
• Assess home - OT improvements, lighting, remove debris
• Footwear check
• Hearing and vision checks
• Leicestershire partnership NHS trust falls prevention service - can refer post discharge
• Active Together

Question 3

Referral and admissions criteria for carehomes

Answer 3

1. Needs assessment - evaluate ADLs and level of support needed - conducted by local authorities
2. Eligibility - severe/complex needs that can’t be supported enough at home, repeated falls/injuries –> safety risk, cognitive decline affecting ability to live independently
3. Financial assessment

Question 4

Referral process for carehome

Answer 4

• GP/hospital or social worker initiates
• Care act assessment carried out to to identify if home is needed
• Consent - if have capacity, need consent, if not it must be in their best interests

Question 5

Financing care home

Answer 5

• Threshold - £23,250 is threshold, if assets above this, will need to fund own care. If not, local authority assistance is given (means tested)
• NHS continuing healthcare - if complex medical conditions assessments determine if eligible for CHC = full cover of cost of care
• Top-up fees - if opts for more expensive care home than one funded by local authority, family or patient need to pay top-up fee