Home visiting at Monkseaton Medical Centre
Information for patients
Patients (or their carers or relatives) would be contacted by the GP by telephone to ensure that a GP visit is the most appropriate way of managing the issue. This is because 25-50% of patients who contact a GP surgery would receive more appropriate care from a different Health Care Professional or service. The GP would advise the patient who is the best individual to receive care from.
Home visits, whilst convenient, actually offer a poorer standard of care compared to surgery consultations. You would be surprised how many patients ask for their GP to visit, but have no problem getting a taxi to a hospital appointment or even a hair appointment! There are many reasons that home visits are less safe:
- Poor facilities (soft beds, poor lighting, lack of hygiene)
- Inefficiency (the doctor could see 4 to 6 other patients in the time taken for a home visit).
- Lack of records and chaperones (required for self-care and examinations).
- If the patient is unwell and needs an ambulance it can be dangerous for them to be left alone. The surgery, where medical and nursing staff and emergency equipment is available, is much safer.
- Patients can be seen more promptly at the surgery often within 30 minutes if the GP thinks it is necessary. For a home visit you may be seen up to 6 hours after you made the visit request.
- The environment in a patient’s home is not ideal to carry out a clinical examination and assessment for both patient and the GP.
We have noticed that many patients are requesting visits that are inappropriate and 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 patient might not know this, we are letting you know our policy.
In our 2017 Patient Survey 80% of house bound patients stated that a telephone consultation with the GP would be useful to them.
If you think you may need a home visit
We would kindly ask that any patient who is mobile (own legs, using walking aids, wheelchair or scooter) see us in the surgery. If you are poorly and think you need an urgent same day visit, please ring your request through to reception on 0191 252 16 16 before 10:30am on the day. The doctor will always consider your request.
Appropriate
- Housbound
- Terminally Ill
- Would cause serious harm if moved
Inappropriate
- No transport or money
- Children, Young people and anyone who is mobile
- Social reasons or for convenience
- Other help more appropriate
If we visit you and feel that your request was inappropriate
If we feel that your 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.
Some myths about home visits (all of these are not true)
- “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 be discriminate simply based on age alone.
- “I can’t bring little Alfie 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 get a visit” – many such patients still go to hospital outpatient 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 (some examples only)
- Children, young people or anyone who is mobile
- Lack of money or transport – this is not a medical responsibility. It is up to the patients to organise transport
- Lack of childcare or not been able to drive – 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, shopping and hospital appointments – patient 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
- It can delay clinical assessment. (The GPs usually visit between 12-3pm or if a late visit is required this would be after 6.30pm)
- The environment in a patient’s home is not ideal for clinical examination and assessment
- Equipment for assessment and treatment by a GP which is portable to a patient’s home is not as effective as equipment in the surgery
- Other help more appropriate – e.g. if you think you are having a heart attack or stroke ring 999.
Where home visits are appropriate and worthwhile
- Terminally ill patients – we have no problems at all seeing those who are at most clinical need
- Truly bedbound patients – we have no problems 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.
Useful information and help
Attend a major A&E Department for the following
- A feverish and lethargic (drowsy) child
- A feverish and floppy (unresponsive) infant
- Difficulty breathing
- Sudden, severe abdominal pain
- Accidental or intentional overdose of medication
- Trauma (including falls) and broken bones
Ring 999 for these life-threatening conditions
- Chest pain (suspected heart attack)
- Suspected stroke
- Suspected meningitis
- Heavy bleeding or deep lacerations
- Anaphylactic shock (severe allergy)
- Difficulty breathing or stopped breathing with change in colour
- Seizure, fit or uncontrollable shaking
- Fluctuating levels of consciousness or completely unconscious
Other options for help:
Self-care – for minor grazes, coughs, colds, sore throats and hangovers
Pharmacist – for diarrhoea, running nose and headaches
Minor injuries unit – for sprains and strains, cuts, rashes, stings and bites
Dentist– Toothache, abscesses, gum disease
Social Services – for advice and help on social matters including respite care, help at home and aids.
Counselling – patients can self-refer to Talking Therapies for mild to moderate anxiety and depression
Health Visitor
Midwife
District Nurses – wounds and dressings
| NHS 111
(non urgent medical advice) |
111 |
| Social Services | 0191 643 2771 |
| North Tyneside Hospital | 0344 811 8111 |
| Newcastle Hospitals | 0191 233 61 61 |
| District Nurse | 0191 238 0044 |
| Lloyds Pharmacy – Monkseaton | 0191 252 11 58 |
| Lloyds Pharmacy – Sainsburys | 0191 252 4000 |
| Fairmans Front street | 0191 252 06 09 |
| Boots- Claremont Cres | 0191 252 37 59 |
| Talking Therapies | 0191 295 2775 |
| Health Visitor | 0191 238 01 06 |
| Midwife | 0191 293 40 32 |
| District Nurse – wound dressing) | 0191 238 0044 |