Domiciliary Care

Question 1

Where may patients be seen on domiciliary visits?

Answer 1

Care-homes, hospitals, homes, day centres

Question 2

For what people is domiciliary care used?

Answer 2

For patients unable to access in any other way
-> Bringing the NHS to the people

Question 3

Who delivers domiciliary care?

Answer 3

• PDS
• Individually nominated GDP
• GDP nominated by care-home
• may be no-one available

Question 4

What must be considered about payment for treatment in domiciliary setting?

Answer 4

Treatment is not necessarily free for people in care homes
-> The POA may have to make decision about payment and consent

Question 5

What would constitute intensive home care?

Answer 5

Someone needing a carer present for 10+ hours per week

Question 6

What aspects must be considered before you partake in domiciliary care?

(as per health and safety at work act 1974)

Answer 6

• Undertake adequate risk assessment
• Lone working policy- there must be 2 people
• Smoke-free- if level is too high then you don’t need to go in
• Manual handling of patients- special training required
• Car parking- is it available, safe, nearby
• Cost
• Kit must be brought with you

Question 7

What are the rules concerning staff safety which should be followed when giving domiciliary care?

Answer 7

• Never be alone
• Have mobile phone
• Dom kits have panic alarm
• Let someone know where you are going

Question 8

What can make patients seen in domiciliary setting even more difficult?

Answer 8

• Chronic diseases- under MDT care
• Psychiatric issues
• Polypharmacy

Question 9

Which treatments can be done in a domiciliary setting?

Answer 9

• Soft tissue disease assessment
• Assessment of dentition or periodontium
• Prevention
• Some stages of dentures

Question 10

What must be brought alongside other equipment for a domiciliary visit?

Answer 10

Emergency drugs and Oxygen

Question 11

Who can issue a section 47 certificate enabling treatment of someone who does not have capacity?

Answer 11

GP

Trained dental pracititoners

Question 12

What are the issues with ambulance transport?

Answer 12

Rarely run on time

Prolonged waiting times for collection

Don’t deliver to GDPs so they must be seen in hospital setting

Pick up multiple patients- sometimes no room for chaperones

Dental appointments are often cancelled as less important than medical appointments

Question 13

What is the issue with remuneration and domiciliary care?

Answer 13

It is never going to be a profitable treatment modality
-> most treatments are not funded on SDR