Visiting patients at home is part of the GP contract but it is the doctor’s decision whether or not the patient can be reasonably expected to attend the surgery.
GP home visits cannot replace the emergency services for several reasons. However GPs should visit patients at home if their medical condition makes it inappropriate for them to attend the surgery.
Each visit should be triaged to ensure it is appropriate.
There are many reasons why a home visit might not be appropriate for the patient:
- It can delay clinical assessment, as visiting cannot be carried out on an emergency basis, whereas assessing patient in the surgery might be. Travelling 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.
- Travelling to and from home visits, when clinically not needed, could prejudice the care of patients in the surgery, as the absent doctor will not be able to treat routine or emergency patients whilst away from the surgery.
- The environment in a patient’s home is not ideal for clinical examination and assessment.
- 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.
Also by taking a GP out of the surgery to do a home visit, including the travel time there and back means they are not able to respond to urgent problems in the practice and this needs to be weighed up against the necessity of the visit.
These are not appropriate reasons for a home visit request:
- Transport issues – We may be able to offer assistance for example with plusbus but overall it is not the responsibility of the practice to arrange transport to help the patients get to the surgery.
- Childcare issues
- Poor mobility – At the GPs discretion patients with poor mobility may be visited but it would be usual for these patients to attend the surgery unless truly housebound. If patients are able to attend appointments elsewhere they should be able to attend the practice.
- Unwell children – Children in particular are best assessed in the practice so that the GP has the best equipment / medication to hand. If a child is truly too unwell to bring to the surgery it is likely that the triage advice would be to call 999 to avoid any further delays in treatment.
- Residents of care homes – This in itself does not automate a home visit and usual criteria and triage should be applied.