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Black hole on in-hours home visits

The Government has admitted that in-hours home visits are the black hole in its plans to allow patients to register at a practice near their workplace.

Primary care tsar Dr David Colin-Thome conceded in a Number 10 webchat that patients who chose to register near their work would have no right to in-hours home visits.

He said the Government would 'try and ensure' local GPs provided the service to patients not registered with them, but indicated it would be relying on GPs' goodwill.

GPs said the grey area showed the registration changes were a badly thought out 'gimmick'.

Responding to questions on the webchat about how in-hours home visits would be provided, Dr Colin-Thome, a GP in Runcorn, Cheshire, said a choice of practice 'is all we are offering'.

He said: 'Out-of-hours won't be a problem, but an in-hours visits will present difficulties unless your local practice where you live is prepared to visit you.

'We will try and ensure that if you are out of your area local general practices will provide a service when you have chosen to register near where you work ­ you will have to set the pros against the cons.'

The Department of Health suggested that 'work' practices could negotiate with 'home' practices to take on such visits.

But GPs said sorting out responsibilities would be stressful and create unnecessary red tape.

Dr Prasad Rao, a GP in Stoke and chair of North Staffordshire out-of-hours co-op, said GPs might feel emotionally blackmailed into visiting unregistered patients.

'This is another grey area and it's very stressful for GPs and their managers,' he said.

'I can't be expected to negotiate with one practice in Stafford, another in Cheshire and one in Birmingham just to arrange home visits.'

Dr Chaand Nagpaul, chair of the GPC service development committee and a GP in Harrow, Middlesex, said GPs had always visited unregistered patients, but had been paid for the work under the Red Book.

He said: 'It should not be down to altruism, but paid for properly. It could be an item of service or enhanced service.'

Dr Robin Jackson, a GP in Lancaster whose practice covers a large rural area, said the registration changes were a 'gimmick'.

He said: 'It just shows the idiots haven't thought it through ­ it's not a question of altruism it's a question of practicalities.'

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