Category: 2.3. Home visits: duty clinicians and collaboration with other practices
West Malling Group Practice in Kent found that it was getting a large number of acute home visit requests during surgery hours. Sometimes, all the GPs would make home visits on the same day, disrupting workloads and causing a backlog.Patients needing home visits would often have to wait several hours until the end of morning or evening surgery, potentially risking their health and postponing any tests or hospital admissions until late in the day.
The practice also struggled with the large number of patients wanting or needing to be seen without appointments. They would have to wait until the end of the surgery to be seen. This increased congestion in the waiting room and extended doctors’ regular hours. In 2002 the practice responded by introducing a duty doctor system. This brought huge benefits for patients and doctors.
The assigned duty doctor has no booked appointments. He or she takes all requests for urgent home visits, gives advice over the phone in urgent cases and receives calls for doctors who are not present. He or she also sees patients at the practice who need urgent attention but don’t have appointments. At West Malling, the record for a number of duty
doctor contacts in a ten-hour day is 120, including phone calls, home visits and patients coming to the surgery for emergency appointments.
‘I think we give patients a fantastic service,’ says Dr Jonty West, a partner at the practice. ‘I know very few other surgeries where a patient is always guaranteed a call back from a doctor. And if someone feels they need a visit immediately, the doctor is able to leave at once, and then get the tests and admissions organised early in the day.’
Dr Jonty West
jonty.west@nhs.net
