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Browney House COVID-19 Business Continuity Plan
COVID-19 has spread rapidly around the world during 2020. The WHO have classified it as a public health emergency of international concern. The reproduction number is estimated at 2-3. The incubation period may be up to 24 days and it appears it may be possible for asymptomatic individuals to transmit the virus to others. It has a very high pandemic potential. GP practices have a duty to protect their patients and a duty as employers to protect their staff. We all have a moral duty to protect our own families from our work related health risks. As independent contractors we need to be proactive in managing these risks for ourselves rather than waiting for direction from others. The practice is open and is here for our patients, however we are doing things a little differently to keep both staff and patients safe during the Covid pandemic.
Practice Plan –
•Keep a diary or log of events during Covid-19. Hopefully, the world will not encounter such fast spreading virus again but a diary or log of events will be a good point of reference for lessons learnt.
•Offer as much up to date information as possible to the Practice community. A notice on the Practice website home page with brief information on Covid-19 and the Practice plan (links to 111, GOV.UK, NHS.UK websites).
•STOP notice on front door and porch doors advising those with fever and acute respiratory symptoms not to enter the building. Face covering and mask posters are also displayed on the front door and front facing windows. Covid-19 posters are also the first information a patient will see when entering the porch. New PPE/sanitizing stations are now located in the porch, reception area and room closest to back door.
•Further Posters have been added in the waiting room also detailing Covid-19. Perspex screens have been purchased by the Practice and added to the reception desk. This is to protect both staff and patients from spreading Covid-19.
•PPE – All practice staff must wear face masks while at work. Clinicians have a large stock of full PPE that must be worn appropriately while carrying out NHS procedures. Posters explaining PPE are displayed in each clinical room. PPE is ordered on a weekly basis from the national portal.
•No patients with acute viral symptoms (fever, cough, myalgia, diarrhoea) to be seen in the practice unless serious concern for their health (mainly age and co-morbidity, or if breathless).
1.As a large proportion of patients with URTI report SOB this should be assessed on phone triage by ability to speak in full sentences and can be supplemented by questioning ability to climb stairs.
2.As a major reason for seeing patients is to rule out bacterial infections/pneumonia and decline antibiotics, antimicrobial stewardship will be temporarily relaxed and antibiotics prescribed if felt appropriate by the GP and allows safe telephone only management of patient.
•The Practice has had to move to a patient triage by telephone system. This is due to concerns that there is now transmission in the community and possible transmission by asymptomatic cases. Telephone triage or video consultations can now take place safely and securely. The NHS IT providers have installed computer software so that better use of video and media communication can be used. Face to face appointments can be used but are only bookable by a clinician after a triage contact.
•Remote working options for clinical and admin staff have been explored by the Practice and the local CCG as staff may need to self-isolate for a number of days. The Practice is prepared to purchase laptops for remote/home working. However, the CCG have provided Covid-19 laptops to Practices for use during self-isolation or temporary closure. The laptops are highly secure, password protected and have clinical software installed.
•Some NHS work has been suspended such as routine annual bloods and BP checks and some disease monitoring. Patient care has not been forgotten about and recall lists have been set up so that patients can eventually receive their tests. This will reduce footfall in the practice. A lot of tests are now available at Practice. We are dictated to by the NHS and local CCG so this is a constantly changing situation.
•Some QOF work has been reduced/scaled back in order to reduce footfall in surgeries and to help prevent the spread of the disease. Financial continuity will continue with help from the NHS.
•Room 3 has been chosen as an isolation room. New kitchen rules have been implemented (use of own cutlery, one person in at a time, rule posters, bench wiping after every use etc.
•In order to reduce footfall and spread of the disease - prescriptions can now be ordered over the telephone or using the new post box in the porch area.
•Appoint a COVID-19 business continuity leads – Louise Young & Andrew Nagi
•Phone messages and redirecting of phones to allow remote working can be easily set up in minutes if the Practice has to be closed for deep cleaning/decontamination.
•The Practice will order extra influenza vaccines in order to help prevent patients getting a mixture of both Covid-19 and Seasonal Flu.
•Vulnerable patients will be prioritised and contacted during Covid-19. The Practice will offer as much help as possible for during this time.
The above list details most of the areas that the Practice has considered essential to make changes to. Covid-19 rules and regulations are constantly changing. The Practice will keep up to date with any changes. Patients and staff will be informed of any further change.