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CAMHS won't see you now

Sudden loss of vision fixed with micropore tape

Dr Nick Luscombe asks for examples of abusive home visits (Letters, October 20). A couple of years ago I was working for our local out-of-hours co-operative as the visiting doctor. Our co-op functions with one doctor working at a primary care centre taking phone calls, giving advice and seeing people who will come up to the primary care centre.

The other doctor is on the road and visits patients who have been triaged by the doctor at the primary care centre.

The call slip for my next patient read '75-year-old lady sudden loss of vision'.

This sounded to me like a potentially urgent problem. I made haste to the housing estate where she lived. Sadly the lift was out of order in her block.

I climbed to the fourth floor where she lived. The door was opened by a woman who looked in good health. She lived alone and I followed her to the living room to start my history and examination. I asked when she started to have problems with her vision. 'When I sat on these' she replied, presenting me with a broken pair of spectacles.

She was a very nice old woman and it was only after I had mended her spectacles with micropore tape that I asked myself: 'Should I be here?'

Dr JA Lawrie

London E6

The following abuses led our practice to telephone triage all visit requests.

 · Visit requested by local nursing home. When I visited the patient had been taken out to the local polling booth to vote!

 · Visit requested by local social services day centre staff. On arrival the staff had taken the patient to the supermarket.

 · Visit requested for breathlessness. No reply when I arrived. The police kindly removed the front door for me. House empty. Patient walked back from the shops to find the door on the green, house alarm ringing and police waiting.

 · Three separate visits requested by a patient. On each occasion the house was empty. Neighbours informed me the patient had walked round to the off-licence.

 · Specific time for visit insisted on so the patient could still make her trip to the hairdressers.

 · Visit called by local sheltered accommodation warden. On arrival, patient out to lunch.

 · Visit called (today in fact) by social services home carers. When the request was discussed with the patient, he and spouse were happy to attend the surgery, and did so.

 · Visit called by patient returning from Ireland with sore throat. Initially arranged to see GP in Ireland, found there was a charge, cancelled it, flew back to the UK, drove back from the airport, passed the surgery front door and immediately demanded a home visit.

And the list goes on....

Dr DJ White

Burnley

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