GP services for older people: a guide for care home managers

Managers' responsibilities and the NHS reforms - NHS structures and integration arrangements

Care homes should ensure that they and their care staff are familiar with the new NHS structure and integration arrangements, especially in relation to what has been agreed locally. They should know how complaints and challenges are handled. Networking, joining local forums and service development groups could all be seen as part of their advocacy role at a strategic level.

The 2013 NHS reforms

Major changes to NHS structures and responsibilities came into force in April 2013 and will inevitably take time to bed in and work smoothly. The new structures are intended to help health and care agencies to work together in more integrated ways and to ensure people who use services and their relatives are central. The changes include abolition of the former PCTs and strategic health authorities, and transfer of responsibilities for commissioning health services to new bodies. For home managers and provider organisations, the reforms will involve changes in key NHS personnel, a need to build up working relationships with new commissioners and the likelihood of transformation over time in the behaviours of provider bodies.

Read more about the NHS reforms and the complaints procedure.

Complaints about NHS services

Since April 2009, the NHS has run a simple two-stage complaints process:


All SCIE resources are free to download, however to access the following downloads you will need a free MySCIE account:

Available downloads:

  • Evidence review on partnership working between GPs, care home residents and care homes
  • GP services for older people: a guide for care home managers
  • Improving access to and experience of GP services for older people living in care homes: practice survey