Out of hours home visits

Re: Out of hours home visits

Karen McQuoid — Mon, 03 Feb 2014 23:49:09 GMT

Our clinic does do its own OOH, and when the call comes in for an OOH home visit we go out, It is often for euthanasia rather than anything else. A vet and nurse at all times. I have often been to some undesirable area's that I feel uncomfortable in and due to location factors these can take hours. we carry the duty phone and hope!

I know we are not expected to risk our personal safety but you don't know what your risking until you get there or something happens. Often called out from non clients, Our vets do fear the wrath of the RCVS hence why we always go.

My personal take is - that OOH house visits should not take place, often a practice that do there own ooh is one vet and nurse, leaving inpatients in kennels and hope that another emergency does not arrive. Is it fair to phone around other staff members in the early hours to request help? OOH centres are in the same position, if in surgery what would be classed as an expectable time to leave a house visit for a sick patient. There are lots of grey areas. When does it become the responsibility of the pet owner to transport there own pet to the practice its all to easy to say I don't drive/had a drink/no neighbours/ we been thinking all day and its now time and I want a vet now/the pet is collapsed etc. Often when you get there the family have arrived with cars and the pet is able to stand and walk.

So while we fear the consequences and re read the code of conduct our house visits will need to continue.

Regards.

Re: Out of hours home visits

Craig McDonald — Mon, 03 Feb 2014 22:01:15 GMT

I work in charity practice and haven't seen a house visit during day before as we will offer to pay taxi one way if owners unable to get down. I did a locum shift where we needed to do a house visit had a patient in the practice the vet couldn't leave as wasn't stable, couldn't find another vet after calling several so in the end another nurse and me went out to medicate dog to stop him fitting and bring him back to the practice for euthanasia as that was owner's wishes. Did pose an issue as one vet can't be in two places at once but equally both patients were in need of veterinary care.

Re: Out of hours home visits

Jacqueline Gallacher — Wed, 29 Jan 2014 22:10:56 GMT

I have been doing OOH work for 6 years now and I have found that very very rarely can people not get into the hospital, I have also found that the majority of people who request a house visit do so because they have no money to pay for a consultation or a taxi. For some reason they think that they wont have to pay for a house visit. with a bit of communication and explanation, ie in most cases it is in the pets best interest to be brought to the hospital for treatment, and that a house visit still has to be paid for, I find that almost 100% of these clients find a way to get in to us. I do think that in some cases the time it takes to do a house visit while leaving in patients unattended is not acceptable. Also doing a PTS at owners home can also cause other issues ie moving a very large body from a house without a trolley or enough staff to help lift. And of course the safety issues which is the main reason why GP's don't do OOH calls anymore.

Re: Out of hours home visits

Steph Worsley — Tue, 28 Jan 2014 22:27:41 GMT

I've worked in practices where we have done our own OOH and there was a couple of occasions we had to go out to the owners...namely one where we had a canal nearby and the O were on a canal holiday and had no access to a car ...although in this case the young female (small) vet went on her own and only told me about it when I got to the hospital to help her out....I told her she should have taken me as well for safety reasons if for nothing else. Most of the time we have had a complete no house calls outside "normal" working hours including on weekends.

I am of the belief that 99.9% of things are better off coming into the practice anyway as if they are that ill they are probably going to need to be admitted for procedures anyway and if the vet ends up putting the animal into their own personal car and has an accident then their insurance can be voided because it is being used for business work unless they have declared that kind of thing when taking it out.

the practice should have a taxi number to hand out to clients who do not have access to a car, Often the cases that do need to be seen urgently can't when a house visit is requested as either the vet has to wait for another member of staff to go with them or on a weekend has to wait until the surgery has been completed so therefore it would be better for the animal for the owner to bring them into the surgery.

Re: Out of hours home visits

Sal the 1st — Tue, 28 Jan 2014 22:02:45 GMT

I have been out on a few visits where I work now - admittedly none of them out of hours (if by out of hours you mean late at night), however I have been out on house calls late at night with other employers where the practice policy was 'safety in numbers' and the practice staff have been 100% female.

There has been quite a bit of discussion on the Chikosi case (which I am assuming is what sparked this off?) I dont feel that it is fair in most cases to expect a veterinary surgeon to carry out a visit when an animal can receive better care in the practice premises, a visit whilst convenient for the owner isn't always in the animals best interests and may well delay the care they need. There are not many cases that I can think of where treatment has been better administered in the home environment. At my current practice most of the visits we carry out are for euthanasia - not for saving life.

I don't agree that it should be mandatory for a VS to carry out a visit, because then the burden of that animals welfare is placed on the VS and not the owner of the animal and may well compromise the care of other animals in the practice. If you own an animal then you are responsible for it and that responsibility should extend to getting it to a place where it can be treated.

I do believe that public expectations of a veterinary practice are sometimes unrealistic - I wonder how many of them would succeed in getting their GP to visit them when they are sick? ( and I do have the figures for my area on this one and can say that the number of domiciliary visits carried out by GP's out of hours is a big fat zero)

In most cases when you explain to people why it would be best to bring their pet in and offer them taxi numbers etc if they have no transport they do manage to make it into the surgery.

Re: Out of hours home visits

lucy ashton — Tue, 28 Jan 2014 17:38:00 GMT

A nurse or an ANA will always go with a vet on a home visit just for security. I can understand why some vets are feeling obliged to go on home visits, especially as I read one vet got struck off recently for not going to see a dog OOHs promptly enough. He didn't want to leave the patient's he had at the hospital to see the patient. I think the RCVS ruled that the inpatients were stable enough and that he could have gone and that he had caused undue suffering to the dog.

Basically I think it always depends on the case, there's no clear cut answers! :(

Re: Out of hours home visits

Leanne Butterwick — Tue, 28 Jan 2014 17:08:00 GMT

We don't do our own out of hours but we do go on a lot of home visits during the day.

I do think that the majority of people are actually able to get their pet into the surgery, we even have local taxi services that are happy to take animals. It is always explained to them that we are limited as to what we can do when we go out to them (only bloods or euthanasia really) and sometimes if it is critical they end up coming in to the surgery after the visit anyway (the owner magically finds a way of getting in).

It is a massive grey area and we have a few vets that are worried about denying a visit just in case they get into trouble.

I know that out of hours organisations have their own rules regarding home visits i.e. vets are not allowed to leave the premesis but I think they should be more worried about RCVS regulations. If I were a vet I'd rather maintain my profession and maybe lose my job than not go on a visit and then be struck off.

It seems really difficult for vets at the moment regarding this whole discussion. And I hope things change for the better. Its not nice for vets to fear losing their jobs over it.