Reviewing with the person who does it

For four years Constance Oyibo answered detailed questions about a medicines routine she does not personally carry out.

Continuity matters more here than in almost any other population, because the history is long and the person telling it may not be the patient.

A year on

The list grows because every appointment can add and almost none are structured to remove. Nobody is at fault; the mechanism simply only runs one way.

We were reviewing with the patient and instructing the carer by leaflet. Exactly backwards.

Samuel Reyes, clinical pharmacy

What the home visit found

Home assessment finds things clinic assessment cannot: the rug, the third step, the light switch at the wrong end of the hall, the chair that is four inches too low.

“It seems obvious,” her son says. “It took four years.”