The aims of the care homes locally commissioned service (LCS) are to:

• provide an additional level of care over and above that of the Alternative Provider Medical Services (APMS) General Medical Services (GMS) or Personal Medical Services (PMS) contracts provided by all GPs as core provision.
• build upon and go beyond the enhanced healthcare in care homes specification underneath the GP network DES contract; ensuring local implementation of the national Framework for Enhanced Health in Care Homes1.
• provide a proactive, preventative service to patients/residents within the specified Nursing, Residential, Extra Care or Intermediate Care Home. All patients to receive care under this specification will be registered with the Service Provider on a permanent or temporary basis2 depending on patient choice.
• improve the quality of care to older people in Nursing, Residential, Extra Care and Intermediate Care Homes, ensuring that all patients receive dedicated medical services.
• minimise the risk and complications to patients within this vulnerable group (including patients with highly complex needs) by providing and monitoring a comprehensive programme of care.
• fulfil the minimum requirements set out in the NSF Older People, 2001; End of Life Care Service as part of the Universal Offer; Gold Standards Framework.
• provide proactive care in managing chronic disease and medicines (including care planning), especially around discharge and end of life care, including in the London Urgent Care Plan Record whether the patient consents or, if unable to consent, to share in his or her best interests.
• reduce reliance on Out-of-Hours services for crisis management and reduction in inappropriate non-elective admissions and A&E attendances.
• reduce inappropriate prescribing and wastage.