Home visits, the decline 
of the roving doctor

28th June 2018 by NASGP

Home visits, the decline 
of the roving doctor

When I was training to be a GP, my tutor showed me a painting by Sir Luke Fildes called “The Doctor”. Its significance was lost to me in those fun-filled days of team-building exercises and group learning, however I remembered it again recently when I was asked to fill out an insurance report for one of my elderly patients.

In it, the underwriter asked what she could do by herself; could she dress unaided? Could she walk unaided? Could she climb stairs? Did she have carers? I felt guilty when I realized that I just did not know. Whenever I had seen her, a family member had brought her into the practice, led her dutifully to my desk and back out when her allotted ten minutes had elapsed. Would I have known her better if I had visited her at home?

Believe it or not, there was a time when you could see a GP in the wild. Far from the reclusive species we know today, GPs would regularly visit a large proportion of their patients at home and would revel in the opportunities that the house call provided. Seeing the patient in their daily habitat gave them a picture of their constitution: their interests, their families, their habits and their current mood. At inception, circa 1948, the role of the general practitioner was one of twenty-four seven, three sixty-five care. When the doctors’ charter of 1966 came into effect, more emphasis was placed on facilities and staff within a practice and one could argue that the focus towards centralised care began here. However the model was unsurprisingly fraught with difficulty and, in effect, was unsustainable.

Read for free

Sign up to access everything.

Free trial


Already a member? Login to view this content.


"Work as GP locum provides me both flexibility and autonomy together with great job satisfaction. However, there are some complexities one needs to address in starting out and doing everything right.

I've generally found answers to any issues I've had on the NASGP website – an excellent repository of very relevant information. The blog and magazines alone are almost worth the small costs of membership. The fact that NASGP is run by motivated fellow GPs gives me confidence in their guidance and advice.

LocumDeck makes my running things as a self-employed GP almost effortless - I don't think I would want to work without it. Invoicing is streamlined and the website is very user-friendly. After a busy week at work, the last thing you want is to spend hours on business admin. LocumDeck is a real timesaver.

Dr James O’Mahony

See the full list of features within our NASGP membership plans