Question 1

Best practice before a Livi appointment

Accepted Answer

Please inform the patient a Livi GP will call them to conduct their consultation, and that it is a specialist service providing remote appointments on behalf of the surgery.

To further help frame the appointment, let the patient know that the GP:

- May call from a number that could be from an area code in another part of the UK.

- May call either AM or PM, but we are unable to provide a specific time.

- Will call twice, and if no answer the appointment will be marked as DNA.

Prior to the appointment, the patient will need a working smartphone and internet connection if the consultation is conducted via video call.

Question 2

Booking appointments with a Livi GP/ACP

Accepted Answer

More information about how you can book appointments with a Livi GP or ACP can be found below. Alternatively, please contact your relationship manager.

__[Booking appointments with a Livi GP
](https://assets.ctfassets.net/h8qzhh7m9m8u/6IbodYd8ZHKZRci2pelSYB/ad6a7f568b1923fe5fe393376c0426a7/Livi_Practice_Triage_Information_2022_.pdf)__

__[Booking appointments with a Livi ACP](https://assets.ctfassets.net/h8qzhh7m9m8u/CwXZit9rAhohTkcirK1a6/d2aaac0ce8749459a31d05a8ee530597/LIVI_ACP_Triage_Information_2022.pdf)__

Question 3

How to find your Livi Practice sessions

Accepted Answer

Click the button below where you'll find out how to view available, bookable Livi appointment sessions in both SystmOne and EMIS Web.

Question 4

Booking children with the service

Accepted Answer

The service is for patients over the age of one.

Our clinicians can consult with anyone over the age of 12 months. Ideally, children should be present for the consultation, but in some situations, we may be able to consult without the child being present, if it is safe and appropriate to do so.

Question 5

Clinical communication

Accepted Answer

- All communication between Livi GPs and your practice will be via the ‘Tasks from Livi’ task group.

- All clinical outcomes that require further action will be sent to this task group, which will be populated with your practice staff who are able to complete or forward tasks to the relevant team members.

- Tasks communicated to the practice become the responsibility of the practice to action.

- __Never send a task back to a Livi clinician__, as they may not see the task until it is too late. Please contact your Relationship Manager if you have a query for a Livi GP.

- Results or letters __must never__ be tasked or assigned directly to our GPs as they may never see the task, letter or result.

Question 6

Outcomes of appointments

Accepted Answer

- __Routine face-to-face appointments:__ The Livi GP will advise the patient to contact their practice to organise an appointment.

- __Urgent face-to-face appointments:__ The Livi GP will signpost the patient to attend their local WIC/UCC/A&E or contact your surgery directly.

- __Fit notes:__ The Livi GP will create and save the fit note into the patient record before tasking to ‘tasks from Livi’ if they are unable to send it to the patient digitally.

- __2ww referrals:__ The Livi GP will complete the 2ww proforma and save this in the patient record. The Livi admin team will then process the referral via E-RS before sending the appointment information to the patients Livi inbox within the app. The Livi admin team will also send a task to 'tasks from Livi' which will include the booking reference number (UBRN) to confirm that the referral has been processed.

- __Blood tests and other diagnostics:__ The Livi GP will put details of the investigations required in the medical notes and task details of the test required under ‘Tasks from Livi’. In most instances, our clinicians do not have access to ICE, so investigations will need to be added to ICE via practice staff.

- __Routine referrals:__ Referrals are processed via E-RS/email by the Livi admin team as per local pathways. Once processed, the appointment information or next steps will be sent to the patients Livi inbox within the app. If Livi does not have an appropriate pathway or the pathway is not accessible to Livi, a task will be sent to 'tasks from Livi' and the referral must be processed by practice staff.

- __Prescriptions:__ The Livi GP will issue an EPS prescription and send this to the patients nominated pharmacy. If the patient does not have a nominated pharmacy or prefers to collect their prescription from elsewhere, the GP will issue an EPS prescription that can be collected from any pharmacy. The GP will also send a confirmation message to the patient's Livi inbox within the app.

*__Please be aware that Livi GPs will generally not request: CT’s, MRI’s or X-rays as the patient will likely need a face-to-face review first.__*

Question 7

Prescribing

Accepted Answer

Our clinicians are prohibited from prescribing certain medications, which include, but are not limited to:

- Antipsychotic medication (newly initiated, with limited exceptions such as prochlorperazine for nausea, vomiting, vertigo)

- Nicotine replacement therapy

- Anticoagulants (newly initiated)

- DMARDS (for example methotrexate, azathioprine)

- Sodium valproate

- All immunosuppressants and immune-modulating drugs

- Cytotoxic drugs

- Botox & fillers

- Schedule 1 and 2 controlled drugs (e.g. morphine, methadone, oxycodone)

- Certain schedule 3 and 4 controlled drugs (e.g. gabapentin, pregabalin, zopiclone, diazepam)

- Drugs needing initiation via a specialist

- Drugs restricted on the local formulary

Question 8

Did Not Attends (DNAs)

Accepted Answer

Our clinicians will attempt to call patients on two occasions. If they do not answer after two attempts, they will be marked as having not attended. Our clinicians will try and leave a voicemail or send a text message to the patient to inform them of the missed appointment. Where our clinicians feel it is appropriate for the practice team to know about the non attendance, they will send a task to the practice, informing them of the missed appointment.

Question 9

Medical concerns our GPs can help with

Accepted Answer

For a list of conditions Livi GPs can treat please visit [livi.co.uk/medical-advice/all-conditions](https://www.livi.co.uk/medical-advice/all-conditions/). The Livi GP will only offer help for one health concern per appointment (unless there are clinical safety concerns). Livi can treat children from age 1+. However, if the patient booked is under 16 (ages 1-15) they would need to be in attendance with the legal guardian/parent.

Question 10

Where remote appointments may not be appropriate

Accepted Answer

Patients with the following symptoms may require immediate assessment and local procedures should be followed:

- Chest pain or signs of a heart attack

- Signs of a stroke

- Severe difficulty breathing

- Severe injuries or heavy bleeding

- Ongoing seizures

- Sudden or rapid swelling of the eyes, lips, mouth or tongue

- Signs of sepsis

- Severe abdominal pain

- Thoughts of self harm or feeling suicidal

- Back pain with any of the following new symptoms: bowel or bladder disturbance; weakness in both legs; numbness to buttocks, saddle area or both legs.

Introducing Livi

Easing pressure on your practice

About Livi GPs

Important information – please read