Home Visit Policy

When is a home visit appropriate?

At St Fillans Medical Centre, we understand that there are times when a patient may be unable to attend the surgery. We will always consider requests for home visits where a patient's clinical condition means that they cannot safely or reasonably attend the practice.

However, a home visit is not automatically appropriate simply because someone is elderly, has difficulty with mobility, does not have transport, or would prefer to be seen at home.

Where possible, we provide care at the surgery because this allows us to offer a wider range of equipment, facilities and clinical support, and enables our clinicians to see more patients who need care.

The decision about whether a home visit is clinically appropriate rests with the GP or other appropriate clinician.

Who may need a home visit?

A home visit may be appropriate if you:

• Are completely or substantially housebound because of your medical condition.
• Are bedbound and unable to leave your home safely.
• Are very unwell or frail and travelling to the surgery would be likely to cause harm or significant deterioration.
• Are receiving end-of-life or palliative care and are unable to attend the surgery.
• Have a medical condition where, following clinical assessment, the clinician believes that a home assessment is necessary.

Being housebound does not necessarily mean that a home visit is required. If you are able to leave your home safely with appropriate support or transport, attending the surgery may still be the most appropriate option.

If you think you need a home visit

Please contact the practice as early in the day as possible and tell our reception team that you believe you need a home visit.

Our reception team may ask you some questions about your condition. This is not to prevent you from seeing a clinician; it allows us to make sure that your request is assessed appropriately and that the clinician has the information they need.

A GP or other appropriate clinician will assess the request and decide the most appropriate way for you to receive care.

This may be:

• A face-to-face appointment at the surgery.
• A home visit.
• A telephone consultation.
• A video consultation.
• Advice or treatment without a consultation.
• Referral or signposting to another appropriate service.

Where a home visit is agreed, the clinician will determine the appropriate timeframe based on your clinical needs.

Please remember – a home visit is not simply an alternative to a surgery appointment

Home visits take considerably longer than surgery consultations and clinicians have access to fewer facilities and pieces of equipment when working in a patient's home.

For example, at the surgery we have immediate access to:

• Your full medical record and practice systems.
• Examination equipment.
• Diagnostic equipment.
• Other members of the clinical team.
• Appropriate facilities for examination and treatment.
• Chaperone support where required.

For these reasons, if you are able to attend the surgery safely, this will normally be the preferred option.

A home visit should therefore be requested because you have a clinical need that prevents you from attending, rather than because it is more convenient.

Situations where a home visit would not normally be appropriate

A home visit would not normally be appropriate because:

• You do not have transport.
• You are unable to drive.
• You have difficulty arranging transport.
• You have work or other commitments.
• You have childcare difficulties.
• You have been drinking alcohol and therefore cannot drive.
• The weather is poor.
• You would prefer to be seen at home.
• You are elderly but are otherwise able to attend the surgery.
• You have mobility difficulties but can travel with appropriate assistance.
• You are worried about bringing a child to the surgery.
• You have several other appointments or commitments that make attending the surgery inconvenient.

We appreciate that arranging transport or assistance can sometimes be difficult. If you are unable to attend because of your mobility, please let us know what assistance you have available so that we can consider the most appropriate option for you.

Children

Children should normally be brought to the surgery for assessment.

Children can generally be transported safely to the practice, even when they are unwell. The surgery also provides a safer clinical environment, with access to appropriate equipment and other members of the clinical team.

If your child is seriously unwell, please do not wait for a GP home visit. Depending on the symptoms, you should contact 999, NHS 111 or attend an appropriate urgent care service.

What if I am worried that I am too unwell to travel?

If you are concerned that travelling to the surgery could make your condition worse or put you at risk, please tell us when you request an appointment.

A clinician will assess your situation and decide whether a home visit is appropriate or whether another form of urgent assessment is needed.

If you have a potentially life-threatening emergency, do not wait for a home visit.

Call 999 if you have symptoms such as:

• Severe difficulty breathing.
• Severe chest pain or suspected heart attack.
• Signs of a stroke, such as sudden facial weakness, arm weakness or speech difficulty.
• Loss of consciousness.
• A severe allergic reaction.
• A seizure that is ongoing or repeated.
• Severe bleeding.
• Any other condition where you believe there is an immediate threat to life.

Home visits in care homes

Being resident in a care home does not automatically mean that a GP home visit is required.

Many care-home residents are able to attend hospital appointments and other healthcare services with appropriate support. Where a patient can safely attend the surgery or another appropriate healthcare setting, this may be preferable.

However, where a patient's clinical condition means that they cannot safely leave the care home, a home visit may be appropriate.

We will work with care-home staff and carers to determine the most appropriate way of providing care.

Why do we have a home visit policy?

Home visits are an important part of general practice, and we are committed to providing them when they are clinically necessary.

At the same time, every home visit takes significantly more clinical time than a consultation at the surgery. A clinician travelling to and from a patient's home may spend considerably longer providing care to one patient than they would during a surgery consultation.

Using home visits appropriately therefore helps us make sure that our clinical resources are available to patients who need them most.

Our aim is not to discourage appropriate home visits. It is to make sure that patients receive care in the setting that is safest and most clinically appropriate for them.

Our commitment to you

At St Fillans Medical Centre, we will:

• Listen carefully to your request.
• Treat every request for a home visit seriously.
• Assess requests according to your individual clinical circumstances.
• Arrange a home visit when it is clinically appropriate.
• Make sure urgent clinical needs receive an appropriate response.
• Consider reasonable adjustments where required.
• Help you access an alternative service where a home visit is not the most appropriate option.

We ask our patients to help us by providing accurate information about their condition and by attending the surgery whenever they are safely able to do so.

Our priority is always to provide the right care, in the right place, at the right time.