The 12 risks of Christmas
“On the first day of Christmas my practice manager said to me…” Christmas can be a challenging time in general practice. Dr Rachel Birch, MPS medicolegal consultant and salaried GP, advises on how to survive the festive season
“12 patients waiting…”
With staff on holiday and the practice closed for several days over the festive fortnight, there may be a great demand for appointments. Patients often wait to attend their own health centres rather than the out-of-hours service.
- Ensure you have sufficient time to plan the staff rotas and consider making contingency plans in case of staff illness.
- Offer influenza vaccinations to all staff members.
- Make all the appointments “on the day” and ensure you have adequate time for house visits, as elderly patients may be housebound if the weather is bad.
- If you are employing locums, provide them with a good induction.
“11 fairy lights flashing…”
Whilst a well-decorated and cheery waiting room can put a smile on everyone’s face, remember that there may be risks involved with festive decorations.
- Consider an artificial tree to avoid the risks of pine needles.
- When decorating the waiting room beware of trailing cables and wobbly ladders.
- Ensure you have followed the relevant safety legislation.
- Arrange for power cables and fairy lights to be checked for safety in accordance with Electricity at Work Regulations (1989). Always use surge protector sockets.
- Ensure baubles are child friendly and not made out of glass.
- Keep any waiting room Christmas music at low volume.
“10 doctors leaping…”
Whilst everyone may be looking forward to the staff Christmas celebrations, remember that patients place a lot of trust in their healthcare team to look after them and behave appropriately.
Be aware of the effects of tiredness and alcohol on performance
- Ensure that you act professionally at all times.
- Be aware of the effects of tiredness and alcohol on performance.
- When in a holiday mood and discussing Christmas plans with patients, do not forget your duty of confidentiality.
“9 results a waiting…”
Hospital laboratories may have a reduced collection and results schedule. This coupled with the Christmas post may lead to delays in the usual services.
- Try to make referrals electronically, where possible, from mid December, so that they are not subject to postal delays.
- If a test result is essential, request it urgently so that it is phoned back to the practice the same day.
- Arrange for important tests, such as INRs, to be done a few days before the long holiday period.
“8 maids a milking…”
It can be fun to bring in ‘treats’, but make sure that you follow some basic rules to ensure the staff don’t all become the patients.
Advertise the festive opening hours in good time and using as many methods as possible
- Check the sell by date on the milk.
- Ensure you follow basic food hygiene rules and do not reheat food more times than is recommended.
- If the cleaning staff are on leave take extra care to wipe surfaces with antibacterial fluids and do the washing up promptly.
“7 notices informing…”
It is surprising how many patients do not consider the altered surgery opening hours until it is upon them.
- Advertise the festive opening hours in good time and using as many methods as possible.
- Many regions publish lists of services and contact details for the festive periods – this may include OOH services, pharmacies, walk in centres, etc.
- Find out which hospital clinics may be closed, so you know where to direct patients should they require treatment.
“6 happy staff smiling…”
Christmas is a good time to show your staff how much you value their hard work during the year.
- Consider having a staff Christmas lunch or night out.
- Try to ensure that all staff get some time off, either at Christmas or New Year.
- Be aware that this can be a stressful time of year and offer support to your colleagues if needed.
“5 gold rings…”
Okay, we don’t expect to receive gold rings as presents, but patients sometimes like to give gifts of chocolates, flowers, wine and fruit.
- Ensure the practice has a gift policy and maintains a register of all gifts received.
- Consider sending thank you cards to those patients who brought you presents.
- Inform the local commissioning body or health board if you receive any presents over the value of £100.
- Doctors should keep thank you letters from patients for their appraisals.
- Don’t leave alcohol in consulting rooms as it may give the wrong impression to patients.
“4 snow storms…”
Practices could find themselves liable if patients injure themselves in the snow and ice.
Ensure that you have adequate public liability insurance
- Fill up your grit bins and keep snow shovels in the practice.
- Draw up a festive rota for clearing snow. Provide training, supervision and provision of suitable equipment.
- Ensure that you have adequate public liability insurance.
- Keep the temperature of the surgery warm to prevent frozen pipes.
“3 winter bugs…”
Winter brings its own set of illnesses, including norovirus, colds and influenza.
- Encourage eligible patients to have their annual influenza vaccinations.
- Consider providing alcohol handwash stations in the waiting room and patient toilet areas.
- Be vigilant to the possibility of atypical presentations of serious illnesses such as heart attacks.
- Liaise with district nurses, social services and consider offering telephone support for vulnerable patients.
- Emotions may run high and if patients need admitting to hospital they may try to stay at home – try to offer the same advice to patients as you would at any other time of year.
“2 emergency prescriptions…”
It is amazing how many patients leave prescription requests until the last minute.
Encourage eligible patients to have their annual influenza vaccinations
- Ask patients to request prescriptions in advance.
- Consider printing reminders on the right-hand side of prescriptions, advertising in the local newsletter and on notices, and consider sending text reminders.
- If sending text reminders, ensure you follow the guidance in the MPS factsheet “Communicating with patients by text”.
- Allocate extra time in the week to deal with extra prescription requests.
- Make sure the practice emergency cupboard is well stocked.
“And an ostrich in a Christmas tree…”
Don’t be an ostrich and bury your head in the sand, or behind the sparkly Christmas tree baubles – be prepared.
This year surgeries will reopen on the Friday after Christmas, making it a potentially difficult day as there is only one working day before the weekend again. Ensure you have adequate staff for this day, and the Thursday and Friday after New Year. Remember that the first full week following the holidays is likely to be busy too.
Good preparation should help you have a successful Christmas and a Happy New Year.