Risk alert: Failure to prioritise home visits

We are aware that members have received a Patient Safety Alert from NHS England warning about the risks associated with the failure to prioritise home visits in general practice.

It advises practices that they should have a system in place to assess requests for a home visit.

Our team of medicolegal and risk management professionals have developed advice for practices to help manage the risks associated with home visit requests.

Action points for GPs

1. Update the medical records – In the context of undertaking a telephone consultation for the purposes of assessing as to whether or not a home visit is indicated, it is important to take and record a comprehensive history, together with the agreed action plan.
2. Agree on where to see the patient – If a decision is made that a face-to-face examination is required, it is important to reach a mutual agreement as to whether that examination should take place at the surgery or in the context of a home visit. If agreement cannot be reached in relation to whether or not the patient is able to travel to the surgery, then the safest approach is to undertake a home visit.
3. Assess the urgency – It is important to determine the urgency of any face-to-face examination (or any other action) that is required and to ensure that the requisite actions are undertaken within a time-frame that is proportionate to the urgency of the clinical situation.

Action points for practice managers

1. Create a protocol for the practice – Practices might wish to develop a protocol (which could take the form of a computer template/algorithm) for the purposes of telephone consultations pertaining to the assessment of home visit requests.
2. Ensure all staff undertaking triage calls receive training – Practice reception staff and healthcare professionals undertaking triage of calls should have adequate training, which should include the assessment and prioritisation of home visit requests.