Phlebotomy LES

							  East Kent Coastal Teaching Primary Care Trust

  Local Enhanced Service for Phlebotomy

  Service Level Agreement



Contents

    1.   Finance Details
    2.   Signature Sheet
    3.   Service Aims
    4.   Criteria
    5.   Accreditation
    6.   Ongoing Measurement & Evaluation

  Finance Details


This agreement is to cover the 12 months, 1 April 2006-31 March 2007.

On agreeing a service plan with the East Kent Coastal Teaching Primary Care
Trust (PCT) for the 12 months commencing 1 April 2006 practices will receive
a payment of:

Level 1:

         £516.13 per 1,000 patients per annum

                             OR

Level 2:

         £810.00 per 1,000 patients per annum.




Note

This contract may become invalid if the practice opts to close its list


PAYMENT WILL ONLY BE MADE UPON RECEIPT OF PRACTICE
SIGNATURE SHEET




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  Signature Sheet



This document constitutes the agreement between the practice and the PCT
in regards to this local enhanced service.

Please indicate the number of
Blood tests estimated to be
undertaken in 2006/2007



Signature on behalf of the Practice:

Signature                             Name                        Date




Signature on behalf of the PCT:

Signature                             Name                        Date




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  Service Aims



This local enhanced service specification outlines the requirements for
undertaking phlebotomy (blood test investigations) in general practice. The
specification of this service is designed to cover the enhanced aspects of
clinical care of the patient, all of which are beyond the scope of essential
services. No part of the specification by commission, omission or implication
defines or redefines essential or additional services.



The aims of the service are:

The provision of a practice based phlebotomy service encompassing the
majority of blood sampling for investigations and follow up arising from the
management of patients in primary care.




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Criteria



This Local Enhanced Scheme has the following criteria


Direct Service Delivery

Data Collection

Facilities

Staffing

Review/Audit




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    Criteria One: Direct Service Delivery



Level 1:

The service to be available to all patients meeting the following criteria:

             Registered practice patients
             Able to attend surgery premises

Patients who are housebound may be sampled by attached community staff
only when they are already on the caseload/being visited or by visits from the
practice nurse/phlebotomist. Where support is provided for the community
staff (i.e. help with difficult sampling) by the practice, this would be considered
as part of the scheme.

Level 2:

In addition to Level 1, practices must provide:

            Dedicated daily appointments1
            Book-able appointments
            Fasting bloods
            Where an urgent blood is required, the Practice will arrange for the
             collection/delivery of the sample as necessary


    Criteria Two: Data Collection



To maintain adequate records of the service provided, incorporating all known
information relating to any significant events e.g. hospital admissions or
wound infections.

The collection of activity related to the provision of the service including
activity, number of contacts and who provided the service.




1
    This could be at a neighbouring surgery if practices have reached an agreement between themselves.



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  Criteria Three: Facilities


Sampling should take place in an appropriate clinical room:

         i         adequate light and ventilation is required
         ii        an appropriate chair (preferably reclining)
         iii       sink/hand wash facilities
         iv        adequate sharps and clinical waste facilities
         v         oxygen easily available and a selection of airways
         vi        access to patient records – ideally computer terminal available
         vii       telephone or other method of communicating with
                   reception/colleagues in an emergency
         viii      adequate supplies of specimen bottles, needles, vacutainer
                   systems etc should be available
         ix        adequate waiting space for patients both before and after
                   sampling procedure




  Criteria Four: Staffing

Please identify the member(s) of staff who will oversee the phlebotomy
service administration (usually the senior practice nurse).




Please provide names of all members of staff who will be undertaking this
procedure.




Practices are free to provide the service using appropriately trained
clinical/non-clinical staff who are able to demonstrate their competency.
Nursing staff will be expected to have undergone appropriate phlebotomy
training as part of the basic competency for practice nursing and subject to
satisfactory in-house supervision and certification by the senior practice
nurse/GP
Non-clinical staff such as receptionists or health care support workers should
undergo basic training with a recognised course provider prior to commencing
supervised practice. Please provide the relevant documentation which
supports this.


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Staff to be aware and updated in the appropriate container selection and
details of specific test protocols (eg Glucose tolerance testing, drug level
analysis) available



All staff involved must be aware of the practice H &S policy with regard to the
disposal of sharps and contaminated materials and spillage. Please provide a
copy of the relevant protocol on disposal of clinical waste.




All staff involved must be immunised against Hepatitis B and their immune
status recorded every 5 years. Please provide evidence of Hepatitis B sero
conversion for each member of staff undertaking the procedure.




All staff must comply with the policy for the management of needle stick
injuries as it applies to them. Please provide a copy of the practice protocol.




  Accreditation


Any staff involved in the provision of this LES will satisfy at appraisal (and
revalidation if necessary) that they have such continuing clinical experience,
training and competence as is necessary to enable them to contract for the
LES shall be deemed professional qualified to do so.




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  Ongoing Measurement & Evaluation


The volume of samples taken over each quarter should be recorded.

An annual audit of the service should be carried out which could include
difficulty with sampling, re-samples and referrals to senior staff/GPs.




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