Home Visit

1.1      Policy statement

The purpose of this document is to ensure that all personnel fully understand the organisation’s system for the triaging and prioritising of home visits thereby ensuring that patient safety is not compromised.

1.2      Status

The organisation aims to design and implement policies and procedures that meet the diverse needs of our service and workforce, ensuring that none are placed at a disadvantage over others, in accordance with the Equality Act 2010. Consideration has been given to the impact this policy might have with regard to the individual protected characteristics of those to whom it applies.

1.3      Training and support

The organisation will provide guidance and support to help those to whom it applies to understand their rights and responsibilities under this policy. Additional support will be provided to managers and supervisors to enable them to deal more effectively with matters arising from this policy.

2       Scope

2.1      Who it applies to

This document applies to all employees of the organisation and other individuals performing functions in relation to the practice such as agency workers, locums and contractors.

Furthermore, it applies to clinicians who may or may not be employed by the organisation but who are working under the Additional Roles Reimbursement Scheme (ARRS)[1].

2.2      Why and how it applies to them

Patient safety refers to the avoidance of unintended or unexpected harm to people during the provision of healthcare. 

Following a patient safety alert issued by NHS England on 30 March 2016, it was recognised that there is a requirement for practices to have in place a system to triage and prioritise home visits. The alert stipulates that when a request for a home visit is made, it is vital that practices have a system in place to assess in particular:

  • Whether a home visit is clinically necessary; and
  • The urgency of the need for medical attention

 

3       Policy

3.1      Home visit requests

Requests for home visits at Whitley House Surgery are received via telephone between normal working hours. All requests for home visits are triaged by relevant clinician, a priority assigned and recorded on SystmOne.

When discussing with the patient their condition, it is essential that the following are confirmed:

  • Patient demographic information - full name (if not the patient, full name of the person calling and relationship to patient), Date of birth, Address
  • Contact telephone number
  • Known existing medical conditions
  • Reason for calling/duration of symptoms

3.2      Home visit justification

Home visits are at the discretion of the GP/clinician who will determine if the visit is clinically necessary. Visits are reserved for patients who are genuinely housebound, including those in nursing and residential homes, and terminally ill patients. 

Home visits will be all carried our by Paramedics. They work on behalf of the surgery and Chelmsford City Health Primary Care Network. The paramedic will carry out the initial assessment of the patient and agree a management plan on their own or together with the on call doctor whom they will have direct access to. If the duty doctor is required to visit after the paramedic has attended due to the complexity of the patient they will do so.

A home visit will take place of the paramedic believes the patient’s condition:

  1. Prevents them from travelling to the practice, or
  2. The condition may deteriorate as a result of travelling to the practice

Home visits will not be authorised as a result of:

  1. A lack of transport
  2. The patient’s financial situation
  3. Childcare issues
  4. Poor weather conditions
  5. Any other situation deemed inappropriate by the clinician

This organisation will also consider whether alternative ways of assessing the patient are appropriate such as either a video call or a telephone call or, if in a care home, the use of a virtual ward.

Following confirmation that a home visit is required, the delegating clinician will ensure that the attending Paramedic has the necessary skills, knowledge, competence and training to deliver the home visit. Furthermore, appropriate supervision and support will also be provided by the organisation and/or delegating clinician.