Faculty of Medical and Human Sciences

							                                            Faculty of Medical and Human Sciences
                                            School of Medicine
                                            Community Based Medical Education Team

                                            The University of Manchester
                                            Stopford Building, Oxford Road, Manchester, M13 9PT
                                            Website: www.manchester.ac.uk



        Lone Working Policy for Medical Students

        Seeing the patient in their own home provides valuable information about the
        patient’s health and their social setting. Some patients are housebound and are
        only able to see you in their own home. It is important therefore that you take every
        opportunity to see patients in their own home but in order to minimise any risk to
        yourself, follow this guidance in conjunction with the ‘Stay Safe’ guidance for
        students in the community.

        Incidents of violence or aggression are rare in the community but do happen.
        Sometimes the threat does not come from the patient but from an aggressive dog
        or other pet. Your GP should assess any risk before sending you to see any
        patient outside the surgery setting. Your GP should already have a system for
        recording any patient or location where there is a known risk to personal safety.

        1. If you are going to see a patient in their own home, let your GP or
        practice manager know where you are going, who you are going to see, your
        contact number, and approximately what time you expect to be back at the
        practice. (This applies whether you are on your own or with your student
        partner). Should you not return at the expected time or the practice does not
        receive a call to say you have left the visit within 30minutes of the expected
        time; the surgery should contact the student on the mobile phone number
        provided.

        2.   Visits during “unsocial” hours or finishing after dark should be avoided.

        3. Your GP should check on the patient record before you visit to ensure that this
        is not a patient with a history of violence or aggression, or that the patient suffers
        from a condition which might in some way put you at risk.

        4. If at all possible, always conduct home visits either with a member of the
        practice team or with your student partner.

        5. When undertaking a home visit there may be times when, on arrival,
        that you feel uncomfortable in either entering or remaining in the house. In
        these circumstances do not enter, and make a suitable excuse, leaving
        immediately. If necessary, make a mobile phone call to the surgery and
        pretend that an urgent call has arisen.

        6. Report any incident of aggression, violence or perceived threat immediately to
        the practice manager or GP.

        7. You should follow this same procedure, not only as a student but also in your
        professional life, when you will almost certainly be conducting unaccompanied visits
        to patients from time to time.


Updated 14.8.07. P. Burns
Lone Worker Policy for Students
        Stay Safe points

                     “Do’s” and “don'ts” of visiting in the community *


                     Do’s                                  Don’ts

        Plan your journey so that you          Don’t leave the journey to
        know in advance where you              chance.
        are going.
        Tell others where you are              Don’t travel alone by choice.
        going and what time you are
        likely to be back.
        Avoid shortcuts.                       Don’t take short cuts.

        Keep to well-lit areas                 Don’t venture into unlit areas

        Carry some identification.             Don’t assume everyone
                                               knows what you are.
        Travel in pairs if possible.           Don’t be an obvious stranger.

        Know the times of trains and           Don’t wait at deserted bus/
        buses.                                 train stops.

        Exercise judgement using               Don’t compromise your
        stairs or lifts.                       safety in high-rise flats or
                                               maisonettes.
        Dress to fit the area you are          Don't wear provocative
        visiting.                              clothes, jewellery or religious
                                               symbols.
        Bring just enough money for            Don’t carry a full purse or
        expenses.                              wallet.

        Talk and behave confidently.           Don't be arrogant.

        Respect the individual.                Don’t talk down to people.

        Leave the environment if               Don't enter a patient's home
        your instincts tell you to.            if your instinct tells you not
                                               to.
        Work in Pairs                          Don't examine patients in the
                                               home if you are
                                               unsupervised

        * Adapted from: -

         Handbook for 4th.year medical students, pre ’96 curriculum, Department
        of Primary Care, the University of Liverpool
         Handbook for medical students, Health in the Community course, the
        University of Toronto.



Updated 14.8.07. P. Burns
Lone Worker Policy for Students