Alliance Federation Standard Operating Procedure For Home Visiting
Many patients believe there is an automatic right to a home visit from a GP between 8am and 6.30pm, but this is not the case:
- For the avoidance of doubt, it is the GP who decides if a home visit is warranted and not the patient and nor an Allied Health Professional (Schedule 6, Regulation 26 Part 1 of GMS Contract Regulations 2004).
- Equivalently important, there is nothing in the Regulation to prevent the GP from completely overriding the request for a home visit and advise the patient to attend A&E, without first seeing them. This is providing “the medical condition of the patient makes the course of action appropriate”.
- Furthermore, and again for the avoidance of doubt, it is not the role of 111 to decide whether a GP visit is required, but to recommend that the patient contacts their own GP service.
Doctors will always encourage people to come into the surgery because this is where the best care can be provided. Specialist equipment is there, tests can be carried out more easily and drugs issued if necessary.
- Again, for the avoidance of doubt, it is not a doctor’s job to arrange transport to the practice. This is in line with local and national current guidance from various health care providers (Warrington GP Out of Hours) and GP professional bodies (Local Medical Committees).
Nationally and in line with guidance endorsed by the Royal College of GPs, a home visit occurs for the following three reasons:
- The patient is terminally ill
- The patient is housebound
- The patient has a severe learning or physical disability
In the time it takes to see one person at home, your GP can see between four and six patients at the surgery.
For this reason and to ensure patient safety, if you request a home visit, your GP may call you back to find out more about your problem before deciding to come out to see and assess you.
This call back is known as a Direct Clinical Assessment (DCA) and usually occurs within four hours of the home visit request.
This call back (i.e. DCA) also satisfies the standards as set out by The Royal College of GPs.
In practical terms, the practice expects home visits to be requested before 10am during the working week.
If your GP cannot, for any reason, undertake this home visit then he may advise you during his call back (i.e. DCA) to call 111 for an alternative service provision (see below) or advise you to directly attend A&E.
If you are seen in the out of hours period (i.e. after 6.30pm or during the weekend), your doctor will be informed of any consultation that you have had with the doctor who saw you. This will ensure that your doctor is fully updated with any medical input which you have received to ensure and uphold patient safety.