On-call Provision For Specialist Areas
Kelly Morris from Guys and St Thomas' NHS Foundation Trust, shares how they manage on-call provision in specialist services.
Guy’s and St. Thomas' NHS Foundation Trust treats a wide range of patients across the sites of St. Thomas' Hospital, Guy's Hospital and Evelina London Children's Hospital and provides a 24 hour emergency physiotherapy service. This includes the provision of 3 on-call rotas across all sites.
Staff are allocated to each rota depending on their static or rotational post. Each site ensures that staff are competent to carry out these duties as part of their contract, through on-call specific training days where the members work in the specialist areas completing a competency document. They are supported through the process by an on-call mentor. Our local on-call policy states a 30 minute response time and therefore staff stay on site.
The on-call mentor role ensures that staff new to the rota receive a structured and supported induction ensuring that they are competent and ready for their first on-call. It also allows for staff to de-brief, reflect and learn from their on-call experiences.
Flexibility is required of staff to manage the 3 different rotas due to the different service requirements of the specialities that are provided across the trust. The range of clinical specialities provides a mixture of 5, 6 and 7 day working with variable start and finish times. Team leads for services and the staff member carrying out their on-call duty must ensure that they are able to meet the expectations of both the service delivery of the clinical area they are working in and the on-call service. Alongside rotations, the staff need to adapt quickly to their new on call rota which at times can be challenging.
The St Thomas’ Hospital rota may involve call outs to patients receiving ECMO treatment. The call out rate for these patients is extremely low (approximately 4 call outs over 5 years) and therefore it was not deemed appropriate or time efficient to train all of the members of the St. Thomas' Hospital rota in this competency. To manage this situation the static critical care B7 and 8 physiotherapists are available to provide telephone advice and work closely with the clinical nurse specialists to ensure that safe patient care is provided 24 hours a day.
Kelly Morris, Guys and St Thomas' NHS Foundation Trust