While putting together this blog, I came across a group called The Business Continuity Institute, and they define business continuity as “Having a plan to deal with difficult situations, so your organisation can continue to function with as little disruption as possible”.

It is a requirement for primary care to have business continuity arrangements in place for both emergencies and major incidents. We know this as the world is still reeling from a spectacularly significant incident that has been rolling on since late 2019.

The requirement

To ensure that we plan, in England, the CQC have written GP Mythbuster 69: Business continuity – Arrangements for emergencies and major incidents to support this need, and if there is a mythbuster on any topic, you can guarantee that
this will be a question that CQC will ask. Before you say, “Great, I’m not in England”, note that throughout the UK, all of us need to comply with the Civil Contingencies Act 2004.

Therefore, this is not simply a common-sense nicety; we all must have a plan.

The Business Continuity Policy

Our Business Continuity Policy [PLUS] has been significantly updated and highlights all the areas that need to be considered when making a plan.

The first section of the policy looks at:

• Organisational priorities and the response to any incident
• Who is responsible for what actions
• Communication, including contact details and the cascade of any information
• Key information, such as safety and recovery planning
• Scenario planning, including training and testing the plan
• Useful tools

Whilst the above points form the policy, the second half of the document looks at the plan, and this is where it becomes localised to suit the practice’s needs. The plan starts at the annexes, of which there are ten.

These are:

1. Risk matrix, register and assessment – A risk assessment starts the plan off as this dictates the risks and the need. This annex considers various areas of the practice, including IT, personnel, clinical and premises.
2. Contact list – Whilst most of us have a mobile phone glued to us constantly, do we have the full team in it? Furthermore, the contact list details all of the important practice numbers that may need to be transferred and those relevant contacts that form the information cascade.
3. Manual consultation record – If you have lost IT function, this and the next annex are manual forms to support the clinician in their role.
4. Manual repeat prescription record – As above.
5. Supplier contact list – A useful list of your suppliers from accountant to vaccines.
6. Communication cascade – A sheet that details who calls who, so the PM does not need to call everyone.
7. Incident management pro forma – This helps command and control when an incident is taking place to ensure that the same message gets passed on.
8. Site incident management meeting agenda – This template details standing agenda items to assist when you almost certainly will have too many other spinning plates to manage.
9. Site map – Having a map of the premises / local area would be incredibly useful.
10. Action cards – There are nine action or ‘kill’ cards which can be distributed to key personnel so that everyone knows exactly what is needed and who to contact.

We can help

Often the depth of a continuity plan varies significantly between practices, and regulators like to see a robust plan. So to assist you and to save you many hours, please see the following:

• Business continuity policy [PLUS]
• Business continuity policy (Scotland)[PLUS]
• Business continuity policy (Wales)[PLUS]

Planning for the plan

How do you know if the plan works? Consider having a team meeting and discussing what actions are needed and when, in case you really have a bad day at the office!

To help, there is Tabletop exercises (TTX) – An Introduction on the HUB.