Drury Surgery Ltd

175 Great South Road
Drury
Phone: 09 294 3005

The Teacher: Dr Peter Coleman and Dr David Shand

"also see Health Point web page Drury Surgery Ltd
Name & address of practice: 
Drury Surgery Ltd. 175 Great South Road Drury. PO Box 19 Drury 2247
Telephone numbers: Phone 09 2943005 Fax 09 2948317
 
Email address:
This address is not available for patients to use. Patients are asked to contact the practice via phone 2943005 fax 2948317 or post PO Box 19 Drury.
Administration to practice manager sneems@drurysurgery.co.nz 
Clinical to nurse’s nurse@drurysurgery.co.nz
 
Practice shareholder director’s owners.
Dr Peter Coleman Dr Judy Goulden Dr David Shand 
 
Practice opened as Drury Surgery May 1985 changed to Drury Surgery Ltd September 2006
 
GP registrar teaching practice from February 2011
 
The Practice 
 
Our practice is situated in Drury. This is about 35 kilometers south of the Auckland Central Business District. Drury is the southern border of Papakura city and lies north of the Franklin District. It is where town meets country. It is flanked by the southern reaches of the Manukau Harbour to the West and farmland to the east with rich and fertile soil. The town has a vibrant industrial zone in Takanini, adequate shopping in the Papakura and Takanini town centers and a 15 minute drive to Manukau City major shopping Centre. Drury also has the added bonus of rural tranquility. The nearby Hunua Ranges have a waterfall and forested walking tracks. It is a convenient drive to beaches at Maraetai, Orere Point, Kawakawa Bay on the Hauraki Gulf and Clarks Beach on the Manukau Harbour.  
Doctors in our practice.
3 Principal GP Owners (FTE 2.5) and 5 locum doctors (FTE 3) and 1 x2 six monthly GP registrars.
Dr Judy Goulden started this practice in 1985 over 20 years ago, and together with her husband, Dr Peter Coleman and Dr David Shand are GP shareholder owners of this practice.
Together David, Peter and Judy have a combined total of over 75 years primary health care experience. They are recognised as high quality health care providers by the public and other healthcare providers.
Peter and Judy have a special interest in sports medicine. Peter was the “Auckland Blues” rugby doctor for many years and Judy was for several years the “NZ Ferns” netball doctor. 
The rest of our team of doctors comprise of Dr Isobella Cheung, Dr Lynnette Ashby, Dr Christine Rushton, Dr Grant Coe and Dr Robyn Chandler.
 
Other health team members: 
Nursing staff.
Margo coordinates our practice nurse team of Rosa, Jill and Michele and Lisa, Jo and Bernie provide casual nurse cover when required. Ange is our practice clinical assistant assist the clinical team with their duties. All of our nurses assist the GPs with minor surgery, patient recalls (including immunizations, chronic care management and diabetes checks), acting as a chaperone, collecting specimens and review of laboratory reports and assisting patients with preventative health care (and information for patients), including blood pressure checks, cardio-vascular and diabetes screening, blood glucose testing, ear syringing, dressings and ACC consultations. Margo is also a qualified cervical smear taker. Our clinical team is wonderfully supported by our reception and administration team.
Reception and administrative staff.
Sue Neems is our Practice Manager and managers the administration and day to day running of the practice.
Kelsi coordinates our reception team of Ruth, Mary, Marilyn and Kathie and Shirley provides casual reception cover. They are very experienced at looking after patient appointments, handling enquiries, taking your payments and dealing with a huge range of administrative issues.
Call any of our receptionists for an appointment on Phone 294 8630
Pauline is our medical typist collating your medical records assisting the doctors with their referral and other typing requirements. 
All of our staff work together closely to ensure that we can provide the best possible primary health services for you. Our doctors, and nurses are qualified and registered medical professionals with the knowledge and skills to provide patient-centered, personal, family, whanau and community orientated comprehensive primary medical care to all of our patients in a professional, friendly and courteous manner. Our practice offers a range of primary health care services by appointment, including:
Standard medical and nursing consultations for any health concerns
Minor surgical procedures 
Dr Grant Coe does vasectomies and has a special interest in plastic surgery seeing referrals from CMDHB under the GPwSI programme
DR Christine Rushton has a special interest in ENT and ORL seeing referrals from CMDHB under the GPwSI programme
IUD and Mirena procedures
Assessment and treatment for minor accidents
Chronic care management
Regular recall for breast examinations, cervical smears, diabetes checks and immunizations
Pregnancy tests and first trimester maternity care
Contraceptive advice, sexually transmitted disease screening and treatment 
6 week new baby check
Well child checks
Insurance medical assessments
Immigration medical assessments
Travel medical checkups and travel immunizations 
Referrals to physiotherapists, specialists and hospital clinics where necessary
Liquid nitrogen for removal of warts and some skin lesions
Characteristics of your practice population.
Family practice covering all age groups, genders, ethnicity, socio-economic status.
As at May 2013 8200 registered Patients plus 900 Casual patients
11% High needs patients determined by either their recorded ethnicity and/or place of residence.
58% Female 42% Male
Highest age group for both Female and Male is the 45-64 yrs followed by 
25-44yrs for both and then 6-14yrs male 15-24yrs females 6-14yrs females and 15-24yrs males
Quality standards 
 
The following statements relate to quality standards in general practice organised according to central concepts of primary care. 
Access and Availability 
Patients are able to obtain timely care and advice appropriate to their needs. 
Appointment times available between 8am - 12.30pm and 1pm – 5pm. 
Standard appointment time is 15 minutes. Doctors sessions are usually four hours or twelve appointments; 3 x 15 minute appointment slots per hour with a 15 minute break for administration and an hour to hour and half break between the morning and afternoon session.
Some appointments a held till the beginning of each day to allow for acute same day appointments. If no appointments are available patients are referred to the nurse to ascertain degree of urgency etc and if need to be seen thru the nurses acutely.
New patients are booked for a 30 minute appointment for their first visit.
Regular Chronic Care Management is booked with the nurse for 15 minutes prior to the doctors 15 minutes.
Smear appointments are available with all doctors and our nurse smear taker.
Minor surgery and Mirena appointments are booked between 30, 45 and 60 minutes depending on procedure.
Normal surgery hours: 8am – 5.30pm Monday – Thursday and 8am – 5pm Friday Outside of these hours our phones are diverted to HML nurse triage service.
Staff are usually onsite between: 7.45am – 6pm Monday – Thursday and 7.45am – 5.30pm
Arrangements for out of hours cover of patients: 
Afterhours calls are diverted to HML nurse triage service.
Drury Surgery Ltd is open from 8am to 5:30pm (Monday to Thursday) and from 8am to 5:00pm on Fridays. 
We are closed all public holidays and every weekend
Medical Emergencies:
For any medical emergency dial the ambulance service on 111
Afterhours all of our calls are diverted to HML nurse triage service or alternatively patients can call
National Health Line: 0800 611 116 for a free after-hours telephone consultation with a registered nurse.
For urgent afterhours accident and medical closest accident and medical clinics are: 
Takanini Care: Phone 299 7670 situated Great South Road Takanini next to BP Express: Clinic hours 8am – 9pm Monday to Friday:  8am – 10pm weekends and public holidays. 
OR Counties Care: Phone 299 9380 situated 175 Great South Road Papakura opposite Roseland’s shopping center: Clinic hours 8am – 8pm Monday to Friday:  8am – 9pm weekends and public holidays. 
OR East Care Accident and Medical: Phone 277 1516 situated at 260 Botany Road they are open 24 hours a day 7 days a week.
How do patients contact a doctor out of hours?
Afterhours calls are diverted to HML nurse triage service.
How do patients get emergency help during the day? For any medical emergency dial the ambulance service on 111 Phone message advises to ring 111 for any medical emergency. 
 
Our phone system has been regularly upgraded. Patients hear a phone menu with option to either select a receptionist for appointment or account enquires or a nurse for medication, results or clinical advice. Each day there is a dedicated phone nurse from the 3 nurses roistered on. If the phone nurse is engaged the calls also ring on the other 2 nurses phones and then if still not picked up will divert to the reception phones. 
When patients arrive they are advised if their doctor is running on time and how many patients are still to be seen prior to their appointment time. If patients arrive after their appointment time they are asked to wait so that the receptionist can check with the doctor if they are still able to be seen or if they need to be rebooked. 
 
Urgent cases: If no appointments are available they will be referred to the nurse for assessment who will determine degree of emergency and if they need to call an ambulance, have a home visit, be seen acutely at our practice or referred to their closest Accident and Medical clinic.
 
Non-urgent cases: If appointments are not available with doctor of choice on the same day they can usually be offered appointment times with another doctor on same day or the following day or alternatively referred to nurses for assessment as above.
 
Patient parking: Parking at the front and the rear of the building with a disabled car park at the front next to the ramp.
 
Staff parking: There are sufficient car parks to enable staff the park in the rear car park. Staff are asked to park in the lower parks to enable patients to have parks closer to the building.
 
Disabled access: Ramp at the front of the building. 
 
How are patients informed about practice fees? Practice leaflet and in waiting room or a laminated copy available at reception. Also advised at time of booking if not booking a standard 15 minute consultation. Terms of trade also on notice board.
 
Continuity 
Arrangements in a practice allow a doctor/patient relationship to develop over time. 
System for appointments - how does this give patients the best opportunity to see the same doctor? The practice leaflet has information on the regular sessions each of the doctor’s works and patients are advised when booking if their doctor of choice is away on leave and who is covering for them.
Co-ordination 
The doctors will co-ordinate the care of the patient both inside and outside the practice  
 
Range of other health and community services in our area to whom we refer in order to improve patient care:
 
ACC, Maternity providers, CMHDB and ADHB all departments and specialties, CMDHB GP scheme referrals for ENT and Plastics, Labtests, DML, Radiology, Primary Options Acute Care, Residential respite, Green Prescriptions, Psychologists, Physiotherapist, Diabetic Nurse, Dietitian and Eye screening Clinics on site for diabetics
 
Meetings held within the practice:
4 – 6 weekly Practice Meetings on alternate Tuesday or Thursday lunch times between February and December. Agenda and minutes for practice meetings are stored in Medtech file.
Separate nursing team and separate reception team meetings as required between practice meetings.
Doctors peer review meetings 4-6 weekly. Minutes for nurse and reception meetings are stored in Medtech file.
Partners meet with our practice manager on the last Tuesday of the month.
 
Roles and responsibilities in relation to the practice staff . 
See practice lines of accountability flow chart. 
Practice manager handles all HR requirements including job descriptions, recruitment, appraisals. Peter or David also are involved in the interview process for new staff. Clinical governance is shared between Dr Peter Coleman and Dr David Shand.
 
List the relevant legislation adhered to in relation to staff employment  
See Healthy Practice website which links to the following Department of labour website.
http://www.ers.dol.govt.nz/law/statutes.html
Copies of legislation
The alphabetical list below covers the main statutes applying to employment relationships. 
All public libraries in New Zealand have copies of current legislation available to read at no cost, and copies of the Acts and Regulations can be ordered online [external link].
The NZ Legislation [external site] website provides free public access to unofficial versions of New Zealand statutes (public, local, and private Acts of Parliament) as well as Statutory Regulations. You can search alphabetically and browse the Act [external site] or Regulations [external site] you want.
Employment-related law online
Employment Relations Act 2000*
Equal Pay Act 1972*
Fair Trading Act 1986
Health and Safety in Employment Act 1992*
Health and Safety in Employment Regulations 1995
Health and Safety in Employment (Asbestos) Regulations 1998
Health and Safety in Employment (Mining Administration) Regulations 1996
Health and Safety in Employment (Mining—Underground) Regulations 1999 
Health and Safety in Employment (Petroleum Exploration and Extraction) Regulations 1999
Health and Safety in Employment (Pipelines) Regulations 1999 
Health and Safety in Employment (Prescribed Matters) Regulations 2003
Health and Safety in Employment (Pipelines) Regulations 1999 Health and Safety in Employment (Prescribed Matters) Regulations 2003
Health and Safety in Employment (Pressure Equipment, Cranes, and Passenger Ropeways) Regulations 1999
Health and Safety in Employment (Rates of Funding Levy) Regulations 1994 
Holidays Act 2003*
Human Rights Act 1993
Industry Training Act 1992
Injury Prevention, Rehabilitation, and Compensation (Accredited Employers Framework) Amendment Notice 2005
Injury Prevention, Rehabilitation & Compensation Act 2001 
Injury Prevention, Rehabilitation, and Compensation (Ancillary Services) Regulations 2002
Injury Prevention, Rehabilitation, and Compensation (Applications to Determine Previous and Subsequent Injury Entitlements) Regulations 2003 
Injury Prevention, Rehabilitation, and Compensation (Code of ACC Claimants' Rights) Notice 2002
Injury Prevention, Rehabilitation, and Compensation (Earners' Levy) Regulations 2008
Injury Prevention, Rehabilitation, and Compensation (Indexation of Maximum Weekly Compensation) Regulations 2004
Injury Prevention, Rehabilitation, and Compensation (Indexation) Regulations 2002
Injury Prevention, Rehabilitation, and Compensation (Interest Rate for Late Payment of Levies) Regulations 2002
Injury Prevention, Rehabilitation, and Compensation (Interim Indexation of Weekly Abatement Amounts) Regulations 2002
Injury Prevention, Rehabilitation, and Compensation (Liability to Pay or Contribute to Cost of Treatment) Regulations 2003 
Injury Prevention, Rehabilitation, and Compensation (Lump Sum and Independence Allowance) Regulations 2002
Injury Prevention, Rehabilitation, and Compensation (Motor Vehicles Levies) Regulations 2008 
Injury Prevention, Rehabilitation, and Compensation (Occupational Diseases) Order 2007
Injury Prevention, Rehabilitation, and Compensation (Public Health Acute Services) Regulations 2002
Injury Prevention, Rehabilitation, and Compensation (Refund Of Fuel Levy) Regulations 2003
Injury Prevention, Rehabilitation, and Compensation (Residual Claims Levy) Regulations 2008 
Injury Prevention, Rehabilitation, and Compensation (Review Costs and Appeals) Regulations 2002
Injury Prevention, Rehabilitation, and Compensation (Work Account Levies) Regulations 2008 
Minimum Wage Act 1983*
Minimum Wage Order 2008
Parental Leave and Employment Protection Act 1987*
Parental Leave and Employment Protection (Rate of Parental Leave Payment) Regulations 2008
Privacy Act 1993
Protected Disclosures Act 2000
State Sector Act 1988
Volunteers Employment Protection Act 1973*
Wages Protection Act 1983*
The following Regulations [external link] are also available online: 
Employment Court Regulations 2000
Employment Relations Authority Regulations 2000
Employment Relations (Code of Good Faith for Public Health Sector) Order 2006
Employment Relations (Prescribed Matters) Regulations 2000
This page was last updated on: 20-Mar-2009 and is current
Consumer participation 
What is the system for dealing with suggestions/complaints? 
Suggestion System 
Purpose: To gather feedback on service and get ideas on improving service.
Policy: A suggestion box is placed in the waiting room. It is checked before every quality group meeting and used to promote quality initiatives.
Complaints. 
Purpose: To enable patients to raise complaints about any aspect of the general medical, nursing or reception services provided by Drury Surgery and know that all such complaints will be handled promptly, fairly, and with emphasis on resolving the issues behind the complaint. 
Policy: Drury Surgery aims to provide high quality primary medical care to the wide range of registered and casual patients who seek medical and nursing care from us. 
Occasionally, patients or their families may feel that some aspect of our service has, for whatever reason, been unsatisfactory. It is an integral part of our service that patients should have the opportunity to make complaints to us about any aspect of the services which we provide. 
It is up to us to look after their primary health care as best we can, within the constraints of general practice and this includes our being receptive to genuine complaints from patients, listening to any concerns raised and doing all we can to resolve the difficulties concerned. 
This policy document outlines the processes which we will follow in enabling patients to raise complaints issues and in the discussion and resolution of such complaints.
Our objective in regard to complaints is to comply with all aspects of Right 10 of the Code of Rights.
Is there a newsletter or similar to patients (please give details)? 
There is a General Practice leaflet which is given to new patients and also a copy is available in the reception area.
 
Equipment 
Medical equipment and resources are appropriate and adequate to ensure comprehensive primary care and resuscitation 
Equity 
The doctor/practice must provide a fair distribution of services in relation to people’s needs 
The following range of services e.g. health promotion and disease prevention initiatives are provided? ProCare Network Manukau Health promotion initiatives including Chronic Care Management for COPD, Diabetes and Depression, CVD risk assessment, Smoking cessation, Primary Options Acute Care. Recalls and screening for smears and mammograms and immunizations and flu vaccinations.
What action is taken to overcome difficulties in communicating with patients whose primary language is not that of the practice medical staff? 
A free interpreter service is available to all general practices via CMDHB, through the 0800 number provided 
(0800 470 0222)
A telephone interpreter is available within minutes (3 way conversation via speaker phone) or 
For face to face interpreters please make a booking if possible.
ProCare Network Manukau Only Vanita Hira 021 576 541 
Telecommunication services for people who are Deaf hearing impaired deaf blind and speech impaired Helpdesk 0800 4 715 715
NZ Relay is NZ's telecommunication service which allows people who are Deaf, Hearing-impaired, deaf blind, or speech-impaired to make and receive phone calls from a standard phone user.
You connect to a Relay Assistant(RA) to complete calls to or from a hearing person. The RA acts as a bridge relaying the entire conversation between you and your caller.
What are the practice’s cultural sensitivity guidelines? In New Zealand, the Health Practitioners Competence Assurance Act 2003 (HPCAA) requires registration authorities to set standards of clinical competence and cultural competence. Go to www.caldresources.org.nz to view a list of the cultural competence standards set by The Medical Council NZ, The Royal NZ College of GPs, Nursing Council of NZ, The Aotearoa NZ Association of Social Workers, etc or go to the website of your professional body to find out more about the standards. Cultural competence refers to an ability to communicate and interact effectively with people of different cultures. Cultural competence comprises four components: cultural awareness, sensitivity, knowledge and skills. 
General Cultural Competency Standards
To work successfully with clients from diverse cultural and linguistic backgrounds the
health and disability workforce needs to demonstrate appropriate attitudes,
awareness, knowledge and skills including (Medical Council of New Zealand, 2006):
Attitudes
1. A willingness to understand your own cultural values and the influence these
have on your interactions with clients.
2. A commitment to the ongoing development of your own cultural awareness
and practices and those of your colleagues and staff.
3. A preparedness not to impose your own values on clients.
4. A willingness to appropriately challenge the cultural bias of individual
colleagues or systemic bias within health care services where this will have a
negative impact on clients.
5. Awareness and knowledge
6. An awareness of the limitations of your knowledge and openness to ongoing
learning and development in partnership with clients.
7. An awareness that general cultural information may not apply to specific
clients and that individual clients should not be thought of as stereotypes.
8. An awareness that cultural factors influence health and illness, including
disease prevalence and response to treatment.
9. A respect for your clients and an understanding of their cultural beliefs, values
and practices.
10. An understanding that clients’ cultural beliefs, values and practices influence
their perceptions of health, illness and disease; their health care practices;
their interactions with medical professionals and the health care system; and
treatment preferences.
11. An understanding that the concept of culture extends beyond ethnicity and
that clients may identify with several cultural groupings.
12. An awareness of the general beliefs, values, behaviours and health practices
of particular cultural groups most often encountered by the practitioner, and
knowledge of how this can be applied in the clinical situation.
Skills
1. The ability to establish a rapport with clients of other cultures.
2. The ability to elicit a client’s cultural issues which might impact on the doctor client
relationship.
3. The ability to recognise when your actions might not be acceptable or might
be offensive to clients.
4. The ability to use cultural information when making a diagnosis.
5. The ability to work with the client’s cultural beliefs, values and practices in
developing a relevant management plan.
6. The ability to include the client’s family in their health care when appropriate.
7. The ability to work cooperatively with others in a client’s culture (both
professionals and other community resource people) where this is desired by
the client and does not conflict with other clinical or ethical requirements.
a. The ability to communicate effectively cross culturally
8. Recognise that the verbal and nonverbal communication styles of clients may
differ from your own and adapt as required.
9. Work effectively with interpreters when required.
10. Seek assistance when necessary to better understand the client’s cultural
needs.
Ethical care 
The care provided by the practice must be ethical: it must observe the principles of respect for patient autonomy, beneficence and non-maleficence and justice in the use of resources  
Are patients interviewed and examined in surroundings designed to ensure privacy?
Doctors have private consultation rooms with curtains around examination bed. Nurses have one private consultation room with curtains around examination bed and the nurses’ station has three treatment areas separated by curtains. Procedures requiring a higher level of privacy should be done in a doctor or nurse consultation room.
What measures are taken to ensure that all communications and records pertaining to patients are treated as confidential?
All staff are aware of patient confidential and have signed a confidential agreement. All Health Information and records shall be gathered, used and stored in accordance with the requirements of the privacy code and any other statutory requirements. 
How would patient consent be gained for educational purposes? Written consent is required this may be included in the patient registration form or on a separate consent form
As a practice team we will ensure that patients are provided with information enabling fully informed consent process.
Procedure: In line with the Health and Disability Code of Consumer’s Rights, the philosophy of Drury Surgery service supports the requirement of all health professionals to ensure that the needs, rights and humanity of all consumers are respected.
When patients have been referred to ( or have self-referred), Drury Surgery's professional medical staff will: 
Encourage rational decision making and self determination 
Use appropriate language 
Exercise their  judgment as to whether the patient has the competency and capacity to understand 
Disclose any risk to the patient 
Ensure the consent is obtained voluntarily, without inducement, force, duress or coercion before the treatment commences.
It is the Policy of Drury Surgery that informed consent must be obtained from the patient for each proposed treatment or procedure without pressure, harassment or coercion.
Copies of written consent will be included in the patient's notes.
Written consent is required for the following circumstances:
(this may be included in the patient registration form or on a separate consent form)
Initial consent to treat will be obtained by Drury Surgery on the admission documentation form and prior to the commencement of treatment. 
Prior to an undergraduate student’s involvement with any assessment, treatment, evaluation of a patient. 
Prior to any patient involvement in research 
The provision of insurance medicals. 
Disclosure of personal information to another party 
Release of notes to another party 
Obtaining previous medical records 
Consent is required to include the patient's personal information in practice activity e.g. screening 
Other situations as agreed to by the practice e.g. invasive procedures
Verbal consent: 
All verbal consent will be recorded 
Patient consent must be obtained prior to any non-service personnel’s involvement with any observation of, assessment, treatment, evaluation of a patient.
This includes other General Practitioners, people on work experience, other health professionals and prospective students.
Ensuring consent
Patients will be kept informed about their treatment, procedures and results 
The risks and benefits of any suggested treatment will be discussed with the patient 
Patients will be told  that interpreters/advocates are available to assist. 
Written information will be available in languages and formats appropriate to the patient population
Background 
There may be routine situations in which obtaining written consent for each individual procedure is inappropriate.  Staff will discuss these situations as they arise.  However Drury Surgery does not support the idea of ‘general consent’, which would permit anything being done without further discussion or approval.
The patient and/or their support person are at any time able to consider their options, access a second opinion, withdraw consent or refuse treatment without prejudice.
If any circumstances arise involving potential contentious issues of informed consent, or if the patient and /or their support person does not consent, then all relevant information must be recorded in the patient's file.
In an extreme emergency or where failure to act or delay in acting will lead to serious consequences treatment should only be that which is necessary to treat the immediate problem.
Fully informed:
an explanation of the condition 
an explanation of the options available (including the option of no treatment) 
assessment of expected risks and side effects 
estimated time until service can be provided 
the results of the tests 
the results of the procedures 
notification of any proposed participation in teaching or research
1.2.02 Informed Consent: 
Policy: 
As a practice team we will ensure that patients are provided with information enabling informed decisions by:
1. Giving an explanation of the condition during the consultation.
2. Providing where possible, the available options - including non -treatment and possible outcomes.
3. Giving an overview of expected risks and side effects of treatment and procedures.
4. Providing up to date, easily understood information:
A variety of pamphlets are available in the waiting and/or consultation rooms
Staff have access to the internet  to download/print  supporting information
5. Giving an estimation of time for completion of service and treatment, wherever possible.
6. Providing access to results and investigations under the written process for the management of reporting of results to the patients, to ensure that messages to patients are consistent and understood by the team. 
Facilitating patient access to results of procedures and specialist opinions.  This is best achieved by offering a photocopy of these reports at the time of consultation and at the patient's request.
7. Informing the patient and gaining consent for any proposed participation in teaching or research.
8. Requesting that the patient read and sign a consent form and, once signed, a hard copy will be kept in the patients file. The patient’s medical record will have a notation stating informed consent gained. Scanning the completed consent form into the patient clinical notes.
Or
9. Patients are provided with a laminated sheet of information to read along with a verbal explanation by the clinician prior to giving their verbal informed consent for a procedure. 
10. Obtaining informed consent for the following is considered best practice and should be obtained, some of these are available as part of the specific process e.g. vaccination
Childhood Vaccination – may be verbal if informed but MOH instruction may specify written consent
Gardasil Vaccination – may be verbal if informed but MOH instruction may specify written consent
Influenza Immunisation– may be verbal if informed but MOH instruction may specify written consent
Ear syringing – laminated sheet
IUCD – Multiload and Mirena - laminated sheet
Surgery ( including Scar Management and Post – Operative Instructions) laminated sheet
Intra-articular cortisone injection - laminated sheet
Cryotheraphy ( Liquid Nitrogen)-   laminated sheet
Practice Policy
All patients MUST be given the pre procedure information to read prior to the ‘verbal consent’ procedures
The clinician MUST check with the patient that they have read and understand the procedure and associated risks
The clinician MUST give the patient an opportunity to ask any further questions
Once all of the above is done, it then can be documented in the notes as “Verbal Informed Consent’ obtained.
Keywords may be useful tool to assist in this process. 
Discussion and Documentation regarding continuous issues screening 
All discussion with patients regarding testing/screening for contentious issues (e.g. HIV in pregnancy, PSA testing, down’s syndrome testing in first, second and third trimesters) must include the following minimum information. 
The risks
side effects,
benefit vs. harm 
potential outcomes
Patients’ should also be provided with supporting information e.g. leaflets, websites as applicable.
The discussion is to be recorded in the patient’s clinical record.  This is done with the use of ‘quick keys/keywords’.
a. .consent  
""Verbal informed consent gained for procedure with the use of laminated information sheet and verbal explanation.""
b. .cont
“Pt advised of risks, side effects, benefits versus harm and potential outcomes. Supporting information offered. "" 
c. Matcon
""I confirm that I have Patient consent for the electronic transfer of the personal and identifying information required for this Maternity claim given 
d. The following contentious consent brochures are in nurses room on the bottom shelf by far door in nurses’ station.
i. Voluntary Counseling and testing for diagnosis of HIV Infection
ii. HIV testing in pregnancy
iii. First Trimester combined screening
iv. Second Trimester maternal serum screening
v. Antenatal Screening for Down Syndrome
vi. Testing for Prostate Cancer
                                                                             
Code of Health and Disability Services Consumers' Rights 1996: www.hdc.org.nz
Consent in Child and Youth Health - Information for Practitioners MOH 1998 www.moh.govt.nz
Braille Translation - RNZ Foundation for the Blind: www.rnzfb.org.nz
Interpreter Availability - Deaf Association: www.deaf.co.nz
Internal Affairs Translation Service: www.dia.govt.nz
 
Evidence based clinical care 
The medical care provided by the GP practice as a whole must reflect current best practice as determined by comparisons with the practice of vocationally registered peers 
Practice audit/review 
Audit or review of activities been carried out in the practice in the last three years:
Annual Procare Health and Safety, Procare Infection Control and Procare Health Information Privacy Audits 
Fire Evacuation Rehearsals six monthly from March 2008 to date
Fellowship Assessment Visit Dr Beverley Howcroft 10 May 2013 candidate Dr Christine Rushton. 
Cold Chain Accreditation 1 March 2013 and 2 April 2009
Autoclave performance requalification compliance 19 Feb 2013; 18 April 2012; 7 April 2011; 20 April 2010; Fellowship Assessment Visit 4 April 2012 candidate Dr Grant Coe. 
MOH PHO agreement Audit 7 Feb 2012 report 16 April 2012. 
RNZCGP Cornerstone assessment. Visit 9 March 2011 achieved Cornerstone accreditation Cycle 1 28 March 2011. Assessment visits for GP registrars Dr Fiona Salies, Dr Rajneesh Sharma, Dr Nicola Coombes, Dr Makarand Orpe and Dr Nagham Hawa between Feb 2011 and May 2013.
Procare Practice Patient Satisfaction Survey November 2010 report January 2011
Fellowship Assessment Visit Dr Viv Tate 26rh August 2009 Report to Candidate Dr Isobella Cheung Member
 
Library 
List reference texts with year of publication that are readily available within the practice 
Now all web based.
 
Nurses keep an up to date supply of written material on various health problems for patient distribution.
 
Nurses provide wellness education which include health management review with dietitian diabetic nurse and retinal eye screening clinics.
Premises 
7 Consulting rooms ( 6 doctor room and 1 nurse room),with phone and internet access, desk with computer chair and 2 consult chairs, a computer and printer. Hand washing facilities with a sink and hot water. Sharp container. Biohazard bin and other rubbish bin. Curtained examination bed, step, and book case.
 
Nurse treatment and work station. 
Nurses’ station with a dual work computer work area and 3 separate curtained consulting areas with beds and chair. In nurses’ area there is an Emergency Bag and also storage cupboards for Medical consumables including dressings, liquid nitrogen and non-dangerous drugs and the Vaccination fridge and sterilization unit. Waste Management bins and sharp containers. 
Phone nurse in server room with computer plus laptop phone and printer. Filing cabinet storing medical and educational information.
 
Reception area.
Reception counter with 2 computer workstations. Free standing work area with shelving for doctor’s mail etc. Three desk workstations for Typist/Scanner, Kelsi administration and Ange Practice clinical assistant all with phone computer internet and printer access. Document destruction bins and copier in the side hallway next to reception.
Practice Managers room. Desk, filing drawers, bookcase, computer, printer and phone. Used for Practice administration and management.
Waiting room. Chairs with arm rests and stacker chairs. Thomas table with a small selection of toys that are rotated weekly. Coffee table with magazines. Radio. Notice board x 2 and pamphlet holder x 2.
 
Staff lunch room. 
Staff room with table and chairs and fridge, microwave, sandwich maker, blender toaster, lockers and separate fridge for lab test samples. Shelving for clean linen and for administration paper work. Rubbish bins.
How are confidentiality and security maintained?
Computer passwords, deadbolt keys and monitored alarm. Patient files in locked storage sheds. All new patients have incoming notes scanned and hard notes destroyed with document destruction firm.
"

Practice opened as Drury Surgery May 1985 changed to Drury Surgery Ltd September 2006

GP registrar teaching practice from February 2011

3 Principal GP Owners (FTE 2.5) and 5 locum doctors (FTE 3) and 1 x2 six monthly GP registrars.

Dr Judy Goulden started this practice in 1985 over 20 years ago, and together with her husband, Dr Peter Coleman and Dr David Shand are GP shareholder owners of this practice.

Together David, Peter and Judy have a combined total of over 75 years primary health care experience. They are recognised as high quality health care providers by the public and other healthcare providers.

Peter and Judy have a special interest in sports medicine. Peter was the “Auckland Blues” rugby doctor for many years and Judy was for several years the “NZ Ferns” netball doctor. 

The Practice

Our practice is situated in Drury. This is about 35 kilometers south of the Auckland Central Business District. Drury is the southern border of Papakura city and lies north of the Franklin District. It is where town meets country. It is flanked by the southern reaches of the Manukau Harbour to the West and farmland to the east with rich and fertile soil. The town has a vibrant industrial zone in Takanini, adequate shopping in the Papakura and Takanini town centers and a 15 minute drive to Manukau City major shopping Centre. Drury also has the added bonus of rural tranquility. The nearby Hunua Ranges have a waterfall and forested walking tracks. It is a convenient drive to beaches at Maraetai, Orere Point, Kawakawa Bay on the Hauraki Gulf and Clarks Beach on the Manukau Harbour.  

 ACC, Maternity providers, CMHDB and ADHB all departments and specialties, CMDHB GP scheme referrals for ENT and Plastics, Labtests, DML, Radiology, Primary Options Acute Care, Residential respite, Green Prescriptions, Psychologists, Physiotherapist, Diabetic Nurse, Dietitian and Eye screening Clinics on site for diabetics

Meetings held within the practice:

4 – 6 weekly Practice Meetings on alternate Tuesday or Thursday lunch times between February and December. Agenda and minutes for practice meetings are stored in Medtech file.

Separate nursing team and separate reception team meetings as required between practice meetings.

Doctors peer review meetings 4-6 weekly. Minutes for nurse and reception meetings are stored in Medtech file.

Partners meet with our practice manager on the last Tuesday of the month.

Registrar timetable

8:30-5:30

Profile updated 1 October 2013