Writing on Lexacom’s Insight platform, Dr Andrew Whiteley looks at the need for GP practices to have robust primary care business continuity plans, assessing the importance of having such a plan and how they can be managed, supported and executed.
Lexacom is a technology company that works in document creation and management. As part of its services, its software suite incorporates digital dictation, speech recognition and transcription that is used across education, healthcare & many other industry sectors. Dr Andrew Whiteley founded the business after being frustrated as a GP partner by outdated dictation recording equipment which was used during the 1990s to write letters and patient referrals.
Seeking out a more efficient way of working, Dr Whiteley produced Lexacom’s first piece of digital dictation software, since when the company has gone from strength to strength.
One of the lessons from the Covid-19 pandemic is the need for GP practices to have robust, workable, and managed primary care business continuity plans.
In this post, we investigate the elements, management, and support of these plans.
Primary care business continuity planning – why it is important
A business continuity plan helps ensure that a primary care practice can maintain an acceptable level of service in the face of an incident or disaster and be able to recover to an acceptable level as rapidly as possible.
This is important for GP practices as there is a wide range of potential incidents that could affect their functioning and provision of health and patient care.
The annual flu outbreak is the regular test of capacity and planning for most primary care practices. Therefore, every practice should have a primary care business continuity plan to deal with this.
With such a plan, the practice has a good basis for an overall primary care business continuity plan.
The next step is to consider other elements. What’s the plan if the practice’s utilities (water, electricity, gas) fail? What about IT functions and support failure? Is the practice in an area that could flood? What happens if the practice’s premises must be temporarily abandoned? Is the practice close to main roads, which means it must provide emergency support for major road accidents? Are the industries in the local area likely to cause a chemical accident? Etc.
Considering these elements and planning with a primary care business continuity plan will enable a practice to effectively recover and adapt so that it can continue to work.
Legislation regarding NHS business continuity planning
Two pieces of legislation, The Civil Contingencies Act (2004) and the Health and Social Care Act (2012), provide a framework, context, and mandate for business continuity planning in the NHS.
However, these deal with category one responders, which for the NHS means Clinical Care Groups [CCGs] and major hospitals, rather than primary care practices and networks. But that does mean every primary care practice can contact its CCG to find out about the CCG’s business continuity plan and how the practice should be supported by that plan.
What is a primary care business continuity plan?
A primary care business continuity plan is a written document that is shared amongst those responsible for implementing it. It should have a regular review and revision schedule (at least once a year), plus its content and access should be shared with everyone in the practice.
Within this broad description, the main objectives of the plan are to:
- Detail/list the core information about the practice. Such as staff, their contact details, and contact information for main suppliers and support services.
- Provide a list and prioritisation of the essential services the practice provides for patients and any related support functions.
- List and describe the known risks to the provision of those services, and how those risks can be mitigated/reduced.
- Detail the practice’s action plan for reacting to disruptive incidents. Which should include a list of the first set of actions that staff take, should an incident happen.
How Lexacom can help with primary care business continuity plans
Lexacom’s range of products can help with primary care business continuity plans. Be that the practice is out of action, is under increased demand, or facing a staff shortage.
Lexacom Echo, our cloud-based speech recognition software, securely stores data away from the practice and its capability isn’t dependent on being in the practice. As such it supports situations where the practice is not accessible or functioning and prevents loss of data should the practice’s in-house IT services be compromised, disrupted, or destroyed.
Lexacom Connect, our cloud-based digital dictation solution, allows users to dictate and send correspondence from multiple sites while sharing resources across those sites. This allows practices to share the load should there be staff shortages or other issues at one practice, and within their Primary Care Network [PCN].
Lexacom Scribe is our fast and flexible transcription service that can be used as needed. Ideal for when workloads are excessive, staffing levels are low, or the normal working environment in the practice is disrupted.
If you’d like to find out about any of these products, fill in a contact form or call us on 01295 236910.
What are the main elements of a primary care business continuity plan?
Within the above description, the business continuity plan needs to cover five core elements:
1. A register of the identified risks and their potential impact on the operations of the practice
The register should include an assessment of both likelihoods of an incident occurring and a measure of severity if it does. For example, a flood, due to a riverbank bursting, may be low, but its impact would be severe. Plus, detail if the impact could be short (up to a month), medium (up to six months), or long term (more than six months) in duration.
2. The planning process and management of the plan
This will cover how the plan elements were determined, how and when the plan is reviewed, who is responsible for those tasks. In addition, the other management tasks needed to keep the plan current, communicated and effective. It should also cover local related risk registers, such as town or county council and the practice’s CCG’s own business continuity plan. This provides a wider context and helps with coordination should the scale of an incident require it.
3. The roles and responsibilities of the practice’s staff
This part names the person responsible for delivering the practice’s business continuity, and their incident management team. This should also cover deputies, in case of absence or incapacity of the main role holders.
4. The communication plan for enacting the business continuity plan
Typically, this is a telephone tree of who calls who. With the aim of each person having to make no more than three to five phone calls to get the plan started and communicated to everyone involved. A backup plan of methods of communicating is also required should phone capabilities not function (both voice and data). This becoming more important as reliance on mobile networks supersedes landlines.
Additionally, this element should include the communication plan for contacting patients, local health service providers and stakeholders such as NHS England or Scotland and the practice’s CCG.
5. Testing and training of the plan
This last part is vital, in the same way as regular fire alarm test drills are important. By testing and training, the plan becomes effective as those involved have experience of what to do. Plus, issues, problems, and failings of the plan are highlighted before they can have a critical real-life impact.
Other areas to consider in primary care business continuity plans
While not an exhaustive list, best practice for a primary care business continuity plan is to include these items:
- Collaboration and sharing of plans with neighbouring businesses (especially if in a shared building), other local practices and healthcare services, plus local government, and emergency services.
- A work-from-home plan if many staff cannot come to work at the practice – both understaffing and physically can’t get to the practice.
- IT systems disruption. Both accidental and intentional, such as cyberattacks.
- Practice premise is unusable for a major time (e.g., two weeks or more)
- Paper records being destroyed or damaged.
- Supplier failure for essential goods or services, with key information such as account numbers, contract details, contact names, and numbers.
- A system to make sure the business continuity plan is available, on and off-site, 24/7.
NHS business continuity planning resources
Given the importance of a practice having a primary care business continuity plan, there are templated resources and guidance articles from the NHS on the web.
Additionally, practices should contact their CCG or local healthcare community as many have developed their own business continuity plan templates.
Some helpful links can be found below:
NHS England business continuity plan template
Glasgow LMC business continuity plan template
Online example of primary care business continuity plan
Examples of primary care business continuity plans can be found through web searches. One impressive example is published by the Dover-based Buckland Medical Practice.
A read of this plan shows that it covers all the above points, and of course, by being on the practice’s website, is easily available 24/7 should it need to be implemented.
