Definition of Housebound 

Patients are deemed as Housebound if:

-        They are unable to leave their home environment through physical and/or psychological illness. 

-        The GP would normally offer home visits as the only practical means of enabling the patient to consult with a GP face to face.

Patients are not deemed to be Housebound if they:

-        Are able to leave their home environment with minimal assistance e.g. assisted/unassisted visits supported by family and friends to the doctor, dentist, supermarket, hairdresser, bingo, public house, etc. 

-        Their inability to attend the surgery is temporary e.g. following an operation. The practice will facilitate home visits based on an assessment of their needs and circumstances during this period. 

Principles 

-        Each patient’s eligibility for housebound status/home visits will be individually determined

-        Patients assessed as not meeting the criteria for housebound will be expected to attend a clinic or surgery setting. 

-        The assessment tool used to determine if the patient meets the eligibility criteria has been agreed and signed off by the Partners at Kearsley Medical Centre. 

-        Individual circumstances will be monitored and where an individual and or health care professional assesses that the patients’ needs have changed the patients’ housebound status will be reviewed. 

-        Patients who have been deemed as not housebound will have the option to appeal this decision by following the appeals process, as stated within this policy. This has been agreed and signed off by the Partners at Kearsley Medical Centre.

Requesting to be placed on the Housebound register

1. Requests to be placed on the housebound register go via the Patient Access Team.
2. The Patient Access Team will follow the ‘KMC Request for Housebound status’ template within SystmOne.
3. The Patient Access Team will consider the housebound eligibility criteria along with the information provided by the patient to determine if the patient is housebound or not.
4. Using the template, the patient will be assigned a read code of ‘Housebound 13CA.’ or ‘Outcome of assessment YA821 [free text ‘Not housebound]’

Appeal process

A patient/carer has the option to dispute the practice decision not to add a patient to the Housebound register. The following process applies;

1. The patient/carer can appeal by: 

A)      Submitting a letter to the Partners to explain the patients circumstances and their reasons to support the need to be placed on the housebound register

B)      Asking a receptionist to relay the patients’ circumstances and their reasons to support the need to be placed on the housebound register, via a ‘Housebound appeal’ task to the Patient Access Team Manager in SystmOne.

2. The Patient Access Team Manager is to give the letter or print out of the task to the Partners in the 11:30am meeting to consider. 

3. The Patient Access Team Manager will respond to the patient in writing with the outcome of the decision.

How to request a home visit 

1. Requests for a home visit must go via the Patient Access Team. This can be over the phone or over the front desk from a relative or carer.  

2. The receptionist must confirm the following information;

Patient’s name & DOB

Address

Keycode (if applicable) – add reminder to home screen if needed

Telephone number

If requested by third party, is the patient aware? 

3. Patient Access Team should complete an online consultation form on behalf of the patient, marking the priority as ‘Very high’

4. Triage GP will prioritise this request and if deemed necessary for a home visit the Triage GP will add to the visit list. Triage GP will update the online consultation with the outcome and forward back to Patient Access Team, who will inform the patient. 

5. If the visit request is triaged before the 11:30am meeting, the visit will be assigned to an appropriate clinician during this meeting. If the visit request is triaged after the 11:30am meeting, the visit will be assigned and the allocated clinician informed. If the Triage GP deems the visit is suitable for the following day it will be added to the following days visit list.

Visit requests for Care Homes and Intermediate Care

Visit requests for Farnworth Care Home, The Hollands and Wilfred Geere can be rang through by staff to the practice’s private phone line. 

The same visit request process will then be followed by practice staff as all other visit requests.