1

Practice Extended Access Pack

TPP SystmOne

2

Contents

Extended Access Clinics, and Who Is Eligible?....................................................................................... 3

Saturday Morning Appointments ....................................................................................................... 3

First 2 Physio Appointments ............................................................................................................... 4

Same Day Appointments .................................................................................................................... 5

Clinical Competencies ......................................................................................................................... 5

Booking and Cancelling Appointments.................................................................................................. 6

Booking Appointments ....................................................................................................................... 6

Cancelling Appointments .................................................................................................................... 8

Data Processing and Data Sharing ....................................................................................................... 10

Clinical System Specific ..................................................................................................................... 10

General Points on Data Sharing ........................................................................................................ 10

Useful Resources .................................................................................................................................. 11

First 2 Physio Service Supporting Documentation .............................................................................. 12

Inclusion, Exclusion Criteria and Red Flags ....................................................................................... 12

Care Navigation Summary ................................................................................................................ 13

Patient Pathway ............................................................................................................................... 14

3

What are the different Primary Care Doncaster Extended Access Clinics, and Who Is Eligible?

Saturday Morning Appointments (TPP Rota Types: Lakeside Practice, Tickhill Surgery, Conisbrough, Thorne Moor)

There will be four hubs around Doncaster which will open every Saturday morning 9am –

12pm and offer routine GP, Nurse and Health Care (HCA) clinics

The hubs are located at:

o The Lakeside Practice, Askern, DN6 0HZ (North neighbourhood) o Thorne Moor Medical Practice, Thorne, DN8 4BQ (East neighbourhood) o Conisbrough Group Practice, Conisbrough, DN12 3JW (South (west) neighbourhood) o Tickhill & Colliery Medical Practice, Tickhill, DN11 9NA (South (east) neighbourhood)

Practices can directly book appointments at all the hubs via their usual clinical system. On

TPP, the clinic locations are shown under “Rota Types” (see next chapter)

These are routine pre-bookable appointments, that can be offered as an alternative to mid-week appointments if this is more convenient to your patient

Each Saturday Clinic will be available to book the Monday before the clinic date

These appointments are NOT for patients who:

o Depend on continuity of care i.e. such as those with more than one long term condition / patients with complex needs

o Conditions that require immediate direction to A&E o Pregnancy related emergencies o Dental emergencies o Mental Health emergencies o Require minor surgery or coil / IUD fitting or removal

There is no geographical restriction on who can access the hubs. If a patient chooses to, they can attend any hub no matter where their usual registered practice is located

Utilisation of these appointments will be closely monitored and fed back to practices via neighbourhood meetings

4

First 2 Physio Appointments (TPP Rota Type: First 2 Physio)

The hub for this element is Devonshire House in the town centre

Chapman Physiotherapy will be based at Devonshire House, on the ground floor and will offer appointments with a physiotherapist

The aim of the service is to reduce pressure on GP appointments for patients needing a first assessment of their musculoskeletal condition

At the appointment the patient will be assessed and given advice, a home exercise programme and where necessary requests for analgesia, onward referral or x-rays will be made via the patient’s registered practice

All GP practices will be able to directly book First 2 Physio appointments via their usual clinical system

Each First 2 Physio Clinic will be available to book into 48 hours in advance, with the exception of the Monday clinic which will be available to book from the Friday before

Inclusion / exclusion criteria and a Care Navigator Summary are appended to this Pack and are available on our website member’s area www.primarycaredoncaster.co.uk and the CCG Care Navigator clinical system template.

Appointments are available throughout the week including evenings and weekends

5

Same Day Appointments (TPP Rota Type: Same Day HC)

PCD is working closely with the Same Day Health Centre (FCMS) to provide additional same day appointments.

These will be provided 7am-8am & 6.30pm-8pm Monday Friday, and 8am-8pm Saturday & Sunday, provided by additional clinicians working alongside the Same Day Health Centre Team at Devonshire House

These appointments are not for patients who depend on continuity of care such as those with multiple long term conditions or complex needs

These appointments should be used when a patient rings and asks for an appointment within the next 24 hours, and their clinical need is urgent enough to warrant this, but your practice does not have the capacity to accommodate them

GP practices will be able to directly book into these appointments via their usual clinical system

Appointments will be released on a daily basis, 24 hours in advance, with the exception of Sunday clinics which will be available to book from each Friday

Utilisation of these appointments will be closely monitored and fed back to practices via neighbourhood meetings.

Clinical Competencies

We are working with TPP on how we show the competencies for our clinicians, including their gender, to show on the slot booking screen. Currently this functionality is not available to us; however you will be able to see the clinician name when you are booking an appointment. Whilst this is being explored, a matrix of clinical competencies by clinician will be available on our website member’s area www.primarycaredoncaster.co.uk.

The clinical competency matrix will be refreshed weekly as new people join our service. Please ensure you check it regularly so you are always using the most up to date information.

In recognition of the need for practices to understand nurse competencies in particular, to ensure appropriateness of booking, we will issue this information separately to practices at the beginning of each week, for ease of reference.

We hope to be able to find a digital solution with TPP as soon as possible.

6

Booking and Cancelling Appointments Booking Appointments 1. Select Appointments - Remote Booking from the ribbon menu.

2. Select the clinic the patient wishes to attend from the drop down list under Rota Type

NB: the column headed “Type” actually details what the clinic is. Please Ignore the Location column

3. Do one of the following to view the slots you can book in the right‑hand pane:

double‑click on the rota, or select the rota and click Request Slots, or

right ‑click on the rota and select Request Slots.

4. Select the slot you want for the patient from the right‑hand pane and do one of the following:

click Book Appointment or right‑click and select Book Appointment and search for the patient in the usual way, or

click Book Appointment from Waiting List or right‑click and select Book Appointment

from Waiting List and navigate to the relevant waiting list using the tree in the left‑hand pane.

7

5. Select the patient and click Ok. The Book New Remote Appointment dialog is displayed. Please make sure that the SMS notification box is not ticked. This function does not work for extended access appointments

6. Please ensure you write the following information in the Details field:

a. Patient contact telephone number b. Reason for appointment c. If a Chaperone is required d. If an interpreter is required e. Any other useful information for the clinician

7. Do not set a referring GP in the Referred by box. You will be prompted to confirm that you do

not want to set the referring GP. Click Yes

8. The Appointment Information dialog is displayed with details of the booking.

8

Cancelling Appointments 1. Press the F9 key to view the Appointment Search dialog.

2. Select Appointments remotely booked into other organisations.

3. Search for your patient as normal so the remotely booked appointment is found.

4. Right‑click on the appointment and select the appropriate option from the Administration sub‑menu, for example 'Cancelled by Unit'.

9

5. You will be asked by the system what you want to do with the appointment:

Rebook Now.

Rebook Later – the appointment is stored in the Appointments for Rebooking dialog, ready for rebooking, see Rebooking an Appointment for further details.

Don't Rebook – the original appointment is cancelled and is not stored for rebooking.

10

Data Processing and Data Sharing

Clinical System Specific All TPP SystmOne Practices have been asked to add the Primary Care Doncaster Extended Access Unit to their ‘already approved list’ within TPP. A guide on how to do this is available on the Primary Care Doncaster Limited website here. Once added to the approved list clinicians working at the Extended Access Service will be able to access patient records of the patients booked into their sessions / clinics. The clinician is granted episodic consent to view the patient record, meaning that if consent is given the clinician is allowed access to the patient record for only the appointment the consent is granted for. Patient consent is required. The clinician working at the extended access service will be prompted to ask for consent at the appointment. If consent is not given then the appointment cannot continue. Primary Care Doncaster Limited acknowledges that this could mean a wasted journey for the patient if they do not consent to share their patient record. At this current time there is no flexibility within TPP to allow for consent to be recorded any earlier that at attendance of the appointment. It is very important therefore, that the practice receptionist explains to the patient at the time of booking, that their consent will be actively sought, the appointment will not be with their own GP, not at their own practice, and check the patient is happy to be booked in with this knowledge.

General Points on Data Sharing Both the EMIS Web and TPP SystmOne Data Sharing Agreements are the nationally used Data Sharing Agreements that are fully compliant with the Data Protection Act (2018) and the General Data Protection Regulations (GDPR) (2018). Primary Care Doncaster Limited also has in place a Data Processing Agreement with each GP Practice. This compliments the clinical system Data Sharing Agreements and sets out:

The subject matter

Duration of the processing

The nature and purpose of the processing

The type of personal data to be processed

The categories of data subjects

The obligations and rights of the controller This has been approved by Dr Eggitt as Data Protection Officer for both Primary Care Doncaster Limited and practices. The full Data Processing Agreement can be found here https://www.primarycaredoncaster.co.uk/extended-access-resources/

11

Useful Resources

To access the full TPP SystmOne User Guides press F1 whilst you are logged into the TPP system

How to register on the Primary Care Doncaster website members area

The Primary Care Doncaster Website the 'How To' register guide.pptx

The Primary Care Doncaster Ltd Website www.primarycaredoncaster.co.uk

12

First 2 Physio Service Supporting Documentation

Inclusion, Exclusion Criteria and Red Flags

The service does not accept patients under the age of 6 years old.

Red Flags If any of the following red flag symptoms are identified the patient is not eligible for the First 2 Physio Service and the practice should see/treat the patient following their usual practice processes. • History of Cancer (particularly breast, kidney, lung, prostate, melanoma and gynae) • Feels unwell i.e. has a fever, decreased appetite, weight loss, night sweats • Pain wakes the patient at night • Swelling in more than one joint • Joint problems associated with a rash • Upper back pain (thoracic pain) • Joint is red and warm • New joint deformity or there is a history of trauma – these patients should be advised to attend

the Emergency Department • Reduced feeling in buttocks or genital area • New onset of bladder or bowel problems (inability to pass urine and not controlling bowel

movements) since pain began

Inclusion Criteria Exclusion Criteria

Musculoskeletal (MSK) pain of less than six months duration, including:

Work related disorders including repetitive strain disorders

RTA / whiplash related disorders

Pain caused by repetitive action / sitting / standing for long periods

Pain or discomfort during walking or running

Post-operative musculoskeletal pain

Chronic (pain of more than 6 months) musculoskeletal (MSK)

Infection

Children under the age of 6 years old

13

First 2 Physio Service in Doncaster

A Summary for Care Navigator

The First 2 Physio Service is a triage and advice service that promotes an alternative to a GP appointment by offering an assessment with an accredited physiotherapist. This service is an initial assessment service only. Patients will be discharged back to their registered GP practice should any follow up appointments be required

The First 2 Physio Service is based on the ground floor, Devonshire House, South Parade, Doncaster, DN1 2DJ.

Who is Eligible?

Patients MUST:

Be registered with a Doncaster GP Practice

Not have meet any exclusion criteria

Not have any red flags

Be over the age of 6 years old

If care navigators ask the nature of the call to practice they can inform the patient

that they can see a physiotherapist if they fit the inclusion criteria.

Under the First 2 Physio Service Patients Will Be Offered:

Free advice and printed information

A home exercise programme

Medication if appropriate

What happens when a patient goes to the physiotherapist for the First 2

Physio Service

All patients will be offered an assessment with a physiotherapist and given

advice on how to manage their condition. This will include what to expect, i.e.

what’s normal for the condition / usual duration of symptoms. The patient will

also be given a home exercise programme. Any requests for analgesia, onward

referral or x-rays will be made via the patient’s registered GP practice.

The three possible outcomes for patients using the service are:

1. Advice only 2. Advice and home exercise programme 3. Signpost back to practice for non-urgent GP appointment (advice, printed

information may still be provided)

What do I do if a patient doesn’t want / refuses to go to the Physiotherapist?

The First 2 Physio Service is optional. Patients who do not wish to use the service

can access medical care via the usual routes.

Key Messages for Patients

All patients can get free advice and assessment from an accredited

physiotherapist without needing to see a GP

First 2 Physio Inclusion Criteria:

Musculoskeletal pain of less than six months duration

Work related disorders including repetitive strain disorder

Road traffic accident / whiplash related pain

Pain caused by repetitive action / sitting / standing for long periods

Pain or discomfort during walking or running

Post-operative musculoskeletal pain

First 2 Physio DOES NOT Include:

Musculoskeletal pain of more than six months duration

Infection

Unwell patients (i.e. has a fever, weight loss, decreased appetite)

Swelling in joints (including red and warm joints)

Pain with a rash

Upper back pain (thoracic pain)

New deformities or deformities following trauma

Reduced feeling in buttocks or genital area

Pain associated with new bladder or bowel problems

Care Navigation Summary

14

First 2 Physio Service Patient Pathway

Call to receptionist with MSK problem

•Patient contacts GP practice complaining of MSK problem.

•Receptionist informs patient of First 2 Physio Service

•Receptionist screens with inclusion/exclusion criteria and red flags

•Receptionist books appointment with First 2 Physio

Attend for Assessment at

Devonshire House

•Patient attends Devonshire House

•Patient has First 2 Physio Assessment

Assessment Outcome

•Patient is given self management strategies and a home exercise programme

•If necessary onward referral for further investigations or to other services is made via the registered GP practice

Evaluation

•Patient Questionnaire follow-up and outcome data collection

• Analysis and Feedback

• Home exercises provided with the Physiotec application and printed for the

patient to retain

• FCMS support on the day prescribing for analgesia.

• Patients registered practice is tasked if any referral to other services or X-ray

etc. is required.

• Primary Care Doncaster Limited to facilitate training and support for

Reception Team

• Verbal consent from patient they are happy to share patient record and

attend First 2 Physio appointment

• Compilation of final report using joint resources.

• Close working between Chapman Physiotherapy, Primary Care Doncaster and

HealthWatch Doncaster to evaluate service