Health

NHS doctors vote to scrap home visits because modern GPs 'don't have time'


Doctors in England have voted to stop doing home visits because they take up too much valuable time.

Under current rules, GPs are required to take call-outs when patients claim they are too ill to make it to hospital.

In a controversial move, regional health bosses voted 54 per cent in favour of scrapping the rule written in GP contracts.

The doctor who proposed the contract change said visiting patients at home ‘isn’t good medicine’ and is ‘virtually unheard of’ anywhere else in the world.

Campaigners said the decision would be disastrous for the housebound, vulnerable, elderly and dying. 

Doctors said they no longer have time to make visits to patients at home and the practice is outdated and 'virtually unheard of' anywhere else in the world (stock image)

Doctors said they no longer have time to make visits to patients at home and the practice is outdated and ‘virtually unheard of’ anywhere else in the world (stock image)

A source close to Health Secretary Matt Hancock said the proposal was a ‘non-starter’ and NHS chiefs are expected to resist the demand for new contracts. 

Home visits have been a cornerstone of general practice for decades – and 10,000 are carried out across England each day.

But doctors have chosen to call for changes to the GP contract which means they’re no longer obliged to visit people at home.

‘Moving away from routine day-to-day contacts would actually improve care,’ said Dr Andrew Parkin from Kent’s Local Medicine Committee, Pulse reported.

‘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.’

GP waiting times and staffing shortages have been in crisis for years and the NHS is battling to improve people’s access to their family doctors.

Doctors are angry about unsustainable workloads and pension regulations which are leaving them out of pocket, and are retiring at a faster rate than they can be replaced.

Health Secretary Matt Hancock last month pledged to employ 6,000 more GPs and 50million more appointments each year during the next Parliament.

But he was accused of making empty promises after the Conservatives’ last effort – a commitment to hiring 5,000 extra doctors between 2015 and 2020 – failed and doctor numbers actually fell over that time.

HOW IS THE NHS TRYING TO HIRE MORE DOCTORS?

  • Health service last year revealed it would offer doctors working in Australia an £18,500 bonus if they moved to the UK to work for the NHS. A recruitment campaign reportedly tried to persuade doctors to move to the land of Harry Potter, Manchester United and William Shakespeare.
  • NHS set up a scheme to recruit 2,000 GPs from abroad by encouraging doctors in other countries to apply to work in the NHS. But only 34 were recruited between 2015 and February this year.
  • Trainee GPs offered a £20,000 ‘golden hello’ bonus if they take a job in hard-to-fill jobs. The young doctors must commit to work for at least three years in areas with notable shortages, including Hull, Plymouth, Lancaster and rural parts of County Durham and North Yorkshire. 
  • Matt Hancock suggested the tax-free pension ceiling could be lifted to try and persuade more existing GPs to work into their 60s. Currently doctors have to pay tax on any pension savings over £1m, but this amount could be increased.

Doctors made the decision to stop home visits at a London meeting of the country’s Local Medicine Committees, which represent GPs at regional levels.

They agreed a separate service should be negotiated for NHS England to provide at-home visits for people who really need them.

At the moment doctors are contractually obliged to do them if their patients require.

Kent’s Dr Parkin added: ‘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,’ according to Pulse.

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

Dr Richard Vautrey, GPs chair at the British Medical Association, said the modern GP doesn’t have the capacity to travel around to see patients.

He said stopping home visits would affect only a small minority of people and improve conditions for the majority.

‘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,’ he said.#

Dr Sarah Matthews, from Coventry, said the resolution was ‘a very bad idea’. She added: ‘This will sell the heart and soul of our profession away. This will allow people to say GPs don’t care about us when we’re very sick, very vulnerable and when we’re dying. 

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

Dr Annie Farrell, from Liverpool, said that ‘far from being old-fashioned, home visits are needed more and more as our patients are living longer’.

Joyce Robins, of campaign group Patient Concern, said the vote was ‘scandalous’ even though GPs were stretched. She added: ‘Patients do not ask for a home visit lightly – they are often housebound, vulnerable, elderly, dying or very ill.

‘Stopping home visits will be a disaster for these people, who will be in dire trouble and left languishing alone. Home visits have always been seen as a core part of the GP service. People value it and rightly expect it when at their very worst. This is a helpless situation and a very sad day for patients.’ 

The full motion called for home visits to be removed from core contract work and for the creation of a replacement service ‘widely advertised to patients’.

More than 300 members of local medical committees took part in the conference vote yesterday.

The obligation for home visits is contained in a five-year contract that came into force in April. It was agreed by NHS England and the BMA. Delegates were told that the chance of achieving the contract change was ‘extremely low’.

An NHS spokesman said last night: ‘When a patient clinically requires a GP home visit they will get one.’



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