We have developed a definition of housebound in collaboration with GPs and community teams to encourage people, who are able, to attend clinics for their appointments and to limit the use of home visits.
Our agreed definition of housebound guidelines aims to ensure that community nurses and GP clinical teams are providing routine clinical appointments in the home setting only when it is appropriate. It is acknowledged that an individual’s needs may change and therefore eligibility for a home visit should be reassessed on a regular basis.
Definition of Housebound
“Patients are eligible for home visits for routine treatment only when a patient is unable to leave their home due to physical or psychological illness as this type of appointment takes much more time than if the patient is able to make it into their local clinic or GP surgery.
A patient will be deemed to be housebound when they are unable to leave their home environment through physical and/or psychological illness.
An individual will not be eligible for a home visit if they are able to leave their home environment on their own or with minimal assistance to visit public or social recreational public services (including shopping).
Wherever possible patients are encouraged to attend local community venues for their care.
Principles
- Ultimate responsibility to determine whether a patient requires a home visit rests with the assessing clinician.
- Each patient’s eligibility for home visits will be individually determined.
- Patients assessed as not meeting the criteria for housebound will be expected to attend a clinic or surgery setting.
- The assessment for housebound will ensure a holistic approach including assessment of the patients’ physical, social and psychological needs.
- Individual circumstances will be monitored and where an individual and/or Health care Professional assesses that the patient’s needs have changed due to either an acute onset of illness or gradual deterioration in their conditions, the patient’s housebound status will be reviewed.”
The implementation of the definition of housebound will bring the following benefits:
- Patients who are not able to travel to a clinic or surgery and need to have their care delivered at home are seen in a more timely and efficient way
- More clinical care is delivered in the best setting for delivering safe care
- Time of clinical teams is most efficiently and cost-effectively utilised
Each patient’s eligibility for home visits will be individually determined by the clinician, based on the above definition and patients assessed as not meeting the criteria for housebound will be expected to attend a clinic or surgery setting. Individual circumstances will be monitored and where an individual and/or health care professional assesses that the patient’s needs have changed, the patient’s housebound status will be reviewed.