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Independents' Day

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

Readers' comments (43)

  • Meanwhile Nigel Farage wants to develop GP surgeries open 24 hours a day. Nothing like a 3am discussion about erectile dysfunction with an entitled gammon to make you wish you’d ticked a different box on the UCAS form. I’ll be staying in Australia a while longer I think.

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  • David Banner

    No political party will back this. It’s a vote loser. This is a Pyrrhic victory. In fact, it puts home visits back in the minds of patients who may have thought that ruthless triaging had effectively banished them in all but name. Many GPs only visit when they deem it necessary (mainly palliative) and stiffly reject/divert/admit/ bring to surgery the rest. If we all did this the problem would rapidly recede, without all the negative publicity we will receive if this is enacted.
    Grow a spine, filter out 80% of requests, regain control, after a while patients stop asking. Only visit if you want/need to at a time that suits yourself. Can’t wait? Then go to A&E, we’re not an emergency service. Study the 2004 contract, we have control if we choose to enforce it.

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  • Vinci Ho

    In a way , I can understand why this is pyrrhic. The truth is that this matter simply epitomises what I described before : we (GPs) have simply sleep-walked into a scorched-earth policy ( if you know what I mean ,the inspiration first came from HK protestors) as a result of the way successive governments have been treating us in the last decade . The government certainly needs us more than we need it .
    I fully understand those colleagues who felt that we might have virtually ‘betrayed’ one of the important virtues in general practice. But it is also ‘enough is enough’ in a belligerent tone . Of course , no political party will immediately take this on board but I will also see this as a ‘benign’ version of an industrial action . Phenomenally , more will come whether these politicians like it or not .
    Our battles go on .
    PS I am even more intrigued on the result of the ballot on ‘rejecting PCNs’ 😗😎

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  • Was there an outcry when the hospital consultants stopped doing house visits?
    No more kneeling in pee or reeking of cigarette smoke for the afternoon surgery. What a terrible shame.

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  • Already on the daily Hail!

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  • These days GPs face any fake accusations from patents just to get money and there is nothing to stop this in a biased system. Do not do any examination that involve exposure for home visits. All it takes is someone saying they were touched or worse and you'll be in trouble.Home visits are high risk.

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  • Finally I hope the BMA will run with this an represent the profession that carried this motion at conference. We need a stop to doing rushed visits in our lunch hour. We need a properly costed model, with funded and allocated time for visits.

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  • More chance of seeing flying bacon than this becoming a reality

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  • I once had patient call the police on a home visit. Usual story of carers requesting, then unable to get a hold of anyone to find out more. 6pm, dark in winter, lone female and I was screamed and shouted at for breaking into a mans house uninvited and police called and visited surgery the next day. As a lone female I have also been asked to visit patients refusing to come in due to feeling suicidal etc. My husband worries and is appalled- he made me
    Install an app on my phone that alerts him immediately if I’m in danger. Aside from all that home visiting is an abused system already. Add to that an ageing population of truly housebound patients and our whole day could be spent visiting. If anything drives me away from GP in the Uk it’s home visits. I had no idea when I trained to do this job I’d have to fit in several visits to people’s homes in my lunch hour, and often find the patient has gone out to the hairdressers instead as I was taking too long. I’ve had calls at 5.50pm For people who have felt ill fit days telling me it was my duty to visit right that instant. No wonder no one wants to be a GP. I keep reading about all these people they are training to do the job but if it carries on like this they will all run for the hills too. Adopt the Australian model and have someone else doing dedicated visits. If the visit is unnecessary as patient not housebound- charge them. And if usually mobile but too ill to come in they need A and E not a GP.fed up with arguing with patients over home visits.

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  • Well said!

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