Herts Urgent Care has created a facility whereby clinicians can access the patient management and telephony services from their own premises and so enable patient triage to take place from outside of our designated static and mobile facilities.
This document is designed to identify the various procedures that will need to be followed in the use of the computer and telephony systems as well as the operational procedures that will be adopted.

Operational Overview

The home working solution will be utilised when the HUC Shift Manager feels that additional, temporary resources are needed to ensure that national and local performance targets are met and so ensure that high standards of healthcare across the county are maintained.

The procedure for requesting additional assistance is as follows:

1. The Shift Manager will directly call those GPs who are on the standby list and have been issued with the appropriate equipment and software requesting that additional clinical resources are needed.
2. The Shift Manager will confirm with the GP which geographical areas or case priorities they would like the GP to concentrate on and deal with. At this point the payment clock will start.
3. When the call volume has reached a satisfactory level then the Shift Manager would stand the GP down. At this point any relevant issues that the GP has come across and that may be still relevant to some of the cases should be communicated to the Shift Manager to ensure that continuity of care is maintained. At this point the payment clock will stop.
   

Payment Procedure

As the home working sessions will sit outside of the standard session patterns the payments for these sessions will not currently be controlled by the session booking website. Therefore when a GP calls in and it is confirmed by the Shift Manager that their services will be required, then the Shift Manager will start to complete and extra hours claim form which is the same form used in PCCs where GPs have been requested to stay on after their normal finishing time.
The Shift Manager will complete the GPs name, the start time for the session and clearly indicate that the session is for home working.
At the point that the Shift Manager agrees with the GP that they can stand down, the Shift Manager will complete the finishing time for the session, authorise the form and ensure that it is passed internally within HUC where it will be processed and paid along with any other sessions that are relevant for that particular month. Basically all administration around the payment for these home working sessions will be undertaken by HUC and there is no requirement for GPs to complete any paper work (other than standard SOLO and pro-forma invoices).

Security and Confidentiality

In order that the home working solution works effectively it is essential that the highest standards of security and patient confidentiality are maintained.
By using the home working solution GPs must ensure that when logged into the patient management system that other members of the family are not able to access the computer or that it is left unattended where potentially information displayed on the computer could be accessed by another party. Similarly, when triaging, this must be done from a location where background noises and risk of disturbance from another family member are minimised.
To minimise the risk of any breaches of information governance, any GP using wireless access to the Internet router should ensure that wireless encryption is in place and that open access to that connection is disabled.
Finally, the Trend Antivirus software which has been provided must not be modified or disabled in anyway. Any modifications to the installation settings or disablement of the software will result in access to Adastra being prevented.

Telephony

Herts Urgent Care has provided a cellular telephone which GPs are requested to use to make calls to patients. The phone remains the property of Herts Urgent Care at all times.
Calls can be recorded by using the procedure attached with the installation documentation. These calls are stored centrally within HUC and can be used should any issues or disputes arise from any conversation that has taken place.
All calls from the phones have itemised billing which will be invoiced directly to HUC and therefore all running costs of the phones are administered centrally. The phones are on government monthly tariffs on the Vodafone network and therefore are not subject to any restrictions about needing to make a minimum number of calls within a period of time to ensure that the number remains live on the network.
GPs are requested to ensure that the telephones are kept safe and are not used for private or non-HUC related business. Should a telephone be lost, stolen or damaged then it should be reported to HUC immediately.

Use of Adastra

Once logged into the home working solution and into the Adastra application, GPs will have all normal facilities available to them with the exception of NHS net for access to NHS only websites.
Navigation within the Adastra application is exactly the same as it would be if you were to use it from a clinical spoke, with facilities such as appointment scheduler all being available in the same way.

Prescribing

Due to the medico-legal aspects of prescribing there isn’t currently a workable solution available which will enable FP10s to be printed and forwarded on to local Pharmacists for dispensing. However this is something that we are in discussions over with the LPC and medical defence organisations to try and get a solution in place as quickly as possible.
Until such time that there is a solution in place any patient who you triage and needs to have a prescription issued will need to be booked into their nearest centre where the local GP will be able to see the patient and issue the prescription as required.

IT Problems

The home working infrastructure that we have in place at HUC has proved to be very stable and reliable, therefore we are not expecting any problems in the use of the system.
If you should experience any problems then the best starting point for trying to resolve the problem would be to close down the computer and start again. If this doesn’t work or you experience continued problems either with the software, phone, fob or access then please email david.archer@hertsurgentcare.nhs.uk or telephone the Shift Manager and ask for assistance.

Equipment

All equipment issued to each GP to enable them to connect to the HUC network remains the property of Herts Urgent Care. No element of the equipment or software can be copied or passed to another party without prior written consent from Herts Urgent Care. Any problems with one or more piece of equipment or software should be reported to HUC following the same procedure as illustrated above.





HUC 2008