2023 Updates

In This Section

December 2023

November 2023

October 2023

December 2023

Current Topic	Change
Medical Equipment	Page restructured and edited for clarity. Renamed – previously Medical Equipment Checking
Child Protection	Resources added, pending a full review in 2024.
Medicine Reconciliation	Rewrote sentence on the prescribing clinician being responsible for ensuring the medicine reconciliation is completed for clarity. Added sentence on checking for potential drug interactions to the medicine reconciliation process list.

November 2023

Current Topic	Change
Blood and Body Fluid Exposure	Page restructured for clarity. Lists reworked for better readability.
Sharps Safety	Page restructured and edited for clarity. Section on disposal of sharps reorganised, and drop-down box added.
Staff Health and Immunity	Page restructured and edited for clarity. Staff illness section simplified.
Waste Management	Page updated and reorganised to make it easier to read. Information from waste disposal is now included on this page, and not on a separate page.
Waste Disposal	Page deleted. Information on this page has been moved onto the new Waste Management page.
Child Protection	Ministry of Health\|Manatū Hauora document Recommended Referral Process for GPs: Suspected child abuse and/or neglect, removed following consultation with the Quality Team, who advised that it is due for review.
All topics	Updated any references to the National Immunisation Register (NIR) to the Aotearoa Immunisation Register (AIR).

October 2023

Current Topic	Change
About IPC at our Practice	Minor editing and bulleted lists updated. New section – The Built Environment – added.
Cleaning, Disinfecting, and Sterilising	This page now incorporates autoclave sterilisation. Guidance on this page has been updated to reflect best practice. Drop-down boxes have been added to provide more information, and the sterilisation procedure section has been updated and reorganised to make it easier to follow.
Cleaning the Practice	New paragraph about who cleans the practice. Updated/new sections providing greater detail: Recommendations for different surfaces, cleaning products and equipment, cleaning blood and body fluid spills.
Managing Infectious Patients	Guidance updated to capture all infectious outbreaks, not just COVID-19. Red-stream information reformatted to make it easier for practices to customise.
Notifiable Diseases	Page restructured to improve readability.
Pandemic Response	Page edited for clarity.
Standard Precautions	Page restructured to improve readability.
Cryotherapy, Drugs for Injection, Venepuncture, Wound Care	Pages deleted. Key information moved to Standard Precautions.
Autoclave Sterilising	Page deleted. Information added to the new Cleaning, Disinfecting, and Sterilising page.
Child Protection	Link to the report of concern form has been removed, as the Oranga Tamariki \| Ministry for Children website advises they do not have an online form at present.

September 2023

Current Topic	Change
Health and Safety in Our Practice	Changed health and safety officer back to health and safety coordinator as there have been changes to the Foundation guidance on who a health and safety officer can be. Information on the health and safety officer will be updated soon as this topic is pending review.
Cleaning Specific Items	Page reviewed with input from an Infection Prevention & Control and Quality Advisor. Updated with best-practice guidance and for improved readability.
Drug Misuse	This page has been edited for clarity and to include relevant information from Long-Term Controlled Substances.
Long-Term Controlled Substances	Page and sub pages deleted. Key content from Terminating a prescription for a controlled substance has been distributed onto Drug Misuse. Clinical content (from Urine Drug Screen) is covered in HealthPathways.
Payroll and Rosters	Page removed as we are reducing detailed office procedures which are not required for Foundation, so that we can better focus on compliance and assessment.
Terms of Employment	This information is more appropriate in individual employment agreements, and not needed in GPDocs.

August 2023

Current Topic	Change
Patient Experience	Instructions for completing PES survey removed as we recommend accessing instructions directly from HQSC's website to ensure they are up to date.
Stress and Well-being	Drop-boxes added to Support for staff section, to provide more information about debriefing and traumatic events.
Reimbursement	Edited for clarity. Link to IRD website added.
Practising Certificates	Location of practising certificates removed as no longer necessary to specify.

July 2023

Current Topic	Change
Open Disclosure	New policy states more clearly the practice's responsibilities and references legislation. New process for managing an open disclosure provides step-by-step instructions to follow, with additional guidance for each step in drop-down boxes. Terminology and concepts are introduced from the new National Adverse Events Policy 2023, which must be adopted by July 2024. Initial changes include: Focus changed from being a one-off disclosure of harm to being an ongoing communication. Inclusion of whānau in process. Focus on understanding the patient's experience of harm. Definition of harm broadened to include cultural and spiritual harm. This page will continue to change as more information about the new framework becomes available.
Emergency Response	All pages in this section have been reviewed and updated, and new pages added. Page rewritten and now includes key information from Responding to an Internal Emergency or Community Disaster, which has been removed. A drop-box has been added, describing potential community roles.
Business Continuity	Page rewritten for clarity and to include key information from Contingency Planning, which has been removed. A drop-box containing information about essential services has been added.
Evacuation	Page rewritten to include a drop-box about debriefing for practices who carry out drills, and to incorporate up-to-date links to Fire and Emergency New Zealand. Detailed information regarding specific roles have been removed as these are highly specific, and are part of your evacuation scheme. They can be made available for your assessor outside GPDocs.
Emergency Procedures	New header page linking to emergency procedures pages. Blue boxes containing high-level information have been added to those pages where a rapid response may be required. A link to the Stress and Well-Being page has been added.
Armed Intruders	New version of Armed Robbery. It has been edited for clarity and to provide better links to other relevant pages in the emergency section.
Bomb Threat	Page edited for readability and so that key information is more accessible. Content regarding suspicious mail moved to a separate page.
Earthquake	New version of the Earthquake page. Rapid Structural Assessment has been removed and a new section, Tsunami risk, added.
Extreme Weather	New page giving guidance on what to do in the event of floods, or high winds.
Fire	Page rewritten for clarity, with key information retained.
Lockdown	Page rewritten so that key information is easier to find. Drop-box explaining full and partial lockdown added.
Power Outage	New page containing guidance in the event of a power outage.
Suspicious Mail	New page containing key, updated information from the previous Bomb Threat page. Links to NZ Police guidance added.
Volcanic Activity	New page giving guidance for those in volcanically active areas.
Emergency Roles and Responsibilities	Page deleted. Key information from this page is now included on the Emergency Response and Business Continuity pages.
Responding to an Internal Emergency or Community Disaster	Page deleted. Key information from this page is now included on the Emergency Response page.
Contingency Planning	Page deleted. Contents merged with Business Continuity and Emergency Response pages.
Adverse Events	Note added at the top of the page about the new National Adverse Events Policy 2023, which general practice must adopt by July 2024. This policy will be reviewed and updated once more details of the new framework are available.
Incidents	Note added at the top of the page about the new National Adverse Events Policy 2023, which general practice must adopt by July 2024. This policy will be reviewed and updated once more details of the new framework are available.
Managing and Reporting Incidents	Note added at the top of the page about the new National Adverse Events Policy 2023, which general practice must adopt by July 2024. This procedure will be reviewed and updated once more details of the new framework are available.
Mandatory and Discretionary Reporting	Added information about Te Tari Pūreke to the Firearms holder unfit for licence drop down, including a link to information for health practitioners. Added a paragraph on what constitutes illegal or suspicious drug seeking to the Illegal or suspicious drug seeking drop down.
Screening and Recall	Added links to Newborn Metabolic Screening Programme and Universal Newborn Screening Programme.

June 2023

Current Topic	Change
Blood or Body Fluid Exposure	Removed sentence advising application of povidone-iodine (Betadine) or isopropyl alcohol to injury sites removed, pending review from a infection prevention advisor.
Urgent Care	This page is for Urgent Care practices only. The page has been reviewed and restructured to reflect the requirements in each of the four sections of the Urgent Care Standard, and to improve readability.
Staff and Family Enrolment	Guidance from the MCNZ added, so that all practices acknowledge the risks of treating staff/friends/family. A new section on treating staff or people close to you includes a list of guidance points about mitigating risk.
Ending an Enrolment	This page has been revised to include up-to-date terminology and appropriate guidance for ending an enrolment.
Medical Emergency Drills	This page has been updated and edited to provide more information and to improve readability. Drop-boxes have been added to provide extra detail about preparing for a drill, running scenarios, and gathering feedback
Medical Emergencies	This page has been updated to provide improved guidance for dealing with medical emergencies.
Leave	This page has been rewritten to have separate sections on legal leave entitlements and how staff can apply for leave. Drop-boxes on different types of leave have been replaced with links to Employment New Zealand, who provide detail on standard New Zealand leave entitlements.
Standing Orders	Following feedback, page was rewritten and restructured to make key information more easy to locate.
Foundation Training	Added link to Health & Disability Commissioner online learning modules for indicator 1 training. Added link to to LearnOnline Compliance with Te Tiriti o Waitangi learning module for indicator 3 training.
Informed Consent	Removed all informed consent forms following guidance that most practices access these directly from the PMS outbox. We will no longer be hosting these documents.

May 2023

Current Topic	Change
Induction and Orientation	Use of HealthPathways added to induction checklists for clinical team and locums. It is best practice to ensure all clinicians are aware of how to access the local, evidence-based guidance in HealthPathways. This is particularly the case for locums and clinicians new to New Zealand, who may not be familiar with HealthPathways or know how to access it.
Complaints	Sentence added about ensuring staff involved in a complaint have access to support. Sentence added saying that the practice encourages staff involved in a serious complaint to seek advice from their professional body. More links to related policies added: Stress and Well-being, Clinical Governance, and Patient Rights.
Complaints Procedure	Additional details added to make the procedure easier to follow. New step added: Try to resolve the complaint. This information was previously included in step 1. Drop-box added to detail when you need to inform PHO about a complaint.
Triage	Triage for Urgent Care practices has been reviewed and edited to ensure it aligns with the NZ Urgent Care Standard. The layout of the page now reflects the generic Triage page, but with more information relating to urgent care. Triage for all other practices now combines Triage and Triage Protocol. The sections "If a patient is in obvious distress" and "Observing patients and wait times" have been combined into one section about monitoring waiting patients and wait times. A short section regarding training non-clinical staff for the annual clinical emergency drill has been added.
Triage Protocol	Page removed. Combined with Triage.
Child Protection	Page undergoing review in consultation with Safeguarding Children. Note that this policy will continue to evolve as we go through the review process. Additional legislation added to policy section. New section: Allegations against staff members. Practices can tell us who they would report allegations against staff members to, and who they would report to if the allegation involved that person. New resource from Child Matters listing indicators of child abuse. Expanded guidance about how to respond to disclosures. Link to Report of Concern form added.
Clinical Records	Renamed following feedback, and to prevent confusion with the newly named New Patient Records.
New Patient Records	Renamed following feedback, previously was called Receiving Patient Records.
Electronic Communication	This page has been updated to better outline regulations and guidelines for communicating electronically with patients. Previously called Texting Patients.
Foundation Training	Open Disclosure LearnOnline training course removed as no longer available. We are not currently aware of any other course, this page will be updated when one is available.
Open Disclosure	Added harm and near miss to the policy statement about open disclosure. Added that the meeting with a patient should be face to face if possible. Amended information about inviting the patient to talk about their experience to make it easier to follow.
Repeat Prescriptions	New sentence added to make it clear that repeat prescription request may be authorised by either the original prescriber or another prescriber at the practice. Sentence about psychotropics and benzodiazepines removed – practices who want to add information about specific medications should add this to their Repeat Prescribing Guidelines document. Policy statement about equitable access to medications updated to include specific measures to increase adherence for groups at risk of inequities, such as Māori. Practices can amend this sentence, however it is a requirement for Foundation indicator 9.1. We are still identifying the best way to include this information in the policy, and it may be updated further as our understanding increases. Step in the repeat prescribing procedure about setting a reminder to follow up with Māori in six weeks removed. Replaced with optional sentence about setting a reminder for patients at risk of non collection or non adherence.
Mandatory and Discretionary Reporting	Following feedback, changed the link for reporting Sexual misconduct the registrars of the responsible authorities. Added a link to a Ministry of Health list of registrars anywhere where reporting to the registrar of responsible authorities is recommended, and a link to the Ministry of Health's information on contacting the medical officer for each district. Added links to information on the Nursing Council of New Zealand site to the Dismissal or resignation due to incompetence, Health Practitioner unable to perform or incompetent, and the Sexual misconduct drop downs.

April 2023

Current Topic	Change
Receiving Patient Records	This page is a new version of Newly Received Patient Records, with a clearer focus on incoming patient records. The new page incorporates information on requesting patient records, from the Transferring Patient Records page.
Transferring Patient Records	New version of Transferring Patient Records, with a clearer focus on outgoing patient records. Information on requesting patient records has been moved to the Receiving Patient Records page.
Bullying, Discrimination, and Harassment	New page combining optional topics Workplace Bullying, and Sexual Harassment. The new page includes discrimination, broadens harassment (including sexual harassment), and contains drop-down boxes with examples for each term. The page describes different ways that staff might deal with bullying, discrimination, or harassment, and provides links to external resources.
Stress and Wellbeing	Page rewritten to focus on the practice's health and safety obligations, and best practice for managing stress and wellbeing. The new page contains a list of items suggesting what you might do to support staff wellbeing.
Mandatory and Discretionary Reporting	Additional mandatory or discretionary reporting requirements now included on this page. Drop-down boxes contain information about each requirement and link to resources for more information. We have used language from the appropriate legislation, e.g. "may report", "must report", etc.
Lone Workers	This is a new page to cover health and safety obligations for staff working alone, either at the practice or during an off-site/home visit. This page replaces the Home Visits and Staff Safety pages, which will be removed at rollout. We will remove the section about off-site/home visits at rollout for practices who don't do this.
Sexual Harassment	Page removed and key information added to the new Bullying, Discrimination and Harassment page.This was an optional topic but you will receive the new page.
Workplace Bullying	Page removed. Key information is being moved to the new Bullying, Discrimination and Harassment page. This was an optional topic but you will receive the new page.
Staff Safety	Page removed and information about staff safety during off-site/home visits is now on the new Lone Workers page. This was an optional topic but you will still receive the new Lone Workers page.
Home Visits	Page replaced by the new Lone Workers page, as part of your Health and Safety policy set. This was an optional topic but you will still receive the new Lone Workers page without the section about off-site/home visits.
Enrolment	Moved the Transferring patient to another clinician at the practice section from the Transferring Patient Records page to the Enrolment page.
Repeat Prescriptions	Altered information about repeat prescribing requests to be only for patients who have been reviewed in 12 months rather than six.

March 2023

Current Topic	Change
Appointments	A new version of this page now combines Arriving Patients, Casual Patients, Late Arrival and DNA, and Patient Fees and Payments. Many of the detailed administration processes have been removed to allow the policy to focus on legislative regulations and compliance. A new Lone Worker policy will be ready by mid-April and will include health and safety information about home and off-site visits. Practices who don't charge fees will be given a different version.
Aggressive People	This new page combines key information from Building and Staff Security, Violent and Abusive Patients, and Trespass Notice, into one more concise page. The new page has been placed into the Health and Safety section.
Arriving Patients	Page removed. Key information has been moved to the new Appointments page.
Building and Staff Security	Page removed. Key Information about building and staff security has been moved to the new Aggressive Patients page. Information about security will be added to a new Lone Workers page.
Casual Patients	Page removed. Information about practice's policy on seeing casual patients has been moved to the new Appointments page.
Late Arrival and DNA	Page removed. Information about late arrivals, cancellations, and no-shows has been added to the Appointments page.
Patient Fees and Payments	Page removed Information about patient fees and payments has been moved to the new Appointments page.
Trespass Notice	Optional page, removed. Information about trespass notices has been moved into the Aggressive People page.
Violent and Abusive Patients	This page has been reworked and replaced by the new Aggressive Patients page, as part of your Health and Safety policy set.
Developing an Equitable Workforce	Gap analysis section wording changed to make it clearer that this is just a framework for thinking about the gaps in the team rather than a formal plan.
Cold Chain Management	Table removed. We are no longer including information in this policy about the location of your cold chain equipment. Removed cold chain responsible staff and resources. This information should already be in your cold chain management policy document that we link to. There is no need to also duplicate it in GPDocs.
Foundation Training	Added a link to the Staff Training Register template to record all staff training for Foundation.
Prescriptions	Updated guidance about repeat prescription audits to "up to 10 patients per prescriber" to align with RNZCGP recommendation.
Complaints	Short section added describing how complaints by/about staff are handled.
Patient Information Privacy	A drop box containing information about checking processes when handling patient information has been added to the section on using patient information. It contains guidance around safe handling of information through emails, during transit, in storage, or when being viewed at the practice.
Managing Infectious Patients	Added separate sections in the Red-stream procedure list for patients who have symptoms when making an appointment, and patients who have symptoms at arrival.
Repeat Prescriptions	Updated best practice recommendations to refer to MIMS medicines information.
Hazardous Substances	Added link to Worksafe and updated the relevant information drop box. This contains Worksafe's guidance around what should be included in the inventory for each hazardous substance.
Te Reo and Tikanga Māori	Renamed from Te Reo and Tikanga in Health Care. Added links to ProCare Ihi app as a resource for Te Ao Māori.

February 2023

Current Topic	Change
Equity Champion	Page deleted as the equity champion information is now on the Achieving Equity page.
Emergency Contact List	Page deleted: Staff contact details should be now included in the Business Continuity Plan. This is personal information and should not be directly in GPDocs.
Practice Meetings	Page deleted: It has been superseded by the Clinical Governance page and is no longer needed. The clinical governance meeting agenda has been moved to the Clinical Governance page.
NEW! Upcoming Changes section	New section to give more transparency to the process of updating policies. Includes: Draft policies that will be rolled out the following month. Comments showing what has been changed and why. Pages scheduled for deletion and an explanation why. Practices should check this section every month so they know what to expect.
Adverse Events	Resource updated to 2023 version of National Adverse Events Reporting Policy 2023.
Foundation Training	Deleted HealthLearn infection prevention and control training as course no longer available. Added two new training courses (South Island only).

January 2023

Current Topic	Change
Resignation	Short section added to this topic, covering exit interviews.
Contingency Planning	Edited for clarity and to improve link with Workload and Staffing page.
Workload and Staffing Levels	Edited for readability. Some extra information about staffing and triage or consulting options added.
Leave	Links added to resources and legislation regarding parental leave.
Foundation Training	Link added – Treaty Resource Centre: Treaty of Waitangi and Cultural Bias training.
Equity Module Training	Link added: LearnOnline: Understanding Bias in Health Care. The same training was already linked to via HQSC, this is an additional link directly to LearnOnline.
Standing Orders	New sentence added for practices using standing orders to state that standing orders are reviewed annually and the authorisation and competency of nurses is checked annually.
Texting Patients	Changed name for consistency.
Controlled Drug Prescriptions (ePrescribing version)	As per legislation change, writing a Controlled Drug Prescription updated to remove requirement to print, sign, and send a hard copy of a controlled drug ePrescription. RNZCGP ePrescribing policy brief moved to top of page to make it more visible, other resources removed as no longer needed now that ePrescribing is widespread.
Medical Equipment	Following review by a Foundation assessor, several pieces of information removed as they are not needed in the policy: Bullets about checking emergency equipment and drugs removed. Sentence about where records of checks are kept removed.
Patient Portal	Following review by a Foundation assessor, Security and Confidentiality section removed as this is already covered by the IT Security policy.
Texting Patients	Page renamed – previously called TXT2Remind or Patient Text Services. Renamed for consistency. Age of patients who need to have texts sent via their parent/guardian's phone changed to "Patients under 16". Previously said 15.
Practice Profile	Link added to RNZCGP practice profile form. This is the form practices fill out and upload to SmartSheet. You can now include this form in GPDocs. Reformatted to improve the appearance of the information. Practices who still had the DHB, Staffing, or Services information have now had this removed. DHBs are now obsolete, and the staffing and services information should go directly on the RNZCGP form instead.
Emergency Supply Kits	Page deleted: It is no longer a requirement to provide emergency kit checklists for Foundation. If you want to retain the checklists, they can be added to your business continuity plan. Email us if you need us to send you a copy of these documents.