Rota Design for 2009 - North Western Deanery

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Example bleep policy 3Manchester Mental Healthand Social Care TrustJunior Doctors Bleep ProcedureIntroductionThis policy seeks to consolidate existing good practicerelating to communication between nursing andmedical staff.A bleep is a device that enables urgent contact to bemade with junior doctors (needs to be explicit). It’scounter productive if used for routine, non urgent calls.In general a bleep should not be used unless there is agood reason to call the doctor immediately.Aims• To make the most effective use of junior doctorclinical time• To enable junior doctors to take the necessary breaksto comply with the New Deal and Working TimeDirective (WTD)• To aid communication between medical and nonmedical staff• To ensure that the bleep system is used for urgentcalls only.Protected HoursParticular care should be taken when bleeping doctorsbetween the following times, to ensure that naturalbreaks and continuous rest (in order to comply with theNew Deal and WTD) are achieved:12:00 – 14:0017:00 – 19:0022:00 – 08:00Within these hours doctors should only be bleeped forurgent calls (defined below).Life Threatening EmergenciesIn this situation, the crash team should be called accordingto procedure. Where the crash call has been replaced witha 999 call the junior doctor should be bleeped.Urgent CallsUrgent calls are defined as:• Any major change in a patient’s general conditionthat will not wait until the doctor’s next routine visit• Distressing symptoms, which may cause the patientundue suffering if not dealt with before the nextroutine visit of the doctor to the ward• Relatives requiring to speak with the doctor becauseof deterioration in a patient’s condition• The arrival of an urgent admission• A & E presentations• Suicide presentation• OverdosesThis list is not exhaustive.Non Urgent CallsGood planning can reduce the need for non urgentbleeps. Junior doctors should take care to communicatewith nursing staff during the day to ensure that allroutine ward work, which cannot be delayed until theirnext planned visit, is completed.When bleeping a doctor it should be consideredwhether the issue could wait for the next planned visitof the doctor. To facilitate this:• The ward should be aware of the doctors nextplanned visit. A system should be in place so theward will have a readily available record of thedoctor’s next visit• Out of usual working hours medical staff should visitall wards at pre arranged time(s) to deal with queriesor problems. Although it’s recognised thatunforeseen events and emergencies will takeprecedent and therefore delays to visits are possible• Each ward should keep a list or book tocommunicate requirements/tasks for the juniordoctor at the next ward visit. Nursing staff should listall the routine and non urgent tasks for the doctorto carry out. The doctor should confirm with thenursing staff that an item has been completed andsign the list or book for verification.50
AppendicesJunior doctors should not be called to deal with thefollowing matters, particularly within the protectedhours defined above:• If a patient suffers a mild fall (and the nursing teamis confident there has been no injury) or is brieflymissing, where there is a member of the nursemanagement team available to deal with this• The writing/rewriting of prescription charts. It’stherefore essential that junior doctors ensure theyhave written up or rewritten any necessaryprescription charts before the end of their shift• To take routine bloods.MonitoringThe effectiveness of this policy will be monitoredthrough the six monthly Department of HealthMinisterial Returns. These returns will highlight whetherthere is an improvement in compliance with the restrequirements of the New Deal and WTD.This list is not exhaustive.Bleep Holders DutiesBleep holders have a duty to answer calls promptly. Ifthis is not possible, ask someone else to answer for you,take a message and determine if the message is urgentor not. When a patient is seen, a note should be madein the patients record of the time, date, details and anyaction taken.Using a BleepBetween 09:00 and 17:00 a designated member of thenursing team within a ward will be responsible forcoordinating the usage of the bleep system. It will bedecided locally who will take on this responsibility. Thisshould avoid unnecessary duplication of calls.Between 17:00 and 09:00 the night manager willcoordinate all calls to the bleep. The night manager willbe responsible for ensuring that the doctor is bleepedaccording to this policy (at Manchester Royal Infirmarybetween 17:00 and 09:00 the doctor will continue tobe bleeped by a designated member of the nursingteam within a ward).All managers must ensure that those responsible forbleeping doctors comply with this policy.51
Page 1 and 2: WORKING TIME DIRECTIVE 2009PUBLICAT
Page 3 and 4: Contents page1. Introduction 21. Se
Page 5 and 6: 2. Importance of goodrota designi.
Page 8 and 9: 2. Basic New Deal andWTD RevisionNe
Page 10 and 11: 3. Rota Design Life CycleRota desig
Page 12 and 13: 2. Feasibility studyAfter identifyi
Page 14 and 15: F1s Mon Tues Weds Thurs Fri Sat Sun
Page 16 and 17: 4. Design“There cannot be a ‘on
Page 18 and 19: 7. ReviewThe three possible outcome
Page 20 and 21: 4. Good Practice GuidanceHandoverMo
Page 22 and 23: Trust WTD policiesThere are many ar
Page 24 and 25: Approval to change band/work patter
Page 26 and 27: STAGE 1AAgreement of trainees to pr
Page 28 and 29: STAGE 1cEducational approval for pr
Page 30 and 31: 5. Pitfalls to avoidRotas monitorin
Page 32 and 33: 6. Banding AppealsThe following sec
Page 34 and 35: At banding appeal1. There is little
Page 36 and 37: 7. Additional Advice1. If trusts em
Page 38 and 39: Points to consider with other worki
Page 40 and 41: 8. Support, evidence andguidance al
Page 42 and 43: Taking this methodology further the
Page 44 and 45: 9. AppendicesAppendix ASoftware too
Page 46 and 47: 1.0 Roles and responsibilities:1.1
Page 48 and 49: Bleep Filtering ChartHospital At Ni
Page 50 and 51: Record of Changes to Document - Iss
Page 54 and 55: Appendix CSample WTD policySouth Ma
Page 56 and 57: Pay Banding SupplementsBand: averag
Page 58 and 59: 2.2 Similarly to 2.1 above, where a
Page 60 and 61: Hours Breach ReportNameGradeDepartm
Page 62 and 63: Example natural break policy 2Guida
Page 64 and 65: Appendix EBanding Appeal GuidancePr
Page 66 and 67: Approval To Change BandTrust:Hospit
Page 68 and 69: 10. References1HSC 1998/204. Workin
Page 71 and 72: 69Notes

Rota Design for 2009 - North Western Deanery

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