Primary Care - Staff Skill Mix Survey * DRAFT *

Staff Skill Mix Information across Primary Care

SENT ON BEHALF OF ANNABEL CROWE HOUNSLOW CCG

In response to the COVID-19 pandemic CCGs across NWL have been asked to establish the staffing and skill mix across Primary Care in Hounslow to support provision of care over the coming period.

This survey will take 2 minutes to complete and is applicable to all staff groups. Responses will enable the re-deployment of staff where needed in the foreseeable future across Hounslow.

Therefore, we need you to please complete the survey as a matter of urgency.

Please note: responses are per individual (not per practice).

Thank you.

Question Title

* 1. Please provide your practice details and name, as listed below. If you are a locum GP please go to the next question.

Practice Network

Practice Code

Practice Name

Staff Name / Surname

Question Title

* 2. Please enter your staff group

General Practitioner

Registered Nurse

Healthcare Support Worker

Pharmacist

Practice Manager

Administrative Staff

Locum

Other (please specify)

Question Title

* 3. Do you possess a professional registration?

YES

If YES please enter registration number and which professional body

Question Title

* 4. Please provide details of other clinical and non-clinical skills you possess, including other relevant training. (examples: GP/Clinical pharmacist/practice nurses with a special interest, health care assistant skills, data entry, note taking)

Question Title

* 5. Do you belong to a vulnerable / risk group?

YES

If YES, please state which group. (Examples: Age, Immunosupressed, Underlying health conditions, Pregnancy)

Question Title

* 6. Do you live with / care for an individual who belongs to a high risk group or have any dependants?

YES

If YES, please specify

Question Title

* 7. Is your role appropriate for remote working?

YES

Other (please specify)

Question Title

* 8. If you have childcare responsibilities, can you work remotely?

YES

Question Title

* 9. Please state details of what working hours and days that you are available to work.

Working hours

Working days

Question Title

* 10. If you are released from your current role, are you available to work in a Hub setting supporting the management of patients with Long Term Conditions? (Example: Diabetes, CVD, CHD)

YES

If YES, please provide your contact details (e-mail address (as a minimum), telephone number and preferred method of contact). (Note: these contacts will not be shared)

Question Title

* 11. If you are released from your current role, are you willing to work in a Hub setting looking after the health needs of someone who is or could be COVID-19 positive on a rota basis?

NOTE: PPE will be provided to all relevant staff.

YES

If YES, please provide your contact details (e-mail address (as a minimum), telephone number and preferred method of contact). (Note: these contacts will not be shared)

Question Title

* 12. What is your current isolation status?

Not Applicable

Diagnosed

Suspected

Family Member (suspected / diagnosed)

If you ticked any of the last 3 options, please state the date of when you are expected to return to work.

Question Title

* 13. Are you currently affected by any travel restrictions (e.g reliant on public transport)?

YES

If YES, please specify

Primary Care - Staff Skill Mix Survey * DRAFT *

Staff Skill Mix Information across Primary Care

Question Title

* 1. Please provide your practice details and name, as listed below. If you are a locum GP please go to the next question.

Question Title

* 2. Please enter your staff group

Question Title

* 3. Do you possess a professional registration?

Question Title

* 4. Please provide details of other clinical and non-clinical skills you possess, including other relevant training. (examples: GP/Clinical pharmacist/practice nurses with a special interest, health care assistant skills, data entry, note taking)

Question Title

* 5. Do you belong to a vulnerable / risk group?

Question Title

* 6. Do you live with / care for an individual who belongs to a high risk group or have any dependants?

Question Title

* 7. Is your role appropriate for remote working?

Question Title

* 8. If you have childcare responsibilities, can you work remotely?

Question Title

* 9. Please state details of what working hours and days that you are available to work.

Question Title

* 10. If you are released from your current role, are you available to work in a Hub setting supporting the management of patients with Long Term Conditions? (Example: Diabetes, CVD, CHD)

Question Title

* 11. If you are released from your current role, are you willing to work in a Hub setting looking after the health needs of someone who is or could be COVID-19 positive on a rota basis? NOTE: PPE will be provided to all relevant staff.

Question Title

* 12. What is your current isolation status?

Question Title

* 13. Are you currently affected by any travel restrictions (e.g reliant on public transport)?

Question Title

* 14. Please enter your Smartcard Number so that the host practice may sponsor and authorize your access to their SystmOne unit.

* 11. If you are released from your current role, are you willing to work in a Hub setting looking after the health needs of someone who is or could be COVID-19 positive on a rota basis?

NOTE: PPE will be provided to all relevant staff.