Doctors Call for Overhaul of GP Home Visits

Peter Russell

November 25, 2019

The Health Secretary Matt Hancock described the idea of curbing GP home visits in England as a "complete non-starter" after doctors backed the idea in a vote.

The decision cleared the way for the British Medical Association (BMA) to negotiate the change with NHS England.

Delegates at the Local Medical Committee Conference passed a motion from Kent that said GPs no longer had the capacity to offer home visits. It called on the General Practitioners Committee to:

  • Remove anachronism of home visits from core contract work

  • Negotiate a separate acute service for urgent visits

  • Demand any change in service is widely advertised to patients

A 'Properly Resourced' Home Visiting Service

In a press statement, the Kent Local Medical Committee (Kent LMC) insisted that the motion was not intended to remove the ability of GPs to perform home visits.

More complex, vulnerable, and palliative patients would be best served by their GP visiting them when needed, it said.

However, Kent LMC said that against a background of increasing demand and falling GP numbers, it wanted to see a home visiting service that was properly resourced. It explained that in parts of Kent, home visits were carried out by multi-disciplinary team members such as paramedics and nurse practitioners.

The Health Secretary told ITV news that he was opposed to the plan. Mr Hancock said: "Of course GPs still need to do home visits. They don't do that for the majority of cases, but some people are very frail and sometimes a home visit by a GP is necessary.

"The idea you would end GPs doing home visits is not going to fly."

Home Visits 'A Core Role for GPs'

The Royal College of General Practitioners said the proposal needed careful consideration.

Prof Martin Marshall, chair of the RCGP, said: "Home visits are a core part of general practice and for some of our more complex and vulnerable patients, they might be the only means of seeing their GP.

"Of course, home visits should be used wisely as they can be time consuming and take GPs away from our surgeries where we could be seeing more patients. But it is vital that patients who need the skills and expertise of a GP are able to access them if they are unable to make arrangements to get to their local surgery."

Prof Marshall said the RCGP was "very supportive of proposals to train other members of the GP team such as physician associates and advanced paramedics to carry out home visits as appropriate", but added that they were "not a substitute for GPs".

Dr Richard Vautrey, BMA GP committee chair, commented: "NHS general practice has changed immeasurably since its birth 70 years ago, and today's GP simply does not have the capacity to make home visits as part of a routine surgery day.

"GP representatives feel that continuing to provide home visits for a few will reduce the level of care they’re able to give to the majority of patients."

The BMA stressed that the motion backed a fully resourced, separately commissioned home visiting service.

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