When you ask this question, you can expect a variety of answers, not all of them helpful or even truthful.

As a live-in carer there will sooner or later come a time when you feel that your client needs to see a doctor. In an ideal world you would call the surgery and make an appointment, dress your client and take them there to see the doctor. Unfortunately, with live-in care it is not an ideal world.

House visits for a doctor mean time away from the surgery. Additionally, the doctor needs to make the visit during their break time, normally between surgeries. The average doctor can see five or six patients in the time that it takes them to make one house visit.

Visiting your client at home means that they are seen in a less than perfect condition. The house may not have the best lighting for the doctor to see the problem, examination facilities will not be as good as in the surgery and the correct equipment will not be at hand.

So, when would you ask the doctor to make a house visit?

Most surgeries suggest that unless your client is genuinely housebound, you make the effort to get them to the surgery.

If you feel that you require a house visit, then you should call the surgery before 11am on the day you need the doctor to visit. Do not be surprised if the doctor makes a telephone call back to you first to discuss the situation. He may be able to give you advice over the phone instead of visiting. Ultimately it is up to the doctor whether a house visit is justified or not.

There are several points which you should consider when you try to arrange a visit.

• Can the medical problem be handled with a telephone call? If yes, then accept a telephone conversation. If no, ask for a visit.

• Does or would travelling to the surgery cause undue suffering or a dangerous deterioration in the patient? If no – accept a telephone conversation. If yes, ask for a visit.

• Is there a reason to believe that an immediate condition requires specialist attention? No, accept a telephone conversation. If yes, ask for a visit or ask the doctor to arrange transport to a hospital.
• Can the condition be handled by another person such as a District Nurse? If yes, ask for a referral. If no, ask for a visit.

Situations for which a home visit is appropriate

Terminally ill. You may have a client who is at the end of life and physically cannot be moved from the bed. To do so would cause a deterioration in the condition.

Where an occasional visit is useful. This may be to asses your client for travel to a hospital or to re-evaluate the condition and adjust medication for End of Life conditions.

Dependant people. These are people who when they are well can normally manage to get to the surgery, but when they are ill, they cannot do this.

Situations where it is not advisable to ask for a house visit

Common problems in elderly people. These can range from poor mobility, aching joints and general malaise. The only exceptions here are if your client is bedbound.

Season things such as flu and colds. People with diarrhoea or coughs are best kept at home to prevent infection from spreading.

In these instances, the doctor will be happy to discuss the condition with you on the telephone and may even send a prescription to the pharmacy on your behalf.

To sum up

While it may be difficult to get your client to the surgery, it is often the best and quickest way to see the doctor.

With the shortage of doctors and overcrowded surgeries you may not even be able to ask your regular doctor to visit and may find a stranger arrives who does not know your client’s condition.

Naturally, if you are unsure and your client’s condition deteriorates then calling emergency services should be your first choice. They will also talk to you about the condition and then send a paramedic to help you. While it is a good idea to get to the surgery, if it means your client is in danger, you should call emergency services right away.

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