Home visits are a valuable part of the service we offer to our frail and housebound patients. However home visits are generally not the best way to assess patients for the following reasons
- It can delay clinical assessment, as visiting cannot be carried out on an emergency basis, whereas assessing patient in the surgery can be more quickly.
- Traveling to and from home visits can delay clinical assessment as the doctor may not be able to locate the patient’s address as quickly as the patient can attend the surgery.
- Traveling to and from home visits, when clinically not needed, could prejudice the care of other patients, as the absent doctor will not be able to treat routine or emergency patients whilst away from the surgery.
- Equipment for assessment and treatment by a GP which is portable to a patient’s home is not as effective as the equipment in the surgery.
- The environment in a patient’s home is not ideal for clinical examination and assessment i.e. lighting may be suboptimal.
Reasons, which do not constitute a reason to visit patients
- Transport issues for the patient: It is not the practice’s responsibility to arrange transport. In these circumstances patients should seek transport help from relatives, friends, or taxis.
- Childcare issues for a patient: If a patient has difficulty arranging for someone to care for their children whilst attending appointments, patients are welcome to bring their children to the surgery.
- Poor mobility- whilst it is understood that having poor mobility is inconvenient and unpleasant, we can cater for patients with restricted mobility. If patients are able to attend appointments at other healthcare settings, then they should also be expected to attend appointments in GP surgeries.
- Children with a fever will not be made worse by transporting a child to a place of care. It is in the best interest of the child to attend the surgery where they can be properly assessed and treated. If a parent believes that the child is too unwell to travel to a surgery, and then it would be advisable for them to seek help from the emergency services by calling 999.
- Residential and sheltered care residents are no different to patients in their own homes. The need to visit should be based upon clinical need, not the availability of transport or staff to attend the surgery. It is the responsibility of care facilities to make transport available for residents so that they can get to medical and non-medical appointments.
We will visit patients in their homes if after a telephone assessment by a doctor they are assessed as medically unfit to travel to the surgery. In general this refers to terminally ill patients (likely to live less than 6 months) and bedbound patients. Patients who would normally be expected to attend hospital by private or hospital transport will be expected to attend the surgery. In order to assess and respond to patients requests for home visits we need to receive requests as early as possible in the day so we can plan doctor’s time. Please telephone to speak to the duty doctor before 11:30am.
It remains at the doctor’s discretion to decide the appropriate timescale for the visit after making a clinical assessment. For requests received later in the day the practice does not routinely visit in the afternoon due to the availability of clinical staff. If the duty doctor decides a patient requires a visit they will be signposted to the Out of Hours service or the visit will be arranged for another day.
The practice is increasingly working with other services and making use of the wider practice team. So another service or member of the practice team if deemed appropriate i.e. community matron rapid response team, the practice nurse or a clinical pharmacist may also visit patients.