Care Home Service – Downloadable Documents
Please use the following documents when submitting information to the PCN Care Home team
Emails should be directed to: cmicb-wi.hwwpcncarehomesupport@nhs.net
New Resident Review
New Resident Care Home Assessment
Please complete this form for all new residents and submit it with their registration paperwork. This will help establish baseline information for safe and proactive care planning.
PCN Vaccination Consent Form
Please complete this form for all new residents and submit it along with their registration paperwork. We strongly encourage all care home residents to receive the flu and COVID-19 vaccines each year. The flu and COVID-19 vaccine are typically co-administered in the autumn, before the start of the flu season, to ensure residents are protected during peak months. The COVID-19 booster is also given in the spring.
Birth Month Review & Structured Medication -Annual Review
Patients will be scheduled for their annual review, which corresponds to their birth month, and a structured medication review. Care home teams will be asked to complete an annual review form prior to the clinical review. Completing this form in advance saves time on the day, allowing the clinician to focus on the clinical assessment rather than gathering information
Temporary Patient Registration Form – GMS1 (send directly to GP practice)
Please submit when registering a new patient with your named GP practice. For residents staying longer than 3 months.
Temporary Patient Registration Form – GMS3 (send directly to GP practice)
Please submit this form when registering a temporary patient. This form is valid for 3 months.
