Professor Susan Smith:

There is a considerable opportunity for general practice to provide structured care in those settings. In my practice in Inchicore we provide a care service for several nursing homes. It is also a way for GPs to diversify in their clinical activities in order that they are not always engaged in face-to-face consultations with the same patients. Some might spend a half day on a ward round in a nursing home. It is important because conversations about individual patients' choices can be had during the day in order that, if something happens in the middle of the night, a patient has already decided that he or she does not want to sit on a trolley in an emergency department for 12 hours and instead wants to be treated in the nursing home or wherever else. This requires a resourced, structured care service in order that patients will be a part of a named GP's practice and that the GP will monitor what he or she does with them. GPs have the skills to do this work.