Misuse of emergency ambulances

Newdawn

Some people definitely call ambulances when they could and should get themselves to hospital. One question I am interested in is this. Do GPs do any house calls now? I haven't had a house call for forty years but wondered whether any are done now? I think Tony Blair's govt offered GPS the option to opt out of house calls? Not go bashing as mine have been excellent.

I had a house call about 3 years ago. Just out of hospital and too ill to get myself to the surgery, I 'phoned for advice - and the decision was made for the visit.
I mentioned my surprise to the doctor - she told me that in certain circumstances, they most certainly do still do home visits.
But, things have deteriorated since then... who knows now?

Casdon The doctors at my surgery don't do home visits. However, they do employ two paramedics who will occasionally visit.

Dickens When I was discharged after my heart attack, I was told by the hospital to see a GP within days for a check up and to arrange medication. I lived on my own and wasn't allowed to drive. When I rang the GP, I was told in no uncertain terms that I didn't qualify for a home visit because I wasn't old and frail enough. That was five years ago.

growstuff

Casdon The doctors at my surgery don't do home visits. However, they do employ two paramedics who will occasionally visit.

I don’t know how they can not do them growstuff. It’s still in the core GP contract. Maybe the paramedics are the first line in your practice, and the GP attends a patient subsequently if the paramedic identifies it as necessary. My surgery designate a doctor daily to do home visits after morning urgent surgery, so they are out on the road from about 11.

My surgery states that they don't do them.

Our surgery still does home visits obviously some patients are too ill or infirm to attend the surgery. These patients still need to see a GP on occasions

growstuff

My surgery states that they don't do them.

That is probably to put people off requesting a home visit rather than attending the surgery when they could do so, so they don’t advertise the fact? If you’re 100% sure that they never visit people at home you could take it up with your local health body because they would be in breach of their contract, unless they can demonstrate that the paramedics had the option to, but never saw the need to request a GP to attend when they had visited a patient on their behalf (which seems unlikely).

Casdon

Fleurpepper

The contract for GPs were changed around 2000. They were told that if they did not do housecalls, they would be docked 7000 from salary.

Many, after spending years and years, doing house calls and night calls, 1 night in 3 or 5, ON TOP of their full-time hours (eg if called at 2am, 4 am and 5 am- they would still have to be at work when surgery opened) - and often for things that could easily have waited, and were not at all emergencies, and for people who were well able to make it to the surgery, etc) - decided that 7000 was a sum they could well afford to lose, in order to get some sleep and get home to see the kids once in a while.

So they stopped. Home visits and night calls went to agencies- and those then stopped too as too expensive.

Where are you *Fleurpepper? Home visits are part of the core contract for GP services. If you look on any GP practice website it will tell you what their arrangements for home visits are. As I said, my neighbour had a home visit from his GP a few days ago, they are definitely still happening.

Only in very exceptional circumstances. And no night/week-end cover. In the UK.

I'm absolutely sure that the GPs don't do home visits and delegate to paramedics or district nurses. I'm not going to take it up with anybody. Personally, I don't think home visits are a good use of a GP's time, but I do think (as I've stated before) that there needs to be an efficient community system, involving paramedics, nurses and carers.

growstuff

I'm absolutely sure that the GPs don't do home visits and delegate to paramedics or district nurses. I'm not going to take it up with anybody. Personally, I don't think home visits are a good use of a GP's time, but I do think (as I've stated before) that there needs to be an efficient community system, involving paramedics, nurses and carers.

Your choice of course. There are circumstances when a GP home visit prevents admission to hospital, when somebody is bed bound (eg multiple sclerosis in the letter stages), terminally ill, or has a serious respiratory issue for example, that needs a medical decision which can’t be dealt with by other health professionals, and I’d be very sad to see my practice stop doing home visits in those circumstances.

Last year my neighbour had severe back pain. They didn’t want to wait at A and E so they called an ambulance obviously not understanding that she’d still be traiaged at the other end. Potentially blocking the ambulance for a real life threatening emergency. The ambulance blocked me in my drive and they had the audacity to look annoyed with me when I asked if they could move forward so I could attend a real emergency with my aged mother with dementia. The entitlement astonishes me.

A neighbour was quite happy to pay for taxis to go to hairdresser's, nail salon, coffee with friends, shopping, etc. But she refused to pay for taxi to take her to hospital apps, 5 mins away by taxi, or with direct 10 mins on bus.

Her right she said, to have an ambulance.

growstuff

I'm absolutely sure that the GPs don't do home visits and delegate to paramedics or district nurses. I'm not going to take it up with anybody. Personally, I don't think home visits are a good use of a GP's time, but I do think (as I've stated before) that there needs to be an efficient community system, involving paramedics, nurses and carers.

GPs will carry out home visits in this area but under exceptional circumstances eg if some is unable to go to the surgery for medical (not transport) reasons.

Whilst we encourage our patients to come to the surgery, where we have the proper equipment and facilities available, we do appreciate this is not always possible for housebound or critically ill patients.

If you or someone you care for need a home visit, you can help us by calling reception before 10:00

Home Visits

Home visits are for patients who are too ill to attend the surgery, not for people who have difficulties with transport. Please ring before 10.00am because this helps the doctors to organise their working time.
A similar message is on other GP surgery websites in this area.

I'm absolutely sure that the GPs don't do home visits and delegate to paramedics or district nurses. I'm not going to take it up with anybody

Being absolutely sure doesn't mean something is necessarily correct and does not wanting to take it up with anyone mean they are not allowed to post a correction?

Fleurpepper

A neighbour was quite happy to pay for taxis to go to hairdresser's, nail salon, coffee with friends, shopping, etc. But she refused to pay for taxi to take her to hospital apps, 5 mins away by taxi, or with direct 10 mins on bus.

Her right she said, to have an ambulance.

Surely you can't just order an emergency ambulance to take you to hospital appointments.

However, patients who have ambulatory problems and who need to get to routine appointments can order Non-Emergency Transport, either by transport ambulance whic can accommodate stretchers and wheelchairs or with a volunteer car driver.

A vital part what we do involves transporting people to and from their medical appointments at clinics, hospitals and day centres. The Non-Emergency Patient Transport Service makes around 700,000 patient journeys every year for patients across Wales

Callistemon21

^I'm absolutely sure that the GPs don't do home visits and delegate to paramedics or district nurses. I'm not going to take it up with anybody^

Being absolutely sure doesn't mean something is necessarily correct and does not wanting to take it up with anyone mean they are not allowed to post a correction?

Sorry, but it is correct. My GP practice works in a consortium with four other GP practices in the area. One of the partners in one of the practices is a good friend of mine and I've discussed it with her. She doesn't agree with the policy because she'd like to do home visits, but the decision was made to send out paramedics and district nurses, who are jointly employed by the practices. If the paramedics or nurses think that somebody needs urgent treatment which they can't provide, they refer patients to hospital. If medication is needed, they ring the practice and prescriptions are provided electronically. There is no out of hours provision.

A patient has to be assessed beforehand.
When you contact us for transport you will be asked a series of questions that will determine whether you are eligible for transport. Eligibility is based upon this medical criteria

Sorry, but it is correct

I've just posted the policies here.
Presumably it must vary from area to area.

It does not mean, because it is correct in your area, that it is the same everywhere.

Home visits take up a lot of time. A GP could see perhaps five or six patients in the same time. Paramedics and community nurses are cheaper. Personally, I'd rather that a GP was in the surgery and able to see all the patients who want to make appointments.

Since 2004.

Callistemon21

^Sorry, but it is correct^

I've just posted the policies here.
Presumably it must vary from area to area.

It does not mean, because it is correct in your area, that it is the same everywhere.

I never claimed that! I was stating the situation in my own area. Presumably, providing paramedic and district nurse cover means that the GP practices are still fulfilling their contract.

I have no idea what the national picture is like.

Callistemon21

A patient has to be assessed beforehand.
^When you contact us for transport you will be asked a series of questions that will determine whether you are eligible for transport. Eligibility is based upon this medical criteria^

Errmmm! Transport isn't based on medical criteria either - not here anyway. Ambulance transport for hospital visits is based on entitlement to benefits. There is a local voluntary organisation, which can sometimes help out.

growstuff

Home visits take up a lot of time. A GP could see perhaps five or six patients in the same time. Paramedics and community nurses are cheaper. Personally, I'd rather that a GP was in the surgery and able to see all the patients who want to make appointments.

A nurse or paramedic doesn’t have all the skills that a GP does. It has to be proportionate, nobody, including GPs themselves would want them to be wasting time on unnecessary home visits, but there are times when only a GP can meet a patients needs. I’m not sure whether you’re saying that you think these patients should be sent to hospital instead, but that is the alternative.

well that seems discriminatory to their disabled patients who are unable to attend the surgery.
they are being deprived of having a doctor's attention.
and you say there is no out of hours service ?
so what happens if a bed-bound patient needs antibx at midnight on xmas eve ?
they ring 111. and ? what happens then, in your area.

Several generations of GPs did out of hours, nights and week-ends, on top of a full time day, and home visits- with pride and because they believed in what they did. Even when it put their own lives in jeopardy and their family.

If only the Governement in 2000-2004, had chosen to reward them with extra payment for doing so, instead of threatening to take away a sum which was an insult to their hard work and dedication, they would probably have continued to do so.

Very sad- and this caused huge damage to the profession, and to patients.