Dover Health Centre Marshal Duties Update (Version 15)

Sat 27th February 2021 at 9.32 am - Sat 31st July 2021 - 11.32 am

Detailed instructions for volunteer Marshals helping at the Centre. Latest update 26/02/21 (Version 15)

Dover Vaccination Marshal Duties (Version 15)

All Marshals

First Marshals on duty - ask Health Centre staff which vaccine is being used that day, as this will change some procedures and marshalling duties. Vaccines may change across the week, dependent on supply. As the age of the vaccination cohorts reduce for first vaccinations, or increases for second, at the direction of the GP Supervisor, you may be asked to change or instigate new procedures that are not outlined below. You must follow his directions. 

 Sign in on arrival at the Office and sign out at the end of your shift. Sanitise your hands, on entry to the building and regularly through your shift. Hand sanitisers are located at various points through the building. Be prepared for outside duties as Marshal 4, by having appropriate clothing for current weather conditions, hi-vis tabard and a mobile phone available.

 Most patients who require a wheelchair, or mobility aid, arrive with their own. However, the Health Centre has one wheelchair available for emergency use, e.g., if patient requires medical assistance post-vaccination or on arrival. Once used, the Marshal needs to ensure it is cleaned with alcohol wipes and return to the Waiting/Observation Area ready for next use.

 However tempting and well-intentioned, please do not re-organise the procedures, patient routes or fixtures and fittings as you may create unexpected problems or hazards. For example, chairs should not be moved (unless to accommodate a wheelchair user and then should be returned to original position once space vacated), or additional seating provided in any area, in order to maintain the 2m social distancing requirement and sound infection control. Likewise, to maintain your personal distance, do not ‘administer’ hand sanitiser from the bottle onto the patients’ hands, or wipe down their own wheelchair/mobility aid handles, but direct them to the nearest location where they can do this for themselves.

 The guiding principle is…

     HANDS                       FACE                          SPACE

 …and please don’t touch your face.

 • Be aware that the Vaccination Centre organiser, Channel Health Alliance, is responsible for your safety and welfare whilst you are working on or adjacent to their premises

 • Follow the instructions of the Vaccination Centre CHA Manager if different from, or additional to, these instructions 

• Report any problems in the first instance to the CHA staff, but if unresolved, advise the volunteer administrator robindodridge@gmail.com

 Patients with children

As the age group for vaccination eligibility reduces, you may find that parents are accompanied by children, a range of ages, some possibly in buggies. Children are the responsibility of parents at all times, and should remain with the parent throughout the process. Do not allow unaccompanied children to wait in the lobby, entrance or any area, or offer to mind them until the parent returns post-vaccination.

 Patients with additional needs

 Some patients have additional needs and find the prospect of the vaccination distressing. Their arrival time and specific needs are usually known to Health Centre staff. However, they may be very vocal or not understand social distancing rules. They may need an alternative, quieter route into the vaccination rooms. Seat them in the entrance area and notify the GP Supervisor that a patient with additional needs has arrived and needs support. Follow the GP Supervisor’s advice re alterations to set procedures, in order to accommodate them. This may include, temporarily holding patients on arrival in the lobby; shutting doors to corridors, or accessing the vaccination rooms via the internal door in the entrance area.

 Fire or other emergency in the building

Establishment and management of the evacuation plan, provision and testing of alarms, marking of exit routes etc. is the responsibility of the premise’s owner. In this regard, Marshals have no more responsibility than any member of the public, although we must expect, simply because you are wearing hi-vis, that other members of the public will look to you for guidance.

 Consequently, correct actions to take either on discovering a fire, or on hearing the alarm -

 • Shout: ‘This is not a test! Follow me to the car park now!’ as you leave the building without delay

 • Report to the fire marshal designated by the premises owner’s evacuation plan and offer administrative assistance with head counts and name checks

 Marshals with, or with possible symptoms of, Covid

Do not attend the Health Centre

 • Advise volunteer administrator Robin Dodridge by phone 07774 167347 or if no reply then by email to robindodridge@gmail.com as soon as possible, who will liaise with Health Centre staff and arrange a replacement Marshal

 • Arrange a test

 • Follow Government Guidelines

 Dogs

 Patients on arrival with dogs, may need a polite reminder that only assistance dogs are allowed into the Health Centre building.

 Marshal Instructions for PFIZER and ASTRAZENECA Vaccines 

Marshal 1

 On weekdays, patients for other health care services may arrive and need to book in at the main reception, or wait in the lobby area until the health professional comes to collect them. Ask them to wait in the lobby area, but away from the patient(s) awaiting vaccination. 

During inclement weather, you may need to mop the floor in main entrance and through to the Reception desk. The blue-headed mop is located in the corner of the Waiting/Observation Area. 

NB – Patient vaccination appointment lists are no longer issued. The main door is operated by the Marshal. Therefore, it is important to remain by the automatic door, in order to keep the patient(s) in the outer lobby until the following checks and questions have been completed. After greeting them -

 • Check patient’s face covering is worn correctly (over mouth and nose)

 • Provide face covering if patient does not have one from clinical trolley i.e., medical masks and face shields (available for those who are exempt for health and disability reasons)

 Ask the patient (and any accompanying person) the following questions -

 • ‘Do you have any symptoms of a cough, cold or sore throat?’

 • ‘Do you have a temperature?’

 • ‘Are you feeling unwell today?’

 • If the response is ‘No’, direct the patient to sanitise hands using the sanitiser positioned on the clinical trolley in the entrance area

 • Direct patient(s) to observe the 2m distancing (and observe) by means of the black stickers on the floor

 • Direct patient(s) to register at the Reception desk

 • If the response is ‘Yes’, or the patient is unsure, ask them to remain in the outer lobby. Advise the Receptionist. The GP Supervisor/Medical Professional will then assume responsibility for that patient 

• GP Supervisor/Medical Professional will advise you if this patient is allowed admission

 NB – whatever vaccine is in use, advise that exit to building will be at the rear entrance. However, please note that some patients’ post-vaccination may still choose to exit via the main door.

• Carer may need to accompany patient or wait on seat in entrance area (seating and social distancing permitting)

 • Fob for internal door to allow access to accessible toilet is located at the Reception and should be returned there after each use

 • Wipe down used chair (arms, seat and back) with alcohol wipe once vacated

 Marshal 2

• Receive patient(s) from Reception desk(s), hold at doorway

 • Direct requested number of patients to Marshal 3 in vaccination waiting area

 • Manage flow of entering and exiting p  atient(s) from vaccination area, maintaining social distancing

 Pfizer Vaccine

• Receive vaccinated patients from Marshal 3

 • Direct to chair and ask to wait for length of time specified by the vaccinator – patient needs to self-monitor time (some wish to leave straight away)

 • Observe patients – report any feeling unwell to Medical Staff in vaccination area. However, if the patient becomes distressed, ask other patients to observe the situation while you seek immediate medical assistance

 • Check patient is feeling OK before leaving

 • Direct patient to rear exit

 • Wipe down used chair (arms, seat and back) with alcohol wipe once vacated

 • Fob for internal door to allow access to accessible toilet is located at the Reception and should be returned there after each use

 NB – the GP Supervisor may bring the gazebo into use as an additional waiting area for patients post vaccination. This is accessed via doors in the Waiting/Observation Area

Allow patients to choose whether to wait inside or in the gazebo, where social distancing rules need to be maintained. Wipe down used chair (arms, seat and back) with alcohol wipe once vacated.

 Please note, that when the gazebo is in use, Marshal 2 will need to be particularly proactive and anticipatory.

 AstraZeneca Vaccine 

Patients will have been advised by vaccinators that there is no need to stay and be observed, however, they should wait for length of time specified by the vaccinator before driving home.

 Some patients may choose to remain in the Waiting/Observation Area because – 

• they do not drive 

• did not come by car

 • came by car on their own

 • live on their own 

• carer/relative is waiting in the entrance area or lobby for them

 and want to ensure they feel well before they leave. Therefore,

 • Receive vaccinated patients from Marshal 3

 • Direct to chair and indicate where the clock is in the room

 • Observe patients – report any feeling unwell to Medical Staff in vaccination area

 • Check patient is feeling OK before leaving

 • Wipe down used chair (arms, seat and back) with alcohol wipe once vacated

 As exit route is now via the rear exit, aid Marshal 3 as patients coming out of the first vaccination room may need direction, as there is no signage.

 • Ask patient to use hand sanitiser, and direct them to the rear exit

 • Explain that the door opens automatically when the pad with the hand symbol is touched, or patient’s hand is near to it

 • Remind them to wait in car for length of time specified by the vaccinator before driving home

 • Direct patient to the left on exiting the door, into the main car park

 • Direct vaccinated patients who wish to remain, to chairs in Waiting/Observation Area and observe

 Marshal 3 

Vaccinators have been asked to come to the door of their room to indicate when they are ready for the next patient.

 Please note that occasionally the chairs are removed from this corridor, dependent on the vaccine being used and the age group being vaccinated. 

Pfizer Vaccine

• Line patients up, in order of arrival, on the black stickers on the floor 

• Advise patients to remove outer garments 

• Liaise with vaccination staff

 • Direct patient to next available vaccinator with belongings

 • Direct vaccinated patients to Marshal 2

 • Signal to Marshal 2 indicating the number of patients required

 Also, chairs may be used for patients who are waiting for their specified amount of time

 • Receive vaccinated patients ask them to wait for length of time specified by the vaccinator 

• If a post-vaccination patient becomes distressed/unwell, seek immediate medical assistance from Medical Staff in vaccination area

 • On departure, ask patient to use hand sanitiser, and direct them to the rear exit

 • Explain that the door opens automatically when the pad with the hand symbol is touched, or patient’s hand is near to it

 • Marshal 3 may need to collect patients for vaccination from the Reception, if Marshal 2 is manning the Waiting/Observation Area and the gazebo

 AstraZeneca Vaccine

•Line patients up, in order of arrival, on the black stickers on the floor 

• Advise patients to remove outer garments

 • Liaise with vaccination staff

 • Direct patient to next available vaccinator with belongings

 • Signal to Marshal 2 indicating the number of patients required

 • Receive vaccinated patients

 • Ask patient to use hand sanitiser, and direct them to the rear exit

 • Explain that the door opens automatically when the pad with the hand symbol is touched, or patient’s hand is near to it

 • Remind them to wait in the in their car for length of time specified by the vaccinator

 • Direct patient to the left on exiting the door, into the main car park 

• If patient wishes to remain, direct to Marshal 2

 Marshal 4 

Position by car park pay station nearest to the Health Centre. As most cars arriving follow the one-way system, they will naturally go near you, wind their window down and talk to you. Be aware that during weekdays patients arrive for other services. Greet patients, many of whom are elderly and will appreciate a friendly face.

 Ask the following questions – 

• ‘Are you here for a vaccination?’

 • ‘What time is your appointment?’

 • Dependent on the length of the queue outside the entrance, if this is more than ten minutes early, ask them to stay in the car until five minutes before their appointment time 

• Periodically, walk up to the corner of the Health Centre to observe length of queue forming outside the main entrance, at least every 15 mins (see ‘own welfare’ below)

 • Give directions to the entrance of the Health Centre by the safest route, which is the path by the hedge. Discourage crossing over the kerb/grassed area between car park and the staff car park

 • Be aware that the footpath is prone to puddling – sweep away regularly with the broom (stored outside rear entrance to Health Centre)

 • Guide patients to follow the same safe route on their return NB – if AstraZeneca vaccine is in use, patients will exit from the rear of the building. However, there will be some who choose to return via the main entrance

 • Watch over the car park and report immediately, by radio if available, any incidents such as slips and falls to the Health Centre Staff to arrange first aid 

• Report periodic hazards such as ice/lack of gritting to Health Centre staff

 • Be aware of your own welfare

 o Walk to the front door and let Marshal 1 know you’re OK

 o Use the panic alarm attached to the large torch if you find yourself in difficulty

 o Go into the Health Centre to warm up or get a hot drink if you’re cold

 Regular Covid Testing

The Government recommends that everyone without symptoms should get tested every 2 weeks, especially if you're leaving the house for a necessary reason such as going to work, shopping for essentials or, of course, volunteering as a Marshal. It’s said that around 1 in 3 people with COVID-19 have no symptoms, so do please get tested regularly to make sure you are not unknowingly spreading the virus. Details can be found at -  

https://www.kent.gov.uk/social-care-and-health/health/protect-kent-and-medway/testand-trace/symptom-free-testing 

There is a symptom-free testing facility in the Dover Discovery Centre just off Market Square and at the Guildhall in Sandwich.

 Reasons for Update to Version 14 

• Ongoing changes to Marshal Duties under the direction of GP Supervisor

 • Outdoor duties – appropriate clothing for current weather conditions

 • Dogs – only assistance dogs allowed into the Health Centre building

 • Addition of term ‘Medical Professional’ 

• Additional clarification – face shields available for those who are exempt from wearing face coverings for health and disability reasons

 • Marshals are not to advise patients of their waiting time post vaccination – this will have been determined by the vaccinator on the basis of their medical need

 • Marshal 1 - re-emphasis of keeping patient in the outer lobby whilst asking screening questions, and not inviting into the building until this has been completed satisfactorily

 • If medical support is required as a result of screening questions, report to the Receptionist and request help from a medical professional

 • Marshal 1 – patients may need reminding that only assistance dogs are allowed into the Health Centre building

 • Marshal 2 – removal of the word ‘monitor’. Marshal’s role is to ‘observe’ and request urgent medical assistance for any patient experiencing post-vaccination difficulties

 • Marshal 2 – at the discretion of the GP Supervisor, the gazebo may be used as an additional waiting area, increasing the demands of maintaining social distancing and the number of seats to be wiped once vacated

 • Marshal 2 – if gazebo is in use, this marshal will need to be particularly proactive

 • Marshal 2 & 3 – if a post-vaccination patient becomes distressed/unwell, ask other patients to monitor the situation while you seek immediate medical assistance

 • Marshal 3 – may need to come and collect patients for vaccination from the Reception Area if the vaccination centre is busy, and Marshal 2 is fully occupied manning the Waiting/Observation Area and the gazebo

 • Marshal 3 – vaccinators have been asked to come to their doors to indicate their availability for next patient

 • Marshal 3 – chairs in the corridor outside the vaccination rooms may be used for patients to wait for their specified amount of time, and not as a pre-vaccination waiting area 

• Main exit is to the rear of the building whatever vaccine is in use