Vhi Women’s Health Clinic provided by Vhi Health and Wellbeing, Vhi Healthcare DAC.

The healthcare professionals providing the service are registered as per the definitions below:

• Women's Health specialist GP: A doctor who has specialist registration in General Practice with the Irish Medical Council
• Psychologist
• Women’s Health Physiotherapist: a physiotherapist who holds registration with CORU

Only members of Vhi Healthcare are eligible to use the service.

Service opening hours: Monday- Friday - 9am – 5pm (Closed Public Holidays)

Service eligibility is subject to the benefit defined in the Vhi member’s policy and for those members with Vhi Employee Extra is dependent on the arrangement with your employer.

Age: The service is only available to persons over 18 years of age.

Parent/ Legal Guardian: The service can only be booked on behalf of another person by parents and legal guardians.

These terms and conditions should be read alongside our Privacy Policy.

Please read the privacy policy carefully as it contains important information on who we are, and how and why we collect, store and use and share personal information.

It also explains your rights in relation to your personal information and how to contact us or supervisory authorities in the event you have a complaint.

This is not an emergency service.

We will not clinically triage any presenting symptoms or conditions until the consultation with a healthcare professional. Therefore please note that any information disclosed to us in advance of a consultation, either electronically or by telephone is for information purposes only and will not be dealt with in advance of the consultation. You must not use the service for emergencies or urgent conditions, such as (but not limited to) those listed below, as this may delay necessary treatment.

If you suspect that you, or someone else is in an emergency, a life-threatening situation or in imminent danger you should contact your local Emergency Services immediately by dialling 999 or 112, especially if you, or someone else is experiencing:

• Severe difficulty breathing or are not breathing
• Symptoms that indicated a heart attack or a stroke
• Severe Chest pain
• Severe Abdominal Pain
• Severe Bleeding
• Loss of consciousness or altered consciousness
• An acute confused state and/ or is having fits which aren't stopping
• Suicidal distress or mental health crisis

The service is not a replacement for face-to-face services from a healthcare professional. You may still need to see a healthcare professional in-person or to contact the emergency services.

Not all presenting complaints will be suitable for treatment or therapy.

The clinician will make an evaluation in an initial assessment as to whether it is safe and appropriate to offer therapy or treatment through the remote service.

If in the course of a consultation, the healthcare professional determines there is imminent risk due to a medical condition, they will encourage you to activate emergency services and/or the healthcare professional will take action to activate emergency services.

Where the healthcare professional suspects there is a risk of harm to yourself or others, they will act in accordance of with the law and notify the appropriate authorities.

A course of treatment or therapy will only be initiated with the patients consent.

Patient consent will be documented in the patient’s clinical record.

The service is not designed or intended to replace your GP or any other healthcare service you regularly attend in the community or the hospital setting.

The healthcare professional does not have access to your full medical record and this may limit the care they can provide.

Where prescriptions are applicable they are only to be used for the person indicated by the prescriber on completion of the prescription (i.e. the patient named on the prescription).

The service has been designed to provide you with the following, where clinically appropriate:

• Advice
• Education
• Evaluation of outcomes/ treatment
• Goal setting including review and progression of goals
• Monitor and review progress
• Recommendations
• Self-Management Support
• Prescription (where applicable)
• Referral (where applicable)
• Diagnostic imaging (where applicable)
• Minor Procedures (where applicable)

If in the course of a consultation, the healthcare professional determines serious imminent risk due to a medical condition, they will encourage you to contact an alternative healthcare service e.g. emergency services and/or the healthcare professional will take the appropriate action.

Additionally, in some cases your clinician may deem the remote consultation inappropriate and recommend that you proceed with a face-to-face consultation or speak to a GP.

We are unable to provide the service in certain circumstances, including but not limited to, where the patient:

• Requires assessment involving physical examination or treatment by the healthcare professional
• Requires clinical triage of any presented symptoms or conditions disclosed electronically or via teleconsultation prior to the consultation
• Is deemed to be 'at risk' if not receiving face-to-face service delivery
• Is in settings in which privacy/ confidentiality may be breached during the consultation
• Presents with significant cognitive dysfunction, mental health or alcohol and other drug issues who may be difficult to assess/ treat remotely, or where face-to-face observation of their physical appearance, behaviour or level of function is indicated as part of their management
• Has severe visual deficits (where video consultations)
• Has a language barrier where an interpreter would be required
• Has cognitive impairments limiting ability to use video software or follow instructions
• Has complex communicative needs e.g. aphasia, deafness
• Has urgent or emergency conditions
• Requires standardised assessments that are not validated for use via a telehealth service delivery model

• Antenatal care – the clinic does not treat women during pregnancy
• Specialist Gynaecological care – including cancer care
• Inpatient Gynaecological care – the clinic is an outpatient clinic as part of a community based women’s health specialist GP led service with no inpatient beds
• Complex Urogynaecological procedures – the clinic is an outpatient, GP led service and not a consultant led service with the ability to provide specialist Urogynaecological procedures
• Fertility treatment – the service does not provide fertility treatment
• Breast lump/(s) for investigation – the service does not provide investigation of breast lump/(s)
• Post-menopausal/ coital bleeding – the service does not provide investigation of post-menopausal/ post coital bleeding (irregular bleeding)
• Cervical Screening – the service is not currently providing cervical screening
• Severe Mental Health issues – or women who are experiencing a Mental health crisis

Issues and concerns associated with menopause including:

• No or in frequent periods (taking into account whether the woman has a uterus)
• Hot flushes
• Night sweats
• Mood changes
• Memory and concentration loss
• Vaginal dryness
• Lack of interest in sex
• Joint and muscle stiffness

The healthcare professional does not have access to your full medical records, and therefore any advice or treatment options given are based on information you provide during the consultation.

It is your responsibility to ensure that any information you provide is honest, accurate and lawful.

If you choose to withhold relevant information from the healthcare professional, it could affect care they are able to give and they may not be able to provide additional services to you.

The service provider (H&W) and the consulting healthcare professional cannot be held responsible should the information you provide be inaccurate or incomplete.

The service provider (H&W) is not responsible for delivering routine or ongoing healthcare to patients.

During the episode of care we do provide, if the healthcare professional asks for permission to share clinical notes or information with another healthcare professional, for example you’re regular GP, we recommend that you agree.

Should you not give us consent to do so, please be aware that the healthcare professional may feel that it is not safe to proceed with any treatment or referral options discussed.

• At the time of your consultation, you should ensure that you are somewhere private.
  
• You must ensure that you are not driving or using any machinery which means you cannot give the healthcare professional your full attention.
• The healthcare professional will terminate the consultation if they feel you are putting yourself at risk.
• You should ensure that any pre-assessment questionnaires are completed and sent back to your healthcare professional prior to the consultation or as required.
• You should ensure access to a device suitable to participate in a telehealth consultation.
• You should ensure access to an internet connection suitable to support a telehealth consultation.

We may not be able to provide full service if you suspect you may be or are pregnant.

The service provider (H&W) has defined the duration of pregnancy to be from conception to 6 weeks post-delivery.

If you are pregnant and book a consultation, we will complete the consultation and the healthcare professional will use their professional judgement when assessing next steps.

The service provider (H&W) policy is that we should not provide medical advice or diagnosis for conditions that may be impacted or influenced by the fact you are pregnant.

For the avoidance of doubt, and where this is the case, our policy is to signpost you back to your own GP or maternity care provider by default, as pregnancy impacts on many conditions for which a telemedicine service is not well suited to make a safe diagnosis or offer treatment including advice.

It is our policy that you should declare to us that you are pregnant or have had a positive pregnancy test, we will signpost you to a local GP or maternity care provider to arrange a 'booking visit' and antenatal care if you have not already done so.

The availability of our online services cannot be guaranteed as mobile data and internet connections are controlled by third parties with whom H&W has no direct relationship or contract.

If the content of any electronic communication you send to us is inappropriate and/or abusive we will take whatever action is appropriate, including reporting the incident to Vhi Health and Wellbeing DAC, who provides you with access to our services through the Vhi Health Assistant App and if required to do so by law, to the relevant law enforcement authorities.

We do not tolerate abuse of our staff in any form.

A complaint means a complaint made about any action of Vhi H&W it is claimed, does not accord with fair or sound administrative practice, and adversely affects the person by whom, or on whose behalf, the complaint is made (Health Act 2004).

Should you wish to make a complaint or would you like to raise a concern you can do so by contacting Vhi Health and Wellbeing directory on the telephone number you have been given to access the service or in writing to Vhi Health and Wellbeing as follows:

Vhi 360 Health Centre, The Hampstead Building, Carrickmines Park, Dublin 18, D18 R6HX

Alternatively, you can e-mail your concerns directly to the service carrickmines@vhi360.ie

You will be notified as soon as we receive your complaint or concern, we will be in touch as we deal with your complaint according to our complaints procedure.

An acknowledgment letter or email will be sent within 5 working days to you following receipt of a complaint notifying you as the proposed time scale to receive a response.

Vhi Health and Wellbeing will make reasonable endeavours to provide a full response to you within 30 days following receipt of a complaint.

Nothing herein excludes or limits our liability for death or personal injury caused by our negligence or fraud or for any other liability which cannot be excluded or limited under applicable law.

Except as may be expressly set out in these terms, all conditions, representations, and warranties relating to the service are excluded to the maximum extent permitted by law.

We shall not be liable for any defects or errors in the services, nor interruptions in or unavailability of the services, nor any breach of any obligations due to a cause beyond our reasonable control.

When using our services, except to the extent permitted by law, we shall not be liable for:

• Any loss, damage or distress incurred by you arising from reliance on information or the availability of the services or
• Any indirect, consequential, special or economic loss, damage or distress incurred by you (including any such loss, damage or distress arising from unauthorised use of or damage to your data or content) or
• Any consequential loss, damage or distress incurred by you arising from where you have not provided us with a full and accurate medical history or where you withhold any relevant information;or
• Any loss, damage or distress arising from use or attempted use of the services for emergency or urgent conditions or any consequential delays to necessary treatment.
• Our total liability to you in connection with the services or otherwise under contract, tort, statute, common law or otherwise (and including for the avoidance of doubt negligence or breach of statutory duty) shall not in any circumstances exceed €500,000.

These services, together with any contractual or non-contractual obligations arising out of or in connection with the services, shall be governed by, and construed in accordance with, the laws of Ireland. All parties agree to submit to the exclusive jurisdiction of the Irish courts.