Following the introduction of a Paramedic role and the lead into preparing for winter pressures ,We have now introduced a home visit policy to enable us to manage home visit demand and patient care. .
Home visits requests are to be called through to the surgery where possible before 11.00 am and will be triaged by our paramedic. Home visits are for urgent requests where a patient or carer is unable to assist a patient coming to the surgery.
1.1 Policy statement
The purpose of this document is to ensure that all personnel fully understand the practice system for the triaging and prioritising of home visits, thereby ensuring that patient safety is not compromised.
This document and any procedures contained within it are non-contractual and may be modified or withdrawn at any time. For the avoidance of doubt, it does not form part of your contract of employment.
1.3 Training and support
The practice will provide guidance and support to help those to whom it applies 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.
2.1 Who it applies to
This document applies to all employees of the practice and other individuals performing functions in relation to the practice, such as agency workers, locums and contractors.
2.2 Why and how it applies to them
Following a patient safety alert issued by NHS England in April 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 states:
“When a request for a home visit is made, it is vital that practices have a system in place to assess:
- whether a home visit is clinically necessary; and
- the urgency of the need for medical attention.”
The practice 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 compared with others, in accordance with the Equality Act 2010. Consideration has been given to the impact this policy might have in regard to the individual protected characteristics of those to whom it applies.
3.1 Home visit requests
Requests for home visits at Bedford Street Surgery are received via telephone between 8.15am and 11am Requests received after 11.00 am are to be referred to the Paramedic
All requests for home visits are triaged by the practice paramedic / ANP or Duty Doctor and recorded on System One .When discussing with the patient their condition, it is essential that the following are confirmed:
- Patient’s full name (if not the patient, full name of the person calling and relationship to patient)
- Date of birth
- Contact telephone number
- Named GP
- Known existing medical conditions
- Reason for calling/duration of symptoms
3.2 Home visit justification
Home visits are at the discretion of the GP surgery , the urgent care team will determine if the visit is clinically necessary through telephone triage. Visits are reserved for patients who are genuinely housebound, including those in nursing and residential homes, and terminally ill patients.
A GP , paramedic or ANP may conduct a home visit if they believe the patient’s condition:
- Prevents them from travelling to the practice, or
- The condition may deteriorate as a result of travelling to the practice
Home visits will not be authorised as a result of:
- A lack of transport
- The patient’s financial situation
- Childcare issues
- Poor weather conditions
- Any other situation deemed inappropriate by the clinician
3.3 Home visit management system
At Bedford Street Surgery the flow diagram at Annex A illustrates the processes which are to be adhered to for home visit requests.
3.4 Recording information
3.5 ANPs and home visits
At Bedford street Surgery Paramedics and ANPs are permitted to undertake home visits for patients with chronic diseases and undiagnosed conditions. The home visit management system is used at the practice to make certain patients receive a home visit in a timely manner.
ANPs who are willing and contracted to undertake home visits will follow the ANP home visit process as detailed overleaf.
Home visits are a fundamental element of general practice and they enable the practice to meet the needs of the patient and ensure that care and treatment are provided in a timely manner. To make sure that the care delivered outside the confines of the practice is appropriate and effective, visits must be structured and clinicians must follow the guidance provided. By doing so, patients will receive the necessary level of care in an appropriate time frame.