GPs vote to reduce patient home visits

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GPs have voted to reduce visits to patients’ homes, saying they “no longer have the capacity” to offer them.

Doctors supported the proposal at a meeting of English local medical committees in London on Friday.

It means British Medical Association (BMA) representatives will lobby NHS England to stop home visits being a contractual obligation.

However, the plans face opposition from Health Secretary Matt Hancock and the Royal College of GPs (RCGP).

Mr Hancock said taking home visits out of GPs’ contracts is a “complete non-starter”.

RCGP chair Professor Martin Marshall said home visits should be used wisely but insisted they are a “core part” of general practice.

An NHS spokeswoman said GPs would still visit patients at home where there was a clinical need to do so.

According to NHS Digital, in one month in 2018, GPs in England made 238,579 home visits out of a total of 27,084,027 appointments.

‘Anachronism of home visits’

A local committee of doctors from Kent brought the motion to the conference, arguing GPs “no longer have the capacity to offer home visits”.

It said representatives from 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”.

The group added it did not want to completely scrap home visits, as “more complex, vulnerable and palliative patients” were “best served” by GP home visits.

Dr Richard Vautrey, chair of the BMA’s GP Committee, said: “GPs are telling us that it would be much better if there was a dedicated home visiting service.”

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, he said.

As a result of the motion being passed, the part of the BMA which represents English GPs – GPC England – will be instructed to negotiate the new policy with NHS England.

Nikita Kanani, the NHS’s national medical director for primary care, said GPs and healthcare professionals such as nurses and advanced paramedics would continue to make home visits when patients needed them.

The London GP said an extra £4.5bn was being invested for local doctors and community services to help fund 20,000 more staff to support GP practices and “offer high quality care for patients”.

The health secretary insisted there was “no prospect” of GPs removing their contractual obligations to making home visits.

He told BBC Radio 4’s Today programme it was “right” that most home visits were made by nurses “but sometimes you need a GP”.

Professor Marshall said: “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.”

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