Committed to safety and care in residential homes

17 April 2020

The concerns being raised for the safety of those living and working in care homes has been prominent in the coverage of the coronavirus pandemic this week.

This has been an issue that has also been front and centre of much of the work that I have been involved with over the past few weeks.

Protecting the vulnerable

Ensuring that the most vulnerable in our society are protected from the worst effects of COVID-19 has to be a priority for our national response and it is a simple fact that many of the most medically vulnerable in our communities live in care homes.

Anxious care home residents and staff

There is huge anxiety being felt by care homes residents, their families and the staff looking after them around many issues including:

  • access to personal protection equipment (PPE)
  • testing
  • routine medical care
  • hospital admission.

Committed to high levels of care

Many have felt frightened and forgotten in all of this. GPs have always had strong relationships with the care homes that they look after, and last week, together with Scottish Care, we published a joint statement recognising the exceptional work of our care home colleagues during this time and reinforcing the message to the public that general practice is absolutely committed to providing the same high levels of person-centred care throughout this time.

Read our tweet on the joint statement.

PPE to protect patients, staff and GPs

Of course, general practice has had to radically adapt to the way it delivers care in the past few weeks to minimise infection risk. If, after appropriate triage and assessment via telephone or video consultation, a resident still clinically requires a face to face assessment, this will happen, with appropriate PPE to protect the patient, the staff and the GP.

I was very grateful to Donald Macaskill, CEO of Scottish Care, for joining with me to publish this message and pleased that it was so widely picked up by the press.

Key questions and answers on care

This week, I have also been working closely with the Scottish Government and the Scottish General Practitioner’s Committee (SGPC) of the BMA to develop three sets of FAQs for care home residents, care home staff and GP practices to provide some clarity and reassurance to key questions about the provision of care during this time.

These are due to be circulated very soon, and I will share the link with you as soon as I have it. Our relationships with care home colleagues have never been more important and I am pleased to be able to support them and indeed, grateful to them for their support in caring for some of our most vulnerable patients during this time.

Guidance on visiting patients who are dying

The Scottish Academy, representing all medical Royal Colleges, published new guiding principles this week, to enable patients who are dying in hospital, care homes and hospices to be visited by their loved ones at the end of life.

With distressing reports across the country of patients dying without their family being able to visit, the intention of the guidance is to ensure that dying patients in Scotland are treated humanely, compassionately and with dignity during the COVID-19 pandemic.

The principles, which have been co-signed by the Scottish Academy, the Royal College of Physicians of Edinburgh, Marie Curie and Scottish Care explicitly state that all patients in Scotland who are judged to be dying from COVID-19 or other terminal conditions must receive equal access to visits from family and friends, with appropriate infection control measures and consent process in place.

Scottish Government has formally supported these guidelines and have committed to help us publicly communicate this message. I was very proud to be a part of this work of the Scottish Academy, acting collectively as advocates for dying patients and their families.

Risk counselling and informed choices

As with so many facets of this pandemic, this is about weighing up the relative risks of taking action. We believed, as medical professionals, that the long-term psychological harm of not being able to be present at the end of a loved-one’s life for many is far greater than the potential harm of developing COVID-19.

In any case, it is not our decision to make, it is our role to adequately counsel on the risks and allow people to make their own informed choices.

Please do continue to get in touch with me through ScottishC@rcgp.org.uk. I really do value hearing from you.


Post written by

Dr Carey Lunan, Chair of RCGP Scotland

Dr Carey Lunan is a GP partner in one of Edinburgh's Deep End practices and is the current Chair of RCGP Scotland.

Prior to this, she held the role of Executive Officer for Patients and Public and Interface working. She also sits on the RCGP Ethics Committee.

Her priorities during her time as Chair include a focus on practitioner wellbeing, improving the interface between primary and secondary care, and growing and retaining the GP workforce.

She has made tackling health inequalities a high priority and has consistently called for the need to engage the public in a "national conversation" about the realistic role of the modern NHS and the importance of collective social responsibility for its use.

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