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Welsh GPs reject call to pass afternoon home visits onto urgent services

Welsh GPs have voted against a motion calling for urgent afternoon home visits to be handled by emergency healthcare services.

Delegates at the Welsh LMCs conference in Llandudno debated a motion that called on the BMA’s Welsh GP Committee to pass urgent home visits after 2pm onto urgent care or ambulance services for review.

The motion, proposed by Dyfed Powis LMC, was voted down after GPs heard it would represent a breach of contract. 

Presenting the motion, GP Survival founder Dr Alan Woodall argued home visits should only occur on a ‘once-daily basis’.

He said: ‘Too many of us now are not running one surgery where we’re seeing one patient at a time. When I’m on call, I’m supervising one acute team of four practitioners that might be seeing 20 patients an hour. If I’m called out on a home visit in an afternoon that can seriously impact the performance of my staff.

‘We’re not proposing to abolish home visits but we’re simply saying we cannot be an urgent call visiting service, mopping up the lack of resources of other services.’

He added: ‘Home visits should be planned and our requirement should be to offer one within 24 hours of the next working day. If someone can’t wait that long then there should be an acute visiting service commissioned by health boards so that we can get on being the most efficient provider of services to our practitioners.

‘I’d like to see that conference can support this motion to see if we can get a revision to our contract so that home visits are only conducted on a once-daily basis.’

In response, BMA Cymru Wales GP Committee chair Dr Phil White said: ‘We understand the sentiment behind this but it’s a contractual issue. 

‘We have a request for the visit to come in as soon as possible in the morning. We can’t support it because it would be giving up a part of the GMS contract, it would have to be a financial deduction.

‘Having said that, there’s nothing that stops a practice from arranging to subcontract this work, if they wish so, to paramedic visiting services – some areas already do that for those who need. This is one we couldn’t support because it would impinge on the GMS contract.’

GP leaders in England recently called for a removal of home visits from the core contract because GPs no longer have the capacity to carry them out

The motion will be debated at the England LMCs conference on 22 November. 

Motion in full

That conference instructs GPC Wales to seek a contractual agreement that requests for urgent home visits after 2pm each working day, if not safe to leave until next day, should be passed either to a commissioned urgent care service or ambulance service for review.