Domiciliary consultation--who benefits?

A survey was conducted of the domiciliary consultation service provided in one health district in order to identify the pattern of referral by specialty, the reasons for the consultation and its outcome and to determine whether the service is realizing its original objectives.The district domiciliary consultation service was used in the majority of cases as an initial means of assessment for elderly patients with chronic disease. The majority of patients were kept out of hospital but responsibility for their care was usually transferred to the consultant. The domiciliary consultation service was rarely used as a means for joint consultation between family doctor and hospital specialist. To facilitate the care of patients in the community, it is suggested that domiciliary visiting should be incorporated into a consultant's NHS contract and the present regulations abandoned.