Introduction
BrisDoc was originally launched in 2001 and over 20 years later employs around 350 staff. We are also, an employee owned, Social Enterprise. We are currently contracted to deliver an Integrated Urgent Care service across Bristol, North Somerset and South Gloucestershire for which we manage the sub-contract for the NHS 111 service. Patients are provided with care via telephone clinical assessment, video consultation or face-to-face contact at multiple Treatment Centres or if there is a clinical need we undertake home visits. We also operate two NHS GP practices – Broadmead Medical Centre, located within Boots Chemist in Broadmead shopping centre, Bristol; and Charlotte Keel Medical Practice, and the Homeless Health Service from which there are numerous service interfaces with third sector services supporting those who are homeless and/or have drug and alcohol dependencies. In addition, we operate System CAS’ which brings together clinicians from other providers to work within Severnside, with a specific focus on patients identified by NHS111 as needing Hospital or an Ambulance. The aim of this work is to ensure that only patients who truly need Hospital or an Ambulance use these pathways and those who are appropriate are managed via an alternative service. These combined services enable BrisDoc to offer 24/7 unscheduled, urgent care with a focus on supporting patient care in the community.
Through continuous review, we understand the risks associated with the delivery of our services and we have developed this strategy to ensure that health and safety is fully integrated into our strategic and operational management.
Our Board members accept that their approach to the management of health and safety must be rigorous, and their statutory requirements and all other organisational roles and responsibilities have been outlined within our policy. The Corporate Leadership Board has delegated to the Quality Board the responsibility to set the direction for health and safety within BrisDoc, and to oversee and monitor the implementation of the health and safety work programme. This is managed and delivered by the Health and Safety Assurance and Steering Group.
We want to target priority areas of action, with an objective base and clear focus against which performance can be measured. Ultimately, we aim to provide our Corporate Leadership Board with management information which allows them to weigh a particular risk against the costs of preventative action in time, money and effort.
Our Processes and Arrangements
We rely on corporate, service and specialty risk assessments to identify key risks and priority work areas, underpinned with supporting assessments and policies/procedures for each of the key risks identified. Assessments will be based on the analysis of incidents reported by co-owners and/or other service users, and the consideration of the likelihood and severity risk score attributed to every incident. All incidents will be recorded on our LERIS and ClarityTeamNet systems. In the event that an incident is scored 15 or more it will be reviewed at the Quality Board.
We will also ensure that notifiable incidents under RIDDOR are reported to the HSE. Having identified both the trends causing harm and critical causes of harm, we will update our risk register and will undertake ‘root cause’ analysis. Findings will be incorporated within updated risk assessments and policies to ensure that managers and co-owners are provided with appropriate guidance.
We will continue to develop training for co-owners both to meet statutory requirements and when particular needs are identified, following on from risk assessments. The Director of Nursing, Allied Health Professionals and Governance is our strategic lead for health and safety, supported operationally by our Quality Manager and the Health and Safety Leads in each of our services.
We will provide the Corporate Leadership Board with regular dashboard display reports and share a quarterly assurance report with the Quality Board. We will also review our risk assessments and update our policies. We will fully engage with managers and our co-owners in our Health and Safety Assurance and Steering Groups (H&SA&SG) through which our Health and Safety action plans will be developed, agreed, delivered and monitored. We will regularly evaluate the success of this strategy and re-address our objectives.
Our Objectives
Through the implementation of the action plans, we aim to achieve the following objectives:
- Identification and management of key risks,
- Board assurance that statutory and contractual requirements have been met and that processes and arrangements achieve and sustain an appropriate level of performance, via a dashboard display and quarterly assurance reports
- Reduced disruption to the business through improved management of risk/incidents and associated costs attributed to co-owner absence,
- Improve overall business resilience.
Our Key Deliverables for 2022-2025
Our key deliverables to maintain and further improve business resilience during 2022/25 include:
- Address risks/gaps identified through baseline and ongoing risk assessments at corporate, service, and speciality level,
- Ensure managers are appropriately trained to enable them to operationalise their health and safety responsibilities in their services,
- Ensure co-owners receive training appropriate to their needs to keep themselves, patients, colleagues, and the service safe,
- Ensure safe driving practice, remote workers and lone working arrangements for co-owners are achieved through training, risk assessment and monitoring,
- Continuous raising of awareness of Health & Safety with co-owners through regular communication,
- Ensure co-owners appropriately report and record accidents in the workplace,
- Continuously strive to deliver safe and effective infection control practice including the management of sharps in accordance with policy, liaising with landlords with respect to safe and compliant premises.