MP Clinic - Infections Risk Assessment Policy

INFECTION RISK ASSESSEMENT

We have assessed our practice for risks outlined and put in additional processes as detailed below Undertaken a risk assessment Record the date of MP Update risk assessment.

• MP Health Clinic will amend its risk policy subject to the latest news or updates issued by the Government. Heightened cleaning regimes New heightened cleaning regimes for MP clinic • Clinic rooms will be cleaned between in each patient • Towels will be changed between each patient • 5-10 min gap between each patient in order to manage proper cleaning • Common areas/loo will be cleaned every hour • Hard surface in common areas will be cleaned twice a day, or more often whereas necessary.

Increased protection measures

• We have removed all treatment couch covers, refreshment area from the clinic. Further, we added “no touch” water dispenser. • Each room (incl. common area) is provided of Hand sanitiser gel Version 1, 18 May 2020 • Added Cashless payments/online bookings • Staff PPE

Put in place distancing measures

• Stagger appointments • Limit the number of patients in common areas and building accordingly

Staff training

• Correct handwashing technique best practice • Put on/remove PPE safely • Individual Staff briefed and trained on updated clinic policies and infection measures

Providing remote/ telehealth consultations

• All patients will have telephone brief pre-screening call • Follow-up/maintenance appointments available via telephone/video call, also face to face my checking body’s temperature and full COVID questionnaire. Table 2a. Protection of staff and patients before they visit, and when in, the clinic.

We have assessed the following areas of risk in our practice and put in place the following precautions to Description of risk Mitigating action When introduced

Pre-screening for risk before public/patients visit the clinic

• Screening for any symptoms of COVID 19 (e.g. high temperature or a new, persistent cough) in the last 7 days • Screening for extremely clinically vulnerable patients • Screening for additional respiratory symptoms or conditions e.g. hay fever, asthmas etc • Screen to see if a member of their household had/has symptoms of COVID-19 or are in a high-risk category i.e. shielded as considered extremely clinically vulnerable • They have been in contact with someone with suspected/confirmed COVID-19 in last 14 days • Inform of the risk of face to face consultation – staff must document that they have informed the patient of risk associated with attending the clinic, and that they are not experiencing symptoms of COVID-19. • COVID discloser form beforehand 22/05/2020 Version 1, 18 May 2020

Table 2a. Protection of staff and patients before they visit, and when in, the clinic. We have assessed the following areas of risk in our practice and put in place the following precautions to Description of risk Mitigating action When introduced

Protecting members of staff

Detect if you have asked your staff if they or a member of their household is in a vulnerable category and how will you manage this if they are? Each member of the staff was asked to detail how it has been during the lockdown, if they had ever been in contact (or still) with either affected people and household member. All staff complies with our policy strictly. (see table 3) 22/05/2020

Confirmed cases of COVID 19 amongst staff or patients

• Staff will be suggested to take an appointment for covid swap asap • If the patient experiences symptoms within 2/3 days of visiting the clinic, any staff with direct contact to that individual should self-isolate • Anyone with indirect contact with the patient, should be advised of the situation and suggest they monitor for symptoms (those with indirect contact with suspected cases COVID 19 do not need to self-isolate) 22/05/2020

Travel to and from the clinic

All staff (clinic director included) is aware of the use of public transports responsibly as little as possible. Preferable being self-equipped. In case more than 2 people in the waiting area occurred, the rest of staff might get asked to wait at the parking are placed at the backyard. 22/05/2020

Entering and exiting the building

• We reduced the capacity for clients attending at the waiting area before the treatment (max 2 at the time) • The client is asked to not come too earlier or late in order to avoid overcrowding. • Staff is asked to change into work clothing at the clinic (changing and storage room provided) and place work clothing in a separate cloth bag. MP clinic provide the washing service. • We are expecting patients to wash their hands (with either soap and water or a form of hand sanitiser) upon entering exiting the building. 22/05/2020

Reception and common areas

• We ask patients to turn up promptly at their appointment time to reduce time in the waiting area • We encourage contactless payment or card instead of cash, and ask patients prior to their appointment • We set up either online booking or payment to reduce people standing at the reception area. 22/05/2020 Version 1, 18 May 2020

Table 2a. Protection of staff and patients before they visit, and when in, the clinic. We have assessed the following areas of risk in our practice and put in place the following precautions to Description of risk Mitigating action When introduced

• We will be using floor spacing markers to indicate distancing from reception • Some of our practitioners still work from home using telehealth.

Social/physical distancing measures in place

• Staggered appointment times so that patients do not overlap in reception • Prescribed a maximum number of staff and/or patients on the premises at any one time 22/05/2020

Face to face consultations (in-clinic room)

• One parent/guardian only with visits for children • No additional family members except if requested as a chaperone • If more than two members of family attend the clinic, we invite them to wait outside the building. 22/05/2020

Table 2b Hygiene measures We have assessed the following areas of risk in our practice and put in place the following heightened hygiene measures Description of risk Mitigating action When introduced

Increased sanitisation and cleaning

• Clinic rooms - plinths, desk, door handles, equipment chairs - between each patient • Reception surfaces, doors and door handles, chairs, taps, card machines, bathroom • Use of at least 99% alcohol sanitisers/wipes, using bleach-based detergents for floors

Actions to minimise the number of surfaces requiring cleaning

• Remove unnecessary linen/use wipeable pillowcases that can be cleaned between patients, no towels. In case plastic cover whether necessary. • Decluttering the clinic rooms and waiting area on unnecessary items • Replace items with COVID policy approved items (e.g. water dispenser) 22/05/2020 Version 1, 18 May 2020

Table 2b Hygiene measures We have assessed the following areas of risk in our practice and put in place the following heightened hygiene measures Description of risk Mitigating action When introduced

Aeration of rooms

• Leaving the window open and the door closed for 5 minutes after each patient • Aeration of common/reception areas e.g. opening windows and or doors 22/05/2020

Staff hand hygiene measures

• Bare below the elbow/hand washing before and after patients with soap and water for at least 20 seconds, including forearms/use of hand sanitiser gel/ use of gloves 22/05/2020

Respiratory and cough hygiene

• Provision of disposable, single-use tissues waste bins (lined and foot-operated) • Hand hygiene facilities available for patients, visitors, and staff 22/05/2020

Cleaning rota/regimes

• Cleaning rota frequency increased from half-day to 2 hours for common areas • Clinic director and staff regularly inspect the common area • Cleaning rota frequent and inspection of washrooms, instructions on notice of washroom door 22/05/2020

Table 3. Personal Protective Equipment: Detail here your policy for use and disposal of PPE Clinicians will wear the following PPE

• Single-use nitrile gloves and plastic aprons with each patient • Fluid-resistant surgical masks (or higher grade) • Eye protection if there is a risk of droplet transmission or fluids entering eyes • When potentially contaminated, damaged, damp, or difficult to breathe through • At the end of a session

Reception staff will wear the following PPE

• Fluid resistant surgical masks for those in direct contact with patients, Patients will be asked to wear the following PPE • Fluid-resistant surgical masks if respiratory symptoms e.g. from hay fever or asthma • Face-covering in clinical and waiting areas PPE disposal • Double-plastic bagged and left for 72 hours before removal, keeping away from other household/garden waste, and then this can be placed in your normal waste for collection by your local authority. • Cloths and cleaning wipes also bagged and disposed of with PPE Version 1, 18 May 2020

Table 4. Communicating with patients: Detail here how you will advise patients of measures that we have taken to ensure their safety and the policies that have been put in place in our clinic Publishing your updated clinic policy

• Publish on clinic wall, available on request • Instruct and rice awareness to patients beforehand • Available on your website

Information on how you have adapted practice to mitigate risk

• Updating of website and via your social media accounts • Email to your patient base Consider how and when this is updated in line with new Government guidance

Pre-appointment screening calls

• There are routine questions the patient is asked before coming to the venue Information for patients displayed in the clinic • Door notices advising anyone with symptoms not to enter the building. • Notices on other public health measures e.g. hand washing/sanitising/Catch-it, bin it kill it • Providing patients contact for more information or indicating the government website

Other patient communications

• plan to include information in a patient e-newsletter • develop a video for your website detailing patient journey and heightened hygiene measures • Ask patients to contact you if they subsequently develop symptoms