Document Details Title Approval process Distribution ... · PDF file5.3 SBAR Communication...

Document Details

Title Transfer of Clinical Care Policy incorporating SBAR tool

Trust Ref No 1543-25204

Local Ref (optional)

Main points the document covers

The main aim of this policy is to ensure that all directorates have adequate arrangements to ensure effective handover of patients between clinical teams providing care for patients.

Who is the document aimed at?

This policy applies to all service directorates who have a responsibility for direct patient care.

Author Narinder Kular Nurse Consultant Community Paediatrics

Approval process

Approved by (Committee/Director)

Steve Gregory Quality & Safety Committee

Approval Date 08/09/2014

Initial Equality Impact Screening

Yes

Full Equality Impact Assessment

No

Lead Director Steve Gregory

Category Clinical

Sub Category All Clinical Services

Review date September 2017

Distribution

Who the policy will be distributed to

All Staff

Method Electronically via Datix web safety alert to senior staff, all staff via the Trust website, Mandatory training

Document Links

Required by CQC

Required by NHSLA This is a mandatory risk management policy for the NHSLA Risk Management Standards accreditation

Other

Amendments History

No Date Amendment

1 20.05.12 New Policy

2 21.5.12 Draft Copy email and face to face discussions with individual stakeholders

3 25.6.12 Final Amended after clinical policies V2

4 29.7.14 Reviewed up dated Clinical Policies incorporate SBAR tool V3

5

Transfer of Clinical Care Policy Version V3

Review Date: September 2017

2 Shropshire Community Health

Index

1. Introduction ................................................................................................................... 3

2. Purpose ......................................................................................................................... 3

3. Definitions ..................................................................................................................... 3

4. Duties ............................................................................................................................. 5

4.1 Chief Executive ...................................................................................................... 5

4.2 Director of Nursing & Medical Director ............................................................... 5

4.3 Service Managers .................................................................................................. 5

4.4 All Clinical Staff ...................................................................................................... 5

5. Guidance on Clinical Transfers of Care ................................................................... 5

5.1. Handover requirements between all care settings, to include both giving and

receiving of information ................................................................................................... 6

5.2. How handover is recorded ...................................................................................... 6

5.3 SBAR Communication Tool ................................................................................. 7

5.4 What should an SBAR communication convey? .............................................. 7

5.5. Emergency and Out of Hours Transfer ................................................................. 8

5.6. Single Point of Referral ............................................................................................ 8

5.7. What if things go Wrong .......................................................................................... 9

6.Dissemination and Implementation ............................................................................ 9

7.Consultation ................................................................................................................. 10

8. Monitoring Compliance ............................................................................................. 11

9. References .................................................................................................................. 14

10. Associated Documents ........................................................................................... 14

Appendix 1 Transfer of Care Table Service Directories .......................................... 15

Appendix 2 - Form 1a Clinical Handover .................................................................... 21

Appendix 2 - Form 1b: SCHT SBAR Handover Record........................................... 22

Appendix 3 - Special Patient Notes ................................. Error! Bookmark not defined. Appendix 4 – Single Point of Referral Service Leaflet ............................................. 21




1. Introduction

Handover of care….when carried out improperly can be a major contributory factor to subsequent error and harm to patients. This is always been so, but its importance is escalating with the requirement for shorter hours for doctors and an increase in shift patterns of working.

Professor Sir John Lilleyman Medical Director

National Patient Safety Agency (2004) This policy has been developed to ensure that Shropshire Community Health Trust (SCHT) has in place a systematic approach for the clinical transfer of care of patients from one clinical team to another at shift change or to achieve the efficient transfer of patient from one care setting to another. Handover involves both the giving and receiving of information and is a two way communication process. Individuals and organisations have a shared responsibility to ensure that effective communication lies at the very heart of good patient care.

2. Purpose This policy applies to all clinical staff working within SCHT Trust within all Adult and Children’s services. This policy refers to clinical handover of patients and transfers to, from and between all the following Trust services:

Community hospitals wards

Community Inter-disciplinary teams

Specialist Services & teams (Children Adolescent Mental Heath Services (CAMHS), Prison Healthcare, Preventative services, Diagnostics, access to assessment, rehabilitation & treatment (DAART), Shropshire Enablement Team, Substance Misuse, Advanced Primary Care Services, Diabetes Nursing service, Continence Service, Podiatry, Minor Injury Unit’s, Therapy services)

Children’s Services

Dental This policy should be applied in conjunction with the Clinical Discharge of Patients Policy.

3. Definitions AMHS Adult Mental Health Service

AHPs Allied Health Care Professionals

APCS Advanced Primary Care Service

CAMHS Children Adolescents Mental Health Services

Carer The term carer is used as the generic term for relatives/friends/neighbours that are providing unpaid care to the patient. They may not necessarily be living in the same household as the person they are caring for.

CCNT Community Children’s Nursing Team

CMHT Community Mental Health Team




CNR Community Neuro Rehabilitation Team [Previously known as SET Shropshire Enablement Team]

CSMT Community Substance Misuse Team

DAART Diagnostic Assessment and Access to Referral and Treatment

DNAR DO NOT ATTEMPT TO RESUSCITATE

EIP Early Intervention Programme

EG Latin expression Exempli Gratia

EWS Early Warning Score

GP General Practitioner

Handover Will involve minimal disturbance to the patient’s activities of daily living. Does not prevent or hamper a return to their usual place of residence. Will not require a significant change in support offered to the patient or their carer in the community.

IDT Interdisciplinary Team

MIUs Minor Injury Units

Multi-Disciplinary Team (MDT)

The team of staff who contributes to the patient’s care and/or discharge. EG Doctors, Nurses, AHP’s, Health Care Assistants, Therapy assistants, Psychologist, Liaison Nurse., Social worker.

NHS National Health Service

NPSA National Patient Safety Agency

OoH Out of Hours [time period 18:30pm-08:00am]

Out of Hours Handover

A handover of information that takes place at night or weekends. [18:30-08:00 hours]

Patient

The People receiving clinical services from the Trust are referred to as patients.

SaTH Shrewsbury and Telford Hospitals

SBAR S = Situation B = Background A = Assessment R = Recommendation

SBAR is an easy to remember mechanism that can be used to frame communications or conversations. It is a structured way of communicating information that requires a response from receiver.

SCHT Shropshire Community Health Trust

SPR Single Point of Referral

Shropdoc GP OoH Provider in Shropshire & Telford

Shrop Shropshire

Transfer of Care

‘The transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group on a temporary or permanent basis’ NPSA




4. Duties

4.1 Chief Executive The Chief Executive has ultimate accountability for the strategic and operational management of the Trust, including ensuring there are effective and appropriate processes in place for the safe transfer of care for patients.

4.2 Director of Nursing & Medical Director The Director of Nursing & Medical Director have responsibility for ensuring that appropriate transfer of care processes for patients are in place and support patient safety at all times

4.3 Service Managers Service Managers are responsible for the day to day operational management of transfer of care processes for patients are in line with the policy and ensuring their teams are aware of the requirements of this policy

4.4 All Clinical Staff Clinical staff are key essential members in ensuring that safe and timely transfer of care takes place, and has the central role in coordinating the patient’s handover in the clinical environment. All clinical staff are required to comply with this policy and to report any patient transfer of care related issues to their line manager and to complete a Datix incident report in line with the Trust’s Incident reporting policy.

5. Guidance on Clinical Transfers of Care During a transfer, patients should be treated and cared for in such a way as to maintain:

Patient safety

Necessary treatment and care

Contact with appropriate staff

Dignity

Respect of individual needs

Contact with appropriate relatives and carers

Confidentiality of information on a need to know basis




5.1 Handover requirements between all care settings, to include both giving and receiving of information Individual clinical areas will have their own requirements for handover dictated by the clinical work, the number of patients involved, their geographical distribution and the working patterns of the staff. It is therefore not possible to be descriptive about all transfer of care arrangements but all directorates should have predetermined arrangements detailing how clinical handover will occur. Service Directorates must have in place procedures for clinical transfer of care handovers between all groups of clinical staff within each department. Handover arrangements need to be recorded in order to ensure consistent practice and enable audit which handover processes can subsequently be audited. The record should cover each tier of staff amongst whom handover occurs and include details of:

Who participates in handover

When handover will be conducted

What information is to be relayed

When handover will occur

How handover will be conducted

What information is to be relayed o Minimum dataset for patients handed over o Criteria for highlighting specific issues

How the information passed over at the handover of care is to be recorded for a permanent medico-legal record.

Lastly, handover is of little value unless action is taken as a result: For example:

- tasks should be prioritised - plans for further care are put into place - unstable patients are reviewed -

5.2 How handover is recorded Adequate documentation is an essential component of communication within the health care setting. The primary source of patient related information remains the patient’s medical record folder. Whilst notes taken by staff at clinical handover meetings may be helpful to them during their forthcoming shift, it is of paramount importance that all critical information relating to the clinical care of patient appears in his or her medical notes. Handover is a two way process. Good handover practice is characterised by the team who are taking over the patient’s care asking questions and having the opportunity to clarify points they are uncertain of. They should not be passive recipients of information. The SCHT transfer of care area’s in each service directorate is area summarised in appendix 1 ‘Transfer of Care table’; it is the duty of each clinical lead to advise on any changes that affect transfer of care to other services. The Clinical Transfer of Care Record Forms 1a and 1b as seen in appendix 2 should be used to record the handover of information which incorporates the SBAR tool; these forms can be adapted by each clinical lead to reflect the service delivery characteristics that may be pertinent to the service area transfer of care summary form.




As such, SBAR can be used very effectively to escalate a clinical problem that requires immediate attention, or to facilitate efficient handover of patients between clinicians or clinical teams.

The written documentation should be recorded using permanent ink and be readable when photocopied or scanned. It should be written clearly, legibly and in such a manner that they cannot be erased. Also, accurately dated, timed and signed (the signatory’s name must be printed at the side of the first entry or be matched to an authorised signatory list). The signatory’s designation / role must also be recorded (this can be alongside the signature or in a specific signature list held within the record).

5.3 SBAR Communication Tool Inadequate verbal or written communication is recognised as being the most common root cause of serious error - both clinically and organisationally. There are some fundamental barriers to communication across different disciplines and levels of staff. These include hierarchy, gender, ethnic background and differences in communication styles between disciplines and individuals. SBAR is an easy to remember mechanism that can be used to frame communications or conversations. It is a structured way of communicating information that requires a response from the receiver. As such SBAR can be used effectively to escalate a clinical problem that requires immediate attention (in conjunction with the EWS) protocol as deemed appropriate), or to facilitate efficient handover of patients between clinicians and clinical teams.

5.4 What should an SBAR communication convey? S: Situation

o Identify yourself and the site / unit you are calling from o Identify the patient by the name and the reason for your report o Describe your concern: Firstly describe the specific situation about which you are

calling, including patients name, consultant, patient location, resuscitation status and the vital signs

B: Background Give the reason for the patient’s admission

o Explain significant medical history o Describe your concern: Give the patient’s reason for admission (or

presentation/referral in community care settings)

o Overview of the patient’s background: admitting diagnosis, date of admission, prior procedures, current medications, allergies, pertinent laboratory results (including infections and or colonization) and other relevant diagnostic results.




For this, you need to have collected information from the patient’s nursing / medical / progress notes.

A: Assessment

Vital signs

Clinical impressions, concerns

Not only should clinician’s review findings from their objective assessment, these finding should also be consolidated with objective indicators, such as laboratory results.

R: Recommendation

o Explain what you need – be specific about request and time frame o Make suggestions o Clarify expectations: Finally, what is your recommendation? That is, what would

you like to happen by the end of the conversation with the clinician?

5.5. Emergency and Out of Hours Transfer For urgent or Out of Hour clinical handover of information, staff should use the “Special Patient Notes” and for sharing information to achieve continuity of care/anticipatory care planning such as a specific management plan.

Palliative care information – Just in case box, DNAR etc refer to appendix 3. To transfer information that can be accessed by Shropdoc (GP OoH Provider Shropshire & Telford). This process will ensure that a consistent approach is in place in the OoH period.

For urgent and OoH transfers, staff should use emergency transport, i.e. ring 999 to summon an ambulance.

For urgent or Out of Hour clinical handover of information, staff should use the ‘Flagging Form’ as seen in appendix 3, to transfer information about the patient onto the GP medical record, this information can then be accessed by Shropdoc (GP OoH Provider Shropshire).

This process will ensure that a consistent approach is in place in the OoH period. For urgent and OoH transfers, staff should use emergency transport, i.e. ring 999 to summon an ambulance.

5.6. Single Point of Access Not all clinical services currently offer access via SPR in SCHT; for those services that do Single Point of Referral provides one contact number for all referrers and will continue to provide systematic access to community nursing services, refer to appendix 4 SPR Service Leaflet.

This service is available to all Health Care Professionals. Patients who have end of life care needs, require catheter care or Warfarin Control also has access to SPR in order to provide an efficient response to their individual needs, and where care is being transferred from Children Nursing Service to Adult Nursing Teams.




The SPR does not exclude clinical conversations. A clinician from the referring service should always be encouraged where possible to have a clinical conversation to the agency where the referral is being made to discuss any issues that may arise pertaining to patients care.

5.7. What To Do If Things Go Wrong If the process of a transfer of a patient goes wrong, the staff involved must ensure they complete the Trust incident form in line with the SCHT incident policy.

6. Dissemination and Implementation This policy will be disseminated and implemented by the following methods:

Directors/Service Leads – to disseminate within their areas

Staff - via Team Brief process

Published to the SCHT Website

Training in the use of the SBAR tool can be accessed via the SBAR training Guide, which has been developed in conjunction with NHS Institute for Innovation and Improvement working closely with clinicians and other frontline staff in the NHS. SBAR resources include:

DVD containing a series of filmed scenarios highlighting the difference of communicating with or without SBAR

Series of filmed scenarios

PowerPoint presentation introducing SBAR

An SBAR e-learning module

SBAR prompt cards and pads SBAR resources are downloads at www.institute.nhs.uk/SBAR

7. Consultation

This policy is an updated version 3 and was circulated via:

E- mail/ Face to face contact with:

Dr Emily Peer Associate Medical Director General Practice

Cath Molineux Nurse Consultant Primary Care

Rachel Allen Head of Infection Prevention & Control

Sharon Boyle Team Leader, Advanced Nurse Practitioner (CCNT)

Alan Ferguson Records Manager and Quality Facilitator

Kate Hidden Team Leader, Children’s Occupational Therapy Services

Gilly Scott Clinical Lead Nurse MIUs and DAARTs

Peter Foord Corporate Risk Manager

http://www.institute.nhs.uk/SBAR




Elaine Edwards Nurse Director Shropshire Doctors Co-operative Ltd

Sarah Watson Single Point of Referral and Home Delivery Service Manager


Review Date: June 2017


8. Monitoring Compliance This policy will be reviewed and updated every two years or as changes in best practice standards, guidance or legislation occurs.

Compliance with this policy will be monitored according to the template below

Element to be

monitored

Lead Tool Frequency Reporting arrangements Acting on

recommendations and

Lead(s)

Change in practice and

lessons to be shared

The adoption of a standardised clinical transfer of care tool across SCHT localised to each clinical service area.

Service Managers

Patient records

audit

Annual

The audit report will be submitted to the Quality and Safety Group. The group is expected to read and interrogate the report to identify deficiencies in the system and act upon them



Training in the use of SBAR for all registered clinical staff working in community hospitals and community care teams within SCHT

Service

Manager

Safer Care

SBAR

Implementation &

Training Guide

Once every 3

years


Any changes to the

process will be identified as part of the audit and allocated to a relevant person(s) within a specified timeframe

Relevant clinical staff will be responsible for changes in the risk assessment. Lessons will be shared with all the relevant stakeholders.




Element to be

monitored


recommendations and

Lead(s)

Change in

practice and

lessons to be

shared

Out of hours Transfer of Care information process

Service

Manager

Patient records

audit

Annual


Any changes to the



Information to be given to receiving healthcare professional

Service

Manager

Patient records

audit

Annual


Any changes to the






Element to be

monitored


recommendations and

Lead(s)

Change in

practice and

lessons to be

shared

The review of audit data and the instigation of remedial action if deficits are identified.

Service

Manager

Patient records

audit

Annual


Any changes to the



Ensure sufficient resources are in place to enable clinical handover, staff training in clinical handover, and on-going evaluation of the effectiveness of clinical handover to occur.

Service

Manager

Patient records

audit

SBAR Tool

Training for

Staff

Annual


Any changes to the






9. References

1. NHS Institute for Innovation and Improvement Safer Care SBAR Implementation and Training Guide (2010) 2. Safe handover, sage patients: Guidance on the clinical handover for clinicians and managers. BMA Juniors Doctors Committee (2004) 3. Department of Health Expert Group (2000) Organisation with a memory. London: National Patient Safety Agency 4. Hoban V (2003) How to….handle a handover. The Nursing Times 99: 54-5 5. Seven ways to no delays (2010) – NHS Institute for Innovation and Improvement 6. High Impact Actions – Ready to go: No delays – NHS Institute for Innovation and Improvement (2010)

10. Associated Documents Clinical Record Keeping Policy

Consent to Examination or Treatment Policy

Clinical Discharge of Patients Policy

Mental Capacity Act 2005 Policy

Safeguarding Adult Guidelines

Safeguarding Children & Young People Policy

Risk Management Strategy and Policy

Incident Reporting Code of Practice

Early Warning Score Protocol for Community Hospitals and Prisons the Detect Deteriorating Patient Infection Prevention & Control – Arrangements and Responsibilities




Appendix 1 Transfer of Care Table Service Directories

Area

From(Service)

To (Service)

Area

From(Service)

To (Service)

CAMHS & Specialist Psychology

External Placing local authority

Shropshire Private care provider

Child & Family Preventative Services

Midwifery Services Health Visiting


CAMHS Tier 4 unit Child & Family Preventative Services

Out of Area Health Visiting


CAMHS AMHS Child & Family Preventative Services

Health Visiting School Nursing


CAMHS EIP Child & Family Preventative Services

Out of Area School Nursing


CAMHS Shrop / T&W CAMHS elsewhere Child & Family Preventative Services

Out of Area Looked After Children


CAMHS elsewhere CAMHS Shrop / T&W Child & Family Preventative Services

Family Nurse Partnership Health Visiting Services




Area

From(Service)

To (Service)

Area

From(Service)

To (Service)

Service Delivery, Integrated Care Services

IDT Nursing home


Acute IDTs DAART OOH


IDT Acute setting


IDTs ShropDoc


DAART Acute


IDTs Tissue viability service


DAART GP


Inpatient, acute services such as SaTH or University Hospital North Staffs

Shropshire Enablement Team


Falls GP


SET

Community MH or Department of Psychological Therapies


Out of hours nurses GP IDTs DAART


SET Substance Misuse Services


SET Social Services


APCS- services Shropshire Secondary Care - diagnostics




Area

From(Service)

To (Service)

Area

From(Service)

To (Service)


SET GP Service Delivery, Integrated Care Services

APCS services - Shropshire Back to GP- finished treatment


APCS services – Shropshire

APCS from referrers Service Delivery, Integrated Care Services

APCS Shropshire Back to GPs – not suitable for services e.g. warts etc



Secondary care – from Triage


APCS Shropshire – particularly dermatology

Secondary care- triage – 2 week rule patients



Secondary care- further treatment


SaTH hospital wards & departments

Diabetes Specialist Nursing (DSN) Service


Other Wheelchair Services if user moves into area

Wheelchair & Posture Service


North Staffordshire Hospital Trust

Diabetes Specialist Nursing Service



APCS from referrers Service Delivery, Integrated Care Services

Podiatry & Foot Health Services – all staff

Referrals sent back to GP’s as inappropriate referral made in first instance





Podiatry & Foot Health Services - -all staff

Secondary care – Acute diabetic foot ulcer clinics




Area From(Service)

To (Service)

Area

From(Service)

To (Service)





Podiatry & Foot Health Services

Secondary care dermatology

Service Delivery, Children’s & spec services

Clients being released from prison

CSMT Service Delivery, Children’s & Specialist Services

Other drug service CSMT

Service Delivery, Children’s & Specialist Services

C.S.M.T Other drug services


Community wards Out of county transfers


C.S.M.T CMHT Service Delivery, Integrated Care Services

Community wards From SATH


C.M.H.T CSMT Service Delivery, Integrated Care Services



Ward SaTH/Acute for diagnostics




Community Nursing and specialist nursing

Care homes particularly nursing homes


APCS services – Telford & Wrekin

APCS from referrers




Area

From(Service)

To (Service)

Area

From(Service)

To (Service)


IDTs Social care Service Delivery, I Integrated Care Services




APCS services – Telford & Wrekin (Dermatology)

Secondary care- triage – 2 week rule patients



Secondary Care - diagnostics

Children’s Medical and Therapy Services

Child development centre School / nursery Service Delivery, Integrated Care Services



Children’s Medical &Therapy Service

Consultant led out patient clinics

Any service available



Back to GP- finished treatment

Children’s Medical and Therapy

Community Paediatric(T&W

Movement Centre RJAH Service Delivery, Integrated Care

MIU To A&E

Specialist Children & Young families Directorate

Acute Hospitals

Community Children’s Nursing Team


Self Referral Community Children’s Nursing Team


MIU Community Children’s Nursing Team


SaTH wards Community Hospital wards


Health Visitors/ School Nurses.



GP/Shropdoc Community Children’s Nursing Team




Area

From(Service)

To (Service)

Area

From(Service)

To (Service)


MIU Community Children’s Nursing Team


APCS- services Shropshire Secondary Care - diagnostics


Health Visitors/ School Nurses.



Podiatry & Foot Health Services – all staff

Referral for shared care with district nurses


SaTH wards Community Hospital wards




________________________________ ________________________________

Appendix 2 – Form 1a Clinical Handover The SBAR tool originated from the US Navy and was adapted for use in healthcare by Dr M Leonard and colleagues from Kaiser Permanente, Colorado, USA

Situation: I am (nurse), (X) a nurse on ward (X) I am calling about (patient X) I am calling because I am concerned that….. (e.g. BP is low/high, pulse is XX temperature XX, Early Warning Score is XX)

S

Assessment: I think the problem is (XXX) and I have…. (e.g. given O2 / analgesia, stopped the infusion) OR I am not sure what the problem is but patient (X) is deteriorating OR I don’t know what’s wrong but I am really worried

A Recommendation: I need you to… Come to see the patient in the next (XX mins) AND Is there anything I need to do in the meantime? (e.g. stop the fluid/repeat the obs) R

Ask receiver to repeat key information to ensure understanding

Background: Patient (X) was admitted on (XX date) with (e.g. MI/chest infection) They have had (X operation / procedure/investigation) Patient (X)’s condition has changed in the last (XX mins) Their last set of obs were (XX) Patient (X)’s normal condition is… (e.g. alert/drowsy/confused, pain free)

B


Appendix 2 - Form 1b: SCHT SBAR Handover Record

Patient Details

Name: DOB: Address NHS No:

GP Details

Name: Practice: Fax Number:

Situation

Identify yourself the site/unit you are calling from

Identify the patient by name and the reason for your report

Describe your concern

Firstly, describe the specific situation about which you are calling, including the patient’s name, consultant, patient location, resuscitation status, and vital signs.

Background

Give the patient’s reason for admission (Or presentation/referral in community care settings)

Explain significant medical history

Overview of the patient’s background: admitting diagnosis, date of admission, prior procedures, current medications, allergies, pertinent laboratory results and other relevant diagnostic results. For this, you need to have collected information from the patient’s medical notes.

Assessment

Vital signs

Clinical impressions, concerns

Recommendation

Explain what you need – be specific about request and time frame

Make suggestions

Clarify expectations

Finally, what is you recommendation? That is, what would you like to happen by the end of the conversation with the clinician?

Any order that is given on the phone needs to be repeated back to ensure accuracy

Type of handover Verbal Face to face Telephone Fax Email Letter Handover given by (print name) …………………………….Designation…………………………… Handover received by (print name) ……………………………Designation………………………… Signature ………………………………


SPECIAL PATIENT NOTES

Please complete the Patient Details and the notes and fax them back to us for a patient to be flagged on our computer system. The instructions will be kept for future reference for as long as the notes are valid.

PATIENT DETAILS Male Female

SURNAME FIRST NAME

D.O.B TEL. No.

ADDRESS

POSTCODE

NHS No.

PATIENT NOTES

DATE:----------------------------- CATEGORY:---------------------------------- CLINICAL NOTE:------------

Please review this note in: 1 week 1 Month 3 Months 6 Months (please circle.)

Please remove this note in: 1 week 1 Month 3 Months 6 Months (please circle.)

SIGNED: POSITION:

The information contained in or attached to this document is intended only for the use of the individual or entity to which it is addressed. If you are not the intended recipient, or a person responsible for delivering it to the intended recipient, you are not authorised to and must not disclose, copy, distribute, or retain this message or any part of it.

This document may contain confidential information.

Shropdoc operates a policy of good practice around information sharing. The sender of this form assumes responsibility for sharing this information in accordance with the provisions of the Data Protection Act 1998, Caldicott Principles and NHS Good Practice Guidelines around patient consent and confidentiality.

If the form is sent electronically, it must be done from an nhs.net address.

ONE of the following categories MUST be selected;: ‘Child at Risk’, ‘Palliative Care’, ‘Addiction’, ‘ Mental Health’,

‘Violent Risk / Risk to HCP’, ‘Basic Notes (other e.g. telehealth)’

Appendix 3 – Shropdoc Flagging Guidelines

Single Point of Referral Service Leaflet 06-14

How to make a Referral

For all new community referrals and domiciliary phlebotomy

requests call Single Point of Referral 01952 607788

Referrer to identify service required

An operator will take your referral

What information will be required?

Patient Details to include NHS number

Referrer contact details

Environment / Access issues to include key codes

Hospital Admission details if applicable

Reason for referral

Already known to the community nursing service

A Community Nursing authorisation for administration of medication

Who can make a referral?

Any Healthcare Professional

Practice Admin Staff

Nursing Home Staff

Care Agencies

Voluntary Services

Patients with end of life / catheter issues

If you would like to make a compliment or complaint about the service. Please contact: Shropshire Community Health NHS Trust Halesfield 6 Telford Shropshire TF7 4BF Telephone: 01952 580322 Fax: 01952 580308

Single Point of Referral A Guide for Health Care Professionals

Single Point of Referral provides one contact number for all new referrals and will continue to

provide systematic access to

community nursing services.

T: 01952 607788 F: 01952 580308

Operational Hours:

M-F 08-00-18.00 Sa-Su-BH’s 08.00-17.00

Out of Hours please contact Shropdoc 08444 068 888

Back L- R: Julie, Sarah Watson – Service Manager and Nicola Front L-R: Gill, Sophie, Lucy and Karen

Appendix 4 – Single Point of Referral

25 Shropshire Community Health What is Single Point of Referral?

Single Point of Referral provides one contact number for all referrers and will continue to provide systematic access to community nursing services.

Who can use this service?

This service is available to all Health Care Professionals. Patients who have end of life care needs, require catheter care or Warfarin Control also have access to SPR in order to provide an efficient response to their individual needs

Benefits

Provides one number for access to services in the right place at the right time

Provides a pro-active and holistic approach to care

Provides a signposting service if required

Referral information taken by administration staff, to include the co-ordination of additional information eg authorisation to prescribe medication and EMIS summaries

Reduction in clinical time spent undertaking administrative tasks

Urgent referrals signposted / passed to teams efficiently and appropriately

Clinical support and guidance available at all times to support administration staff

Reduction in duplication of paperwork for patients already known to service

What services can I refer to through SPR?

Community Nursing Teams

Respiratory Nurses

Domiciliary Phlebotomy

Domiciliary Physiotherapy

Therapy Teams

Examples of Clinical Priorities

URGENT End of life care. Syringe drivers. Blocked catheters. Deep Vein Thrombosis (DVT). IV Therapy, Exacerbation of LTC Acute Illness etc

Once referral has been received by a nurse the patient will be seen and assessed within 1-3 hours

SEMI-URGENT Wound dressing (new, daily) Suture removal Non-acute Long-term conditions (LTC) Hospital discharges that need assessment within 24hrs.

Once referral has been received the patient will be seen and assessed that day or within 24hrs depending on information given by referrer

ROUTINE Ongoing monitoring of patients with a LTC. Ongoing preventative care/advice. Chronic disease management Planned ongoing care Routine injections eg B12, zoladex.

This will be determined on an individual patient basis guidance will be given by referrer.

Date post:	07-Feb-2018
Category:	Documents
Upload:	phungque
View:	216 times
Download:	1 times