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Home Visits: Understanding the GMS Contract and CQC Expectations

Home visits are an integral part of the General Medical Services (GMS) contract and are acknowledged as necessary for certain patients under specific circumstances. However, it’s important to understand that home visits are not an automatic entitlement for every patient. The decision to provide a home visit is based on a clinician’s professional judgment and assessment of the patient’s condition.

GMS Contract and Home Visits

According to the GMS contract, home visits are required when:

  1. A patient’s medical condition makes it necessary for the contractor (the GP or healthcare provider) to attend.
  2. Attending the patient at the practice would be inappropriate given the patient’s condition.

The contract specifies that home visits should be conducted at the most appropriate location, which can include:

  • The patient’s last recorded home address.
  • Another location agreed upon between the patient and the contractor.
  • A location within the contractor’s practice area that best meets the patient’s needs.

The contract also makes clear that home visits are not an obligation in all circumstances. For example, GPs may refer a patient without visiting them first if it is medically appropriate, or they may visit a patient outside the circumstances outlined in the contract when necessary.

In short, while home visits are recognised as an important part of patient care, they are not automatically guaranteed for every patient. The decision is ultimately made by the clinician, who will assess the patient’s condition and determine the best approach to care, which may or may not involve a home visit.

Home Visits and the Care Quality Commission (CQC)

The Care Quality Commission (CQC) incorporates home visits into its inspection process and examines them as part of its Key Lines of Enquiry (KLOE), which evaluate the overall quality of care provided by a practice. Specifically, CQC looks at the following:

  • R1 – Are services organised to meet people’s needs?
  • R3 – Can people access care and treatment in a timely manner?

The CQC seeks evidence from practices on how home visits are managed, ensuring that they are available for patients who require them. During inspections, the CQC will focus on:

  1. Decision-making process: How does the practice determine whether a home visit is necessary for a patient?
  2. Prioritisation of visits: How does the practice prioritise home visits based on urgency or patient need?
  3. Alternative arrangements for urgent needs: What happens when a home visit is deemed inappropriate or unnecessary due to the urgency of the patient’s condition?

Practices must be able to demonstrate how they handle home visits, particularly in cases where a home visit may not be the most suitable option.

Downloads and Links

For further information and guidance on home visits, please refer to the CQC’s official advice on the matter.

CQC advice on home visits

 

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