Background
The Special Allocation Scheme (SAS) is a GP service for people who have been violent in a healthcare setting.
Face-to-face clinics run every Tuesday afternoon at Bristol Royal Infirmary. Appointments are between 2pm-3:15pm and telephone calls are offered throughout the week.
The patient phone line is open from 8:30am-6:30pm Monday to Friday and there is capacity to leave a message.
The SAS service is a GP led service and does not provide any nurse led services such as dressings. If a dressing is needing reviewed urgently in the out of hours period, please refer the patient to ED.
The Special Allocation scheme update us regularly with a list of patients currently using their services. Patients registered with SAS will have a special note in Cleo detailing this.
We have requested that all practices inform us of patients who have been violent and are in the process of being referred to SAS.
If there are references to a patient being removed from a practice list in the recent past, please enquire further about the reason for this, before requesting a face to face assessment, and discuss with the CC.
SAS Patients in the Out of Hours Period
When managing a case relating to a patient on the SAS scheme, if it is safe and appropriate to do so, please manage the case remotely. If the patient requires face to face assessment in the out of hours period and is not safe to wait until the SAS service opens please advise the patient to attend the nearest ED (not a MIU or UTC) and phone ahead to herald their arrival.
DO NOT BRING SAS PATIENTS INTO AN OUT OF HOURS TREATMENT CENTRE.
SAS Discharge
When a patient is discharged from SAS back to usual GP care, the special note on Cleo will detail this. If a face to face assessment in the out of hours period is required, please treat these patients on a case by case basis and review EMIS to support decision making and consider discussion with the CC.
If the patient requires face-to-face assessment during the OOH period, make the shift manager aware, so they can be seen at a treatment centre where more than one clinician is working. If this is not possible consider assessment in ED.
If this person is verbally aggressive on the phone:
- Give a verbal warning and attempt to de-escalate.
- If the behaviour continues, terminate the call
- Phone the shift manager to make them aware, and so you can be supported
- Submit a learning event, to trigger consideration of a zero-tolerance letter being sent to the patient. Consideration of an additional special note will occur as part of the learning event review.
- If the patient requires face to face assessment, discuss options with the CC
- Consider referring them to ED and phoning ahead to advise of their arrival
The BrisDoc Violence, Aggression and Discrimination Prevention and Reduction Policy has a flow chart on page 15 which details the actions to be taken following an incidence of violence, aggression or discrimination.
Further information can be found on Remedy.