user guide - ppmsupport.leedsth.nhs.uk€¦ · choose your clinic, mdt or theatre from the list of...

PPM+ User Guide v4.3.0b.docx 1 of 28 Last updated: 02/08/2016

Email: [email protected]

User Guide Contents (click on a header to go to that section)

Access and Login ................................................................................................... 2

Home Screen ........................................................................................................... 3

Save and Keep Searches ....................................................................................... 3

Single Patient View ................................................................................................. 3

Patient Search ....................................................................................................... 3

Patient Details ........................................................................................................ 4

View Audit Log ....................................................................................................... 4

Clinical Record Types ............................................................................................ 5

Centre .................................................................................................................... 6

Add Button ............................................................................................................. 6

GP Tab .................................................................................................................. 7

Mental Health Tab .................................................................................................. 7

Community Tab ...................................................................................................... 7

Adult Social Care Tab ............................................................................................ 8

External Systems .................................................................................................... 8

Clinics, MDTs and Theatres ................................................................................... 9

Contacts ................................................................................................................ 10

Advanced Search .................................................................................................. 10

Ward Patient List / eWhiteboard .......................................................................... 11

Ward Search ........................................................................................................ 12

Bed State Management ....................................................................................... 12

Discharge / Transfer Planning .............................................................................. 14

Ward Columns ..................................................................................................... 17

Diabetes Column.................................................................................................. 23

eWhiteboard Online Status .................................................................................. 24

Creating a Custom Ward List ............................................................................... 25

Customising the Ward Patient List ....................................................................... 26

Printing the Ward Patient List ............................................................................... 26

Browsing Patient Lists ......................................................................................... 27

User Menu ............................................................................................................. 27

Contact Us ............................................................................................................. 28



Access and Login Open up PPM+ from the icon in your Taskbar or from your computer’s desktop:

If you work for LTHT then select The Leeds Teaching Hospitals NHS Trust option under the Organisation drop-down menu. Insert your network user name and password, then press Enter ↵ or click

on . You can also login using your SmartCard by selecting

. Click here for a step-by-step video to logging in with your SmartCard. Unsuccessful sign-in will result in a prompt to change your password. Please contact the Informatics Service Desk if you are still unable to login. Users will be reminded if their password is about to expire. Click on

to avoid being locked out of PPM+ due to an expired password. If this is your first login, thoroughly read the Terms and Conditions then

click on if you accept the terms.

http://lthweb/sites/smartcard

https://www.youtube.com/watch?v=EX0fvlD5_uw

mailto:[email protected]?subject=PPM+

mailto:[email protected]?subject=PPM+



Home Screen

Top row: System Alerts; Search

functionality; User Menu (your name). Left-hand side: Actions bar includes: Browsing Patient Lists, Creating Inpatient List, Browsing Contacts and External Systems. Centre: My Notifications, My Recent Patients, My Recent Lists (which includes Clinics, MDTs, Theatres, Wards and Custom Lists), My Recent Reports, Trust Communications and Did you know?

Save and Keep Searches You can save and keep regularly used lists and patients at the top of My Recent Lists and My Recent Patients by clicking on the pin icon . You can remove the list or patient from the top of the list by clicking again on

the pin icon .

Single Patient View

Patient Search Make sure Patient is selected from the drop-down box and enter in their name or NHS Number (preferred) into the text-box.

Press Enter ↵ or click on the search

icon and your search results will be displayed. Click on the name of the patient you

require (or anywhere in their row) to

open up the Single Patient View.



Patient Details In the Actions bar on left-hand side of the screen, click on View Patient Details. Your patient’s details will then be displayed in the centre of the screen. There are 3 tabs within Patient Details: Details NHS Number, Name, Date of Birth, Allergies etc. GP Details and Other Identifiers: Unit/District, PAS and HSP Numbers. Contact Info Address, telephone numbers, NOK (Next of Kin) information. Clinical Contacts Displays a record of clinicians involved with the patient.

View Audit Log

Click on View Audit Log in the Actions bar, to display the usernames of everyone who has viewed that patient’s record and when.



Clinical Record Types

In the Actions bar on left-hand side of screen are the Clinical Record Types. Displayed are the available clinical records, broken down into categories. The number (in brackets) indicates how many clinical entries have been recorded under each category. If there are no entries against that type no brackets will be displayed. We do not currently hold data for those Clinical Record Types that are greyed out. Click on a category title and it will be displayed in the centre.

The links with an action button next to them, will take you to that patient’s record for the selected external system. Additional training information and support is available for ICE (OrderComms) and epro via the IT Training site.

REMEMBER PPM+ should not yet be considered a full Electronic Patient Record (EPR) and can only therefore be treated as an electronic guide - it may not show

a patient’s full clinical history.

http://lthweb/sites/it-training



Centre The centre of the screen will display the specific clinical information you have selected. In this example, we shall select Encounters/Events from the Actions bar. From the Encounters/Events list, we have a selected an Admission. This opens up further tabs relating to the admission on the right-hand side of the Centre Screen. Namely: Admission Details, Discharge, Documents and Care Episode.

Add Button

Use the button in the Single Patient View to:

Add Clinical Documents such as an Adult Resuscitation Intervention Event.

Add an Attachment such as a document or image to a patient’s record.

Dictate a letter for the patient on epro.

Add a Free Text Annotation to the patient’s record.

Top Tip Each Clinical Record Type has

its own unique tabs

http://lthweb/sites/informatics-projects/projects/Digital%20Dictation/project-homepage



GP Tab The GP tab is displayed in the Single Patient View when the patient is registered to a Leeds GP. Every GP in Leeds (100%) is sharing data into the Leeds Care Record. To view details such as Current Problems, Medications and Allergies, click on the GP tab in the Single Patient View:

Click here for a supporting training video on the GP and Leeds Care Record tabs.

Mental Health Tab

If a patient has an open Mental Health referral, or has had one closed within the last year, a Mental Health Tab will appear in the Single Patient View next to the GP Tab:

Users will first get a FAQ and explanation of data items, then a summary of the information that Leeds and York Partnership Foundation Trust (LYPFT) hold for the patient.

Community Tab

A Community tab will appear in the Single Patient View if the patient has an open Leeds Community Healthcare referral:

http://www.leedscarerecord.org/

http://lthweb/sites/it-training/gp-tab-for-ppm/

http://lthweb/sites/it-training/gp-tab-for-ppm/

http://www.leedsandyorkpft.nhs.uk/

http://www.leedsandyorkpft.nhs.uk/

http://www.leedscommunityhealthcare.nhs.uk/



Adult Social Care Tab

An Adult Social Care tab will appear in the Single Patient View if the patient has an open Adult Social Care referral:

External Systems Clicking on any of these links at the bottom of the Action bar will take you to the login screen for the selected external system. Additional training is available for some of these systems (Click here for our Training site).

http://www.leeds.gov.uk/residents/Pages/Adult-Social-Care.aspx





Clinics, MDTs and Theatres To search for a Clinic, MDT or Theatre, choose from the drop-down list and enter in a keyword (e.g. Speciality, Doctor’s name,

Clinic Code) and click the search icon . Choose your Clinic, MDT or Theatre from the list of Search Results and the next 30 days of your selection will be displayed (as default). You can also find your Clinic, MDT or Theatre using the Browse List function from the Actions bar on the Home screen. You can choose a Date Range from the Actions bar on the left or you can create a

custom range using the calendar function in the centre. Once you have selected your list, it will be displayed in chronological order by default. You can arrange by the other headers by clicking on them. For example, you can arrange a clinic alphabetically by selecting the Patient header. You can choose which columns are displayed by clicking on

. There is also the option to print the selection by clicking on print symbol

in the top-right.

Top Tip If there is only one search result, you will be taken straight to that

Clinic, MDT or Theatre.



Contacts If you would like to search for a contact within PPM+, for example a Consultant or GP, select Contact from the search options and search for their name. You will be presented with a list of search results. Choose the contact you require and their Contact details will be presented. Use the Contact Detail, Membership, Profile, Summary and Full Details tabs to navigate around the Contact.

Advanced Search

If you would like to perform a refined search then an Advanced Search is for you. Click

on underneath the search icon. You will now be presented with a list of additional fields you can search with. Fill in as much of this information as you

can then click on .

There is also the option to , which empties the fields, enabling you to do perform another search, and an option to

.

Top Tip Different advanced searches will bring up different searching fields. For example, an advanced Clinic

search will allow you input Clinic Name, Clinic Code, Site/Team, Clinical Service and Organisation.



Ward Patient List / eWhiteboard The Ward Patient List is designed for use with the eWhiteboards in a Ward environment - please see the example below:

REMEMBER No ward will have all the available columns

activated on their eWhiteboard. The columns are set by the Ward Manager.



Ward Search Select Ward from the drop-down search options and enter in a ward into the search box.

Press Enter ↵ or click on the search icon and then select your ward from the search results. If there is only one result then the Ward will appear straight away. You will now be presented with a list of the patients admitted on that ward like on the example on the previous page.

Bed State Management

Overall Purpose To better manage and view bed availability and occupancy, the Ward Patient List has many Bed State Management features. In the Ward View, patients will be displayed, as default, into Groups. Namely: Bed Unassigned (for those with no bed assigned), All Beds (lists the total number of beds for a particular ward) and Other Locations (this is a custom feature where patients may be on a trolley or chair, for example).

Ward Configuration Users can select the Configure Ward feature from the left-hand Actions bar to add, edit or remove any of the beds. NB: when configuring a ward, you will be changing the eWhiteboard view for everyone. Make sure you have been authorised by the Ward Manager to do so. Note: (Occupied) next to the beds with patients in them. To add further beds, enter the name/number of the bed into the input in the bottom left and click

on . To edit the name/number of any of the beds, click

on in the Action column and if you would like to remove them completely, select

.



You can arrange how the beds appear on the eWhiteboard here also using the Order column.

Click and hold on the symbol and drag the bed to the position you require. You can move any of the beds as much as you require to suit your Ward needs. You can show all the patients admitted onto the Ward, without the unoccupied beds, by selecting

the button in the top right. You can

then select to re-group into Bed Unassigned, All Beds and Other Locations.

Managing Bed State To assign a patient to a bed, or update their bed location, click on the cell of the patient you would like to update in the Bed column. Make sure to add the Bed Status (where applicable). If you have chosen Other under Patient Location, enter their location in the Other free-text box and then they will appear at the bottom of the Ward Patient List under Other Locations. Any unassigned patients will appear at the top of the Ward View under Bed Unassigned.

Any free beds will appear under All Beds as a grey row. You can update the Bed Status of free beds by clicking in the cell of the bed you would like to update. NB: Clear the Bed Status before allocating a patient to a bed.



Grouped Wards Grouped Wards such as JTC and JTCC appear on the eWhiteboard together. When configuring the beds, ensure you select the correct Ward when adding a bed. When assigning a patient to a bed you can only choose from the beds configured for the ward they are admitted to in Patient Centre (PAS).

Discharge / Transfer Planning

LTHT is undertaking a review about effective use of our services called Leeds Clinical Utilisation Review (LCUR). This is to ensure our patients are in the most appropriate setting for their needs, which includes considering whether ongoing assessments or care needs can be provided elsewhere. This relates to the Discharge / Transfer Planning columns, namely EDD (Expected Date of Discharge), MFFD (Medically Fit for Discharge), Planning and Needed For Discharge / Transfer. Clicking on any of those columns will bring up the Discharge / Transfer Planning form.

EDD (Expected Date of Discharge) Enter in the patient’s Expected Date of Discharge into the box provided. You can also click on the down arrow to bring up a calendar and you can select the date from there.

Click on the button to select today’s date. The date will then be displayed on the eWhiteboard. Patients who do not have an Expected Date of Discharge after 24 hours will be shown on the eWhiteboard with a red question mark .

http://lthweb/sites/it-training/pas-training/patient-administration-training-system



MFFD (Medically Fit for Discharge) The MFFD column will no longer show a date. A patient is Medically Fit for Discharge when a clinical decision has been made that the patient no longer needs to occupy an acute hospital bed and their ongoing care needs can be assessed and/or provided elsewhere. If the patient is medically fit for discharge, select

on the Discharge / Transfer Planning form. This is then displayed with a green tick on the eWhiteboard. If the patient is not medically fit for discharge the MFFD column will appear blank.

Planning The Planning column will display the planned next destination for the patient (if applicable) and whether or not they are fit to lodge.

Does the patient need to be on this ward?

The form will default to say that the patient does need to be on this ward. If you select

, you will be asked what the next planned destination is for the patient.



What is the next destination planned for this patient?

If the patient is due to be discharged then no further planning information is required. NB: If the patient is to be discharged that day, make sure you’ve also marked them as Medically Fit for Discharge.

If the patient is to be transferred to an internal ward, select the Speciality, Hospital/Site and Ward/Unit.

If the patient is to be transferred externally for further treatment or the commencement of treatment not available within the current hospital, select the hospital they’re to be transferred to and any additional external transfer details.

Select Repatriation for the return of a patient to a care provider to receive or conclude treatment closer to their home. Enter in the receiving hospital information and whether the referral has been accepted. NB: Selecting Yes will automatically add the current date/time to their record. Therefore, should be completed as near to actual referral acceptance time as possible. Is the patient Fit To Lodge? Enter in whether the patient is Fit To Lodge or not and this will be displayed on the eWhiteboard with either NFTL (Not Fit To Lodge) or FTL (Fit To Lodge) as above.



Needed for Discharge / Transfer Displayed in the Needed for Discharge / Transfer column will be the details of what needs to happen before the patient can be discharged or transferred. Select from the list of common actions or you can select from Other and enter in your own.

Ward Columns Action

Clicking on the down arrow in the Action column will bring up the options for that patient. Such as, open the Single Patient View or epro to dictate a letter:

Ward This is the ward the patient is admitted onto. This information is pulled through from PatientCentre. Bed (Bed Number) Please see Managing Bed State as above. Patient Click on the patient’s name and a brief summary of that patient’s information will open up. To signify gender, a patient’s name will be shaded pink for female, blue for male and no shading for indeterminant or unknown.

Patients admitted to the Ward with similar (or same) names will be displayed with an amber exclamation mark :

http://lthweb/sites/it-training/epro-digital-dictation

http://lthweb/sites/it-training/pas-training/patient-administration-training-system



Age The Age column displays a patient’s age in years (over 2 years old), months (between 2 years and a month) or days (under a month). Alerts The Alerts column will display the amount of Alerts on that patient in the Ward Patient List. Click in the cell to open up the Patient Clinical Alerts in the Single Patient View:

Consultant This will display the initials of the consultant in charge of that patient’s care. Hover over the initials to display their name or click for further details. You can show a certain Consultant’s inpatients by creating a Custom Ward List.

Specialty This is to display the specialty that patient is admitted under. For example, Cardiology. LOS (Length of Stay) This is to show the amount of days that the patient has been admitted in the Trust. Clicking in the cell will display the date the patient was first admitted to the Trust and to the specific ward. If a patient has been re-admitted within 30 days, it will be displayed with an amber exclamation mark.

EDD (Expected Date of Discharge) Please see Discharge / Transfer Planning as above. MFFD (Medically Fit For Discharge) Please see Discharge / Transfer Planning as above. Planning Please see Discharge / Transfer Planning as above. eDID (electronic Discharge Initiation Documents) Please visit the Training Interface for step-by-step Training and a full User Guide can be found on our Intranet site. Needed For Discharge / Transfer Please see Discharge / Transfer Planning as above.

http://traininginterface.leedsth.nhs.uk/

http://lthweb/sites/it-training/ppmplus/



Clinical Summary This is a free-text box to input a brief current clinical summary of the patient. This column is used in the Handover section and, due to confidentiality, does not display on the eWhiteboard. Handover Comment Enter any handover comments into the free-text box provided. This column is used in the Handover section. Medical Jobs & Other Jobs Some common jobs will appear for you to select or you can enter in your own in the free-text box. This column is used in the Handover section. School (Status) Click in the cell to update a patient’s School Status:

Paed Nutr (Paediatric Nutrition Requirement) Click in the cell to update a patient’s Paediatric Nutrition Requirement or you can enter in your own:

CR (Clinical Review) The Clinical Review column is to display whether the patient requires a review by a clinician. Select from Registered Nurse (RN), Consultant (CON), Registrar (REG) or Junior Doctor (JD). Click in the cell again to update

the Clinical Review to . This column is used in the Handover section.

AR (Admission Review) The Admission Review column enables clinical teams to record whether a review is required at the point of admission. Click in the cell to update the information. Underlined red text will mean that the review is required and green text will mean that the review is complete:

http://www.ppmsupport.leedsth.nhs.uk/MPV/Handover.html







Abs (Antibiotics Prescribed?) Click in the cell to update a patient’s antibiotic status:

Not known.

Intravenous (IV) or Oral antibiotics prescribed.

None. NEWS (National Early Warning Score) Clicking in this column will open up a dialogue box to input the patient’s National Early Warning Score. DAS (Dementia CQUIN Assessment) Click in the cell to update the Dementia CQUIN Assessment status:

Not Applicable (NB: will default to Not Applicable if the patient is under 75 or assessed in last 6 months).

Risk Assessment due or Incomplete.

Confirmed dementia following full assessment.

Risk Assessment not required or does not have dementia following full assessment. VTE (Venous Thromboembolism) Click in the cell to update the patient’s VTE assessment (and view previous assessments):

Not Applicable - Patient does not require VTE Assessment or is under 18.

1st VTE Assessment Required.

Next VTE re-risk assessment due.

Recorded paper or electronic assessment has been completed. Diab (Diabetes) Please see Diabetes Column as below.

HAI (Healthcare Associated Infection) Click in the cell to update the HAI status from the available options:

SI (Source Isolation) Click in the cell to update the patient’s Source Isolation status:

Source isolation status unknown.

Source isolation required - patient requires side room.

Low risk - source isolation not required.



Fall (Falls Assessment) Click in the cell to update the Falls status:

Falls Assessment Not Completed.

Falls Assessment Result: At Risk.

Falls Assessment Result: Not At Risk. PU (Pressure Ulcer) Click in the cell to update the Pressure Ulcer status:

Pressure Ulcer Assessment Not Completed.

Pressure Ulcer Assessment Result: At Risk then update the patient’s Skin Status.

Pressure Ulcer Assessment Result: Not At Risk. Nutr (Nutrition Assessment) Click in the cell to update the Nutrition status:

Nutrition Assessment Not Completed.

Nutrition Assessment Result: At Risk.

Nutrition Assessment Result: Not At Risk. (Named) Nurse (or Nursing Team) Click in the cell to update the assigned nurse or nursing team:

RT (Red Tray) Click in the cell to change the Red Tray status: Blank: Does not require Red Tray.

Requires Red Tray.



Diet (Dietician), OT (Occupational Therapy) and PT (Physiotherapy) Click in the cell to update the status of the above three columns:

PCT (Palliative Care Team) and MSW (Medical Social Work) Click in the cell to change the status of the above two columns:

Med Rec (Medicines Reconciliation) Pharmacy staff can update the Medicines Reconciliation status of a patient by clicking in the Med Rec column:

AKI (Acute Kidney Injury) The AKI column displays the Acute Kidney Injury stage (where applicable) which is automatically populated from reported abnormal blood results:

Click in the cell to update the STOP AKI questions.



Diabetes Column Patients who have been previously recorded within the Trust with a permanent type of diabetes, will have an alert automatically shown on the eWhiteboard:

Patient has diabetes

Patient does not have diabetes

No diabetes information recorded for the patient

This information has been taken from a one-off snapshot of PatientCentre (PAS) coding data. Registered Clinicians should confirm the diagnosis is correct. Where necessary they can update an incorrect status:

If a patient’s status is changed to No through the eWhiteboard, then this will be retained for 7 days following the patient’s discharge and will display as No if re-admitted within that time. If they are re-admitted further to those 7 days, the eWhiteboard will show a blank status (as above).

If a patient’s status is updated to Yes through the eWhiteboard, then this will be retained permanently in PPM+ from one admission to another, unless this is reset to No . For further information/guidance please contact:

Afroze Abbas Consultant Endocrinologist

[email protected]

mailto:[email protected]



eWhiteboard Online Status To ensure that you know whether the eWhiteboard you are viewing is working, online and refreshing with the most up-to date patient information, at the top of the screen will be your ward’s eWhiteboard status. If the eWhiteboard is online and up-to-date you will see a green “online” status and message saying it’s Online:

In the rare event that the eWhiteboard does go offline, the last-updated copy of patient information will be displayed with a red “offline” status and contact details of the Service Desk:

When there is maintenance or a scheduled update to the system, for the brief time the eWhiteboard is not refreshed a message will appear to let you know the work is underway:

REMEMBER If you’d like to enable any of the newer columns on your Ward’s eWhiteboard, please contact the Informatics Service

Desk at x26655 or [email protected].




Creating a Custom Ward List

In the Ward Patient List, if you would like to view a list of inpatients to meet a specific requirement, you can create a Custom Ward List. In this example I would like to display a certain Consultant’s admitted patients for a specific Ward, however, Custom Ward Lists can be as simple or complex as you like. Click on Create Ward List in the Actions bar in the Ward View (or Create Inpatient List > Ward from the Home screen). Enter a name for your Custom View. First, we’re going to search for a Consultant whose admitted patients we’d like to view. Select Consultant from the filter type list.

for the Consultant you require using their Name, Initials, GMC number or Speciality. The search results are then displayed under the Select Consultant header. Click on the Consultant’s name you require and the symbol next to their name will change from a

to a to signify the selection and will be highlighted in green. The Consultant will then be shown under the Filter Criteria header on the right. We shall now add a Ward to the filter criteria: search and add your desired Ward in the same manner as above and it will then appear on the right under Filter Criteria along with the Consultant. If you would like to remove any of the Filter

Criteria, click on .

Click and your Custom Ward View will be displayed. You can delete a Custom List by clicking on Edit

Custom MPV and then on the button.

From Ward View:

From Home Screen:



Customising the Ward Patient List

At a computer, you can customise the columns in the Ward Patient List to suit your requirements.

Click on the button in the top-right of the Ward Patient List. You will then be presented with the Configure Columns dialogue box. Here you can select (and de-select) the columns you would like to be displayed at your workstation. The columns on the right are the ones which will be displayed.

Click on and you will see your customised Ward Patient List.

Printing the Ward Patient List

You can print off the Ward Patient List of your selected ward by clicking on the print button in the

top-right . You will then be presented with the Select Columns to Print dialogue box to customise which columns would like to print out.

Click on in the bottom-right. You will be shown a print preview for you to review before finally sending it to the printer by clicking on the Print button.



Browsing Patient Lists On the Home screen you can view different patient lists via the Browse List function. These include Outpatient (Clinics), Operating Theatres, Multidisciplinary Teams, My Custom Views, Inpatient (Wards) and Virtual Lists. This is an alternative method to search for Clinics, Theatres, MDTs and Wards opposed to using the search function at the top of the page.

User Menu

Click on your name in the top-right to bring up the

PPM+ User Menu.

will take you to the LTH Intranet

Home Page.

will take you the Frequently Asked

Questions page.

is where you will find information

about what’s new in the latest version of PPM+.

will take you to the PPM+ Help Site.

To let us know about anything you’d like to see

changed or added into PPM+, click on

Once you are finished using PPM+, please click

on .

Top Tip For help with the Unplanned Patient List please see the User Guide on the PPM+

Training Site

http://lthweb/

http://lthweb/

http://www.ppmsupport.leedsth.nhs.uk/FAQ.html

http://www.ppmsupport.leedsth.nhs.uk/FAQ.html

http://www.ppmsupport.leedsth.nhs.uk/WhatsNew.html

http://www.ppmsupport.leedsth.nhs.uk/

http://lthweb/sites/it-training/ppmplus

http://lthweb/sites/it-training/ppmplus



Contact Us Please contact the Informatics Service Desk at x26655 or [email protected] to:

Reset your password.

Report a problem you are having within PPM+ functionality.

Report a data quality problem within PPM+.

Request new user accounts for PPM+.

Disable PPM+ accounts for any leavers from your department. Please contact the PPM+ EPR team at [email protected] if you have any development ideas or comments on your experience of using the EPR. If you would like to make a request for change to PPM+, please contact us at: [email protected] with a completed Request for Change (RFC) form available here. PPM+ Intranet Site: http://lthweb/sites/informatics-projects/projects/ppmplus/ Please contact the IT Training Department at [email protected] if you require further training on PPM+ or any other Clinical System. For further guides and support please visit the PPM+ Help Site: http://www.ppmsupport.leedsth.nhs.uk/ or the PPM+ Intranet Site: http://lthweb.leedsth.nhs.uk/sites/it-training/ppmplus




http://lthweb/sites/informatics-projects/projects/ppmplus/documents/REQUEST%20FOR%20CHANGE.docx

http://lthweb/sites/informatics-projects/projects/ppmplus/


http://www.ppmsupport.leedsth.nhs.uk/

http://lthweb.leedsth.nhs.uk/sites/it-training/ppmplus

http://lthweb.leedsth.nhs.uk/sites/it-training/ppmplus