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On Call Pack

of 90

Contents

On Call Managers Numbers........................................................................................................................... 5

Disaster Recovery Plans:............................................................................................................................... 5

Disaster Recovery Process – Fire at Moorgate Primary Care Centre, Bury...................................................6

Disaster Recovery Process – Fire at Rochdale Urgent Care Centre (RUCC)......................................................6

Disaster Recovery Process – Fire at Bolton WMHC.........................................................................................7

Disaster Recovery Process – Fire at Bolton, A&E............................................................................................9

Building Evacuation Procedure - Bury.......................................................................................................... 10

Building Evacuation Procedure - Rochdale...................................................................................................11

Building Evacuation Procedure - Heywood..................................................................................................12

Building Evacuation Procedure – Bolton WMHC..........................................................................................13

Building Evacuation Procedure – Bolton A&E...............................................................................................14

Building Evacuation Procedure – Prestwich Walk in Centre..........................................................................15

Disaster Recovery Process – Loss of Power at Bury......................................................................................16

Disaster Recovery Process – Loss of power at Rochdale...............................................................................17

Disaster Recovery Process – Loss of power at Heywood..............................................................................18

Disaster Recovery Process – Loss of power at Bolton WMHC.......................................................................19

Disaster Recovery Process – Loss of power at Bolton A&E...........................................................................20

Disaster Recovery Process – Loss of power at Prestwich Walk in Centre......................................................21

Disaster Recovery Process – Telephones go down.......................................................................................22Activating the telephony disaster recovery divert..........................................................................................................................................22

Disaster Recovery Process – Telephones go down at Rochdale.................................................................24

Disaster Recovery Process – Telephones go down at Heywood.................................................................25

Disaster Recovery Process - PCD – Telephones go down...........................................................................26

Disaster Recovery Process – Telephones go down at Bolton A&E..............................................................27

Disaster Recovery Process – Telephones go down at Prestwich Walk in Centre.........................................28

Disaster Recovery Process – Adastra goes down at all sites......................................................................29

Disaster Recovery Process – Adastra goes down at Bury...........................................................................30

Disaster Recovery Process – Adastra goes down at Rochdale UCC.............................................................31

Disaster Recovery Process – Adastra goes down at Heywood...................................................................32

Disaster Recovery Process – Adastra goes down at Bolton........................................................................33

Disaster Recovery Process – Adastra goes down at Bolton A&E................................................................34

Disaster Recovery Process – Vehicle Breakdown.......................................................................................35

Escalation Plan............................................................................................................................................ 36Escalation Levels..............................................................................................................................................................................................36

Operational Cover:................................................................................................................................... 36Contact Centre Agent or Driver.......................................................................................................................................................................36Telephone Triage Nurse..................................................................................................................................................................................37General Practitioners.......................................................................................................................................................................................37

2

Volume Increase..............................................................................................................................................................................................37

Clinical Space........................................................................................................................................... 37Consulting Rooms............................................................................................................................................................................................37Cars..................................................................................................................................................................................................................37Home Working.................................................................................................................................................................................................38

Clinical Commissioning Group – Contact Information...............................................................................38

Service Continuity Plan............................................................................................................................... 39

Key Service Providers Contacts.................................................................................................................... 39

Adastra - How To Add New Users or Providers To Adastra – Procedure.......................................................41

Introduction............................................................................................................................................. 41

Terminology............................................................................................................................................ 41

Screens.................................................................................................................................................... 42

Possible User or Provider Permutations...................................................................................................42

Information Required to Create a User or Provider Account.....................................................................42

Checks To Perform Before Creating a New User or Provider......................................................................43

How to Add a Non-Clinician working for BARDOC.....................................................................................44

How to Add a Clinician Working For BARDOC...........................................................................................47‘Case Sensitive’ Patient Information...............................................................................................................................................................50

Child Safeguarding Procedure..................................................................................................................... 53

Closing DNA cases for Treatment Centres....................................................................................................54

-.................................................................................................................................................................. 55

Controlled Drugs Procedure Flowchart........................................................................................................ 55

................................................................................................................................................................... 55

Failed Contact Configuration Process.......................................................................................................... 56

Failed Contact- Clinicians......................................................................................................................... 56

Failed Contact- Despatcher...................................................................................................................... 58

Options available..................................................................................................................................... 58

Dispatcher Screen Changes...................................................................................................................... 59

Special & Cautionary Notes Procedure........................................................................................................ 59

MOORGATE PRIMARY CARE CENTRE........................................................................................................... 62

FIRE SAFETY EVACUATION STRATEGY & PROCEDURES.................................................................................62

1. Purpose............................................................................................................................................... 62

2. RESPONSIBILITIES................................................................................................................................. 62

3. TENANTS & PARTNER ORGANISATIONS................................................................................................63

4. STAFF WITH SPECIFIC DUTIES................................................................................................................ 63

5. THE FIRE ALARM SYSTEM..................................................................................................................... 64

6. STAFF FIRE ROUTINE............................................................................................................................ 66

7. EVACUATION PROCEDURE.................................................................................................................... 66

8. FIRE FIGHTING EQUIPMENT.................................................................................................................. 67

9. EVACUATION CHAIR INFORMATION.................................................................................................67

3

RESTOCKING DRUGS OVER THE WEEKEND................................................................................................68

Safeguarding Minors Procedure – For Call Handlers..................................................................................69

Safeguarding Vulnerable Adults Procedure – For CCA...............................................................................70

Toughbooks (CF19/Bury) - Irretrievable Signal Loss - Computer Shutdown - Procedure.............................71Signal Strength – Aremote Indicator...............................................................................................................................................................71The System Tray and Signal Icon.....................................................................................................................................................................71Loss of Signal Indicator....................................................................................................................................................................................71How to Detect Irretrievable Signal Loss..........................................................................................................................................................72How to Rectify the “Irretrievable Signal Loss” - Reconnect / Get Signal........................................................................................................72

Toughbooks (XFR/Bolton) - Irretrievable Signal Loss - Computer Shutdown - Procedure..............................73Signal Strength – Aremote Indicator...............................................................................................................................................................73The System Tray and Signal Icon.....................................................................................................................................................................73Loss of Signal Indicator....................................................................................................................................................................................73How to Detect Irretrievable Signal Loss..........................................................................................................................................................74How to Rectify the “Irretrievable Signal Loss” - Reconnect / Get Signal........................................................................................................74

New Clinician Process................................................................................................................................. 76

Fast Tracking Calls....................................................................................................................................... 77

History..................................................................................................................................................... 77

Why we need a fast track process............................................................................................................ 77

By Whom................................................................................................................................................. 77

When do we fast track?........................................................................................................................... 77

How?....................................................................................................................................................... 77Examples of calls that cannot be fast tracked include:...................................................................................................................................77

Process for Spillages of blood and body fluids.............................................................................................78

Expected Natural Death – based on history/special notes and/or the information provided by relatives/carers................................................................................................................................ 79

Visiting criteria for -Advanced Nurse Practitioners.......................................................................................80

Procedure for control Drugs in Cars /satellite stations if required................................................................81

Controlled Drug Procedure –Signing out Drugs for Visiting Clinicians...........................................................81

Pharmacy Refrigerator and Safe Storage of Medicines Requiring Refrigeration............................................82Mandatory requirements for GlucaGen..........................................................................................................................................................83

Homeworking - Laptop Guide...................................................................................................................... 83

Cross Boundary Contact Numbers............................................................................................................... 87

4

On Call Managers Numbers

Manager Phone Number

Vicky Riding 07738642077

Clare Toomey 07796400572

Joanne Kennington 07754898715

Dr Chauhan 07729186598

Janet Hall 07464722187

Lyndsay Brennan 07425233064

Rosie O’Connell 07752252199

Sam Turner 07796953810

Rosie Aslam 07834785361

Sue Obertelli 07805388419

5

Disaster Recovery Plans:

Disaster Recovery Process – Fire at Moorgate Primary Care Centre, Bury

The fire alarm sounds at Moorgate Primary Care Centre

All staff and patients are to evacuate the building immediately. Shift Lead / Overnight Supervisors or Overnight Nurse should exit with the following:

1. Cordless Phone and all daisy chain mobile phones2. Fire Register Book (from fire log at main entrance 2nd floor).3. Disaster Recovery Pack4. Emergency Evacuation Kit and Umbrella

Shift Lead / Overnight Supervisor to arrange / delegate:

1. Give the fire brigade the plastic wallet in the evacuation box containing the fire panel key, master key and site plans

2. Head count using staff register (from fire log at main entrance 2nd floor).3. Inform the On Call Manager, satellite centre staff and drivers (if appropriate)4. Manual call handling process using cordless phone for incoming calls and mobiles for outgoing calls

Evacuation Point: Furthest point away from premises in Moorgate Primary Care Centre patient car park

Shift Lead/Overnight Supervisor to establish from fire department ASAP if it is a false alarm or a real fire? Once confirmed:

Q – Is this a real fire which is likely to keep us out of the building for more than 1 hour?Y

NoA serious fire at Moorgate could knock out all of BARDOC’s telecoms. If this happens it should be

reported to Matrix 24/7 08447 707 532 Inform Matrix 24/7 that BARDOC is a PRIORITY EMERGENCY MEDICAL SERVICE.Ring BT on 0800 181 079 to divert our primary ISDN number which is 0161 763 8530, state the number we wish to divert to 07889812439 (first number in daisy chain). Inform BT that BARDOC is a PRIORITY EMERGENCY MEDICAL SERVICE.SITE ASSURANCE OPTION ONE REF: ELSA-UK-MATRIX-MOORGATE RETAIL PARK-BURYNUMBER TO BE DIVERTED ON ACTIVATION: 01617638530 (Note: This number is BARDOC’s ISDN primary number)NUMBER TO BE DIVERTED TO ON ACTIVATION: 07889812439 (Note: This is the first mobile number in the daisy-chain mobiles)PASSWORD: BlackhawkPRODUCT TYPE: ISDN30

Authorised people: if you are asked to ring to divert please give an appropriate name below based on your gender.

Alex Pilkington Lee Hunt Kaye Wheeler John Whittington

Amanda Jones Lesley Garrity Joanne Kennington Andy Calvert

Ben Hopkins Lucy Kelly Karen Valley Lyndsay Brennan

Caron Brooks Paul Howard Libby Greenhalgh Ryan Heywood

Clare Toomey Vicky Riding Samuel Turner Tony AthertonDr Zahir Mohammed Stephen Barnes Rebecca Barlow

Contact the On Call Manager if not already on site. Provide update and discuss moving staff to satellite centres and informing PCT’s and neighbouring services.

Update the On Call Manager and upon re-entry update the BARDOC Hub with all relevant details, including times & reference numbers. All details for ALL CALLS MUST be logged on Adastra.

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Disaster Recovery Process – Fire at Rochdale Urgent Care Centre (RUCC)

Update the BARDOC Hub with all relevant details, including times & reference numbers.

Inform the BARDOC On Call Manager who will inform if appropriate the CCG Director on call by telephoning 0345 133 0099 – On dialling this number you will reach the NWAS Health Control Desk where you should ask for the Bury & HMR CCG Director On Call.

1. If appropriate, ask local staff to redirect patients to BARDOC Heywood (The Phoenix Centre) or BARDOC Bury (Fould’s Suite) and change their location in Adastra.

2. Contact Patients booked into the Rochdale Centre who have not arrived, inform them of the situation and rebook into alternative BARDOC sites.

3. When possible and if required, ask the Rochdale Doctor to attend an alternative BARDOC site (Heywood) the next Rochdale shift staff may also need to be re-directed.

Request constant updates from the BARDOC receptionist at Rochdale keep all other staff updated and inform all triaging clinicians at all sites to book no further Treatment Centre appointments at Rochdale.

Ensure that the fire has been reported to the fire brigade giving the full address as:Rochdale Urgent Care CentreRochdale InfirmaryWhitehall StreetRochdaleOL12 0NB

All staff and patients are to evacuate the building immediately

7

Disaster Recovery Process – Fire at Bolton WMHC

The fire alarm sounds at Water’s Meeting Health Centre

All staff and patients are to evacuate the building immediately. Shift Lead / Overnight Supervisors should exit with the following:

5. Fire Register Book (In Reception)6. Disaster Recovery Pack7. Emergency Evacuation Kit

Shift Lead/Overnight Supervisor to establish from fire department ASAP if it is a false alarm or a real fire? Once confirmed:

Q – Is this a real fire which is likely to keep us out of the building for more than 1 hour?

Shift Lead / Overnight Supervisor to arrange / delegate:

1. Head count using staff register (from fire log in call handling room) 5. Inform the On Call Manager, satellite centre staff and drivers (if appropriate)6. Manual call handling process using cordless phone for incoming calls and mobiles for outgoing calls

Evacuation Point: Furthest point away from premises in Water’s Meeting patient car park

No

Yes

Update the On Call Manager and upon re-entry update the BARDOC Hub with all relevant details, including times & reference numbers. All details for ALL CALLS MUST be logged on Adastra.

1. Patient’s at the treatment centre will need to be redirected to one of the satellite centres, change their location in Adastra from ‘Bolton’ to ‘Bury’ ‘Rochdale’ or ‘Bolton A&E’

2. Contact Patients booked into the Bolton WMHC who have not arrived, inform them of the situation and rebook into alternative BARDOC sites.

3. When possible and if required, ask the Bolton Doctor to attend Bury, Rochdale, or Bolton A&E depending on activity at each site. The next Bolton shift staff may also need to be re-directed.

4. Operational staff to be moved to Bury, Moorgate as phone lines are on a automatic divert

5. Shift Lead to stay and determine what course of action is needed

Contact the On Call Manager if not already on site. Provide update and discuss moving staff to satellite centres and informing PCT’s and neighboring services.

8

Disaster Recovery Process – Fire at Bolton, A&E


Inform the BARDOC On Call Manager who will inform if appropriate the CCG Director on call by telephoning 0345 133 0099 – On dialling this number you will reach the NWAS Health Control Desk where you should ask for the Bury & HMR CCG Director On Call.

Request constant updates from the BARDOC receptionist at A&E, keep all other staff updated.

Ensure that the fire has been reported to the fire brigade giving the full address as:Accident and Emergency DepartmentRoyal Bolton HospitalMinerva RoadFarnworthBolton BL4 0JR

All staff and patients are to evacuate the building immediately

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Building Evacuation Procedure - BuryThis procedure has been produced to ensure business continuity should we need to

evacuate the building for whatever reason at any time and should be followed.

Shift Lead/Overnight Supervisor to evacuate the building with the following:

1. Emergency Evacuation Kit containing the Fire Panel Key, Master Key and Site Plans2. Staff Register3. Hands free Phone & Daisy Chain Mobiles

All Staff and Patients to evacuate the

building.

EVACUATION POINT:Furthest Point Away from the premises in the

Moorgate Primary Care Centre Car ParkOn Right Hand Side as you exit the premises from the front entrance

Shift Lead/Overnight Supervisor delegates head count to colleague.To be cross referenced with Fire Register

Shift Lead/Overnight Supervisor contact BT – 0800 181 079 to divert our primary ISDN number. You may need to quote our ISDN number which is 0161 763 8530.

1. Explain Scenario and that we are an ‘24/7 Emergency Medical Service’2. Request telephone number 0161 763 4242 to divert to 07889812439 (The first

mobile in the daisy chain). 3. You may be asked for some of the information below, supply all that is needed.a) Name - give an appropriate name of authorised people based on your gender. (List

at bottom of this procedure)b) The password: Blackhawkc) Product Type: ISDN30d) Site assurance option 1 plan reference: ELSA-UK-MATRIX-MOORGATE RETAIL

PARK-BURY

Integral OOH Contact number for issues relating to Moorgate - 01925 293041

Contact the On Call Manager who will assess the situation & decide further.

On Call Manager to contact if appropriate the CCG Commissioning Director on call should the incident affect other services commissioned on 0345 133 0099

Monitor patient’s conditions and keep in regular contact with the Duty Doctor(s) until normal operations resume.

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Authorised People - BTAlex Pilkington Lee Hunt Kaye Wheeler John Whittington





Building Evacuation Procedure - Rochdale

This procedure has been produced to ensure business continuity should we need toevacuate the building for whatever reason at any time and should be followed.

All Staff and Patients to evacuate the building.


UCC Car ParkOn Right Hand Side as you exit the premises from the front entrance

Receptionist to head count colleague(s).*Reception, Doctors, Nurses any other BARDOC staff*

If this is a serious evacuation lasting longer than 1 hour patients that have not yet arrived at the Urgent Care Centre should be rang by the CCA’s at Bury or Bolton and informed of the

situation and be redirected to one of the other BARDOC sites.

Patients already at the UCC should be redirected to one of the other BARDOC sites if not possible the patient(s) should be monitored by the Duty Doctor, Shift Lead to keep in regular

contact with the Staff and Duty Clinical Staff until normal operations resume.


If appropriate On Call Manager to contact the CCG Commissioning Director on call should the incident affect other services commissioned on 0345 133 0099

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Building Evacuation Procedure - HeywoodThis procedure has been produced to ensure business continuity should we need to




Phoenix Centre Car Park

Receptionist to head count colleague(s).*Reception, Doctors, Nurses any other BARDOC staff*

If this is a serious evacuation lasting longer than 1 hour patients that have not yet arrived at the Phoenix Centre should be rang by the CCA’s at Bury or Bolton and informed of the situation and be redirected to one of the other BARDOC sites.

Patients already at the Phoenix should be redirected to one of the other BARDOC sites if not possible the patient(s) should be monitored by the Duty Doctor

Shift Lead to keep in regular contact with the Staff and Duty Clinical Staff until normal operations resume.


If appropriate The On Call Manager to contact the CCG Commissioning Director on call should the incident affect other services commissioned on 0345 133 0099

12

Building Evacuation Procedure – Bolton WMHCThis procedure has been produced to ensure business continuity should we need to



Shift Lead/Overnight Supervisor to evacuate the building with the following:

1. Emergency Evacuation Kit 2. Staff Register


Water’s Meeting Health Centre Car ParkOn Right Hand Side as you exit the premises from the front entrance

Shift Lead/Overnight Supervisor delegates head count to colleague.To be cross referenced with Fire Register

Phone lines now ring both WMHC and Moorgate so patients will still be able to get through to us

6. Patient’s at the treatment centre will need to be redirected to one of the satellite centres, change their location in Adastra from ‘Bolton’ to ‘Bury’ ‘Rochdale’ ‘Heywood’ or ‘Bolton A&E’

7. Contact Patients booked into the Bolton WMHC who have not arrived, inform them of the situation and rebook into alternative BARDOC sites.

8. When possible and if required, ask the Bolton Doctor to attend Bury, Rochdale, Heywood or Bolton A&E depending on activity at each site. The next Bolton shift staff may also need to be re-directed.




13

Building Evacuation Procedure – Bolton A&EThis procedure has been produced to ensure business continuity should we need to




Patient Car ParkOn Left Hand Side as you exit the Accident and Emergency Department entrance

A&E Receptionist to conduct a head count of all BARDOC staff*Reception, Doctors, ANP and any other BARDOC staff*




14

Building Evacuation Procedure – Prestwich Walk in Centre

This procedure has been produced to ensure business continuity should we need toEvacuate the building for whatever reason at any time and should be followed.

All Staff and Patients are to evacuate the building.(Reception staff is to ensure all patients in the waiting area are safely evacuating, the clinical

staff are required to escort any patients being seen)

The Receptionist is to evacuate the building with the following:

1. Emergency Evacuation Kit (Behind Reception)2. Fire Register (On the reception desk)

EVACUATION POINT:

The far end of the rear car parkThe evacuation point is marked with a green fire assembly point sign

The Fire Marshal (Reception staff) is to delegate a head count out to a selected member of staff. Cross reference this with the fire register. Please note the fire register is used by the

building as well meaning other services may use it as well.

A serious evacuation at PWIC could cause problems for the patients as they will still be presenting at the WIC during an evacuation please designate a member of staff to monitor

the entrance to the building ensuring no patients go back inside.

9. Patients at the WIC will need to be redirected to NHS 111 or their own surgery in hours and a BARDOC treatment centre Out of hours. They must be assessed by a clinician before leaving. Any patients who leave without a triage must be contacted to ensure their safety.

10. Inform patients who were waiting to be seen the appropriate redirection.

11. If the building is likely to be out of service for the rest of the shift contact Bury base and inform them you have members of staff who need redeploying of permission to send them home. This decision must be made by either the Service lead, Operations Management or the shift lead.

In hours contact the Operations Management team, Out of Hours contact the Shift Lead in Bury they will assess the situation & decide further.

If appropriate On Call Manager to contact the CCG Commissioning Director on call should the incident affect other services commissioned.

Monitor patient’s conditions and keep in regular contact with the Duty Clinician(s) until normal operations resume.

15

Disaster Recovery Process – Loss of Power at Bury

If there is a power cut at BARDOC Bury the emergency lights will come on.

1. Contact Moorgate Estates/Integral on 0161 872 7925 (In Hours) & 01925 293 04. 2. Try to find out how long the power is likely to be off. 3. Contact the On Call Manager to make them aware of the situation.

The backup building generator will allow the lift, emergency lights, and doors to continue working. The UPS (Uninterrupted Power Supply) will allow the computers to work. In order to increase the life span of the UPS a member of staff will need to turn off any computers or other electrical equipment that is not being used.

Clinical staff may be redirected to alternative sites.The next shift staff may also need to be re-directed.

Shift Lead/Overnight Supervisor to report all relevant details, including times & reference numbers, on the hub.

16

Disaster Recovery Process – Loss of power at Rochdale

If there is a power cut at Rochdale report to Shift Lead at Bardoc on 0161 763 8547

Shift Lead to inform the on call manager to make them aware of the situation

If the power is likely to be off for more than an hour then patients already at the UCC, where possible, should be transferred to one of the other BARDOC sites.

BARDOC CCA’s to contact Patients booked into Rochdale Urgent Care Centre who have not arrived, inform them of the situation and rebook into alternative BARDOC sites

Where possible and if required, ask the Doctor to attend Bury or Bolton. The next shift staff may also need to be re-directed.

Ask the Shift Lead to report all relevant details, including times & reference numbers, on the hub.

17

Disaster Recovery Process – Loss of power at Heywood

If there is a power cut at Heywood report to Shift Lead at Bury on 0161 763 8547 and contact Phoenix Manager 01706 261989 try and ascertain how long the power will be off, there is no generator at

Heywood.

Shift Lead to inform the On Call Manager to make them aware of the situation.

If the power is likely to be off for more than an hour then patients already at the Phoenix, where possible, should be transferred to one of the other BARDOC sites.

BARDOC CCA’s to contact Patients booked into Heywood (Phoenix Centre) who have not arrived, inform them of the situation and rebook into alternative BARDOC sites

Where possible and if required, ask the Doctor to attend Bury or Rochdale. The next shift staff may also need to be re-directed.


18

Disaster Recovery Process – Loss of power at Bolton WMHC

If there is a power cut at Bolton report to the security guard on-site who is aware of the protocols in the event of site problems. Also report to the Shift Lead/Overnight Supervisor at Bury on 0161 763 8547. The Shift Lead will contact the Trust on call manager 01204 390 390 to see if alternative rooms at the Trust site can be made available.

Shift Lead to inform the on call manager to make them aware of the situation.

If the power is likely to be off for more than an hour then patients already at WMHC, where possible, should be transferred to one of the other BARDOC sites.

BARDOC CCA’s to contact Patients booked into Water Meetings Health Centre who have not arrived, inform them of the situation and rebook into alternative BARDOC sites

Where possible and if required, ask the Doctor to attend Bury, Heywood or Rochdale. The next shift staff may also need to be re-directed.


19

Disaster Recovery Process – Loss of power at Bolton A&E

If there is a power cut at Bolton A&E report to the Shift Lead at Bury on 0161 763 8547.


If the power is likely to be off for over 1 hour, where possible and if required, ask the Clinical Staff to attend Bolton, Bury or Rochdale.

The next shift staff may also need to be re-directed.

Ask the Duty Manager to report all relevant details, including times & reference numbers, on the hub.

20

Disaster Recovery Process – Loss of power at Prestwich Walk in Centre

If there is a power cut at PWIC report the fault to NHS Property Services 0844 225 2774, this centre is 24/7 and will liaise with the appropriate service. In hours please contact the Operations

Management team, Out of hours contact the Shift lead in Bury base 0161 763 8547.


If the power is likely to be off for more than an hour then patients already at PWIC, where possible, should be transferred to one of the other BARDOC sites.

Clinician(s) on site are to perform a triage on the patients already waiting and signpost to the appropriate services.

Where possible and if required, ask the clinician(s) to attend other BARDOC services should the fault be expected to last longer than a shift.


21

Disaster Recovery Process – Telephones go down

telephone number

Activating the telephony disaster recovery divert

In the event of the telephone system failing at Bury, the below steps should be taken to ensure maximum business continuity. Please note, only authorised people are able to divert the phone, these are listed in the table below, if you are asked to ring to divert please give an appropriate name below based on your gender.

If the phones have gone down at Bury (Moorgate Primary Care Centre), take a number that you can contact the site on e.g. a mobile number.

Ring Octagon Communications on 08712 263 926, ask an engineer to visit site if there are any physical

actions required e.g. Rebooting servers etc.

If Octagon advise, it is a “line issue”, contact Matrix 24/7 (ISDN30 line provider) on

0845 36 20 247

Obtain reference numbers from both companies and log with job that is logged on the hub (last step)

Useful Information

BARDOC’s ISDN30 base number is 0161 763 8530 (this

may be asked for by Matrix 24/7)

Inform the on call manager – The on call manager should make a decision as to whether the divert should be enacted

(see page 2 for instructions).

Make all relevant staff aware at all sites

Update BARDOC Hub with all relevant details, times and reference numbers.

22

Diverting our primary phone line to the first daisy chain mobile will mean that we can still take calls on it. If the first mobile is busy, it diverts to the second, if the second is busy it diverts to the third etc. If the 10th mobile is busy, it diverts back to the first.

Authorised people:Alex Pilkington Lee Hunt Kaye Wheeler John Whittington





Important Information:

SITE ASSURANCE OPTION ONE REF: ELSA-UK-MATRIX-MOORGATE RETAIL PARK-BURYNUMBER TO BE DIVERTED ON ACTIVATION: 01617638530 (Note: This number is BARDOC’s ISDN primary number)NUMBER TO BE DIVERTED TO ON ACTIVATION: 07889 812 441 (Note: This is the first mobile number in the daisy-chain mobiles)PASSWORD: Blackhawk

Procedure:

1) Ring 0800 181 079 to divert our primary ISDN number. You may need to quote our ISDN number which is 0161 763 8530.

2) State the number we wish to divert to 07889 812 441 (The first mobile in the daisy chain)

3) You may be asked for some of the information below, supply all that is needed.

a. Authoriser name (see above)b. The password: Blackhawkc. Product Type: ISDN30d. Site assurance option 1 plan reference: ELSA-UK-MATRIX-

MOORGATE RETAIL PARK-BURY

23

Disaster Recovery Process – Telephones go down at Rochdale

telephone number

Ring the receptionist on 01706 517 000 or the mobile number you took from them earlier and update them on the situation. Ensure the Doctor has access to the backup phone and knows the procedure for recording calls.

Update BARDOC Hub with all relevant details, times and reference numbers.

Make all staff aware that the receptionist at Rochdale cannot take calls.

Inform the On Call Manager

Recording Calls Procedure

1. Dial 0161 763 8532

2. Following the instructions enter *47*2407365

3. You will now hear a dialling tone

4. Dial 9 followed by the number you wish to dial.

Ring Octagon Communications on 08712 263 926

If you receive a phone call to say the phones have gone down at Rochdale, take a number that you can contact the receptionist back on i.e. a mobile number.

24

Disaster Recovery Process – Telephones go down at Heywood

telephone number

Ring Octagon Communications on 08712 263 926


1. Dial 0161 763 8532




Update the BARDOC Hub with all relevant details, times and reference numbers.

Make all staff aware that the receptionist at Heywood cannot take calls.

Ring the receptionist and update them on the situation, ensure the Doctor has access to the backup phone and knows the procedure for recording calls.

If you receive a phone call to say the phones have gone down at Heywood, take a number that you can contact the receptionist back on i.e. a mobile number.

25

Disaster Recovery Process - PCD – Telephones go down

Before calling PCD ICT service desk – please check that calls to the PCD are not being forwarded by calling the normal PCD number (0161 716 1716) Take a note of any tone / announcements if the call is not answered.

If there is a problem please complete the following steps

Please ring Octagon on 0871 226 3926 to see if there is a problem with the PCD lines.

All incidents should be raised in the first instance with Pennine Care ICT service desk on 0161 716 1234 (if no response please use OOH number) - 07773 240351

Please state:

Your name Your job title / position A suitable contact number (include a mobile in addition to a landline) The nature of the issue

Ensure that you mention any affect on the “Pennine Care Direct / Bardoc Service”.

Pennine Care Service Desk have been instructed to give incidents that affect PCD service a higher than normal priority.

If the problem is OOH then please call the ICT on Call Technician on the following number:

0161 716 2716


26

Disaster Recovery Process – Telephones go down at Bolton A&E

telephone number

Inform the on call manager

Update the BARDOC Hub with all relevant details, times and reference numbers.

Make all staff aware that the receptionist at Bolton cannot take calls.

Ring the receptionist and update them on the situation, ensure the Doctor has access to the backup phone and knows the procedure for recording calls.

Ring GMCSU on 0161 765 6681


1. Dial 0161 763 8532




If you receive a phone call to say the phones have gone down at Bolton, take a number that you can contact the receptionist back on i.e. a mobile number.

27

Disaster Recovery Process – Telephones go down at Prestwich Walk in Centre

Telephone number

If the fault has a long or unknown time frame then the shift lead will provide TWO Mobile phones

from the daisy chain system in Bury base. These must be returned once the problem has been

resolved.

Complete an incident report form located in the disaster recovery box; update the shift lead when the fault has be fixed. If your shift ends before the fault is fixed please handover any

information to the member of staff taking over. Any repair summaries or sheets left by engineers must be attached to the incident reporting form.

Regular updates to the shift lead are required as the on call manager will need updating.

The reception staff will need to make sure all clinicians on site are aware of the fault, if calls are being made on mobile phones either personal or BARDOC provided please follow the “Recording

Calls Procedure”.

Contact the shift lead in bury base to inform them the phone lines are down, if a timeframe is known also

state the time frame and who informed you.


1. Dial 0161 763 8532

2. following the instructions enter *47*2407365


4. Dial 9 followed by the number You wish to dial.

Phone lines are not working or down for maintenance.

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Disaster Recovery Process – Adastra goes down at all sites

If there is an issue with Adastra at any BARDOC site e.g unable to access the system, contact the Shift Lead or Overnight Supervisor at Bury and at Bolton and the Bury Shift Lead/Overnight Supervisor must lead in

contacting AHC (Adastra)

All live cases in Adastra can be printed from the Service Continuity Tracker (SCT) laptop which can be found in the records store room (245). The printouts will need to be distributed appropriately:

All Treatment Centre patients at Fairfield Faxed to the base doctors at Fairfield on 0161 778 2821All Treatment Centre patients at Rochdale UCC Faxed to Rochdale on 01706 517004All Treatment Centre patients at Heywood Faxed to Heywood on 01706 261989All Treatment Centre patients at Bolton WMHC Faxed to Bolton WMHC on 01204 381 954All Treatment Centre patients at Bolton ACU Faxed to Bolton ACU on 01204 390 286

Once cases are completed fax notes to Moorgate 0161 763 4555 and place notes in various folders relating to location.

Report the full problem to Adastra (Advanced Health & Care) on 01233 722 700

Regularly chase Adastra for updates and timescales and keep the On Call Manager informed. The On Call Manager may need to attend if Adastra is expected to be down at all sites for an extended period of time or if it happens during a busy period

Update the On Call Manager and the BARDOC Hub with all relevant details, including times & reference numbers.

The manual call handling process should be implemented for all new calls. ** All notes for the same case needs to be put together and put in the relevant folders at Moorgate **

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Disaster Recovery Process – Adastra goes down at Bury

The manual call handling process should be implemented for all new calls. ** All notes for the same case needs to be put together and put in the relevant folders at Moorgate **

All live cases in Adastra can be printed from the Service Continuity Tracker (SCT) laptop which can be found in the records store room (245). The printouts will need to be distributed appropriately:

Arrived Treatment Centre patients at Fairfield faxed to the base doctors at Fairfield on 0161 778 2821Yet to arrive at Fairfield faxed to the base doctors at Fairfield on 0161 778 2821


Report the problem to Adastra (Advanced Health & Care) on 01233 722 700.

If there is no problem at the satellite centres, find out if 1st floor reception in Bury are having problems. This will tell you if the problem is with the whole building or just BARDOC’s network within Moorgate in which case you may be able to use room 246 for entering cases and telephone triage, and a spare WIC nurse room for Treatment Centres cases.

If Adastra goes down at Bury, it may be a local problem or at the hub in Denton which would affect all BARDOC and GoToDoc sites, or a problem with the internet connection at Moorgate which would not affect any other site.

To confirm, ring the receptionists at each of the satellite centres and then check with GoToDoc Supervisor on 0161 337 2240 or their main number 0161 336 3252 to check if their Adastra system is down as well.

Regularly chase Adastra for updates and timescales and keep the On Call Manager informed. The On Call Manager may need to attend if Adastra is expected to be down at all sites for an extended period of time or if it happens during a busy period.


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Disaster Recovery Process – Adastra goes down at Rochdale UCC



If there is no problem at the satellite centres, find out if the rest of Rochdale UCC are having problems. This will tell you if the problem is with the whole building or just BARDOC’s network within the Urgent Care Centre.

If Adastra goes down at Rochdale UCC, it may be a local problem or at the hub in Denton which would affect all BARDOC and GoToDoc sites, or a problem with the internet connection at Moorgate which would not affect any other site.


Report the problem to Adastra (Advanced Health & Care) on 01233 722 700.Look to deploy home working laptops. If a tough book is available this can also be re-deployed.

All live cases in Adastra can be printed from the Service Continuity Tracker (SCT) laptop which can be found in the records store room at Bury (245). The printouts will need to be distributed appropriately:

Print off and fax all Rochdale Treatment Centre cases and fax to Rochdale on 01706 517 004 When patient has been seen and appropriate treatment given - fax notes to Moorgate on 0161 763

4555 Cases should be completed on the system at Bury base.


Inform the On Call Manager and discuss the possibility of closing Heywood and re-directing the next Heywood shifts to alternative sites if necessary.

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Disaster Recovery Process – Adastra goes down at Heywood

If Adastra goes down at Heywood, it may be a local problem or at the hub in Denton which would affect all BARDOC and GoToDoc sites, or a problem with the internet connection at Moorgate which would not affect any other site.




Unable to log onto the desk top .Check that the computer is switched to the correct setting, check that the correct passwords are being used. Ask the on call manager for their details If Adastra goes down at Heywood only (both PCs), it is likely to be a problem with the internet connection at Heywood.

Report the problem to Adastra (Advanced Health & Care) on 01233 722 700.Look to deploy home working laptops. If a tough book is available this can also be re-deployed.


CCA to print off and fax all Centre cases and fax to Heywood on 01706 261989When patient(s) has been seen and appropriate treatment given fax notes to Moorgate on 0161 763 4555 Cases should be completed on the system at Bury base.


Inform the On Call Manager and discuss the possibility of closing Heywood and re-directing the next Heywood shifts to alternative sites if necessary.

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Disaster Recovery Process – Adastra goes down at Bolton



The manual call handling process should be implemented for all new cases. ** All notes for the same case needs to be put together and put in the relevant folders at Moorgate **


Arrived patients at WMHC Faxed to the Reception at Bolton WMHC on 01204 381 954



If there is no problem at the satellite centres, find out if the rest of WMHC are having problems. This will tell you if the problem is with the whole building or just BARDOC’s network within Water’s Meeting Health Centre.

If Adastra goes down at Bolton WMHC, it may be a local problem or at the hub in Denton which would affect all BARDOC and GoToDoc sites, or a problem with the internet connection at Moorgate which would not affect any other site.


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Disaster Recovery Process – Adastra goes down at Bolton A&E



The manual call handling process should be implemented for all new cases. ** All notes for the same case needs to be put together and put in the relevant folders at Moorgate **


Arrived patients at ACU faxed to the Reception at Bolton ACU on 01204 390 286



If there is no problem at the satellite centres, find out if the hospital or A&E are having problems. This will tell you if the problem is with the whole building or just BARDOC’s network within Bolton Royal Hospital.

If Adastra goes down at Bolton A&E, it may be a local problem or at the hub in Denton which would affect all BARDOC and GoToDoc sites, or a problem with the internet connection at Moorgate which would not affect any other site.


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Disaster Recovery Process – Vehicle Breakdown

Update the BARDOC Hub with all relevant details, including times & reference numbers

In extreme circumstances, if a replacement car is not available during a period of high pressure contact:

Lex AutoleaseWindsor House

Hollins Brook WayBury, Lancs

BL9 8RTTel: 0844 824 0729 (Open 24/7)

Our fleet code(account code) is FW0495That along with our company name and address should allow bookings

Alternatively

Manchester Medical Services may be able to supply a car and driver at short notice. Manchester Medical Services can be contacted only with the authorisation of BARDOC’s On

Call Manager on 08452 694 833 or 07894 294 548

The Shift Lead should inform the On Call Manager and discuss the possible need for another car to be sent out to help with visits

If a BARDOC car breaks down, the driver should call:

ALD Automotive on 0800 032 3277

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Escalation Plan

BARDOC’s Escalation Plan has been developed to ensure, as far as is reasonably practicable, that the service provision to patients is not compromised during periods of increased demand. The Plan is compliant with the Department of Health National Quality Requirements, specifically those relating to Access, Clinical Assessment and Definitive Consultation. The underlying principle of the Escalation Plan is to use Predicative Analysis based on previous demand data and modelled using our Capacity and Demand Resource Application. It is intended to guide Operational staff in times of pressure but is not a replacement for the disaster recovery policy and procedures which may be consulted in conjunction with this plan.This plan has clearly defined trigger points, which should ensure the early identification of demand and capacity, and determine the appropriate actions to be taken with BARDOC and the wider health communities in which we operate. There are four levels of escalation based upon the demands being placed on the service, and other services such as A&E departments, Walk in Centres and the ambulance service.

Escalation Levels

OPEL One (Green)Normal operational demand within predicted activity and resource profiles. No action required, business as usual.

OPEL Two (Amber)Operational demand is above predicted activity and resource profile but does not exceed escalation triggers.

Actions – Communicate internally. Shift Lead to advise On-Call manager and Standby Clinician(s) of the current situation in preparation for the possibility of further escalation.

OPEL Three (Red)Escalating operational demand, which if not managed will exceed escalation triggers.

Actions – Standby Clinician(s) to be called in to alleviate pressures in a timely manner. Shift Leads to advise On-Call manager of the current situation who in turn should advise the Director On Call of the situation. Further mitigating actions to be implemented by the On-Call Manager as required.

OPEL Four (Black)Escalating operational demand, beyond acceptable levels of control.

Actions – On-Call Manager to trigger the local health economy escalation (bronze, silver, gold)

Operational Cover:

Contact Centre Agent or Driver If a staff member cannot attend or has to leave during a shift, the Shift Lead must attempt to contact other staff members. All staff contact details are available via the database or

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via a paper system should the computer system fail. If no one is available to cover then the On-call Manager will be informed to assess the situation and if necessary stand in.

Telephone Triage NurseIf a Telephone Triage Nurse cannot attend or has to leave during a shift the Shift Lead will initially assess if the remaining Triaging Nurses can maintain an effective service, if this is deemed to be inadequate level of service then the Shift Lead makes contact with the On-call Manager to discuss providing extra support from working GP’s.

General Practitioners If a Doctor cannot attend or has to leave during a shift the Shift Lead will assess the situation and if necessary attempt to fill the shift from the GP list available via the database or via a paper system. If this is unsuccessful, the Shift Lead should then contact the On-call Manager. It is the responsibility of the On-call Manager to immediately assess if there is adequate cover within the current shift pattern assessing patient contact. If it is deemed that there is further cover required then the directors must be informed that we require urgent medical cover.

Volume Increase If the volume of demand increases dramatically and unexpectedly, action will be taken to provide extra medical and operational resources. This action will be triggered if any of the following occur:-

The Contact Centre Agents cannot answer the incoming calls within 90 seconds

The waiting times in the Treatment Centre’s exceeds two hours

Triage calls exceed one hours wait

Visits either exceed 6 outstanding visits per mobile Doctor, or the waiting time for routine visits exceed 6 hours

If any of the above occurs the Shift Lead will contact the On-call Manager to assess the situation and determine the resources required to prevent escalation and alleviate the pressures on the service.

Clinical Space

Consulting RoomsIf extra clinical space is required as a result of the increase in demand on service, the On-call Manager will need to liaise with the Lead Nurse at Bury, Rochdale and Prestwich WIC’s, to negotiate use of the consulting rooms. These rooms are set up ready to be used and BARDOC has emergency packs for use in the event of escalation to provide relevant medical equipment and paperwork.

CarsBARDOC maintain seven vehicles. Should there be enough demand for visits that eight or more cars are required, Duty Doctors can also be asked to undertake visits in their own vehicles. Petrol costs will be reimbursed on request, full breakdown cover is available and the On-call Manager can authorise car hire if appropriate.

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NHS Bury21 Silver StreetBuryBL9 6PHTel: 0161 762 3100

NHS HMR3rd Floor, 1 RiversideSmith StreetRochdaleOL16 1XUTel: 01706 652 863

NHS OldhamEllen HouseWaddinton StreetOldhamOL9 6EETel: 0161 622 6400

NHS Tameside & GlossopNew Century HouseProgress way - Windmill laneDentonM34 2GPTel: 0161 304 5300

If increased demand for home visits is contained with BARDOC’s geographical area then it may be an option to approach neighbouring out of hours providers to discuss capacity for cross-boundary working.

Home WorkingHome working clinicians are able to dial in to assist with telephone triage, often at short notice. This option should also be considered when there are pressures in other areas of the service. This is because adding home workers to the pool of triaging clinicians can help to free up on site clinicians to assist with treatment centre appointments or home visits.

Clinical Commissioning Group – Contact Information

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Bolton F/TTrust HeadquartersRoyal Bolton HospitalMinerva RoadFarnworthBoltonBL4 0JR

Key Numbers:Main Switch Board - 01204 390 390A&E - 01204 390 300Chairman / Chief Executive - 01204 390 912

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Service Continuity PlanKey Service Providers Contacts

Bury:

Electricity:Moorgate Estates / Integral – In

Hours0161 872 7925

Moorgate Estates / Integral – Out of Hours

01925 293 041

Telephones:Octagon Communications

0900 - 17000845 678 7878

Octagon CommunicationsOut of Hours

0871 226 3926

BT Communications 0800 181 079Building Alarm/Security/ Heating ect

Moorgate Estates / Integral – In Hours

0161 872 7925

Moorgate Estates / Integral – Out of Hours

01925 293 041

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Building Alarm/Security/ Heating ectSecurity and Heating

Alarms01772 229 637 Eric Wright

07834 265 858

Adastra - How To Add New Users or Providers To Adastra – Procedure

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Rochdale:

Building Alarm/Security/ Heating ectPennine Acute Trusts 01706 377 777 For Estates or Duty

Manager

Heywood:

Introduction

This procedure explains how to appropriately add new providers and new users to Adastra.

Please note that the entire document should be read in full and understood before proceeding with the creation of accounts. If uncertain seek advice from the appropriate individual(s).

Terminology

Provider(s) – This is a clinician e.g. DR / Nurse etc Provider Group(s) – This is the organisation of which the provider works for e.g. a GP

Practice User(s) – An individual who works for BARDOC i.e. who needs a Adastra

username/password to login User Group(s) – User(s) are added to “Group(s)” to manage system access. In-turn

Groups are assigned “permissions” Permission(s) – Used to define what parts of the system can be accessed

Screens On the left hand side in Adastra the “Menu” will have a sub menu titled “User Administration”, This is where you will access the screens from.

(01) Allows you to change your password only

(02) Is a read-only search for “Personnel Details” i.e.

staff details

(03) Is a read-only search for “Provider Details” i.e.

clinician details

(04) Allows you to edit only the “Personnel” details of a

user i.e. phone number

(05) Allows you to create/edit “Provider” records i.e.

clinician records

(06) Allows you to unlock a locked out user or change their password

(07) Allows you to create/edit user groups

(08) Allows you to create edit user records i.e. usernames

The screens that will be needed for the below processes are

(05) Provider Maintenance

(08) User Maintenance

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Possible User or Provider Permutations

Generally speaking the following will apply

User Account Provider RecordNon-clinician working for BARDOC Clinician working for BARDOC

Information Required to Create a User or Provider Account

User Account Provider Record

Forename (mandatory) (mandatory)

Surname (mandatory) (mandatory)

Job Title (mandatory) (mandatory)

Mobile Phone Number (desirable) (desirable)

@nhs.net Email Address (desirable) (desirable)

GMC / NMC Number (mandatory)

Smartcard Number (mandatory)

RA02 Form Completion (mandatory)

Checks To Perform Before Creating a New User or Provider

(A) You have the correct verified information

(B) They have passed all HR checks relevant to their role

(C) The request has been recorded on the BARDOC Hub and appropriately signed off

(D) You must perform a search to make sure that there is not an existing record. If there is an existing record for that individual then it should be used. Please make sure that “Obsolete” records are also searched for at the point of looking for existing Users or Providers.

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How to Add a Non-Clinician working for BARDOC

(01) Click on “User Maintenance” menu to open the “User Maintenance” module/screen

(02) To perform a search on an existing user enter your search criteria in the search box and click the “search” button. Results returned will appear below the search box.

Note: a wild card (%) can be used to represent any character, therefore when searching it is advised to add the percentage sign (%) before and after your criteria.

(03) To edit an existing user record double left click on the correct record to enter the “User Maintenance” screen.

(04) Click on the “New User” button

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(05) Fill in the highlighted sections as shown in the above screen shot including adding the user to the appropriate groups.

Note:

(A) The username should be in the format of: forename.surname

Note: Please add a full stop between forename and surname

(B) The “Full name” should be in the format off: title forename surname e.g. Dr Forename Surname

(C) The “organisation group” should be “BARDOC”

(D) The “Log in restriction location group” should be “BARDOC”

(E) The “Authentication type” should be “smartcard”

(06) By clicking on the “Is organisation personnel?” tick box the “Personnel Details” tab will appear (see screen shot below)

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(07) Only complete contact numbers, all members off staff will see these details and therefore only contact phone numbers that the member of staff has provided should be inputted here.

(08) Once all details are have been entered and correct press the “Update” button

to save and record the inputted details.

(09) For new users you will be asked to input an initial password for the user.

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How to Add a Clinician Working For BARDOC

(01) Click on “Provider Maintenance” menu to open the “Provider Maintenance” module/screen

(02) To perform a search on an existing provider enter your search criteria in the search box and click the “search” button. Results returned will appear below the search box.


(03) To edit an existing provider record double left click on the correct record to enter the “Provider Maintenance” screen.

(04) Click on the “New Provider” button

(05) Fill in the highlighted sections as shown in the above screen shot

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Note: The “Formal Name” and “Lookup” field will be automatically populated from the details entered in the “Forename”, “Surname” and “Provider Type” field. These should not be edited to anything other than the format surname, forename.

(06) Click on the relevant “Doctor Details” or “Nurse Details” tab and input the GMC or NMC Number.

Note: That the tab will be named differently depending on the “Provider Type” selected.



Now create the corresponding user account…

(01) Click on “User Maintenance” menu to open the “User Maintenance” module/screen

(02) To perform a search on an existing user enter your search criteria in the search box and click the “search” button. Results returned will appear below the search box.


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(03) To edit an existing user record double left click on the correct record to enter the “User Maintenance” screen.

(04) Click on the “New User” button

(05) Fill in the highlighted sections as shown in the above screen shot including adding the user to the appropriate groups.

Note:

(F) The username should be in the format of: Forename. Surname

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Note the full stop between Forename and Surname

(G) The “Full name” should be in the format off: title forename surname e.g. Dr Forename Surname

(H) The “organisation group” should be “BARDOC”

(I) The “provider record” should be the one created and or found from “provider maintenance”

(J) The “Log in restriction location group” should be “BARDOC”

(K) The “Authentication type” should be “smartcard”



(07) For new users you will be asked to input an initial password for the user.

‘Case Sensitive’ Patient Information

By marking patient’s as ‘Sensitive’ in Adastra non-clinical staff will be issued a warning that they are not authorized to see any clinical information, including the original symptoms documented by the call handler. This is to add an extra layer of security.

‘Sensitive’ patients are deemed as:

Staff members

Family members of staff (If known to be related to a member of staff)

Celebrities/VIP’s

To mark a patient as ‘Sensitive’ at case entry, please follow the procedure below:

Take the patient’s demographics and symptoms as normal.

Before passing the call to the clinician please click the ‘Mark Case As Sensitive’ button.

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The button will highlight itself in orange. (As seen below).

Pass on the call as normal.

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When you highlight the call in case tracking the details will not show in the summary box at the bottom of the screen. You will see a message that states “You do not have the rights to view clinical information”.

Only Clinicians will be able to see symptoms in case tracking.

If you double click on the case you will receive the message below. This is the same for clinicians and non-clinicians.

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No member of staff should be bypassing this screen without a valid reason. This is being closely monitored and reported.

If opened in error. - Click X on the right side to Close the Lookup Details tab. DO NOT Click the bypass button - this will open the case and automatically create a report to the Head of Clinical services. Inappropriate use of the bypass button could result in disciplinary action.

Only clinicians who are triaging the call will be able to access the details via the clinician options, without having to bypass this screen.

If you have any questions/problems please speak to the Shift Lead on duty.

Child Safeguarding Procedure

Any Advice calls, visits or Treatment Centre appointments concerning children (Under 18’s) should not be cancelled by CCA’s/Shift Leads without any input from a Clinician.

Patient Representative Calls back to inform that the patient has attended A&E and the advice call, Visit or Treatment Centre appointment is no longer required.

Patient Representative calls back to inform that the patient’s condition has settled and the advice call, Visit or Treatment Centre appointment is no longer required.

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Closing DNA cases for Treatment Centres

Inform the caller that the information will be passed to one of the Clinicians on duty.

Log on the call which A&E patient has attended.

CCA/Shift Lead to contact relevant A&E to confirm that patient has attended and to log on call that you have verified the patient has attended A&E.

The Clinician will then close the call or contact the family if there are any concerns.

If the Patient Representative cannot be contacted to provide further advice the Clinician will need to make a decision to either close the call or pass on as a visit.

The call can then be cancelled once verification has been made that patient has attended A&E.

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-Controlled Drugs Procedure Flowchart

Patient has DNA'd or has left the Treatment Centre without being seen

Shift Lead or dedicated CCA to comfort call patient/patient rep and specify the reason for not attending

If the patient/patient rep is no longer wanting the time slot in the treatment centre then the call can be closed by the duty

Shift Lead

Duty Shift Lead to case edit the call and Close/Complete Call

Follow the procedure for closing DNA cases

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The Doctor is responsible for the Controlled Drugs at all times.

The Designated Key holder must ensure that the C.D cupboard is locked at all times.

The Doctor must fill in the corresponding CD Register and the Designated Key Holder must witness and sign. The Doctor and the Designated Key Holder must then restock from the corresponding stock for each car Doctor and Designated Key holder sign the drugs book to confirm the C.D quantity is correct and has been returned.Legal Requirements: Drug Name Date / Time Batch No/expiry Date Patient Name Stock BalanceDoctor SignatureWitness Signature

The Designated Key holder must witness the doctor signing the book

The Designated Key Holder is responsible for the keys to unlock the CD cupboard cuccccccccccccuoCupboardcupboard.

If no drugs used

The Doctor and Designated Key Holder must check the drug name; amount allocated to each car and signs the book to confirm they are all correct and that that GP is responsible for the C.Ds whilst on home visits.C.D.s must be placed in the car safe ASAP

If C.Ds have been used

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Failed Contact Configuration Process

Failed Contact- Clinicians

(A) Clinician unable to contact patient based on criteria

Note: The recording of phoning patients should be done through the existing procedure. This process is a further addition.

Try all numbers just once before handing responsibility for finding the patient over to the Operations team. Please continue with the following process:

(B) Exit the case and right click on the patients name in the “case list” and choose the option “Failed Contact”

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(C) On the next screen click “Next>” to pass the case to the dispatcher

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Failed Contact- Despatcher

When the “No Reply” procedure needs to be enacted right click on the case choose “No Reply”

Options available

The dispatcher has three options (after double clicking on the case)

“Failed contact” should be used to record a failed contact each time one occurs, this will add an audit event to the case.

“Contact Made – Return to Clinician” should be used when the patient has been successfully contacted and the case is ready to be returned to the clinical queue for clinical consultation

“No Reply” – This enacts the ‘No Reply Procedure’ and will return the call to the clinical queue

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Note: The case will-

(A)Case type changes to “GP Advice”

(B) Case status changed to “OLC”

(C)Add a case tag added “No Reply Procedure”

The no reply tag will be displayed as:

Dispatcher Screen Changes

The screen “sort” has been changed so that the screen is first split by the “status” of the case and then is displayed in descending time order (old to new)

As you can see there is a new status of “Failed Contact” to distinguish the failed contact cases passed from the clinicians from the existing dispatch cases which all have a “Call is waiting to be despatched” status.

Special & Cautionary Notes Procedure

Special and Cautionary notes are used to advise clinicians of any information that is necessary for the patients treatment. This can vary from advising a patient is expected to pass away to advising not to prescribe certain drugs for a patient. Their notes are very important and can avoid distressing situations for patient’s families should the patient pass away out of hours. It is imperative that notes received are entered promptly and accurately onto Adastra.

Special & Cautionary notes are received via fax.

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In Adastra under the ‘Manager Options’ Menu, select ‘Special Patient Note Edit’

Enter the patient’s date of birth and click ‘search’.If the patient’s details are showing highlight the patient by clicking on the name and then click ‘New Note’If the patient already has special notes their record will show in green as above.If the patient’s details are not showing then click ‘Advanced’ and search with the patient’s NHS Number. If there are still no matches then click ‘New Patient’.

Enter the notes exactly as they appear on the written notes received.

If the note is advising that the patient is an ‘Expected Death’ then you must document whether the doctor can issue the death certificate the next working day and also when the patient was last seen.

If this information is not on the notes received but the note implies the patient is expected to die, you must follow this up with the surgery/doctor and ask them for an updated note. If the patient was not seen within the last two weeks this must also be followed up with the surgery/doctor.

All Special Notes should be checked and entered on Adastra on receipt of the note.

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Once you have inputted the notes you need to click on the ‘Patient Details’ tab. If the patient wasn’t already on the system you will need to enter the patient’s demographics. You need to perform the PDS lookup. Document your reason for the note using the ‘Reason for change’ box on the right hand side of the patient details. Then press ‘Update’.

At the bottom of the faxed note the boxes must be filled in by the person adding the notes into Adastra.

You must say ‘Yes’ to ‘Added to Adastra’ enter the date, your name and the review date of the note.

Once the note has been actioned and the boxes above filled in, the note must be filed in the relevant folder (According to surname) in the safe haven cupboard.

N.B. Special Notes can be taken verbally over the phone if the doctor is unable to get to a fax machine. However this must be followed up for a paper copy the next working day.

If you cannot get this information the note needs to be entered onto Adastra stating we do not have confirmation the doctor can issue the death certificate. This then needs to be followed up the next working day.

For expected deaths the review date should be set to two weeks after the patient was last seen.

All other notes should be reviewed 1 month after the note is received

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MOORGATE PRIMARY CARE CENTRE. FIRE SAFETY EVACUATION STRATEGY & PROCEDURES.

1. Purpose

The Purpose of this Fire Safety Evacuation Strategy is to provide general guidelines and to highlight areas which warrant particular attention at Moorgate Primary Centre in relation to Fire Safety Arrangements and Evacuation. This document should be considered in conjunction with each organisation’s Fire Safety Policy occupying the building.

The Fire Emergency Plan included with this document describes the procedures to be followed in event of a fire incident in Moorgate Primary Care Centre.

2. RESPONSIBILITIES

Chief Operating Officer – NHS Property Services Ltd

NHS Property Services Chief Operating Officer is responsible for ensuring the implementation of FIRECODE Guidance in ALL premises owned or occupied by NHS Property Services.

Service Delivery Manager – NHS Property Services Ltd

The Service Delivery Manager shall have nominated responsibility for the implementation of FIRECODE guidance within Moorgate Primary Care Centre

Health, Safety Security Fire Advisor – NHS Property Services Ltd

There is a Health Safety Security Fire Advisor for the group of premises occupied by NHS Property Services in accordance with FIRECODE. The HSSF Advisor will assist the Senior Fire Marshal in carrying out their duties.

Senior Fire Marshal

There is a Senior Fire Marshall (SFM) in place for Moorgate PCC. The SFM in conjunction with tenants and partner organisations is to ensure that there are sufficient numbers of Fire Marshals available at all times the building is occupied to facilitate a full evacuation. (Please see “Fire Marshals” below) The Senior Fire Marshal will also coordinate the evacuation in conjunction with the Fire Marshals.

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Fire Marshals

NHS Property Services in conjunction with partner organisations and tenants will ensure that suitable numbers of staff are appointed as Fire Marshals in each of premises that NHS Property Services occupies.

Fire Marshals should make provision to notify the SFM if for any reason they are unable to fulfil their duties, for example sickness absence or annual leave. They should also notify the SFM if they relocate to another building for any duration of time, or permanently, so that adequate cover can be organised with tenants and partner organisations. The Fire Marshals will evacuate the areas they are responsible for in the event of fire alarm activation.

Service Managers

Service Managers at all sites are responsible for ensuring that the relevant fire safety measures in place are maintained in the building/area/departments for which they are responsible.

Managers are also to ensure that all staff are aware of fire safety instructions for the premises at which they work, and a site specific induction for all staff is carried out as soon as is reasonably practicable for the location they are based at.

It is also the manager’s responsibility to ensure that they and all staff including clinicians undertake fire safety training sessions once in every 12-month period.

All Employees’ Responsibilities

All staff will identify fire associated risks as part of any risk assessments that are undertaken and either take the appropriate action, or report the risks to the designated managers, Responsibility for attending any mandatory fire training including e-learning packages rests with every employee. Staff are to ensure that their Line Manager is informed if they have not attended mandatory fire training within the prescribed timescale. Staff are also reminded to conduct themselves in such a way as to reduce the risk of fire on the premises, and to ensure all safety measures in place on site are not tampered with or damaged in any way.

3. TENANTS & PARTNER ORGANISATIONS

Responsibility for ensuring staff attend fire safety awareness sessions rests with their organisation, and they should provide NHS Property Services with assurance that suitable and sufficient training has been carried out. Any procedures set by NHS Property Services in consultation with Tenants and Partner Organisations should be disseminated to all relevant personnel who occupy and use the building. Tenants and partner organisations should also participate in fire safety evacuations when required, to ensure that procedures in place on site are suitable.

4. STAFF WITH SPECIFIC DUTIES

The Centre Coordinator has specific responsibility for Fire Safety Management and as such

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will be the Senior Fire Marshall (SFM). A deputy will be appointed for sickness absence and holiday cover, or if the Centre Coordinator is working from another site, Nominated members of staff will hold the position of Fire Wardens. Their role is to ensure that Fire Safety is maintained in their designated area. Rotas are displayed for information.

Duties of the Senior Fire Marshall:

The duties of the Senior Fire Marshall are as follows:

i. Liaise with tenants and partner organisations to ensure that any new employees introduced to the workplace are made aware of the fire routine, fire alarm system, location of fire extinguisher points, fire exits and general fire regulations in conjunction with their line manager.

ii. Ensure that all staff knows the location of the Fire Assembly Point for Moorgate Primary Care Centre, which is at the far end of the building car park.

iii. Liaise with Fire Marshals within the building to ensure all areas have sufficient cover to facilitate a full evacuation at all times including out of hours services.

iv. Act as point of contact for all Fire Marshals and the Fire & Rescue Services in the event of full evacuation from the premises during normal business hours of 09:00hrs to 17:00hrs, and coordinate all staff in roles of responsibility accordingly. Out of these core hours, the role of SFM will be deputised to a lead within the out of hour’s service from 17:00hrs onwards.

Identified staff will be trained in stair evacuation procedures for disabled people using Evacuation Chairs.

Important points for consideration are:-

1. In the event of a meeting taking place at Moorgate PCC, as part of house keeping, the meeting chair will give evacuation instructions to attendees verbally at the start of the meeting, and will ensure that all attendees of the meeting have been made familiar with the instructions, giving details of the test alarm if necessary. The meeting chair will be responsible in the event of fire alarm activation and subsequent evacuations to direct all visitors to the nearest available exit. Signage noting the evacuation routes are in the meeting rooms and staff rooms.

2. None of the lifts provided in Moorgate PCC are classed as evacuation lifts.

5. THE FIRE ALARM SYSTEM

The fire alarm system covering the building is an addressable type system. The main panel is situated in the ground floor by the Main door. When the alarm is activated a siren will sound on all floors.

All doors fitted with magna guards security devices will disengage. Doors and windows are to be closed to restrict the passage of heat and smoke if possible. The integrity of most internal doors will be at least thirty minutes.

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1. 3rd Floor panel – NOTE the alarm cannot be silenced from this panel.

Main fire panel

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6. STAFF FIRE ROUTINE

On the suspicion or discovery of a fire, staff must immediately raise the alarm.

TO RAISE THE ALARM:

Break the glass of the nearest break glass alarm call point.

The Senior Fire Marshall (SFM) or deputy will take charge of the incident; the fire service will automatically be alerted. The SFM, deputy or person in charge during out of hours should dial 9 - 999 to confirm that there is a fire so the Fire & Rescue Service can respond appropriately. The Site Service Officer (SSO) should not be contacted as their mobile phone should be left clear to ensure the Alarm Receiving Centre EMCS can contact them and ascertain if there is a fire.

On hearing the fire alarm, evacuation will begin and all ambulant patients, visitors and staff will proceed to the designated assembly point. The exception to this is that non-ambulant persons will be moved to a refuge whilst the fire situation is assessed. A decision whether to evacuate them or not will be based on the remoteness or immediacy of the fire risk.

IF YOU HEAR THE FIRE ALARM:

On hearing the fire alarm, Fire Marshals will begin to mobilise personnel within their area and the evacuation will begin. All ambulant patients, visitors and staff will proceed to the designated assembly point. The exception to this is that non-ambulant persons will be moved to a refuge whilst the fire situation is assessed. A decision whether to evacuate them or not will be based on the remoteness or immediacy of the fire risk.

7. EVACUATION PROCEDURE

During office hours – Monday to Friday 09:00hrs to 17:00hrs

Staff holding specific appointments under this Emergency Plan will proceed as follows:

I. The Senior Fire Marshal – Centre Coordinator (or Deputy) will:

a. Ensure the fire service have been called and that they are ready to meet themb. That the initial evacuation is taking placec. That the evacuation of non-ambulant persons is taking place where possible

II. Departmental Fire Marshals will clear their zone making a brief check of all rooms including toilets and store rooms, and ensure all staff, patients, and visitors leave by the shortest or safest route as quickly as possible. After a Fire Marshal has cleared his/her area he/she reports to the SFM in person on the ground floor that clearance is complete.

III. Staff trained in doing so will move non-ambulant persons to the nearest available refuge. These staff do not themselves evacuate the building. The FM reports to the SFM details of staff/patients in the refuge point in person via the evacuation check list. Those in the refuge can communicate via the refuge telephone how many non ambulant persons there are in the refuge confirming their location and the nature of their disabilities, and await further instructions from the SFM.

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IV. Ambulant disabled people who are capable of evacuating themselves without assistance by means of the escape stairs are free to do so, if they so wish. Alternatively any available member of staff not otherwise needed for the evacuation process may assist them.

V. The attending fire service authority will inform the SFM on decisions and actions to be taken. If those in the refuge are safe then they remain where they are; if in immediate danger they will be evacuated using the evacuation chairs provided.

VI. On advice of the Fire Service a decision for evacuating or remaining in refuge will be made. Unless smoke or flames are visible through the observation panels in the fire-resisting doors comprising the entrance into the refuge, it is in order to stay in refuge without evacuating.

VII. The SFM, or other member of staff detailed for this duty, meets the Fire Service when they arrive and provides them with a report on the status of the incident. This staff member will place himself or herself outside the Main Entrance and other access points into the building, to prevent any further people from entering the building whilst the incident is ongoing.

VIII. Re-entry of the building is prohibited until the Senior Fire Service Officer declares that it is safe to do so.

Out of Normal Office Hours – Before 08:00hrs, after 18:00hrs, Weekends

The above instructions are to be followed, but the SFM will not be on available on site. The Fire Marshal(s) for the occupying service(s) will deputise for the SFM and carry out this role between them. The SFM should ensure that all services working out of normal working hours are fully conversant with their roles and responsibilities in the event of an evacuation.

8. FIRE FIGHTING EQUIPMENT.

Foam extinguishers (9 litres) and carbon dioxide extinguisher (2kg) are located at various points within Moorgate PCC. In the Communal Staff room there is a CO2 extinguisher (5kg).

The emphasis must be on evacuation of patients. Caution must be taken in areas filling up with toxic smoke or fumes.

STAFF MUST NOT TAKE UNDUE RISKS.9. EVACUATION CHAIR INFORMATION

In the event of an emergency, there are Evacu-Trac chairs available to use within the facility, situated on each floor within each stairwell at the disabled refuge point.

Clinical and administrative departmental staff will be trained in using Evacuation Chairs. This body of staff, along with Fire Wardens, will form ‘evacuation teams’ embedded in departments, whose priority will be to act as a resource to move their patients and visitors to a place of safety outside the centre or to move them temporarily to a refuge point to await evacuation, or to return them to the department in the case of a minor incident or false alarm.

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RESTOCKING DRUGS OVER THE WEEKEND

It is the duty of the Shift Lead to maintain safe stock levels over the weekend and especially during Bank Holidays. At the end of a mobile shift it is the responsibility of the GP/driver to pass on the promissory notes, which have been issued during the shift.

The Shift Lead needs to file the promissory note in the appropriate file for the vehicle i.e. Alpha, Beta, Charlie, Delta, Echo, Foxtrot and Golf. The same drug then needs to be replenished from the relevant drawer and placed in the basket for the appropriate vehicle, and a record needs to be entered into the appropriate file recording the date, medication replenished, batch number/ expiry date and the call number

Each vehicle has its designated drawer, all medication in these drawers are pre-booked out, so no work needs to be carried out on the computer. Once the medication is replenished it is the driver’s duty to place the medication in the orange box before each shift when loading the vehicle.

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Safeguarding Minors Procedure – For Call Handlers

If Social Services call BARDOC in relation to a patient, please take

the relevant details and refer to a GP who will

call social services Governance will refer to Social Services

and provide feedback as needed.

Clinician to follow Safeguarding Minors

Procedure for Clinicians

Flag concerns with Shift Lead, escalate if

needed

Shift Lead to pass details to Governance

via HUB

Call 999

Physical Danger or

LTE

Follow usual call process

Refer call for urgent triage and discuss with clinician. DO NOT write concerns in case entry

notes.

NoYes

Concerns Raised?

Patient/Representative Contacts BARDOC

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Safeguarding Vulnerable Adults Procedure – For CCA

Shift Lead to pass details to Governance Team

BDOC.governace.nhs.net

Clinician to follow Safeguarding

Vulnerable Adults Procedure for

Clinicians

If Social Services call BARDOC in relation to a patient, please take

the relevant details and refer to a GP who will

call social services Governance Team will refer to Social

Services and provide feedback as needed.

Flag concerns with Shift Lead, escalate if

needed

Call 999

Physical Danger or

LTE

Follow usual call process

Refer call for urgent triage and discuss with clinician. DO NOT write concerns in case entry

notes.

NoYes

Concerns Raised?

Patient/Representative Contacts BARDOC

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Toughbooks (CF19/Bury) - Irretrievable Signal Loss - Computer Shutdown - Procedure

Signal Strength – Aremote Indicator

Green:

This means there is good signal and Aremote can communicate as designed / intended.

Orange:

This means there is average signal and Aremote can still communicate however there may be reduced performance i.e. slower to communicate

Red:

This means there is very poor signal but NOT necessarily total signal loss. Aremote can still communicate however there will be a severely reduced performance i.e. very slow to communicate

IF THERE IS A “RED” SIGNAL STRENGTH INDICATOR PLEASE CHECK FOR TOTAL SIGNAL LOSS (SEE THE SECTION “LOSS OF SIGNAL INDICATOR”)

The System Tray and Signal Icon

In the system tray (located at the bottom right hand side of the screen) you will see a signal meter also referred to by Adastra as “Pan Pipes”. This shows the current signal and is the most accurate indicator of the Aremote signal. The above screen shot is an example of “Normal” signal i.e. good signal.

Loss of Signal Indicator

If you see the above symbol in the system tray this means that there is NO SIGNAL and Aremote cannot communicate i.e. cannot send or retrieve data.

THIS SYMBOL IS NORMAL IF YOU ARE IN AN AREA WHERE THERE IS NO SIGNAL

When you return to an area with signal the icon should return to “normal” as shown in the screen shot in the “System Tray” section.

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PLEASE NOTE THAT A GOOD INDICATOR OF SIGNAL IS YOUR MOBILE PHONE! PLEASE USE YOUR MOBILE PHONE FOR A SIGNAL COMPARISON

How to Detect Irretrievable Signal Loss

In the system tray (located at the bottom right hand side of the screen) you will see a signal meter also referred to by Adastra as “Pan Pipes”.

If the icon looks like or for a few minutes when you are in an area where there is signal then you can conclude that there is an “Irretrievable Signal Loss”.

How to Rectify the “Irretrievable Signal Loss” - Reconnect / Get Signal

THIS PROCESS WILL NOT LOSE THE INFORMATION CURRENTLY INPUTTED INTO AREMOTE I.E. THE CONSULTATION INFORMATION WILL NOT BE LOST

(01) Firstly you must notify the dispatcher and ask them to inform Adastra

(02) To regain signal you will need to put the laptop into “Sleep” and then “wake” the laptop. This will power-cycle the toughbook’s internal modem.

(03) Hold down the Function Key (FN) and then press the F7 Key

(04) The laptop screen will go blank i.e. go to “sleep” the green lights at the bottom left of the laptop will go off

(05) Next the power signal light will intermittently (every 4/5 seconds) flash green. This indicates the laptop is in “sleep” mode

(06) As if you where turning the laptop on, push the power button to the right and let go, the laptop will now “wake up” and return to the point at which you started the process.

The signal icon in the system tray should now return to normal after approximately 1-2 minutes.

NOTE: During this waiting period you may see the signal icon change many times, this is normal as the modem is “rebooting” but the normal signal icon should return.

IF AFTER 5 MINUTES THE SIGNAL ICON DOES NOT RETURN TO “NORMAL”…

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The toughbook must be shutdown and powered on again.

However, before doing this you must make sure that information that has been entered into Aremote and that has not been communicated back to base is written down on the “Doctors – Manual Call Sheet”.

Before powering off the device CONTACT THE DESPATCHER to determine what information has or has not been sent back to Adastra/Base.

Only then is it safe to shutdown and power on the toughbook.

Toughbooks (XFR/Bolton) - Irretrievable Signal Loss - Computer Shutdown - Procedure

Signal Strength – Aremote Indicator

Green:

This means there is good signal and Aremote can communicate as designed / intended.

Orange:

This means there is average signal and Aremote can still communicate however there may be reduced performance i.e. slower to communicate

Red:

This means there is very poor signal but NOT necessarily total signal loss. Aremote can still communicate however there will be a severely reduced performance i.e. very slow to communicate

IF THERE IS A “RED” SIGNAL STRENGTH INDICATOR PLEASE CHECK FOR TOTAL SIGNAL LOSS (SEE THE SECTION “LOSS OF SIGNAL INDICATOR”)

The System Tray and Signal Icon

In the system tray (located at the bottom right hand side of the screen) you will see a signal meter also referred to by Adastra as “Pan Pipes”. This shows the current signal and is the most accurate indicator of the Aremote signal. The above screen shot is an example of “Normal” signal i.e. good signal.

Loss of Signal Indicator

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If you see the above symbol in the system tray this means that there is NO SIGNAL and Aremote cannot communicate i.e. cannot send or retrieve data.

THIS SYMBOL IS NORMAL IF YOU ARE IN AN AREA WHERE THERE IS NO SIGNAL

When you return to an area with signal the icon should return to “normal” as shown in the screen shot in the “System Tray” section.

PLEASE NOTE THAT A GOOD INDICATOR OF SIGNAL IS YOUR MOBILE PHONE! PLEASE USE YOUR MOBILE PHONE FOR A SIGNAL COMPARISON

How to Detect Irretrievable Signal Loss

In the system tray (located at the bottom right hand side of the screen) you will see a signal meter also referred to by Adastra as “Pan Pipes”.

If the icon looks like or for a few minutes when you are in an area where there is signal then you can conclude that there is an “Irretrievable Signal Loss”.

How to Rectify the “Irretrievable Signal Loss” - Reconnect / Get Signal

THIS PROCESS WILL NOT LOSE THE INFORMATION CURRENTLY INPUTTED INTO AREMOTE I.E. THE CONSULTATION INFORMATION WILL NOT BE LOST

(07) Firstly you must notify the dispatcher and ask them to inform Adastra

(08) To regain signal you will need to turn the wireless switch off and back on again. This will power-cycle the toughbook’s internal modem.

(09) Locate the wireless switch on the right hand side of the machine

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(10) Slide the switch to off, wait a couple of seconds and then slide the switch back on.

The signal icon in the system tray should now return to normal after approximately 1-2 minutes.

NOTE: During this waiting period you may see the signal icon change many times, this is normal as the modem is “rebooting” but the normal signal icon should return.

IF AFTER 5 MINUTES THE SIGNAL ICON DOES NOT RETURN TO “NORMAL”…

The toughbook must be shutdown and powered on again.

However, before doing this you must make sure that information that has been entered into Aremote and that has not been communicated back to base is written down on the “Doctors – Manual Call Sheet”.

Before powering off the device CONTACT THE DESPATCHER to determine what information has or has not been sent back to Adastra/Base.

Only then is it safe to shutdown and power on the toughbook.

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New Clinician Process

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Structured Interview

Induction incorporating telephone triage

Audit of all (100%) calls of at least the first three shifts

3 month review with Dr Mohammed / Caron Brooks

Continue audit of all calls

Remedial plan

Can undertake overnight shifts(Full audit of at least first three overnight shifts)

6 month review with Dr Mohammed / Caron Brooks

Satisfactory

Satisfactory

Unsatisfactory

Unsatisfactory

Fast Tracking Calls

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History

Historically patients presenting with certain conditions are more likely to require a face to face consultation with a clinician, either in the home or in the treatment centre.

Why we need a fast track process

In order to provide a high standard of care, meet the standards set by the Government to provide a definitive clinical assessment and ensure that patients are triaged in a clinically appropriate timeframe that is both safe and reliable; patients with specific symptoms can be fast tracked.

Fast tracking should be undertaken when the volume of calls is high. This will help the flow of patients through the system and stop the issue of treatment centre (tc) appointments and visits being delayed creating bottlenecks in the system. It will also help to deal with potentially unwell patients much quicker

The aim of the fast track triage is not to reduce the work for the nurses or the doctors, but to provide a better more timely service to the patient.

By Whom

Fast tracking should be undertaken by designated clinicians with the appropriate experience. The aim is to identify patients on the advice call list who, from the information provided, will most likely need a t/c appointment or a visit.

When do we fast track?

Specific nurses will cover the fast tracking process at peak demand times. These nurses will be asked at the start of their shift by the Shift Lead to work at fast tracking if applicable. The shift lead will inform the audit manager of times and dates that nurses have been asked to use this process.

How?

Fast tracking of potential t/c patients no triage is required if on reading the information you feel that, in your experience, the patient would usually need a t/c appointment then just add the word fast tracked to the history and pass the call on to the Call Centre Agent (CCA).

If on contact the patient declines a t/c appointment the CCA should return the call to the triage list with the information that a fast tracked appointment has been declined to avoid the patient being put through the same system again.

Examples of calls that cannot be fast tracked include:

1. Any Breathing problems or Asthmatics with coughs2. Anyone with a temp over 38.8⁰C, (the temperature should have been checked within the last

30 minutes)3. Any child under the age of 2 years old4. Any adult over the age 75 years who is in a care home or rest home5. Any Terminally ill patient.6. A patient that requires a face to face consultation.

The Fast Track Process is being used to improve services for the patient at this period of acute demand.

Process for Spillages of blood and body fluids

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Wear protective clothing and mop up organic matter with paper towels or disposable cloths Use spill kit if required. Clean surfaces thoroughly with a solution of detergent and hot water using paper towels or

disposable cloths Rinse the surface and dry thoroughly Dispose of materials as clinical waste – Group A Orange Bags Clean the bucket/bowl in hot soapy water and dry Cleanse hands

Spill Kits

There are spill kits and personal protective protection equipment kept at all sites: Instructions on packaging.

Site Position of spill kits

Rochdale Surgery 1 Lower filling cabinet drawerRochdale Surgery 2 Bottom desk DrawerHeywood filing cabinet with the prescriptionsBury Fairfield Bottom drawer of each of our locked chest of drawers in each surgery, there

are also spares in the grey locked wall cupboards in each room.Bury Moorgate Bottom drawer of each desk and spares in storeroom on 2nd floorBolton Blue cupboard in the back office

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NotesIf information suggests the death is expected but there are no special notes or they are out of date, you can try to contact the patient’s own GP for verbal confirmation that the MCCD will be issued. Alternatively if it is a few hours until the surgery opens then the deceased can remain at home with the surgery being informed at 08:00am. The coroner’s office is happy for nothing to be done until the surgery can make a decision as to whether MCCD can be issued.

Unexpected deaths, expected unnatural deaths and industrial related deaths should be passed to the policeUnder no circumstances should the deceased’s family or the carers be asked to contact the police, this should be either done by the clinician directly or by contacting base and asking the shift lead to make the call.

Visiting criteria for -Advanced Nurse Practitioners

Verify death and allow deceased to be transferred to a funeral home Yes

(option1)

Yes

No

No

Are the notes in date? (patient seen within the last 14days)

There are two options to explore before passing to the police . Both of these depend on the time of verification1-GP rung and verbal confirmation obtained that MCCD will be provided2-Verify death and leave deceased at home with agreement of the relatives or carers. Please inform shift lead as surgery will be contacted at 08.00

.

NoYes

YesNo

Verify death and inform police Are there special notes in place

Expected Natural Death – based on history/special notes and/or the information provided by relatives/carers

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These symptoms are subject to the nurses own competencies

Ear, Nose and throat Possible Urine infection Exacerbation of COPD Exacerbation of asthma Possible chest infection Diarrhoea &Vomiting Leg pain Eye infections Abdominal pain Constipation Pyrexia/ fever Minor illness and ailments Skin conditions Back pain Joint pain Wound infections Social problems Patient- “off legs” Recent BARDOC GP Visit Children Mental Health Palliative patients- care of the dying pathway Severe multiple co-morbidities PEG feeds Recent CVA Renal patients- dialysis Unexpected death Expected death- (until training arranged)

Procedure for control Drugs in Cars /satellite stations if required

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The silver boxes (or any other suitable box) that contain Midazolam and Diamorphinecan be pre-packed and sealed similar to the Palliative Care bags

Each car should have 2 packs ready, with a spare kept in the control drugs cupboard

The name, strength, form, expiry and quantity of each medication and content is recorded and displayed on the outer Tamper-proof seal attached

Bags are to be checked on a weekly basis to ensure date appropriate

The box is to be signed in and out by the clinician, there is no requirement to check the contents, if the is seal is intact.

If medication is used then record the medication details, seal number and document in CDregister and inform shift lead

Replace box with sealed box

Drugs which are not used can be reused in new packs

Each pack should contain Small syringe and 3 needles

Controlled Drug Procedure –Signing out Drugs for Visiting Clinicians

The key holder is responsible for the drugs and must follow this process. Clinicians are not allowed access to the Controlled Drug Cabinet unsupervised.

Retrieve the Controlled Drug Cabinet Key from the key safe.

Open the silver case for the correct visiting car and physically check the amounts in the wallet:

Bolton Base Bury Base

Morphine 15mg/1ml x 3 Diamorphine 5mg powder x 3

Morphine 10mg/1ml x 3 Midazolam 10mg/2ml x 3

Midazolam 10mg/2ml x 3

Oxycodone 10mg/1ml x 3

If a Palliative Pack is to be taken out (only in use Out of Hours from Bury Base), do not open the blue pack as the amount has already been checked by a clinician and a witness and contains 10 x Diamorphine 5mg Powder and 10 x Midazolam 10mg/2ml .You are recording that the whole unopened pack is being taken out on a visit.

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Record the Clinicians/Drivers name, date, time, car, amount and both sign in the Controlled Drug Singing In/Out Book. The drugs are then in the possession of the clinician/Driver and are their responsibility until returned. Repeat the process on return.

If any of the drugs are used from the silver case or the Palliative Pack they must be recorded in the corresponding Controlled Drug Record Book from the location they were used and in chronological order within 24 hours .The legal requirement is that the patients name, amount, form, strength and running total is recorded in ink, preferably black and signed by the clinician and a witness. Therefore it is essential that this done whilst signing the drugs back into the cupboard.

If any mistakes are made whilst writing in the record book please do not cross out, amend or use a correction pen, leave visible and make a footnote in red ink at the bottom of the page and briefly explain the error sign and date .

If any stock has been used from the silver case replenish from the back-up wallet for the corresponding car, this is to maintain a safe stock levels for the next visiting clinician. You do not need to record the movement of this in the record book as these drugs are already included in the running total .

If a Palliative Pack is used a spare pack for each car is available for use by the next visiting clinician.

Pharmacy Refrigerator and Safe Storage of Medicines Requiring Refrigeration

When a delivery of fridge line or cold chain products are signed for they are to be stored in a pharmacy fridge as soon as possible to maintain the chain

Vaccines must be kept in their original packaging Monthly stock check of all medication and expiry dates are to be completed The medicines fridge must be secure and accessible only to staff, the fridge should be locked

or kept in a locked room The fridge should be in a well-ventilated position and away from heat sources The fridge must be maintained in a clean condition with no build-up of ice There should be a maintenance contract that allows for at least yearly servicing, calibration of

the temperature gauge and Portable Appliance Testing Products are to be stored on the shelves not the floor of the fridge to ensure circulation and

consistent temperatures Temperature measuring probes should be place in a central position, not in the door and

preferably between products Alarms should be tested routinely Records of the temperature must be completed daily and records kept for a minimum of 6

months Storage temperature of drugs should be between 2 and 8 degrees Celsius, if the temperature

alters two degrees either way staff should inform Head of Operational Services In the event of a power cut or the refrigerator not working, transfer all medicines to another site

and clearly label

BARDOC formulary drugs that require immediate refrigeration are Chloramphenicol eye drops and Glucagen

Mandatory requirements for GlucaGenGlucaGen HypoKit should be stored at a temperature of 2–8°C (in a refrigerator), but it must not be frozen. If stored in the refrigerator the shelf life from the manufacturer is 36 months.

GlucaGen HypoKit can be stored outside the refrigerator at a temperature not exceeding 25°C for 18 85

months provided that the expiry date is not exceeded. It should be stored in the original package in order to protect from light. When the product is taken from refrigerated storage label the product with the date it was taken out of the fridge or a revised expiry date

Homeworking - Laptop Guide

KEEPING PATIENT INFORMATION SAFE AND SECURE

Booting up and logging on

Firstly plug in the laptop to the mains power and then turn on the laptop. The first screen you will be presented with is the laptop encryption authentication screen.

Step 1: Encryption and PIN

Enter the PIN and press the enter key (return key).

IMPORTANT: If you do not know the pin number or feel you have the right pin number but it is not working. Please contact the BARDOC Shift Lead to verify the PIN. TOO MANY WRONG ATTEMPTS WILL LOCK THE LAPTOP. IF THIS HAPPENS THE LAPTOP WILL NEED TO BE RETUEND TO BARDOC TO BE UNLOCKED.

Step 2: Loading Screen

On the next screen the computer will now boot.

Step 3: CTRL + ALT + DELETE

Press CTRL + ALT + DELETE on the keyboard to reach the “login screen”

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Step 4: Username and Password

Enter the username and password and press the arrow or press the enter key (return key)

IMPORTANT: If you do not know the Username and Password or feel you have the right details but it is not working. Please contact the BARDOC Shift Lead to verify the Username and Password.

The Desktop Icons

On the desktop there are a number of important icons for connecting to your clinical application and two others, one for remote assistance (if available) and one for screen size customisation (resolution changing). See “Step 8 – Launch Your Clinical Application” For further details.

Step 5: Wireless Networks

To connect to your home wireless network double click on the “Wireless Networks” icon and choose the appropriately named network.

Next you will need to enter your wireless network password. The password entered should save automatically (after first input) therefore generally this icon should only needed to be clicked to (A) check connectivity or (B) to re-connect to the wifi.

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IMPORTANT: The laptop WILL NOT automatically connect to your home network for the first time, you need to enter your wireless network password (BARDOC DO NOT KNOW THIS PASSWORD)

Step 6: CISCO (VPN)

Once connected to the wireless network the next step is to double click on the CISCO (VPN) icon on the desktop.

In the window that opens on the bottom right of your screen check that it says “BARDOC” in the drop down box and the status is “Ready to connect” then click the “Connect” button.

To make sure you have the correct VPN for your laptop check that the serial number on the back of the VPN Token matches the serial number on the “Laptop VPN Token” sticker.

In the popup window ensure that the username in the box matches the username printed on the on the laptop sticker titled “Laptop VPN Token”.

In the “password” field you need to enter the six digits on the VPN Token. The screen on the VPN token by default is blank, to generate a “password” press the grey button. When the number appears input this into the password

field and press the “Ok” button.

Important: The grey button should always be to the left of the VPN token screen when looking at it; this ensures it is the correct way up. Also to generate a new “password” press the grey button again (repeat until a new “password” is generated).

TOO MANY WRONG ATTEMPTS WILL LOCK THE VPN TOKENIF THIS HAPPENS YOU WILL NEED TO CONTACT THE BARDOC SHIFT LEAD.

When connected a status popup will appear on the bottom right of your screen showing you have successfully connected, this popup will automatically close.

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INFO: Once connected, if you wish to check at any point the status of the VPN connection double left click on the CISCO (VPN) icon.

Step 7: Authenticate with your smartcard

There is a smart-card reader on the left hand side at the front of the laptop. Insert your smartcard and login using your PIN and select the appropriate smartcard role for your session. If you do not have your smartcard available skip this step

IMPORTANT: To access the eReferral Gateway you must have your smartcard present.

Step 8: Launch your clinical application.

Once connected to the VPN double left click on the clinical application icon on your desktop

Application Icon Clinical Role Relevance Description

Odyssey Users

Only users who will be using the embedded clinical triaging tool “Odyssey” should use this icon. All other users please use the “Adastra Launcher” icon.

Non-Odyssey Users

All users, except those using the embedded clinical triaging tool “Odyssey”.

NB: Users wishing to access the BARDOC training system can also use this icon.

HMR Referral Gateway Service Triaging Clinicians

Used to access the NHS eReferral Service

IMPORTANT: Those users using the “Adastra Citrix Launcher” will have their own individual username and password to login to the AHC Citrix Platform. THIS IS NOT YOUR ADASTRA USERNAME AND PASSWORD. The username is in the format off “bar_firstname.lastname”

If you do not know the Username and Password or feel you have the right details but it is not working. Please contact the BARDOC Shift Lead for further advice.

7 Day Access Emergency Contacts Emergency OnlyGP Care Services LTD ECG's Eric Wright (Heywood)01706 906 940 01772 229 637M-F 0800-1629 (Kingsway & Littleborough) Black Box

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General Enquires BARDOC 01772 421 1290161 763 8292 If alarms don’t set (Kingsway 12467, Littleborough) EMISGeneral Enquires Appts Frankie Hall 0845 122 233207507 737 127 Emergency OnlyService Hours I.T System Dr Walker (Peterloo)General Enquires Kingsway Medical 07813 807 22407519 034 412 Emergency OnlyHub site receptionist Birtle View Emergency at Peterloo Dr Tonge (Peterloo)07535 147 481 07970 069 837Hub site receptionist Littleborough Emergency Only07523 549 806 Emergency at Peterloo Dr Jiva (Peterloo)Hub site receptionist Peterloo 07545 459 41907946 267 095 Emergency OnlyHub site receptionist Health Desk – Manager On Call Emergency at Peterloo Dr Zaman (Peterloo)0345 113 0099 07968 787 168Service Issues Michael Rowe (Bromwell) Emergency Only0161 236 0141 Emergency at Peterloo Kelly Vines (Littleborough)0161 765 6683 07446 953 479IT On Call Engineer Emergency at Littleborough IT Help desk number0161 765 6690

Cross Boundary Contact Numbers

Out of hours Service Area Covered Phone NumberGo To Doc Tameside Oldham Manchester 0161 336 5958East Lancashire Medical Services (ELMS) Whitworth Blackburn/Darwen Burnley Rossendale Clitheroe 111Bridgewater Ashton-In-Makerfield Wigan Leigh 01942 829911Chorley OOH’s Chorley 01257 267402

Salford Foundation Trust Salford GP Out of Hours Service (Treatment Centre) 0161 206 0423

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