Changes in home visiting and night and weekend cover: The patient's view

Abstract

Changes in the work of general practitioners have included a substantial reduction in home visitng and a growing use of rota systems and deputising services for night and weekend cover. These are part of a series of changes that have been made to raise the quality, status, and morale in general practice. Our research shows that so far as home visiting is concerned the general level of satisfaction remains high, though there are some groups such as people without cars and parents with young children who are more adversely affected. All concerned may need to consider whether the policy of reducing home visits is being applied with sufficient flexibility. On the other hand, it is clear that some discrimination is used because elderly people on the whole seem to have less difficulty in obtaining home visits. Patients who are chronically ill or housebound may be suffering from a reduction in the number of repeat or regular visits from their doctor. The use of rota systems - either of doctors in a practice or of those from neighbouring practices - for night and weekend cover seems to be generally acceptable though satisfaction is strongly related to the time taken to answer the call. The use of deputising services leads to much greater dissatisfaction, irrespective of waiting time.