Home Visits

The LMC thus recommends that GPs should visit patients in their homes if they feel that they are medically unfit to travel to the surgery. It is important that practices triage requests for home visits for necessity and urgency, so that they can be appropriately managed.
 
However, there are a number of reasons why home visiting may be detrimental to patients -

• It can delay clinical assessment, as visiting cannot be carried out on an emergency basis, whereas assessing patient in the surgery can be.
• Travelling to and from home visits can delay clinical assessment as the doctor may not be able to locate the patient’s address as quickly as the patient can attend the surgery.
• Travelling to and from home visits, when clinically not needed, could prejudice the care of patients in the surgery, as the absent doctor will not be able to treat routine or emergency patients whilst away from the surgery.
• Equipment for assessment and treatment by a GP which is portable to a patient’s home is not as effective as the equipment in the surgery.
• The environment in a patient’s home is not ideal for clinical examination and assessment.

The LMC advises practices that reasons other than being medically unfit do not constitute a reason to perform a home visit. These reasons may include -

• Transport issues for the patient - It is not the GP practices responsibility to arrange transport, or to perform home visits because the patient has difficulty arranging transport. In these circumstances patients should seek transport help from relatives, friends, or taxi firms.
• Childcare issues for a patient - If a patient has difficulty arranging for someone to care for their children whilst attending appointments, the patients are welcome to bring their children to the surgery.
• Poor mobility - Whilst it is understood that having poor mobility is inconvenient and unpleasant, GP surgeries are designed to cater for patients with restricted mobility. If patients are able to attend appointments at other healthcare settings, then they should also be expected to attend appointments in GP surgeries.
• The unwell child - Children with a fever will not be made worse by transporting a child to a place of care. It is in the best interest of the child to attend the surgery where they can be properly assessed and treated. o If a parent believes that the child is too unwell to travel to a surgery, then it would be advisable for them to seek help from the emergency services by calling 999. If the GP feels that attending the child at home, based on the clinical history, may prevent delay in treatment because of distance from available ambulance services, then they should attempt to do so.
• Residents of care home - Care home residents are no different to patients in their own homes. The need to visit should be based upon clinical need, not the availability of transport or staff to attend the surgery. It is the responsibility of care facilities to make transport available for residents so that they can get to medical and non-medical appointments.

The LMC encourages GP practices to use this guidance to generate a home visiting policy for the practice, which should be shared with patients and PPGs.