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Help for practice managers

If you've already got an NASGP account, whether as an Associate, NASGP membership or Practice Manager member, login to your NASGP dashboard.

  • Ownership of a Spip is included as part of free NASGP Practice Manager membership.
  • Add unlimited number of GPs, nurses and practice staff to view or edit your Spip.
  • It's completely free to clinicians and staff to view a practice's Spip, assuming you have their authorisation.
  • For secure access you will need to be registered with NASGP as an Associate, but that's free too.
  • GP wishing to set up a Spip? Become a 'Spip Clinician' (register as a free NASGP Associate or become a paying NASGP member) and ask your practice manager to activate you as a 'Spip Editor'. From your NASGP Dashboard (after signing in) you can formally invite your practice manager to set up a Spip.

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.

Step 1 (OPTIONAL*) | Network-Cudos - 4 hours initial setup, 20 minutes/week thereafter

  • Performed by a Network (CCG, federation etc) employee (manager, administrator or clinical lead) who has oversight of where links and documents are published or stored.
  • Accessible to unlimited number of the Network's practices.
  • Arriving Summer 2016.
  • * If Network-Cudos not available, practice can add this information to their own Cudos - 2 to 4 hours initial setup, 10 minutes/week

Step 2 | Practice Cudos - 2 to 4 hours initial setup, 10 minutes/week thereafter

  • ‘Simply’ transferring information from the practice’s address book to their practice's Cudos.
  • Performed by designated practice employee (user assigned as 'Editor' by the practice manager).
  • Unlimited number of practice staff who need to access information in Cudos, such as contacts and practice policies, can be assigned as 'Staff' by the practice manager.

Step 3 | Practice Spip - 2 hours initial setup, 10 minutes/week thereafter

  • Performed by practice manager and/or other experienced manager.
  • Selects which information to display from the Network-Cudos (if available) and practice's own Cudos, and adding other relevant information specific to their practice.

Step 4 | Practice Spip - 1 to 2 hours review, 10 minutes/week collectively thereafter

  • Performed by one or more practice GPs (users assigned as 'Editors' by practice manager).
  • Unlimited number of users who need to access any of this information for the purposes of patient care are assigned by practice manager as 'Clinician'.
  • A well organised and up-to-date Spip says a lot about how your practice supports all clinicians and staff to do their job safely, efficiently and effectively.
  • They'll have more time, and less stress. A survey we carried out in September 2015 about a typical morning surgery revealed that, on average, locum GPs spend 20 minutes, and GP partners 10 minutes, trying to find precisely the sort of information found in Spip.

wordblock - accredited practice pack (1)To help practices recruit, we've produced a Spip logo that we encourage you to include with any correspondence with locums, add to your job adverts, and include on your website etc, to give assurances about the importance of giving clear information to your clinicians.

 

Spip_-_My_AccountClick on the Choose Practice Pack logo (you'll need to sign in if you've not already done so) and select Invite new GP practice.

You can invite as many practices to set up a Spip as you like.

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?

Spip:

  • 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.

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!".
  • 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
    • nhs.net
    • nhs.uk
    • hscni.net
  • 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'.

NASGP's Standardised Practice Information Portal (Spip) allows any practice to present all 200+ items of shared information immediately in front of all its clinicians at the point of patient contact.

Although every GP knows tens of thousands of 'bits' of clinical information that he or she can formulate into a diagnosis and management plan within minutes of seeing a patient, when it comes to managing that patient's condition, they need to have access 200+ 'bits' of very localised non-clinical information about practice processes affecting safe patient management (e.g. managing test results, referrals, handover arrangements, prescribing procedures etc) and how the practice interacts with local resources.

Even for an established senior partner, practice processes, regulatory requirements and other local non-clinical information can change at a frightening pace, so having instant access to this information isn't just a luxury but a central requisite of modern patient management.

It's far safer, and more efficient, to spend two minutes updating information centrally in Spip than having a GP interrupt their surgery for 10 minutes to ask a staff member or another GP.

Now take into consideration the position of a locum GP, who can typically work in around 30 different GP practices every year, where in each of these practices, practically all these 200 'bits' of non-clinical information can be alien to them. By enabling all clinicians caring for your patients to have instant access to your Spip, you'll be empowering them to be better at what they do, and more efficient. No more time wasted having to interrupt the consultation to ask for simple but essential non-clinical information.

Locums may be most at risk of falling into pitfalls created by gaps in information about practice procedures but practice-based GPs and staff may also be prone to errors and misunderstandings. For instance, evidence from Medical Protection suggests that 57% of 107 practices undergoing a Clinical risk self assessment (CRSA) were found to have risky referral systems, often related to lack of understanding of referral protocols by practice staff and clinicians.

  • Improve the quality of admissions and referrals by all clinicians who work in your practice, whether full-time, part-time or an ad-hoc locum basis, by making sure all this information is at their fingertips. Especially useful if you’re taking on a new partner, salaried GP or GP registrar.
  • Increase efficiency by enabling any clinician or staff-member to access any piece of important information about patient management within 3 clicks of a mouse, whether they’re in surgery with a patient, at home or on a visit.
  • Improve patient safety by publishing simple but important practice-specific procedures and safety-netting information for all clinicians and staff to relay to patients.
  • Better value for money from ad-hoc staff and clinicians such as locum GPs and nurses; they can review your Spip before arrival, access it on the day, and they’ll be able to spend more of their time on direct patient care rather than having to bother busy members of staff.
  • Satisfy the CQC that you are publishing essential information to all clinicians and staff who care for patients in your practice.
  • Reduce errors by having this information in one central place that can be updated instantaneously.

 

Network-Cudos (Centralised Updatable Directory of Services) allows any CCG, GP federation, practice hub or a provider to centrally populate its own relational database of records that then seamlessly integrate with any related practice's Spip (Standardised Practice Information Portal).

To set up a Network-Cudos, you'll need to sign up for it here. You'll also then need to invite local practices to share it with, and they will have to accept your invitation.

By having a Network-Cudos, a CCG, GP federation etc can maintain a complete live database of all local organisations, departments, individuals, roles, services, guidelines, pathways and policies. Each of the Network's practices can then choose any of the Network's records to be displayed within its own practice's Spip, and even customise some of the Network's information for practice-specific use.

All of this extra functionality is in addition to a practice's own Cudos and usual Spip.

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.

You can access them all from within your Practeus help section ,or go direct to the page here.

The person who first signed up for the Spip - usually the practice manager, 'Practice' - has full control over the information that appears in their Spip, as well as being able to input information themselves.

Practice, via their Dashboard, will also invite Clinicians to view their practice's Spip, and can also reassign any Clinician to become an Editor.

Editors will usually be members of your practice team who are familiar with your practice procedures and local services e.g. GPs, medical secretaries, practice nurses. An experienced, trusted locum could also be a suitable editor.  Editors can keep Spip up-to-date in the same way as Practice.

Even Clinicians can contribute to your Spip's completeness by leaving comments on any Spip page.

We are working hard to soon develop a group-sharing system which would allow neighbouring practices or a CCG to pool information using a shared 'Network-Cudos'.

This all depends on what role the Practice has assigned you.

RoleSpipCudosGroup’s CudosExplanation
PracticeOwn & EditOwn & EditViewA 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.
EditorEditEditViewSame as Clinician; can also add and delete contacts in Cudos as well as in Spip.
StaffViewViewViewSame as Clinician; can also view Cudos.
ClinicianViewHiddenHiddenCan view all content in Spip that has been authorised for viewing by Practice or Editor. Can not directly view Cudos.
networkDummyHiddenEditComing 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.

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.

Research conducted by the NASGP found that, on average, GP partners spend 20 minutes a day, and locums 40 minutes a day, having to ask someone else for essential information about practice processes or how the practice interacts with other service providers. And then factor in the time of the person they're asking who has been interrupted from their duties. And then the risks of delays, increased work and costs, and lapses in patient care if accurate, up to date information is not available.

And that's just a GP survey. What would a similar survey of practice nurses and the administrative team reveal?

So a couple of minutes adding a practice policy, a useful contact or a care pathway could repeatedly save a clinician, a patient and other members of your practice team many multiples of the time it takes to add it.

Spip can help with CQC compliance so completing Spip could be seen as part of your CQC preparation - but with the added benefit that you'll also be creating a live, easy access, interactive, centrally updateable information portal for all your team to refer to in their daily work.

It is not the intention that one individual will complete Spip all at once.

Some frequently-used or safety-critical items you may wish to add immediately. It's likely that this core of around 20% of the items in Spip will be used 80% of the time, so for a relatively small investment of time - 2-4 hours - you could have a very useful Spip that will already be improving safety, saving precious time and reducing frustration for your over-stretched practice team.

Less commonly used items can be added "on the go" over time by your team of Editors. Some items you may decide never to complete if you feel they are not relevant to your setting.

Arriving Summer 2016 - Network-Cudos

  • This will allow a GP network, such as a CCG, to independently populate a Network-Cudos and make it available to local practices.
  • After accessing a Network-Cudos item e.g. a care pathway, practices can add their own specific information about how that information is implemented in their practice.
  • 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 EditorsClinicians 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.

The entire NASGP website, including Practeus and its associated components LocumDeck and Spip, is 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.

We use the very latest programming language PHP 7.2 with its state-of-the-art speed and security features.

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.

If you're able to, we strongly recommend you upgrade to a modern browser like Google Chrome, IE10, Firefox or Safari to run alongside IE8 if it's still needed for NHS legacy websites.

We are also A-rated for security headers (takes a few seconds to load).

Use a LocumDeck alternative? Use the link above to check that service too.

Sucuri firewall

The entire NASGP website is also protected by a firewall provided by Sucuri, preventing the site from malicious attacks designed to steal data or deny users access to the NASGP website.

Using passwords

The latest advice is to ditch using complex letter/character combinations, and use passphrases instead.

New NIST guidelines recommend using long passphrases instead of seemingly complex passwords. A passphrase is a “memorizsed secret” consisting of a sequence of words or other text used to authenticate their identity. It’s longer than a password for added security, but much easier to learn.

Create unique passphrases you can remember, using whatever characters they want. e.g

  • Honeymoon beach flower ketchup
  • Correct horse battery staple

Locum folders are great, but they can easily get lost, go out of date quickly and it's often difficult to find the relevant information. So now, practices can add all that information to Spip - easy to search, can't get lost, simple to update, and all free as part of Spip!