Introduction
Welcome to the Oakwood Surgery.
It is our aim to provide high quality medical care in first class surroundings. To this end we endeavour to foster an open and enquiring team where communication is clear, honest and respectful. We are keen to maintain a friendly workforce where everyone feels valued.
Becoming and maintaining the status of a training practice is important to the team at the Oakwood Surgery.
We understand the value of being surrounded by enquiring minds and have fond memories of our time as training doctors. We hope that you find your time at the Oakwood Surgery educational, stimulating and enjoyable. Whilst we will endeavour to do all that we can to meet these aims, we appreciate that your willingness to achieve as a doctor will play a large part in what you manage to achieve in the short time that you have with us. Ultimately, as a self directed professional you will be responsible for your own learning but we freely give our time to support you in any way that we can in your personal and professional development.
Whilst helping you read through the curriculum of the Royal College of General Practitioners and obtaining the certificate of completion of training (CCT) by completion of the Membership of the Royal College of GP’s (MRCGP) is our primary goal we also hope to create a doctor capable of the rigors of general practice for the future. This means not only developing a doctor whom is capable of lifelong learning but also developing one’s extra curricular skills in leadership, management and medical politics.
Please use your time with us to your advantage.
Telephone numbers
GP 1
GP 2
GP 3
Registrar
F2
Main Treatment Room
Treatment Room 2
Treatment Room 3
Reception Desk
Admin Desk 1
Admin Desk 2
SAT
Secretary
Main Office 1
Main Office 2
Practice Bypass number
Practice Mobile
Emergency number
Emergency Care Practitioner
Single Point of Access
212
211
213
215
214
216
217
218
220
221
222
225
226
230
224
379314
07804078482
371399
Advice and Guidance – 01302 976440
Induction - to do list
The following is a list of information that our practice manager will need to see before you can begin employment at the practice.
Please tick through this checklist as your start your induction with us.
Once completed, please return it to your clinical supervisor
Proof required: Shown
GMC certificate
Proof of Professional Clinical Indemnity
Driving License
Bank details
Proof of DBS
Salary Details
P45
Smart Card
To do list –
Your contract details
Car Expenses / Mileage Claim Form
How to apply for leave
Tour of building
Introduction to staff
Fire Procedures
Complaints procedures
Panic alarms
Handbook Of Terms And Conditions Of Service For GP Trainees
Confidentiality Clause
Chaperone Policy
Equal Opportunities Policy
First fortnight - to do list
This is a list of tasks, forms and systems that you should try to quickly become familiar with during you first fortnight.
Please tick through this checklist as you progress in your first fortnight though this placement.
Once completed, please return it to your clinical supervisor
Use of Computer:
o Logging in
o Call Patients
o Entering consultations
o How to look at results
o How to look at ‘Workflow’
o Looking at appointments
o Acute Prescribing
o Repeat Prescribing
o Immunisation Status
o QOF
Appointment System
Timetables
Visits
Duty Doctor duties
Triage and Minor Illness clinic
Arranging Follow Ups
Sick Notes
Other Certificates
Patient Information Leaflets (PILs)
How to Refer
Where to Refer
2 week wait
‘Auto-letters’
Arranging Blood Tests
Arranging Microbiology
Arranging X-Rays
Arranging ECGs/Spirometry/24hr BP
Results
Paper letters & forms
Suitability & arrangement of Minor Surgery
Familiarisation of Practice Area
Safeguarding Children/Adults
Liaising with Health Visitors
Liaising with District Nurses
Pregnancy Management
Dealing with emergencies
Holidays
Confidentiality
Health & Safety: Fire alarms & exits
Calling for help in consulting rooms
Learning agreement
There are two areas that you are signing
You should read both carefully
st section is within your ‘Contract of Employment’
2nd section is in the ePortfolio
They will countersigned by your clinical supervisor
Fees
o All fees received by you by virtue of your position in the practice shall be paid to the practice or as they may direct
o Any specific or pecuniary legacy or any gift of a specific chattel shall be considered your personal property
Outside Activities
o Subject to the provisions of clause 14 of your contract of employment, you must not, without the prior written consent of the GP Trainer/educational supervisor, accept any other employment outside the Practice
o Consent will not be unreasonably withheld
o Any such employment must not impinge on your contracted duties or your education as determined by the GP Trainer/educational supervisor
o You hereby agree to permit your GP Trainer/educational supervisor to approach any other company, firm or person whom you are, or may be, employed for the purposes of ascertaining the extent of outside activitieso The GP Trainer/educational supervisor’s consent to your accepting outside employment does not imply any responsibility on his or the Partners’ part for your acts and omissions in the course of such activities
Personal Use of Telephone
o The Practice telephone (including any mobile telephone with which you have been issued) should not be used for personal calls except where it is unavoidable
o Such calls should be short and (if on a conventional phone) normally within the local area; any calls outside the local area will be charged for and you should therefore notify the Practice Manager
Name of Trainer
…………………………………………………
Signature of Trainer
…………………………………………………
Date
…………………………………………………
Name of GP Registrar
…………………………………………………
Signature of GP Registrar
…………………………………………………
Date
…………………………………………………
Your consulting room
GP registrars have an allocated consulting room which you will be shown during induction.
In your room, you should find all essential items required to carry out your work. It is your responsibility to keep your room stocked, and if you need any more equipment please speak to Tina Hope who will help you find what you need.
You will also be given a visit bag containing all the equipment you will need for doing a home visit.
You will be responsible for the contents of your room and bag and will be charged for any items damaged or lost whilst in your care.
Items Present
Practice Stamp
X Ray forms
Pathology Forms
FP10 Pad – for hand writing
Auroscope
Ophthalmoscope
Spare ear pieces
Tongue Depressors
Portable sphygmomanometer
Thermometer
Peak flow meter
Equipment list
In Each Room
Weighing Scales
Swabs
Height measuring equipment
Urine Dipsticks
Sphygmomanometer
Electronic thermometer
Pulse Oximeter
Measuring Tape
Stethoscope
Peak Flow Meter
Auroscope
Ophthalmoscope
Peak Flow Meter
Tongue depressors
In The Practice
Speculums – in the medical store of side examination room
Blood taking facilities – in treatment room or phlebotomy room
ECG – in treatment room
Spirometer – in treatment room
Glucometer – in treatment room
24hr BP Machine – in treatment room
Oxygen – in the treatment room
Digital Video Camera – in Dr Eggitt’s room
Communicating with the extended team
During you time at The Oakwood Surgery you will come into contact with:
o Midwives
o District nurses
o Health visitors
o School nurses
o Pharmacists
o Physiotherapists
o Community Intervention Team
o Social Services
o Community Mental Health Team
o Elderly Community Mental Health Team
Please be polite and courteous to all professionals that you come into contact with. We all play our own small but important part in the wider NHS and healthcare community. There is very little to be gained from upsetting your colleagues, but much to be gained from befriending them.
Contacting your trainer
It is essential that you can access your trainer or their nominated deputy at all times.
You will usually be working at the same time and same venue as your trainer and will be able to ask for help whenever you need it.
If you need help with your computer or stationary, please speak to one of the reception team who will be able to help
People at the practice
Dr Ruth Harding
GPStR Training
Contraceptive Implants
Medical Student Training
Dr Dean Eggitt
GPStR Training
Safeguarding Lead
LMC and Medical Politics
Joint Injections (Shoulder, Knee, Troch Bursa, Med / Lat Epicondyl, Plantar Fasciitis)
Minor surgery
Ngozi Nwokoma
GP
F2 Training
Joint injections
Richard Harris
Pharmacist
Prescriber
Nurse – Amybeth Jones
Prescriber
Cervical Screening
Minor illness (not children under 2 years)
Contraception
Travel Vacs
Smoking Cessation
Chronic disease
Nurse – Sally Hall
Colonic Irrigation
Smoking Cessation
Chronic disease
Minor illness
HCA and Reception – Jackie Barlow
Blood pressure
ECG
Phlebotomy
Weight/height
Chaperone
Customer services
HCA and Reception – Kerry Wigham
Blood pressure
ECG
Phlebotomy
Weight/height
Chaperone
Customer services
Allison Edgeler
Staff and services management
Contracts and finances
Jane Cartwright
Enhanced services, audit, CQC, QoF
Staff management
Barbara Dale
Enhanced services, audit, CQC, QoF
Staff management
Janie Drago
General secretarial skills
Knows all of the referral routes!
Sue Lee
Customer services
Insurance reports
Meloney Derosa
Customer services
Jacqueline Huckerby
Customer services
Services offerred by the practice
Liquid Nitrogen
For those patients who require cryotherapy to simple skin tags and warts.
Book in for an appointment with Dr Eggitt.
This service is not used for warts and verrucas which can easily be treated with Bazuka Gel. If you are unsure, please ask.
Nexplanon
Provided by Dr Harding
Please discuss with Dr Harding before booking in
Ring pessary
Coils / IUD
Endometrial Biopsy
Provided by Dr Philips
Please discuss with Dr Phillips before booking
First to Physiotherapy
We are fortunate to have ech access to physiotherapists
We can book in directly using SystmOne
Minor Surgery
Dr Eggitt provides minor surgery for the practice and usually has a clinic every other week.
If you are not sure: ask…..
After the decision has been made to offer the procedure, the name should be given to reception to book the appropriate appointment
Services provided include
o Skin Tags (including on eyelids)
o Seborrheoic Keratoses
o Lipomas
o Sebaceous Cysts
o Warts
o Benign Naevi
Maximising your experience with us
When booking your surgeries we try to vary your experience bearing in mind the following factors
o Your ST year
o Your current pressures [exams: shorter appointments, more videos, more joint surgeries]
o Workload within the consultations [QOFs, ‘added value’, patient mix]
o Observations following debriefs
o Your ePortfolio
o Feedback from the non-trainer supervised debriefs
o Receptionist feedback
o Timekeeping
o Other PCHT member feedback
The balance of case mix during a session is carefully monitored and adjusted to ensure a broad variety of patients. This is achieved by
Face to face consultations
Most of your consultations will be face to face. You will start on 30 minute appointment and bit by bit work your way towards 10 minute appointments by the end of ST3.
Telephone triage
Patients are effectively screened by us before you see them. We will ensure that they are appropriate for you to see. You will be given the opportunity to talk to patients and conduct triage over the telephone.
Telephone consultations
These are introduced after roughly 3 months in practice. This is usually done after gaining some experience at the out of hours service.
Chronic disease clinics
You will have the opportunity to see patients which chronic diseases. These are usually co managed between doctors and our nurse team. The exposure that you need to each chronic disease area depends upon your own personal learning needs. Patients will be allocated to you as the need arises following review of your ePortfolio, debriefs and feedback from the PCHT.
Minor surgery
You will have the opportunity to join Dr Eggitt in the minor surgery clinic.
Baby Clinic
You will be expected to work with supervision as the doctor supervising the baby clinic conducting 6-8 week old baby checks.
Investigations
Available In Practice
Random Blood Sugar (BM)
Venous blood sampling
Sputum samples
Urine Samples
Stool Samples
Semen Samples
Wound Swabs
Nail Mycology
Cervical Smears
Vaginal Swabs
24hr Urine Collections
Spirometry including reversibility
Urine Dipstick
12 Lead ECG
Peak Flows
24hr Blood Pressure / Home blood pressure monitoring
Available Outside Practice
Paediatric blood tests (aged < 12)
DEXA Scanning
Standard X-Rays
CT
MRI
Ultrasounds
Barium Meals
OGD / Colonoscopy
24hr ECG
Urgent Requests
These should only be requested if urgently needed and will affect the management of the patient
Please remember that urgent patients are slotted in between already full clinics and so any urgent requests makes a big difference to the workload of others.
Be polite and ask your colleague if they have the time to do the test, rather than tell them to do it.
If there is no capacity to do the test at the practice urgently, then speak to your supervisor.
Haematology/Biochemistry/Microbiology (including swabs)
Ask the healthcare assistant or nurse if it would be possible to do the test now, or do it yourself.
Complete all the details on ICE.
Write on the request ‘urgent request: please phone result through’.
Someone will need to phone ahead through to the labs so that they are prepared to receive an urgent sample – either do this yourself or kindly ask one of the reception staff to do this on your behalf.
Samples are collected at 1pm at the latest. Any samples done after this time will not be taken to the hospital the same day. If the sample is still needed urgently in the afternoon, then the patient will have to be sent to the hospital to have their bloods done there.
ECG
There are few reasons why an urgent same day ECG is needed in primary care. If there is something acutely wrong with a patient’s heart, then they usually need to be in hospital.
Ask the healthcare assistant or nurse if it would be possible to do the test now, or do it yourself.
Once the ECG is done, the healthcare assistant or nurse will show it to you straight away. Be prepared to read it and act upon it straight away.
In reality, if the ECG is genuinely urgent then the patient is likely to need admission or AE.
Minor surgery
One injection can be booked into a 10-minute routine appointment
All minor surgery should be booked into the minor surgery session which usually happen on a Wednesday afternoon. These appointments are booked by reception.
If you want to book a patient in for minor surgery, then inform reception and they will do the booking.
All patients requiring minor surgery will need to be checked by Dr Eggitt first to ensure the lesion is suitable for surgery and that it can be removed in house. Please speak to Dr Eggitt whilst the patient is with you.
RH
Small skin tag – liquid nitrogen
Medium skin tag – liquid nitrogen
Solar keratosis – for topical Picato unless isolated lesion.
Warts – use otc treatment first line
DE
Shoulder joint injection
Knee joint injection
Tennis elbow injection
Golfer’s elbow injection
Trochanteric pain injection
Plantar fasciitis injection
Drainage of prepatella bursa
Drainage of olecranon bursa
Small skin tag – liquid nitrogen
Medium skin tag – liquid nitrogen
Large skin tag – minor surgery
Solar keratosis – for topical Picato unless isolated lesion.
Warts – use otc treatment first line
Skin cyst – minor surgery
Benign skin lesions – needs individual review
Small lipoma – minor surgery.
Repeat steroid injections can be given 4-6 monthly if they are effective. If they are not effective, then there is no point in trying another injection.
Any queries or questions: please discuss with individual clinician
Larc / coils
All women being reviewed for contraception should be offered long acting reversible contraception and coded to show this.
There is a template for this, where you can simply tick the box showing that you have offered LARC advice.
Long Acting Reversible Contraception is one of the following
o Nexplanon
o Depo-Provera
o Mirena
o Copper coil
Arranging:
Discuss any uncertainty with your supervisor before booking
Consider swabs before coil or Mirena fitting
Please ensure the woman is not pregnant
All Nexplanon need a prescription issuing in advance
The normal/routine fitting is made through reception: please write on a slip of paper required procedureCoils/Mirena: please book for triple swabs and then book a telephone appointment with Dr Phillips to counsel the patient
Depo-Provera: book within the first 5 days of period starting
Nexplanon: please book a telephone appointment with Dr Harding to counsel the patient
Coils for post coital contraception: appointment can be booked up to 19 days of the period starting AND within 5 days of unprotected sex. Book a telephone appointment with Dr Phillips to counsel the patient. If Dr Phillips is not available, signpost the patient to the East Laithgate Sexual Health Clinic.If the Mirena is fitted for menstrual or HRT reasons and the lady has contraception [male/female sterilization]: the coil can be fitted at any time during the cycle
Device Duration of action
Nexplanon 3 years
Mirena 5 years
Copper Coil 3 years
Depo-Provera 12 weeks
Read Code Short Code Read Code
Advice About Long Acting Reversible Contraception LARC 8Caw.00
Referral letters
Aim
To provide clear and concise letters that are easy to read, summarise the relevant information for the receiving clinicians
Choose & Book
2ww referrals are via ‘Choose & Book’. Add the patient as an appointment under the Choose and Book session on the day.
Suspected Cancer Referrals
This must go through the 2 week wait process on a pro-forma
These ‘pro-formas’ are ‘auto-letters’: please ask you supervisor to show you how to access these
The patient must be informed that they will be seen at the hospital within 2 weeks and if not to inform the practice that this has not happened
This should be recorded in the notes
This must be handed to a receptionist with the words ‘this is a two-week wait referral’
How to Get a Letter Typed
Type it yourself!
Format of Letter
Dear Colleague,
Thank you for seeing this… year old patient who presented with …
Further history reveals…
On examination I have found…
Investigations done so far have shown…
I wonder if this is…
I would be grateful if you would…
Kindest Regards,
Dr X
Medications and problems will be automatically added to the letter by SystmOne.
Save the letter.
Add the patient as an appointment under the Choose and Book session on the day.
Training activities
This is a list of the activities that occur regularly within the practice
Please make the most of them
Debriefing
After every surgery
During surgery if natural break
Discussion during surgery if problems
Tutorial
Once weekly with all the trainees in the practice
The tutorial time is rotated through all of the partners
Is normally before surgery starts [therefore start time will vary]
Topic of tutorials to be decided by you
Additional PHCT member can teach: please arrange with individuals
Practice On-Calls
Weekly with supervisor cover
Arranged two weeks in advance
Need to be contactable by mobile phone and have access to personal transport
Chronic Disease Clinics
Please make arrangements with nurses to gain exposure
Baby Clinic
Please refer to individual timetable
Will be timetabled monthly
Videoing
Useful for developing consultation technique
Used as assessment for COTs
Useful preparation for CSA
Remember consent: see separate section within this guide
Give reception plenty of warning to organise the consent forms
Others
Practice meetings: Monday lunchtime
Palliative Care Meetings: Every 3 months
Safeguarding Meetings: Monthly
Forum Target: Monthly
Practice Target: Quarterly
Minor surgery: as hoc
Out Of Hours (by appointment)
On call - duty dr
These are an important part of general practice care.
There is always an ‘on-call’ doctor, every day to deal with all of the non routine tasks that the day may bring. The on call doctor is also known as the duty doctor.
Task list –
Telephone consultations
Appointment management for the team on that day
Assignment of home visits
Supervision of the team
Reception
Admin
HCA
Nurses
Managing investigation results for team members who are not there
Routine repeat prescriptions (electronic and paper)
Problem prescriptions
Controlled drug prescriptions
“Tasks”
Managing incoming letters
On-Call starts from 0800 and finishes at 1800.
Please ensure you are aware of which GP partner is supervising your on call and have their phone number in case of difficulty.
You should ensure that reception has your mobile phone number.
You should remain contactable at all times and will need to let the reception staff and your supervising doctor know if you are leaving the practice premises. You will then need to be contactable via mobile phone.
Please check your signal on your mobile if going anywhere where a mobile signal is likely to be less than idea
DON’T PANIC
o General Practice is ‘team work’
o If you don’t know what to do, ASK
o If you feel you are getting overwhelmed with ‘work’:
ASK FOR HELP
Home visits
These are an important part of general practice care. As GP’s we are privileged to be able to go to people’s home to see how they live. They allow us to see the patient in their own environment and allow us to assess how they are functioning and as such are an indispensable way of getting to know your patients.
Home visits are given to those patients who are unable to attend the practice because of ill health. Consequently, they are usually for elderly patients or those who are receiving palliative care.
We will try to minimise the number of home visits that we offer. You will not normally have to do any more than 1-2 per day.
On those days where you need to use your car for a home visit, you are also eligible for claiming a mileage allowance for driving from your home to work, and back to home again. Claims must be submitted to the Practice Manager within the following month.Initially you will do joint visits with your supervisor and eventually you will be able to do these on your own. However, your supervisor will always be available for advice over the telephone.
Home visits are a great way of learning how to deal with the unexpected and how to liaise with the wider health care team.
Tutorials
Occur once a week
You will have a chance to have a tutorial with all of the partners. Each partner has a different skill set and different perspective of general practice.
The tutorial topic can be negotiated with your tutor, but please allow 3 days notice for preparation if this is needed.
The focus of the tutorial will not be on imparting book/internet knowledge but the application of the knowledge into day-to-day work as well as more esoteric work such as ‘teaching’, ‘commissioning’, ‘performance’ or ‘clinical governance’.
Format of the tutorial will vary depending on what has come up & how you wish to learnAdditional tutorials can be arranged with other PHCT members depending on your needs [practice management, chronic disease clinics and so on]
The tutorial should be documented after each tutorial on your ePortfolio in the appropriate section.
WPBA
The ePortfolio will be reviewed regularly and if there are a lack of entries, educator notes will be used to remind you.
Remember, it is ultimately your responsibility.
There are also a range of assessments to be completed before the local Doncaster ARCP panels.
Maintaining the ePortfolio is difficult and time consuming. We understand and sympathise with this, but ask you to remember that it is an integral and unavoidable part of your learning.
During the normal working week, you have the opportunity to add to the ePortfolio in-between surgeries and in your personal study half days. The ePortfolio is an ongoing learning tool and should be regularly updated.
We think there is enough time for you to add good numbers of entries but if you choose to conduct other activities during the time you may have to complete the ePortfolio during evenings and weekends. By hook or by crook, it must be done.
Audit
You are required to undertake a GP based service improvement activity in your 3 years of training. Usually, this is undertaken as a clinical audit. This should be inline with COGPED guidance and utilise the following headings:
1. Reason for choice of audit
2. Criterion/Criteria Chosen and why
3. Standards set and why
4. Preparation and Planning
5. Data Collection (1) and comparison to standards set
6. Change(s) to be evaluated
7. Data Collection (2) and comparison to standards set
8. Conclusions
Ideally, you should perform the first data collection for your audit in your first 6 months of GP training, in order to allow time for your changes to be implemented and the second data collection to be completed in the final year of GP training. You are always welcome to return to the practice to complete your audit after your attachment has finished, for example during your hospital posts, or if your second GP attachment is with another practice. You are entitle to use study leave to do this
The choice of audit topic is yours, but should be something that is of interest to you and hopefully of benefit to the practice population. In choosing your topic, you may wish to try and tie in with the practice’s audit programme.SystmOne has data search capabilities which you will find of significant benefit. Talk to Tina or Jane and they will help you to collect your data.
Definition Of Audit
“The process to assess, evaluate and improve the care of patients in a systematic way in order to enhance their health and quality of life”
Why Bother?
There are many reasons to do audit and these include:
Improvement in patient care
Improvement of efficiency within the practice
Less chance for clinical and organisational errors to occur
Improvement of effectiveness
Demonstration of good care
Meeting patient needs
Bidding for resources (particularly if change is needed to make improvements)
Promotes higher standards in secondary care
You have to do one GP based quality improvement project as part of MRCGP
AUDIT IN 9 EASY STAGES…
STEP ONE:
CHOOSE A TOPIC TO AUDIT.
Demonstrate consideration of several topics and be able to state the objective of the audit.
STEP TWO:
DEFINE CRITERIA
What do you want to look at?
What is measurable?
STEP THREE:
DEFINE STANDARDS
Examine local literature for expected standards including guidelines
Discuss them with the Team
Be able to evaluate appropriate standards for the selected audit topic
STEP FOUR:
DECIDE ON METHODOLOGY
How will the data be collected and what sample size and type will be used?
STEP FIVE:
DATA COLLECTION
Design a way that can be used to collect relevant data, e.g. data collection sheet
STEP SIX:
COLLECT DATA
This is usually done in a specified timescale
STEP SEVEN:
ANALYSE THE RESULTS AGAINST CRITERIA AND STANDARDS
What criteria do not meet the set standards?
STEP EIGHT:
RECOMMENDATIONS FOR CHANGE
These should have an impact on the standards that are currently not met
STEP NINE:
RE-AUDIT
After an appropriate timescale has passed, repeat the audit. This should allow you to see improvements
Videos
We encourage you to video yourself consulting for several reasons:
How am I doing?
CSA Reviewing
COTs (at lease 3 should be done with this technique)
Getting you comfortable with ‘observation’
The camera links into Dr Eggitt’s computer to allow review of the consultations.
Process for organising video surgeries:
1. Discuss with reception best surgery to do videoing
2. Agree this and get a ‘Video Tag’ added to your surgery screen
3. Ensure there are enough ‘Video Consent Forms’ with reception.
4. Ask Dr Eggitt for the video camera
5. Familiarise yourself with the video camera
6. Check the consent with the patient before you start videoing
7. Check the consent with the patient after the videoing has finished
8. Make arrangements how to review the videos
a. By yourself
b. Or with Dr Eggitt
9. Once you have finished with the camera, please return to Dr Eggitt. You will be responsible for the camera whilst it is in your possession.
Leave
This policy applies to all forms of leave:
Annual Leave
Study Leave
Paternity/Maternity Leave
Only one F2/GPStR will be allowed leave at any one time (with the exception of parental leave)
One month’s notice of intended holiday to be given to the Trainer
Applications for leave must be made using the leave request forms
Applications must be approved via the manager
All leave to be recorded in the Trainee’s personal file and in the leave diary for all clinicians
HOLIDAY, STUDY & PARENTAL LEAVE REQUEST
All leave requests:
Must be on the appropriate form
Must be discussed with your trainer first
Your trainer must sign form
Only one trainee off at one time
All study and holiday applied at least 4 weeks before planned leave
Study Leave:
Your study leave is 5 days per six months
This is over and above the HDRC study time
Only approved courses will be allowed within this time
Must be applied for at least 8 weeks before planned leave
Must comply with Doncaster GPST Programme Guidance
Approval for the course must go through the following steps:
o Discuss with trainer
o Update PDP to reflect course
o Complete FRS surgery study leave form
o Apply to Doncaster GPST Programme
Sick Leave:
Please complete absence form as soon as you return from any absence due to illness.
Contractual obligations
You must maintain current GMC registration
You need to be on a National Performers list
Have a currently valid CRB /DBS check
You must have medical defence organisation cover during your general practice post
Have an ‘NHS Smart Card’
Normal Working Week
o Payment for GP Trainees during normal working hours is that of a 40 hour week
o Included in this time is time for half-day release activities
o Contractually the working day starts when the trainee session’s starts at the Practice and ends when the session is scheduled to finish
o Lunchtimes are not included in the working hours
o The ½ day per week off has never been a contractual obligation on the part of the employer, but we accept that by custom and practice it has become an expectation of trainees to have a ‘Personal Study’ half-day
o There should be no problem in a trainee having the ‘personal study half-day’ during the week as long as they can demonstrate that they are undertaking timetabled sessions for 40 hours per week in their Training Practice. This can include surgeries visiting time, study and audit time etc. This should give Registrars flexibility whilst meeting their contractual obligations
Out of Hours
o Trainees are contractually obliged to undertake no less than sixteen 4 ½ hours sessions (or equivalent with about ½ hour debriefing) in the 12 month GP training
o This is addition to your contracted 40 hours and allows payment of the 40% supplement
o It is recommended that trainees undertake at least 8 sessions in the first 6 months
o It is important that trainees do not exceed the maximum permitted hours as stipulated by the European Working Time Directive
Please also refer to the ‘The Oakwood Surgery Employee Handbook”. This is available on the intranet.
Chaperones
The Oakwood Surgery is committed to providing a safe, comfortable environment where patients & staff can be confident that best practice is being followed at all times and the safety of everyone is paramount
This policy adheres to local and national guidance and policy: “NCGST Guidance on the Role and Effective Use of Chaperones in Primary and Community Care settings”
The policy is clearly advertised through patient information leaflets and on notice boards
Patients are encouraged to ask for a chaperone if required at the time of booking an appointment wherever possible
All staff are aware of, and have received appropriate information in relation to, this chaperoning policyAll formal chaperones understand their role and responsibilities and are competent to perform that role
Checklist for Consultations Involving Intimate Examinations
1. Establish there is a genuine need for an intimate examination and discuss this with the patient
2. Explain to the patient why an examination is necessary and give the patient an opportunity to ask questions3. Offer a chaperone. If the patient does not want a chaperone, record that the offer was made and declined in the patient’s notes
4. Obtain the patient’s consent before the examination and be prepared to discontinue the examination at any stage at the patient’s request
5. Record that permission has been obtained in the patient’s notes
6. Once chaperone has entered the room give the patient privacy to undress and dress. Use drapes where possible to maintain dignity
7. Explain what you are doing at each stage of the examination, the outcome when it is complete and what you propose to do next. Keep discussion relevant and avoid personal comments
8. If a chaperone has been present record that fact and the identity of the chaperone in the patient’s notes
9. Record any other relevant issues or concerns immediately following the consultation
Click here to link to the latest GMC guidelines for intimate examinations:
Read Codes Used
Z18210 Chaperone Offered
Z18220 Chaperone Present
Z18230 Chaperone Refused
Z18240 Nurse Chaperone
Significant events
There is no single definition of a Significant Event. Practices should record any incident or situation sufficiently out of the ordinary to warrant a permanent record, and perhaps with the potential to prompt action learning or change. Events may be adverse, or may be commendable incidents, and both require a record, a review, and appropriate acknowledgement
Examples of significant or critical events
Any incident that gives rise to actual or possible physical injury or patient dissatisfaction.
An injury sustained by a member of staff during the course of work
Any near miss i.e. an incident which if it did not cause harm could do so if it happened again.
Post operative infections
Medication errors/issues
Death on the premises
New cancer diagnoses
Suicides
Mental Health Act admissions
Child protection cases
Inaccurate or incomplete medical records
Delayed or missed diagnosis
Referral difficulties
Failure in message handling
Events which have resulted in a complaint
Objectives Of Significant Event Reporting
To record a incidents that may effect or have effected patients or staff
To record “near misses” so that steps may be taken to prevent a recurrence
To learn from the event as a team, discuss, and put change or procedures in place to improve
To commend and acknowledge good practice
To provide a permanent record of events and evidence of remedial steps taken.
To satisfy the requirements of QOF and nationally required incident reporting standards
To operate and discuss incidents in an open environment and within the safety of a “blame-free culture”
Process
Complete the form below
The completed forms are reviewed to ensure no ‘immediate action’ needs to be taken
The event is then discussed in a multidisciplinary team meeting
Actions are decided by the multidisciplinary team
Minutes are kept of the meeting
The minutes are reviewed periodically to ensure the required actions have being completed
When using the form below please do not add any patient identifiable information.
If you feel that the event requires learning outside of the practice, please complete the official NHS online reporting form
Confidentiality
During you time as a trainee at The Oakwood Surgery, you will be party to a large amount of sensitive information
From patients
From partners
From accountants
From meetings
From staff
You must remember that this information is extremely privileged and sensitive
We ask you respect the information that is afforded to you without question and that wider knowledge of this sensitive information could do harm to individuals and the practice as a whole
The knowledge you gain from the sensitive information will be extremely helpful to your future career even if not obvious at the time.
We thank you in advance for you co-operation
Information security
INFORMATION SECURITY IS EVERYONE’S RESPONSIBILITY
This Practice is committed to preserving, as far as is practical, the security of data used by our Information Systems. This means that we will take all reasonable actions to:
Maintain the CONFIDENTIALITY of all data within the Practice by:
Ensuring that only authorised persons can gain access to our System
Not disclosing information to anyone who has no right to see it
Maintain the INTEGRITY of all data within the Practice by:
Taking care over input
Ensuring that all changes are reported and monitored
Checking that the correct Record is on the screen before updating any informationLearning how the System should be used and keeping up-to-date with changes which may affect functionality
Reporting all apparent errors and ensuring they are resolved
Maintain the AVAILABILITY of all data by:
Ensuring that all equipment is protected from intruders
Ensuring that Backups are taken at regular, pre-determined intervals
Ensuring that contingency is provided for possible failure or equipment theft and that any such contingency plans are tested and kept up-to-dateThe Practice will take all reasonable measures to comply with our legal responsibilities under:
The Data Protection Act (1998, 2018)
The Copyright, Designs and Patents Act (1988)
The Health & Safety at Work Act (1992)
The Access to Health Records Act (1990)
GDPR (2018)
All members of the Practice will endeavour to increase their awareness of Security Issues
A first and necessary pre-requisite will be to complete the online information governance toolkit and to provide Jane with a copy of the certificate of completion. Please discuss this with the practice manager.
Complaints
The Oakwood Surgery follows the NHS Complaints Procedure
A full version of ‘The Oakwood Surgery Complaints Procedure’ is available for download by clicking here
Here are the highlights:
The Complaints Manager for the Practice is the Practice Manager
All complaints should be directed to Allison
The ‘responsible person’ for the practice is Dr Phillips
Patients may complain to the practice, or to the Area Team.
All complaints, written and verbal will be recorded
Written complaints will be acknowledged in writing within 3 working days of receipt
If a complaint is made verbally and is resolved to the complainants satisfaction within 24 hours, it need not be responded to formallyThe reply to the patient should be made within 10 working days [with updates and estimated timescale if the investigation is taking longer]
Patients can make complaints within 12 months of the incident or coming to their attention
If a patient is unhappy with the outcome of the complaint they can ‘escalate’ the complaint by involving the Ombudsman.
Occupational health
Good Medical Practice dictates that it is very important that you are currently registered with a GP and that you are not registered with this practice.
As an employee of The Oakwood Surgery you are also able to access local Occupational health services.
NHS Doncaster CCG occupational health service is run by Doncaster Royal Infirmary and they can be contacted on 01302 366666 [extension 3651]
The principle of occupational health is to manage any health related effects of work and also to make alterations if necessary to working hours and conditions if a medical problem requires this, through liaison with the employer
Workplace wellbeing [Counselling Service]
Workplace wellbeing offer confidential counselling services to GP trainees as well as other NHS staff in South Yorkshire
This is a free and confidential service.
It is a self-referral service
We, and no other person or organisation locally or within the Deanery, will have no awareness that you have accessed the service (unless you wish otherwise)
The website is at http://www.phs-sheffield.nhs.uk/wwb/
The telephone number is 0114 226 1810
The line is open 0900-1645 with a voicemail service outside those times
Disabilities
This policy should be read in conjunction with the practice’s equal opportunity policy.
The premises
The Oakwood Surgery was built to ensure physical access for disabled staff and patients.
The following areas have been given specific consideration:
Steps and stairways
Kerbs
Exterior surfaces and paving
Parking areas
Building entrances and exits (including emergency escape routes)
Internal and external doors
Toilet facilities
Lighting and ventilation
Floor coverings
Signs
Furniture
Adjustments for staff
The practice is committed to ensuring that any currently employed or potential staff with disabilities are able to work with us and will make any reasonable adjustments required in order to facilitate this. Examples may include:
Making adjustments to the premises
Reallocation of minor duties to another employee
Offering flexible working hours
Allowing absences during working hours, for rehabilitation, assessment or treatment
Assigning or transferring a job or an employee to a place of work more suited to their needs. For example, moving a workstation to a more accessible location
Providing appropriate or additional training
Equal opportunities
The Practice:
Values its employees equally
Will offer equal opportunities to all employees regardless of age, sex, marital status, race, ethnicity, disability, sexual orientation, religion or belief
Will not tolerate any discrimination against any employee or job applicant for any of the above reasons: any such discrimination will be considered as a disciplinary offence
Will not tolerate any discrimination against a visitor or patient; any such discrimination will be considered as a disciplinary offence
A positive effort will be made by the practice to overcome disadvantages and prevent discrimination whether it be by overt or unintentional acts
All staff will accept personal responsibility for applying the policy in the practice
Applicability:
The policy applies to all employees and partners, and also applies to other people who work at the Practice
Procedure:
If you feel discriminated against:
You should bring the matter to the attention to Allison
Allison will investigate the matter thoroughly and confidentially within 5 working days
Allison will establish the facts and decide whether discrimination has taken place and advise you of the outcome of the investigation within 10 working days
Allison will take appropriate action to prevent further discrimination and discipline the offender(s), if appropriate, via the Practice’s Disciplinary Procedure
If you are not satisfied with the outcome, you should progress the matter via the Practice’s Grievance Procedure, starting at the Formal Procedure Stage 1
If the complaint is against your manager, you should bring the matter to the attention of the partner responsible for human resources at the practice: Dr Harding