Policies and Procedures

Assistance Dogs and Other Animals Policy 

Table of content

1      Introduction

1.1       Policy statement

1.2       Status

2      Guidance

2.1       Requirement

2.2       Definition

2.3       Policy

2.4       Maintaining infection control measures

2.5       Clinicians’ responsibilities

2.6       Non-clinicians’ responsibilities

2.7       Owner’s responsibilities

2.8       Injury sustained from an assistance dog

3      Employees with an assistance dog

3.1       Requests

3.2       Employee’s responsibilities

3.3       Reasonable adjustments

4      Other animals

4.1       Therapy dogs

4.2       Pets

4.3       Visiting animals

4.4       Injury sustained from a non-assistance animal

Annex A – Assistance dog risk assessment

1       Introduction

1.1      Policy statement

This policy predominantly supports those patients and employees who may have the need for an assistance dog but also refers to therapy animals, pets and other animals that may visit Hoveton and Wroxham Medical Practice. Under the Equality Act 2010, assistance dogs, guide dogs, hearing dogs, medical alert dogs and their owners have the same rights to access this organisation as everyone else.

1.2      Status

The organisation aims to design and implement policies and procedures that meet the diverse needs of our service and workforce ensuring that none are placed at a disadvantage over others, in accordance with the Equality Act 2010. Consideration has been given to the impact this policy might have regarding the individual protected characteristics of those to whom it applies.

This document and any procedures contained within it are non-contractual and may be modified or withdrawn at any time.  For the avoidance of doubt, it does not form part of your contract of employment. Furthermore, this document applies to all employees of the organisation and other individuals performing functions in relation to the organisation such as agency workers, locums and contractors.

2       Guidance

2.1    Requirement

Assistance dogs are welcome at this organisation as we are committed to providing services that are equally accessible and responsive to all sections of the community.  This includes assistance dogs in training along with their walker or sponsor.

Other types of animals that are permitted within this organisation are detailed at Section 4.

2.2      Definition

The Equality Act 2010 defines an assistance dog as:

• A dog that has been trained to guide a blind person
• A dog that has been trained to assist a deaf person
• A dog that has been trained by a prescribed charity to assist a disabled person who has a disability that consists of epilepsy or otherwise affects the person’s mobility, manual dexterity, physical co-ordination or ability to lift, carry or otherwise move everyday objects
• A dog of a prescribed category that has been trained to assist a disabled person who has a disability (other than those described above)

Assistance dogs are working dogs that have been rigorously trained by the following associations:

• Guide Dogs for the Blind
• Hearing Dogs for Deaf People
• Support Dogs
• Dogs for the Disabled
• Canine Partners
• Dog A.I.D
• Medical Detection Dogs
• Dogs for Good
• Service Dogs UK
• The Seeing Dogs Alliance
• Veterans with Dogs

Registered assistance dogs are working animals, not pets, and are relied on by their owners for independence. Each charity will have their own agreements outlining the expectations and responsibilities of the owner. They will also regularly monitor the owner and the dog to ensure their expectations are fulfilled. Information about these charities can be found at www.assistancedogs.org.uk.

It is important to note that there is no legal requirement for assistance dogs to have been trained by a charity, or for them to carry specific identification, therefore there is no ‘proof’ that can be requested. Without any identity or any proof of training, it is not possible to confirm whether the animal is a pet or an assistance dog.

Further to this, in healthcare settings, there has been a significant growth in the number of working therapy dogs that help people with physical conditions and also assist with mental wellbeing.

The two main classifications of therapy dog are:

• Animal-assisted therapy (AAT), which is delivered in conjunction with other healthcare professionals, is ordinarily goal directed with the outcomes documented and evaluated
• Animal-assisted activity (AAA) is the term used when a handler brings a dog to the patient/resident for general interaction. These dogs are usually owned by the person who is their handler. This is also termed as being an emotional support animal (ESA) and further information on this can be found here. ESAs are pets that are required for a person’s ongoing mental health treatment or for their hidden disability.

Due to the nature of primary care, therapy dogs are unlikely to be needed within this organisation. Likewise, ESAs do not have the same legal recognition as an assistance dog.

The Equality and Human Rights Commission provides useful guidance on the legal standing and how businesses should comply with the Equality Act 2010.

2.3      Policy

Assistance dogs are able to enter most areas of this organisation.

A risk assessment has been conducted and it has been deemed that, for infection control purposes, the treatment room area is not permissible for any assistance dog to enter. In these circumstances, the owner will be requested to ensure that alternative arrangements are made for the short period while they are receiving treatment. In these instances, the patient should be advised that it is the organisation’s wish to minimise any separation time from their dog.

A risk assessment template is at Annex A which details all types of visiting animal.

2.4      Maintaining infection control measures

The organisation will pay particular attention to the maintenance of infection control following any animal having been on the premises. If necessary, should there be any animal body fluids that need to be cleared, this should be treated the same as the normal procedure as for human waste. Personal protective equipment should be worn and all surfaces cleaned with the appropriate cleaning solution.

Following attendance by an assistance dog to the organisation, the cleaning staff are to be made aware of any areas that the assistance dog visited. This will enable them to provide a higher level of cleaning to these areas.

2.5 Clinicians’ responsibilities

Physical contact with a dog by clinical staff will be resisted during any consultation or examination.

All clinical staff must ensure good hand washing with soap and water prior to contact with an assistance dog, this will ensure the safety of the dog. All clinical staff must ensure good hand washing with soap and water after any contact with an assistance dog to ensure the safety of other patients.

Clinical staff  and reception staff are to be mindful following any attendance of an assistance dog that they then consider other patients in their surgery list for that session who are potentially adverse clinically to the presence of dogs.

This may include patients who:

• Have an allergy to animals, especially dogs
• Are immunosuppressed
• Have a phobia of dogs
• Another medical reason

2.5 Non-clinicians’ responsibilities

Other staff are to ensure that following any physical contact with the assistance dog they also promote good hand hygiene.

2.6      Owner’s responsibilities

The owner has a responsibility to ensure that their assistance dog is well behaved and supervised throughout the visit.

Additionally, they are to ensure that their dog:

• Is physically fit before visiting the practice. If pets become ill, diagnosis and treatment by a vet must be sought
• Is kept on a lead throughout the visit and is clearly identified as an assistance dog
• Is discouraged from jumping, scratching and licking
• Does not come into contact with open wounds
• Is of an acceptable hygienic standard, i.e., not wet, muddy etc.
• Is exercised and has had its toileting and feeding requirements met
• Has claws trimmed to reduce the risk of scratches
• Is regularly groomed and checked for signs of infection or other illness
• Has received the relevant inoculations and is wormed on a regular basis

2.7      Injury sustained from an assistance dog

Should an animal bite and injure any person, first aid is to be administered and the incident recorded in the accident log. It is recommended that the incident be recorded as a significant event to facilitate learning and prevent future similar incidents.

England only: Should the police become involved, then the Care Quality Commission is to be informed as this is considered a notifiable incident.

3       Employees with an assistance dog

3.1      Requests

Members of staff considering the need to apply for an assistance dog should apply to the Organisation Manager who will seek advice from the occupational health service and a work place assessment is likely to be required.

In addition, any employee who requires an assistance dog will also require a personal emergency evacuation plan (PEEP).

The same principles will apply to any new starting employees.

Prior to any assistance dog arriving with the employee, arrangements will be made with the relevant charity to carry out appropriate training with other organisation staff.

3.2      Employee’s responsibilities

To ensure that day-to-day operational activity is not affected at the organisation, the employee/assistance dog owner will be responsible for the behaviour of the dog at all times.

To ensure that infection prevention and control is being maintained, the employee is to ensure that they clean any mess that the dog may leave or, should this be difficult due to their disability, the employee is then to inform another member of the team to request support.

3.3      Reasonable adjustments

The Organisation Manager will ensure that specific space will be made available for the dog and its bed. Changes to working hours will be considered to allow for short breaks for exercise and toileting purposes.

4       Other animals

4.1      Therapy dogs

The Royal College of Nursing (RCN) document titled Working with Dogs in Health Care Settings discusses therapy dogs and animal assisted intervention and how this supports patients within a healthcare setting. Due to the nature of primary care, it is unlikely that there is any need for therapy dogs although larger multidisciplinary health centres may utilise therapy dogs.

4.2      Pets

This organisation will adhere to the guidance detailed in the RCN’s Working with Dogs in Health Care Settings whereby pets are not permitted into healthcare settings unless in exceptional circumstances. This applies to staff members. However, should a pet be allowed into the organisation, it will be requested that the owner completes a risk assessment (see Annex A) to detail their knowledge and requirements of the pet. This risk assessment is to also confirm if employees have any allergies or phobias to animals.

The owner’s responsibilities remain the same as detailed at Section 2.7.

4.3      Visiting animals

This non-admittance is also to be extended to other pets, such as neighbourhood cats that may simply visit the organisation. Therefore, all animals, except assistance dogs, are not permitted and they are to be discouraged from entering the organisation’s premises.

This matter has been discussed this with the organisation’s insurer.

4.4      Injury sustained from a non-assistance animal

Actions are to be taken as detailed above at Section 2.8.

Should a pet animal injure any person, then recourse is to be taken against the pet owner.

Annex A – Assistance dog risk assessment

CQC has powers under the Health and Social Care Act 2008 to access and use your health information where it is necessary to carry out their functions as a regulator.

This means that inspectors may ask to look at certain records to decide whether we are providing safe, good quality care.

More information about the CQC can be obtained on their website.

If you have a complaint or concern about the service you have received from the doctors or any of the staff working in this GP surgery, please let us know. This includes Primary Care Network staff working as part of our GP surgery. We operate a complaints procedure as part of an NHS system for dealing with complaints. Our complaints system meets national criteria.

How to complain

We hope that most problems can be sorted out easily and quickly when they arise and with the person concerned.

In the first instance please discuss your complaint with the staff member or department lead concerned. Where the issue cannot be resolved at this stage, please contact Mrs Sheila Curtis (Complaints Manager) on 01603 782155 who will try to resolve the issue and offer you further advice on the complaints procedure.

If your problem cannot be resolved at this stage and you wish to make a more formal complaint, please let us know as soon as possible by email to nwicb.hwmc@nhs.net or by letter.

By making your complaint quickly, it is easier for us to establish what happened. If it is not possible to do that, please let us have details of your complaint:

• Within 6 months of the incident that caused the problem; or
• Within 6 months of discovering that you have a problem, provided this is within 12 months of the incident.

Complaints should be addressed to the GP surgery team verbally or in writing to the Practice Manager. Alternatively, you may ask for an appointment with the GP surgery to discuss your concerns. They will explain the complaints procedure to you and make sure your concerns are dealt with promptly. Please be as specific as possible about your complaint.

What we will do

We will acknowledge your complaint within three working days. We will aim to have investigated your complaint within ten working days of the date you raised it with us. We will then offer you an explanation or a meeting with the people involved, if you would like this. When we investigate your complaint, we will aim to:

• Find out what happened and what went wrong.
• Make it possible for you to discuss what happened with those concerned, if you would like this.
• Make sure you receive an apology, where this is appropriate.
• Identify what we can do to make sure the problem does not happen again.

Complaining on behalf of someone else

We take medical confidentiality seriously. If you are complaining on behalf of someone else, we must know that you have their permission to do so. A note signed by the person concerned will be needed unless they are incapable (because of illness) of providing this.

Complaining to NHS England

We hope that you will use our Practice Complaints Procedure if you are unhappy. We believe this will give us the best chance of putting right whatever has gone wrong and an opportunity to improve our GP surgery.

However, if you feel you cannot raise the complaint with us directly, please contact NHS England. You can find more information on how to make a complaint at https://www.england.nhs.uk/contact-us/complaint/complaining-to-nhse/.

Unhappy with the outcome of your complaint?

If you are not happy with the way your complaint has been dealt with by the GP surgery and NHS England and would like to take the matter further, you can contact the Parliamentary and Health Service Ombudsman (PHSO). The PHSO makes final decisions on unresolved complaints about the NHS in England. It is an independent service which is free for everyone to use.

To take your complaint to the Ombudsman, visit the Parliamentary and Health Service Ombudsman website or call 0345 015 4033.

Need help making a complaint?

If you want help making a complaint, Healthwatch Norfolk can help you find independent NHS complaints advocacy services in your area.

Under no circumstances do we share your information with third parties, that are not directly related to a legitimate episode of care within the NHS, without your explicit consent. However, we do understand that it is sometimes necessary for a family member to talk to us on your behalf, if you would like to give us the permission to talk to a nominated person(s), please ask our care navigation team for a consent form.

Your Information

Hoveton & Wroxham Medical Centre takes privacy seriously and we want to provide you with information about your rights, who we share your information with and how we keep it secure.

Please use the links below to find more information about the practice and data protection.

• Transparency
• CCTV
• Telephone Recording
• Case Finding (ECLIPSE)
• Information Sharing Norfolk and Waveney

GDPR Videos

Keeping Records

What We Do With Your Information

How We Keep Your Information Safe

Your Information Rights

Summary Care Record (SCR) is an electronic record which contains information about the medicines you take, allergies you suffer from and any bad reactions to medicines you have had.

Why do I need a Summary Care Record?

Storing information in one place makes it easier for healthcare staff to treat you in an emergency, or when your GP practice is closed. This information could make a difference to how a doctor decides to care for you, for example which medicines they choose to prescribe for you.

Who can see it?

Only healthcare staff involved in your care can see your Summary Care Record.

Do I have to have one?

No, it is not compulsory. If you choose to opt out of the scheme, then you will need to complete a form.

For further information visit the NHS Care records website.

Routine access to a doctor of your choice and the availability of specialist health care at Hoveton & Wroxham Medical Practice is good, but we cannot hope to give all patients the appointment of their choice all the time.

If you require an urgent appointment, we cannot always arrange for you to see a doctor of your choice. All doctors have to respond to emergencies from time to time; so, occasionally, your consultation may be delayed. In such cases, all patients will get the best from our service if they are understanding and thoughtful of the needs of other patients.

Your Responsibilities

We would like you to treat doctors and practice staff with the same level of respect that you expect from them.

The doctors require the receptionists to gather information, please answer them as fully and clearly as possible.

If you cannot keep an appointment please cancel it in good time.

If you change your address and telephone number don’t forget to let us know.

We look forward to enjoying a good working relationship with all of our patients and are committed to achieving this, we would like you to feel the same.

The NHS operate a zero tolerance policy with regard to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons.

Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.