Infection Control Policy

ThanksDoc does not have any registered physical locations for clinical procedures or consultations. ThanksDoc is an online and mobile GP consultation platform. ThanksDoc utilises partner premises to carry out their services. Partner premises include GP surgeries, Pharmacies, Aesthetic clinics. Partner premises are responsible for the appropriate policies for infection control. ThanksDoc doctors are advised to report any locations that are unsuitable, unsafe, poor hygiene. These locations will be removed from the platform until they can evidence implementation of our recommendations . ThanksDoc GPs are responsible for their personal infection control and are advised of these standards on induction.

ThanksDoc believes that adherence to strict guidelines on infection control is of paramount importance in ensuring the safety of both patients and staff. It also believes that good, basic hygiene is the most powerful weapon against infection, particularly with respect to cleaning and handwashing. ThanksDoc will work in collaboration with all local infection control agencies to maintain the highest standards of infection control at all times and ensure that, as far as is reasonably practicable, patients and staff are protected from the spread of infection.

Infection prevention and control (IPC) is the clinical application of microbiology in practice. It is a scientific approach and practical solution designed to prevent harm caused by infection to patients and health workers. It is grounded in infectious diseases, epidemiology, social science and health system strengthening. IPC occupies a unique position in the field of patient safety and quality since it is relevant to health workers and patients at every single health-care encounter.

Legislation

ThanksDoc will adhere to the following legislation.

The Health and Safety at Work, etc Act 1974 and the Public Health Infectious Diseases Regulations 1988, which place a duty on ThanksDoc to prevent the spread of infection.
The Reporting of Incidents, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), which place a duty on ThanksDoc to report outbreaks of certain diseases as well as accidents such as needle-stick incidents.
The Control of Substances Hazardous to Health Regulations 2002 (COSHH), which place a duty on ThanksDoc to ensure that potentially infectious materials within ThanksDoc are identified as hazards and dealt with accordingly.
The Environmental Protection Act 1990, which makes it the responsibility of ThanksDoc to dispose of clinical waste safely.

Guidance

ThanksDoc complies with the following best practice guidance:

The Health and Social Care Act 2008: Code of Practice on the Prevention and Control of Infections and Related Guidance, Department of Health and Social Care
Healthcare-associated Infections: Prevention and Control in Primary and Community Care (Clinical guideline CG139) National Institute for Health and Care Excellence (NICE)
National Infection Prevention and Control Manual for England (NHS England)

Roles

The Registered Manager Dr Linda Odogwu is the infection prevention lead for ThanksDoc

Procedure

ThanksDoc does not have any registered physical locations for clinical procedures or consultations. Thanksdoc utilises partner premises to carry out their services. Partner premises include GP surgeries, Pharmacies, Aesthetic clinics. Partner premises are responsible for the responsible and appropriate policies for infection control.

To work with ThanksDoc, partners must sign a contract to ensure that their premises are suitable for the services being held there. This includes, but is not limited to;

Sharps bin
Clinical waste bin
Hand washing facilities
Alcohol Hand Gel/foam
Toilets that patients and staff/doctors can use in an emergency
Infection control policies

ThanksDoc Doctors will carry the following for infection control measures:

Alcohol gel
PPE
Disposable gloves

Doctors will carry with them equipment to be used on patients. This includes (but not limited to):

Stethoscope
Thermometer
Otoscope
Pulse oximeter
Tendon hammer
Tourniquet
BP monitor

Single use items will be thrown into clinical waste bins provided by the partner locations.

Doctors will work within infection control guidelines if carrying out minimally invasive procedures requiring needles such as vaccinations, infections.

Prior to working on the platform, doctors will provide immunisation records as per CQC regulations.

Needlestick Injury Procedure

IMMEDIATELY:

(a) Make the wound bleed, if possible.

(b) Clean well with copious amounts of soap and running water.

(d) Identify the source of the sharp.

Obtain sufficient information to identify the patient and the member of staff. Take a focused and impartial history to identify risk of HIV, HEP B (HBV) and HEP C (HCV).
If at high risk for HIV start Post Exposure Prophylaxis preferably within an hour, but worthwhile up to 36 hours post-exposure. Find HBV status of “recipient” and consider booster even if good immunity, consider HEP B immunoglobulins – advised from Occupational Health or the Local Emergency Department may be required.
Note the type of injury, depth, gauge of needle, if used for injecting or aspiration, and if hollow bore or blood-stained.
Counsel and consent “donor” to take blood for immediate testing regardless of history.
Counsel and consent “recipient” for bloods to be taken and stored for HIV, HBV and HCV

Appropriate clotted blood specimens from the member of staff involved and the source patient may be requested immediately and in three months’ time, and should be sent with request forms and details of the accident. HIV testing is not routine and will not be undertaken without full counselling.

If immunoglobulin is required the member of staff will be contacted and treated by the Accident and Emergency Unit. Immunoglobulin must be given within 48 hours to be of most benefit.

Spillages of bodily fluids will be reported to the owner of the premises to be dealt with as per their infection control policies. If in doubt, the doctor should prevent access to contaminated areas, and call our on call number (0800 246 5824) for further advice. The priority is to make sure that both themselves, patients and members of the public or other staff are safe and contamination is contained.

Clinical staff in ThanksDoc should ensure that their hands are decontaminated:
1. Immediately before every episode of direct patient contact or care, including aseptic procedures
2. Immediately after every episode of direct patient contact or care
3. Immediately after any exposure to body fluids
4. Immediately after any other activity that could potentially result in hands becoming contaminated, such as after handling specimens, clinical waste or soiled items
5. Immediately after removal of gloves
Hands should preferably be decontaminated with a suitable hand rub except in the following circumstances when liquid soap and water must be used:
1. When hands are visibly soiled or potentially contaminated with body fluids or
2. In clinical situations where there is potential for the spread of alcohol-resistant organisms (such as clostridium difficile or other organisms that cause diarrhoeal illness)
All cuts or abrasions, particularly on the hands, should be covered with waterproof dressings at all times.
In addition to the above, all staff should decontaminate their hands after using the toilet, after blowing their nose and before handling foodstuffs.
All staff have a responsibility to help keep the premises clean and tidy and to identify areas which fall below acceptable or safe standards. Management of the routine cleaning of the location is the responsibility of the partner. ThanksDoc staff have the responsibility to feedback to the infection control lead if a premises is not suitable or poses health and safety risk or infection risk.
Partner staff should treat every spillage of body fluids or body waste as quickly as possible and as potentially infectious. They should wear protective gloves and aprons and use disposable wipes wherever possible. Eye protection should also be used if there is risk of splashing. For a spillage of blood, a 10,000ppm hypochlorite solution should be used. Solid or semi-solid matter (e.g. faeces) in the spillage should be removed first as this can inhibit the disinfectant.
Chlorine releasing disinfectants such as hypochlorite should never be used directly on urine spills as this can release irritant chlorine gas. Urine should be cleaned up using towels and the area cleaned with detergent before applying disinfectant.
ThanksDoc believes that using certain single use, disposable equipment is preferable, wherever practical, to using equipment that requires sterilisation. All equipment that is not disposable should be cleaned after use. Non-risk equipment should be thoroughly cleaned with hot water and detergent.
All clinical waste should be disposed of in sealed yellow plastic sacks. Non-clinical waste should be disposed of in normal black plastic bags. Partner locations will supply these and take responsibility.
It is the responsibility of the GP to provide themselves with all infection control equipment including disposable gloves, aprons, masks etc.
Sharps — typically needles, blades and broken ampoules — should be disposed of in proper, purpose-built sharps disposal containers complying with BS7320. Partner locations will supply these and take responsibility.
The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) obliges ThanksDoc manager to report the outbreak of notifiable diseases to the Health and Safety Executive. Notifiable diseases include: cholera, food poisoning, smallpox, typhus, dysentery, measles, meningitis, mumps, rabies, rubella, tetanus, typhoid fever, viral haemorrhagic fever, hepatitis, whooping cough, leptospirosis, tuberculosis and yellow fever.
In the event of the suspected outbreak of an infectious disease at ThanksDoc, the local public health infection control team should be contacted immediately.
Arrangements will be in place for regularly reviewing the immunisation status of healthcare staff and providing appropriate vaccinations in line with national guidance. Staff should have appropriate immunisation to protect against infection, including blood borne viruses such as hepatitis B and C and HIV. Any member of staff who has a significant occupational exposure to blood or body fluids will be provided with appropriate occupational health support and follow-up.

Covid-19 Infection Prevention and Control

ThanksDoc will take all appropriate measure to ensure that it keeps its staff and patients as safe as possible from the risk of transmission of the Covid-19 coronavirus. It is understood that the principle route of infection is via airborne aerosols and droplets from the exhaled breath of an infected person. Transmission can also occur through touching contaminated surfaces. We understand that some measures are recommended but not enforceable.

ThanksDoc recognises that key measures in Covid-19 infection prevention are advised by the government and include:

Carrying out appropriate risk assessments and keeping these up to date
Careful attention to hand hygiene, including hand washing and the use of alcohol hand rubs and sanitisers
The effective use of personal protective equipment such as disposable aprons and gloves, surgical face masks and respirators, face protection, etc
Enhanced cleaning, especially frequently touched surfaces
The maintenance of social distancing in areas such as reception
Increased ventilation
Requirements for patients and other visitors to thanksdoc to wear face masks when on the premises
Vaccination of staff
Full compliance with covid-19 testing requirements by staff
Full compliance with government self-isolation rules by staff who have symptoms of infection or who have a positive test result
Effective return to work procedures for staff who have completed self-isolation.

In ThanksDoc, all staff must comply fully with the self-isolation recommendations contained within UKHSA guidance:

ThanksDoc will keep up to date with all new Covid-19 guidance, research and best practice. It will maintain close links with local commissioners and with local public health leads/teams and will work to keep its patients and staff informed throughout the pandemic. Business continuity contingency plans will be kept under review to ensure that suitable arrangements are in place to ensure that essential functions can be carried out, for instance, in the event of severe staff shortages caused by the pandemic.

ThanksDoc recommends all staff to be fully vaccinated against Covid-19, including the third “booster” jab.

Blood

Two major potential hazards from blood are contraction of Hepatitis B and C and the HIV virus. The risk of contracting any of these is minimal if the operator does not inject his or her self with the patient’s blood. If the operator has an open wound and spills an infected patient’s blood there is a potential for transmission of one of these infective agents. These risks are mitigated if the staff member wears PPE.

As per the Health and Safety (Sharp Instruments in Healthcare) regulations 2013, all medical sharps used in practice should be a ‘safer sharp.’ These replace any traditional, unprotected medical sharps. Safer sharps are those that incorporate mechanisms to prevent the risk of accidental sharps injuries, or transmission of blood borne viruses. They do so by the use of a shield or cover that pivots to cover the needle after it has been used.

The situation of a patient who is bleeding rarely poses a significant risk to the staff. However, some risk does exist and extra precautions and therefore needed:

Always wear gloves and an apron when dealing with open wounds whether or not they have stopped bleeding.
Always wear gloves and an apron when dealing with significant bleeding.
Patients should not leave the centre whilst they are still bleeding as this poses a risk to the general public.
Contaminated clothing belonging to a patient should be placed inside a plastic bag and returned to the patient with appropriate advice about soaking clothing in cold water before washing and about prevention of contamination of the clothing of other people. The patient should be advised to disinfect the bowl or sink that the clothing is soaked in.

Major Accidents:

Occasionally, personnel will be involved with a major incident or accident where many people are injured, possibly seriously. All personnel are to take reasonable steps to protect themselves from injury and contamination. However, it is recognised that this may fall far short of the guidelines above. Personnel should remember that their prime duty under these circumstances is to the patient whilst maintaining as many safety precautions as possible. For this reason vaccination with the Hepatitis B vaccine is mandatory for all staff.

Sharps boxes:

The purpose of a sharps box is to protect personnel from injury. The most likely time that injury will occur is when inserting an object into the sharps box. Therefore, it is important that the box is not used beyond the two-thirds full stage.

All Sharps bins must be dated when they are opened and must be replaced no later than 3 months after opening – whether they are full or not. If the box is more than two thirds full, seal it and start a new box. Never force objects into the box. If an object is too big to fit into the box, even though the box is not yet two thirds full, start a fresh box.

Sharps bins are the responsibility of the partner location.

Waste Management

The partner location has a general duty to ensure, as far as is reasonably practicable, the health and safety of employees and other persons who may be affected by the storage, handling or disposal of waste products. It is essential that waste is disposed of in a proper manner and that the method of disposal, and the standard of record keeping, complies with both legislation and best practice.

Definition of Waste: Waste is anything which is discarded. The method of dealing with waste varies according to the nature of the waste itself, and the need to dispose of the class of waste in a safe manner, both for staff, contractor staff, and the environment. Hazardous waste is defined as waste having the potential to harm persons or the environment. If the premises produce Hazardous Waste, then it must be registered with the Environment Agency, although some types of business (typically offices producing less than 200kg a year) may be exempt. Most authorised contractors will undertake this registration on behalf of customers, and generally this must be done prior to removal of the waste. Although waste may be of many differing types, the remainder of this policy will deal with types of waste commonly found in healthcare settings.

Clinical Waste: Any waste which consists wholly or partly of human tissue, blood or other body fluids, excretions, drugs or other pharmaceutical products, swabs or dressings or syringes, needles or other sharp instruments, being waste which unless rendered safe may prove hazardous to any person coming into contact with it. This includes other waste arising from the provision of treatment such as disposable clothing, towels, or any other waste which may cause infection to any person coming into contact with it. Clinical waste is classed as hazardous, as it has properties which may be harmful to persons or the environment.

Non-clinical Waste: General waste, such as paper, cardboard, packaging, flowers, tins and items of a non-contaminated or non-hazardous nature. Glass is defined as non-clinical waste; however it is separately disposed of (see below) to ensure safety. Non-clinical waste items may be hazardous or non-hazardous, according to its nature. Examples of hazardous non-clinical waste are fluorescent light tubes, some electrical components, solvents, or used chemicals.

Note: Pressurised containers/aerosols must not be placed in yellow bags, as they present a hazard to the incinerator operator (a risk of explosion).

Yellow Clinical Waste bags must be sealed by tying at the neck of the bag and affixing the identification tag.

Sharp containers are to comply with BS 7320 (1990). All used Sharps Containers must be sent for incineration. Sharp containers for disposal must be properly assembled, sealed and secured, then tagged, and should not be filled above the level line marked on the container.

Procedures for handling waste: All staff handling waste must wear appropriate and suitable protection (gloves, aprons) and be trained in Infection Prevention and Control; and Control of Substances Hazardous to Health (COSHH) risk mitigation procedures at least on an annual basis.

All waste must be placed into an “appropriate” container, which must clearly indicate the nature of its contents, and must be secure in relation to its nature. As a minimum, externally stored containers must be lockable and preferably stored in a secure and dedicated area. There may be a need to segregate waste, especially chemical waste which may interact.

All waste is to be handled and disposed of by an authorised contractor who will provide certified waste transfer notices and who will be responsible for disposal of the waste using registered disposal sites. Casual disposal of waste or the use of casual contractors is not permissible. Waste management and clinical waste disposal is the responsibility of the partner locations and a contract will be signed to make them aware of this at sign up.

Infection Control Training

All new staff/ sub-contractors should be encouraged to read the policy on ICP as part of their induction process. As part of compliance, the GPs will have their training certificates reviewed prior to on-boarding onto the platform.

Summary

In general, ThanksDoc does not have any registered physical locations for clinical procedures or consultations. Thanksdoc utilises partner premises to carry out their services. Partners are responsible for the responsible and appropriate policies for infection control of their premises and sign an agreement to upkeep and adhere to infection control and health and safety national guidance for clinical areas to carry out consultations, vaccinations or other procedures requiring needles.

ThanksDoc may audit its partner premises twice a year to ensure they are compliant with its IPC policies.

Date 01.12.2025