Due dates everywhere, and a car that never stops
A domiciliary podiatrist has a list of housebound patients: some at home with a partner, some living alone with carers visiting, some in sheltered housing. Most need routine care every six to ten weeks. Each is booked when they fall due, so Monday means a visit north of the river, then one twenty minutes south, then back north for a patient whose daughter can only be there at noon.
At the end of the day, notes are typed up at home, payments are reconciled against a notebook, and the next week's visits are phoned through one by one.
Why domiciliary rounds sprawl
- Visits are booked individually as each patient falls due, not planned as rounds.
- Each patient's due date is a single day, when in practice there is a window of a week or two that would work.
- Some patients need a family member or carer present, which fixes the time.
- New patients are slotted in wherever there is a gap, regardless of where they live.
- Phoning patients to confirm takes a long time, and many do not answer.
Clinic software is built around a practitioner in a room, with patients coming to them. Domiciliary work turns that around, and the planning has to follow.
What the zigzag costs
Driving time that is not treatment time. Fewer patients seen per day, which limits how many housebound patients the practice can take on. Late arrivals that worry patients and carers. Evenings spent on notes. And a waiting list of new domiciliary patients who cannot be fitted in.
| Planning by | Result |
|---|---|
| Individual due date | Visits scattered across the week and the area |
| Due window and area | Patients in the same area seen on the same day |
| Phone confirmations | Hours of calls, many unanswered |
| Text or carer confirmations | Most confirmed without a call |
How we build round planning
- Each domiciliary patient has an address, a recall interval set by the podiatrist, a due window, and any fixed availability, such as mornings only or when a carer is present.
- A planning view shows patients falling due over the coming weeks on a map, grouped by area.
- For each round day, the planner suggests which patients to include and a driving order, using Google Maps or a similar service. The podiatrist or coordinator adjusts it by dragging patients in and out.
- Confirmations go to the patient, or to the family member or carer who manages their appointments, by text, call or letter, with a simple way to say a day does not suit.
- New patients are placed into the round that passes nearest to them, rather than wherever a gap appears.
- On the day, the podiatrist sees the round on a phone, records notes and payment at each visit, and it syncs to Cliniko, WriteUpp or your system when signal allows.
- The next visit is proposed automatically from the interval and added to the planning view.
Kit is part of the plan. If a round includes a patient due for a procedure that needs extra equipment or dressings, it shows on the day's list, so the podiatrist loads the car accordingly.
What a round day looks like afterwards
Patients in the same area are seen on the same day. Driving drops and treatment time goes up. Carers and families know when to expect the podiatrist. Notes are done at each house. Next visits plan themselves. And the practice can take on housebound patients it would previously have turned away.
Could your rounds be planned better?
- You cross the same area more than once in a week.
- Home visits are booked individually as each patient falls due.
- Confirming visits by phone takes hours.
- Notes are typed up in the evening.
- You turn away housebound patients because the diary is full of driving.