(Time to read: 6 minutes)

An essential and extremely important part of a practice manager’s role is ensuring adequate inductions are performed. While your new staff members – temporary or permanent – may have worked in other GP practices, yours may be very different, utilising different software and working to unique processes.

In order to deliver safe and effective care, practices need to ensure that all staff have the appropriate training, induction and access to accurate information that will allow them to safely and effectively manage patients.

The CQC also views inductions as an important part of a practice’s activities, with Nigel Sparrow, Senior National GP Advisor and Responsible Officer commenting: “When we inspect, we look at the practice’s arrangements for ensuring its policies and procedures are communicated to staff and implemented effectively. As part of key line of enquiry (KLOE) S3 we look at whether the systems, processes and practices to keep people safe are identified, put in place and communicated to staff. We also look at the arrangements for supporting staff to deliver effective care and treatment and training.

“Safe, effective patient management in primary care is very complex.  It requires a series of seemingly simple steps and often involves different members of the practice team. Securely linking these steps together with good information management is vital for a safe patient journey.”

So how do you deliver an effective induction?

According to a document issued by Cambridgeshire LMC, a locum induction could include:

Practice logistics

• A walk around the practice to meet staff and ensure familiarity with the waiting area, reception, administration office, consulting rooms, fire exits, toilets, kitchen.

Emergency equipment

• Location of emergency equipment to include resuscitation kit and defibrillator, oxygen and masks, nebulisers and emergency medication.

Safety

• Practice door key or alarm code if the locum doctor may be left alone in the building. Details of whom and how to contact in an emergency if need arises after surgery has closed and locum GP is still working in the building.
• When to expect routine callers such as cleaning staff or security personnel.

Routine equipment, special kits and specimen collection

• Location of special kits including phlebotomy bottles and needles, eye examination equipment, microbiology bottles and swabs, other specialised transport media,  gynaecology and obstetric equipment (including foetal heart monitor), dressings, practice fridge for storage of samples.
• Appropriate place to leave specimens prior to collection.

Access

• Key codes or temporary use of swipe card to allow entry to appropriate areas within the practice.

Consulting room

• Door sign with the doctor’s name on the door if possible. A temporary sign typed on paper and stuck on the door. A more formal sign if the arrangement is longer term.
• Receptionists and patients should be clear in exactly which room the locum doctor is based and what the doctor’s name is.
• Method of calling patient from waiting area (e.g.in person/ tannoy/ computerised sign in waiting area) to be clarified.
• Location of emergency or panic button in consulting room if applicable.
• Location of basic examination equipment in consulting room (e.g. gloves, speculae, tongue depressors) and consumables (e.g. printer and prescription paper) and to ensure adequate supply prior to session commencing.

IT systems

• Computer login and password for all relevant applications that the doctor will encounter in their daily work (including windows, EMIS/ SystmOne/ Vision etc, T-quest, Docman for example).
• Access to some of these (e.g. T-quest, NHS Smartcard, choose and book) may need to be requested in advance.
• All passwords should be private and known to the user only, for security purposes.
• Each clinical entry should be easily identifiable to the relevant doctor.
• Instruction in the use of systems for external telephone interpreters for non-English speaking patients if applicable.
• Both the locum doctor and the practice to ensure that the doctor has familiarity and competence with the computer systems used.

Induction packs

According to the CQC, when it sees problems in practices with information knowledge, it all too often revolves locum nurses and GPs, who may be especially prone to error caused by lack of access to relevant information. Practices have a responsibility to mitigate this risk by equipping all staff to work safely and effectively (further guidance on the safe use of locum staff can be found here.

An essential for any induction is therefore an effective practice induction pack. They’re an ideal way of communicating policies and procedures to practice staff to ensure they are effectively implemented. A quick online search suggests that numerous CCGs and LMCs have produced template packs for practices to use, so this could be a good place to start.

The pack could essentially be a checklist of important items and procedures to cover off in the induction and for the new starter to keep as a reference tool. It’ll include everything from contact details through to information on passwords, policies and procedures, covering the likes of how to order investigations, the process for arranging follow-ups, patient communication and internal data management. It’s also essential that new starters are shown the practice building and its surroundings.

A number of helpful induction documents, checklist and templates are available via Practice Index PLUS. Click here to access those. In addition, a good example found during our search was one put forward for locum inductions by North East Sessional GPs – the document can be found here. In addition

Effective formats

When it comes to the format of induction packs, the CQC suggests practices consider its format and how this supports safe and effective care. For example, unindexed paper versions and bulging folders are not effective, as they can’t easily be searched and used at the point of need.   When a practice uses their intranet, they should consider whether it is transparent and usable for staff who are not familiar with the practice or the way the intranet is structured.

A good practice induction pack should be:

• Easy-to-search format with familiar navigability, so that clinicians and staff can access essential information at the point of need, even if they are unfamiliar with that practice.
• Regularly reviewed and easily updated by all relevant team members.
• To ensure safety, as a minimum the pack should contain frequently-used or safety-critical items. Packs that promote maximum effectiveness and efficiency as well as safety will contain a more comprehensive range of items.
• Accessible by as many staff as deemed necessary by the practice.
• Easily searched and navigated for information at the point of need.
• Centrally updatable, so any policy or service information changes are available to all users.

Wider policy management

It’s worth noting that practices are expected to have clear, regularly reviewed practice policies and procedures in line with overall policy management regulations. Key to their safe and effective implementation is how well they are communicated to staff and practices need to demonstrate that all staff both understand and are trained in practice procedures, and that all staff are regularly updated and, ideally, have easy access to refer to this information in their daily working lives. The induction pack is integral to this, so it should never be underestimated or overlooked.

And finally…

As if all the above wasn’t enough, we conclude with a video that explains the importance of GP locum inductions and how to carry them out effectively. It’s well worth a watch.

What tips can you share when it comes to inductions? Let us know by commenting below, or head to the Practice Index forum thread here to share your ideas with your fellow practice managers.

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