A linked service is a group of two or more services that operate under a common management structure and share common policies and procedures across all sites within an organisation.
Services must meet the following criteria to be considered linked:
- The service must share policies across all sites
At the time of a JAG assessment, the service can upload any shared policies to the evidence bank. It is service's responsibility to make clear in the comments if there are any site specific protocols.
- The service must conduct and present audits as a trust/organisation?
JAG expects that clinical audits are based on data extracted for the trust/organisation as a whole rather than site specific.
- The service must meet privacy and dignity standards equally across all sites within the organisation
All sites meet same sex accommodation standards equally (if in England).
Where a trust/organisation has more than one site and can demonstrate that its sites operate as one endoscopy service and meets the criteria above, the following rules will apply:
- The trust/organisation will submit one GRS that covers all linked sites and the scores must be identical for all sites.
- JAG assessments to linked sites will be conducted on consecutive days or within a two-week period and will be assessed by the same assessment team. The second site assessment may be shorter than that of the main site, however this will depend on the service's core functions. The timetable will be set by the lead assessor.
- Following the assessment, the assessment team will give brief feedback on the first day at local level, with a robust, organisation-wide feedback session at the end of day two.
- The organisation will receive one report for linked services.
- Linked services will have a linked accreditation decision when the service is assessed. If one site is ready to be awarded accreditation when the other is not, both sites would have accreditation deferred. In some circumstances, linked services can be unlinked to allow one to be awarded accreditation and the other to pass, particularly for environmental reasons, however this decision must be escalated to the JAG office.
- The linked services would complete one annual review each year for all linked sites.
- Where services in the organisation have different reaccreditation due dates (after five years of accreditation), the reaccreditation assessment must be conducted when the first reaccreditation assessment is due. This may result in some services having their assessment earlier than planned.
Issues for services to consider when deciding to operate as one service with linked sites:
- If one site deteriorates for any reason it will impact upon all sites. Lower GRS returns impact on all sites.
- If one unit deteriorates then all linked services will be affected and this may impact screening and Best Practice Tariff rates.