Requests for home visits are received via telephone (usually between 0800 and 1000). They are triaged by a clinical member of the team and recorded on the clinical system. Requests received outside of these times are to be referred to the duty doctor. A non-urgent home visit request will be booked into the next day, if slots are not available.
When discussing the condition with the patient, it is essential that the following are confirmed:
Patient’s full name (if not the patient, full name of the person calling, relationship to patient and that consent has been provided), date of birth, address and contact telephone number
And any known existing medical conditions, reason for calling/duration of symptoms.
The patient or carer should be reminded that staff are not to be unduly exposed to risks.
Risks may include:
Moving throughout the premises, animals, second hand (or passive) smoking or any other obvious risks that may cause harm to the employee. In addition, the name, address and telephone number of the next of kin, a family member or nearest keyholder should also be considered in case of a failed visit.
Home visits are at the discretion of the GP 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.
A healthcare professional from the Practice may conduct a home visit if they believe the patient’s condition:
Prevents them from travelling to the Practice, or their condition may deteriorate as a direct result of travelling to the Practice.
Home visits will not be authorised because of:
A lack of transport, the patient’s financial situation, childcare issues or poor weather conditions or any other situation deemed inappropriate by the clinician.
This Practice 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.
Llandaff Fields Medical Practice has an obligation to our staff when visiting any patient’s home and would expect that they are not exposed to risks. While there is no law to protect anyone working in a patient’s home, the Practice rely on their understanding and goodwill to ensure that the healthcare professional is not unduly exposed to risks during their employment.
Not being exposed to risk is an absolute right and should the member of staff feel compromised, then the Practice will fully support their decision in all circumstances.
Following any visit, should the staff member be concerned, or have highlighted that the patient’s home is potentially hazardous to their own or others’ health or safety, then a patient contract can be raised to formalise the arrangement. A template contract is available as an annex within the Dealing with Unreasonable, Violent or Abusive Patients Policy.
Expectations would be that the consultation area is smoke-free, there is a space to safely enable the clinicians to undertake their role, or that any animal that is likely to cause a nuisance is not in the same room for the duration of the visit.
Any risk and mitigating actions are to be recorded using the Home Visit Risk Assessment Form.
Details of any contract, risk management or significant event should be detailed within the clinical system, enabling any visiting healthcare professional to view potential risks.
Should there then be non-compliance with this agreement, then the member of the team will need to determine how to proceed on the day. As the Practice has a duty of care to both patients and staff, the University Health Board is to be consulted to discuss the next steps. This may include requesting that any future visits are conducted at an alternative venue. The Medical Defense Union and/or LMC may also be contacted for advice.
The flow chart shown below in Annex A illustrates the processes that are to be adhered to for home visit requests.
