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Development, Approval, Implementation and Review of Patient Group Directions (PGDS) Policy (P5)

The purpose of this policy is to set out a generic framework for a co-ordinated approach to the development and control of PGDs in use in Derbyshire Community Health Services (DCHS) Trust. The policy contains a standard template for all locally developed PGDs. Using the framework and template should ensure that PGDs comply with the legislation and are reviewed and updated every 3 years or in response to updated guidance, stock availability, safety alerts or best practice.

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Guidelines for the use of bladder scanner in children`s services (G188)

To provide safe research based information in order to assess bladder function using ultrasound on children and young people under the age of 19 years.

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Prevent Policy (P46)

The overall aim of the policy is to make clear the duties, responsibilities, and arrangements in place to enable DCHS staff to safeguard and support individuals (children, young people, adults or staff); where it is suspected that the individual(s) is at risk of being drawn into terrorism or other forms of extremist activity. Safeguarding and promoting the welfare of children, young people and adults is everyone’s responsibility and this Policy sits alongside the DCHS Safeguarding Adults Policy and the DCHS Safeguarding Children’s Policy. The Counterterrorism and Security Act 2015 places a duty on certain bodies, including NHS Trusts, to have “due regard to the need to prevent people from being drawn into terrorism”; including a statutory responsibility to appoint a Prevent Lead and provide training for all staff. Healthcare staff have a key role in Prevent. Prevent focuses on working with individuals (patient’s and/or staff) who may be at risk of being exploited by radicalisers and subsequently drawn into terrorist related activity. Prevent does not require staff to do anything in addition to normal duties. Staff are expected to raise concerns about individuals who are being exploited in this way (DOH 2011).

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Safeguarding Adults Policy (P28)

The aim of this policy is to support staff to comply with their duties under the Care Act 2014 (sections 42-46) for safeguarding adults and the Derbyshire and Derby Safeguarding Adults Boards Safeguarding Adults Policy and Procedures. The policy sets out the principles and practice of safeguarding adults and the responsibilities of Derbyshire Community Health Services (Trust) staff when caring for an adult (aged 18 years and over) where safeguarding concerns arise. “Safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect…people and organisations working together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action” (Care and Support Statutory Guidance 2017:14.7).

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Advance Decisions Policy

It is a general principle of law and medical practice that adults have a right to consent to or refuse treatment. The courts have recognised that adults have the right to say in advance that they want to refuse treatment if they lose capacity in the future, even if this results in their death. A valid and applicable advance decision to refuse treatment has the same force as a contemporaneous decision. This has been a fundamental principle of the common law for many years and is now set out in the Mental Capacity Act 2005, which came into force in 2007 supported by the Code of Practice to the Act. Derbyshire Community Health Services NHS Foundation Trust aims to achieve a more balanced partnership between patients and healthcare professionals and acknowledges that it is the right of every adult patient with capacity to determine whether or not to accept medical treatment. In addition, it is the right of every adult patient to express views about their future care and treatment. The primary responsibility lies with the patient (the maker) to write an Advance Decision to Refuse Treatment (ADRT). The Trust endorses the good practice of staff, set out in national guidance and professional standards to provide information to and general support for patients who wish to write an ADRT. The Trust always encourages patients who wish to discuss their plans for future care and will provide advice to patients and support to advance care planning by helping to coordinate care and communicate plans. In addition, it is supportive of those patients who present with an advance decision and where this is valid and applicable, comply with that specific decision. This policy should be read in conjunction with the Trust’s Consent Policy and aims to raise awareness and give guidance to staff about advance decisions.

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0-19 Children’s Services Standard Operating Procedure (S92)

This Standard Operating Procedure gives an overview of the service provided by the 0-19 Children’s Community Services. It also supports a commitment to ensure evidence-based tools and training are embedded within practice, supporting the national commissioning for outcomes recommendations, and offering assurance that the service is focused on personalised and needs based care. This Standard Operating Procedure should be used in conjunction with other DCHS Childrens and DCHS Trust policies along with The NMC Code.

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Requesting and Managing Pathology Results within DCHS Community Hospital Wards SOP (S98)

The purpose of this Standard Operating Procedure (SOP) is to outline the steps required to effectively manage the requesting, receiving, filing and actioning of all pathology results by either an electronic process or by a relevant paper-based system. Utilising an electronic system (such as ICE) enables pathology requests to be requested, reviewed and actioned electronically via the electronic patient record within TPP SystmOne. There are an estimated 1.12 billion pathology tests undertaken each year in England (NHS England, 2020) It is imperative a record of all pathology samples is accurately maintained to avoid patient harm and improve patient outcomes (WHO, 2021). The Care Quality Commission (2021) inspects the management of test results to ensure processes are robust, practice is safe and care is effective.

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Completion of agency checks within the 0-19 Children’s Service Guidelines (G249)

The purpose of this guidance is to ensure that health visitors and school nurses clearly understand their roles and responsibilities when they are asked to complete an agency check. This includes ensuring that the relevant consent to share information has been obtained from parents/ those with parental responsibility for the child/ young person ( this should be obtained by social care). The guidance also clearly outlines the process for admin staff to follow to ensure that any requests are sent to the clinical teams and that in turn the clinical teams can respond in a timely manner.

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Guidelines for the management of patients who Did Not Attend (DNA) an appointment (G265)

To standardise the process for managing patients who DNA initial and follow-up appointments.

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Opportunistic Maggots Guidance (G274)

Every year during the hot weather we experience an increase in patients with opportunistic maggots in the community. This guidance is to aid assessment and management of these patients.