Condition-specific assessments - where clinically indicated
NorMed · Home Visiting Service
Your housebound and care home patients reviewed — without adding to your workload. Fully Managed QOF Annual Review Service
GP practices lose QOF income and LCS payments every year because housebound and care home patients can't get to the surgery. NorMed handles the whole thing — cohort planning, visits, documentation, and coding — so your team doesn't have to.
Get started — book a 15-minute callWho this is for
Two patient groups. One managed service.
Housebound Patients
Patients unable to attend the surgery due to physical or cognitive conditions who still require structured annual LTC reviews — including those with diabetes, frailty, heart failure, COPD, and complex multimorbidity.
Care Home Residents
Residents of CQC-registered nursing and residential homes who require planned QOF and Long Term Condition (LTC) reviews. This service supports delivery alongside the PCN DES for Care Homes and complements LCS obligations.
Scope of service
What this service is — and isn't
✔ What We Deliver
- Fully managed end-to-end: cohort planning, booking, scheduling, clinical delivery, and documentation
- Delivered against an agreed cohort list and schedule
- Clinical oversight built in throughout
- Vaccinations delivered at home — flu, pneumococcal, shingles, RSV, and others (excluding COVID-19)
- A support service to your existing clinical structure
✗ What We Are Not
- Not an acute or urgent visiting service
- Not a same-day response model
- Not a replacement for the GP
- Not a reactive service — everything is pre-planned and agreed in advance
Clinical scope
What we deliver during each visit
Every visit is structured around the patient's registered conditions and agreed cohort requirements. The clinical elements below are drawn from QOF indicators, PCN DES obligations, and local incentive schemes — ensuring every visit supports both clinical quality and practice income.
| Element | Detail |
|---|---|
| Core LTC Review — delivered on every visit | |
| Template completion | Completed for all registered long-term conditions using practice templates and agreed coding. Supports QOF indicator achievement and local incentive scheme reporting. |
| Observations | Blood pressure, pulse, BMI, weight, oxygen saturation, and temperature. Lying/standing BP recorded where falls risk or postural hypotension is indicated. |
| Phlebotomy | Blood draw for HbA1c, lipids, renal function, thyroid, FBC, and other agreed panels — performed at the visit to avoid a separate appointment. |
| Care plan review | Review and update of goals, actions, and safety netting. Universal Care Plan updated where required. Supports PCN DES Care Homes framework. |
| Lifestyle & education | Diet, physical activity, alcohol, and smoking advice aligned to the patient's conditions. Nutritional assessment included where appropriate. |
| Condition-specific assessments — where clinically indicated | |
| Cognitive screening | Memory and cognitive assessment using a validated tool (e.g. 6-CIT) where the patient is on the dementia register or where new concerns are noted. |
| Mental health screening | PHQ-9 (depression) and GAD-7 (anxiety) screening where indicated — particularly relevant for care home residents and housebound patients. |
| Falls risk & bone health | Falls risk screening (including lying/standing BP and basic mobility observation) and osteoporosis risk identification. |
| Wound & foot assessment | Diabetic foot check (QOF requirement) and wound assessment where appropriate. |
| ECG / pulse check | Pulse rate and regularity recorded as standard. Portable ECG available where required — supporting AF detection, heart failure monitoring, and anticoagulation management. |
| Medication recording | Current medicines captured and passed to the practice pharmacist to review, supporting medication safety in complex multimorbidity patients. |
| Vaccination service — available as a standalone or package visit | |
| Vaccinations | Any clinically due vaccination delivered at home — flu, pneumococcal, shingles (Shingrix), RSV, and others as nationally or locally recommended. Can be incorporated into the Enhanced package's third visit at no extra cost, or commissioned as standalone visits. |
Delivery model
How it works
Care Navigator
Coordinates and books patients, ensures templates are ready, manages the schedule, and keeps the pathway on track — so your team doesn't have to.
Visiting Clinician
GP Assistant or HCA attends the patient, completing reviews, phlebotomy, education, and care plan updates within the agreed visit structure.
Paramedic Oversight
A paramedic reviews cases and provides clinical governance and oversight — ensuring high-quality, safe, and consistent service delivery across all visits.
Pricing
Service packages
Both packages operate on a per-patient, per-year basis, billed monthly. Visits include travel. Consumable items are provided by the practice.
Standard QOF Review
Designed for patients where two touchpoints are sufficient to complete the annual review and follow-up actions.
Visit 1: Annual QOF review (60 min)
Visit 2: 6-month review / follow-up (45 min)
Enhanced QOF Review
Designed for patients with diabetes, frailty, complex multimorbidity, or care home residents with multiple review domains.
Visit 1: Annual review (60 min)
Visit 2: 6-month review / follow-up (45 min)
Visit 3: Vaccination or outstanding review elements (45 min)
Additional Visits
Sometimes a patient needs more than their package allows — whether that's a vaccination that falls outside the review cycle, an outstanding clinical element, or an extra planned touchpoint. Speak to us and we'll agree the right approach.
The financial case
Is this cost-effective? The case in numbers.
The question most practice managers ask is straightforward: does the cost justify the return? When you view QOF income, local incentive scheme payments, and avoided internal costs together, the answer is clearly yes.
Care Home Patients
| Income stream | Residential | Nursing |
|---|---|---|
| Global sum (weighted capitation) | £123–£250 | £123–£250 |
| PCN Care Home Premium (DES) | £144 | £144 |
| Local Incentive Scheme (LCS) | £120 | £220 |
| QOF indicators completed (est. 3) | £200–£400 | £200–£400 |
| Total income / patient | £614–£914 | £714–£1,014 |
| NorMed Enhanced package | £150 | £150 |
| Practice surplus (Enhanced) | £464–£764 | £564–£864 |
Housebound Patients
| Income stream | Est. value |
|---|---|
| Global sum (weighted capitation) | £150–£250+ |
| PCN Care Home Premium (DES) | Not applicable |
| Local Incentive Scheme (LCS) | £0–£100 |
| QOF indicators completed (est.) | £200–£400 |
| Total income / patient | £350–£750 |
| NorMed Enhanced package | £150 |
| Practice surplus (Enhanced) | £200–£600 |
*Before considering the avoided cost of sending a nurse or in-house AHCP to visit. Local incentive scheme rates vary by ICB.
The bottom line
A practice with 30 nursing home patients on the Enhanced package pays NorMed £375 per month — £4,500 per year.
Those same 30 patients generate an estimated £25,920 in combined annual income through the Global Sum, PCN Care Home Premium, local incentive scheme payments, and QOF — a net surplus to the practice of over £21,000.
That income is already flowing. NorMed simply ensures the clinical activity happens that unlocks it.
Why practices use this
Five reasons practices commission this service
Improves QOF completion rates
Systematic, scheduled visits ensure housebound and care home patients are not overlooked in annual review cycles.
Reduces admin and coordination burden
NorMed handles cohort planning, scheduling, and pathway management — freeing your team for in-surgery demand.
Structured, repeatable pathway
A consistent process ensures patients do not fall through the gaps and reviews are delivered within appropriate timeframes.
Built-in clinical oversight
Paramedic-level governance across all visits provides assurance and accountability without additional management overhead on your side.
Supports LCS compliance and QOF payment
Structured documentation and coding aligned to practice templates supports QOF coding requirements and LCS reporting obligations.
Predictable monthly cost
Monthly subscription billing (patients × rate ÷ 12) means no end-of-year surprises — easy to budget and audit.
Ready to get started?
We can map your cohort and agree a package in a 15-minute call.
Or email us at medical@normed.co.uk
