What drugs should I carry or have accessible?
- GPs must be able to defend themselves on grounds of good clinical practice, but balance that against the risk of carrying drugs.
- Different practices operate in different settings with different resources around them i.e. a GP practising in a remote rural setting will have different considerations from one close to a hospital.
- GP practices should consider how they manage emergency requests made to them and whether the GP practice is the appropriate service to respond. If there is an “emergency” for a housebound patient then generally paramedics would be better to manage that via the patient calling 999.
There is no specific guidance in relation as to which drugs to carry. However, there are some guides that you could draw on e.g.
- CQC GP Mythbuster 9 : Emergency medicines for GP practices
- GP notebook emergency bag guide
- Drugs and Therapeutics Bulletin – Drugs for the doctor’s bag: Adults
- Drugs and Therapeutics Bulletin – Drugs for the doctor’s bag: Children
You should have access* to urgent treatment for emergencies that you may come across where treatments have a time dependent element for life-saving purposes.
e.g.
- aspirin for an MI
- adrenaline for anaphylaxis
- benzylpenicillin for meningitis
- Just in case (JIC) medications for palliative visits
*The definition of appropriate access will depend on the set up and location of your surgery. Practice may vary from each doctor having their own personal emergency drug bag or a designated emergency drug store/bag being available in the surgery.
We suggest that each practice should meet, look at the available advice and decide a policy for what treatments are available and how they are available (personal bag, practice cupboard, practice emergency bag) and base that decision on their unique practice circumstances. For good practice they should document their decision.
Home Visiting – The Doctor’s Bag
Home visits are requests to attend a patient in their own residence, including care or rest homes. In modern general practice there can be services set up to deliver home visiting on behalf of a practice, PCN or area. However, some practices will still deliver home visiting, and it is important for GPs and other visiting health care professionals to consider what they need to provide effective assessments of patients in their own environments.
A traditional view of the GP bag carrying multiple tools and medicines to assess and treat patients in their own homes has now evolved to a more streamlined set of equipment that GPs tend to carry.
There are no hard or fast rules here, and GPs and practices should consider what might be needed during home visits to carry out assessments that they might normally undertake in their own consulting rooms. This might include (for example, but not mandatory):
- Sphygmomanometer for BP assessment
- Thermometer
- Sats monitor
- Otoscope/ophthalmoscope
- Stethoscope
- Urine pot and urine dipsticks
- Reflex hammer
- Gloves and lubricant gel
In reality this should be up to the individual clinician and their assessment of the type of home visiting they are likely to undertake, given the demographic and situation of their practice. The clinician needs to be sure they can assess a patient effectively to make decisions about their ongoing needs, including the safe handover of care to other services if needed (eg admission to acute setting).
Some practices will even have one or two home visiting bags with equipment for GPs that are undertaking home visiting as part of their rota that day.