Other countries manage well without the need for a home visiting service
The UK is the only country to routinely offer a home visiting service - no other country has adopted such habits and patients have not been shown to be harmed from lack of a home visiting service
Home visits may be convenient but they are very inefficient and costly
It can take the doctor six times longer to attend a home visit than to see a patient in the surgery, and paying for highly trained and expensive GPs to drive around the practice area is not cost efficient
Home visits are riskier and actually offer a poorer standard of care
When compared to surgery consultations, home visits offer poorer quality of care due to poor facilities, lack of equipment, records and chaperones
The majority of home visit requests are inappropriate or unnecessary
Such visits take the doctor away from those with more clinical need
Unnecessary visits have a negative impact upon our services
Excessive visits reduce our ability to provide other services for our patients
There is much misconception around when home visits are actually appropriate
It is actually up to the doctor to decide if a home visit is needed
If you need to be seen, it is the GP who determines where the consultation should take place
Rising workload means we must all provide care as efficiently as possible
We need to evaluate all aspects of
our service so that the system does not break down
Inappropriate home visits damage staff morale and increase stress levels
Inappropriate home visits are often quoted
by GPs and nurses as a major source of dissatisfaction
There are genuine safety concerns in visiting patients at home
Doctors and nurses, particularly during lone working, are vulnerable to attack
Medicolegally, home visiting is fraught with difficulties
An assessment made in a setting that is far from ideal clinically may not always lead to the best decision-making
We have updated our policy based on existing guidance -
We have not acted alone and have adopted established and accepted guidance already in place that has been published widely by Local Medical Committees - please download our leaflet or read on
Home visits, whilst convenient, actually offer a poorer standard of care compared to surgery consultations
This is because of:
Poor facilities (eg, soft beds, poor lighting, lack of hygiene)
Inefficiency (the doctor could see 4 to 6 other equally needy patients in the time taken for a home visit)
Lack of records and chaperones (required for safe care and examinations)
We have noticed that many patients are requesting visits that are inappropriate or unnecessary. This is having a negative impact upon other aspects of our service
Calling the doctor out unnecessarily takes them away from patients who may be in more clinical need. Most of the consultations during home visits could easily and safely be carried out in the surgery. Because patients might not know this, we are letting you know our policy on home visits.
Some myths about home visits
There are many preconceptions about home visits. We seek to address some of these below
"It's my right to have a home visit" - under GP terms of service, it is actually up to the doctor to decide, in their reasonable opinion, where a consultation should take place
"I should get a visit because I'm old" - our clinical work should not discriminate simply based on age alone
"I can't bringing little Freddie out in this weather" - no-one will be harmed by being wrapped up and brought in
"The doctor needs to check I'm ready to go into hospital / have a ward to go to" - paramedics can provide initial lifesaving care and patients will be dealt with appropriately in A+E departments
"I'm housebound" - being housebound does not always prevent use of transport.
"I live in a care home so I always get a visit" - many such patients still go to hospital outpatients and take trips out
"Can the GP just pop out and see me" - we have fully booked surgeries and cannot simply drop everything to visit people urgently
Where home visits are NOT appropriate
Many requests for home visits are inappropriate, and a poor use of resources
Children, young people or anyone who is mobile – children are portable and can be seen quickly in the surgery
Lack of money or transport – this is not a medical responsibility. It is up to patients to organise transport
Lack of childcare or been drinking alcohol and not able to drive – again this is not a medical responsibility
Can't get out due to bad weather – we are also affected by snow, ice or bad weather
Timed visits between hairdressing and shopping appointments – patients who are clearly mobile are taking doctors and nurses away from patients more at need
Well but need a check over to make sure everything is all right – our priority is seeing the unwell
Other help more appropriate – e.g., if you think you are having a heart attack or a stroke, please ring 999
Where home visits are appropriate
Terminally ill patients – we have no problems at all seeing those who are at most clinical need.
Truly bedbound patients – we have no problems at all seeing those who are confined to bed.
So poorly would be harmed if moved – we have no problems at all seeing those who are at most clinical need.
If we visit you and feel that your request was inappropriate
If we feel that your visit request was inappropriate, we may inform you so that you may use our services more appropriately in the future. Please do not be offended, as we have a duty to use our resources effectively for the safety and benefit of all patients.
Do I actually need a home visit?
There are many options where a home visit from the doctor might not be necessary
Attend a major A+E department for the following:
A feverish and lethargic (drowsy) child
A feverish and floppy (unresponsive) infant
Sudden, severe abdominal pain
Accidental or intentional overdose of tablets or medicines
Trauma (including falls) and broken bones
Ring 999 for these life-threatening conditions:
Chest pain (suspected heart attack)
Anaphylactic shock (severe allergy)
Heavy bleeding or deep lacerations
Fluctuating levels of consciousness or completely unconscious
Difficulty breathing or stopped breathing with change in colour
Seizure, fit or uncontrollable shaking
Other options for help:
Self-care – for minor grazes, coughs and colds, sore throats, and hangovers.
Pharmacist – for diarrhoea, runny nose and headaches.
Minor injuries unit – for sprains and strains, cuts, rashes, stings and bites, road traffic accidents. Download an information poster .
Dentist – toothache, abscesses, gum disease. Ring NHS 111 if you need to find a dentist.
NHS 111 – general advice, medical help or not sure who to call.
Social Services – for advice and help on social matters, including respite care, additional help at home, and aids.
Podiatry – patients can refer themselves to Ripley Hospital for foot and nail care.
Physio – patients can refer themselves to a physio for back, neck and joint problems.
Counselling – patients can refer themselves to a counsellor for mild to moderate anxiety and depression.
Citizens Advice Bureau – patients can book an appointment to see an advisor at the surgery.
Continence Advisory Service – patients can refer themselves to this service for all continence issues.