We have assessed our practice for risks outlined and put in additional processes as detailed below
Undertaken a risk assessment
Date of risk assessment – 18th May 2020. This will reviewed monthly depending on changing guidelines and situation regarding the pandemic situation.
Heightened cleaning regimes
- Clinic rooms will be cleaned between in each patient – desk areas will be wiped with detol, the clinic has plastic chairs which will be wiped with detol, the couches will all be cleaned with detol and the pillow as these are wipeable. Door handles will all be wiped. The computer keyboard and mouse will also be wiped in between and with changes with ppe.
- Common areas/washrooms will be cleaned after each patient/staff member use. All areas sprayed with detol.
- Door handles will be wiped between each patient use. Card payment machine will be wiped between each use.
- The phone will be wiped between each use.
Increased protection measures
- All linens from the clinic have changed to plastic couch covers, pillows are wipeable.
We have introduced screens for reception areas.
- Cashless payments/online bookings – patients can take our payment details to pay by BACS payment – 090128 65065428 or pay using our terminal - under £45 contactless over £45 use our machine, this is wiped between each use.
- Staff PPE – the staff will wear face mask, apron and gloves.
Put in place distancing measures
- We have staggered appointments where possible to limit interaction of patients. Our procedure is to have patients ringing the practice in the car park or when outside the practice no more than 5 min before your treatment. The patients will wait until they are asked to enter the practice by phone or sms. On entering the clinic the patients’ temperature will be taken. Patients will be taken straight into the treatment room by the osteopath.
- Patients will only access reception to pay for their treatments and only when the osteopath checks the reception is clear so only one patient in the reception at a time.
- Staff have adequate space to maintain a 1 metre distance form each other moving around reception and the kitchen (the osteopaths will wear a face mask when in the clinic.
Detail here any additional training that you and your staff have undertaken:
- Correct handwashing technique best practice – please see posters.
- Put on/remove PPE safely – posters are in the kitchen area our donning area. Dopping shall occur in the treatment room.
- Staff briefed and trained on updated clinic policies and infection measure.s
Providing remote/ telehealth consultations
Detail here what telehealth/remote consultations you are offering e.g.
- All patients will have telephone pre-screening call – the receptionists will ask for each patient our screening text.
- Follow-up/maintenance appointments available via telephone/video call – if a face to face consultation is not appropriate.
So you are aware in advance of coming in, we will be wearing PPE as advised by our professional body. This will comprise an apron, face mask and visor. This is not anything to be concerned about, this is our way of ensuring your health and our commitment to your safety.
By the same token, we would also ask you to wear gloves and a mask or face covering when you attend the clinic.
Whilst we will obviously be thoroughly washing our hands before and after each treatment, if you would prefer us to wear gloves as well while we treat you we can certainly do that too. Just let us know when you arrive.
To help maintain social distancing and to allow us time to thoroughly disinfect surfaces between appointments, we are allowing additional time between appointments. We would ask you not to arrive more than 5 minutes before your appointment time if possible. If you are travelling by car, please wait in your car when you arrive, ring us to let us know you are here and we will ring you back when we are ready for you to come in. You will then have your temperature taken and if high will not be permitted to enter the practice.
Regarding payment, we are asking you to pay by bank transfer in the first instance, although we are accepting card payments if you prefer.
We are obliged to run through a quick screening before making your appointment so if you would just bear with us with these few questions.
- Have you had a high temp or developed a new continuous cough within last 7 days?
- Has anyone in your household had a high temperature or developed a new continuous cough within last 7 days?
- Are you or anyone in your household currently in the high risk/vulnerable categories?
- Are you expecting to visit anyone in the high risk/vulnerable categories in the next day or 2? (If so do you wish to defer treatment till afterwards?)
- Any change in taste or smell in the last week.
Are you happy with everything I have gone over with you and obviously we can give you a phone/video consultation with exercise advice and general advice and you do not have to have treatment if you are unsure or not happy with the risk involved with the current situation?
Please the reception staff put a note on the patient notes that they have had a screening questionnaire.
Table 2a. Protection of staff and patients before they visit, and when in, the clinic.
We have assessed the following areas of risk in our practice and put in place the following precautions to
Description of risk
Pre-screening for risk before public/patients visit the clinic
NB: All triage pre-screening information must be documented in the patient notes.
Protecting members of staff
All reception staff have been interviewed and the staff that have top shield due to their family situation have been offered home working.
Staff will be in a well ventilated room and behind a shield so they can decide whether they wish to wear a face mask. If they are cleaning they are to wear a face mask.
Confirmed cases of COVID 19 amongst staff or patients?
Positive test or symptoms of Covid 19 in staff –
The staff should contact Chris asap.
- If the patient experiences symptoms within 2/3 days of visiting the clinic, any staff with direct contact to that individual should self-isolate. Ring 119 for a test to be arranged asap. If the test is negative return to work.
- Anyone with indirect contact with the patient, should be advised of the situation and suggest they monitor for symptoms (those with indirect contact with suspected cases COVID 19 do not need to self-isolate).
Travel to and from the clinic
Staff should bring a change of clothes to the clinic to change into at the end of day or have a space on return home to doff their clothes and wash at 60 degrees outside of their home environement. Patients should only enter the building once they have been advised to do so from the receptionist or osteo via phone or sms. Pt can bring a chaparone however they must have a pre-screening questionnaire.
Entering and exiting the building reception and common areas.
- Staff should bring a change of clothes to the clinic to change into at the end of day or have a space on return home to doff their clothes and wash at 60 degrees outside of their home environment.
- The patient is asked to arrive no earlier than 5 min before their appointment and only access the practice when they are called. The Osteopath will check the reception area and only let the patient enter the reception to pay if it is clear of patients and osteos. The patient will stay in the demarked areas of reception.
- The reception has been altered to allow 2 metre areas so that staff can socially distance whilst moving around the practice.
- Patients will be asked to wear gloves.
- Sanitiser is offered in the treatment room and next to the reception desk for paying.
Social/physical distancing measures in place
- Were possible appointments will be staggered.
Face to face consultations (in-clinic room)
- One parent/guardian only with visits for children who will have answered screening questions.
- If a chaperone is requested they must have the prescreening question before attending themselves.
Table 2b Hygiene measures
We have assessed the following areas of risk in our practice and put in place the following heightened hygiene measures
Description of risk
Increased sanitisation and cleaning
Detol spray will be used in the following areas;
- Clinic rooms - plinths, desk, door handles, equipment chairs - between each patient
- Reception surfaces, doors and door handles, chairs, taps, card machines between each use.
- Bleach-based detergents for floors with a steam mop for the hard floor areas.
Actions to minimise the number of surfaces requiring cleaning
- All unnecessary linen has been removed and plastic pillowcases that can be cleaned between patients are used.
- The rooms have been decluttered.
- Putting in place plastic runners on carpeted areas
Keeping doors between common areas open if safe and appropriate to do so, to reduce touch points
Aeration of rooms
Aeration for clinic rooms e.g.
- Leaving the window open and the door closed for 20 minutes after each patient
- Back room will have the door open and the conservatory ventilated.
- Air-circulation mechanisms will not be used.
Aeration of common/reception areas e.g. opening windows and or doors every x period will remain open.
Staff hand hygiene measures
Hand hygiene measure put in place e.g.
- Hands will be washed before each patient the Osteo will put on gloves, on glove removal use of hand sanitiser on hands and forearms to elbow.
Respiratory and cough hygiene
Communication of cough hygiene measures for staff and patients e.g.
- ‘Catch it, bin it, kill it’ posters
- Waste bins lined and foot-operated.
- Hand hygiene facilities available for patients, visitors, and staff
- The toilet will be cleaned after each patient use and at end of day.
Table 3. Personal Protective Equipment: Detail here your policy for use and disposal of PPE
Clinicians will wear the following PPE
Detail here what PPE will clinicians wear and when risk assessed, in what circumstance they will be used
- Single-use nitrile gloves and plastic aprons with each patient.
- Fluid-resistant surgical masks (or higher grade)
- Eye protection will be available if the patient does not wear a mask.
When will PPE be replaced
- When potentially contaminated, damaged, damp, or difficult to breathe through masks will be replaced.
- Mask at the end of a session will be disposed of.
Reception staff will wear the following PPE
- Fluid resistant surgical masks when cleaning or moving around the practice if behind the screen they can choose not to wear a face mask.
Patients will be asked to wear the following PPE
- Fluid-resistant surgical masks if respiratory symptoms e.g. from hay fever or asthma
- Double-plastic bagged and left for 72 hours before removal, keeping away from other household/garden waste, and then this can be placed in your normal waste for collection by your local authority.
- Cloths and cleaning wipes also bagged and disposed of with PPE
Table 4. Communicating with patients: Detail here how you will advise patients of measures that we have taken to ensure their safety and the policies that have been put in place in our clinic
Publishing your updated clinic policy
- Publish on clinic wall, available on request
- Available on our website
Pre-appointment screening calls
Detail here when the pre-screening calls may take place and by whom e.g.
- 24 hours/morning before a scheduled appointment?
- A clinician will call on request.
- Our reception staff will be trained and have a script that they will use before appointments are made.
Information for patients displayed in the clinic
- Notices on other public health measures e.g. hand washing/sanitising.
- Providing patients contact for more information if needed.
Other patient communications
Video consultations will be offered where appropriate.