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Notice of changes to eligibility criteria for referrals to District Nursing services

Notice of changes to eligibility criteria for referrals to District Nursing services from the Birmingham Community Healthcare NHS Foundation Trust (BCHC) – effective from Monday June 26th 2017

All GPs and Practice Managers.

I trust you find the email below to be self-explanatory. I would reiterate the point in my final paragraph and suggest you challenge your CCG on this decision; please also let the LMC know if your practice is put in a position of being expected to carry out any uncontracted community nursing work following decommissioning of services by the CCGs.

Dear Richard

It’s very disappointing to see this message go out. As I have repeatedly made clear, GMS/PMS GP contracts are for the provision of primary medical services, not nursing services. Whilst I appreciate that many practices are now commissioned to provide certain nursing services, for example basic dressings and suture removal etc, through LIS or enhanced service arrangements, these do not cover the full range of community nursing services and not all of them are and of course taking up such contracts is entirely voluntary on the part of practices.

I would remind you yet again that community nursing services must be commissioned to provide for the nursing needs of all patients who are not in hospital, not merely the “housebound”. I would also reiterate the point that practices employ practice nurses in order to support them in the delivery of contracted services, and not in order that uncontracted, unfunded and non-commissioned community nursing services might be inappropriately dumped on them. It’s a great pity that you have chosen to disregard the LMC’s views in this respect and I would be most grateful if you could now confirm what arrangements you have in place to provide for the community nursing requirements of all patients who are not “housebound” and whose practice is not contracted to provide the required nursing services. The Birmingham CCGs have legal obligations in this respect. My understanding is that this decision has been made because the community nursing contract is “over performing“ and therefore rather than increasing investment in community nursing the CCGs are seeking to save money, at the expense of practices and, more pertinently, patients who require fit for purpose community nursing services to meet their needs.

I would welcome the opportunity to meet up with you and representatives of other CCGs in order to further discuss this matter.

This message will be copied to all Birmingham CCG’s member practices who are advised to challenge their CCG over this matter; I also expect that, inevitably, secondary care referrals are likely to increase as a result of this decision

TO ALL GPs As clinical chair of the BCHC Integrated Multidisciplinary Teams (IMTs) service review group, I am writing on behalf the Birmingham CCGs to inform you of changes to the eligibility criteria for referrals to District Nursing services provided by BCHC effective Monday June 26th 2017.

Following a review of the service provision and approvals via governance processes; District Nursing services will be moving to a “housebound only” service (see briefing pack for details). This will include patients who are either permanently or temporarily housebound e.g. following a hospital admission.

As part of the mobilisation we are writing to key stakeholders; NHS provider Trusts, GPs and the Local Authorities, to inform them of the start of the implementation of the revised criteria for new referrals only.

I would be grateful if you could disseminate the attached briefing pack which includes details of the revised criteria - ensuring that clinicians and managers in your respective organisations are clear about the revised eligibility criteria. If you have any questions please feel free to contact me at until 23rd June. We are setting up a dedicated inbox for feedback queries post launch and will notify you of this in due course.

Kind Regards,

Dr Richard Mendelsohn – Clinical Head of Commissioning BSC CCG


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