Summary: [an overview of what this SOP is about]
Who’s it for: GPs, Paramedics, Care Coordinators, and other Clinicians on Home Visits
What is a home visit?
If a patient is housebound, GPs, Paramedics and Care Coordinators can offer them an appointment at their home
- Home visits are generally only offered to those who are long-term housebound
- Before agreeing to a home visit, it is vital for a paramedic or the duty doctor assesses whether a home visit is clinically necessary and the urgency of the request
- In some cases the urgency of need will be so great that it would be inappropriate for the patient to wait for us to visit, and therefore alternative arrangements should be made
Requesting a home visit
Reception
- Take details of the caller, the patient, and the nature of the medical problem
- Double check that we have the correct contact number and address on the system
- Advise that the request will be passed onto the duty doctor to make a decision
- Enter the request on the duty book on EMIS, and add a comment under the entry ‘Home visit request’
- Tell the Paramedic (if on site) or the duty doctor, either verbally or by screen message
Blood tests for housebound patients are done by the District Nurse - see District Nurse (Lewisham) or District Nurse (Southwark & Lambeth) for how to arrange an appointment
Process
Paramedic or Duty Doctor
Triage
The goal of this step is to assess:
- Is the home visit is clinically necessary?
- How urgent is the need?
- Review the patient’s records, and if necessary contact the patient or carer to gather information and provide safety netting advice
- Document your prioritisation assessment on EMIS
- If the situation is too urgent to wait for a home visit, the patient should be advised to call 999 or go to A&E
Preparing for a visit
If it’s decided that a home visit is necessary you should:
- Ensure that you’ve read the patient’s notes
- Check if any other staff members are involved e.g. the Care Coordinator
- Ensure that you have the home visit bag (see below), a mobile phone, and a way to take notes
During the visit
- Check that the patient is genuinely housebound, and set alerts on EMIS
- If they are, confirm their next of kin and nominated pharmacy
- Check for any safeguarding or social issues
- Check their vitals
- Check their medications and complete, or arrange, a medication review if needed
- If the patient is long-term housebound, a mental health assessment should be done
After the visit
- Log your notes from the visit on EMIS
- Ensure that any necessary onward referrals are initiated
- Ensure that any prescriptions needed are issued
Equipment for home visits
The Visiting Clinician
Each practice has it’s own Home Visit bag, which should be taken on every visit
Checking
The bag will be checked monthly by the Site Paramedic (See also Emergency Medication and Equipment Trolley)
Restocking
- Once you return from the home visit, please restock the bag according to the equipment list using surgery stock
- If you’re unable to find something speak to the Site HCA
- If you need equipment to be reordered, speak to the Lead Pharmacist
Equipment list
- Always carry a mobile phone, and ensure someone at the practice can contact you
- Anaphylaxis Kit: If vaccinating, you must carry an anaphylaxis kit with you
- Note Taking: Take a pen & notepad or another electronic form of notetaking
PPE
Item | Quantity |
S, M, L & XL Gloves | 5 Pairs of each |
Masks | 10 |
Hand Sanitizer | 1 |
Waste Bag | 5 |
Sharps Bin | 1 |
Observations & examination
Item | Quantity |
Scales | 1 |
Measuring Tape | 1 |
Thermometer & Tips | 1 |
Glucometer | 1 (+ at least 5
lancets & test strips) |
Pulse Oximeter | 1 |
Stethoscope | 1 |
BP Machine + Paeds,
Adult and Large Adults Cuffs | 1 |
Otoscope & Tips | 1 |
Phlebotomy kit
Item | Quantity |
Torniquet | 1 |
Alcohol Swabs | 10 |
Blood Collection Set
(Butterfly + Bottle Holder) | 5 |
Cotton Swabs | 10 |
Plasters | 10 |
Gold Vacutainers | 5 |
Purple Vacutainers | 5 |
Other Vacutainers | As needed |
Stool Sample Pot | 5 |
Urine Sample Pot | 5 |
Black Swab | 5 |
Orange Swab | 5 |
Yellow Swab | 5 |
Sample Bags | 5 |