Home Visit Protocol

Practice Leads

  • Doctors: Ramesh Mehay & Sudhir Krishnan
  • Admin: Chris Rushton

Date Reviewed

28 April 2016

Date of Next Review

September 2017

There will be a 'visits surgery' on SystmOne for each day - where admin staff can log all requests for home visits.  It will be up to the doctors to triage and decide which of these patients actually requires a home visit and by whom.

Allocating visits

  • On Call Doc
    • The on-call doctor will be ultimately responsible for ensuring all home visits have been allocated.
    • Please allocate visits before 1130 so that other docs can go off on their visits when they finish their surgeries and are not kept hanging about.
    • When allocating visits, please DISTRIBUTE THE ACUTE VISITS EVENLY across all the doctors available that day REGARDLESS OF WHETHER THEY HAVE PUT THEMSELVES DOWN FOR REVIEWS.   The only exception to this rule is if a doctor has stipulated, for example, max 1 visit.
    • Also worth considering when allocating acute visits is to look briefly into the record to see which doctor knows them best; this will help promote continuity of care.  It will take an unfamiliar doctor perhaps 40 minutes to sort out a complex patient yet a familiar doctor would probably sort them in 15.
  • Other Working Docs - this does not stop you from allocating visits to yourself.  Please periodically look at the acute visit list and assign yourself to someone you know.

If for any reason you cannot do a visit

  • Please put something like 'DR XXX - no home visits, IT meeting' onto the home visit list; i.e.  your name, 'no home visits' message, and concise details of why you can't do visits
  • If you know in advance you cant do visits, please log this onto the visit screen in advance too - DO NOT LEAVE IT TIL THE ACTUAL DAY.
  • If you do end up leaving it til the actual day, please see how many docs are actually around to do visits in your absence.  If it is low, is it possible you can take at least one visit?  If so, write something like...  Dr YYY (1 visit max, CARE meeting).  You may need to liaise with the on-call doctor.

Reducing the number of unnecessary visits

  • Consider telephoning all your visit requests before going out to see them.  You will be surprised how often you can manage someone over the phone.  For example, a patient with recurrent knee pain already on tramadol 1qds and known to have OA, might just need the tramadol increasing to 2qds if the pain is continuing rather than visiting acutely.
  • Visits are for house-bound ill patients who cannot get to the surgery.   If you feel a patient CAN get to the surgery in the future - please tackle this and do so gently and with compassion.  Otherwise they will keep calling for inappropriate visits in the future.
  • Remember, not all care plans or medication reviews need a home visit.

If you are putting a patient down for a future home visit review

  • Carefully consider whether a home visit is necessary - only you can decide.  But in many instances, a telephone follow-up call in one of your routine surgeries might be an alternative.
  • If you do put down a face-to-face home visit review - make sure you put them on the list for a day when you are actually going to be in surgery.
  • Put your name down next to the review eg. Review Breathing (Dr. Hamblin).

Actions for Admin Staff

  • EVERY MONDAY - log onto each home visit screen for Mon-Fri of that week and list which doctors are available for visits for those days.  A list of usually available docs is available at reception - but check who is on leave.
  • Add home visit requests  before 1130  to the home visit list in SystmOne.
  • For all patients requesting a visit, please encourage them to come down to the surgery.  If they can't come down ask why.
  • Please take a look at the home visit list at 12 noon to ensure every visit is allocated.  If any are not, please contact the emergency oncall doctor for that morning ASAP.
  • For home visit requests after 1130: please inform the morning emergency duty doctor who will then hopefully triage the request and decide whether or not it is appropriate and when the visit should be done.