Nowadays, home visits are the exception rather than the rule. This is in stark contrast to say 30 years ago, when GPs frequently visited patients at home, more due to tradition than medical necessity. GPs have a statutory duty to visit patients registered on their list at the agreed registered address but only when medical necessity dictates. This is entirely at the discretion of the doctor, taking into account the medical circumstances. Patients should not feel they have an absolute right to request a visit under any other circumstances.
Please would patients consider the following points:
- It generally takes four times longer to see a patient at home than in the surgery
- These days most patients have access to a telephone and some form of private transport
- Surgery appointments times are generally longer than in the past and in addition doctors have substantially more administration to carry out – a typical working day will involve around forty consultations per doctor.
- Many developed countries have never had a tradition of home visits and the system has operated effectively without them
Guidance when requesting a home visit
An example of an appropriate home visit would be an elderly or infirm adult who could not be brought to the surgery other than by specialised transport. This would include terminally ill patients.
Patients with very sudden onset severe illness, e.g. collapse, acute severe chest pain, acute, severe breathlessness, would be more appropriately dealt with by dialing 999.
Children rarely, if ever, require a home visit as they can usually be carried into a car and brought to the surgery.
In most cases, when a visit is requested the doctor will telephone the patient at some stage to clarify the situation. Please be prepared to accept that the doctor may decide that a home visit is not necessary, and also please try to understand that this is not a means of avoiding a necessary visit but rather an attempt to manage a heavy workload.
Some other points to consider
Try to view the GP’s surgery as an extension of the hospital – if you are usually able to attend a hospital outpatient clinic you should be able attend the surgery.
Hard as it may seem, social circumstances are not a valid reason for requesting a home visit.
Some popular myths discredited
“People who are ill should not be taken outside” - This is clearly incorrect, as the most seriously ill people need transporting to the hospital.
“If I come to the surgery I will be feeling ill put to the back of the queue” - We make every effort to see people promptly who have agreed to come to the surgery in these circumstances.
“I will be seen and treated quicker if I have a home visit” - The opposite is often true and it may be longer before prescribed medication can be collected.
“GPs have an obligation to visit all patients over 65/70 years old regularly” - This has never been true.
“I need to be examined before the doctor can decide what is wrong with me” - This sometimes true but often it is not and there is now general agreement that a fairly high proportion of medical problems can be assessed and managed perfectly adequately from information obtained at a telephone consultation.