This article relates to the CQC key question: Is your practice safe?
It is recognised good practice for GP practices to have systems in place to triage and prioritise home visits.
NHS England issued a patient safety alert in April 2016 to raise awareness. This follows a patient safety incident where a patient’s death was related to the lack of prioritisation of GP home visits.
The alert states that:
'When a request for a home visit is made, it is vital that general practices have a system in place to assess:
- whether a home visit is clinically necessary; and
- the urgency of need for medical attention.
'This can be undertaken, for example, by telephoning the patient or carer in advance to gather information to allow for an informed decision to be made on prioritisation according to clinical need. In some cases the urgency of need will be so great that it will be inappropriate for the patient to wait for a GP home visit and alternative emergency care arrangements will be necessary.
'Many practices will already have systems in place to manage home visits. Where this is the case, consideration should be given to whether a review is required in light of this alert. The review should also consider whether all clinical and non-clinical staff involved in the process are aware of their responsibilities when managing requests for home visits, and if any outstanding training needs exist.'
GP practices should action the alert as soon as possible, and no later than 4 May 2016.
CQC inspections: responsive
One of the CQC's key questions is whether services are organised so that they meet people’s needs. In particular, key lines of enquiry (KLOEs):
- R1 - are services organised so that they meet people’s needs?
- R3 – can people can access care and treatment in a timely way?
We specifically look for evidence from the practice on home visits and whether they are available for people who would benefit from them. Inspectors may ask a practice about:
- How they decide whether a home visit is necessary
- How a practice prioritises home visits
- What they do if the urgency of need is so great that a GP home visit is not appropriate.
CQC inspections: safe
Another key question is whether practices are providing safe care.
We look at the practice’s processes and systems to monitor patient safety through reporting patient safety incidents and how they learn from these incidents and significant events.
This patient safety alert demonstrates how important it is for GP practice staff to report all patient safety incidents to the NRLS so lessons can be learned across general practice.
- CQC Essentials: reporting patient safety incidents to the National Reporting and Learning System (NRLS) for GP practices
- Patient safety incident report form: GP and out-of-hours staff
- Professor Nigel Sparrow is senior national GP advisor and responsible officer at the CQC
More CQC resources
- View the full CQC Essentials series on Medeconomics
- CQC's recommended reading to help practices meet regulations and prepare for an inspection