The Ivers Practice

Home Visits

When you should phone 999 rather than request a home visit

If you have a severe injury or critical condition, then phoning for a home visit can delay your attendance at accident and emergency department. In some conditions such as stroke, heart attacks and sepsis as some examples this can have an impact on outcomes. If you are not sure whether to call 999 you can call 111 for advice. We also have further information under Emergencies (Adult) where we describe some common conditions which require you to ring 999.

Who do we normally visit?

Our visiting is generally reserved for:

Terminally ill patients
We work with the local palliative care team and district team to provide care at home.

Truly housebound non-mobile patients
Some patients are permanently confined to their beds and we work with the local district nurse team, to ensure this group of patients is visited for any significant illness. The district nurse team support treatment of ulcerations including bed sores.

Significant illness with risk of harm if moved
This group is relatively small and tends to be older people with significant illness and frailty.

Arranging a home visit

If you are unwell and think you may need an urgent home visit, please call our reception team as early as possible in the day so we can schedule your home visit around the other clinics going on.

If you are not in the regular visiting groups referred to above, please consider whether you should call 999 instead of requesting a home visit and consider all the points below before calling us.

All visits are triaged when the doctor is available and the decision to visit will be based on medical need only (as explained below) and if the GP considers you need to be urgently assessed in hospital, they may arrange this without you been visited.

Why are there not more visits and ideas to support you get to the surgery

There are a number of reasons home visits are not done more often including:

Emergency assessment in the surgery is better
It is always quicker and safer to urgently assess patients in the surgery.

Efficiency and capacity

  • The time to do a visit can be equivalent to seeing 3-6 patients in the surgery.
  • A home visit can mean interrupting a surgery and thus delaying seeing some patients who have equally significant needs.

Quality of care with home visiting is not the same as in surgery

  • A GP has access to all your notes and important documents in the surgery
  • There is always better medical equipment in the surgery
  • Conditions of examination at home can be poor such as lighting and access to patients (e.g., position and height of bed).
  • A GP has direct support from other clinicians in the surgery if required.

Contractually the decision to visit is made by the GP purely based on medical need
This is explained under the NHS England GP contract (section 7.6 attendance outside practice premises).  NHS England » GP Contract. Importantly what some patients may not realise is that there is no social requirement to offer a home visit.

Proportion of elderly and care homes in the UK are significantly increasing
GPs must meet the needs of all their elderly population so they cannot visit based on age alone as the numbers are just too great.

Patient chaperone
Both the patient and doctor do not have easy access to a patient chaperone (a chaperone is explained under our chaperone policy).

As we have said GPs cannot visit for social reasons (e.g., lack of transport, childcare issues, weather) but we include some ideas followed by other patients.

Not able to drive to the surgery (e.g., illness, consumption of alcohol, car not available, lack of money, do not regularly go out, living in a care home,)
Many patients ask support from family or local friends, who are happy to help out. If you do not have this resource under Transport, we include contact details of local taxis companies including those who offer to take wheelchairs.

Lack of childcare
Many patients find family and local friends are happy to help out. If you do not have this resource we understand in this situation if you do need to bring your whole family down to the surgery.

Concern about safety of going out
Children can be brought out safely even if they have a fever and their assessment will always be quicker in the surgery.

Weather (such as ice and snow)
Patients may have a friend or local friend who has appropriate transport. Many taxi companies have all weather vehicles which can help. GPs cannot offer visits for social reasons but in addition most GPs do not have access to all weather vehicles and so are in exactly the same position with personal transport as their patients.

Our appreciation

We will always appreciate you making the effort to come down to the surgery, we know on occasions this is not easy and how many of you come down to the surgery despite difficult circumstances.  

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