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Gold, incentives and meh

GPs vote for home visits to be removed from contract

GP leaders have voted for a motion for home visits to be removed from core GP contract work at the England LMCs conference in London in a shock result.

The motion called on the BMA GP Committee to 'remove the anachronism of home visits from core contract work' and 'negotiate a separate acute service for urgent visits'.

They also voted for the GPC to negotiate a separate acute service for urgent visits.

After a long debate, with many speakers on both sides, it was voted 54% for to 46% against. 

The vote means that the GPC will be mandated to negotiate for this in contract negotiations. In the debate, the GPC said that it was highly unlikely NHS England would accept such proposals.'

Dr Andrew Parkin, from Kent LMC, who proposed the motion, told delegates that this 'would send out a political message, and there is no better time for a political message than three weeks before a general election.

He added: 'This would not disadvantage vunerable, frail patients.

'Moving away from routine day-to-day contacts would actually improve care. All our patients will benefit, by gaining us that most precious and rare commodity in general practice, time. Home visits take up the most time of anything we do.'

'Two to three hours a day for the majority. They cause the most friction, complaints and litigation. You have the most highly trained, endangered, and in-demand people in primary care driving around 25 square miles to see two patients an hour, and in the case of rural colleagues, maybe only one.

'This isn’t good medicine. No other country has on-demand visits like the UK. New Zealanad, Canada, Australia – home visits are virtually unheard of.'

Dr Sarah Matthews, speaking against the motion, said: ‘This is a very bad idea. This will sell the heart and soul of our profession away.

‘The idea that if we recommission service away, to somebody else, that they will care more, better for the patient than me, than you, who has known the patient for 20 years, is just not true.’

Dr Richard Vautrey, BMA GP committee chair, said: '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.

'Of course, patients who can be treated only at home will still need to be seen – and NHS England will need to ensure this happens outside of the GP contract, with any changes communicated clearly and sensitively to patients.'

KENT: That conference believes that GPs no longer have the capacity to offer home visits and instructs the GPC England to: i. remove the anachronism of home visits from core contract work ii. negotiate a separate acute service for urgent visits iii. demand any change in service is widely advertised to patients

Related images

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Readers' comments (42)

  • Bob Hodges

    The argument that home visits do not allow the practise of modern medicine is the most potent.

    The 'Daily Mail reader in the street' also needs to know that this is apecularly Britsh and old-fashioned thing that no other health system in the world has adopted.

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  • Good to see they voted against unnecessary home visits . Now what? Would DOH do some thing?

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  • Don't worry the BMA will negotiate a "better deal" for us. It will involve picking up urgent visits from 111 and 999 for a reduction in our core contract. We will of course be able to earn the money back with a new PCN incentive to review every patient with ear wax ever 6 weeks to check on progress to ensure a "world class ear wax service" is offered.

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  • BMA will now our home visits as part of the PCN contract, and showcase that as the game changer for general practice
    PCNs will take down general practice , wait and see

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  • Looking forward to seeing the response on the TV news this evening.
    The timing just before an election is likely to increase the significance.

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  • Finally a Dickensian vestige found only in uk medicine may be on its way out, good riddance.

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  • Finally the UK has caught up with the rest of the world on providing ancient inefficient home visits. It will help staff retention.
    I bet those that voted to retain this are either people who do not see patients or does only 1 to 2 sessions of clinical work.

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  • home visits are not the heart and soul of general practice - we just did it in the good old days cause we were the only ones who could afford a car. before the NHS patients paid for home visits. now most people have a car why are we still visiting? should only be for palliative care and the permanently housebound as a dedicated service which is more cost effective and has better continuity of care especially at nights and at weekends. being a martyr to the NHS just drives doctors away. when patients need to get to surgery more services get provided to help them, like taxi services, dial a ride and volunteer drivers etc. there are alternate ways here. the world has changed - so should we.

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  • Vinci Ho

    It is coming .
    I am not going to repeat my long comment ( previously under Jaimie’s editorial).
    The right thing at the right time and right place could easily become the wrong thing to do when circumstances had changed.
    The ‘system’ ( hence , government) simply cannot afford GPs to do home visits right now

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  • The Daily Mail readership aren't going to be happy.

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