CALL LOG


Manager Practice


Call log


These cases are based on actual calls made to MDDUS advisers and are published here to highlight common challenges within practice management. Details have been changed to maintain confidentiality.


VAPING IN THE SURGERY Q A


A nurse has advised us that an associate dentist in our practice has been vaping in the consulting room between patients. Are we allowed, on legal grounds, to demand that she stop this behaviour?


UK law prohibits cigarette smoking in enclosed public places and workplaces but the laws do not cover vaping. Organisations are free to make their own policy on the use of e-cigarettes on their premises. The practice should have a non-smoking policy in place and this could be extended to cover vaping. If you have no policy on smoking, a good place to insert one is in the drugs and alcohol policy. Any changes to the existing policy should be communicated to practice staff in writing. Practices should also ensure that their smoking policy is kept separate from the employment contract and details are provided in an employee handbook. This will allow the policy to be amended without having to get employees’ agreement to amend their contract. Public Health England has published framework advice for businesses and employers to help create policies on the use of e-cigarettes. Access at tinyurl.com/jsf6wcr


PRE-ADOPTION RECORDS REQUEST Q


We have a three-year-old patient whose adoptive mother would like to access his pre-adoptive medical notes to obtain information relating to complications during pregnancy and childbirth. She is keen in particular to gain further information about alcohol consumption during the pregnancy. The mother states she was not provided a medical history for the child from social services.


04 A


Adoptive parents take on parental responsibility and can therefore request access to a child’s medical notes. The adopted child will be given a new NHS number and all previous medical information relating to that child is put into a newly created medical record. The new medical record should therefore contain all relevant information about the child’s previous treatment in primary and secondary care but must not contain any information relating to the identity or whereabouts of the birth parents. The pre-adoptive information is regarded as confidential and any relevant medical information should have been shared with the new parent by social services during the adoption process. The scenario set out here presents a difficult situation for both the surgery and the mother and you may wish to emphasise the importance of keeping the pre-adoption notes confidential. You should urge the mother to discuss her concerns with social services who may be able to access the information she desires without breaching the birth mother’s confidentiality. The adoptive mother should also be encouraged to discuss any concerns about the child’s health or development with the GPs in the practice for further advice and assessment.


STUDENT NURSE INDEMNITY Q


Our practice has agreed to take a student nurse on placement from a local university. The individual will be


monitored by our practice nurse and will only consult with patients under supervision. We are an MDDUS discount practice scheme. Can you confirm your position regarding indemnity for the student nurse?


A


A student nurse acting in accordance with the duties delegated by an employee of the practice will have access to indemnity through the vicarious liability of MDDUS GP partners. MDDUS does not indemnify individual student nurses and it is possible that they could be sued in their own right and may consider obtaining personal indemnity for complete peace of mind. The university or employing trust is likely to retain a degree of vicarious liability for the student nurse and MDDUS would reserve the right to pursue any third party for a contribution if we consider it appropriate.


CASH DONATION Q


Last year a 91-year-old female patient of the practice left an envelope at reception containing £500 in cash. An accompanying note said the money was a donation to help spruce up the waiting area for other patients. Apart from some minor memory issues there appear to be no acute concerns regarding the patient’s capacity. The practice accepted the gift and used it to repaint the reception area. Recently she left another envelope, again with £500. Should we keep accepting these donations?


AUTUMN 2018  ISSUE 19


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16