Asking the patient to sign an agreement is just adding to the enormous bureaucracy we already have and it may also have an adverse impact on this vulnerable patient group. It is surely common sense to ask the patient, who is sleeping rough, which is their preferred c/o address Then to tell them to keep checking if there is mail (that's what I do). This is acting in the best interest of the patient. It is nonsense to suggest the practice is liable if the patient does not check their mail. They are far less likely to get their mail if they use the CCG headquarters! That is definitely not acting in the patient's interest and is called "Passing the buck"
Assessment is the enemy of effective reflection. We benefit, psychologically and professionally, from reflecting on our practice and so do our patients. But these reflections should be private with selected learning points only entered into the portfolio/appraisal.