Everything your clinicians need to know to manage patients in your practice.
- Spip | What is Spip?
- Spip | Any examples of how Spip can help clinicians?
- Spip | Who can see the information within Spip and Cudos?
- Spip | Messaging, comments and notes
- Spip | How much does a Spip cost?
- Spip | Your Spip and the CQC
- Spip | How was it developed?
- Spip | How do I create a Spip for a practice?
- Spip | How does a GP invite a practice to set up a Spip?
- Spip | We’ve got DXS/Map of Medicine – why do we need Spip?
- Spip | What are the Practice, Staff, Clinician and Editor roles in Spip?
- Spip | What is an ‘Editor’
- Spip | Can’t they just ask the receptionist?
- Practeus | Compatibility and security
- Spip | Who owns the information?
- Spip | Will any 3rd parties be able to see our data?
- Spip | Is it mobile-friendly?
- Spip toolkit | Checklist for home visits
- Spip toolkit | Dictate referral
- Spip toolkit | Pre-arrival checklist
- Spip toolkit | Restock room equipment
Spip | What is Spip?
Spip is NASGP's Standardised Practice Induction Pack. It is a secure online platform that enables a practice team to centrally store and safely display essential information to enable any clinician working in any of its premises to manage patients quickly, effectively and efficiently.
It is not linked to your clinical IT system (EMIS, SystmOne etc) and does not contain any patient-identifiable information, so can be shared with any locums visiting your practice and can be accessed from home and on home visits. Within Spip you will find a centrally updatable directory of services - Cudos.
Spip | Any examples of how Spip can help clinicians?
When it comes to managing a patient in a GP surgery, we need access to one of atleast 200 items of information that are specific to that practice. If we can't recall this from memory, or it's not immediately accessible, retrieving this information can waste precious minutes or even hours of our time, a colleagues time and , most importantly, our patients time and even put a patient's health at risk.
It's those 200 bits of local, practice-based, non-clinical information that Spip enables practices to provide for all clinicians caring for their patients:
- How do I organise an urgent ECG in the middle of a busy surgery?
- What do I tell a patient about how they will be informed of abnormal blood tests?
- Which helicobacter pylori test is used at this practice?
- I've seen a nine year old boy with suspected testicular torsion who needs emergency referral. Which team do I refer him to?
- The local DVT pathway says 'Do a D-dimer test'. How is this done at this practice?
- Where are echocardiograms carried out? How do I request one? What do I tell the patient about the appointment-making process?
- I've requested a chest x-ray on a 68 year old man with a cough. How do I alert his usual GP that he may have a significant diagnosis?
- What's the extension number for main reception?
- Who's the practice's child safeguarding lead?
- I need a foreign language interpreter.
- How do I organise an urgent coil fitting as emergency contraception?
- What's the door access code to the toilet?
Spip contains over 200 similar, simple-yet-essential everyday scenarios.
Spip | Who can see the information within Spip and Cudos?
This all depends on what role the Practice has assigned you.
|Practice||Own & Edit||Own & Edit||View||A single authorised person within the practice who controls and manages Spip and Cudos. Can add and delete contacts in Cudos and content in Spip; can invite anyone to be a Clinician and change the status of Clinician to Editor or Staff. Can also invite and activate Group.|
|Editor||Edit||Edit||View||Same as Clinician; can also add and delete contacts in Cudos as well as in Spip.|
|Staff||View||View||View||Same as Clinician; can also view Cudos.|
|Clinician||View||Hidden||Hidden||Can view all content in Spip that has been authorised for viewing by Practice or Editor. Can not directly view Cudos.|
|network||Dummy||Hidden||Edit||Coming April 2016! Can only be invited by Practice; can add and delete contacts in a separate Network Cudos. Can not view any contents in Spip. By inviting a Network (e.g. a single contact at a CCG or a GP federation) to add and delete contacts in a separate network Cudos; Practice or Editor can choose to also use contacts that have been added by Network.|
Spip | Messaging, comments and notes
Simple, yet powerful
Spip comes with its own messaging, comments and notes system. It's a great way for all members of a practice - including visiting locum GPs - to share local information about service quality.
If you have any unread messages, we'll send you an email at 2pm to let you know, allowing you to go straight to your messaging area.
Comment on this page
All users can comment on any page within any Spip they have access too - advice to colleagues, useful tips etc.
That comment will only be visible on that particular practice's Spip. A copy is sent via the Spip's messaging system, and the Practice can edit the comment.
Leave a personal note
Useful for Clinicians to leave a personal note about that service for themselves. Only the person who made that note can see it.
Unlike 'comments', personal notes will be visible in all other Spips (on that specific page) - but again, visible only to the person who created that note.
Report service issue to Practice
Great for flagging up issues to a Practice about a service, enabling them to collect and escalate these issues further to prevent them happening again.
You must never include any patient-identifiable information in these reports.
Request page update
If you’ve looked something up in Spip but couldn’t find it, or something was out-of-date or wrong, this lets the practice know.
Send internal message
Allows the user to send an internal message to any other user of the practice that they're currently signed in to.
Great for when you don't have a colleague's email.
Spip | How much does a Spip cost?
- Starting August 2016, Practice Manager membership of the NASGP is now free. Spip comes free with that membership.
- Spip has the additional capability to link with any local networks (CCGs, federations, practice hubs etc), for which that network will pay a small monthly charge of no more than £24 for each practice it links to.
- It's also always free to Editors, Clinicians and Staff.
- A Practice will be able to add as many Editors, Clinicians or Staff it needs; although all users have to sign in with an email and a password, they will never have to pay to join the NASGP.
- A Practice can cancel their membership at any time.
- A Practice can ask us to remove all their data at any time, otherwise we will automatically remove all Spip data after one year. A Practice, and therefore all its Clinicians, Staff etc can re-access its Spip at anytime simply by rejoining.
Spip | Your Spip and the CQC
Spip can help with CQC compliance
Spip is 'CQC ready', with a dedicated section to easily categorise, store and display all your necessary policies.
Spip is a great way to demonstrate to the CQC that the right information is available at the right time to all members of your practice team to allow effective implementation of all your practice procedures. So Spip will not only provide you with a 'go to' place for your team to refer to and update information, in creating it, you will also making your CQC compliance less onerous.
See what the CQC has to say about Practice packs.
- Spip allows you to upload, link and add freetext notes for handy summaries and 'soft intelligence' about key practice operational procedures. It is a live, interactive, centrally updatable system designed to be easily searched and navigated.
- Once you’re up and running with Spip you will be able to show the CQC that your Staff and Clinicians need never be more than 3 clicks away from information they need.
- GPs can already access key practice policy information that directly affect them as Clinicians e.g. chaperone policy, complaints procedure, clinical handovers, appointment system and access arrangements, practice prescribing procedures, contamination incidents etc.
Managing risk and quality
Monitoring quality of services
- On every Spip page displayed to your team there is a feedback comment system with a prompt to report any problems with a service at the point of use. This intelligence can be collated by the practice for discussion at internal meetings and/or to be raised with the local commissioners and providers.
Patient communication and reducing risk
- Throughout Spip you are prompted to add detailed information about Safety netting, missing results procedures, delayed referrals etc.
- The aim is for everyone in the team to have this information available quickly so that after every patient contact, it is clear to the patient and the practice what is expected next.
Co-operation with other providers of services
Spip is designed to provide up-to-date information which the Clinician can access at the point of need. You have the option of adding enriched information about each service which would equip the Clinician with
- Awareness of the existence of a service.
- Understanding exactly what the service does; the boundaries of roles and responsibilities between the service and the practice, fostering good team working.
- How to access the service and up-to-date resources to do this e.g. referral forms etc
- What to tell the patient about what to expect next.
- Interactive feedback; ability to leave comments or tips for future Clinicians; ability to report a problem with the service; ability to inform you if service details need updating.
Spip | How was it developed?
15 years ago, locum GP and NASGP chairman, Dr Richard Fieldhouse was named ‘Sessional GP of the Year’ by the Doctor newspaper. The award recognised his development of the inspired GP ‘Practice Pack’, in essence, a one-stop paper portfolio for busy GPs which could be updated with a practice’s key information, such as local referral pathways and vital admin information.
Fast forward to 2015 and the need for such readily accessible, highly localised and practice-specific information, is even more compelling as health care tends to be delivered by an ever-increasing and ever-changing array of services and teams. In the intervening years technology has transformed how such information may be stored, accessed and updated.
So Spip – a secure online platform inspired by the earlier paper version - has taken over two years for Sara Chambers and Richard Fieldhouse to develop. Both are sessional GPs with over 35 years collective experience of having worked in over 150 different GP surgeries throughout their GP careers.
MPS have supported the development of Spip and CQC have helped with advice.
Spip | How do I create a Spip for a practice?
- The person who initially sets up a Spip takes on the lead role, known as 'Practice', is responsible for administrative tasks such as managing other Spip users e.g. controlling who can view and edit Spip.
- Therefore, usually the practice manager is best placed to initially set up a Spip by registering for Practice Manager membership of the NASGP.
- Spip is included free as part of Practice Manager membership.
- You will need an NHS email address ending in
- Once your Spip has been created, you can change your email address to a non-NHS email.
- If you are a locum GP who wants to be involved in creating Spips for practices you work in, you can become a 'Spip Clinician' by registering with the NASGP as an Associate (free) or Full member. Once signed in, you will be able to 'Invite new GP practice' to create a Spip.
- If you are a GP wishing to create a Spip for your own practice, unless you want to take on the administrative tasks of managing Spip users, the best route is to ask your practice manager to register for Practice Manager membership and set you up as a 'Spip Editor'.
Spip | How does a GP invite a practice to set up a Spip?
Spip | We’ve got DXS/Map of Medicine – why do we need Spip?
Think of Spip as the information air traffic control of your GP practice, while services like DXS and Map of Medicine are the different airlines. Information used in GP practices comes from many different internal and external sources, and DXS/Map of Medicine are only one of these, and are generally outside the control of the practice.
Spip is practice-specific, focused on enabling a Clinician at the point of use to run a safe, effective and efficient consultation, or a Staff member referring to up-to-date information about practice processes. This encompasses far more than is contained in a local guideline.
For example, a local guideline may simply state “Arrange urgent ultrasound scan”. Enacting this seemingly simple instruction will actually involve the Clinician having access to lots of bits of information about how your practice works:
- How do I organise an urgent ultrasound in this practice?
- Do I just send a form or do I also have to phone radiology?
- Where are the referral forms?
- How does this practice handle urgent referrals?
- What’s this practice’s policy on informing the patient of the results?
- Is completely controlled by you and is centred around your practice rather than the CCG.
- Does not require an NHS smartcard, and is not integrated into the clinical system. So it can be accessed by any clinician from a smartphone or from home, during visits, and before visiting a practice for locum work for the first time - or any time!
- Uses a standardised format - all practice Spips have exactly the same structure - which is quick and easy to navigate, so you can direct Clinicians to key information about how your practice works and how you link up to local guidelines.
Spip | What are the Practice, Staff, Clinician and Editor roles in Spip?
The Practice is the lead role in Spip. This person will have authority from the practice to create a Spip and an NHS email address. They will usually be a practice manager or another senior member of the practice team.
The Practice is able to
- add and edit items to Spip and Cudos
- manages other users of Spip and Cudos
- Practice can invite or deactivate Clinicians
The Clinician role can view Spip.
Clinicians can be any clinician working in your practice who can benefit from access to Spip e.g. practice-based GPs, locum GPs, nurses etc.
- Practice can invite or deactivate Clinicians
- Practice can invite or deactivate Staff
- Staff can view Spip and Cudos.
- Cudos may contain items that are just for use by your practice staff e.g. building maintenance, IT system support, health and safety protocols. You would not want to display these in Spip but you can make them accessible to your practice staff by setting them up as Staff roles.
- Practice can invite Editors.
- The Editor role can view Spip and Cudos but also add or edit items in Spip or Cudos.
- Editors will usually be established members of your practice team who are entrusted to share their knowledge of practice procedures and services with Clinicians, via Spip, and with Staff via Spip and Cudos e.g. GP partners, medical secretaries, nurse practitioners etc.
- Switch roles
- Practice can switch people between different roles e.g. upgrade a Clinician to an Editor so they can crowdsource their knowledge of services
Spip | What is an ‘Editor’
The owner of a Spip - 'Practice' - can upgrade a Clinician to an Editor.
In addition to everything a Clinician can do, an Editor is also able to populate and edit Spip itself, keeping it up-to-date and relevant.
A Practice can invite as many Clinicians or Staff as it likes to help it 'crowdsource' information.
It's easy to downgrade an Editor back to a Clinician.
Spip | Can’t they just ask the receptionist?
They - being a GP, nurse, locum or new team member - could just ask the receptionist, but
- the receptionist may not know the answer. Often this is the case, and a time-consuming game of "Pass the parcel" ensues, taking up time of multiple staff. This is no bad reflection on anyone in the practice team; it's just there's so much to know and it's always changing, so it is not reasonable to expect the duty admin team to be 'know it alls'.
- it wastes time - not just the person seeking information (often a GP in the middle of a busy surgery), but the receptionists too.
- it undermines the GP-patient relationship: "...if the GP doesn't even know how to refer me to physiotherapy, how do I know she's even made the correct diagnosis? I know, I'll rebook to see another GP!".
Practeus | Compatibility and security
It's hosted on a dedicated server by FastUK in London, using ISO 27001 and ISO 9001. All data during transmission is encrypted and authenticated using AES 128 GCM and uses ECDHE RSA as the key exchange mechanism.
You do not need to download any software.
Like any website, although Practeus will still function using the obsolete Microsoft IE8 browser, we strongly recommend you use a secure, modern browser that runs on a modern operating system. Since Microsoft no longer supports IE8 on Windows XP or Windows 7, any PC that uses IE8 is vulnerable to security breaches.
Spip | Who owns the information?
Spip | Will any 3rd parties be able to see our data?
Spip | Is it mobile-friendly?
It is being designed so that a Clinician can use Spip from a smartphone using wifi or data (3G or 4G), and planning for a full smartphone offline version in 2016.
Using Spip on a smartphone as Practice will be slightly limited to the fact that, as with many smartphones, it's not currently possible to select a document for upload, since the smartphone may not have a document storage facility.
Spip toolkit | Checklist for home visits
Home visits are some of the most complicated activities that GPs do. Away from electronic records, usually after a busy surgery, through traffic, to sick or frail patients, often with multiple problems and anxious carers.
Our template helps you make the whole process go much more smoothly.
And don't forget, your Spip practice pack can be accessed via smartphone too.
Spip toolkit | Dictate referral
These allow clinicians to make a physical record of every consultation that needs referral, reducing the likelihood of a referral going missing.
Spip toolkit | Pre-arrival checklist
To get the most out of your freelance GPs and minimise stress to your practice staff and disruption for patients, it is helpful to have the following in place in time for your GPs to smoothly start their session.
Spip toolkit | Restock room equipment
The best person to let you know when a room needs reequipping is the last person that used it. Print some of these out and pin to each room's notice board.