GPs are making fewer home visits, and no one has systematically asked them why—or what is lost when they stop. This matters because home visiting has shifted from routine care to a service reserved for patients too sick or frail to travel. Rates vary wildly across England, suggesting some practices have found ways to make visits work while others have abandoned them. Yet there is almost no evidence on what GPs themselves think their role should be, or what patients gain or lose when a doctor no longer comes to the door. The researchers will review existing literature and interview 30 GPs from diverse areas—different regions, visit rates, and deprivation levels—to understand how they decide whether to visit. Two workshops with GPs, patients, and other professionals will then turn those findings into priorities for future research and policy. If this succeeds, it will provide the first clear picture of why home visiting varies so much and what trade-offs are involved. That could help practices and policymakers decide where visits are most valuable, rather than letting the practice fade by default.
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Background: Home visiting rates have declined steadily over time, but with a recent escalation in the last few years related to Covid-19, the GP workload crisis and a change in GP contracts. Home visiting is now largely reserved for those who are unable to get to the GP practice and are therefore often medically or socially complex. In-hours home visits include both urgent and planned care. There is variation in home visiting rates around the country, suggesting differences in strategy between practices but there is little understanding of why this is the case and what is working well or not. There is a paucity of evidence around what role GPs should be playing in home visiting and what is gained and lost if they no longer make home visits to their own patients. Aim: What are GPs views on their role in home visiting in providing effective, equitable, sustainable and efficient in-hours primary care? Objectives: 1. To understand what is known about the role of GPs in home visiting in in-hours primary care 2. To explore how GPs see their role in home visits during in-hours primary care 3. To undertake two workshops to discuss the findings with a wider audience including academics, patients, GPs and other professionals working with home visits, to inform future research and policy priorities. Methods: A scoping review will be undertaken to establish the current literature surrounding current and historical perspectives on the role of GPs in home visiting. Following this, 30 semi-structured interviews with GPs will be undertaken to explore their views on their role in home visits for in-hours primary care and how they make decisions around this. GPs will be selected to ensure a diversity of experiences, including location in England, rates of home visiting in that area and the area’s level of deprivation. Finally, a series of two workshops will be undertaken to discuss the results with academic and non-academic audiences and co-construct next steps and priorities for research. Planned dissemination: Findings will be distributed through both academic and non-academic routes. Academically, interim and final results will be submitted for conference presentation and an academic journal publication produced. Non-academic outputs will include feedback for those involved in as an interviewed GP, PPI member or workshop participant. Both an academic and lay-person report will be produced following the workshops for those involved and other interested people. A non-academic written piece will be produced for healthcare professionals. This is an exploratory study, and as such it is anticipated that it will lead to a further funding application that can more comprehensively inform policy.
NIHR School for Primary Care Research - Primary Care
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