Clinical Services

P_CS_45 Policy for Clients who Do Not Attend (DNA) and No Access Visits

Lincolnshire Community Health Services NHS Trust recognizes that people may choose not to attend appointments, or discontinue contact with the services that are provided for them. In some cases this may not be problematic but there will be occasions when a person’s non attendance is an indicator that there may be a risk to themselves or to others through deterioration in their health. Therefore, any failure of planned contact should be regarded as a potentially serious matter and should lead to an assessment of potential risk. Practitioners using this policy and procedure must have an up to date knowledge of clinical risk assessment, adult and child safeguarding procedures. Evidence from Serious Case Reviews / Domestic Homicide Reviews, both nationally and regionally have featured DNA and NAV as a precursor to serious child/ adult, abuse and death.: The wellbeing of the person is often not known at the point of DNA.This policy applies to adult and 0-19 services within the Trust.



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G_CS_86 Guidelines for self Weighing of Babies and Children

This guideline aims to ensure that the care provided improves outcomes for children and families, specifically to:

  • remove the necessity of over weighing of infants by professionals.


  • enable parents/carers to confidently self-weigh their babies when attending self-weigh sessions where scales are made available and understand growth charts.


  • provide good interaction between families and professionals

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P_CS_08 Resuscitation Policy

It is the aim of Lincolnshire Community Health Services to provide a high quality, consistent and evidence based response from appropriately skilled staff to any sudden collapse, medical emergency or cardiopulmonary arrest within their work environments.


In the context of this document the term resuscitation applies to and includes cardiopulmonary arrest, paediatric and medical emergencies involving life support actions.




LCHS recognises that an effective response to, and the management of a cardiac arrest or medical emergency is a key objective


The Trust will aim to achieve the core standards for Resuscitation,  (Quality Standards for cardiopulmonary resuscitation practice and training, Resuscitation Council, 2013, 2016) :


  • Ensuring effective communication arrangements to summon an appropriate response

  • An early warning system is in place for the recognition of patients at risk of cardiac arrest (Patient Safety First, NPSA, 2009) LCHS uses the National  Early Warning Score.

  • Ensure access to appropriate equipment, including defibrillators / Automated External Defibrillators to ensure defibrillation can be achieved in 3 minutes

  • Provide access to appropriate training and development to ensure the competencies of staff

  • Ensure all training in accordance with Resuscitation Council (UK) Resuscitation Guidelines 2015

  • Ensure staff understand decisions specific to CPR and  Do Not Attempt CPR (DNACPR) policy is in place.

  • Reporting of all Life Support actions using Datix and review of all deaths following cardiac arrest where LCHS staff are present by the Mortality Review Panel.

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G_CS_85 Continence Product Formulary

The products listed in this formulary have been selected by the Continence Formulary working Party, Lincolnshire Community Services NHS Trust, Lincolnshire localities only.  Judgement was based on expert opinion and evidence of clinical and cost-effectiveness.

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G_CS_83 SOP for Supervision and Mentoring Employees, Administrating Bowel Management Plans

Bowel management is the regular delivery of a programme of planned interventions designed to pre-emptively achieve effective bowel evacuations at a specific frequency in individuals with central neurological conditions, reducing the impact on quality of life by avoiding faecal incontinence and constipation, minimising associated morbidity and facilitating carer input where required” ( Coggrave, 2012).


Bowel care, including digital rectal interventions can be given by a personal assistant, carer, nurse or other person chosen by or acceptable to the individual. A care-giver provided by a statutory agency or care agency should have received appropriate training, provided by a qualified healthcare practitioner competent in this area of care , and be deemed capable of to meet the individual’s bowel care needs and promote their autonomy. As an employee of a healthcare organisation or agency, the competency of the care giver should be established by the employer and evaluated at regular intervals (CQC 2012); vicarious liability for the employee’s actions then lies with the employer ( Coggrave 2012).

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G_CS_84 SOP for Triaging Continence Assessments by Administration Staff

Historically, continence re-assessments have not been completed by clinical staff within the given time frames due to competing demands on resources, increased demand due to winter pressures and increasing numbers of patients requiring continence products. As a solution to this problem, it has been proposed that a new project using non-clinical staff may address the shortfall in the service. The proposal recommends the installation of a Continence Co-Ordinator role, who will act as a point of contact for patients in receipt of continence products. The role will ensure that there is a timely identification of product failures and effective signposting to the most appropriate healthcare professional; thus preventing moisture lesions. The process aims to signpost the patient to the most appropriate healthcare professional for further care whilst maintaining the accuracy of the Community Nurse Inactive caseload list.

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G_CS_80 - Prompting Patients with Medicines in the Community SOP

The purpose of this standard operating procedure is to implement a co-ordinated and standardised approach toensure that in specific circumstances carers can prompt patients with their medicines safely.

This SOP should be known, understood and followed by all practitioners and staff working within Lincolnshire Community Health Services who assess for and deliver this process.

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G_CS_79 0-19 Team Preceptorship Guidelines

The purpose of this guidance is to ensure that all Health visiting staff and school nursing staff in Lincolnshire Community Health Services NHS Trust (LCHS) understand their role and responsibilities in respect of supporting newly qualified health visitors and school nurses in the preceptorship period.





Preceptorship aims to empower practitioners to develop their knowledge and skills acquired during their formal training to become confident and accountable practitioners.




The Institute of Health Visiting (2015) states ‘Preceptorship helps practitioners to understand coping strategies and build compassionate resilience’




This guidance follows the National Preceptorship Framework for Health Visiting, (Institute of health visiting 2015).




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