Background

BrisDoc must ensure that the highest level of service to patients is maintained regardless of what might happen to clinical/non clinical procedures or the infrastructure or facilities at our GP Practice.

 

BrisDoc views it operational model and its operational bases, in terms of core functions, for example Information Management and Technology and Patient Access, in conjunction with plans for the restoration and support of utilities and services, without which the core business functions would not be able to continue. Examples of these are: Gas, Water, Electricity, Fire alarms, Security system, IT system, Telephone / Communications, PCC Buildings Services.

 

The Action plans defined in this document identify the risk of events and how they will be responded to.

 

Plans are distributed to supporting managers and key staff as required. Copies of this document are held at the practice and centrally at BrisDoc’s Head Office and intranet radar. The plan is reviewed annually or as a result of a service change and amended and redistributed as described in the Plan Location section below.

Introduction

The purpose of this document is to define the actions plans that need to be carried in the event of one of the following scenarios.

• Limited Fire damage, building useable
• Total Fire damage
• Flood/Storm Damage
• Theft
• Failure of utility – phone, gas, water, electricity
• Failure of server or computer network
• Heating failure in winter
• Major disease outbreak
• Non-clinical data safety
• Or other event where the building becomes unusable for a period of time

Staff Training and Awareness

It is important that all staff members are made aware of the Plan and are familiar with the contents and their own related duties and responsibilities. The Plan should be tested by those persons who would undertake those activities if the situation being tested occurred in reality.

The test procedures should be documented and the results recorded. This is important to ensure that feedback is obtained for fine tuning the Plan. Equally, any changes or amendments to the Plan must be fully tested.  Staff should also be kept abreast of such changes in so far as they affect their duties and responsibilities.

 

            Responsibilities

The Head of Practice Services has overall accountability for continuity of all service provision reporting to the Managing Director, in line with contractual requirements. Accountability for overall service continuity may be delegated to the Practice Manager or Designated Lead.

All BrisDoc Staff are responsible for contributing to service continuity in the event of a disruptive event.

BrisDoc will adopt the nationally recognised ‘operational, tactical, strategic’ command framework which corresponds to the emergency services’ ‘bronze, silver, gold’ structure as explained below;

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Operational (bronze) command refers to those responsible for managing the main working elements of the response to an incident. They will act on tactical command.

 

This Role will be taken by all staff on shift or additional supporting resources e.g. Head of Transformation, Head of Governance, Head of Workforce and Payroll or Boots supporting resources during the time of the incident as required.

 

Tactical (silver) command is responsible for directly managing the organisation’s response and/or health economy in response to an incident. They develop the tactical plan which will achieve the objectives set by strategic command utilising the content of this document as appropriate.

 

This Role will be taken by the Practice Manager or by the Designated Lead should the Practice Manager be unavailable (due to sickness, leave or training) during the time of the incident.

 

Strategic (gold) command has overall command of the organisation’s resources. They are responsible for liaising with partners to develop the strategy and policies and allocate the funding which will deal with the incident. They delegate tactical decisions to their tactical commanders. This Role will be taken by BrisDoc’s Head of Practice Services during the time of the incident.

Information cascade

In Service Operating Hours

In the event of a disruptive incident occurring in hours, staff working will need to be notified of the incident and any alternative working arrangements. Any staff due to come onto shift will need to be notified of any alternative arrangements before they arrive or changes to working practices when they get to work. Staff will be notified as per the communications cascade detailed below in Table 1.

The Practice Manager is nominated as the first point of contact out of hours for any incident affecting the practice building – such as fire or flood – and will therefore be responsible for initiating the cascade. Each member of staff identified as being responsible for notifying other personnel will need to hold contact details for those for whom they are responsible. All members of staff should ensure that the Practice Manager holds current contact details.

In hours, where any member of staff becomes aware of (or the potential for) a disruptive incident this should be communicated immediately to The Practice Manager or designated lead, firstly ensuring that the incident is contained where possible and there is no risk of harm to other staff or patients. The same order of notification should be followed.

Staff will be notified of an incident occurring using NetMaster. All current contact details are kept on NetMaster and this can be accessed remotely if required. All members of staff should ensure that their contact details held on RotaMaster are current and correct.

 

 

 

 

Outside Normal Operating Hours.

Manager and designated lead will need to ensure that Boots Management have up to date contact details.

Staff will be notified as per the communications cascade detailed below in Table 2.

The Practice Manager or designated lead can log onto NetMaster remotely and cascade the information to all BMC staff. All current contact details are kept on NetMaster and this can be accessed remotely if required. All members of staff should ensure that their contact details held on RotaMaster are current and correct.

Patients will be informed of any disruption by SMS text from MJog.

 

 

 

 

 

 

Plan Location

This plan will be located on radar BrisDoc’s Intranet and as a hard copy Business Continuity Folder in the Business Continuity Box located within the practice.

 

Incident Reporting & Post Incident Review

Business Continuity Incidents will be reported and followed up as described in Appendix B.

 

Maintaining the business continuity plan and Review

The business continuity plan is maintained by BrisDoc’s Head of Transformation in conjunction with the Practice Manager. The plans will be reviewed and signed off by the Managing Director.

Plans will be reviewed annually or as a result of an incident of change in service areas of review with include;

• Validate compliance with the Business Continuity Management policies and standards when used;
• Review the Business Continuity solutions in light of use and current service;
• Validate the organisations Business Continuity plans in light of use and current service;
• Verify that appropriate exercising and maintenance activities are taking place;
• Highlight deficiencies and issues and ensure their resolution.

 

Action Plans

It is the responsibility of all staff on duty on the day of the incident to follow and manage the action plans as below.

Responsibilities will be assigned as described in section 4 above. Lead responsibility will be assigned to the most senior person on duty.  This will normally be the Practice Manager or her assistant in her absence. If the incident relates to clinical issues and concern the lead GP or Nurse should assume responsibility.

Other staff should take instruction as necessary but should use some common sense to issues relating to health and safety and security.

Each action plan is intended to be used by the command structure as appropriate and should serve as a reference point in light of the situation that has arisen that required activation of these plans.

 

 

Limited Damage, Building Useable ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Limited Damage, Building Usable	Medium	Staff should inform the Practice Manager or the Designated Lead. Inform Boots of the problem consulting Boots Emergency Continuity Pan for contacts. Cordon off the damaged area and re-site patient, staff areas as necessary. Consider using SMS facility if available to inform patients if there are any service effecting issues. Inform BrisDoc Head of Transformation if this has affected the PC’s and their use.  Inform the Insurance Company, see contacts section. Ask Boots to contact fire system supplier to attend to check all fire points, alarms and equipment. Inform Head of Primary Care Services at the CCG. Reschedule booked appointments as necessary to reduce traffic into the surgery. Book home visits to accommodate frail, elderly, immediate and essential care. Place sign outside surgery (see Appendix H) to inform patients of best access point for practice and instructions and signposting to new operational area. Advise unregistered patients that limited service only available. Advise of other services available, such as dialling NHS111, contacting their own GP surgery, other urgent care centre’s (Southmead Hospital, South Bristol Urgent Care Centre, Yate Minor injury unit). Offer telephone advice from a nurse. Inform BRI A&E and SBCH (South Bristol Community Hospital) of limited service available at Broadmead. Inform NHS111 that we are on ‘RED’ alert. Update DoS https://www.pathwaysdos.nhs.uk  Email dosteam.southwest@nhs.net Communications Checklist (see Appendix A for details) 1)    BrisDoc’s Managing Director or On Call Director. 2)    Boots (landlord) and security/fire system supplier 3)    Patients possibly via SMS using EMIS 4)    BrisDoc Head of Transformation 5)    Insurance Company 6)    Head of Primary Care Services see contacts 7)    NHS 111 8)    Updated DOS 9)    Referring and support services BRI A&E, SBCH 10) BCH tactical team manager

 

Total damage, building unusable ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Total damage, building unusable	High	As above plus: Place signs as near as possible to surgery advising patients of other NHS services available. Advise of bus routes and other transport options to the South Bristol Community Hospital and Southmead and Yate Minor Injuries Department Speak to local practices to see if consulting space available at local surgeries. Reciprocal agreements are in place with: ·         Montpellier Health Centre (0117 9426811) ·         Lawrence Hill Health Centre (0117 9543060) ·         Air Balloon Surgery (0117 9099912) Set up consulting area in Boots consultation room (if unaffected by disaster) for immediate and necessary care of patients who were non-contactable. If equipment unaffected rooms may be able to be set up within Boots or within the local Broadmead Baptist Church. Ring to enquire (0117 929 1387). Please see appendix F for maps showing the Broadmead Baptist Church and to alternative surgeries. If unavailable then speak to Bristol CCG to see if they can offer any assistance (0117 9766600). Inform the Head of Information Governance at the SWCSU of the damage and to what extent, if any, that patient notes have been lost (0117 9766600) Inform LMC to see if they can offer advice and assistance (0117 9702755) Communications Checklist ( see Appendix A for details) 1)    BrisDoc’s Managing Director or On Call Director. 2)    Boots (landlord) and security/fire system supplier 3)    Patients possibly via SMS text from EMIS 4)    BrisDoc Head of Transformation 5)    Insurance Company 6)    Head of Primary Care Services see contacts 7)    NHS 111 8)    Update DOS (as per above) 9)    Referring and support services BRI A&E, SBCH 10) Head of Governance 11) BCH tactical team manager

 

 

Theft ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Theft	Low/ Medium	Contact local police (New Bridewell or Trinity Rd Police Station) New Bridewell Police Station, Rupert Street, Bristol BS1 2QH – Tel: 0845 4567000 Trinity Road Police Station, St Philips, Bristol BS2 ONW – Tel: 0845 4567000 Inform Avon SWCSU of the PCs and printers that have been stolen. Inform Insurance Company. Contact Boots Security Company to review incident and security procedures in place. Communications Checklist ( see Appendix A for details) 1)    Police 2)    Avon SWCSU 3)    Insurance Company 4)    Boots Security Company 5)    BrisDoc’s Managing Director or On Call Director.

 

 

 

Phone Failure ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Phone	Medium	The surgery has a Bistec telephone system.  A maintenance contract is in place with Communication Stem. Contact details for the surgery phone system maintainer is on contacts list below.

 

 

 

Gas/Hot Water Failure ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Gas	Low	The consequences are no hot water at any time of year, and no heating in winter.  A kettle is to be put in the nurse area to ensure that water can be heated for hand washing at all times. Check use of hand sanitiser kit and deploy additional if required. Contact Boots store manager if there is a problem with gas supply as Boots manage our utilities within the practice.  If no Boots contact available we need to contact Boots maintenance on 0115 957555 option 5,1, for store number 243

 

 

 

Water Failure ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Water	Medium	Contact Boots store Manager Contact Boots store manager if there is a problem with water supply as Boots manage our utilities within the practice.  If no Boots contact available we need to contact Boots maintenance on, 0115 957555 option 5,1, for store number 243 1.     Close off patient toilets. • 2.     If patients or staff need to use the toilet they can use the Boots staff toilet if available or the toilet on the top or first floor of the Mall. (Patients need to be escorted at all times if using the staff toilet) • 3.     Ensure alcohol hand cleaning solution in all rooms. • 4.     Avoid doing invasive procedures unless absolutely necessary. • 5.     Bloods – all patients booked in for bloods in next few days need to be reviewed by GP. Blood taking services to be cancelled unless absolutely necessary or as directed by GP. • 6.     Lists to be reviewed for booked invasive procedures such as smears/minor ops, these to be cancelled for the next 48hrs and then each day the same process to be undertaken. • 7.     If the duration of the problem looks to extend, we will need to review these guidelines daily • 8.     Liaise with company providing our water cooler and arrange for daily delivery of their bottled water until service reconnected • 9.     When water comes back on, we will need to know if the level of contamination means hand washing between patients is compromised.  Do not do any invasive procedures until we have been informed by Bristol Water or Boots that the water is safe to drink and wash hands. • 10.  Instigate deep clean if necessary.

 

 

Electricity Failure – ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Electricity	Medium	Will involve loss of lights, loss of heating, loss of hot water (boiler will go off), loss of computers, loss of surgery telephone system, loss of equipment such as ECG. The electricity cupboard is on the second floor opposite the lift; the key is in the key cupboard in the multi-purpose room. Check this first to ensure that a fuse hasn’t blown. If a fuse has blown the corresponding switch will be in a different position from the others and showing a red mark. If this is the case flip the switch to indicate a green mark. Contact Boots store Manager Contact Boots store manager if there is a problem with electricity supply as Boots manage our utilities within the practice. If no Boots contact available we need to contact Boots maintenance on 0115 957555 option 5,1, for store number 243 Clinicians will need to handwrite notes and enter them onto the clinical system at a later date. Maintain a manual appointment list which can be printed off from reception resources if computers still available. There should also be a printed sheet available of appointments booked to date as this is printed each night by reception team for this purpose as a backup. A manual working box is available in the multi-purpose room. The box contains printed, blank consultation sheets and appointment planning sheets.

 

 

 

Lighting Failure ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Lighting Failure	Medium	If the lighting fails, the emergency lighting will come into operation. To operate the emergency lighting manually insert the final exit key into the slot by the light switch, by the door, and turn on. Emergency lighting is checked monthly within the practice by Boots.

 

 

 

Water or Sewage Leak ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Water or sewage Leak	Medium	Should a member of staff identify a water leak, they should immediately advise (with as much detail as possible) the Practice Manager. The area should be cordoned off the area. The Practice Manager needs to identify whether the leak is likely to cause a danger to life or power failure i.e. if near electricity Subject to this evaluation either the Power failure or Evacuation Action Plan may need to be invoked as matter of urgency Contact Boots help desk0115 957555  option 5, 1, for store number 243). Follow Action Plan for building un-usable.

 

 

 

Heating in winter failure ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Heating Failure In Winter	Low/ Medium	Contact Boots store Manager Contact Boots store manager if there is a problem with gas supply as Boots manage our utilities within the practice. If no Boots contact available we need to contact Boots maintenance on 0115 957555 option 5,1, for store number 243 Borrow electric heaters from staff if possible, purchase heaters as required from local stores.

 

 

 

Evacuation ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Any incident that requires evacuation	Medium	If a member of staff identifies that an incident that may require evacuation they should contact the Practice Manager or designated lead. Staff, visitors and patients should be made aware that it is necessary to evacuate the building. This may be using the Fire Alarm system or being verbally advised by BrisDoc staff.  Staff should be reminded, where to gather post evacuation.   Any consulting clinician will take responsibility of the patients and their carer and relatives who are in the consulting room. Reception staff will take responsibility for the patients in the waiting room. Visitors will be the responsibility of the person they are visiting. Staff, visitors and patients will exit the building using the signposted Fire exits. The lifts should not be used. There is an Evac Chair available for any people who cannot use the stairs unaided. All staff has been trained in the use of the Evac Cahir. It is expected that all BrisDoc staff should assist those who need help during an evacuation, particularly any visitors or patients, whilst not putting themselves at risk The meeting point is opposite the Broadmead Boots at St Augustine’s. If this is unsuitable then the meeting point used will be main podium which is situated to the left of the Boots entrance. The designated lead will check that all the rooms (clinical and non-clinical) and toilets are vacated on both floors if it is safe to do so. Where possible all the doors should be closed as the designated lead leaves the floor. THE DOORS SHOULD NOT BE CLOSED IF THE INCIDENT IS A GAS LEAK. All PCs should be logged off if safe to do so The designated lead should perform a ‘roll call’ asap following evacuation by consulting the signing in book, the visitor sheets and/or the patient log book.   The designated lead will be the point of contact for the Boots lead. The designated lead will be the first point of contact with the appropriate authority i.e. estate lead, police, fire brigade.   If any staff/patients/visitors are identified as ‘missing’, please alert the relevant on site authority asap.   The BC site lead manager will need to ascertain as quickly as possible how long the building may continue to be inaccessible.   Notify referring services ·         NHS111 ·         South Bristol Walk in Centre. ·         Bristol Community Health ·         BCH tactical team manager The designated lead will contact the Head of IT at BrisDoc Head Office.   Subject to advice from the relevant authority, designated lead will decide the appropriate action that will follow an evacuation .The options open to them include:   ·         Return and resume work. ·         Advise staff to go home as shift end is approaching and the next shift will be advised of the relocation plan. ·         Advise staff of an alternative plan and next steps as decided.   If advised to return to site, please check that all equipment that may have been affected by the incident is working and reset if necessary.

 

 

 

 

Failure of server, computer network or n3 service ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Failure of Server, Computer Network or N3	Medium	Virus protection and firewalls are provided and maintained as appropriate by the CSU and EMIS.  Server is backed up every night. An additional local backup of the EMIS appointment book is made, that can be subsequently be used as the basis for a paper based appointment book if required. The local domain and server are protected by UPS devices, should the server go down due to power, support would be sought from the SWCSU to shut down the servers. (0300 5610400) If there is a complete system down contact SWCSU (0300 5610400) and EMIS immediately. (0300 0241270) If it turns out to be network failure, inform the SWCSU (0300 5610400) immediately and request high priority, see Contacts section.  For escalation path refer to ‘Information Asset Register, which is located in shared drive. Clinicians will be required to hand write notes for entry into records when system is back up and running. Manual working forms can be found in the manual working box in the multi-purpose room. Forms are appended in Appendix C. There is also a backup IT Support Service that can be called for additional support if necessary 0117 370 8800. Although not directly involved in the IT management at the practice they can offer valuable advice and support with IT queries.

 

 

 

Major disease outbreak ACTION PLAN

Threat	Impact On Organisation If Threat Occurs	Action
Major Disease Outbreak	Medium/High	See pandemic flu plan. There are several problems to contend with: high demand for appointments; low staff numbers due to sickness; shortage of medical supplies due to deliveries being affected Non urgent appointments to be cancelled, patients who report flu like symptoms should be given a telephone consultation with the GP and not asked to attend surgery. Notices to be put on the door asking people only to attend the surgery if necessary.  If they are suffering from flu like symptoms then to telephone the surgery. Pandemic box to be distributed amongst clinicians and staff i.e. Masks, aprons, alcohol gel etc. Try to separate streams of patients by utilizing the 2 different floors for contagious and non-contagious symptoms. Advise patients telephoning the practice to remain at home and arrange a clinician call back rather than inviting them into the surgery where they can spread infection.

 

 

 

 

Manual operation and data safety

There is much data necessary for the smooth running of the practice e.g. forms, standard letters, guidance and advice documents etc.  Wherever possible, users should be encouraged to keep these on the ‘shared folder’ on the server rather than on individual PCs.  This has the advantages of being backed up every night, being available to the user at every PC, being available to others, and still being there if their PC is replaced either at routine or breakdown replacement.

Where critical data is kept on a single PC e.g. payroll, accounts, it must be backed up twice If the system fails it is important that there are robust processes in place to ensure continuity of care and accurate record keeping

1. In the event of EMIS web access being unavailable, a backup appointment list is printed each evening.
2. These lists should be used to pull notes for the surgeries.
3. Copies of the surgery lists should be given to the session holders
4. Patients phoning in for appointments should be advised of the situation and that only patients requiring immediate and necessary care by a doctor on the day will be seen.
5. Patients wanting to book a routine appointment for a later date should be asked to call back in 48hours
6. Patients phoning in the morning requiring a same day appointment should be asked to come to the surgery to be assessed or be put on the manual telephone triage queue.
7. Reception should agree with the afternoon duty Doctor, what time patients should be told to come to the surgery and an afternoon surgery list created.
8. Patients requesting advice or a visit should be told a Doctor / Nurse will phone them back. Patient details should be recorded on the attached form and passed to a Doctor.
9. Patients attending the Surgery will be put on the surgery list as they arrive with the time of arrival and given a number ticket. The ticket number will be noted on the surgery list.  When the Nurse/Doctor is ready to call a patient in they call in number ‘1’.  That patient hands the Nurse/Doctor their ticket.  When the consultation has finished the Nurse/Doctor will call the next number in until all patients have been seen.
10. If possible patients need to have their manual notes pulled from the patient data cupboard and given to the doctor prior to their appointment time. These need to be filed after use.
11. All manual notes need to be entered onto EMIS when up and running
12. Patients requesting a repeat prescription should be advised of the situation and be asked to call back in 48hours. Patients who insist they need their prescription earlier should have the details completed on the prescription request form, making sure a contact phone number is available.  The doctor should ring the patient to discuss with patient and prepare a hand written script as necessary.

 

At the end of each morning all Lloyd George notes, details of phone calls and prescription requests should be returned to reception.  These will be filed in date order and locked away.

When the system is repaired all contacts will be recorded from the documentation.  The hard copies will be filed in the patients paper records.

 

 

 

 

Civil Unrest

INTRODUCTION

Broadmead Medical Centre (BMC) is a GP surgery with a registered list of around 10,500 patients. We also host a walk in centre contracted to see 24,000 walk ins per year.(This service is currently closed due to Covid 19 pandemic) The medical centre is within the Boots store in Broadmead, Bristol. BMC is a service under the umbrella of BrisDoc Healthcare Services Ltd.

LIMITATIONS

BMC has to operate within the constraints of its location. Boots have set security rules in relation to opening and these need to be considered with any planning of this sort.

COPE

During a situation of civil unrest, BMC would always try to support the local community in providing medical support for minor illness or injury within the limitations as set out above. We also have valuable links with the local Urgent Care Service at BrisDoc.

OPERATIONAL PLAN

• Public Health will engage with BMC should any planned event be scheduled that may cause additional demands on the urgent care services in Bristol.
• BMC will be aware of the situation and risk assess the anticipated impact on the service.
• BMC will liaise with Boots to ensure that they are aware and have assessed the situation with regards to security arrangements and store opening.
• BMC will communicate with service users / stakeholders if any significant impact expected.

• Service users will be contacted via an SMS messaging campaign and posters within the surgery and on outside swing boards.
• Stakeholders will be contacted via email, fax, and telephone as appropriate.

 

ZERO TOLERANCE

BMC will always make every effort to protect their staff. We will be happy to see service users who respect our staff and behave in a civil and respectful way. Any incidents of aggressive behaviour, whether this be physical or verbal, racial or discriminatory will be handled under our zero tolerance policy and security and / or police will be called.

Should the civil unrest be such that our staff are felt to be danger, the practice will be closed with notices put on main doors to notify service users to this effect. The cascade communication should be enacted as in the Action Plan for Limited Damage, Building Useable.

BOOTS SECURITY STRATEGY

BMC is protected under the Boots security team and operates in conjunction with Boot’s business continuity plan.

If civil unrest appears such that the store feel that they need to manage the flow of people in and out, Boots will shutter down all entrances bar one and a security guard will be posted at this door. Customers to the store and patients of the practices will be directed in and out of the store by this Guard. The store is well signed and this should cause minimal disruption to service users.

Should there be a planned event, Boots will review the security need and have additional security staff on call or available on site.

Should the situation become unmanageable the store will be closed completely to protect the store and the practice.

Severe Weather Procedure

What is Inclement Weather?

‘Inclement weather’ covers conditions such as snow, ice, fog, floods which render extremely hazardous journeys by road, by both public and private transport. ‘Extremely hazardous’ is defined as those conditions in which the police and/or appropriate motoring organisations advise people not to make unnecessary journeys or indeed travel at all.

What if I can’t get to work because of the weather?

If there are extreme weather conditions you are expected to make every reasonable effort to get to work, adapting your means of travel if necessary, even if this means you will arrive late. If you really are unable to attend work because of the weather conditions you must notify your line manager within one hour of your usual start time. In this case you would normally be expected to take the time as annual leave, at your request, to cover the time lost. Any exceptions to this would be at the discretion of your manager.

Please note that failure to notify an appropriate manager that you are unable to attend work would count as unauthorised absence and therefore be unpaid. You may be able to work at a Practice nearer to home or it may be possible for some staff to work from home in cases of inclement weather. These options should be discussed and agreed with your manager.

What if the weather means I am late for work?

If you do arrive late because of inclement weather you will not normally be expected to make up the time lost. Likewise, if you wish to leave work early because of the weather you should consult with your manager. In the case of worsening, or particularly hazardous conditions you should be able to leave work earlier than usual without having to make up any time lost. Normally all staff that attend work during such hazardous conditions, but work a shorter day than normal because of the weather, will be granted their standard day.

What if I need to leave work early?

Your manager will be responsible for deciding whether any request to leave early (as a result of adverse weather) is warranted, bearing in mind all available information including the home circumstances, distance to be travelled and mode of transport of the employee concerned.

In circumstances where the manager is satisfied that early release is justified, arrangements will be made for the staff member to go home as soon as practicable, ensuring that adequate cover is in place to maintain core working.

What if the Practice is closed due to bad weather?

In exceptional circumstances, a decision may be made by the management of BMC or by Boots, or other nominated individual, to close the buildings and either send all staff home or tell them not to arrive for work. In this instance you would not be required to make up lost hours.

What if the bad weather continues?

The nature of this policy is to cater for initial, emergency situations. However it is recognised that in some instances bad weather may continue and other services may be affected. In this situation other policies may need to be referred to – for example if schools are closed and you need to take time off to look after your children. You should discuss your individual situation with your manager.

What if inclement weather prevents me returning to work from a holiday destination?

You should make contact with your manager at the earliest opportunity to let him/her know that your return to work is delayed and when your likely return date will be. On your return to work your manager will discuss with you how this leave can be best managed e.g. making up the hours, holiday, or unpaid leave

** It is acknowledged that individual circumstances will vary greatly and therefore it is unlikely that this policy will cover all eventualities. Management discretion may be necessary if there are exceptional circumstances.

What to do on the day:

• Ensure all default appointments are set to embargoed for ‘on the day’ only booking.
• All reception/ admin staff to run the front desk and telephones as a priority
• Request local staff not on duty, to attend in the event of a severe crisis if possible.
• Consider any elderly / disabled patients who are due to come in and whether to reschedule their appointments
• Check with local pharmacies re opening hours and whether able to make urgent deliveries of medication to patients if needed
• Identify staff that might have a suitable vehicle (4×4) to assist others into work and/or home; or for patient visits – only if it is safe to do so.
• Check whether path lab services are running as normal
• Review weather situation at routine intervals through day. Review staffing levels and revise service provision arrangements for the afternoon session/s if needed
• Revise telephone message to advise patients of the altered surgery arrangements
• If service is to be closed early, send out a SMS message to all patients to advise using the Mjog platform.
• Add a ‘newsflash’ to our website to advise patients.
• Ring the BCH Tactical Manager, South Bristol Urgent Care Centre and the BRI A&E dept to advise (see below)

 

• The BCH Tactical Manager 0333 103 4776
• South Bristol Community Hospital 0117 923 0000
• UHB BRI A&E dept 0117 342 2710

• Update the DOS dosteam.southwest@nhs.net following the EMIS F12 template

 

 

 

 

 

Recovery Time Objective for Essential Services

In the event of a disruptive incident Broadmead Medical Centre will endeavour to maintain its critical functions as listed in the Table below. The practice will seek to restore all other services according to the order of priority detailed in the table. Where it is likely that services will have to be reduced or suspended, the Practice Manager will communicate this to the relevant CCG contact as listed in Appendix A.

 

The decision to reduce or suspend services will be taken by the practice’s Incident

Management Team, in consultation with the CCG.

 

Priority	Service	Recovery Time Objective
H	Operations – Clinical Services comprising: ·         Telephone Answering ·         Triage ·         Face-to-Face Appointment ·         Home Visiting	2 hours
H	Information Storage	4 hours
H	Clinical and staff rotas	1 day
M	Legal / Contractual	1 week
M	Finance	1 week
M	Medicines Management	1 day
L	Essential (mandatory)  Training	1 week
L	Alternative Premises within NHS infrastructure	1 week[1]

 

 

Local Bus Service arrangements to alternative urgent care facilities

 

Service	Bus Route	Where to catch
South Bristol Community Hospital	50 / 51 75 / 76 90	Wine Street Haymarket The Horsefair
Southmead Hospital	76	Haymarket
Yate Minor injury Unit	47 /48/ X46 / X49	Bus Station or Cabot Circus

Appendix A – Contacts

Primary Care Services England
SWCSU	0300 5610400	Other computer problems not software
LMC	0117 970 2755
Bristol CCG	0117 976 6600	Head of Information Governance
Bristol CCG	0117 976 6600	Head of Primary Care
NHS111	0117 240 1111	NHS111 Supervisor
Directory of Services (DOS)	0117 2401115	Pathways update
Insurance Company	01438 739731	Towergate mia Policy No. MIA/SUR/P/02836
BRI A&E	0117 3422710
South Bristol Community Hospital	0117 923 0000
Montpellier Health Centre	0117 942 6811
Lawrence Hill Health Centre	0117 954 3060
Air Balloon Surgery	0117 909 9912
EMIS		Our site 16593
BrisDoc Head of Transformation	07753 447068	Deb Lowndes
BrisDoc Head of Governance	0117 9370906	Clare-Louise Nicholls
Photocopier	08712219460	Serial number WZW8240702
Boots store number	0117 9293631	Store number 243
Boots Operations manager	0117 9293631	Lyn – 07958 107988
Boots maintenance	0115 9575555 option 5, 1	for store number 243
Avon and Somerset Police	101
South Bristol Community Hospital	0117 3429692	Urgent care centre
Broadmead Baptist Church	0117 929 1387
		Email webbscleaning@btinternet.com

 

 

Appendix B – BC Incident Reporting & Post Incident Review

 

Location of the incident
Date & Time of the incident
Specific Service Areas disrupted
Duration of Incident
Reported By (inc. contact details)
Incident Details. Summary: Severity: Known Causes: Injuries/Personnel Evacuated/Infrastructure Damage/Environmental Impact/Records Damaged
Action Plans Immediate Actions Taken: Actions Plans Utilised: Resumption/Continuity Actions: 3rd Party Contacts/Involvement
DAC Incident Reporting started
Incident Review Summary/Lesson Learnt
Follow Up Actions/Contacts
DAC Incident Reporting Completed

 

 

 

 

 

Appendix D -Business continuity for shared care services

 

Appendix E – Assembly points for evacuation

Appendix F – Alternative premises map

Appendix G – Practice closure notice

Broadmead Medical Centre

 

TEMPORARY CLOSURE

 

There has been an incident that makes it impossible to use this building

 

Please call

0117 937 0900

For further information on the planned reopening times.

 

Alternative Urgent Care Services:

 

Bristol Royal Infirmary A&E department

 

South Bristol Community Hospital Hengrove

 

Southmead Hospital A&E department

 

Yate Minor Injuries Unit

Broadmead Medical Centre

 

This access point is temporarily closed.

 

Please access the Surgery using the entrance on the first floor.

 

Please use the escalator and turn left at the top.

 

 

1.     Tables

Date	Reviewed and amended by	Revision details	Issue number
12/03/2012		Reference to Asset register page 7 Updated contacts section
12/07/2012	DD	Changes made to remove services that will no longer be available from April 2012 i.e. GP 8-8 service and Knowle and City Gate WIC and new services added i.e. South Bristol Community Hospital.	2-3
02/10/2014		Policy reviewed and updated.
13/07/2015		Amendments to bring in line with other BC formats
26/02/2018		Updates in line with changes in organisation structure and minor tweaks
12/11/2018		Updates in line with changes in organisation structure and minor tweaks
15/09/2021		Minor tweaks such as telephone numbers and WIC information

 

[1] Needs to be reviewed in the context of the move to new premises and the collocation with other services