Business continuity plan

This plan sets out the measures we have taken to reduce the possibility of various threats affecting the service we provide and the procedures we will follow to minimise the impact of those threats should they materialise. We consider that the threats that are most likely to affect the services we provide are:

  • Telephone line failure
  • IT systems failure
  • Equipment failure
  • Failure of electricity supply
  • Failure of water supply
  • Strong winds
  • Floods (including frozen pipes)
  • Fire
  • Pandemics

NB: Many of these threats to the business overlap. For example, severe fire damage may also involve disruption to IT and communications. The various sections of this plan should be read together, as necessary, in order to provide a complete solution to a given situation.

Proactive steps

We have taken various proactive steps to reduce the risk of the threats identified above affecting our services:

General steps:

  • This policy is part of the practice website – since it is stored online, it is secure in the event of a localised system failure, disaster or emergency and may be accessed by any team member who is able to connect to the internet.
  • This policy is also printed off and in reception so that it is available for all team members to see.
  • Telephone and email contact details for team members and essential support services (eg dental engineer, IT support, electrician, etc) are stored on the practice mobile telephone as well as the practice computer network and in the practice address book.
  • Every day we print off a paper list of the patients due to visit the practice in the next 24 hours (known as a “day list”); this list contains both names and telephone numbers that allow us to contact people to cancel appointments in the event of an emergency that results in the computer network being inaccessible.
  • The business has buildings, contents, business interruption and practice expenses insurance policies to meet the cost of repairs and other practice overheads where necessary.

Telephone line failure: We have one telephone line at the practice and a practice mobile telephone with VOIP. 1 March 2017 Root Canal Dental Referral Centre 351 Richmond Road East Twickenham TW1 2ER

IT systems failure: We renew IT systems on a regular basis (the complete network was installed in 2017). All IT hardware is protected by antivirus & anti-malware software that automatically updates from the internet. We also employ firewalls to protect our systems from unauthorised access and malicious damage. Our operating systems automatically download and install upgrades to reduce system vulnerabilities. We carry out monthly checks to ensure that important software is up-to-date. We have mirrored hard drives so that if one fails the system will continue to function on the other. Data from the dental software is stored in a secure web based cloud storage. It is also backed up locally every day. We operate an encrypted “cloud” backup system that copies all critical data from the practice to a remote site. We can securely access the dental software from off-site (which includes patient names, appointment times, appointment length and contact details) so that we can contact and reschedule patients in the event of an IT system failure.

Equipment failure: We carry out regular equipment testing and maintenance in accordance with our testing, maintenance and audit schedule in order to reduce the risk of equipment failure. We also renew practice equipment at appropriate intervals. We carry spare parts and even spare equipment (in the stock cupboard, office cabinets).

Failure of electricity supply: There is nothing we can realistically do to guard against a failure in the electricity supply since we are entirely in the hands of the utility company.

Failure of water supply: There is nothing we can realistically do to guard against a failure in our water supply since we are entirely in the hands of the utility company.

Strong winds: The practice is in a reasonably sheltered position. We keep the building well maintained, but otherwise there is little we can do to guard against strong winds.

Flood: External flooding: The practice is in an area where there is a very low likelihood of River or Sea flooding to an estimated Medium flood depth of 0.3m < x <= 1.0m. likely to be seriously affected by external flooding. Data provided by JBA Risk Management indicates no risk of flooding from Surface Water within 25 meter of the property. The property is not located within 250 meters of a body of surface water, such as streams, river, canal, reservoir, lake or pond. Data provided by the Environmental Agency indicates that the property is not within 250 meter of an area that has been flooded in the past. Internal flooding caused by plumbing services: (such as burst pipes) is a more likely problem. In the winter months we leave heating switched on (but at a low setting) during periods where temperatures are likely to fall below zero degrees in order to guard against frozen (and therefore burst) pipes.

Fire: The practice has a comprehensive fire and intruder alarm system. This is linked to a remote monitoring service that will summon the fire brigade in the event of an activation. The fire station is less than a 7-minute drive from the practice premises. We have properly positioned and maintained firefighting equipment and a fire evacuation procedure. We carry out fire drills to practice this. The electrical wiring in the building is fully tested by a qualified electrician every five to seven years. Portable electrical appliances are tested every 12 months. Waste bins are emptied regularly. 1 March 2017 Root Canal Dental Referral Centre 351 Richmond Road East Twickenham TW1 2ER

Pandemic: There is little we can do to prevent or significantly influence a pandemic outbreak of human disease. The practice maintains approximately 1 month’s supplies of essential consumables so that we could continue to operate in the event of supply chain disruption. We keep supplies of face-masks, disposable gloves and alcohol based hand wash as part of our routine infection control.

Reactive Steps

Telephone line failure: If our landlines fail, calls will be automatically be diverted to the practice mobile (no change in telephone number).

IT systems failure: In the event of an IT systems failure, the first point of contact is Dr Nicolai Orsteen, who will attempt to resolve the problem if possible. If they are not available or are unable to resolve the issue, the computer maintenance company should be contacted. Their contact number is XXX. If the issue involves replacing/re-installing or dealing with an issue involving the dental software then the software supplier, Dentally, can be contacted on 020 3542 1600. Data backups can be accessed on the cloud based server and from the “cloud” backup held by Microsoft. We have a cloud based dental software and keep computers off site. These computers will be brought into the practice and the software will be up and running within minutes since the dental software is cloud based.

Equipment failure: The first point of contact is Dr Nicolai Orsteen on 7810 392 798. If he is not available or are unable to resolve the problem, then there are different people to contact, depending on the nature of the equipment:

  • general dental & x-ray equipment: Pars Dental 0208 854 2700
  • autoclaves/compressor: Pars Dental 0208 854 2700
  • other electrical equipment: Pars Dental 0208 854 2700
  • plumbing: Pars Dental 0208 854 2700
  • replacement equipment: Pars Dental 0208 854 2700

If the failure is such that we would be unable to provide an acceptable standard of care, we would contact patients with appointments booked in the near future and rearrange these, as necessary.

Failure of electricity supply: In the event of an electricity supply failure, it would be impossible to provide an acceptable standard of care until supplies are restored. The first action to take is to call EDF to try to establish the reason for the power failure and likely time scale for restoration of supplies. In the event of an interruption likely to last 24 hours or more, we would use the practice mobile (see above) to contact patients with appointments booked in the next 24 hours in order to rearrange their appointments, as necessary. The cloud based dental software allow us to contact patients through accessing the software at a different location. In the event of an interruption that is likely to last over 24 hours, we would contact patients booked for the following day. This would allow us to contact affected patients and rearrange appointments as necessary. Where a patient is in  1 March 2017 Root Canal Dental Referral Centre 351 Richmond Road East Twickenham TW1 2ER need of urgent treatment before supplies are restored, we would contact the practices with whom we have reciprocal holiday cover arrangements Perio and Implant Dental Referral Centre (020 8912 1346) or Richmond Dental Suit (020 3714 3618) and ask them to make arrangements to see the patient concerned.

Failure of water supply: In the event of a water supply failure, it would be impossible to provide an acceptable standard of care until supplies are restored. The first action to take is to call Thames Water on 0800 714 6140 to try to establish the reason for the supply failure and likely time scale for restoration of supplies. We would contact patients with appointments booked in order to rearrange these, as necessary. Where a patient is in need of urgent treatment before supplies are restored, we would contact the practices with whom we have reciprocal holiday cover arrangements Perio and Implant Dental Referral Centre (020 8912 1346) or Richmond Dental Suit (020 3714 3618) and ask them to make arrangements to see the patient concerned.

Strong winds: The most likely consequence of strong winds in our experience is to cause travel disruption as a result of downed trees, road accidents, cancelled trains, etc. This may prevent staff getting to work. If the dentist is unable to reach the practice or not enough staff in total are able to get to the premises to provide an acceptable standard of care then we will rearrange the appointments of patients due to be seen in the next 24 hours (or as necessary). Where a patient is in need of urgent treatment before we can resume normal service, we would contact the practices with whom we have reciprocal holiday cover arrangements Perio and Implant Dental Referral Centre (020 8912 1346) or Richmond Dental Suit (020 3714 3618) and ask them to make arrangements to see the patient concerned.

Flood: Flood damage to the building itself or flooding of such severity as would prevent staff and patients safely accessing the building at all is extremely unlikely. If there were flood damage to the building itself caused by a burst pipe, for example, the action to be taken would depend on the severity of the damage. If it were not possible to provide an acceptable standard of care as the result of flood damage, we would contact patients and rearrange their appointments as necessary. It is the responsibility of the Dr Nicolai Orsteen to arrange repairs. If it is not possible to effect repairs and resume normal service within 14 days, we would contact other practices in the area to see if they had surgery space available to rent. Where a patient is in need of urgent treatment before we can resume normal service, we would contact the practices with whom we have reciprocal holiday cover arrangements Richmond Dental Suit (020 3714 3618) and ask them to make arrangements to see the patient concerned.

Fire: If the building were damaged by fire, the action taken would depend on the severity of the damage. If it were not possible to provide an acceptable standard of care as the result of the damage, we would contact patients and rearrange their appointments as necessary. It is the responsibility of Dr Nicolai Orsteen, to arrange repairs. If it is not possible to effect repairs and resume normal service within 14 days, we would contact other practices in the area to see if they had surgery space available to rent. If the damage were so severe as to require the complete or partial rebuilding of the practice premises (and the attendant long delay), we have two alternative plans. If a patient were in need of urgent treatment before  1 March 2017 Root Canal Dental Referral Centre 351 Richmond Road East Twickenham TW1 2ER we could resume normal service, we would contact the practices with whom we have reciprocal holiday cover arrangements Richmond Dental Suit (020 3714 3618) and ask them to make arrangements to see the patient concerned.

Pandemic: In the event of a pandemic disease outbreak, we will continue to provide services only if it is safe to do so both for our patients and our staff. We will adopt a “stayat-home” policy for team members who report relevant symptoms (eg in the case of flu, this would include fever, cough, headache, sore throat, aching joints and muscles) and a “separation” policy to ensure that infected patients are only treated when this is essential and that, when they are, they are kept away from patients believed to be uninfected (eg infected patients can be seen after the end of normal opening hours). We will also try to prevent visitors attending the practice where they display symptoms (eg infected people accompanying well patients). Face masks may be worn, disposable gloves used and hand hygiene measures introduced outside the surgeries (in addition to our normal infection control procedures). Tissues will be provided in the reception area and a lined bin placed there for their disposal. Alcohol based hand-rub will also be provided at the front desk and visitors will be encouraged to use this. Additional environmental cleaning procedures will be introduced (in particular relating to the reception desk and toilet areas). In the event of a severe or locally intense outbreak it is likely that we would choose to suspend services until the outbreak subsides. This decision is the responsibility of the Dr Nicolai Orsteen. We may, in any event, be ordered to suspend operations under the government’s emergency powers, in the same fashion that schools may be closed and hospitals restricted to emergency services only. We will monitor and follow guidance issued by the government (see www.direct.gov.uk and www.businesslink.gov.uk), the British Dental Association, Department of Health and National Health Service.

Reporting to the CQC

In the event that the practice is unable to continue normal operations, any service
interruption must be reported to the Care Quality Commission. It is the responsibility of Dr Nicolai Orsteen, to notify the CQC.

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