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National Care Standards: Independent Specialist Clinics
4-14
Your treatment
4 Consent
5 The decision is made, attending for treatment
6 Treatment
7 Preventing infection
8 Staff
9 Clinical effectiveness
10 Your environment
11 Medicines' safety
12 Information held about you and confidentiality
13 Children and young people
14 Expressing your views
Consent
Standard 4
You are able to make an informed choice about whether or not to agree to undergo the treatment offered by the specialist clinic. Your consent to treatment is obtained in line with best practice guidelines and current law.
1 You can be confident that you have received sufficient accurate information to reach a decision.
2 You have enough time to think over whether or not to proceed with the treatment.
3 You do not feel pressurised into making your decision by the clinic staff.
4 You can be confident that your clinician will want to make sure that you take a well-informed decision, with a clear head. So they will ask you not to take any alcohol or drugs which are not prescribed for you before you consent to or undergo your treatment.
5 You are asked by the practitioner carrying out your treatment to sign a consent form only after you have chosen and decided to proceed.
6 You are made aware that you can withdraw from treatment at any time, including after signing the consent form.
7 You can be confident that you will be asked to sign your consent form before the administration of any pre-medication treatment.
8 You know that the consent form includes in writing the procedure to be carried out and that signing the form authorises the named practitioner to perform the agreed treatment or investigation.
9 If you are under 16 years old,
8 you know that the clinic staff are aware of and comply with the law on whether you are able to agree to receive or to refuse the treatment offered to you.
10 If you are over 16 years old
9 and have difficulty in reaching decisions on medical treatment, you know that the clinic staff will take account of current law and best practice guidelines.
11 You know that the named practitioner will only carry out the agreed treatment or investigation and that, except in an emergency, you have the right to specify that other procedures should not be carried out without further discussion and your consent.
12 You can be confident that in the situation of you needing emergency treatment and you are able to give consent, you will be asked to do so, having received an explanation.
13 You can be confident that, in the situation of you needing emergency treatment and being
unable to give consent (for example, collapsed or unconscious), treatment will be given in line with current legislation and best practice.
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The decision is made, attending for treatment
Standard 5
You are made aware of what is going to be involved and you receive safe and effective care and treatment that reflect current best practice.
1 When you arrive and at all times during your stay you are welcomed
and made to feel at ease. You can be confident that the staff will be prepared for you and will take time to put you at your ease. All members of staff looking after you or caring for you will introduce themselves and will know how you want to be addressed.
2 You feel fully prepared for your treatment and have an understanding of your likely needs, which include the following:
details about the clinic, how to find it, when to arrive and where to go;
what to bring for your stay (for example, suitable clothing and current medication);
whether you should avoid eating and drinking;
what to do with your current medication;
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details of any future planned treatment;
written guidance on financial arrangements;
contact information for you and your family;
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an invitation to bring someone with you;
how long your treatment is likely to take;
an indication of how you will feel and what you will be able to do when you leave the clinic, including any support arrangements you may need;
the transport arrangements you will need to make for a safe journey home; and
emergency procedures.
3 You are asked by staff to confirm that all your personal details are correct in a manner which is sensitive to your privacy.
4 You will receive an apology and an explanation if you have to wait beyond the specified appointment time. Options will be discussed with you. Similarly, if you are late for your appointment it may be necessary to make a new appointment for you.
5 You know that your medical history is confirmed by a registered practitioner.
6 You can be confident that if an anaesthetist is going to be involved in your treatment you will be examined by him or her. He or she will discuss the anaesthetic to be used, whether local or general, and explain clearly the risks and side effects.
7 You know that the clinic follows a clear, written policy on the management of resuscitation. This takes account of best practice guidelines, including those from the National Resuscitation Council.
8 You know that clinical staff with resuscitation skills are available at the clinic whenever it is open.
9 If your health is poor and it is possible that resuscitation will be required, you can be confident that your specialist will advise on options for having your treatment performed in a facility where a staffed critical care unit is available.
10 You are made familiar with your environment and its facilities. These will include:
telephone facilities;
toilet and washing facilities;
arrangements for storage of personal medication;
ordering refreshments;
storage of valuables and personal belongings; and
a call system for attracting help or support if you will be alone at any time.
Treatment
Standard 6
You can be confident that your treatment will be carried out in a professional manner, according to the plan agreed by you and your practitioner. You are clear on what to expect during the treatment and on how to care for yourself when you have left the clinic.
1 You can be confident that there is a plan of treatment which details your needs and preferences and how these will be met.
2 You have time to ask questions and are encouraged to be fully involved in all aspects of your treatment. Your practitioner confirms again the reason for your treatment and care and takes time to answer questions on the expectations and likely results of your treatment. Risks involved in your treatment have been noted and documented.
3 You can be confident that you can, at any time in your treatment, have the treatment stopped if it is safe and practicable to do so.
4 Your treatment is carried out to professional standards, when you expect it, and in a manner designed to put you at ease. You are advised of the recovery process and options for the management of any discomfort or pain.
5 You are accompanied to and from the treatment area by an appropriately qualified member of the healthcare team.
6 You can be confident that appropriately qualified staff will look after you throughout your procedure or treatment.
7 You know that, if anything unexpected happens, arrangements are in place for your safe transfer to other facilities.
8 You can be confident that, following treatment, your condition will be closely monitored by appropriately qualified staff and your privacy will be safeguarded.
9 You can be confident that information about your treatment, your recovery and any instructions for your care will be communicated to you both verbally and in writing.
10 You know that your wishes for privacy with visitors and in receiving telephone calls are respected by the clinic and its staff.
Preventing infection
Standard 7
You can be confident that you will be protected from contracting preventable infections while in the clinic.
1 You can be confident that the environment in which you are treated will be clean.
2 You can be confident that the clinic has a comprehensive policy and procedures for the prevention and control of infection, reflecting relevant legislation and professional guidance.
3 You can be confident that all staff are knowledgeable about, and practise, good prevention and control of infection measures. Training in this is part of the induction and ongoing development and training programme for all staff.
4 Whenever possible, you are fully involved with, and understand the need for, procedures designed to prevent and control infection.
5 If you have an infection, you are informed and receive an explanation of what this means to you and your care.
6 You will be encouraged to inform the clinic of any infections you may suffer after your discharge, so that the clinic can take action.
Staff
Standard 8
You can be confident that your care and treatment are provided by staff with suitable qualifications, experience, skills and abilities for the job they are doing.
1 You can be confident that the clinic's recruitment and selection procedures for all staff follow a clear, written policy which complies with all relevant legislation.
2 You can be confident that the clinic checks the qualifications and all necessary records of all staff before they start work, including appropriate Disclosure Scotland checks.
3 You can be confident that the clinic has a procedure in place for checking the registration of professional staff, in line with the requirements of their regulatory bodies.
4 If the clinic has contracting arrangements with a nurse or medical agency, you can be confident that staff will make sure that the agency, where relevant,
13 is registered with the Care Commission and makes all relevant checks on staff provided by it to the clinic.
5 You can be confident that the clinic has rules and regulations for specialists who work there and you can see these.
6 You can be confident that all staff, including temporary staff, receive induction and ongoing training that meets the needs of the staff and the procedures, treatments and services they provide in the clinic.
7 You can be confident that every member of staff has a personal professional development plan which reflects the recommendations of professional and regulatory bodies. This is regularly reviewed and updated by a relevant professional.
8 You can be confident that the clinic supports staff to have the opportunity to take part in training and to update knowledge relevant to their roles. This includes recommended training identified in best practice guidelines and as required by legislation.
9 You can be confident that the clinic has in place supervisory and managerial structures for all staff.
10 You can be confident that mechanisms are in place to help staff to raise concerns (in confidence) about any aspect of service delivery that they feel may harm your care and the care of others or the quality of the service.
Clinical effectiveness
Standard 9
You can be confident that the quality of your care benefits from the regular review of clinical practice within the clinic.
1 You can be confident that there is a process for measuring and reviewing the performance of clinical treatment against best practice guidelines.
2 You know that the process of review leads to changes in practice and improvements in the standard of care delivered.
3 You know that all healthcare staff take part in the process of review and the development of improvements to practice. You can receive information about this.
4 The care and treatment you receive from the clinic reflect the relevant NHS Quality Improvement Scotland standards.
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Your environment
Standard 10
You can be confident that the design, layout and facilities of the clinic will support the safe and effective delivery of your treatment and your care.
1 Your care environment is suitable to your needs, offers you privacy and ensures your comfort.
2 You can find your way about easily.
3 You can be confident that the buildings and services are maintained and reviewed in line with health and safety regulations and any other relevant laws, regulations and best practice guidelines. Where necessary, staff take prompt action to make sure that the care environment continues to be safe.
4 You can be confident that all equipment used is appropriate for your care and treatment. It is installed, checked and serviced according to the manufacturers' instruction manuals, and legal requirements and best practice guidelines.
5 If there is a failure in any major service, you know that the clinic will make sure that you are kept safe.
6 You feel safe and secure during your time in the clinic.
7 You can be confident that the preparation and serving of any food and drink will be in line with current food and hygiene legislation and guidelines.
8 You know that the clinic has arrangements for ensuring your personal safety which include:
security checks on the premises;
a system for monitoring people who may need access to the premises and its facilities;
a system that allows you to summon help when needed;
arrangements for maintaining confidentiality about your presence in the clinic; and
emergency procedures.
9 You have facilities available for keeping your valuables safe whilst in the clinic.
Medicines' safety
Standard 11
In some cases, medication can be an important part of your treatment. You can be confident that your medication will be managed by the clinic during your treatment period and at discharge, to maximise the benefit and minimise the risk of harm from medicines.
1 You can be confident that your medicines are managed within a comprehensive policy for the use and administration of medicines during your treatment period from admission to discharge. The policy is based on current legislation
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2 If you bring medicines to the clinic, you can be confident that they will be stored safely and used, if necessary, only for your treatment. Any unused medicines will be returned to you when you leave or disposed of safely with your agreement.
3 You can be confident that any drugs used or prescribed by the clinic for your treatment, including weight management, are recognised for such treatment and will be provided to you in line with current prescribing and best practice guidance.
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4 You can discuss your medication, its benefits and side effects with your consultant, specialist, the pharmacist or nurse, so that you can make informed choices.
5 You know that any drugs used in the management of obesity are only available on an ongoing basis subject to specific conditions. It is explained to you that you will need to have a regular review of your progress and your drug treatment, and that changes may be needed.
6 Before you leave the clinic, you and (if you want) your family, friend or carer, receive instructions that explain:
how your medication will work;
lifestyle changes you may need to make to make sure that the medications are effective, including those for weight management;
the reasons for taking the medication;
any side effects likely to be experienced, and action to take as necessary; and
any restrictions necessary as a consequence of taking the medication.
7 You know that any pharmacy service provided or used by the clinic is under the control of a registered pharmacist.
8 You can be confident that, when the clinic prescribes medicines as part of your treatment and care, it will provide you with any details about adverse effects and interaction with other medicines you may be prescribed. The clinic will make sure that it provides the same information to your GP or pharmacist. If the clinic cannot share this information with your GP and pharmacist, staff will explain to you any implications for your care. These could include the clinic refusing to proceed.
Information held about you and confidentiality
Standard 12
You can be confident that the clinic will keep an accurate, up-to-date and comprehensive patient care record17of all aspects of your care. This will be available to you and those involved in your care at the clinic.
1 You can be confident that all your personal information will be stored securely. All staff work within current legislative requirements and guidelines in regard to information held about you.
2 You know that only you and the people involved in your care, or agreed by you, have access to information held about you.
3 You can be confident that all staff are aware of the need for ensuring your confidentiality at all times and that they do not disclose any information about you to people not involved in your care.
4 You know that your record is used by appropriate members of your healthcare team to ensure continuity of your care and treatment. It contains up-to-date information recorded by all healthcare professionals about all aspects of your care on each visit to the clinic.
5 You know that your details will not be passed on to any commercial organisation unless you have given your signed permission.
6 You can get an explanation about anything you are unclear about in your record.
7 You, and with your agreement, your GP, receive full and up-to-date results of any tests or investigations carried out on you.
8 You can be confident that, if the clinic closes down, it will have contingency arrangements in place for the safe transfer and storage of records and for any subsequent retrieval, if needed.
Children and young people
Standard 13
You can be confident that children and young people will be looked after in a safe and friendly environment. Their special physical, psychological and social needs will be met by appropriately trained staff in partnership with parents or guardians.
1 You can be confident that all practitioners treating and caring for children and young people are regularly involved in the treatment of children and young people and are appropriately qualified in their care and management.
2 You know that staff are aware of the law on whether children and young people are able to agree or refuse to receive, and understand the consequences of, medical treatment.
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3 You can be confident that the staff looking after children know and implement child protection procedures.
4 You know that children and young people will have the opportunity to be accompanied by a parent or guardian.
5 You can be confident that all staff with access to children have an enhanced disclosure check from Disclosure Scotland before taking up a post at the clinic.
Expressing your views
Standard 14
You can be confident that the clinic will actively seek and welcome any comments on all its services and act upon complaints, so that it can continuously improve its quality of care. If you feel unable to represent yourself, you receive support from a representative of your choice.
1 You are supported in a safe and confidential manner to make known any views (positive or negative) on any aspect of your care.
2 You have access to the clinic's policy for handling any complaint or concerns you may have, which is in a language or format that you can easily understand. It will include the timescales involved and any external options available to you, including complaining directly to the Care Commission or other relevant regulatory body.
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