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LIME TREE SURGERY EMERGENCY PLAN Document Review Arrangements This document will be reviewed on a yearly programme or when there is a change in the working systems of the practice or changes to the contact arrangements of staff or suppliers that affect the content. This will be the responsibility of the Practice Manager. Training and Exercising The emergency and business continuity response arrangements within this plan are useless if the staff that are expected to implement them at the time of an emergency are unaware of them. To this end all staff will be made aware of the plan as part of their induction training. If there are any significant changes to the plan that affect the way in which staff respond these must be communicated to them. The arrangements within this plan should be exercised at least once a year; this will help to validate their effectiveness and highlight any gaps in the plan, which can then be amended. Activation of the Plan The nominated person for this surgery to decide whether the plan or any part of the plan is activated will be the most senior GP partner available or the practice manager. Contact details are:- Dr D Mannings Dr M Shipsey Dr K Patel Dr K Palan Dr I Pogoda Dr R Dhillon Paula Russell Home Mobile 01903 873013 07500931603 07811 353900 07876 705077 0772 0323222 07816 224902 07882 673649 07795488779 01903 610495 01273 550269 01243 555237 The decision to activate all or part of this entire plan can be done using the following process: The most senior doctor having made the decision to activate the plan should contact the following staff members: The practice manager – Paula Russell 01243 555237 or 07795 488779 Business Support Administrator – Sheila Lidbetter 01903 526219 or 07949032823 The reception manager – Nicki Howick – 01903 525398 or 07748 3498878 1 Emergency Response The GPs and staff at the practice will do their best within available resources and assuming circumstances allow, to assist the CWS CCG and the community generally in the event that assistance is required for: Rest, evacuation and survivor centres Prescribing and supplying medications Mass vaccination / prophylaxis Participation in the co-ordination of services in the event of a major incident. Contact Surrey & Sussex Area Team (NHS England) in core hours Kirsty Sibandze 01293 778833/07825 780545 or Shelley Eugene 01293 847047/07795 637105 Outside core hours contact the on-call Head of Service for the Surrey and Sussex Area Team on 0844 822 2888 quoting NHS42. CWS CCG Contacts– Elizabeth Tinley – 01273 574662 Kim Williams – 01273 574637 Chemical Biological Radiological and Nuclear (CBRN) Incidents In the event that a contaminated casualty presents at the practice the following steps should be taken. 1 2 3 4 5 6 Contain the casualty away from others, keep all staff at a distance. Consider also containment for those who have already come into contact with the casualty. Call the ambulance service, stating that you have a contaminated casualty at the practice. Ask the casualty to remove their clothing, as this has been shown to reduce the contamination by up to 80% of contaminant. Provide a plastic bag for the casualty to place the clothes in. Provide the casualty a 10lt bucket of warm water containing 10ml of washing up liquid and a sponge, encourage the casualty to wash their whole body. Eyes should be washed with plain water, they should blow their nose and wash their mouth out with water. Provide a blanket once decontamination is complete and awaiting the ambulance service. Remember all efforts must be taken to prevent further contamination of others. Business Continuity Priority order of services provided GP surgeries offer a wide range of services to their patients; below in table 1 is a list of the services that this surgery provides: In the event of an emergency or business interruption this practice will endeavour to maintain services to usual or as close to usual standard, but it 2 may be evident that this is not possible, at this point the most senior partner available/practice manager will decide which are the priority services that the practice must continue and which will be reduced or stopped. Any decisions made to reduce or stop services must be communicated to the Contact Surrey & Sussex Area Team (NHS England) in core hours Kirsty Sibandze 01293 778833/07825 780545 or Shelley Eugene 01293 847047/07795 637105 Outside core hours contact the on-call Head of Service for the Surrey and Sussex Area Team on 0844 822 2888 quoting NHS42. CWS CCG Contacts– Elizabeth Tinley – 01273 574662 Kim Williams – 01273 574637 Patient consultations with doctors and health care professionals Home Visits Specialist Clinics Childhood Immunisation Minor Surgery Cervical cytology Public health vaccination programmes Neonatal checks IUCD fitting Drug monitoring 24 hr blood pressure monitoring and 24 hr ECGs Spirometry/reversibility testing Health promotion Pregnancy testing Smoking cessation services Learning disabilities action planning H pylori testing PSA monitoring Substance misuse support Domiciliary phlebotomy Leg ulcer clinics Mental health assessments Loss of main surgery building If the practice building is uninhabitable for any reason the services will be provided in a suitable alternative venue. The options open to the practice are: Transferring to St Lawrence Surgery or Findon Valley Free Church Hall 3 Failure of IT systems See TPP Disaster Recovery Policy attached. Prescriptions If it is not possible to print prescriptions these will need be hand written. In this event it may be necessary to contact CWS CCG to obtain more prescription pads. This can be done in office hours by faxing a request form to the post room on 01903 246013, followed up by a phone call to 01903 708589. Outside core hours contact the on-call Head of Service for the Surrey and Sussex Area Team on 0844 822 2888 quoting NHS42 CWS CCG Contacts– Elizabeth Tinley – 01273 574662 Kim Williams – 01273 574637 Loss of hardware or software If the practice experiences loss of either a computer or software through theft or damage the Practice Manager will contact the Sussex HIS contact centre 08458454488 or TPP – 0845 6042817 to arrange reloading of software. Protection of servers During periods of extreme heat ensure that the server is maintained at a temperature that will not cause overheating and subsequent failure. Loss of Medical Records TPP Systmone is a remotely hosted medical records system which is held in Leeds, West Yorkshire. TPP have a business continuity plan for when problems arise. The contact number is 0845 6042817. Lloyd George paper based records are held in secure storage at Curtis Storage:93, Marlborough Road Tel. 01903 767750 Churchill Industrial Estate Fax. 01903 767750 Lancing Business Park Lancing BN15 8TR Email. mailto:[email protected] If the paper records are lost or damaged in any way these may be reconstructed using the data held on the computer system. Failure of Telecommunications The telephone system and lines are from The Focus Group – telephone number for any faults is 0845 450 5225 4 If the system is dependant on electrical supply check the supply, if found to be an electrical problem follow the instructions for loss of electricity. If the main system fails all calls can be redirected to the analogue line which is 01903 693771 or to the practice mobile 07867992438. Failure of Electricity supply The electrical fuse boxes for this practice are located: Main Surgery – kitchen cupboard Supply to 6 Coombe Rise Air con unti treatment room 2 Air con unit Heater fan kitchen Heating controls time clock and contractor Outside lights Cooker Sockets – east and west office, kitchen, corner office and room 12 Lights - kitchen, corner office, room 12 south and north office Heater – corner office Waiting area cupboard Heaters – room 1, waiting room, room 2, reception passage, foyer treatment room 1 Sockets – room 1 and 2, reception, toilets, waiting rooms 1 and 2, fridge pharmacy Lights – toilets, room 1 and 2, reception hallway, treatment room 1, lights entrance and reception, telephone system, pharmacy lobby, waiting area Passage cupboard in extension Alarm supply Air con unit Lights – room 3 and toilet, rooms 4, 5, 6 and 7. first floor, waiting room and passageways, boiler supply, Sockets – first floor north, rooms 4& 5 and passage, rooms 6 and 7, first floor south, room 3, waiting area and walkway Pharmacy Lights – north, east and emergency, south east, outside lights and sign, west Air con 1 and 2 Passageway mains cupboard 5 Heaters – room 8, 9,10, 11, staff toilet, passageway Passageway cupboard – main building Heater point south waiting room Heater first floor pharmacy Sockets – pharmacy and ground floor office, office, kitchen first floor pharmacy Water heater – pharmacy Lights Air con unit first floor store pharmacy Consulting room 16 Sockets – district nurses, rooms 3 and 13, conference room and room 15, room 17 and room 16. Sockets – secretaries, photocopying room, training room, rooms 14 and 15 and boiler, 16 and hallway, immersion heater Lights – secretaries and training room, hallway up, toilet and photocopying room, conference room, rooms 14, 15, 16 and hallway, room 13, room 17 and room 18, room 3 and hallway, toilet and hallway Cupboard waiting room Fire alarm supply Please see attached schedule for more detail. In the event of failure in the electricity supply our suppliers are 8 Coombe Rise - Eon 0800 783 8866 - account no is 012827119380 Main Building and 6 Coombe Rise –Dual Energy 08007838866 account number 012827119380 Emergency torches and spare batteries are stored in the reception kitchen. In the event of a power failure first check the trip switches in the fuse boxes, if this is not the cause, contact the supplier and report the failure. Ask if they are able to give an estimated length of time the power will be off, for planning purposes. A decision should be made as to whether the surgery business can be continued safely, or if relocation to an alternative site will be required to maintain business. Any decisions made to reduce or stop services must be communicated to the Contact Surrey & Sussex Area Team (NHS England) in core hours Kirsty Sibandze 01293 778833/07825 780545 or Shelley Eugene 01293 847047/07795 637105 Outside core hours contact the on-call Head of Service for the Surrey and Sussex Area Team on 0844 822 2888 quoting NHS42. 6 CWS CCG Contacts– Elizabeth Tinley – 01273 574662 Kim Williams – 01273 574637 If it is an electrical fault within the practice contact Cobb Electrical Ltd 01273 566667 The systems and appliances that will be affected during a power failure are: Lighting IT System Telephones Heating Refrigerators Diagnostic equipment Alarm systems Each of the above will require consideration and follow the section specific to the system. Clinical refrigerators – if failure is for a significant period, which will be detrimental to the contents, the contents will be assessed and any temperature critical drugs will be relocated to St Lawrence Surgery via cool bags to maintain them at optimum temperature. Computers During a mains electrical failure please switch off the computers to protect them from power surge when the power is restored. Failure of Gas supply The gas shut off valve for the 6 Coombe Rise is located in room 18. If there is a failure in the gas supply 6 Coombe Rise – British gas 0800 111 999 (24 hours) if you smell gas or 0800 652 4040 account no 600023406 9970 to report the failure and to request if they are able to give an estimate of the length it will be off, for planning purposes. 8 Coombe Rise – Eon 0800 111 999 (24 hours) if you smell gas or 0845 055 0065 (8.00am – 6pm) account no 0128 2711 9970 to report the failure and to request if they are able to give an estimate of the length it will be off, for planning purposes. Heating - If heating is lost, assess the effect of the loss of heating related to time of year and general temperature, included forecast temperature. If it is felt that the practice’s business will be affected by loss of heating contact Platinum Heating 07748 547077. 7 Failure of Water supply The mains water shut off within the practice is located: For the main surgery – in the cleaner’s cupboard next to the disabled toilets For 6 Coombe Rise – in the small downstairs toilet next to the kitchen For 8 Coombe Rise The water supplier for this practice is Southern Water and their emergency contact is 0845 2780845. For internal plumbing emergencies contact Platinum Heating 07748 547077 In the event that water supply fails assess the impact on the practice. Toilets – would have to use public toilets next to the library Hand Hygiene – use alcohol gel Drinking water – already have bottled water available Toilets If toilets will be unavailable for a significant length of time arrange for portable toilets to be hired from WC Hire Ltd based in Henfield, tel 01273 928068. Hand Hygiene Alcohol gel is available. Drinking Water Supplies of bottled water would be obtained from Tesco, Kings Parade, Findon. Fuel Shortages In the event of a fuel shortage the ability to maintain services mat be affected either by staff being unable to carry out services such as home visits, or being able to get to the surgery. Each PCT will have a fuel crisis contingency plan, which will be integrated with the multi agency plans. The arrangements for obtaining fuel will be communicated by the PCT. Disruption to supplies During a major emergency there may be interruptions in the supply of consumables and equipment required by the practice. This may be a primary cause of an incident, ie a supplier factory fire, or disruption to the transport network such as in a fuel crisis. 8 In such an event, the most senior partner available will be responsible for assessing the impact on the business of the practice. If there is a need to obtain supplies from another source the options are: Mutual aid from another practice or CWS CCG. Strand Surgery: St Lawrence Surgery: 01903 243351 01903 222900 Fire On discovering a fire or on suspicion of a fire ie smell of burning, raise the alarm by pressing nearest alarm fire point and call 999, clearly stating the full address of the premises. In the event of the fire alarm sounding this will be a continuous bell/siren dependent on which area of the surgery they are situated in. All staff have a responsibility to evacuate the premises ensuring that all patients and visitors are assisted via the identified fire exits (see below). All persons will congregate at the fire evacuation assembly point in the car park, where the Senior Partner or Practice Manager will check that all persons have been evacuated. If you suspect that there are persons still inside do not re-enter the premises. On arrival of the Fire and Rescue Service the Senior Partner or Practice Manager will greet them and give the following information: Location of fire or suspected fire. Persons suspected of still being inside, with possible location Location of any inflammable materials / oxygen cylinders The exits are located: Area of premises Main Surgery Pharmacy New extension 6 Coombe Rise Nearest identified Exit Main front door Pharmacy front door Door in link way Front door Room 14 Conference room door Front Door 8 Coombe Rise Staff Shortage There may be occasions when individual staff are incapacitated for a variety of reasons. Their absence will have a varying effect depending on the role they are responsible for. In some cases roles can be covered by other staff by ensuring that knowledge and skills are shared between groups of staff. Other 9 roles may be highly specialised and cover will need more thought and planning especially if a service depends on that person alone. There may also be the scenario when a number of staff are all incapacitated at the same time such as in an influenza pandemic situation. On discovering there is going to be a shortage of staff inform Practice Manager or Reception Manager who will be responsible for assessing the impact on the business of the practice and the contingency to be employed to maintain continuity of service. Options available: The absence of staff for a short period does not have a significant impact on the business of the practice – monitor the situation only. The absence of staff will have direct impact on the front line services/ business of the practice, - divert workload to or between other staff that are capable of covering. The absence of staff will have a direct impact on the front line services/ business where there is no other employee who is able to cover the role(s). Seek appropriate bank/agency staff to cover. The impact of one or a number of staff being incapacitated is such that the practice is unable to continue services - Practice Manager or Reception Manager will be responsible for assessing the capabilities of the practice and possibly which services will be reduced (see list of services in priority above) or through mutual aid arrangements be diverted to other practices. Contact Strand Surgery 01903 243351 or St Lawrence Surgery 01903 222900 If there is any reduction in patient services, Practice Manager or Business Support Manager will contact Any decisions made to reduce or stop services must be communicated to the Contact Surrey & Sussex Area Team (NHS England) in core hours Kirsty Sibandze 01293 778833/07825 780545 or Shelley Eugene 01293 847047/07795 637105 Outside core hours contact the on-call Head of Service for the Surrey and Sussex Area Team on 0844 822 2888 quoting NHS42. Mutual Aid Arrangements with other Practices Strand Surgery 01903 243351 or St. Lawrence Surgery 01903 222900. Arrangements for Replacement Medical Staff Strand Surgery 01903 243351 or St. Lawrence Surgery 01903 222900. Arrangements for Replacement Nursing Staff Strand Surgery 01903 243351 or St. Lawrence Surgery 01903 222900. Arrangements for replacement Admin and Management Staff 10 Strand Surgery 01903 243351 or St. Lawrence Surgery 01903 222900. Communicating with Patients In the event that a business interruption is so severe that alternative arrangements for the provision of care need to be communicated to the clients of the practice, this will be done in collaboration with the CWS CCG. In the event that support from CWG CCG is required in publicising the alternative arrangements Practice Manager or Reception Manager will contact at the earliest possible moment to allow as much time as possible to achieve communication with clients. Where clients knowing contingency plans in advance would help to mitigate the effects of business interruption, arrangements within this plan will be shared with them in patient information regarding the practice. It is important to maintain communication with clients during any period of business interruption; the aim of the practice will be to reassure the clients with regular information on the progress made in returning to normality. Activation of the Plan Primary Secondary Paula Russell, Practice 01243 555237 Manager 07795488779 Sheila Lidbetter 01903 526219 07949 032828 Staff Contacts District Nurses 01903 276525 Doctors Home Mobile Dr David Mannings Dr Maurice Shipsey Dr Karen Patel Dr Katja Palan Dr Iwona Pogoda Dr Rani Dhillon Dr James Duddy Dr Marion Smith Dr Rebecca Richards Dr Sophie Young 01903 873013 01903 692581 01903 200288 01273 321194 01903 772214 01903 856810 07500 931603 07811 353900 07876 705077 07720 323222 07816 224902 07882 673649 07964 599203 07977 418950 07791 152232 07951 758622 Nurses Home Mobile 01273 453759 07764 994776 07870 787203 Sue Boysons Eileen Wilson 01903 610495 01273 550269 11 Jackie Bodger Kay White Clare Johnson Kerry Munson 01903 260457 01903 816007 01903 533215 01903 856333 07990 666030 Fran Ransley 01903 267491 07955 617604 Staff Home Mobile 01903 525387 01903 731613 01903 201330 01903 871194 01903 521528 07748 348878 07811 032215 07957 444271 07843 440444 HCA’s Reception Nicki Howick Michele July Julia Cripps Jenny Hall Jane Howard Katie Sanderson Kerry Boone Tracy Robinson Valerie Bond Alison Watkins 01903 209194 01903 538970 01903 263348 01903 533584 07786 620555 07753 605405 07708 898645 07955 619566 07956 954532 07540 661258 Admin Sheila Lidbetter Elaine Pickard Tom Mannings 01903 526219 01903 792508 07949 032828 01903 209287 01903 850048 07979 892711 07803 709905 01903 872044 01903 700756 01903 263554 01903 267272 07749 420190 07719 635792 07956 953429 07892 682617 01903 877612 01903 500072 07749 758668 07983 361336 Secretaries Jane Dennis Katrine Hartley Prescriptions Alice McHenry Dizzy Jones Claire Hathway Eloise Luff Coding Claire Heasman-Aves Marina Walsh 12 Utilities / Services Contacts Service IT systems Provider SystmOne TPP Telecommunications Focus 4 U Electricity EON (8 Coombe Rise) Dual Energy British Gas No 6 EON (8 Coombe Rise) Southern Water Contacts 0113 20 500 [email protected] www.tpp-uk.com 0844 692 8090 Account no FC3402 0800 783 8866 0845 5214291 0800 652 4040 0845 0550065 0845-2780845 Provider Cobb Electrical Ltd Platinum Plumbing Paine & Manwaring Contacts 01273 566667 01903 526593 01903 237522 Gas Water Tradesmen Trade Electrician Plumber Heating Engineer Other Practices with whom we have mutual aid arrangements Mutual aid available Practice Contacts All Strand Surgery Tel: 01903 222 900 All St Lawrence Surgery Tel. 01903 222900 Review Date May 2013 Comments Staff Member PR 13