Contents
1 Aim
Clinical handover is necessary to ensure safe and seamless continuity of care for inpatients, between medical staff teams, working within and out of hours.
A good handover allows continuity of care, with subsequent medical professionals being exposed to essential information and tasks without dealing with extraneous information.
The trust currently uses an electronic handover procedure using the NHS.net accounts each doctor was supplied with at Induction with the trust. This account provides access to the generic on-call account where handover information is posted and acted upon daily. This also applies to non-training grade doctors working in the first on-call doctor rota.
The aim of standard operating procedure is to provide a clear guidance on the standards required around clinical handover of care via an electronic system.
The effectiveness of e-handover can be evaluated through a yearly clinical audit of system over a reference period.
2 Scope
This standard operating procedure applies to the ward based and on-call doctors, who use this system for clinical handovers, within and out of hours.
E-handover is necessary for the patients requiring ongoing attention, follow-up and, or interventions by doctors working across different times of the day.
Junior doctors will be supervised for this piece of work by their respective clinical supervisors.
3 Link to overarching policy/h2>
This standard operating procedure is overarched by the Information governance policy and management framework (includes data protection policy content).
4 Information and support
Junior doctors will be briefed on the process of e-handover during induction. It will also be checked they have access to the appropriate email addresses and e-handover folders and understand how to use the system. A copy of e-handover presentation given during induction will be provided for future reference.
Junior doctors will be supervised and supported by their clinical supervisors for their day-to-day clinical work related to e-handover. The junior doctors are encouraged to exception report any safety related or urgent issues to do with e-handover on allocate and address them with their clinical or educational supervisor through the review process. E-handover will also be a standing item on the junior doctors’ forum, where procedural or process related issues will be discussed.
5 Procedure or implementation
Ward areas or teams covered by the first on-call doctor rota should send a handover email (even if there is nothing to handover) at the following times:
- daily e-handover from day ward team to on-call doctor (Monday to Friday, before 5pm)
- daily e-handover from on-call doctor to day ward team (Monday to Friday) or next on-call doctor (weekends and bank holidays) before the completion of on-call at 9am
E-handover information should be of the appropriate quality (see below for information on content) but does not replace the need for a verbal handover.
All email correspondence should be sent securely protecting patient identifiable information by using the nhs.net accounts supplied with at Induction with the trust. The information sent should contain the following:
- at least 2 patient identifiers (for example, name, date of birth, NHS number)
- location of patient
- relevant background clinical information
- task or information being handed over
- requesting doctor’s information (name and grade)
5.1 Non nhs.net accounts
A daily on-call email from the medical staffing will advise of any doctors who do not have a nhs.net email account and advise that Egress is to be used to conduct the e-handover.
When sending communications with confidential information such as patient handover notes by a locum doctor who is not a current employee of RDaSH and does not have an NHS.net email, then the Egress secure email facility can be used. When using Egress the on-call locality folder email address must be copied into emails. If both parties are NHS.net emails, then this facility is not necessary as email between those addresses are by default secure.
Please see appendix B for a guide to using Egress.
6 Process evaluation
6.1 Clinical audit
Junior doctors are encouraged to do a clinical audit once a year across three different sites to assess adherence to the prescribed standards. A period of randomly selected two or four consecutive weeks will be chosen for data collection. In the case of any deficiencies in meeting standard a full audit cycle will be completed.
7 Appendices
7.1 Appendix A Electronic handover reporting template
7.2 Appendix B User guide Egress secure email facility
7.2.1 Sending and receiving emails via the Egress secure email facility
When sending communications with confidential information such as patient handover notes for an ad hoc doctor who is not a current employee of RDaSH and does not have an NHS.net email, then the Egress secure email facility can be used. If both parties are NHS emails then this facility is not necessary as email between those addresses are by default secure.
7.2.1.1 For non NHS.net users (Hotmail, Gmail)
Go to a web browser and go to the Egress non NHS web access (opens in new window).
7.2.1.2 For NHS.net users
Go to a web browser and go to the NHS mail large file transfer secure form website (opens in new window).
If you have a valid NHS.net email address, enter your address into the Egress ID field and select sign in. If you entered a valid NHS.net account email, you will be asked to select the “Sign in at NHSmail” option, select it.
You will be taken to the NHS page and asked to sign in to authenticate. Enter your email password and select “Sign In”.
If you have a non NHS.net email account (Hotmail, Gmail), and have not created an Egress account, select the option “New User”, complete the sign-up details and security questions then using the security code you will receive to your email, enter it and authenticate your account.
If you have already signed up for an Egress account, use your existing details to sign in.
7.2.2 Composing emails, users who log in with an NHS.net email address
You will then be taken to a compose email page, add the email address to send to, a subject, email content and attach any file required.
To attach a file, select the “Add Files” option and brown the browser, select the required file to upload to Egress.
The required file will then be attached to the email message.
On selecting “Send” you will be asked to verify that the email is correct. If the details are correct, select “Submit”.
Confirmation of the successful send will then be displayed on screen.
If no more emails are required to be sent, select “Sign Out” at the top of the screen.
7.2.3 Composing emails, users who log in with a non NHS.net email address (hotmail.com)
Go to the Egress NHS web access (opens in new window) and log in with the details of the account you created. This must be the account other users using egress, will be sending emails to.
Select the middle option to compose a secure email.
Compose the email with email address, subject, content and attach a file if required.
When complete select “Send Secure”.
You will then get confirmation the email has been sent securely.
If finished, select “Sign Out” at the top.
7.2.4 Receiving an Egress secure email
When you receive a notification email that an Egress secure email has been sent to you, it will be in a similar format to that shown below.
Select the “Open Secure Files” link which will show the following page.
Select the “Open Online”.
Sign in with your NHS details or personal email if you do not have an NHS.net account (see the above steps for sending a secure email, to create an account if you have not done so already).
Sign in at NHS web page if requested.
You will then be presented with the email, any attached document can be selected and viewed in the web page itself.
Don't
- do not download it to a personal computer as it can be viewed fully online
Don't
- do not download it to a personal computer as it can be viewed fully online as shown
Document control
- Version: 3.1.
- Unique reference number: 293.
- Approved by: Clinical policy review and approval group.
- Date approved: 7 May 2024.
- Name of originator or author: Consultant psychiatrist (intellectual disability).
- Name of responsible individual: Executive director of nursing and allied health professionals.
- Date issued: 23 May 2024.
- Review date: 31 May 2025.
- Target audience: Medical staff employed or working within the trust who use this system for clinical handovers.
- Description of change: Amendment to remove requirement to complete a verbal handover.
Page last reviewed: January 21, 2025
Next review due: January 21, 2026
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