Criterion GP5.1 – Practice facilities

Why this is important

Without appropriate facilities, the patient care you provide can be compromised and patient safety may be put at risk. Your facility must therefore provide an environment that enables the practice team members to perform their duties safely and effectively.

Meeting this Criterion

Design and layout

Your facilities must be fit-for-purpose and the design and layout must enable privacy, security, consultation space, and access to facilities such as toilets and hand-cleaning facilities.

The layout of the practice will ideally provide reception staff members clear sight of the waiting areas, so that they can see and monitor waiting patients.

You could also consider the cultural requirements of your patients in areas such as the waiting room.

Consultation rooms need to be kept at a comfortable temperature.

Privacy and patient dignity

A well-designed layout can help to maintain patient privacy and confidentiality. For example, you could consider whether:

• there is adequate sound proofing between internal walls
• there are areas where private conversations can be held
• the computer screens in the reception area are hidden from the view of patients and other visitors
• private and confidential discussions in the reception area (on the phone and directly with patients) can be overheard
• the layout, music and other features of the reception area protect patient privacy during discussions (eg protection of details such as phone number, address and medical information).

You must protect the dignity of each patient by ensuring both visual and auditory privacy.

Visual privacy ensures that others cannot see the patient during the consultation, and that the patient can undress in private and be covered as much as possible during an examination. This can be achieved by practitioners: • using a gown or sheet to cover patients

• leaving the room while a patient is undressing and dressing
• providing an adequate curtain or screen.

Auditory privacy ensures that other people cannot overhear a consultation. This can be achieved by the practice:

• having solid doors (instead of doors with paper cores)
• using draught-proofing tape around door frames and a draught-excluder at the base of doors
• playing appropriate background music to mask conversations between members of the practice team and patients.

If a practice has areas where auditory privacy is not possible, such as nurses’ treatment bays, there must be a private room available for confidential conversations.

Privacy when providing consultations by telehealth

Patient privacy and confidentiality during telephone and video consultations rely on secure environmental/physical, audio and visual components. Refer to the RACGP’s Guide to providing telephone and video consultations in general practice for guidance on how to maintain privacy and confidentiality when providing telephone and video consultations.

When commencing a telehealth consultation, ask the patient whether they are able to have a private conversation during their consultation. Some patients do not have access to a private space, so your practice could provide advice on how to implement a private space when consulting via telehealth. This advice could include asking the patient to:

• find a quiet, closed space where others cannot see or hear them during the consultation
• ensure that others nearby are aware the patient is not to be disturbed (eg letting them know prior to the consultation, or having a sign on the door)
• ensure any devices being used are secure (eg ensuring a telephone is a fixed line that others cannot join).

In addition, the practitioner must confirm who is present at the practice end on the telehealth consultation.

If a patient joins a telehealth consultation and cannot ensure privacy (eg they are in a public space), ensure that they provide consent to proceed with the consultation.

Location of toilets and hand-cleaning facilities

Toilets need to be easily accessible and well signposted. They will ideally be located inside the practice but, if this is not possible, they must be as close to the practice as possible.

You could provide separate toilets for the practice team and patients.

Washbasins need to be in or close to the toilets in order to reduce the possible spread of infection, and the practice team and patients need to be able to access them easily.

Environmental cleaning

Your practice could appoint one member of the practice team who has the primary responsibility for ensuring that appropriate cleaning processes are in place.

If your practice engages commercial cleaners for environmental cleaning, have them sign a written contract that outlines a schedule, suitable products to be used, and areas to be cleaned. You could also consider having the cleaners record their work in a log.

Environmental cleaning must be intensified in the event of a pandemic or other infectious disease outbreak. This includes increasing the frequency of cleaning high-touch surfaces (eg door handles, tables and handrails), disinfecting surfaces after cleaning and terminal cleaning. You might need to refer to local, state and national public health guidance to determine if there are any additional cleaning requirements.

Meeting each Indicator

GP5.1 A Our practice’s facilities are fit for purpose.

You must:

GP5.1 B All face-to-face patient consultations in our practice take place in a dedicated consultation or examination space.

You must:

GP5.1 C Our consultation spaces permit patient privacy and confidentiality.

You must:

You could:

• provide patient privacy screens.

GP5.1 D Our practice has a waiting area that accommodates its usual number of patients and other people who would be waiting at any given time.

You must:

You could:

• configure the reception area so reception staff members can monitor the waiting area.

GP5.1E Our practice has access to toilets and hand-cleaning facilities.

You must:

You could:

• have clear signs showing the location of the toilets and other facilities
• consider having separate toilets for the practice team and patients.

GP5.1 F Our practice is visibly clean.

You must:

You could:

• provide washable children’s furniture and play equipment • have a written and signed agreement with commercial cleaners
• use a cleaning log.