INTRODUCTION

It is generally accepted that the best place for a patient to receive medical care is with their registered GP. The registered GP has access to medical records and can provide follow up in a seamless way.

It is also accepted that it is difficult for staff to always access their registered GP when working shifts or full time. At the same time BrisDoc needs to ensure that its services are used for the purposes for which they are commissioned and funded.

Within this context, this policy aims support BrisDoc meet its core values for workforce and patient care by supporting staff, and ensuring that they receive the best quality of care as well as consider appropriate use of resources within the local health economy.

RATIONALE

There are several reasons why BrisDoc considers it is better for staff to consult with their own GP surgery services unless by exception of sudden illness whilst at work. These include:

• Potential conflict of interest
• Difficulty for the consulter of remaining completely impartial
• Risk of under/over diagnosing due to compensation
• Staff personal details becoming available to other members of staff and therefore potentially open to indiscretional use
• Confidentiality issues generally.

 

In the exceptional circumstance that staff do need to access care/advice whilst at work they may be assured their consultation will be afforded the usual patient/clinician confidentiality.

SUDDEN ILLNESS WHILST AT WORK

If a member of staff is suddenly taken ill whilst working at one of BrisDoc’s sites, it is acceptable for them to seek advice from a clinician on duty.  This will enable them to decide how to get the most appropriate care, including self-care, and will enable them to be sent home if the illness is infectious or they are perceived to be too ill to continue working.

Members of staff who require medical attention when taken ill at work should be entered onto the relevant patient record system, either by going through NHS 111 or by the Host/Shift Manager or Receptionist as if they were a walk-in patient or temporary resident.  All records must be updated in full to comply with normal Governance arrangements.  This includes the issuing of any prescription or details of any medications issued from stock (when pharmacies are closed.)

MINOR ILLNESS

Staff are expected to manage minor illness in the same way as any other member of the public. Information is available at each Out of Hours base on the location and opening times of local pharmacies, and at each practice. Pharmacies provide useful information on the self-management of minor illness, and appropriate over the counter medications that they can purchase.

Staff need to report sickness absence to their line manager in line with HR policies and procedures if a minor illness will prevent attendance at a shift. In the case of Out of Hours a short notice absence should be reported to the shift manager via the shift manager mobile. If staff members are still well enough to attend work but need simple medication to manage symptoms of minor illness, then such medications should be brought in for personal use.

Staff use of Out of Hours stock medications is not permitted.

CLINICAL CONSULTATIONS

It is not appropriate for staff members to seek a consultation with a BrisDoc clinician as a staff member on shift. If a clinician consultation is required this should be made with the individual’s own GP/Practice Nurse. BrisDoc can assist staff in registering with a local GP Practice if they are not already registered.

SECOND OPINIONS

It is not appropriate for staff members to expect a BrisDoc doctor to provide a second opinion with regards to the care a staff member is receiving from their registered GP. This puts the doctor in a difficult position as they may not know the full situation. If a staff member has concerns with their registered GP they should be encouraged to discuss this with the relevant practice.

BRISDOC IS MY HEALTHCARE PROVIDER

If a BrisDoc practice is a staff member’s normal healthcare provider then their registered surgery uses BrisDoc for its OOH cover. The individual is therefore free to use the service outside of working hours as a member of the public via NHS 111. BrisDoc will, in these instances, provide staff members with equivalent care to other patients. Staff can see the doctor within the remit of the OOH service. However, staff members are encouraged not to use these services as a substitute for their normal registered GP.

Staff members who believe they require Out of Hours care will need to phone NHS 111 and undergo a triage process. If staff members walk into an Out of Hours base whilst off duty, they will be advised to phone NHS 111 unless the criteria of walk-in patients.

RECORD KEEPING

Notes can be marked as ‘sensitive’ so only named/clinical staff can view them. The Host or Receptionist can be asked to mark the record as ‘sensitive’ to enable staff to use the Out of Hours Service, if appropriate, and to have confidence in the protection of their health information.

BrisDoc has key performance indicators to adhere to. This means that staff members may be asked sensitive information regarding their personal health. If staff receive care by BrisDoc they will be expected to complete this information in the same way as other Out of Hours or walk in patients. Any record generated will be sent to the staff members own GP surgery via Adastra as per normal processes.

REGISTERING AT A BRISDOC SURGERY

It is not recommended that staff register with a BrisDoc service even if they live within the practice boundaries. It is advisable for staff to endeavour to register with another nearby surgery to ensure that that full privacy can be maintained. If staff have a specific reason for wishing to register with BrisDoc practice please discuss this with the Lead GP at the surgery prior to registering. However, it is recognised that given the size of the Out of Hours Service, a significant majority of staff will now be served by BrisDoc during the out of hours period. It is therefore important that staff can access the service as and when appropriate criteria are met, and the triage process undertaken by NHS 111 is the formal mechanism for satisfying these criteria.

RELATED POLICIES AND PROCEDURES

Sickness Absence Management

Data Protection, Confidentiality and Disclosure

CHANGE REGISTER

 

Date	Version	Author	Change Details
01.03.10	DRAFT	DD
10.06.10	1	CM
10.12.10		S BROWN	Review
31.01.14	V2	H England	Reviewed in context of new OOH service
28.02.14		G white	Review
23.5.17	3	CL Nicholls	Inclusion of all BrisDoc practices and services, values slide, related policies and procedures, rationale, CQC standards, new reviewer.
27.07.2020	4	LG	Routine review
03.05.2023	5	LG	Review and removal of reference to WIC