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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.

Midazolam by Buccal Administration for Children (UTC)

PGD Midazolam by Buccal Administration for Children (UTC)

WRES data report 2023.docx

APPENDIX 4 Application for Adoption Leave and Pay Form.docx

Organisational strategy - Bitesize slides - Healthy Communities.pptx

Organisational strategy - Bitesize slides - Healthy Communities.pptx

Trust Policy for Free of Charge (FOC) Medicines Schemes (P109)

This policy is to ensure consistent, equitable and robust consideration of any free of charge (FOC) scheme that DCHS clinicians would like to be considered for use within DCHS, in line with the National guidance on FOC schemes. Including the requirement for consideration of schemes within Derbyshire for system approval prior to use within DCHS by the Derbyshire Joint Area Prescribing Committee. Where the medicine is currently commissioned by NHS England Specialised Commissioning, ICSs should discuss all FOC schemes with their regional specialised commissioning team in the first instance, before a decision is made on whether to implement the FOC scheme.

8540-My-Community-Autumn-2019-V5-ONLINE.pdf

My Community Autumn 2019

Screen shots for opening one patient record at a time on SystmOne draft.docx

Missing from Known Address Policy (P71)

The purpose of the Missing Children and family Alert (MCFA) process is to locate pregnant women and children who have disappeared from view following an undisclosed change of address and for whom there may be concerns about child welfare in respect of unmet need, vulnerability or abuse. Working Together to Safeguard Children (HM Government 2018) identifies that all children should be safeguarded and have their welfare promoted. This Policy is aimed at DCHS Services that hold a child caseload.

Intravenous Therapy and Vascular Access Device (VAD) Policy - Adults (P47)

The use of intravenous medicines has many healthcare benefits for patients. Intravenous medicines are increasingly commonplace within the community setting and the need for an intravenous medicine is often a reason for patient’s being admitted to secondary care. Following the implementation of national and local policy, there is a new direction for community care providers such as DCHS to develop services that can be provided within the community hospital or community setting to accommodate patient’s being able to receive more complex care. The aims of this policy are: To prevent unnecessary acute hospital admission and to facilitate early discharge from the acute hospital setting by enabling patients to receive IV medicines safely within their own home or a community health care setting. To ensure an IV medicine is the most appropriate treatment for the patient and that it is administered via the most appropriate Vascular Access Device, the most appropriate vascular access site is chosen and the IV medicine is administered at the right time. To reduce the risk of complications by ensuring registered practitioners’ practice safely and consistently in relation to the administration of IV medicines, Vascular Access Device Insertion and the care and maintenance of Vascular Access Devices (VADs), through the implementation of evidence-based practice and by providing staff with the necessary guidance on clinical practice and training. To preserve and promote patient vessel health in the short and long term by ensuring any Vascular Access Device inserted is the most appropriate device for the treatment being administered and that it is placed by the most appropriately qualified practitioner.