Disaster recovery or business continuity plans are not fun to do and hopefully you won’t need to use it, but it is a key piece of work as it allows you to plan for what you would do should the worst occur.
Time spent now will greatly reduce your stress lately. Below are eight key tips to help you ensure your plan meets your practice’s needs and remains up to date.
1. Assign responsibility for the plan
The practice manager will usually be the person responsible for the disaster recovery plan, but all partners have a responsibility to be involved in the planning as well. The more input into the plan, the more detailed it will be and the more use it will be if you need to use it.
2. Identification of risk
The first step is to identify any problems that might happen.
Crises to consider include the following:
- IT failure
- Telephone system goes down
- Severe weather
- Pandemic flu or outbreak of any other disease
- Terrorist attack
However, this list is just a starting point and you should think about other potential crises that could affect your ability to deliver patient care effectively or threaten your business.
3. Risk assessment
A risk assessment looks at the likelihood and impact of risks that could cause a business interruption and assesses the impact of these.
See the attached NHS England Business Continuity Toolkit and the Business Continuity Management Toolkit produced by the government for more information on how to do this but an example would be:
|Terrorist attack||Very low||Severe|
You can also read more about risk management in general practice here on Medeconomics.
4. Scenario planning
Go through your contingency plans for these events and write down all the steps you could take to mitigate these risks. For example
- Has everyone done their mandatory training?
- Have the fire alarms been tested regularly?
- Have you gone through the fire drill with all staff and with patients?
- Are all the fire exits clearly marked and free of clutter?
- Have you tested your back up system?
- Does the practice have laptops with the clinical system loaded so that they could be used in the event of the surgery network going down?
- How would you consult – do you have supplies of prescription pads and an agreed format for taking a patient history which could be scanned and read coded afterwards?
- Do you have signs for reception to explain that only urgent cases can be seen?
- How would you operate payroll and other key business but non clinical processes?
5. Key contact list
Your plan should have a key contact list that is regularly updated. Consider asking key contacts, such as IT service desk and the CCG for a copy of their business continuity plan around primary care - it will give useful tips to think about.
These are numbers that should be on your key contact list. This list is not comprehensive, go through your email contacts to make sure all of them are in the plan if you think you might need them.
- IT service desk
- Telephone service desk
- CCG contacts
- NHSE contacts
- Insurance contacts
- Utilities (gas, electricity and water)
- Key staff contacts – make sure staff mobile numbers are checked at least annually when you check the plan
- Medical supplies
- Alarm maintenance
- Fire extinguisher maintenance
- Clinical waste
- Shredding company
- Air conditioning
- Vaccine fridges
- Vaccine suppliers
- Office suppliers
- Local pharmacies
- Out of hours service
- Neighbouring practices
6. Make sure all staff are aware of the plan and their role
Do your staff members know how to locate your facility’s disaster plan? Do they know their specific role during a disaster? An important aspect of any disaster plan is for each individual to have a basic understanding of his or her role.
It is a good idea to run through the plan as a team and practice responses to various scenarios. Staff members who are involved in disaster response exercises can make suggestions regarding the process and suggest improvements. Through these exercises, knowledge gaps can also be identified, allowing for future training specific to those areas.
7. Check emergency supplies regularly
Is the latest version of the plan printed and kept in a central location at the practice and off site?
Do you have supplies of personal protective equipment (aprons, gloves etc) that are checked to be in date and in a recognised location?
Is the emergency equipment checked regularly?
Do you have signs that you could use in an emergency to advertise how patients contact the surgery?
8. Have a communication plan
If there is a problem, how is this communicated to staff and patients? Make sure everyone knows what to do if there is an urgent situation both in and out of hours.
It may be that there is flooding at the weekend, who is responsible for notifying staff, the patients and NHSE and CCG? It is also a legal requirement to inform CQC if there is a disruption to services that would prevent you carrying out your usual activities.
Repeat this process at least annually. The best plan is no use if it is not up to date and no one knows about it!
- Fionnuala O'Donnell is a practice manager in Ealing, West London, and a CCG board member