Over the past 30 years there has been a shift in the way that people access their General Practitioners (GPs). In 2002/03, most GP consultations (86 per cent) in GB took place in surgeries or health centres. This proportion increased from 73 per cent in 1971.
GP home visits decreased considerably over the same period, from 22 per cent of all consultations in 1971 to 5 per cent in 2002/03. Telephone consultations more than doubled from 4 per cent in 1971 to around 10 per cent from 1998/99 onwards. During this period phone ownership has increased and telephone consultations with GPs have been made more widely available.
A GP’s decision on whether to visit a patient at home will depend upon a number of factors. These include the severity and urgency of the condition, as well as the patient's access to transport, distance from the practice and their ability to communicate over the phone.
People aged 75 and over are the most likely to receive a home visit. In 2002/03, 17 per cent of GP consultations for people in this age group were home visits. Older people are more vulnerable to illness, are less likely to own a car, may be less willing or able to use a phone and are more likely to be housebound than younger age groups.
The change in site of consultation represents improved access, convenience to patients and more efficient use of GP time. The criteria for deciding whether a home visit is necessary have become more rigorous.
There are now more ways to access primary care than in the past, especially out-of-hours, when many home visits occur. These include nurse-led walk-in centres (which have long opening hours), NHS Direct, and ferrying people to a central surgery by car for emergency consultations.