Post on 13-May-2020
Version v0.9 @ 17 Dec 2018
Improved Access
Practice Handbook
December 2018
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South Cotswold GP Surgeries Improved Access
Contents:
Contents Page No.
SECTION 1 – About this Service
A Quick Guide 3
Useful Contacts - technical 4
Useful Contacts – surgeries and hubs 5
Useful Contacts – commonly used numbers 7
On Arrival – receptionist Information 8
On Arrival – doctor information 9
Prescribing/Dispensing Patient code information 10
Requesting Action to be taken after you have seen a patient. (Tasking) 11
Standard Operating Procedure – TPP SystmOne 12
Standard Operating Procedure – EMIS Tasks 14
Referrals, imaging and blood tests 15
Chaperoning 16
SECTION 2 – Contact Information
Referral Support Options 17
Complaints 21
SECTION 3 – Internal Practice Information
Receptionist Appointment Booking Procedure 22
SECTION 4 – Governance
CQC Statement of Purpose 23
Confidentiality 23
Information Sharing Agreement 23
Financial Pathway 24
Business Continuity Plan 25
SECTION 5 – Technical Information
EMIS guides Appendix 1
SystmOne guides Appendix 2
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South Cotswold GP Surgeries Improved Access
SECTION 1 – About this service – a quick overview
This is the South Cotswolds Improved Access Service. Clinics are run Monday through to
Saturday morning and are based at various locations around the locality.
As part of this service you will see only patients who are registered at the following
Practices:
o Cirencester Health Group (formerly Avenue and St Peter’s Road Surgeries)
o Hilary Cottage Surgery Fairford
o Phoenix Surgery (Cirencester and Tetbury – formerly Romney House Surgery)
o Rendcomb Surgery
o Upper Thames Medical Group (formerly Park and Lechlade Surgeries)
You will have full read/write access to medical records and will view this via both
SystmOne and EMIS.
You will log into a single SystmOne Hub for all SystmOne practices and directly into each
of the EMIS practices systems. System access will be on the basis of:
Access SystmOne
Log in with smartcard
From Remote Booking clinic list access patient’s notes and proceed with
consultation.
To Access EmisWeb
Log in with username, password and SURGERY SPECIFIC CODE (to be supplied)
When smartcard login is available this will supersede.
Patients registered at EMIS practices will have the word EMIS and the name of their surgery
written in the appointment book so you know which EMIS system to access.
All patients will be pre-booked by their surgery – there will be no walk in or NHS111
booked patients into any of the South Cotswold IA clinics.
You will not be able to directly request any investigations or directly refer patients as a
result of these consultations. You should:
o Write referral information in the patient record and use ‘Tasking Instructions’ in
Section X to let the patients practice know the referral needs to be sent
o Write investigations required, and why, in the patient record and use ‘Tasking
instructions’ in Section X to let the patient’s own practice know the investigation
needs to be arranged.
o In all instances where a follow up action is required patients should be advised to
contact their own surgery to ensure arrangements have been made.
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South Cotswold GP Surgeries Improved Access
Useful Contact Information: Clinical systems and technical
help
Clinical Systems Helplines
EmisWeb for:
Phoenix Surgery Cirencester
Phoenix Surgery Tetbury
(formerly Romney House)
Rendcomb Surgery
0330 024 1270
TPP/SystmOne for:
Hilary Cottage Surgery
St Peter’s Road Surgery
The Avenue Surgery
Upper Thames Medical Group
(aka The Park Surgery and
Lechlade Medical Centre)
0113 205 0095
To Add New Staff to Clinical
system and any Login issues
or password resets
Work Group Co-ordinator:
The Avenue Surgery
1 The Avenue
Cirencester
GL7 1EH
anitalogan@nhs.net
01285 653122 or
01285 652944
GDOC Contact details for
technical issues
GDoc Admin Team GDoc@nhs.net
01452 389300
GDOC Contact details for all other queries
Karen Pitney Business Development Manager
Karen.pitney@nhs.net
01452 389307
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Useful Contact Information (confidential) - Surgery and Hub:
Surgery Address GP Practice Lead Practice Manager IT System
Cirencester Health Group (Avenue Surgery) 1 The Avenue Cirencester GL7 1EH 01285 653122 01285 652944
Dr Anna Keitley annakeitley@nhs.net
Anita Logan anitalogan@nhs.net Bypass Tel No: 01285 658516
SystmOne
Hilary Cottage Surgery Keble Lawns Fairford GL7 4BQ 01285 712377
Dr Graham Wallis graham.wallis4@nhs.net
Diane Piatek dianepiatek@nhs.net Bypass Tel No: 01285 715322
SystmOne
Phoenix Surgery - Cirencester 9 Chesterton Lane Cirencester GL7 1XG 01285 652056
Dr Rohit Sethi rohitsethi@nhs.net
Julia Maclean juliamaclean@nhs.net Bypass Tel No: 01285 646562
EmisWeb
Rendcomb Surgery Rendcomb Cirencester GL7 7EY 01285 831257
Dr Ian Davis ian.davis10@nhs.net
Kate Jacques kate.jacques@nhs.net Bypass Tel No: 01285 832142
EmisWeb
Phoenix Surgery - Tetbury 41-43 Long Street Tetbury GL8 8AA 01666 502303
Dr Angus McMyn angus.mcmyn@nhs.net
Emma Vynne emma.vynne@nhs.net Bypass Tel No: 01666 504814
EmisWeb
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Surgery Address GP Practice Lead Practice Manager IT System
Cirencester Health Group (St Peter’s Road) 1 St Peter’s Road Cirencester GL7 1RF 01285 653184
Dr Martyn Hewett martyn.hewett1@nhs.net
Sue Dunham sue.dunham@nhs.net Bypass Tel No: 01285 643650
SystmOne
Upper Thames Medical Group The Park Surgery Old Tetbury Road Cirencester GL7 1US 01285 654733 and Oak Street Lechlade GL7 3RY
Dr Julian Tallon julian.tallon@nhs.net
Richard Marshall richard.marshall6@nhs.net Bypass Tel No: 01285 652553 Bypass Tel No: 01367 252511
SystmOne
Cirencester Hospital Tetbury Road Cirencester GL7 1UY 0300 421 6200
n/a
n/a
Both available on PC
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Useful Contact Information - Commonly Used Contact Numbers
Cirencester Hospital Switchboard: 0300 422 2222
Single Point of Clinical Access: 0300 421 0300
• To access Rapid Response
• Community IV Therapy Team
• Referring patients into hospital (not children)
• Ambulatory Emergency Care Service – inclusion criteria document
Adult Social Services Helpdesk 01452 426868 for public and professionals
Acute Medicine Advice Line 10-4pm 07788 565362
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On Arrival – Receptionist Information
South Cotswold GP Surgeries Improved Access
Receptionist Check-in Procedure:
Patient attends Surgery/Cirencester Hospital for pre-
booked Improved Access appointment
Receptionist: Remind patient that GP / Practice Nurse (if
Saturday morning) will need consent for full access to their
patient record
Receptionist: Completes patient booking
CONSENT GIVEN
Receptionist: Inform patient that the GP / Practice Nurse will be
unable to see them and advise to contact their registered Surgery
CONSENT NOT GIVEN
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On Arrival – Doctor Information
South Cotswold GP Surgeries Improved Access
GP (Monday to Saturday) or Practice Nurse (Saturday morning):
Clinicians will log into Emis and then SystmOne at the beginning of the shift using
practice Emis password and South Cots Cluster SystmOne. You will have full read-
write access to patient’s medical records.
All Emis patient’s consultations will be recorded on the relevant Emis system, the
appointment book is on SystmOne and will tell you which Emis practice the patient is
from.
You will need to log into EMIS with the passwords first, then sync this to your
SmartCard.
Please check your smartcard to ensure you have access to South Cots SystmOne
Module.
GP or Practice Nurse (Saturday morning) will need to collect
patient from waiting room (call systems will not be available)
SystmOne SurgeriesEnsure correct patient
selectedFree text patient name
Date of birthConsent given
Initials of staff memberName of booking Surgery
in appointment book
EmisWeb SurgeriesEnsure correct patient
selectedFree text patient name
Date of birthConsent given
Practice Nurses: There is an Agreement in place that Nurses working at Phoenix Surgery Saturday morning can seek advice from the Improved Access GP as and
when required
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South Cotswold GP Surgeries Improved Access
Dispensing Patients:
EmisWeb Prescriptions
Phoenix Surgery and Rendcomb Surgery
Clinician will have full access to patient record and therefore can use patient’s registered
practice prescription code.
SystmOne Prescriptions
All Other Practices
South Cots Prescribing Code to be used for Improved Access appointment prescriptions
ONLY during:
6.30 to 8.00 pm Monday to Thursday
2.00 to 8.00 pm Friday
8.30 to 12.30 pm Saturday morning
Code: 680148
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South Cotswold GP Surgeries Improved Access
Requesting Action to be taken after you have seen a patient.
If, as a result of your consultation, you require a patient to have any form of follow up
(referral, imaging, blood tests etc. – see below Referrals, Imaging and blood tests for more
specific details on each) you will need to:
1. make a note of the action, including typed referral letter details and reason for
investigations, into the patients record,
2. ask the patient to contact their own surgery to follow up
3. send an ‘electronic’ message back to the patient’s own practice so they are aware of
what is needed.
The next few pagers hold the agreed Standard Operating Procedures for how you send task
requests back to surgeries.
PLEASE BE AWARE – UNTIL FURTHER NOTICE PLEASE ENSURE THAT IN ADDITION TO THE
ABOVE AN E-MAIL MUST BE SENT TO THE PATIENTS REGISTERED SURGERY INFORMING
THEM OF THE NEED TO VIEW THE PATIENTS NOTES TO ACCESS A FOLLOW UP TASK AS A
RESULT OF YOUR CONSULTATION.
E-MAIL ADDRESSES TO BE USED ARE:
Surgery Generic E-mail Address to use
Cirencester Health Group - Avenue Site Cirencester.healthgroup@nhs.net
Hilary Cottage Surgery Hilarycottage.secretary@nhs.net
Phoenix Surgery - Cirencester GLCCG.phoenixsecretaries@nhs.net
Rendcomb Surgery GLCCG.TheRendcombSurgery@nhs.net
Phoenix Surgery - Tetbury phoenixtetbury.secretaries@nhs.net
Cirencester Health Group - SPRS Cirencester.healthgroup@nhs.net
Upper Thames Medical Group (The Park) theparksurg.admin@nhs.net
Upper Thames Medical Group (Lechlade) correspondence.lechlade@nhs.net
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Standard Operating Procedure – TPP SystmOne
This SOP is intended for Clinicians using TPP SystmOne Hubs and is guidance on
how to send tasks to the patients registered Practice safely.
USING SYSTM ONE TO SEND TASKS TO REGISTERED SURGERY WHEN RECORD IS SHARED.
WARNING – Always ask patient to contact surgery in case message goes missing.
If the task is urgent please e-mail the patient’s registered practice on the account provided (If you
do not have an NHS Mail account ask the receptionist to do this for you).
1. Open the Clinical Resources Template
2. Select the ‘Task Patient’s usual GP’ button at the bottom of the page.
3. Amend the pre-populated text.
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4. Select the patient’s registered GP surgery, staff member and usual GP.
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Standard Operating Procedure – EMIS Tasks
This SOP is intended for Clinicians using EMIS and is guidance on how to send tasks to the
patients registered Practice safely.
Add a patient task 1. Access Tasks.
Click , point to Workflow, select Workflow Manager, and then click Tasks in the
navigation pane.
2. On the ribbon, click Add Task.
3. Beside the Task Type field on the Task Details screen, click and select the
required task type. The list displayed depends on which task types are configured as
available. 4. Beside the Patient field, do one of the following:
● Click and select the current patient’s name.
● Click , and then use the Patient Find screen to find and select the required patient.
5. In the Due Date field, type the date by which the task is to be actioned, or click and then select the required date. The default is today’s date.
6. Beside the To field, click , and then use the Find Teams or Users screen to select
the required recipient. If you have configured a default recipient for the selected task
type, that recipient is displayed in the To field. However, you can change the recipient,
if required.
7. If required, and if you are sending the task to more than one recipient, select All
Recipients to Action Task. If you select this option, a separate task is sent to each
selected recipient, and they must all action the task.
8. In the Notes field, type details of the action required.
The maximum number of characters you can type in this field is 8000. A
counter at the bottom of the screen indicates the number of characters you have
used.
9. If required,
select Urgent.
10. Click Send. The task is sent to each selected recipient and displayed in their To-Do List. A separate task for each recipient is displayed in your Sent Tasks list. A red arrow tasks, is displayed beside high priority and they are displayed at the top of the list Surgery Recipient group names for South Cotswold EMIS practices
Phoenix Cirencester Reception
Phoenix Tetbury Reception
Rendcomb Doctors
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South Cotswold GP Surgeries Improved Access
Referrals, Imaging and Blood Tests:
Due to current ICE operability issues, please issue old-style paper blood forms to the patient
and ask their registered practice via Task (see prev page) to carry out any imaging and
referrals deemed necessary during the Improved Access appointment.
If Improved Access is to work we will need to carry out the requests for each other, and
trust that when we have told a patient that a certain referral or request will be made, that it
will be done. These requests to the patients’ registered practice are likely to be infrequent.
Blood Tests
Complete form with patient with registered practice details
Hand to patient
Please include:
- NHS number
- Date of Birth
- Name and patient’s address
- along with Registered GP practice details (pg 15-16)
Referral
Write the body of the referral letter within the consultation and to whom the referral
should be sent
Send a clinical system TASK (see pg8 for details) to the patients’ registered practice GP
informing them of the action required.
The patient’s registered practice GP will then action as usual within their practice.
Imaging/tests
Write the test etc. required in body of the referral letter and the reason why.
Send a clinical system TASK (see pg8 for details) to the patients’ registered practice GP
informing them of the action required.
The patient’s registered practice GP will then action as usual within their practice.
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South Cotswold GP Surgeries Improved Access
Chaperoning
Unless additional staff are available chaperoning is not available within these clinics.
Chaperoning can only be arranged where there are, trained, staff available in addition to
those manning reception.
In an urgent situation and where clinically indicated patients requiring chaperoning should
be re-directed to MIU or A&E. In a routine situation patients should be referred back to
their own practice.
Patients who have requested chaperoning should not be seen if this decision is reversed
when informed that the service is not available in these clinics. These patients should be
diverted as outlined above.
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SECTION 2 - Other important IA information:
Referral Support Options
Please be aware information regarding services should be obtained
directly from G-Care – a link for which will be on the screen of the
computer you are using. The information below was accurate in
April 2018 and should only be used where access to G-Care is not
possible.
Where possible all contact information etc. should be obtained directly from G-Care – a link
to which should be on your desktop. Where this is not possible the information below
should help and is up to date as of April 2018.
By Speciality in Alphabetical Order
Care of the Elderly
Consultant Advice Line for pts >75yrs old. 07584 202090
8.00 am-4.00 pm Monday to Friday
Dermatology
Email Advice & Guidance
Diabetes and Endocrinology
Email Advice & Guidance
ENT
Email Advice & Guidance
Urgent ENT assessment on ward via ENT SHO Bleep 2069
Gastroenterology
Email Advice & Guidance
Consultant Advice Line 8.30am-5pm: 0300 422 6896. >5pm via Switchboard
Gynaecology
Email Advice & Guidance
Gynae Consultant Bleep 2225
Gynae Reg Bleep 5524
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Haematology
Email Advice & Guidance
Consultant Haematologist Hot Advice 3.00 -5.00 pm number:
07766 424282
Maternity
Maternity Triage 0300 422 5541
Hyperemesis Gravidarum day case treatment on Ward 9A GRH via Gynae Reg bleep
Early Pregnancy Assessment Unit: Cheltenham and Gloucester 0300 422 5549
Memory
Managing Memory – including community nurse 0800 694 8800
Mental Health
GP Access to Recovery based consultant for medication and prescribing advice:
Telephone 0800 015 1499
Fax 01452 894418
Email 2gnft.fpccadmin@nhs.net
Mental Health Acute Response Service (Crisis Team) OOH number 0800 169 0398
Let’s Talk NHS Gloucestershire Talking Therapy self-referral: 0800 073 2200
CYPS Practitioner Advice Line: 01452 894 272
Teens in Crisis: 01594 372777
For Face to Face and online counselling for Gloucestershire patients between 9-21 years of
age:
Cruse Counselling: 01242 252518
Drugs and Alcohol service – CGL 01452 223014
Neurology
Email Advice & Guidance
Oncology
Oncology Hotline: 0300 422 3444
Ophthalmology
Eye Casualty Line for Emergency GP referrals: 0300 422 3578
Orthopaedics
Fracture clinic referral: Fax 0300 422 5270
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Children’s Physio self-referral 0300 421 6980
Paediatrics
Advice & Guidance
Paediatric ‘next day’ appointment clinic booking number 0300 422 8305
Battledown CGH for Paeds bloods – booking number 0300 422 4462
Children’s Physio self-referral 0300 421 6980
Pain Management
Advice & Guidance
Palliative Care
Community Palliative Care Team 0300 422 5370
Sue Ryder number for medical advice 01242 230199
Renal
Advice & Guidance
Respiratory
Consultant Advice Line 8.30 – 5.00 pm and OOH, via Switchboard
Rheumatology
Advice & Guidance
Sexual Health
Telephone triage system for patients – self referral 0300 421 6500
Urology
Advice & Guidance
District Nurses
District Nurse Cotswold Referral Centre 01285 881080
District Nurse OOH 0300 4210555
Social Services
Cirencester for Social Services, Physio, Occupational Therapy
01285 881080
Children’s Practitioner Advice Line 01452 426565 (option 1)
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Two Week Wait Pathways
Two week wait referral forms should be downloaded from G-Care. Access
to which should be directly available from the screen on the PC you are
using.
Consultant Advice Lines
• Acute Medicine Advice Line 10.00 am-4.00 pm: 07788 565362
• Cardiology: in hours and after 5pm is via Switchboard
• Respiratory: 8.30am-5.00 pm and out of hours via Switchboard
• Gastroenterology: 08.30am-5.00 pm 0300 422 6896, out of hours via Switchboard
Community Hospitals, Out of County Hospitals and Private Hospitals
• BMI The Ridgeway, Marlborough 01793 814848
• Cirencester Hospital 0300 421 6803
• North Cotswold Hospital, Moreton in Marsh 0300 421 8770
• Nuffield Private Hospital Cheltenham 01242 246500
• Winfield Hospital Gloucester 01452 331111
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South Cotswold GP Surgeries Improved Access
Complaints:
Patients wishing to complain should be directed to raise their concerns directly with the
Practice Manager of their registered GP practice.
Staff working as part of the Improved Access Clinics should follow their existing Complaints
procedure and/or Significant Event procedure as appropriate.
If the complaint cannot be resolved, this should be escalated to the Improved Access GP
Provider Lead: Dr Anna Keitley
Contact: annakeitley@nhs.net
Tel. 01285 653122
For GDOC member of staff:
Contact: Karen Pitney
Business Development Manager
Karen.pitney@nhs.net
Tel. 01452 389307
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SECTION 3 Receptionist Appointment Booking Procedures:
Patient telephones or visits Surgery
Patient requests GP Appointment
Appointment available at time/date suitable for
patient with GP at patient’s registered
Surgery
YES
Book appointment at patient’s registered
Surgery
NOInform patient of Surgery/
Cirencester Hospital address
Patient accepts appointment at other Surgery/Cirencester
Hospital
Inform patient that the GP will need their consent to
access their medical records
CONSENT GIVEN
Find alternative appointment with
patient’s registered Surgery
Receptionist: “I can offer you an Improved Access appointment at one of our Cluster Surgeries with a GP. This is a new service
for all patients registered in South
Cotswold”.
CONSENT NOT GIVEN
Take patient details: Name and DoB
SystmOne SurgeriesBook patient into Hub
Clinic of choice
EmisWeb SurgeriesMake textual booking in
Hub Clinic of choice (include name of patient’s
registered surgery)
Book appointment and inform patient of
Surgery/Hospital address
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SECTION 4 Governance:
CQC Statement of Purpose:
As a member Practice of South Cotswold Cluster we also participate in the provision of
Improved Access appointments via a shared rota. This gives patients an opportunity to book
an appointment with General Practice each weekday Monday to Thursday 18.30 - 20.00 hrs,
Saturday mornings from 08.30 – 12.30 hrs and at Cirencester Hospital from 14.00 to 20.00
hrs each Friday.
Records are shared across the practices with adherence to strict IT Governance and
Confidentiality rules and a signed Information Sharing Agreement has been signed and
approved by each practice Named Improved Access Lead and approved by each practice
Caldicott Guardian.
The South Cotswold Locality consists of 7 GP practices:
Avenue Surgery (The)
Hilary Cottage Surgery
Phoenix Surgery
Rendcomb Surgery
Romney House Surgery
St Peter’s Road Surgery
Upper Thames Medical Group (aka The Park Surgery and Lechlade Medical Centre)
Patients from cluster practices are managed under our current registered Regulated
Activities and consulting GP responsibility agreement.
Confidentiality
Practices will adhere to their own Practice Confidentiality Policy and Agreement. All aspects
of this agreement will also apply to patients registered with other practices who may attend
the Surgery.
Information Sharing Agreement
Signed by all South Cotswold practices and GDOC.
Copy of South Cots signed ISA.pdf
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Financial Pathway:
Expected income for each quarter calculated by GDOC and agreed with Cluster IA Finance Lead
GDOC calculates monthly practice payments based on planned rota and agrees sign-off with
Cluster IA Finance Lead
Cluster IA Finance Lead requests via Senior Management Accountant for CCG to transfer
amount to GDOC
Practices paid via GDOC along with email statement
Invoice raised by GDOC and authorised by Cluster IA Finance
Lead to enable funds to be transferred to GDOC Business
Account
Cluster 5% Contingency is retained by CCG
(for unplanned costs)
Practice makes ALL payments to Individual staff member or into
practice account
Based on actual monthly plan
Variances to Cluster Plan Within month/following month
A single adjustment for the month received by or on the last day of the
month will be processed with the month’s payments. An adjustment
received after the end of the month incurred will be adjusted in the
following month.
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Business Continuity Plan
Electricity Power Failure
In the event of an electricity power failure at a practice or Cirencester Hospital that is
providing Improved Access sessions, the following actions should be taken:
The Receptionist/Administrator should contact the local Electricity Board to obtain
information on the likely duration of the power cut and an estimated time for the
power to resume. Should the duration of the power failure to be estimated as less
than 30 minutes, then patients arriving should be given the choice as to wait or to
re-book their appointment for the following day.
If the duration of the power failure is estimated to last for over 30 minutes, then
those patients arriving should be advised to re-book their appointment the following
day, unless it is an emergency.
If GPs see emergency patients then a manual record should be made of the clinical
consultation and forwarded to the patient’s registered surgery (via Task) once power
has resumed.
GP or Administrator Unable to Attend Improved Access Session
Monday to Thursday Clinics
The Practice are responsible for providing a GP and receptionist and should have plans in
place to provide cover in case of sickness or similar occurrence.
Friday to Sunday Clinics
GDOC are responsible for providing a GP and reception cover in collaboration with the
Phoenix Surgery and should have contingency plans as above.
If for an unavoidable reason (due to unforeseen circumstances) a session is unable to go
ahead as planned then, please inform Kate Jacques, South Cotswold Improved Access
Finance Lead at kate.jacques@nhs.net as soon as possible to ensure the appropriate
financial adjustments can be made.
Any Problems NOT listed Above
For any other incidences that may occur, the Practice GP or GDOC GP/Receptionist should
refer to their Practice or Cirencester Hospital Business Continuity Plan.
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SECTION 5 Technical Information:
See appendix 1 and appendix 2