1. Introduction
BrisDoc recognises that its staff are fundamental to its success. To ensure that all staff begin their work in a positive and supportive environment where they become effective and efficient in their role as quickly as possible, it is essential that all staff new to BrisDoc, or the role, receive a timely induction.
Induction is the process by which a new member of staff is integrated into the organisation. The process begins with the first contact at recruitment stage and ends when the person has been fully integrated into the team. Induction ensures that all staff obtain a good understanding of how BrisDoc works including its principles, values and objectives. It ensures that all new recruits have the knowledge and skills necessary to perform their role in a safe working environment.
BrisDoc’s primary objective is to provide high quality, safe patient care by staff members that are able to meet the requirements of their role and discharge their duties safely. In light of this, BrisDoc is committed to integrating new staff into the organisation as effectively as possible by providing them with the information, support and training to become productive and satisfied members of the team confirming that they made the right decision in joining the organisation BrisDoc is committed to:
Patient Care · Ensuring that staff our equipped to know what is expected of them in order to perform their role and carry out the best possible patient care.
Workforce Care · Making sure staff feel welcomed, valued and supported. · Ensuring that all new staff are made aware of what is required of them in their job role including all legal aspects such as health & safety and Information Governance. · Ensuring that each new recruit adjusts to their new working environment and becomes a useful and integrated member of the team. · Ensuring that each new staff member is provided with all the necessary resources and support in order to carry out their role with success.
Quality Care · Ensuring that all commitments outlined in this policy are monitored and measured in order to ensure that the induction process is being carried out. · Ensuring that all managers are trained in the induction process and are aware of the responsibilities. · Ensuring that all staff know what is expected of them in order to reduce the likelihood of underperformance. Resource Care · Effective induction reduced the risk of high turnover and subsequent recruitment costs as well as costs of managing underperformance.
2. Scope
This policy relates to all newly appointed staff (including bank/casual/locum staff) and to existing staff members who have taken on a new role within BrisDoc. The whole induction process is expected to last 6 months as each new recruit will have a 6-month probationary period. During this time, staff are expected to be proactive in their own induction, and ensure that they receive from appropriate sources the relevant information and support that enables them to apply themselves to their job and fully contribute to the success of the company.
This policy aims to set out BrisDoc’s approach to Induction and to indicate how appropriate inductions can be provided. The policy will be accompanied by guidance on procedures (Induction Checklists) for managers – please refer to Appendices 1-5 and the Managers’ Guide to Induction Document.
The core content and aims of induction for all new recruits remain the same. However, it is expected that certain aspects of induction will differ and this will reflect the specific needs and requirements of the individual and their role.
3. AIMS & PRINCIPLES OF INDUCTION
The following induction principles apply:
3.1 To encourage and foster good working practices.
3.2 To form lasting positive attitudes, which will create the right disposition for continuous learning and growth.
3.3 To ensure all new employees have skills and competencies relevant to their role and can apply these in the workplace.
3.4 To support the effective integration of new employees into their new working environment or existing staff moving into a new area/department within BrisDoc.
3.5 To minimise the risk of employee turnover in the early stages of employment.
3.6 To help create a positive and supportive working environment.
3.7 To help define performance expectations/standards, maintain motivation and identify training and development needs.
3.8 To ensure that BrisDoc complies with its legal obligations such as health and safety legislation and other contractual obligations and that they are communicated to all staff.
3.9 To ensure staff are aware of BrisDoc’s expectations for adhering to standards and processes with respect to areas that may cause harm to the organisation e.g. adverse use of social media, inappropriate management of patient income.
3.10 To embed a culture of training compliance, providing clarity around training requirements and expectations.
4. PROCEDURE
BrisDoc’s approach to induction focuses on both “Corporate level” and “Local level”. This policy primarily takes the “Corporate” approach which complies with standards recommended by the Care Quality Commission (CQC).
CORPORATE INDUCTION
Corporate induction primarily focuses on the legal obligations that every staff member must be made aware of when joining BrisDoc. In particular, this includes the Health and Safety policies and procedures. It also consists of informing the individual of the company’s structure, vision and values in order that they understand how their job role fits into the bigger picture of the organisation.
It is therefore the responsibility of all line managers to ensure that staff attend a Corporate Induction and receive a local (Service specific) induction (see checklists/suggested touchpoints set out in Appendices 1-5.
They have been structured according to the following timeframes:
o Corporate Induction Checklist – Required
o Local Induction Checklist – Required
o Month One suggested Touchpoint
o Month3 suggested Touchpoint
o Month 6 Checklist – Required
The Workforce Department will set up new staff on Rotamaster noting their line manager and start date, as well as logging the Corporate Induction Checklist. Rotamaster will then auto-generate reminders to the Line Manager for the appropriate local checklist above.
The line manager, together with the staff member, will follow the process through according to the required checklists and timeframes and using the suggested touchpoint checklist/s if appropriate. The Line Manager will ensure a signed copy of the Local and Month 6 checklist is passed to the Workforce Team for logging. The Workforce Department will record the appropriate Induction checklists onto Rotamaster. Corporate and Local Induction performance will be reported to Directors through the Corporate Dashboard.
LOCAL INDUCTION
Local induction primarily focuses on the member of staff’s actual job role and the responsibilities they have alongside of delivering local personal safety/health & safety information. Local induction may also apply where a member of staff has moved to another department with the organisation.
The specific activities within job induction will be dependent on the demands of the role and the skills and knowledge that the individual brings with them. This will be at the discretion of the line manager.
As part of Local induction where appropriate (i.e. where an underlying health condition has been identified during the recruitment process that may require workplace adjustments) the line manager should also undertake a risk assessment (Appendix 6) with the new staff member. In addition, a Risk Assessment in line with any current national/government guidelines (for example Covid-19 – see Appendix 7) should be undertaken.
The responsibility for organising the local induction lies with the line manager of the new member of staff although specific activities may be delegated at the line manager’s discretion or within departmental guidelines and practices. It is good practice for individuals and line managers to retain records of completed induction activities.
CORPORATE INDUCTION EVENING
BrisDoc aims to hold monthly corporate induction sessions (dependent upon numbers of new starters) which a new member of staff is expected to attend. If a staff member is 6 ready to commence work before a corporate induction session is scheduled the line manager must complete a Corporate Induction checklist together with local induction with that staff member. They should also ensure the staff member is booked onto the next available Corporate Induction session.
The corporate induction will be run by a member of the Workforce Team with, where possible, a welcome from a member of BrisDoc’s Leadership Board.
The corporate induction will be run by a member of the Workforce Team with, where possible, a welcome from a member of BrisDoc’s Leadership Board. The aim of the corporate induction session is to have a “formal introduction” to BrisDoc in a relaxed and welcoming environment. Using the Corporate Staff Handbook and Induction presentation, new staff will be informed about the background of the company and the main vision and values. The corporate induction will emphasize the importance of team working / mutual respect and BrisDoc’s minimum standards and expectations for example, with respect to customer service, dress code, policies and communication including social media. In order to embed the culture of expectations around training and development, staff members will also be given guidance on the Training Matrix, training for their role and expected timeframes for completion. There will also be opportunities to ask questions.
HANDBOOKS
Each new member of staff will receive an electronic Corporate Staff Handbook and Induction Pack in readiness for attendance at the Corporate Induction. This is a general handbook consisting of background information on BrisDoc, the structure of the company, vision, values, key contact information and a summary of policies, procedures and other company rules and regulations. Responsibility for keeping this document up to date rests with the Workforce Department. The electronic induction pack includes Code of Expectations; IG staff handbook; HSE Law and Workstation DSE information.
Each service within BrisDoc will also provide a new recruit with a Local Service Handbook / Guidelines e.g. Integrated Urgent Care Handbook / GP Practice handbook/guidelines. Responsibility for keeping this document up to date rests with the manager for the service.
INDUCTION AND IT
In order for the employee to work with ease within their role, it is also essential that all the necessary “log ins” and IT information are updated. The following process should be followed in order to ensure the successful induction of a new employee.
At induction a new starter will also be issued login details for their relevant statutory and mandatory training (issued via Workforce Support)
COMPLETING AND REVIEWING THE INDUCTION PROCESS
There are two main ways that the effectiveness of BrisDoc’s induction process is reviewed:
(1) Performance & Development Review (PDRs) – these measures how well the individual is performing against the set standards of the role within their probationary period.
(2) Induction Questionnaire – this helps to understand how the individual feels about how well their induction progressed.
Performance & Development Review
Performance and Development Review (PDR) Meetings are conducted within the first 6 months of the new starter’s employment (please refer to Appendices 3, 4 and 5). During these meetings personal objectives and a personal development plan, linked into BrisDoc’s overall objectives will be set, and the individual’s progress monitored and reviewed. The manager should assess levels of attainment and performance in the job, as well as looking at related matters, such as morale, attitude, timekeeping and attendance levels, and integration into the work group. The staff member will be given the opportunity to ask questions and raise matters of concern. Any problems should be addressed and this may involve training and development. The PDR at the end of the 6 months probationary period completes the induction process. Performance is then measured and monitored in line with BrisDoc’s Performance & Development Review Policy.
Induction Questionnaire
Three months after the new recruit commences employment, the Workforce Team sends out an Induction Questionnaire for completion electronically. This questionnaire contains a few questions to gain the opinion from the staff member themselves about their experience of our induction programme.
The questionnaire is divided into 2 sections. The first section asks questions about the areas that should have been covered in the Induction Programme to know if they have been informed about some of the more important aspects of the induction. The second section covers how well they think their Induction Programme had been carried out and how they think they have benefited from the Programme.
5. RELATED POLICIES
- Recruitment & Selection Policy and Procedure
- Equality & Diversity Policy
- Performance & Development Review Policy and Procedure
- Health & Safety Policy and Manual
- Training & Development Policy
- Information Governance Policy
- Social Media Policy
- Quality Policy
- SMART card Policy
6. RELATED DOCUMENTS
- Corporate Staff Handbook
- Local Service Handbooks
- Patient Private Income Cash Handling SOP
- Code of Expectations.
Appendix 1: Induction Checklist – Day one
Month one- Touchpoint
Month- Three Touchpoint
Month Six- End of Probation
Appendix 5: Risk Assessment for Individual Job Roles and People
Risk Assessment Pack
Risk Assessment Guidelines
Risk Assessment Matrix
Risk Score Recording and Reporting Guidelines
Risk Assessment Form and Action Plan
Guidance for Undertaking a Risk Assessment
A risk assessment is a careful examination of what could cause harm to people, the environment, the organisation etc., to enable a review of whether enough precautions are in place or whether more should and can be done to prevent harm.
BrisDoc has a legal responsibility to identify and categorise risks and either eliminate or reduce them to the “lowest level that is reasonably practicable”.
The risk assessment process will generate BrisDoc’s Risk Register.
The 5 steps in the risk assessment process are:
Step 1 Look for and identify the hazard/problem.
Step 2 Decide who or what might be harmed and how.
Step 3 Evaluate the risks and decide whether the existing control measures/precautions in place are adequate or whether more should be done. Controls could range from eliminating/stopping the activity, to reducing the risk by introducing new control measures, to transferring the risk to another body, to accepting and managing the risk if it is unavoidable.
Step 4 Record your findings on the Risk Assessment Form and communicate the risk and control measure to those who need to know – i.e. all people who could be harmed.
Step 5 Review the assessment looking at the effect of the risk and any actions taken.
Some examples of when it is appropriate to undertake a risk assessment are:
- Before introducing new equipment i.e. cars or computer systems.
- Before a change in environment i.e. new base or office move.
- When developing a new service, or changing an existing one.
- Following a near miss or adverse event.
- Following a complaint.
The level of risk associated with each hazard is assessed in accordance with the Risk Scoring Matrix. This identifies both the severity of the hazard and its likelihood of occurrence. The aim of the risk scoring is to systematically establish relative priorities. The purpose of risk treatment is to determine what will be done and who will be responsible for the risks that have been identified. Risk treatment converts the risk assessment into an action plan. This information is then recorded in the Risk Register.
Clearly, it will not be possible to minimise or eliminate all risk identified immediately. Some will require further research and development to be undertaken, others may require financial planning or have a lead time to undertake the work required. Sometimes, when confronted with problems which demand quick solutions, people succumb to the imperative of haste and move directly from risk identification to treatment of the risk.
By omitting consideration of the context of the risk and not performing appropriate analysis and evaluation, the people undertaking the assessment risk implementing inadequate ‘quick fixes’. It is important to consider underlying systems when undertaking a risk assessment. It may be necessary to implement short-term solutions, but in considering all information, the risk analysis process can help inform longer term planning processes. For example, where risks arise from the physical layout of a building or department, if these risks are analysed and recorded it may help to ensure that if the service moves to another or a new building/department that those risks that were previously identified are not present in the new facility.
It takes time to plan and implement change. A robust monitoring and review system is essential to ensure actions are followed through, and priorities are re-assessed, so that risk management is an ongoing process that is embedded into normal management processes. Ensure that when undertaking the assessment the details of the date of the review and the people who will be undertaking the review are documented and this process is followed through.
Risk Assessment Matrix
Severity/Consequence of event occurring again
| Description | Category | Risk to patient, staff, business |
| Catastrophic | 5 | Incident leading to death, non-delivery of business objectives, event which impacts on large number of patients/staff, multiple breeches to statutory duty, prosecution, national media coverage/total loss of public confidence, >25% over project budget/loss of >1% of budget, loss of contract, 1day loss of service. |
| Major | 4 | Major injury leading to long term incapacity, significant harm to patient, >14days off work, uncertain delivery of business objectives, enforcement action/multiple breeches of statutory duty, uncertain delivery of service due to lack of staff, national media coverage, 10-15% over project budget/loss of 0.5-1% of budget, >12hrs interruption to service. |
| Moderate | 3 | Moderate injury requiring professional intervention, some harm to patient, 4-14days off work, unsafe staffing level, single breech of statutory duty, local media coverage/long term reduction in public confidence, >8hrs interruption to service, 5-10% over project budget/0.25-0.5% loss of budget, late delivery of business objectives. |
| Minor | 2 | Minor injury, minimal harm to patient, low staffing reduces service quality, breech of statutory legislation, local media coverage/short-term reduction in public confidence, >1hr interruption to service, <5% over project budget/loss of 0.1-0.25% of budget, minor impact on business objectives, >3days off work. |
| Negligible | 1 | Minimal injury, no harm to patient, no time off work, no/slight impact on business objectives, insignificant cost increase/financial loss, rumours, <30mins interruption to service, <1 day shortage of staff, no/minimal breech of statutory duty. |
Likelihood of event occurring again
| Almost certain | 81% -100% likelihood of occurrence | 5 | Will undoubtedly happen/recur, possibly frequently |
| Likely | 51% – 80% likelihood of occurrence | 4 | Will probably happen/recur but is not a persisting issue |
| Possible | 21% – 50% likelihood of occurrence | 3 | Might happen or recur occasionally |
| Unlikely | 6% – 20% likelihood of occurrence | 2 | Do not expect it to happen/recur but possible it may do so |
| Rare | 0% – 5% likelihood of occurrence | 1 | This will probably never happen
|
Score the risk
| Severity of Consequence | |||||||
| Likelihood | Almost certain | 5 | 10 | 15 | 20 | 25 | |
| Likely | 4 | 8 | 12 | 16 | 20 | ||
| Possible | 3 | 6 | 9 | 12 | 15 | ||
| Unlikely | 2 | 4 | 6 | 8 | 10 | ||
| Rare | 1 | 2 | 3 | 4 | 5 | ||
| Negligible | Minor | Moderate | Major | Catastrophic | |||
|
The risk score = likelihood multiplied by severity/consequence |
|||||||
Risk Score Analysis, Recording and Reporting
Risk Score 1 – 4 Low Risk, (Green)
Will be managed by Line Managers and recorded within the risk register by the Service/Practice Manager. Risks of this magnitude are considered low level risks and are well within BrisDoc’s risk appetite. They are usually those which are experienced on a daily basis, are managed and actioned as part of the normal managerial risk assessment process, and monitored on a monthly basis. Line Managers should retain a record of all low level risk and share information with the Head of Governance.
For low risks quick and easy controls (measures) can be implemented immediately and further action planned for when resources permit or no further action may be required.
Risk Score 5 – 8 Moderate Risk, (Yellow)
Will be recorded within risk register and managed by Service/Practice Managers. The completed risk assessment form will be sent to the Head of Governance. These risks are within BrisDoc’s risk appetite. Close monitoring by risk owner is required with consideration of additional risk mitigation measures. Actions to control moderate risks will be implemented as soon as possible, and no later than the next financial year.
Risk Score 9 – 12 High Risk, (Orange) Will be immediately reported to a Director. The risk assessment form will be completed and sent to the Service/Practice Manager for entry onto the risk register and presented by the Service/Practice Manager at the relevant Governance Board Meeting. The Line Manager may be asked to attend this meeting to discuss the risk and the actions taken or proposed. A contingency plan and urgent need to consider risk mitigating action are required. The risk is managed and closely monitored by the Service/Practice Manager and is borderline for BrisDoc’s risk appetite. The Risk assessment form will be sent to the Head of Governance.
Orange risks can only be closed on the risk register with the authority of the Executive Directors.
Actions to control high risks will be implemented as soon as possible and no later than within 3 months of the risk being identified. The Board of Directors is made aware.
Risk Score 15 – 25 Extreme Risk, (Red)
All risks identified as category red are to be reported to the Managing Director. The risk assessment form must be completed and sent to the head of Governance for entry onto the risk register and presented by the Service/Practice Manager at the Quality Management Forum/Clinical & Services Governance Board Meeting. The Line Manager may be asked to attend the next Board meeting to discuss the risk and the actions taken or proposed.
Red risks can only be closed on the Risk Register with the authority of the Chairman and should be reported to the Commissioning Support Unit if directed by the Board of Directors.
Extreme risks require emergency action and a contingency plan. They are beyond BrisDoc’s risk appetite. The BrisDoc Board is made aware and immediate action is implemented. Any process, procedure or operational service must be stopped immediately.
APPENDIX 7: RISK ASSESSMENT FORM – COVID 19
Emerging data suggests that alongside underlying health conditions and obesity, there are demographic factors that can affect peoples’ vulnerability in relation to Covid-10 outcomes: These include:
- Age
- Gender
- Ethnicity
Please undertake a risk assessment on any staff who fall into the following categories. Please listen carefully to the staff member’s views and concerns:
- Aged 70 or older (regardless of medical conditions)
- under 70 with an underlying health condition listed below (ie anyone instructed to get a flu jab as an adult each year on medical grounds):
- chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
- chronic heart disease, such as heart failure
- chronic kidney disease
- chronic liver disease, such as hepatitis
- chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
- diabetes (Type 1 or 2)
- Spleen problems – for example, sickle cell disease or if you have had your spleen removed
- a “weakened” immune system as the result of conditions such as HIV and AIDS, or medicines such as continuous / frequent steroid tablets, chemotherapy or other drugs which depress the immune system.
- being seriously overweight (a body mass index (BMI) of 40 or above)
- those who are pregnant
- those who have BAME backgrounds
- those who are male
Please use the scoring below to initially assess risk level. Once you have undertaken the assessment, please discuss any anomalies with a clinician within the Covid-19 senior medical team to finalise / agree the plan based on overall risk. For example, a worker meets “at risk” criteria but is well and wishes to continue in a patient facing role. Senior Medical Team – Kathy Ryan, Caroline Stovell, Chris Dykes and Anne Whitehouse, (Kathy primary contact for IUC, Caroline for practices)
7. Change Table
| Date | Reviewed and amended by | Revision details | Issue number |
| May 2009 | C Edmunds | 1 | |
| November 2011 | C Edmunds | 2 | |
| November 2015 | C Edmunds | 3 | |
| September 2016 | CL Nicholls | 4 | |
| July 2020 | N Clegg | 5 |