You ring because they cannot get to the surgery, not because anyone is trying to buy luxury. The stairs have become a negotiation. The last outing ended with a day in a chair and a night of pretending it was fine. A daughter is on the landing with her voice lowered, because the person in the chair can still hear perfectly well when they want to.
A GP home visit elderly parent request is usually that scene, not a brochure. You want a named doctor in their living room, with enough time to look at the chest and the house, and to tell you whether this is a 999 problem, a today problem, or a this week problem.
Chest pain, signs of a stroke, severe breathlessness, heavy bleeding, a severe allergic reaction or symptoms of sepsis need 999 or A&E immediately. A fall after which they cannot be woken is the same door. A home visit is not an ambulance.
When a GP home visit elderly parent is the safer option
The short version is this. If they can travel, a clinic appointment is simpler, cheaper, and has a couch and a light I control. A 30 minute clinic slot is £100. If they cannot travel without making things worse, or if the house is part of what I need to see, I come to them.
Here is the longer version. Frailty does not always look dramatic. It looks like a person who used to manage the kettle and now does not. It looks like medicines in four different boxes, some of them from a stay in hospital that nobody has reconciled. It looks like a fridge with one onion and a pint of milk. You cannot see that on Green Lanes. You can see it from their armchair.
A home visit with us is up to an hour. Day visits are £250. A visit starting from 20:00 is £450. Those figures are published. We agree them before I set off, not on the doorstep. I am a GP coming to do an assessment. I am not a blue light. If they have fallen and they cannot be woken, if one side of the face has dropped, if the chest pain is sitting there now, you call 999 and you do not wait for me to cross North London.
It is worth saying plainly. Families sometimes ring us because they are frightened of wasting an ambulance, or frightened of a hospital that sent them home last week. Those are understandable fears. They are not a reason to delay 999 when 999 is indicated. Use us when the problem is medical and the house is the right room. Use 999 when the problem is an emergency.
What I look at when I arrive
What I look at in clinic still applies, only the clinic is their chair. The history first, from them if they can give it, and from you if they minimise, which they often do when a child is in the room. When this started. What “normal” looks like for them, because a confusion that is new is an emergency until we know it is not, and a confusion that has been there for years is a different examination.
Then the person. Colour. Pulse. Blood pressure. Temperature. Oxygen. Respiratory rate. Chest. Heart. Abdomen. Legs, for swelling and for the tender calf. Skin, including the sacrum and the heels if they have been sitting or lying, because a pressure sore is information about how the last fortnight has actually gone. Hydration. Whether they can stand, and how they stand, and whether the furniture has become a walking aid.
Then the house, because the house is part of the diagnosis. Stairs. The bathroom they actually use. Whether the bed is downstairs now. Whether there is food. Whether the heating is on. Whether the floor is a trip. I am not doing an occupational therapy assessment. I am noticing the things that make the medical plan either possible or fantasy.
The medicines on the sideboard tell you as much as the story on the phone. Boxes from three pharmacies. A hospital bag that never got unpacked. Doses doubled because yesterday was forgotten and today was guessed. Inhalers that have expired. Pain tablets taken for the joint, which then make the kidneys worse, which then make the ankles swell, which then look like heart failure. I line them up. I ask what is actually being swallowed, not what the repeat list says. The piece most people miss is the tablet in the wrong person’s dosette, or the one that was stopped in hospital and restarted at home out of habit.
I look at the notes they do have. Discharge letter if there is one. The last bloods. The anticoagulation booklet if they have one. Bring those to the table before I arrive if you can. I would rather read a crumpled letter than invent a plan that duplicates a scan from last Tuesday.
The second layer is almost always the family. A daughter who has started doing the nights. A son who lives further away and is trying to manage this by phone. Guilt, and the particular anger that sits on top of guilt. A parent who is frightened of a care home and so reports that everything is fine. None of that is an interruption to the medical work. It is the medical work. Carer exhaustion behind a family asking for a visit is a pattern. Naming it without turning the visit into a family therapy session is the job.
I also look for the things that hide under “they are a bit off”. Urine infection. Constipation. A chest that is quiet rather than noisy. A sodium that will only show if we draw blood. A medicine that was started last week. Alcohol that has increased because pain has increased. Low mood that looks like tiredness. I am not going to find all of that in one hour. I am going to find the thing that cannot wait, and a plan for the rest.
If I need bloods, I can often draw them there. The price of each test already includes the £20 collection fee. If I need a referral, the letter is included in the consultation fee after the assessment. If I need a chest x ray or a scan, that is a different building, and we talk about how they get there, or whether hospital is more honest.
If I do not know yet, I say so. Let us look again in 2 days, with these red flags for 999 tonight, is a legitimate end to a visit. A vague “keep an eye on them” is not.
When to come in sooner
Call 999 rather than us if any of these are true. Call us today if they are unwell and none of these are true.
- Chest pain, signs of a stroke, severe breathlessness, heavy bleeding, a severe allergic reaction, or symptoms of sepsis.
- A fall after which they cannot be woken, or a head injury on blood thinners with a worsening headache or vomiting.
- New confusion, a sudden inability to stand, or a fever in someone who already looks frail.
- Black stools, vomiting blood, or a faint from which they have not recovered.
- A limb that is swollen, painful, and hot, or breathlessness that started suddenly.
- They have not drunk, not passed urine, or not eaten, and there is no one who can stay tonight.
If the question is “I do not like how they look, and they will not come to clinic”, that is a reason to ask for a visit, not a reason to wait until Friday.
How a home visit is arranged here
You call Clinique Alpa, or you send a booking enquiry. You do not send confidential medical detail by WhatsApp. We confirm the fee, the window, and the address. I come to the house. You get a named doctor and an hour, not a script. Read what a home visit actually involves if you want the practical sequence before you ring.
We cover North London from Palmers Green. If the address is one I cannot reach in a useful time, we say so, rather than pretending. If a clinic appointment in Palmers Green would actually be possible with a taxi and two adults, we may say that too, because £100 and a couch can be the better assessment. The visit is for when the house is the right room.
Fees are on the fees page: £250 on a weekday, £325 at weekends and on bank holidays, £450 for a start from 20:00, each up to an hour. Extended visits exist if the work will take longer, and those are priced before we start. Subject to availability, always.
With your consent I write to the NHS GP. A private visit that never reaches the record is a story the next out of hours doctor does not have.
If the house is no longer safe, I will say that. I will not pretend a tablet will make the stairs behave. You can still decide what to do with that information. The visit is for seeing it clearly, not for being talked into a particular next chapter.
Ask for a visit if the house is the safer way to be seen. Read our fees page, or call 020 8882 8088. Home visits £250 weekday, £325 weekend and bank holiday, £450 from 20:00. Published in full. In an emergency call 999. Subject to availability.
Written by Dr Mitesh Parmar, MBBS MRCGP, GP and founder of Clinique Alpa, 466 Green Lanes, Palmers Green, London N13 5PA. This article is general information, not personal medical advice. In an emergency call 999. For NHS advice call 111 or visit nhs.uk.