GPs vote to reduce patient home visits

Doctors have supported a proposal to reduce visits to patients' homes, saying they 'no longer have the capacity' to offer them.

The decision means that British Medical Association (BMA) representatives will lobby NHS England to stop home visits being a contractual obligation, although the plans already face opposition from Health Secretary Matt Hancock and the Royal College of GPs.

Hancock has stated that taking home visits out of GPs' contracts is a 'complete non-starter', while Martin Marshall, chair of the college, said that home visits should be used more wisely but maintained that they are remain a 'core part' of general practice.

In one month lasst year, GPs in England made 238,579 home visits out of a total of 27,084,027 appointments. An NHS spokeswoman said GPs would still visit patients at home where there was a clinical need to do so.

A local committee of doctors from Kent brought the motion to the London medical committee conference, arguing that the BMA should renegotiate with the NHS to 'remove the anachronism of home visits from core contract work, negotiate a separate acute service for urgent visits, and demand any change in service is widely advertised to patients'.

Dr Richard Vautrey, chair of the BMA's GP Committee, said that practices could focus on the needs of patients in the surgery while a specialist team of people - made up of nurses, paramedics and GPs - visited those who were housebound.

The RCGPs Marshall 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.

"General practice is under enormous pressure at present and we have a severe shortage of GPs, so we are 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 they are not a substitute for GPs. This proposal is now for the BMA, as the doctors' union, to decide, but it would need a lot of consideration and any changes would need to be widely and sensitively communicated to patients. Meanwhile, we would urge our patients requesting a home visit to consider very carefully whether they really need one, so that valuable GP time is spent most wisely on those patients who need it most."