SCHEDULE 2 THE SERVICES A. Service Specifications Mandatory headings 1 4. Mandatory but detail for local determination and agreement Optional headings 5-7. Optional to use, detail for local determination and agreement. All subheadings for local determination and agreement Service Specification No. Treatment Room Service Commissioner Lead Provider Lead NHS Wyre Forest Clinical Commissioning Group Period 01/04/2014 30/09/2014 Date of Review 30/09/2014 1. Population Needs 1.1 National/local context and evidence base All practices are required to provide all essential services and those additional services for which they are contracted. This enhanced service specification provides details of more specialised or additional services within the treatment room which are considered to be beyond the scope of essential or additional services. No part of this specification by commission, omission or implication redefines essential or additional services. General practice increasingly carries out a range of procedures within primary care that have previously been performed in secondary care. The provision within general practice of the tests covered by this enhanced service will improve access and convenience and choice of location for patients. Patient attendance at a hospital is not necessary for the management of some conditions. The provision of these services within primary care has not necessarily been resourced separately in the past but has been absorbed by general practice into the workload of practice nurses, health care assistants and phlebotomists funded through GMS routes. 1 P age
2. Outcomes 2.1 NHS Outcomes Framework Domains & Indicators Domain 1 Preventing people from dying prematurely Domain 2 Enhancing quality of life for people with long-term conditions Domain 3 Helping people to recover from episodes of ill-health or following injury Domain 4 Ensuring people have a positive experience of care X Domain 5 Treating and caring for people in safe environment and protecting them from avoidable harm X 2.2 Local defined outcomes To reduce the attendance of patients to an Emergency Department or Walk in Centre when treatment for a minor injury or wound care is required; To increase the availability of care closer to home; To provide more choice. 3. Scope 3.1 Aims and objectives of service Aim The aim of this service is to provide care which is accessible to all patients requiring wound care or treatment for a minor injury. It will provide care closer to patients homes therefore reducing the need for patients to present to an Emergency Department. Objectives The objectives of the service are: Improve access to health services in the community; Provide a service for patients requiring minor injury interventions and access for post-operative care in the community. 3.2 Service description/care pathway Payment under this Service will be made for the following services: Postoperative care of surgical wounds in patients who can attend surgery premises and where the care of such wounds falls within the 2 P age
skill and experience of the staff involved; Management of Minor Trauma which would not normally require attendance at Accident and Emergency including simple removal of foreign bodies within the experience of a practitioner; Follow up of A&E patients when signposted back to Primary Care from A&E; Phlebotomy (GP Initiated); Ear syringing; Dressing and bandaging of ulcers; Injections prescribed by a GP and not covered by the global sum, e.g. B12 injections; Zoladex implants; Tests suggested by hospital practitioners (excluding INRs, near patient testing and MRSA screening) where GPs have clinical responsibility for the result. Staff involved in the delivery of this service will be appropriately trained and competent in the provision of the services offered. 3.3 Population covered The registered population of all patients within the Practice. Any treatment for patients, outside of this definition, will not be paid for by NHS WFCCG. 3.4 Any acceptance and exclusion criteria and thresholds There are no specific acceptance or exclusion criteria for this service. 3.5 Interdependence with other services/providers 4. Applicable Service Standards 4.1 Applicable national standards (eg NICE) Compliance with relevant guidance and policy The service must comply with the guidelines produced by the following organisations (where applicable): Rules of Professional Conduct 3 P age
http://www.gmc-uk.org/guidance/index.asp NICE Guidance and recommended pathways http://guidance.nice.org.uk/ Applicable policies produced by NHS WFCCG and any adaptations to these policies as adopted from the 1st April 2014. Care Quality Commission registration requirements. 4.2 Applicable standards set out in Guidance and/or issued by a competent body (eg Royal Colleges) 4.3 Applicable local standards Equal Opportunities The service provider must demonstrate how they meet equal opportunity requirements in the following areas: They must be committed to equal opportunities and must not discriminate in performance of the service towards service users or members of staff in any way; The service provider must be able to provide chaperones at the patient s request; The service provider must also be able to provide premises, facilities and treatment rooms that are compliant with disability legislation; The service provider must be able to provide access to foreign language interpreter if necessary. Clinical qualifications Staff involved in the delivery of this service will be appropriately trained and competent in the provision of the services offered. The services provided and scope of this service will be reviewed with staff as part of the annual appraisal process. The service provider must provide evidence to the CCG that their healthcare professionals have the appropriate knowledge, skills, experience, qualifications and competency to provide the service. This must include but would not be limited to the following requirements: Enhanced Disclosure and Barring Service (DBS formally Criminal Records Bureau CRB) checks have been completed; Where applicable staff will be fully registered with the appropriate Professional Body; All staff will be able to provide evidence of their continuing professional development post qualification. 4 P age
The service provider must comply with all relevant policy and procedure as contained in the NHS Standard Contract including but not limited to; safeguarding of vulnerable patients (including children), health and safety, marketing and branding and insurance requirements (professional, public and product and employers liability). The service provider must also comply with all relevant guidance and referral protocols produced by the CCG. The aim of these protocols will be to ensure that patients are treated by the most appropriate professional, in the most appropriate location with the most effective treatment. Patient transport arrangements do not form part of this service specification. Patients will be expected to make their own transport arrangements. Those patients who are entitled to assistance with transport under existing NHS arrangements will be able to access this through their GP Practice as per local arrangements. Clinical Governance The service provider will be responsible for their own system of clinical governance. This will include but not be limited to the following: An appointed Clinical Governance Lead; Development and implementation of Clinical Governance policies; Adherence to the Serious Untoward Incident reporting and investigation process; Compliance with Infection Control policies. The service provider will have secure IT systems in place which enable the capturing of patient information and activity reporting. They will ensure that all information relating to patients is safeguarded and complies with the Data Protection Act (1998), the Access to Health Records Act (1990), the Freedom of Information Act (2000) and the Caldicott Principles. Activity reporting will be submitted by the service provider through a secure nhs.net email address. 5. Applicable quality requirements and CQUIN goals 5.1 Applicable quality requirements (See Schedule 4 Parts A-D) 5.2 Applicable CQUIN goals (See Schedule 4 Part E) N/A 6. Location of Provider Premises 5 P age
Within the GP practice or other appropriate room. 7. Individual Service User Placement The services delivered under The Treatment Room Service will be subject to clinical audit and monitoring. Participating practices will be paid a total of 1.06 per patient per annum based on their registered list size on 1 st April of 2014. 6 P age