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Introduction:

The Dr Tatiana Clinic is led by NHS trained Doctors and Surgeons, and is CQC registered to provide the following types of services in our clinical environment:

  • Treatment of disease, disorder or injury
  • Surgical Procedures
  • Diagnostic procedures

This policy has been developed using existing guidance from the UK government and relevant UK medical bodies. Importantly, it adheres to the following UK Government guidance:

  • Keeping Workers and Clients Safe During Covid-19 in close contact services
  • Reopen your business safely during coronavirus (COVID-19)
  • Working Safely during COVID-19

The safety of our patients and team members is central to this policy. We acknowledge that COVID-19 is an evolving and dynamic crisis and therefore this policy will be regularly updated. This policy must be considered in addition to guidance from the UK government.

Appointments:

  • Patients who fall in ‘moderate’ or ‘high risk‘ COVID-19 categories are requested not to come to clinic for their safety. Criteria for these categories are available at: https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk-from-coronavirus/whos-at-higher-risk-from-coronavirus/
  • Patients (or people they live with) that have experienced any of the following symptoms in the last 10 days are requested not to attend clinic, but to call NHS 111 for further advice (please see Appendix 1 for triage questions to be asked by our bookings team).
    • Fever
    • Shortness of breath
    • Loss of smell/taste
    • A new cough
    • Diarrhoea or vomiting
  • Patients that attend the clinic with the above symptoms will politely be asked to reschedule their appointment.
  • Patients will have their temperature taken on arrival.
  • Appointments are by prior arrangement only. No walk-ins will be permitted.
  • Patients attending clinic should wear a face covering. This does not need to be a surgical mask, it could be a home-made mask made of fabric. Please see this UK government link on how to make and wear a face covering: https://www.gov.uk/government/publications/how-to-wear-and-make-a-cloth-face-covering/how-to-wear-and-make-a-cloth-face-covering
  • Patients will be encouraged to wear face coverings properly. This involves:
    • Washing hands thoroughly with soap and water for 20 seconds or using hand sanitiser before putting a face covering on, and after removing it.
    • When wearing a face covering, avoid touching their face or face covering.
    • Change their face covering if it becomes damp.
    • Continue to clean their hands regularly.
  • Appointment times have been extended with 30 minute gaps between appointments to prevent overcrowding and to help ensure 2 metre distancing between patients
  • Waiting areas will be able to maintain social distancing
  • Signage has been installed to remind patients and visitors to follow social distancing reccommendations
  • Patients should present at the time of their appointment, not earlier or later, to help prevent overcrowding.
  • Patients should present to clinic by themselves, and not bring friends or family.
  • Patients should limit the number of personal possessions they bring with them.
  • Patients should use the stairs rather than the lift wherever possible.
  • All lift buttons, handrails and touch surfaces have been treated with an anti-viral touch guard with a life span of 10 years, that has been tested against the COVID-19 virus.
  • Upon arrival, patients will be immediately directed to the clinical room in which they will be treated.
  • A maximum of 3 patients are permitted in the clinic at any one time. If the clinic is at capacity (3 patients), any further patients presenting will be politely asked to return at a later time.
  • Patients will be asked to sign a COVID Consent form.
  • Patients who require a repeat of their creams or prescriptions can contact us by phone to arrange delivery direct to their home.
  • Consultations can be carried out via video teleconference.
  • Patients will not be offered food or drink (unless medically required).
  • Brochures will not be given to patients in clinic, but will be emailed instead.
  • The clinic will be ‘paper-free’ wherever possible.
  • Skin products will be sent via post rather than collected in clinic.
  • Patients should pay by card rather than cash wherever possible.
  • The clinic will maintain records of staff, patients and visitors for the purposes of NHS Test and Trace.
  • Patients will be encouraged to scan our QR code for the government’s test and trace programme and download the NHS contact tracing app.

2 metre distancing:

  • Team members to maintain 2 meters distancing from one-another. Outside areas will be used for staff breaks.
  • Patients should wherever possible maintain 2 metre distancing with other patients.
  • All team members should not shake hands of patients or other team members
  • All clinical team members to use the same clinical room, rather than swapping during the day.
  • Please note, in an emergency, for example a medical emergency, accident, fire or break-in, 2 metres social distancing is not required.
  • Team meetings to take place via teleconference.

Hand washing:

  • Team members to wash hands for 20 seconds with virucidal handwash (using surgical 7-step technique) between patients and after any activity that potentially results in hands being contaminated.
  • Patients should use virucidal handwash or hand sanitizer upon arrival to clinic and when their treatment has been completed.
  • Hand sanitizer and handwashing facilities are available in multiple locations in the clinic.

Clinical cleaning procedures:

  • We are cleaning door handles, chairs, treatment couches, laptops, telephones and shared surfaces with a powerful virucidal wipe before the start of each day, every 30 minutes, between patients and at the end of each day.
  • We are using disposable paper towels, rather than re-usable fabric towels.
  • iPads and card payment machines are being wiped with a virucidal agent between each patient.
  • The clinic is kept well ventilated, with windows opened and ventilation systems used wherever possible. Filters will be monitored and managed in accordance to manufacturer instructions.
  • The clinic is subject to a thorough clean with a disinfection regimen daily, using a combined detergent disinfectant solution at a dilution of 1000 parts per million (ppm) available chlorine (av.cl.)
  • Cleaning staff wear surgical masks and gloves and are trained in hand hygiene protocols.
  • Team members keep personal belongings in a locked storage room rather than in clinic rooms.
  • Clinical equipment is cleaned following each procedure as per manufacturer guidance and disposable items are used where possible.
  • Toilet floors, sinks, toilet seats, and soap dispensers are cleaned with a combined detergent disinfectant solution at a dilution of 1000 parts per million (ppm) available chlorine (av.cl.) three to four times a day. Patients are asked to flush the toilets using a tissue paper to hold the handles, and flush with the lid closed to prevent aerosolisation.

Personal protective equipment (PPE):

  • Clinical team members to wear surgical scrubs, surgical mask (Type IIR), gloves, visor/goggles for all procedures (scrubs to be washed daily at 60 degrees, to be kept in a separate laundry bag and not worn to and from clinic) and be ‘bare below the elbows’. Gloves to be changed between patients, mask to be changed 4-hourly. Please see Appendix 2 for how to safety use PPE equipment.
  • On-site receptionist to wear scrubs and surgical mask (surgical mask to be changed 4-hourly).
  • Scrubs to be changed into on site.
  • All LASER procedures that are aerosol or plume generating to be carried out by Dr Rishi Mandavia or Dr Tatiana Lapa, who will wear FFP3 masks, eye screens, full sleeve disposable surgical gowns, gloves and utilise a smoke extractor system. Extended time periods will be used for such procedures for purposes of ventilation. Eye screens to be cleaned using Clinell wipes following treatment.
  • Goggles should be worn for any procedures with risk of splashes.
  • The reception desk is protected with a screen barrier.
  • All PPE should be disposed of in clinical waste bins.
  • All team members have been trained in donning and doffing and disposal of PPE.

Transport to clinic and team-member support:

  • All team members to come to work either via: Car, Bike, Walking or Taxi. Public transport to only be used during non-rush hours, where it is easier to maintain 2 metres social distancing. PPE is provided to team members for transport to and from clinic.
  • All team members that are not essential to be at work will work from home. These team members will be provided with sufficient equipment to work from home.
  • Only 1 patient coordinator will work on site, other administrative staff will work from home.
  • Team members that fall within the governments ‘moderate’ or ‘high risk‘ COVID-19 categories will work from home.
  • All team member that require support for their health and well-being will inform Dr Rishi Mandavia who will arrange appropriate support.
  • Team meetings will be carried out using electronic platforms rather than in person.

Receiving and sending goods safely:

  • Personal contact will not be made with delivery teams
  • Confirmation of deliveries will be signed electrically
  • Frequency of deliveries will be minimised and re-stocking will take place outside of clinic operating hours.

Suspected infection:

  • All team members that have experienced any of the following symptoms in the last 10 days should not come to work, rather stay at home and self-isolate for at least 10 days from when symptoms started and immediately inform Dr Rishi Mandavia (07947643912; rishi@drtatiana.co.uk).
    • Fever
    • Shortness of breath
    • Loss of smell/taste
    • A new cough
    • Diarrhoea or vomiting

Dr Mandavia will then coordinate COVID-19 testing for the affected staff member.

  • All team members that live with anyone experiencing the symptoms above should not come to work, rather stay at home for 10 days and inform Dr Rishi Mandavia (07947643912; rishi@drtatiana.co.uk) immediately, who will coordinate COVID-19 testing.
  • Should a situation arise where a suspected COVID-19 positive patient, visitor or staff member has been in the clinic, Dr Rishi Mandavia will immediately be informed, all activity will stop when safe to do so, no other patients/visitors will enter the clinic, doors will be kept closed with windows open to improve airflow and ventilation. The clinic will then undergo a deep clean using disposable equipment and a combined detergent disinfectant solution at a dilution of 1000 parts per million (ppm) available chlorine (av.cl). All cleaning cloths/wipes as well as all waste associated with suspected positive patient will be disposed into clinical waste.
  • If there is more than one case of COVID-19 associated with our clinic, Dr Mandavia will contact the local PHE health protection team to report the suspected outbreak.
  • If the local PHE health protection team declares an outbreak, Dr Mandavia will assist with identifying contacts.

This policy will be made visible in patient waiting areas and provided to patients via email.

Please contact our COVID-19 Lead, Dr Rishi Mandavia: rishi@drtatiana.co.uk if you have any questions.

Appendix 1:

Triage questions for bookings team:

The following questions are asked to all patients for a face-to-face appointment. In the event of any of the below being confirmed, patients will be requested not to come to clinic for their safety.

  • Are you currently suspected of having COVID-19?
  • Have you been in contact with or are living with someone suspected or confirmed of having COVID-19?
  • Have you experienced any of the following symptoms in the last 10 days: fever, shortness of breath, loss of smell/taste, a new cough, diarrhoea or vomiting?
  • Do you suffer from any of the following: diabetes, cardiovascular disease, including hypertension, chronic lung disease, immunodeficiency, undergoing active treatment for cancer?
  • Are you pregnant?
  • Are you over 70 years of age?

Appendix 2:

How to wear a mask correctly

Staying COVID-19 Secure in 2020