Improved Access Practice Handbook...Add a patient task 1. Access Tasks. Click , point to Workflow,...

Version v0.9 @ 17 Dec 2018

Improved Access

Practice Handbook

December 2018

Version v0.9 @ 17 Dec 2018 of 26

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



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.



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

[email protected]

01285 653122 or

01285 652944

GDOC Contact details for

technical issues

GDoc Admin Team [email protected]

01452 389300

GDOC Contact details for all other queries

Karen Pitney Business Development Manager

[email protected]

01452 389307

mailto:[email protected]




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 [email protected]

Anita Logan [email protected] Bypass Tel No: 01285 658516

SystmOne

Hilary Cottage Surgery Keble Lawns Fairford GL7 4BQ 01285 712377

Dr Graham Wallis [email protected]

Diane Piatek [email protected] Bypass Tel No: 01285 715322

SystmOne

Phoenix Surgery - Cirencester 9 Chesterton Lane Cirencester GL7 1XG 01285 652056

Dr Rohit Sethi [email protected]

Julia Maclean [email protected] Bypass Tel No: 01285 646562

EmisWeb

Rendcomb Surgery Rendcomb Cirencester GL7 7EY 01285 831257

Dr Ian Davis [email protected]

Kate Jacques [email protected] Bypass Tel No: 01285 832142

EmisWeb

Phoenix Surgery - Tetbury 41-43 Long Street Tetbury GL8 8AA 01666 502303

Dr Angus McMyn [email protected]

Emma Vynne [email protected] Bypass Tel No: 01666 504814

EmisWeb












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 [email protected]

Sue Dunham [email protected] 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 [email protected]

Richard Marshall [email protected] 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







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


On Arrival – Receptionist Information


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


On Arrival – Doctor Information


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



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



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 [email protected]

Hilary Cottage Surgery [email protected]

Phoenix Surgery - Cirencester [email protected]

Rendcomb Surgery [email protected]

Phoenix Surgery - Tetbury [email protected]

Cirencester Health Group - SPRS [email protected]

Upper Thames Medical Group (The Park) [email protected]

Upper Thames Medical Group (Lechlade) [email protected]










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.


4. Select the patient’s registered GP surgery, staff member and usual GP.


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



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.



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.



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


ENT


Urgent ENT assessment on ward via ENT SHO Bleep 2069

Gastroenterology


Consultant Advice Line 8.30am-5pm: 0300 422 6896. >5pm via Switchboard

Gynaecology


Gynae Consultant Bleep 2225

Gynae Reg Bleep 5524


Haematology


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 [email protected]

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


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



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)


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



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: [email protected]

Tel. 01285 653122

For GDOC member of staff:

Contact: Karen Pitney

Business Development Manager

[email protected]

Tel. 01452 389307





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



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



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.



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 [email protected] 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.




SECTION 5 Technical Information:

See appendix 1 and appendix 2

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