For many years it has been clear that the vast majority of primary health care should be provided in the setting of a modern, well-equipped surgery in a well-lit, purpose-built environment with rapid access to affiliated services, such as nursing and a pharmacy.
The decision as to whether or not a visit is required should be based on the clinical condition of the patient and should be made by the assessing clinician.
Home visits should be reserved for situations where it has been determined that a face-to-face consultation is necessary and:
- The patient is housebound, or
- The patient is in the later stages of a terminal illness, or
- The patient may be suffering from a medical condition which would be worsened by travelling.
The vast majority of patients are not harmed by car or taxi travel. Therefore, most feverish children, people with abdominal pain, diarrhoea and vomiting, upper respiratory tract infections, injuries and musculoskeletal problems, who are deemed to require a face-to-face consultation, are fit to be transported to the surgery for assessment.
There exists a grey area where there are no clear medical grounds to justify a home visit but where, for social reasons, patients or their carers feel they are unable to accept the invitation to attend the surgery. There is no requirement to provide a home visit in these circumstances, but the clinician may choose to offer a home visit in these cases as a pragmatic compromise.
Occasionally, if a patient clearly requires hospital admission following triage, this can be arranged without the need for a face-to-face contact following the agreement of the admitting hospital Doctor.