Practice Policies & Patient Information
Accessible Information Standard
The standard aims to make sure our patients, or their carers, with a disability, sensory loss or impairment are provided with information they can easily read or understand with support, for example large print, so they can communicate effectively with health and social care services
If you have any information or communication support needs relating to a disability, impairment or sensory loss please let us know.
Chaperones
Our Practice is committed to providing a safe, comfortable environment where patients and staff can be confident that best practice is being followed at all times; the safety of everyone is of paramount importance.
All medical consultations, examinations and investigations are potentially distressing. Patients can find examinations, investigations or photography involving the breasts, genitalia or rectum particularly intrusive (these examinations are collectively referred to as ‘intimate examinations’). Consultations involving dimmed lights, the need for patients to undress or intensive periods of being touched may also make a patient feel vulnerable.
Chaperoning is the process of having a third person present during such consultations to provide support, both emotional and sometimes physical, to the patient, to provide practical support to the Doctor as required, and also to protect the Doctor against allegations of improper behaviour during such consultations.
Please refer to our Chaperone Policy shown below for further information
Chaperone Policy
Introduction
This Policy is designed to protect both patients and staff from abuse or allegations of abuse, and to assist patients in making an informed choice about their examinations and consultations.
Guidelines
Clinicians (male and female) will consider whether an intimate or personal examination of the patient (either male or female) is justified, or whether the nature of the consultation poses a risk of misunderstanding.
- The Clinician will give the patient a clear explanation of what the examination will involve
- They will always adopt a professional and considerate manner and be careful with humour as a way of relaxing a nervous situation, as it can easily be misinterpreted
- The patient will always be provided with adequate privacy to undress and dress
- A suitable sign will be clearly on display in each Consulting or Treatment Room offering the Chaperone Service
The above guidelines are to remove the potential for misunderstanding. However, there will still be times when either the Clinician, or the patient, feels uncomfortable, and it would then be appropriate to consider using a Chaperone.
Patients who request a Chaperone will never be examined without a Chaperone being present. If necessary, where a Chaperone is not available, the consultation/examination will be rearranged for a mutually convenient time when a Chaperone can be present.
Complaints and claims have not been limited to Doctors treating/examining patients of the opposite gender – there are many examples of alleged assault by female and male doctors on people of the same gender.
Consideration will always be given by staff to the possibility of a malicious accusation by a patient, and a Chaperone organised if there is any potential for this.
There may be occasions when a Chaperone is needed for a home visit in which case the following procedure will be followed.
Who can act as a Chaperone?
A variety of people can act as a Chaperone in the practice, but staff undertaking a formal Chaperone role will have been trained in the competencies required. Where possible, Chaperones will be clinical staff familiar with procedural aspects of personal examination.
Where the Practice determines that non-clinical staff will act in this capacity, the patient will be asked to agree to the presence of a non-Clinician in the examination, and for confirmation that they are at ease with this. The staff member will be trained in the procedural aspects of personal examinations, be comfortable acting in the role of Chaperone, and be confident in the scope and extent of their role. They will also have received instruction on where to sit/stand and what to watch and listen for.
A Chaperone will document in the patient notes that they were present, and detail any issues arising.
Confidentiality
- The Chaperone will only be present for the examination itself, with most of the discussion with the patient taking place while the Chaperone is not present.
- Patients are reassured that all Practice staff understand their responsibility not to divulge confidential information.
Procedure
- The Clinician will contact reception to request a Chaperone
- Where no Chaperone is available, a Clinician may offer to delay the examination to a date when one will be available, as long as the delay would not have an adverse effect on the patient’s health
- If a Clinician wishes to conduct an examination with a Chaperone present but the patient does not agree to this, the Clinician will explain clearly why they want a Chaperone to be present. The Clinician may choose to consider referring the patient to a colleague who would be willing to examine them without a Chaperone, as long as the delay would not have an adverse effect on the patient’s health
- The Clinician will record in the notes that the Chaperone is present, and identify the Chaperone
- The Chaperone will enter the room discreetly and remain in the room until the Clinician has finished the examination
- A Chaperone will attend inside the curtain/screened-off area at the head of the examination couch and observe the procedure
- To prevent embarrassment, the Chaperone will not enter into conversation with the patient or GP unless requested to do so, or make any mention of the consultation afterwards
- The Chaperone will make a record in the patient’s notes after examination. The record will either state that there were no problems, or give details of any concerns or incidents that occurred. The Chaperone must be aware of the procedure to follow if any concerns require to be raised
- The patient can refuse a Chaperone, and if so this must be recorded in the patient’s medical record
Clinical Governance
Clinical governance is the system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care, by creating an environment in which clinical excellence will flourish.
Clinical governance encompasses quality assurance, quality improvement and risk & incident management.
Complaints
We make every effort to give the best service possible to everyone who attends our Practice.
However, we are aware that things can go wrong, resulting in a patient feeling that they have a genuine cause for complaint. If this is so, we would like the matter to be settled as quickly, and as amicably, as possible.
To have your complaint investigated, you need to complain within 12 months of the event happening, or as soon as you first become aware of the issue you want to complain about.
The time limit can be extended in special circumstances.
Interpreting Service
We can arrange for a meeting with the Practice Manager and an Interpreter for any patient whose first language is not English and needs help with their complaint.
How to make a compliment or complaint
Whether you are happy or unhappy with the care and treatment that you have received, please get in touch and let us know your views.
Receiving compliments and complaints is important to ensuring good quality local healthcare in our Practice – helping us to find out more about what we’re getting right and what we can improve.
We hope this will help you to make your feelings and experiences known to the appropriate people. Should you have a complaint we hope this page will give you more information about what to do, who to contact and what happens next.
How do I raise a concern / informal complaint?
You can speak to any member of staff initially with your complaint. This gives you the opportunity to resolve any concern you may have without it going through a formal process.
Most complaints are best resolved within the practice and these should be made via the Practice Manager.
Formal Complaint
What we will do
We will contact you about your complaint within three working days and offer to discuss with you the best way to investigate it, including the time scales for a reply. We will aim to offer you an explanation within that time frame. Or a meeting with the people involved.
- Find out what happened and what went wrong
- Invite you to discuss the problem with those involved, if you would like this
- Apologise where this is appropriate
- Identify what we can do to make sure that the problem does not happen again.
If you feel you do not want to contact the surgery directly, then you can contact the NHS Complaints team on:
NHS England,
PO Box 16738,
Redditch,
B97 9PT
If you are making a complaint please state: ‘For the attention of the complaints team’ in the subject line.
In General
If you have a complaint to make, you can either contact the Practice Manager or ask the Receptionist for a copy of our Complaints Procedure. We will endeavour to:
- acknowledge any letter or Complaints Form within 3 working days of receiving it.
- deal with the matter as promptly as possible – usually within 20 working days – dependent on the nature of the complaint.
Who can complain?
Complainants may be current or former patients, or their nominated or elected representatives (who have been given consent to act on the patients behalf).
Patients over the age of 16 whose mental capacity is unimpaired should normally complain themselves or authorise someone to bring a complaint on their behalf.
Children under the age of 16 can also make their own complaint, if they’re able to do so.
If a patient lacks capacity to make decisions, their representative must be able to demonstrate sufficient interest in the patient’s welfare and be an appropriate person to act on their behalf. This could be a partner, relative or someone appointed under the Mental Capacity Act 2005 with lasting power of attorney.
Appropriate Person
In certain circumstances, we need to check that a representative is the appropriate person to make a complaint.
For example, if the complaint involves a child, we must satisfy ourselves that there are reasonable grounds for the representative to complain, rather than the child concerned.
If the patient is a child or a patient who lacks capacity, we must also be satisfied that the representative is acting in the patient’s best interests.
If we are not satisfied that the representative is an appropriate person we will not consider the complaint, and will give the representative the reasons for our decision in writing.
Time Limits
A complaint must be made within 12 months, either from the date of the incident or from when the complainant first knew about it.
The regulations state that a responsible body should only consider a complaint after this time limit if:
- the complainant has good reason for doing so, and
- it’s still possible to investigate the complaint fairly and effectively, despite the delay.
Procedure
We have a two stage complaints procedure. We will always try to deal with your complaint quickly however if it is clear that the matter will need a detailed investigation, we will notify you and then keep you updated on our progress.
Stage one – Early, local resolution
- We will try to resolve your complaint within five working days if possible.
- If you are dissatisfied with our response, you can ask us to escalate your complaint to Stage Two.
Stage Two – Investigation
- We will look at your complaint at this stage if you are dissatisfied with our response at Stage One.
- We also escalate some complaints straight to this stage, if it is clear that they are complex or need detailed investigation.
- We will acknowledge your complaint within 3 working days and we will give you our decision as soon as possible. This will be no more that 20 working days unless there is clearly a good reason for needing more time to respond.
Complain to the Ombudsman
If, after receiving our final decision, you remain dissatisfied you may take your complaint to the Ombudsman.
The Ombudsman is independent of the NHS and free to use. It can help resolve your complaint, and tell the NHS how to put things right if it has got them wrong.
The Ombudsman only has legal powers to investigate certain complaints. You must have received a final response from the Practice before the Ombudsman can look at your complaint and it will generally not look into your complaint if it happened more than 12 months ago, unless there are exceptional circumstances.
Address:
Parliamentary & Health Service Ombudsman,
Tower 30,
Millbank,
London,
SW1P 4QP
Phone: 0345 015 4033
Other organisations that can help you make a complaint about health services
Citizen’s Advice
Healthwatch County Durham
NE NHS Independent Advocacy Service
Confidentiality
All complaints will be treated in the strictest confidence.
Where the investigation of the complaint requires consideration of the patient’s medical records, we will inform the patient or person acting on his/her behalf if the investigation will involve disclosure of information contained in those records to a person other than the Practice or an employee of the Practice.
We keep a record of all complaints and copies of all correspondence relating to complaints, but such records will be kept separate from patients’ medical records.
Statistics and reporting
The Practice must submit to the local primary care organisation periodically/at agreed intervals details of the number of complaints received and actioned.
Give feedback or make a complaint
You can complain to a member of staff at the NHS service you went to, such as a GP surgery or hospital, or you can complain to the organisation in charge: Give feedback or make a complaint from NHS UK.
Confidentiality
The practice complies with the Data Protection Act. All information about patients is confidential: from the most sensitive diagnosis, to the fact of having visited the surgery or being registered at the Practice.
All patients can expect that their personal information will not be disclosed without their permission except in the most exceptional of circumstances, when somebody is at grave risk of serious harm.
All members of the primary health care team (from reception to doctors) in the course of their duties will have access to your medical records. They all adhere to the highest standards of maintaining confidentiality.
You have a right to know who holds personal information about you. This person or organisation is called the Data Controller. In the NHS, the Data Controller is usually your local NHS Health Authority and/or your GP Surgery. The NHS must keep your personal health information confidential. It is your right.
Please be aware that our staff are bound to the NHS code of confidentiality; they are therefore not permitted to discuss any of our patient’s medical history, including their registration status, without their written consent to do so.
Once written consent has been received and verified with the patient we can provide you with information as required; this includes communicating with you on behalf of the patient with regards to any complaints, but excludes patients who are unable to act on their own behalf and already have a designated person or carer responsible for their medical care.
Under 16s:
The duty of confidentiality owed to a person under 16 is as great as the duty owed to any other person. Young people aged under 16 years can choose to see health professionals, without informing their parents or carers. If a GP considers that the young person is competent to make decisions about their health, then the GP can give advice, prescribe and treat the young person without seeking further consent.
However, in terms of good practice, health professionals will encourage young people to discuss issues with a parent or carer. As with older people, sometimes the law requires us to report information to appropriate authorities in order to protect young people or members of the public.
We therefore respectfully ask parents, relatives and guardians not to request information regarding their relatives/friends or to complain on their behalf unless we have their written consent that you may do so. If consent is required we advise that the person concerned attends the Practice to complete the required form.
Consent Protocol
Consent to treatment is the principle that a person must give permission before they receive any type of medical treatment, test or examination and is generally requested on the basis that an explanation of the required treatment, test or procedure has been received from a Clinician.
Consent from a patient is needed regardless of the procedure, whether it’s a physical examination, organ donation or something else.
The principle of consent is an important part of medical ethics and international human rights law.
Defining consent
For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision.
These terms are explained below:
- voluntary– the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family
- informed– the person must be given all of the information in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment doesn’t go ahead
- capacity– the person must be capable of giving consent, which means they understand the information given to them and they can use it to make an informed decision
If an adult has the capacity to make a voluntary and informed decision to consent to or refuse a particular treatment, their decision must be respected. This is still the case even if refusing treatment would result in their death, or the death of their unborn child.
If a person doesn’t have the capacity to make a decision about their treatment, the Healthcare Professionals treating them can go ahead and give treatment if they believe it’s in the person’s best interests.
Clinicians must however take reasonable steps to seek advice from the patient’s friends or relatives before making these decisions.
Read more about assessing the capacity to consent.
How consent is given
Consent can be given:
- verbally– for example, by saying you are happy to have an X-ray
- in writing– for example, by signing a Consent Form for surgery to be performed
Someone could also give non-verbal consent, as long as they understand the treatment or examination about to take place – for example, holding out an arm for a blood test.
Consent should be given to the Healthcare Professional directly responsible for the person’s current treatment, such as:
- a Nurse arranging a blood test
- a GP prescribing new medication
- a Surgeon planning an operation
If someone is going to have a major medical procedure such as an operation, their consent should ideally be secured plenty of time in advance, so that they have time to obtain information about the procedure and ask questions.
If a patient changes their mind at any point before the procedure, they are entitled to withdraw their previous consent.
Consent from children and young people
If they’re able to, consent is usually given by patients themselves. However, someone with parental responsibility may need to give consent for a child up to the age of 16 to have treatment.
Read more about the rules of consent applying to children and young people.
When consent isn’t needed
There are a few exceptions when treatment may be able to go ahead without the person’s consent, even if they’re capable of giving their permission.
It may not be necessary to obtain consent if a person:
- requires emergency treatment to save their life, but they’re incapacitated (for example, they’re unconscious) – the reasons why treatment was necessary should be fully explained once they’ve recovered
- immediately requires an additional emergency procedure during an operation – there has to be a clear medical reason why it would be unsafe to wait to obtain consent, and it can’t be simply for convenience
- with a severe mental health condition such as schizophrenia, bipolar disorder or dementia, lacks the capacity to consent to the treatment of their mental health (under the Mental Health Act 1983) – in these cases, treatment for unrelated physical conditions still requires consent, which the patient may be able to provide, despite their mental illness
- requires Hospital treatment for a severe mental health condition, but self-harmed or attempted suicide while competent and is refusing treatment (under the Mental Health Act 1983) – the person’s nearest relative or an approved Social Worker must make an application for the person to be forcibly kept in Hospital, and two Doctors must assess the person’s condition
- is a risk to public health as a result of rabies, cholera or tuberculosis (TB)
- is severely ill and living in unhygienic conditions (under the National Assistance Act 1948) – a person who is severely ill or infirm and is living in unsanitary conditions can be taken to a place of care without their consent
You can always talk to the clinician providing you with care if you have any concerns in relation to consent.
Consent and life-sustaining treatments
A person may be being kept alive with supportive treatments – such as lung ventilation – without having made an advance decision based on information which outlined the care that they may have refused to receive.
In these cases, a decision about continuing or stopping treatment needs to be made based on what that person’s best interests are believed to be.
To help reach a decision, the Healthcare Professionals responsible for the person’s care should discuss the issue with the relatives and friends of the person receiving the treatment.
They should consider, among other things:
- what the person’s quality of life will be if treatment is continued
- how long the person may live if treatment is continued
- whether there’s any chance of the person recovering
Treatment can be withdrawn if there’s an agreement that continuing treatment isn’t in the person’s best interests.
The case will be referred to the Courts before further action is taken if:
- an agreement can’t be reached
- a decision has to be made on whether to withdraw treatment from someone who has been in a state of impaired consciousness for a long time (usually at least 12 months)
It’s important to note the difference between withdrawing a person’s life support and taking a deliberate action to make them die. For example, injecting a lethal drug would illegal.
Complaints
If you believe you’ve received treatment you didn’t consent to, you can make an official complaint, please write to the Practice Manager, who will assist you with this process.
Duty of Candour
We share a common purpose with our partners in health and social care – and that is to provide high quality care and ensure the best possible outcomes for the people who use our services. Promoting improvement is at the heart of what we do.
We endeavour to provide a first class service at all times but sometimes things go wrong and our service may fall below our expected levels.
In order to comply with Regulation 20 of the Health and Social Care Act 2008 (Regulations 2014) we pledge to:
- Have a culture of openness and honesty at all levels
- Inform patients in a timely manner when safety incidents have occurred which may affect them
- Provide a written and truthful account of the incident, explaining any investigations and enquiries made
- Provide a written apology
- Provide support if you are affected directly by an incident
Entitlement to NHS Treatment
The NHS is the UK’s state health service which provides treatment for UK residents. Some services are free, other have to be paid for. The regulations that govern who can and can’t receive treatment are complex and may change.
If you have any questions relating to entitlement to treatment under the NHS please contact the Practice.
Free Services
GP and Nurse consultations in primary care, treatment provided by a GP and other primary care services are free of charge to all, whether registering as an NHS patient, or as a temporary patient (which is when the patient is in the area for more than 24 hours and less than 3 months).
For secondary care services, the UK’s healthcare system is a residence based one, which means entitlement to free healthcare is based on living lawfully in the UK on an approved and settled basis. The measure of residence that the UK uses to determine entitlement to free NHS healthcare is known as ‘ordinary residence’. This requires non-EEA nationals subject to immigration control, to also have the immigration status of ‘indefinite leave to remain’.
Individuals who are not ordinarily resident in the UK may be required to pay for their care when they are in England. However, some services and some individuals are exempt from payment.
The following NHS treatment is available to anyone:
- Treatment in an emergency (but not follow up treatment)
- Treatment of certain communicable diseases
- Compulsory psychiatric treatment
GPs are the first point of contact for virtually all NHS patients:
- They can direct you to other NHS services and are experts in family medicine, preventative care, health education, and treating people with multiple and long-term conditions
- If you’re planning to live and work in England, you need to register with a local GP
- Being registered with a GP Practice does not in itself mean you’ll be entitled to free NHS hospital treatment
- You’ll need to fill out a GMS1 form (PDF) using exactly the same details you used when you filled out your visa
- If you’re in England for a short visit but need to see a GP, you can register as a temporary patient with a local Doctor – to do this, you need to be in the area for more than 24 hours but less than 3 months
- Treatment will be free of charge, but make sure you present your Global Insurance Card if you have one
Medical emergencies
If you need immediate medical assistance (e.g. because of an accident) telephone 999. The call is free.
An Operator will ask you which emergency service you require (Fire, Police or Ambulance). You will need to tell the emergency services what has happened and where you are.
If someone is injured and needs to go to Hospital, an ambulance will be sent out to pick the patient up and take them to the nearest Hospital that has an Accident & Emergency Department.
If you need urgent treatment but are well enough to travel please make your own way to the nearest Accident & Emergency Department.
Equality and Diversity
Our Policy is designed to ensure and promote equality and inclusion, supporting the ethos and requirements of the Equality Act 2010 for all visitors to our Practice.
We are committed to:
- ensuring that all visitors are treated with dignity and respect
- promoting equality of opportunity between men and women
- not tolerating any discrimination or perceived discrimination against, or harassment of, any visitor for reason of age, sex, gender, marital status, pregnancy, race, ethnicity, disability, sexual orientation, religion or belief
- providing the same treatment and services (including the ability to register with the Practice) to any visitor irrespective of age, sex, marital status, pregnancy, race, ethnicity, disability, sexual orientation, medical condition, religion or belief
This Policy applies to the general public, including all patients and their families, visitors and contractors.
Procedure
Discrimination by the Practice or Visitors / patients against you
If you feel discriminated against:
- You should bring the matter to the attention of the Practice Manager
- The Practice Manager will investigate the matter thoroughly and confidentially within 14 working days
- The Practice Manager will establish the facts and decide whether or not discrimination has taken place, and advise you of the outcome of the investigation within 14 working days
- If you are not satisfied with the outcome, you should raise a formal complaint through our Complaints Procedure
Discrimination against our Practice staff
The Practice will not tolerate any form of discrimination or harassment of our staff by any visitor. Any visitor who expresses any form of discrimination against or harassment of any member of our staff will be required to leave the Practice premises immediately. If the visitor is a patient they may also, at the discretion of the Practice Management, be removed from the Practice list if any such behaviour occurs.
Freedom of Information
The Freedom of Information Act creates a right of access to recorded information and obliges a public authority to:
- Have a publication scheme in place
- Allow public access to information held by public authorities.
The Act covers any recorded organisational information such as reports, policies or strategies, that is held by a public authority in England, Wales and Northern Ireland, and by UK-wide public authorities based in Scotland, however it does not cover personal information such as patient records which are covered by the Data Protection Act.
Public authorities include government departments, local authorities, the NHS, state schools and police forces.
The Act is enforced by the Information Commissioner who regulates both the Freedom of Information Act and the Data Protection Act.
The Surgery publication scheme
A publication scheme requires an authority to make information available to the public as part of its normal business activities. The scheme lists information under seven broad classes, which are:
- who we are and what we do
- what we spend and how we spend it
- what our priorities are and how we are doing it
- how we make decisions
- our policies and procedures
- lists and registers
- the services we offer
You can request our publication scheme leaflet at the surgery.
Who can request information?
Under the Act, any individual, anywhere in the world, is able to make a request to a practice for information. An applicant is entitled to be informed in writing, by the practice, whether the practice holds information of the description specified in the request and if that is the case, have the information communicated to him. An individual can request information, regardless of whether he/she is the subject of the information or affected by its use.
How should requests be made?
Requests must:
- be made in writing (this can be electronically e.g. email/fax)
- state the name of the applicant and an address for correspondence
- describe the information requested.
What cannot be requested?
Personal data about staff and patients covered under the Data Protection Act.
For more information see these websites:
General Practice Extraction Service (GPES)
General Practice Extraction Service (GPES) is a centrally managed, primary care, data extraction service being introduced across England, and is managed by the Health and Social Care Information Centre (HSCIC).
The purpose of GPES is to extract and compare data from across the NHS, allowing data to be turned into accurate and usable management information; this in turn leads to improvements in patient care and greater efficiency across the service as a whole. The data extracted is also used to support QOF, although GPES does not calculate or make these payments, that task is carried out by the Calculating Quality Reporting Service (CQRS).
Click on the link below to be redirected to a more in depth review of how ‘Care Data’ is being managed.
For further information please access: General Practice Extraction Service (GPES) – NHS England Digital
Giving Consent to Treatment
You have the right to accept or refuse treatment that is offered to you, and not to be given any physical examination or treatment unless you have given valid consent. If you do not have the capacity to do so, consent must be obtained from a person legally able to act on your behalf, or the treatment must be in your best interests.
Your valid consent (agreement to the course of action) is needed for the treatment that’s offered to you before any physical examinations or treatment can be given. If you haven’t given your consent, you can accept or refuse treatment that’s offered to you.
It’s important to be involved in decisions about your treatment and to be given information to help you choose the right treatment. When making treatment choices, you’ll often discuss the options with your doctor or another healthcare professional.
GP Earnings
The average earnings for GPs working in the Pelton and Fellrose Medical Group in 2021/22 was £89,622 before taxation and National Insurance. This is for 3 full time GPs and 2 part time GPs who worked in the practice for more than 6 months.
Disclaimer
NHS England require that the net earnings of Doctors engaged in the Practice is publicised, and the required disclosure is shown above. However it should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time Doctors spend working in the Practice, and should not be used to form any judgement about GP earnings, nor to make any comparison with any other Practice.
Infection Control Statement
We aim to keep our surgery clean and tidy and offer a safe environment to our patients and staff. We are proud of our modern, purpose built Practice and endeavour to keep it clean and well maintained at all times.
If you have any concerns about cleanliness or infection control, please report these to our Reception staff.
Our GPs and nursing staff follow our Infection Control Policy to ensure the care we deliver and the equipment we use is safe.
We take additional measures to ensure we maintain the highest standards:
- Encourage staff and patients to raise any issues or report any incidents relating to cleanliness and infection control. We can discuss these and identify improvements we can make to avoid any future problems
- Carry out an annual infection control audit to make sure our infection control procedures are working
- Provide annual staff updates and training on cleanliness and infection control
- Review our policies and procedures to make sure they are adequate and meet national guidance
- Maintain the premises and equipment to a high standard within the available financial resources and ensure that all reasonable steps are taken to reduce or remove all infection risk
- Use washable or disposable materials for items such as couch rolls, modesty curtains, floor coverings, towels etc., and ensure that these are laundered, cleaned or changed frequently to minimise risk of infection
- Make Alcohol Hand Rub Gel available throughout the building
Named GP Policy
As part of the NHS commitment to providing more personalised care, from June 2015 all practices are required to provide all their Patients with a named GP who will have overall responsibility for the care and support that our surgery provides.
- This will not impact your experience at the practice, the provision of appointments, your treatment, or which GP you can see
- You may wonder why your allocated GP is not necessarily the one you see most regularly. Please be assured that you can still access all of our medical team in exactly the same way as before
- Having a named GP does not guarantee you will always be seen by that GP
- Please note that the GP responsible for your care may be subject to change and reallocation in the future
You do not need to take any further action, but if you have any questions or wish to know your named GP, please speak to a member of the reception team.
What does ‘accountable’ mean?
This is largely a role of oversight, with the requirements being introduced to reassure patients that they have one GP within the practice who is responsible for ensuring that this work is carried out on their behalf.
What are the named GP’s responsibilities to 75s and over?
This is unchanged from 2014-2015; for patients aged 75 and over the named accountable GP is responsible for:
- working with relevant associated health and social care professionals to deliver a multi-disciplinary care package that meets the needs of the patient.
- ensuring that these patients have access to a health check as set out in section 7.9 of the GMS Contract Regulations.
Does the requirement mean 24-hour responsibility for patients? No. The named GP will not:
- take on vicarious responsibility for the work of other doctors or health professional
- take on 24-hour responsibility for the patient, or have to change their working hours. The requirement does not imply personal availability for GPs throughout the working week
- be the only GP or clinician who will provide care to that patient
Can patients choose their own named GP?
In the first instance, patients should simply be allocated a named GP. However, if a patient requests a particular GP, reasonable efforts should be made to accommodate their preference, recognising that there are occasions when the practice may not feel the patient’s preference is suitable.
Do patients have to see the named GP when they book an appointment with the practice?
No. Patients can and should feel free to choose to see any GP or nurse in the practice in line with current arrangements. However, some practices may see this change as a way to encourage and promote a greater degree of continuity of care for patients.
Non-Smoking Premises
Smoking is not permitted either within the Practice premises or in the Practice car park.
Privacy Policy
Our Practice aims to ensure the highest standard of medical care for our patients and we are committed to protecting and respecting your privacy. To do this we keep records about you, your health and the care we have provided, or plan to provide, to you. This Privacy Policy does not provide exhaustive details of all aspect of the collection and use of personal information by the practice. However, we are happy to provide any additional information or explanation needed.
Introduction
- This is a notice to inform you of our Policy about all information that we record about you. It sets out the conditions under which we may process any information that we collect from you, or that you provide to us. It covers information that could identify you (personal information) and information that could not. In the context of the law and this notice, ‘process’ means collect, store, transfer, use or otherwise act on information.
- We regret that if there are one or more points below with which you are not happy, your only recourse is to leave our website immediately.
- We take seriously the protection of your privacy and confidentiality. We understand that all visitors to our website are entitled to know that their personal data will not be used for any purpose unintended by them, and will not accidentally fall into the hands of a third party.
- We undertake to preserve the confidentiality of all information you provide to us, and hope that you reciprocate.
- Our Policy complies with UK law accordingly implemented, including that required by the EU General Data Protection Regulation (GDPR).
- The Law requires us to tell you about your rights and our obligations to you with regards to the processing and control of your personal data. We do this now, by requesting that you read the information provided at Know Your Privacy Rights.
- Except as set out below, we do not share, sell or disclose to a third party, any information collected through our website.
What is GDPR?
The GDPR is the replacement for the Data Protection Act and comes into effect on the 25th of May 2018. Although it is European legislation the UK will be adopting GDPR into UK law even after Brexit.
Caldicott Guardian
The Caldicott Guardian/IG Lead is responsible for;
- Ensuring implementation of the Caldicott Principles and Data Security Standards with respect to Patient Confidential Data.
- Ensuring that the Practice processes satisfy the highest practical standards for handling patient information and provide advice and support to Practice staff as required.
- Ensuring that patient identifiable information is shared appropriately and in a secure manner. The Caldicott Guardian will liaise where there are reported incidents of person identifiable data loss or identified threats and vulnerabilities in Practice information systems to mitigate the risk.
The aim of the Caldicott Guardian is to ensure the organisation implements the Caldicott principles and data security standards; there is no need to appoint a Caldicott Guardian, but there is a need to have an Information Governance lead (sometimes referred to as a Caldicott lead) who, if they are not a clinician, will need support from a clinically qualified individual.
Care Quality Commission (CQC)
The CQC regulates health and social care services to ensure that safe care is provided. The Law says that we must report certain serious events to the CQC, for example, when patient safety has been put at risk.
Information about the Care Quality Care Commission (CQC)
CCTV
Please note this policy is only applicable if CCTV has been installed.
Closed circuit TV is installed at our premises. This is for the purposes of staff, patient and premises security. Cameras are located at various places on the premises and images from the cameras are recorded. The use of CCTV falls within the scope of the Data Protection Act. Images from cameras and recordings are held on a computer system and held in secure storage with controlled access for the required statutory period.
Child Health Information
We wish to make sure that your child has the opportunity to have immunisations and health checks when they are due. We share information about childhood immunisations, the 6-8 week new baby check and breast-feeding status with our NHS Trust health visitors and school nurses.
Clinical Audit
Information may be used by the CCG for clinical audit to monitor the quality of the service provided to patients with long-term conditions. Some of this information may be held centrally and used for statistical purposes (e.g. the National Diabetes Audit). When this happens, strict measures are taken to ensure that individual patients cannot be identified from the data.
Clinical Research
We fully respect your confidentiality and will not share your medical information with any identifiable data (no names, full postcodes, NHS numbers or full dates of birth).
If you have requested that you data is not to be shared outside the practice then your information will not be included in these statistics. However sometimes your information may be requested to be used for research purposes – we will always ask your permission before releasing your information for this purpose.
If you have any queries about this please ask to speak to the Practice Manager.
Complaining
When we receive a complaint, we record all the information you have given to us.
We use that information to resolve your complaint.
If your complaint reasonably requires us to contact some other person, we may decide to give to that other person some of the information contained in your complaint. We do this as infrequently as possible, but it is a matter for our sole discretion as to whether we do give information, and if we do, what that information is.
We may also compile statistics showing information obtained from this source to assess the level of service we provide, but not in a way that could identify you or any other person.
How you can complain
If you are happy for your data to be extracted and used for the purposes described in this privacy notice then you do not need to do anything. If you have any concerns about how your data is shared then please contact the Practice.
- If you are not happy with our Privacy Policy or if have a complaint then you should tell us by writing to us.
- If a dispute is not settled then we hope you will agree to attempt to resolve it by engaging in good faith with us in a process of mediation or arbitration.
- If you are in any way dissatisfied about how we process your personal information, you have a right to lodge a complaint with the Information Commissioner’s Office. This can be done at ICO concerns.
- The Information Commissioner,
Wycliffe House,
Water Lane,
Wilmslow,
Cheshire,
SK9 5AF
Phone: 0303 123 1113
Confidentiality Statement
We are committed to maintaining confidentiality and protecting the information we hold about you. We adhere to the General Data Protection Regulation (GDPR), the NHS Codes of Confidentiality and Security, as well as guidance issued by the Information Commissioner’s Office (ICO).
You have a right to access the information we hold about you, and if you would like to access this information, you will need to write to the practice requesting the information. Furthermore, should you identify any inaccuracies; you have a right to have the inaccurate data corrected.
Anyone who receives information from us also has a legal duty to keep it confidential and secure.
All staff in the Practice sign a Confidentiality Agreement that explicitly makes clear their duties in relation to personal health information and the consequences of breaching that duty.
Please be aware that your information will be accessed by non-clinical Practice staff in order to perform tasks enabling the functioning of the Practice. These include, but not limited to:
- typing referral letters to Hospital Consultants or allied Healthcare Professionals
- opening letters from Hospitals and Consultants
- scanning clinical letters, radiology reports and any other documents not available in electronic format
- photocopying or printing documents for referral to Consultants
- handling, printing, photocopying and postage of medical legal and insurance reports and of associated documents
How we keep your information confidential and safe
Everyone working for our organisation is subject to the Common Law Duty of Confidence. Information provided in confidence will only be used for specific purposes in accordance with the law. The NHS Digital Code of Practice on Confidential Information applies to all NHS staff and they are required to protect your information, inform you of how your information will be used, and allow you to decide if and how your information can be shared. All our staff are expected to make sure information is kept confidential and receive regular training on how to do this.
The health records we use may be electronic, on paper or a mixture of both, and we use a combination of working practices and technology to ensure that your information is kept confidential and secure. Your records are backed up securely in line with NHS standard procedures.
We ensure that the information we hold is kept in secure locations, is protected by appropriate security and access is restricted to authorised personnel. We also make sure external data processors that support us are legally and contractually bound to operate and prove security arrangements are in place where data that could or does identify a person are processed. We are committed to protecting your privacy and will only use information collected lawfully in accordance with:
- Data Protection Act 2018
- Human Rights Act
- Common Law Duty of Confidentiality
- NHS Codes of Confidentiality and Information Security
- Health and Social Care Act 2015
- And all applicable legislation
We have a senior person responsible for protecting the confidentiality of patient information and enabling appropriate information sharing. This person is called the Caldicott Guardian.
We are registered with the Information Commissioner’s Office (ICO) as a data controller which describes the purposes for which we process personal data. A copy of the registration is available from the ICO’s website by searching on our name.
We maintain our duty of confidentiality to you at all times. We will only ever use or pass on information about you if we reasonably believe that others involved in your care have a genuine need for it. We will not disclose your information to any third party without your permission unless there are exceptional circumstances (such as a risk of serious harm to yourself or others) or where the law requires information to be passed on.
COVID-19 supplementary notice
The health and social care system is facing significant pressures due to the coronavirus outbreak. Health and care information is essential to deliver care to individuals, to support health and social care services and to protect public health. Information will also be vital in researching, monitoring, tracking and managing the outbreak. In the current emergency, it has become even more important to share health and care information across relevant organisations.
This notice describes how GPs and other health and social care organisations may use your information within the health and social care system to protect you and others during the Coronavirus (COVID-19) outbreak with regard to your Summary Care Record.
Further information regarding COVID-19 supplementary privacy notice from NHS UK
Data Controller
The Data Protection Act 2018 requires organisations to register a notification with the Information Commissioner to describe the purposes for which they process personal and sensitive information.
We are registered as the data controller and our registration can be viewed online in the public register at: Register of fee payers.
Any changes to this notice will be published on our website and in a prominent area at the Practice.
Data Processor
Data processors are responsible for the processing of personal data on behalf of the data controller. Processors must ensure that processing is lawful and that at least one of the following applies:
- The data subject has given consent to the processing of his/her personal data for one or more specific purposes
- Processing is necessary for the performance of a contract to which the data subject is party, or in order to take steps at the request of the data subject prior to entering into a contract
- Processing is necessary for compliance with a legal obligation to which the controller is subject
- Processing is necessary in order to protect the vital interests of the data subject or another natural person
- Processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller
- Processing is necessary for the purposes of the legitimate interests pursued by the controller or by a third party, except where such interests are overridden by the interests or fundamental rights and freedoms of the data subject which require protection of personal data, in particular where the data subject is a child
At our Practice all staff are classed as data processors as their individual roles will require them to access and process personal data.
Data Protection Officer (DPO)
The Data Protection Officer is responsible for ensuring the Practice remains compliant at all times with Data Protection, Privacy & Electronic Communications Regulations, Freedom of Information Act and the Environmental Information Regulations. The Data Protection Officer shall:
- Lead on the provision of expert advice to the Practice on all matters concerning the Data Protection Act, compliance, best practice and setting and maintaining standards
- Inform and advise the organisation and its employees of their data protection obligations under the GDPR
- Monitor the organisation’s compliance with the GDPR and internal data protection policies and procedures. This will include monitoring the assignment of responsibilities, awareness training, and training of staff involved in processing operations and related audits
- Advise on the necessity of data protection impact assessments (DPIAs), the manner of their implementation and outcomes
- Serve as the contact point to the data protection authorities for all data protection issues, including data breach reporting
The DPO will be independent and an expert in data protection. The DPO will be the Practice’s point of contact with the Information Commissioner’s Office. Please address your request for the attention of the Data Protection Officer (DPO).
Please contact the Data Protection Officer if:
- You have any questions about how your information is being held
- If you require access to your information or if you wish to make a change to your
- information
- If you wish to make a complaint about anything to do with the personal and healthcare
- information we hold about you
- Or any other query relating to this Policy and your rights as a patient.
The Data Protection Officer for the Practice is: Liane Cotterill
If you would like to contact the Data Protection Officer, please use the following Email: liane.cotterill@nhs.net.
Or you can write to the DPO at:
Liane Cotterill,
Senior Governance Manager & Data Protection Officer,
North of England Commissioning Support,
Teesdale House,
Westpoint Road,
Thornaby,
Stockton-on-Tees,
TS17 6BL
Data Retention
We manage patient records in line with the Records Management NHS Code of Practice for Health and Social Care, which sets the required standards of practice in the management of records for those who work within or under contract to NHS organisations in England. This is based on current legal requirements and professional best practice.
If you transfer to another GP and we are asked to transfer your records we will do this to ensure your care is continued. Currently the NHS is required to keep GP records for 10 years after a patient has died. Exceptions to these rules are detailed in the code of practice.
Data Subject Access Requests (DSAR)
Data Subject Access Requests (DSAR): You have a right under the Data Protection legislation to request access to view or to obtain copies of what information the surgery holds about you and to have it amended should it be inaccurate. To request this, you need to do the following:
- Your request should be made to the Practice – for information from the hospital you should write direct to them
- There is no charge to have a copy of the information held about you
- We are required to respond to you within one month
- You will need to give adequate information (for example full name, address, date of birth, NHS number and details of your request) so that your identity can be verified, and your records located information we hold about you at any time
Department for Work and Pensions
Our Practice is legally required to provide anonymised data on patients who have been issued with a fit note under the Fit for Work scheme. The purpose is to provide the Department for Work and Pensions with information from Fit Notes to improve the monitoring of public health and commissioning and quality of health services.
Identifying patients who might be at risk of certain diseases
- Your medical records will be searched by a computer programme so that we can identify patients who might be at high risk from certain diseases such as heart disease or unplanned admissions to hospital.
- This means we can offer patients additional care or support as early as possible.
- This process will involve linking information from your GP record with information from other health or social care services you have used.
- Information which identifies you will only be seen by this practice.
- Contact us if you require more information on this.
Individual Funding Request
An ‘Individual Funding Request’ is a request made on your behalf, with your consent, by a Clinician, for funding of specialised healthcare which falls outside the range of services and treatments that CCG has agreed to commission for the local population.
An Individual Funding Request is taken under consideration when a case can be set out by a patient’s Clinician that there are exceptional clinical circumstances which make the patient’s case different from other patients with the same condition and who are at the same stage of their disease, or when the request is for a treatment that is regarded as new or experimental and where there are no other similar patients who would benefit from this treatment.
A detailed response, including the criteria considered in arriving at the decision, will be provided to the patient’s Clinician.
Invoice Validation
Invoice validation is an important process. It involves using your NHS number to check which CCG is responsible for paying for your treatment. Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for invoice validation purposes.
We can also use your NHS number to check whether your care has been funded through specialist commissioning, which NHS England will pay for. The process makes sure that the organisations providing your care are paid correctly.
Job application and employment
If you send us information in connection with a job application, we may keep it for up to three years in case we decide to contact you at a later date.
If we employ you, we collect information about you and your work from time to time throughout the period of your employment. This information will be used only for purposes directly relevant to your employment. After your employment has ended, we will keep your file for six years before destroying or deleting it.
Keeping your records up to date
GDPR requires that the information we hold about you is accurate and current. We rely on our patients to tell us if they have moved house, or had medical treatment abroad.
For our part, we will update your medical records at each consultation with a doctor or a nurse (either face to face, or by telephone), and with any relevant information we receive from hospital, community or social services providers (e.g. new diagnoses, change in circumstances).
Medicines Management
CCG’s and some GP Federations operate Pharmacist and prescribing advice services to support local GP practices with prescribing queries, which may require identifiable information to be shared. These Pharmacists work with your usual GP to provide advice on medicines and prescribing queries, and review prescribing of medicines to ensure that it is appropriate for your needs, is safe and also cost-effective.
Where specialist prescribing support is required, the CCG Medicines Management Team may order medications on behalf of your GP Practice to support your care.
Supporting Locally Commissioned Services, CCGs support GP Practices by auditing anonymised data to monitor locally commissioned services, measure prevalence and support data quality. The data does not include identifiable information.
Mobile phone numbers
If you provide us with your mobile phone number, we may use this to send you reminders about any appointments or other health screening information being carried out. This may be by telephone call or SMS text messaging, if this service is available.
Please contact the reception if you wish to ‘opt-out’ of this service and this information will be added to your records.
National Fraud Initiative – Cabinet Office
The use of data by the Cabinet Office for data matching is carried out with statutory authority under Part 6 of the Local Audit and Accountability Act 2014. It does not require the consent of the individuals concerned under the Data Protection Act 2018. Data matching by the Cabinet Office is subject to a Code of Practice.
For further information see UK Government publications code of data.
National Registries
National Registries (such as the Learning Disabilities Register) have statutory permission under Section 251 of the NHS Act 2006, to collect and hold service user identifiable information without the need to seek informed consent from each individual service user.
National Screening
The NHS provides national screening programmes so that certain diseases can be detected at an early stage. These currently apply to bowel cancer, breast cancer, aortic aneurysms and diabetic retinal screening service. The law allows us to share your contact information with Public Health England so that you can be invited to the relevant screening programme.
More information can be found at: Population screening programmes, or if you prefer please contact the Practice.
Please contact the Practice if you do not wish to participate in any National Screening programmes offered.
National Data Opt-Out – General Practice Data for Planning and Research (GPDPR)
NHS Digital want to collect
- data about diagnoses, symptoms, observations, test results, medications, allergies, immunisations, referrals, recalls and appointments, including information about physical, mental and sexual health
- data on sex, ethnicity and sexual orientation
- data about staff who have treated patients in a pseudonymised way (which is still personal data, as the data can be linked back
Further information about General Practice Data for Planning and Research (GPDPR) and opting out can be found at NHS Digital.
Opt-outs
You have a right to object to your information being shared. Should you wish to opt out of data collection, please contact a member of staff who will be able to explain how you can opt out and prevent the sharing of your information; this is done by registering a Type 1 opt-out, preventing your information from being shared outside this Practice.
If you have previously opted-out of any data sharing arrangements, your opt-out I will continue to be valid.
Other Matters
Use of our website by children
- If you are under 18, you may use our website only with consent from a parent or guardian
- We collect data about all users of and visitors to these areas regardless of age, and we anticipate that some of those users and visitors will be children
- Such child users and visitors will inevitably visit other parts of the site and will be subject to whatever on-site information they find, wherever they visit
Encryption of data sent between us
We use Secure Sockets Layer (SSL) certificates to verify our identity to your browser and to encrypt any data you give us.
Whenever information is transferred between us, you can check that it is done so using SSL by looking for a closed padlock symbol or other trust mark in your browser’s URL bar or toolbar.
NHS APP
The NHS App is a nationally run service that allows individuals to access a range of services within the Practice and beyond. NHS England and NHS Digital are joint data controllers of the NHS App and any personal data that is necessary for accessing the App.
The data controller or processor of your personal data within a service accessed via the App will depend on the organisation accessed. Please see the NHS App privacy notice for further information.
NHS Digital
NHS Digital collects health information from the records health and social care providers keep about the care and treatment they give, to promote health or support improvements in the delivery of care services in England.
Our legal basis for sharing data with NHS Digital
NHS Digital has been legally directed to collect and analyse patient data from all GP practices in England to support the coronavirus response for the duration of the outbreak. NHS Digital will become the controller under the General Data Protection Regulation 2016 (GDPR) of the personal data collected and analysed jointly with the Secretary of State for Health and Social Care, who has directed NHS Digital to collect and analyse this data under the COVID-19 Public Health Directions 2020 (COVID-19 Direction).
All GP practices in England are legally required to share data with NHS Digital for this purpose under the Health and Social Care Act 2012 (2012 Act). More information about this requirement is contained in the data provision notice issued by NHS Digital to GP practices.
Under GDPR our legal basis for sharing this personal data with NHS Digital is Article 6(1)(c) – legal obligation. Our legal basis for sharing personal data relating to health, is Article 9(2)(g) – substantial public interest, for the purposes of NHS Digital exercising its statutory functions under the COVID-19 Direction.
The type of personal data we are sharing with NHS Digital
The data being shared with NHS Digital will include information about patients who are currently registered with a GP practice or who have a date of death on or after 1 November 2019 whose record contains coded information relevant to coronavirus planning and research.
The data contains NHS Number, postcode, address, surname, forename, sex, ethnicity, date of birth and date of death for those patients. It will also include coded health data which is held in your GP record such as details of:
- diagnoses and findings
- medications and other prescribed items
- investigations, tests and results
- treatments and outcomes
- vaccinations and immunisations
How NHS Digital will use and share your data
NHS Digital will analyse the data they collect and securely and lawfully share data with other appropriate organisations, including health and care organisations, bodies engaged in disease surveillance and research organisations for coronavirus response purposes only.
These purposes include protecting public health, planning and providing health, social care and public services, identifying coronavirus trends and risks to public health, monitoring and managing the outbreak and carrying out of vital coronavirus research and clinical trials. The British Medical Association, the Royal College of General Practitioners and the National Data Guardian are all supportive of this initiative.
NHS Digital has various legal powers to share data for purposes relating to the coronavirus response. It is also required to share data in certain circumstances set out in the COVID-19 Direction and to share confidential patient information to support the response under a legal notice issued to it by the Secretary of State under the Health Service (Control of Patient Information) Regulations 2002 (COPI Regulations).
Legal notices under the COPI Regulations have also been issued to other health and social care organisations requiring those organisations to process and share confidential patient information to respond to the coronavirus outbreak. Any information used or shared during the outbreak under these legal notices or the COPI Regulations will be limited to the period of the outbreak unless there is another legal basis for organisations to continue to use the information.
Data which is shared by NHS Digital will be subject to robust rules relating to privacy, security and confidentiality and only the minimum amount of data necessary to achieve the coronavirus purpose will be shared. Organisations using your data will also need to have a clear legal basis to do so and will enter into a data sharing agreement with NHS Digital.
Information about the data that NHS Digital shares, including who with and for what purpose will be published in the NHS Digital data release register.
For more information about how NHS Digital will use your data please see the NHS Digital Transparency Notice for GP Data for Pandemic Planning and Research (COVID-19).
National Data Opt-Out
The application of the National Data Opt-Out to information shared by NHS Digital will be considered on a case by case basis and may or may not apply depending on the specific purposes for which the data is to be used. This is because during this period of emergency, the National Data Opt-Out will not generally apply where data is used to support the coronavirus outbreak, due to the public interest and legal requirements to share information.
Your rights over your personal data
To read more about the health and care information NHS Digital collects, its legal basis for collecting this information and what choices and rights you have in relation to the processing by NHS Digital of your personal data, see:
- the NHS Digital GPES Data for Pandemic Planning and Research (COVID-19) Transparency Notice
- the NHS Digital Coronavirus (COVID-19) Response Transparency Notice
- the NHS Digital General Transparency Notice
- how NHS Digital looks after your health and care information
Payments
Contract holding GPs in the UK receive payments from their respective governments on a tiered basis. Most of the income is derived from baseline capitation payments made according to the number of patients registered with the practice on quarterly payment days.
These amount paid per patient per quarter varies according to the age, sex and other demographic details for each patient. There are also graduated payments made according to the practice’s achievement of certain agreed national quality targets known as the Quality and Outcomes Framework (QUOF), for instance the proportion of diabetic patients who have had an annual review.
Practices can also receive payments for participating in agreed national or local enhanced services, for instance opening early in the morning or late at night or at the weekends. Practices can also receive payments for certain national initiatives such as immunisation programs and practices may also receive incomes relating to a variety of non patient related elements such as premises.
Finally there are short term initiatives and projects that practices can take part in. Practices or GPs may also receive income for participating in the education of medical students, junior doctors and GPs themselves as well as research.
In order to make patient based payments basic and relevant necessary data about you needs to be sent to the various payment services. The release of this data is required by English laws – NHS England’s powers to commission health services under the NHS Act 2006 or to delegate such powers to CCGs and the GMS regulations 2004 (73)1).
Prescriptions
Processing of prescriptions
We process prescription requests on a daily basis. This involves our staff accessing information held about you on our computer database, to produce prescription(s) that you, your carer, nominated person, or Pharmacy has requested. Prescriptions can be requested using various methods: by telephone, online via our computer system, Electronic prescriptions, by post, in writing, via fax (if available) or in person. Please refer to our Prescription Procedure for further information. If using the postal service always allow extra time so you do not run out of your medication.
Collection/uplift of prescriptions
We will always ask for your details when a prescription uplift request is received; this could be your name, date of birth and address, medication you requested, or Community Health Index Number (which uniquely identifies you). This ensures that we can produce your prescription(s) efficiently, and reduces the risk of an incorrect prescription being given to you or your nominated person/carer/Pharmacy.
Please allow the allotted time before uplifting your prescription. Prescriptions can be collected/sent via the following methods:
- In person
- Via your nominated choice of person/organisation, this could be your carer, pharmacy, family member or friend (please be aware if you are not uplifting your own prescription we may ask for proof of identification from that person before we issue your Prescription, and we may also require a signature for our own records)
- Post – if using the postal service, please always allow extra time when ordering your medication, as we cannot guarantee postal delivery schedules
- Home delivery service – some Pharmacies may deliver your prescription directly to your home; please check with your local Pharmacist to see if they can provide this service for you.
Processing of information
The basis on which we process information about you
The Law requires us to determine under which of six defined bases we process different categories of your personal information, and to notify you of the basis for each category. If a basis on which we process your personal information is no longer relevant then we shall immediately stop processing your data.
If the basis changes then, if required by Law, we shall notify you of the change and of any new basis under which we have determined that we can continue to process your information.
Lawful basis for processing
The legal basis will be
Article 6(1)(c) “processing is necessary for compliance with a legal obligation to which the controller is subject.”
And
Article 9(2)(h) “processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services on the basis of Union or Member State law or pursuant to contract with a health professional and subject to the conditions and safeguards ”
Information we process because we have a contractual obligation with you
When you join our Practice, receive medical services from us, or otherwise agree to our terms and conditions, a contract is formed between you and us. In order to carry out our obligations under that contract we must process the information you give us. Some of this information may be personal information.
We may use it in order to:
- verify your identity for security purposes
- provide you with our services
- provide you with suggestions and advice and how to obtain the most from using our website
We process this information on the basis there is a contract between us, or that you have requested we use the information before we enter into a legal contract. Additionally, we may aggregate this information in a general way and use it to provide class information, for example to monitor our performance with respect to a particular service we provide. If we use it for this purpose, you as an individual will not be personally identifiable.
We shall continue to process this information until the contract between us ends or is terminated by either party under the terms of the contract.
Why do we collect this information?
The NHS Act 2006 and the Health and Social Care Act 2012 invests statutory functions on GP Practices to promote and provide the health service in England, improve quality of services, reduce inequalities, conduct research, review performance of services and deliver education and training. To do this we will need to process your information in accordance with current data protection legislation to:
- Protect your vital interests;
- Pursue our legitimate interests as a provider of medical care, particularly where the individual is a child or a vulnerable adult;
- Perform tasks in the public’s interest;
- Deliver preventative medicine, medical diagnosis, medical research; and
- Manage the health and social care system and services.
About the personal information we use
We use personal information on different groups of individuals including:
- Patients
- Staff
- Contractors
- Suppliers
- Complainants, enquirers
- Survey respondents
- Professional experts and consultants
- Individual captured by CCTV
The personal information we use includes information that identifies you like your name, address, date of birth and postcode.
We also use more sensitive types of personal information, including information about racial or ethnic origin; political opinions; religious or philosophical beliefs; trade union membership; genetic and biometric data, health; sex life or sexual orientation.
The information we use can relate to personal and family details; education, training and employment details; financial details; lifestyle and social circumstances; goods and services; visual images; details held in the patient record; responses to surveys.
Information we process with your consent
Through certain actions when otherwise there is no contractual relationship between us, such as when you browse our website or ask us to provide you with more information about our business, including job opportunities and our services, you provide your consent to us to process information that may be personal information.
Wherever possible, we aim to obtain your explicit consent to process this information, for example, by asking you to agree to our use of cookies.
Sometimes you might give your consent implicitly, such as when you send us a message by e-mail to which you would reasonably expect us to reply.
Except where you have consented to our use of your information for a specific purpose, we do not use your information in any way that would identify you personally. We may aggregate it in a general way and use it to provide class information, for example to monitor the performance of a particular page on our website.
We continue to process your information on this basis until you withdraw your consent or it can be reasonably assumed that your consent no longer exists.
You may withdraw your consent at any time by instructing us in writing. However, if you do so, you may not be able to use our website or our services further.
Information we process for the purposes of legitimate interests
We may process information on the basis there is a legitimate interest, either to you or to us, of doing so.
Where we process your information on this basis, we do after having given careful consideration to:
- whether the same objective could be achieved through other means
- whether processing (or not processing) might cause you harm
- whether you would expect us to process your data, and whether you would consider it reasonable to do so
For example, we may process your data on this basis for the purposes of:
- record-keeping for the proper and necessary administration of our business or profession
- responding to unsolicited communication from you to which we believe you would expect a response
- protecting and asserting the legal rights of any party
- insuring against or obtaining professional advice that is required to manage business or professional risk
- protecting your interests where we believe we have a duty to do so
Information we process because we have a legal obligation
We are subject to the Law like everyone else. Sometimes, we must process your information in order to comply with a statutory obligation.
For example, we may be required to give information to legal authorities if they so request or if they have the proper authorisation such as a search warrant or court order.
This may include your personal information.
Information we process may be categorised as special category data
Special category data is personal data which the GDPR says is more sensitive, and so needs more protection. For example information about an individuals:
- race
- ethnic origin
- health
- sex life or
- sexual orientation
We may process this information for the purposes of medical diagnosis, provision of health treatment and management of the health of our patients and the community we serve.
Specific uses of information you provide to us
Healthcare Professionals who provide you with care maintain records about your health and any treatment or care you have received previously (e.g. NHS Trust, GP Surgery, Walk-in clinic, etc.). These records are used to help to provide you with the best possible healthcare.
NHS healthcare records may be electronic, on paper or a mixture of both, and we use a combination of working practices and technology to ensure that your information is kept confidential and secure. Records we hold about you may include the following information;
- Details about you, such as your name, address, carers, legal representatives and emergency contact details
- Any contact the Surgery has had with you, such as appointments, clinic visits, emergency appointments, etc.
- Notes and reports about your health
- Details about your treatment and care
- Results of investigations such as laboratory tests, x-rays, etc.
- Relevant information from other Healthcare Professionals, relatives or those who care for you
To ensure you receive the best possible care, your records are used to facilitate the care you receive. Information held about you may be used to help protect the health of the public and to help us manage the NHS. Information may be used within our GP Practice for clinical audit to monitor the quality of the service provided.
Some of this information will be held centrally and used for statistical purposes. Where we do this, we take strict measures to ensure that individual patients cannot be identified.
Sometimes your information may be requested to be used for research purposes – the Surgery will always gain your consent before releasing the information for this purpose.
Who else may ask to access your information
- The Court can insist that we disclose medical records to them
- Solicitors often ask for medical reports. These will always be accompanied by your signed consent for us to disclose information. We will not normally release details about other people that are contained in your records (e.g. wife, children parents etc.) unless we also have their consent
- Social Services – The Benefits Agency and others may require medical reports on you from time to time. These will often be accompanied by your signed consent to disclose information. Failure to cooperate with these agencies can lead to loss of benefit or other support. However, if we have not received your signed consent we will not normally disclose information about you
- Insurance Companies frequently ask for medical reports on prospective clients. These are always accompanied by your signed Consent Form. We will only disclose the relevant medical information as per your consent. You have the right, should you request it, to see reports prepared for Insurance Companies or employers before they are sent. We may contact you on receipt of a third party request to discuss your consent and clarify what will be shared.
If you have any questions about the above points please contact the Practice.
Access to to your own information
- Confirmation that your personal information is being held or used by us
- Access to your personal information
- Additional information about how we use your personal information
Although we must provide this information free of charge, if your request is considered unfounded or excessive, or if you request the same information more than once, we may charge a reasonable fee.
If you would like to access your personal information, you can do this by submitting a written request to the Practice.
Once we have received your request and you have provided us with enough information for us to locate your personal information, we will respond to your request without delay, within one month (30 days). However, if your request is complex we may take longer, by up to two months, to respond. If this is the case we will tell you and explain the reason for the delay.
Rights to object
You have the right under Article 21 of the GDPR to object to your personal information being processed. Please contact the Practice if you wish to object to the processing of your data. You should be aware that this is a right to raise an objection which is not the same as having an absolute right to have your wishes granted in every circumstance.
GP Practices process personal data under Article 6(1)(c) on a lawful and legitimate basis where the organisation is obliged under law to comply with:
- The General Data Protection Regulations (GDPR)
- The Freedom of Information Act
- The NHS Constitution
- The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009
By complying with these laws, the Practice has compelling legitimate grounds for the processing which override the interests, rights and freedoms in the right to object.
The right to rectification
If the personal information we hold about you is inaccurate or incomplete you have the right to have this corrected.
If it is agreed that your personal information is inaccurate or incomplete we will aim to amend your records accordingly, normally within one month, or within two months where the request is complex. However, we will contact you as quickly as possible to explain this further if the need to extend our timescales applies to your request.
Unless there is a risk to patient safety, we can restrict access to your records to ensure that the inaccurate or incomplete information is not used until amended.
If for any reason we have shared your information with anyone else, such as for a referral to another service, we will notify them of the changes required to ensure their records are accurate.
If on consideration of your request we do not consider the personal information to be inaccurate then we will add a comment to your record stating your concerns about the information. If this is the case we will contact you within one month to explain our reasons for this.
Public Health
Public health encompasses everything from national smoking and alcohol policies, the management of epidemics such as flu, the control of large scale infections such as TB and Hepatitis B to local outbreaks of food poisoning or Measles. Certain illnesses are also notifiable; the doctors treating the patient are required by law to inform the Public Health Authorities, for instance Scarlet Fever.
This will necessarily mean the subjects personal and health information being shared with the Public Health organisations.
Some of the relevant legislation includes: the Health Protection (Notification) Regulations 2010 (SI 2010/659), the Health Protection (Local Authority Powers) Regulations 2010 (SI 2010/657) , the Health Protection (Part 2A Orders) Regulations 2010 (SI 2010/658) , Public Health (Control of Disease) Act 1984, Public Health (Infectious Diseases) Regulations 1988 and The Health Service (Control of Patient Information) Regulations 2002
Registering for NHS care
NHS Digital collects health information from the records health and social care providers keep about the care and treatment they give, to promote health or support improvements in the delivery of care services in England.
- All patients who receive NHS care are registered on a national database
- This database holds your name, address, date of birth and NHS Number but it does not hold information about the care you receive
- The database is held by NHS Digital, a national organisation which has legal responsibilities to collect NHS data
- More information can be found at NHS Digital or you can telephone general enquiries on 0300 303 5678
- NHS England’s privacy notice
- NHS App privacy policy
Risk Stratification
‘Risk stratification for case finding’ is a process for identifying and managing patients who have or may be at-risk of health conditions (such as diabetes) or who are most likely to need healthcare services (such as people with frailty). Risk stratification tools used in the NHS help determine a person’s risk of suffering a particular condition and enable us to focus on preventing ill health before it develops.
Information about you is collected from a number of sources including NHS Trusts, GP Federations and your GP Practice. A risk score is then arrived at through an analysis of your de-identified information. This can help us identify and offer you additional services to improve your health.
Risk-stratification data may also be used to improve local services and commission new services, where there is an identified need. In this area, risk stratification may be commissioned by the our NHS Clinical Commissioning Group (OCCG). Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for risk stratification purposes.
Further information about risk stratification.
If you do not wish information about you to be included in any risk stratification programmes, please let us know. We can add a code to your records that will stop your information from being used for this purpose. Please be aware that this may limit the ability of healthcare professionals to identify if you have or are at risk of developing certain serious health conditions.
Safeguarding
The Practice is dedicated to ensuring that the principles and duties of safeguarding adults and children are holistically, consistently and conscientiously applied with the wellbeing of all, at the heart of what we do.
Our legal basis for processing For the General Data Protection Regulation (GDPR) purposes is: –
- Article 6(1)(e) ‘…exercise of official authority…’.
For the processing of special categories data, the basis is: –
- Article 9(2)(b) – ‘processing is necessary for the purposes of carrying out the obligations and exercising specific rights of the controller or of the data subject in the field of employment and social security and social protection law…’
Sending a message to our Practice Team
When you contact us, whether by telephone, through our website or by e-mail, we collect the data you have given to us in order to reply with the information you need. We record your request and our reply in order to increase the efficiency of our Practice.
We keep personally identifiable information associated with your message, such as your name and email address so as to be able to track our communications with you to provide a high quality service.
Sharing of information
Local Information Sharing
Your GP electronic patient record is held securely and confidentially on an electronic system managed by your registered GP Practice. If you require attention from a local Healthcare Professional outside of your usual practice services, such as in an Evening and Weekend GP Access Clinic, GP Federation Service, Emergency Department, Minor Injury Unit or Out Of Hours service, the professionals treating you are better able to give you safe and effective care if some of the information from your GP record is available to them.
Where available, this information can be shared electronically with other local healthcare providers via a secure system designed for this purpose. Depending on the service you are using and your health needs, this may involve the Healthcare Professional accessing a secure system that enables them to view parts of your GP electronic patient record ,or a secure system that enables them to view your full GP electronic patient record (e.g. EMIS remote consulting system).
In all cases, your information is only accessed and used by authorised staff who are involved in providing or supporting your direct care. Your permission will be asked before the information is accessed, other than in exceptional circumstances (e.g. emergencies) if the Healthcare Professional is unable to ask you and this is deemed to be in your best interests (which will then be logged).
Disclosure and sharing of your information
Information we obtain from third parties
We sometimes receive data that is indirectly made up from your personal information from third parties whose services we use. No such information is personally identifiable to you.
Information provided on the understanding that it will be shared with a third party
We will only ever use or pass on information about you if others involved in your care have a genuine need for it. We will not disclose your information to any third party without your permission unless there are exceptional circumstances (i.e. life or death situations), where the law requires information to be passed on and / or in accordance with the new information sharing principle following Dame Fiona Caldicott’s information sharing review (Information to share or not to share) where “The duty to share information can be as important as the duty to protect patient confidentiality.”
This means that Health and Social Care Professionals should have the confidence to share information in the best interests of their patients within the framework set out by the Caldicott principles. They should be supported by the policies of their employers, regulators and professional bodies.
Who are our partner organisations?
We may also have to share your information, subject to strict agreements on how it will be used, with the following organisations;
- NHS Trusts / Foundation Trusts
- GPs
- NHS Commissioning Support Units
- Independent Contractors such as Dentists, Opticians & Pharmacists
- Private Sector Providers
- Voluntary Sector Providers
- Ambulance Trusts
- Clinical Commissioning Groups
- Social Care Services
- Health and Social Care Information Centre (HSCIC)
- Local Authorities
- Education Services
- Fire and Rescue Services
- Police & Judicial Services
- Voluntary Sector Providers
- Private Sector Providers
- Other ‘data processors’ which you will be informed of
You will be informed who your data will be shared with and in some cases asked for explicit consent for this to happen, when required.
We may also use external companies to process personal information, such as for archiving purposes. These companies are bound by contractual agreements to ensure information is kept confidential and secure.
What to do if you don’t want your information shared
Please tell us if you don’t want your information to be shared – either in some or all circumstances. We can make a note on your record that will ensure that your records can only be accessed by a health professional in the Practice (i.e. no administrative staff will be able to look at your records) or we can block your health data so that it can’t be accessed by other health service bodies e.g. Electronic Care Record.
Information submitted online
The practice website allows for the submission of some personal information for the purposes of updating your medical record e.g. new contact details. The service is provided by accredited suppliers, and all information submitted is covered by the same regulations as all other patient information.
Patient Rights (as the Data Subject) The right to erasure
The right to erasure is also known as “the right to be forgotten” and in general refers to an individual’s right to request the deletion or removal of personal information where there is no compelling reason for the Practice to continue using it.
As with other rights, there are particular conditions around this right and it does not provide individuals with an absolute right to be forgotten.
Individuals have the right to have their personal information deleted or removed in the following circumstances:
- When it is no longer necessary for the purpose for which it was collected
- When the Practice no longer have a legal basis for using you your personal information, for example if you gave us consent to use your personal information in a specific way, and you withdraw your consent, we would need to stop using your information and erase it unless we had an overriding reason to continue to use it
- When you object to the Practice using your personal information and there is no overriding legitimate interest for us to continue using it
- If we have used your personal information unlawfully
- If there is a legal obligation to erase your personal information for example by court order
The Practice can refuse to deal with your request for erasure when we use your personal information for the following reasons:
- to comply with a legal obligation for the performance of a public interest task or exercise of official authority
- for public health purposes in the public interest
- archiving purposes in the public interest, scientific research historical researcher statistical purpose
- the exercise or defence of legal claims
The right to restrict processing
You have the right to control how we use your personal information in some circumstances. This is known as the right to restriction. When processing is restricted, the Practice is permitted to store your personal information, but not further use it until an agreement is reached with you about further processing. We can retain enough information about you to ensure that your request for restriction is respected in the future.
Examples of ways you can restrict our processing would be:
- If you challenge the accuracy of your personal information, stop using it until we check its accuracy
- If you object to processing which is necessary for the performance of our tasks in the public interest or for the purpose of legitimate interests, we will restrict our processing while we consider whether our legitimate grounds override your individual interests, rights and freedoms
- If our use of your personal information is found to be unlawful and you ask for restriction instead of full erasure we will restrict our processing
- If we no longer need your personal information but you need it to establish, exercise or defend a legal claim, we will restrict our processing
If we have shared your personal information with any individuals or organisations, if we restrict our processing, we will tell those individuals or organisations about our restriction if it is possible and not an unreasonable amount of effort.
Whenever we decide to lift a restriction on processing we will tell you.
Direct Care Emergencies
There are occasions when intervention is necessary in order to save or protect a patient’s life or to prevent them from serious immediate harm, for instance during a collapse or diabetic coma or serious injury or accident. In many of these circumstances the patient may be unconscious or too ill to communicate.
In these circumstances we have an overriding duty to try to protect and treat the patient. If necessary we will share your information and possibly sensitive confidential information with other emergency healthcare services, the police or fire brigade, so that you can receive the best treatment.
Social Prescribing
Social Prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services. NHS England describes social prescribing as “enabling all local agencies to refer people to a link worker”.
Link workers – known locally as Community Connectors – give people time, and focus on what matters to the person. They connect people to community groups and agencies for practical and emotional support.
If you have an appointment with a Community Connector, only limited information would be passed on. There are agreements in place to protect your data.
The NHS Care Record Guarantee
The NHS Care Record Guarantee for England sets out the rules that govern how patient information is used in the NHS, what control the patient can have over this, the rights individuals have to request copies of their data and how data is protected under the Data Protection Act 2018.
The NHS Constitution
The NHS Constitution establishes the principles and values of the NHS in England. It sets out the rights patients, the public and staff are entitled to. These rights cover how patients access healthcare services, the quality of care received, the treatments and programmes available, confidentiality, information and a patient’s right to complain if things go wrong.
Third Parties mentioned on your Medical Record
Sometimes we record information about third parties mentioned by you to us during any consultation. We are under an obligation to make sure we also protect that third party’s rights as an individual and to ensure that references to them which may breach their rights to confidentiality, are removed before we send any information to any other party including yourself. Third parties can include: spouses, partners, and other family members.
Video and Telephone Consultations
As an alternative to face to face appointments, there may be instances where we may offer you an appointment via telephone or video consultation. By accepting the invitation and entering the consultation you are consenting to this. Your personal/confidential patient information shared on the consultation will be safeguarded in the same way it would with any other consultation with relevant information added to your patient record.
Video or audio consultations/appointments are not typically recorded, but if are, your permission will be sought as to the purpose and use of the recording i.e.: for direct care purposes: diagnosis, treatment or care. Recordings will be stored as part of your patient record in line with NHS Digital Record Management Code of Practice (2016).
If, as part of the consultation, still images or photographs are taken/obtained and are to be kept, they will be securely stored as part of your patient record in line with NHS Digital Record Management Code of Practice (2016).
If the recording/images are to be used for any other reason than what the original permission was obtained for, then further permission would be required prior to that use.
If recordings or still images obtained are no longer needed (i.e.: adequately described in the clinical notes) then the recording/images will be confidentially and securely destroyed as per our policies and in line with NHS Digital’s guidance.
Your Rights
The right of access
Individuals have the right to access their personal data and a request can be made verbally or in writing. We have one month to respond to a request and in most circumstances we cannot charge a fee. Please refer to our Subject Access Request section for further information.
The right to rectification
The GDPR includes a right for individuals to have inaccurate personal data rectified or completed if it is incomplete. We have one month to respond to a request and in some circumstances, we may refuse this request.
The right to data portability
The right to data portability allows individuals to obtain and re-use their personal information for their own purposes across different services. It allows them to move, copy or transfer personal information easily from one IT environment to another in a safe and secure way. For example: it enables consumers to take advantage or applications and services which can use their information to find them a better deal.
The right to data portability only applies when the individual has submitted their personal information directly, through electronic means to our Practice. This means that in most circumstances the right to data portability does not apply within the Practice.
Rights related to automated decision making and profiling
You have the right to object to any instances where a decision is made about you solely by automated means without any human involvement, including profiling.
The Practice does not undertake any decision-making about you using wholly automated means.
Invoking your rights
If you wish to invoke any of the data subject rights then please write to The Practice Manager, at the above address.
Your Data
Your health records contain a type of data called confidential patient information. This data can be used to help with research and planning.
You can choose to stop your confidential patient information being used for research and planning. You can also make a choice for someone else like your children under the age of 13
To find out more about the benefits of data sharing, how data is protected, or to make/change your opt-out choice visit NHS your data matters.
Compliance with the Law
Our Privacy Policy has been compiled so as to comply with the Law of every country or legal jurisdiction in which we aim to do business. If you think it fails to satisfy the Law of your jurisdiction, we would like to hear from you.
However, ultimately it is your choice as to whether you wish to use our website.
Further Information – Understanding Patient Data
Understanding Patient Data’ supports better conversations about the uses of health information. Our aim is to explain how and why data can be used for care and research, what’s allowed and what’s not, and how personal information is kept safe. We work with patients, charities and Healthcare Professionals to champion responsible use of data.
Review of this Privacy Policy
We may update this Privacy Notice from time to time as necessary. The terms that apply to you are those posted here on our website on the day you use our website. We advise you to print a copy for your records.
If you have any question regarding our Privacy Policy, please contact us.
Quality Assurance
Our Practice aims to provide quality, consistent primary care for all patients. We strive to meet the high standards expected in any clinical setting and we expect all members of our Team to work to these standards to help us achieve our aim.
The policies, systems and processes in place in our Practice reflect our professional and legal responsibilities and follow recognised standards of good practice. We evaluate our Practice on a regular basis, through audit, peer review and patient feedback and monitor the effectiveness of our quality assurance procedures.
Quality standards and procedures
To assist our Team in providing our patients with care of a consistent quality we will:
- Provide a safe and welcoming environment
- Ensure all members of our Team are appropriately trained
- Provide patients with information about the Practice and the care available, and ensure the patient understands the terms under which care is offered
- Explain all treatment options and agree clinical decisions with the patient(s), explaining the possible risks involved with each option
- Obtain valid consent for all treatment
- Refer to Specialists for investigation or treatment as appropriate and without undue delay
- Maintain contemporaneous clinical records with an up-to-date medical history for all patients
- Provide secure storage of patients records to maintain confidentiality
- Explain the procedure to follow for raising a complaint about the service, identifying the Practice contact
To provide our patients with a Team that provides care of a consistent quality we will:
- Provide a safe working environment through hazard identification and risk assessment
- Provide relevant training for all new Team members
- Provide Job Descriptions and Contracts of Employment
- Agree terms for all non-employed contractors working at the Practice
- Maintain staff records, ensuring they are kept as up-to-date as possible
- Ensure staff are notified where all Practice policies and procedures are stored and accessed
Removal of Patients from our List
It is our policy not to remove patients without serious consideration. If a patient has a serious continuing medical condition, removal will be postponed until the patient’s condition stabilises.
Possible grounds for consideration of removal include:
- Physical violence to staff, Doctors or other patients
- Threat of violence to staff, Doctors or other patients
- Abusive or disruptive behaviour including when under the influence of alcohol or drugs
- Theft from the Surgery, staff, Doctors or other patients
- Criminal damage to the Surgery
- Dangerous dogs posing a real or potential hazard on home visits
- Altering documents e.g. prescriptions, insurance certificates
- Defamation of Doctors or staff
- Misuse of appointments
- Misuse of home visits
- Moving outwith the area
- Any other breakdown of the bond of trust between Doctor and patient
It should be noted that if a patient does not attend for their appointment they will not be given another one for 48 hours. In the event of a patient not attending on three occasions they will receive a letter advising them that if they miss another appointment, they will be removed from our Practice list.
In some cases we reserve the right to remove other members of the household. We will continue to be responsible for the patient’s medical care for a period of up to 8 days from the date of notification to our local health authority or until the patient registers with another Doctor, whichever is the sooner.
Safeguarding Children
Our Primary Care Team is committed to safeguarding children. The safety and welfare of children who come into contact with our services either directly or indirectly is paramount, and all staff have a responsibility to ensure that Best Practice is followed, including compliance with statutory requirements.
We are committed to a Best Practice which safeguards children and young people irrespective of their background, and which recognises that a child may be abused regardless of their age, gender, religious beliefs, racial origin or ethnic identity, culture, class, disability or sexual orientation.
The Primary Care Team are committed to working within agreed policies and procedures and in partnership with other agencies, to ensure that the risks of harm to a child or young person are minimised. This work may include direct and indirect contact with children, access to patient’s details and communication via email or text message/telephone.
Our Surgery is supported by the CCG who have designated Nurses and Doctors in post who offer professional expertise and advice regarding safeguarding children.
Shared Decision Making
Making decisions about your care with your doctor or nurse (shared decision making).
When you visit your doctor’s surgery you will often find that there are decisions to be made about your health and the treatments that might be available to you. This includes when you are choosing between different types of treatment or different ways of managing any condition(s) you have.
When these decisions are made it is important that you are part of that process, so that you are able to come to the best decisions based on what is important to you.
Shared Decision Making
Your doctor/nurse is an expert about health and health care. You are an expert in knowing about yourself, the impact that any conditions have on you, and what is important to you in treating your condition and in your wider life.
When you and your doctor/nurse work together to share what you both know, and then use all of that information to come to a decision together, this is called ‘Shared Decision Making’.
How to get involved
In order for you to be involved in decisions about your care there are three key things you need to know;
- What are my options?
- What are the possible risks, benefits and consequences of each option?
- How can we make a decision together that is right for me?
With shared decision making your doctor/nurse is there to support you by providing good quality information, helping you understand this information, and giving you support and guidance as you think about what is most important to you.
This will help you to understand what choices are available to you, the pros and cons of each option, and then use that information to come to a decision together about the best option for you.
If you would like to know more about Shared Decision Making the following video provides further information: https://vimeo.com/80885122?p=1s
Patient Decision Aids
Patient Decision Aids (PDAs) are designed to help you decide which treatments and care options are best for you.
PDAs are useful because they allow you to pick out the things that are most important to you (your values) and make comparisons about how different treatments might affect these values.
Patient decision aids have been developed for a number of common health care decisions and your doctor/nurse may use one or refer you on to one when you talk with them, or you might find it useful to look at one by yourself.
If you would like to know more about patient decision aids and look at some of the patient decision aids that are publicly available, the following website: An international inventory of decision aids.
If you are looking for information about the risk of cardio vascular disease or Type 2 diabetes and ways in which those risks can be reduced – The Absolute CVD Risk/Benefit Calculator: Q Intervention
Social Media
Patients are reminded that if they are found posting any derogatory, defamatory, or offensive comments on social media directed to the Practice or members of staff on social networking sites, this may result in them being removed from the Practice List. We ask if you have a complaint to please contact the Practice Manager in the first instance. We would be grateful if patients could be pro-active in reporting any incidents of this nature to the Practice Manager.
Subject Access Requests (SAR)
A request by a patient, or a request by a third party who has been authorised by the patient, for access under the GDPR (and DPA 2018) is called a Subject Access Request (SAR). If you want to see your health records, or wish a copy, please complete a Practice Subject Access Request Form which you can complete online or please contact the Practice and we will provide you with our paper format.
Online Subject Access Request Form
Contact will subsequently be made by the Practice to arrange a time for you to come in and collect or read them. You don’t have to give a reason for wanting to see your records and there is no charge for this service. You will however be required to produce proof of identity before being allowed to read them.
The Practice has up to 28 days to respond to your request. If additional information is needed before copies can be supplied, the 28-day time limit will begin as soon as the additional information has been received.
The 28 day time limit can be extended for two months for complex or numerous requests where the data controller (usually your Practice) needs more time to collate and supply the data. You will be informed about this within 28 days and provided with an explanation of why the extension is necessary.
When writing/calling, you should say if you:
- want a copy of your healthcare records as well as to see them (if you wish to see them your Doctor or member of staff will be present to assist you and explain any medical terms to you)
- want all or just part of them
- would like your records to be given to you in a specific format that meets your needs, and we will endeavour to accommodate your request
- If you request your records to be emailed, then we will secure you or your representative’s agreement (in writing or by email) that they accept the risk of sending unencrypted information to a non-NHS email address
You may also need to fill in an Application Form and give proof of your identity. The Practice has an obligation under the GDPR and DPA2018 to ensure that any information provided for the patient can be verified.
Please note we never send original medical records because of the potential detriment to patient care should these be lost
Who may apply for access?
1(1) Patients with capacity
Subject to the exemptions listed in paragraph 1(6) (below) patients with capacity have a right to access their own health records via a SAR. You may also authorise a third party such as a Solicitor to do so on your behalf. Competent young people may also seek access to their own records. It is not necessary for them to give reasons as to why they wish to access their records.
1(2) Children and young people under 18
Where a child is competent, they are entitled to make or consent to a SAR to access their record.
Children aged over 16 years are presumed to be competent. Children under 16 in England, Wales and Northern Ireland must demonstrate that they have sufficient understanding of what is proposed in order to be entitled to make or consent to an SAR. However, children who are aged 12 or over are generally expected to have the competence to give or withhold their consent to the release of information from their health records. In Scotland, anyone aged 12 or over is legally presumed to have such competence. Where, in the view of the appropriate health professional, a child lacks competency to understand the nature of his or her SAR application, the holder of the record is entitled to refuse to comply with the SAR. Where a child is considered capable of making decisions about access to his or her medical record, the consent of the child must be sought before a parent or other third party can be given access via a SAR (see paragraph 1 (3) below).
1(3) Next of kin
Despite the widespread use of the phrase ‘next of kin’, this is not defined, nor does it have formal legal status. A next of kin cannot give or withhold their consent to the sharing of information on a patient’s behalf. As next of kin they have no rights of access to medical records. For parental rights of access, see the information above.
1(4) Solicitors
You can authorise a Solicitor acting on your behalf to make a SAR. We must have your written consent before releasing your medical records to your acting Solicitors. The consent must cover the nature and extent of the information to be disclosed under the SAR (for example, past medical history), and who might have access to it as part of the legal proceedings. Where there is any doubt, we may contact you before disclosing the information. (England and Wales only – should you refuse, your Solicitor may apply for a court order requiring disclosure of the information. A standard consent form has been issued by the BMA and the Law Society of England and Wales. While it is not compulsory for Solicitors to use the form, it is hoped it will improve the process of seeking consent).
The Practice may also contact you to let you know when your medical records are ready. If your Solicitor is based within our area, then we may ask you to uplift them and deliver them to your Solicitor. This is because we can no longer charge for copying and postage, so we would appreciate your help if you can do this, or alternatively ask your Solicitor if they can uplift your medical records.
1(5) Supplementary Information under SAR requests
The purposes for processing data
The purpose for which data is processed is for the delivery of healthcare to individual patients. In addition, the data is also processed for other non-direct healthcare purposes such as medical research, public health or health planning purposes when the law allows.
The categories of personal data
The category of your personal data is healthcare data.
The organisations with which the data has been shared
Your health records are shared with the appropriate organisations which are involved in the provision of healthcare and treatment to the individual. Other organisations will receive your confidential health information, for example Digital or the Scottish Primary Care Information Resource (SPIRE) or research bodies such as the Secure Anonymised Linkage Databank (SAIL). (This information is already available to patients in our Practice privacy notices).
The existence of rights to have inaccurate data corrected and any rights of objection
For example, a national ‘opt-out’ model such as SPIRE etc.
Any automated decision including the significance and envisaged consequences for the data subject
For example, risk stratification.
The right to make a complaint to the Information Commissioner’s Office (ICO)
1(6) Information that should not be disclosed
The GDPR and Data Protection Act 2018 provides for a number of exemptions in respect of information falling within the scope of a SAR. If we are unable to disclose information to you, we will inform you and discuss this with you.
1(7) Individuals on behalf of adults who lack capacity
Both the Mental Capacity Act in England and Wales and the Adults with Incapacity (Scotland) Act contain powers to nominate individuals to make health and welfare decisions on behalf of incapacitated adults. The Court of Protection in England and Wales, and the Sheriff’s Court in Scotland, can also appoint Deputies to do so. This may entail giving access to relevant parts of the incapacitated person’s medical record, unless health professionals can demonstrate that it would not be in the patient’s best interests. These individuals can also be asked to consent to requests for access to records from third parties.
Where there are no nominated individuals, requests for access to information relating to incapacitated adults should be granted if it is in the best interests of the patient. In all cases, only information relevant to the purposes for which it is requested should be provided.
1(8) Deceased records
The law allows you to see records of a patient that has died as long as they were made after 1st November 1991.
Records are usually only kept for three years after death (in England and Wales GP records are generally retained for 10 years after the patient’s death before they are destroyed).
Who can access deceased records?
You can only see that person’s records if you are their personal representative, administrator or executor.
You won’t be able to see the records of someone who made it clear that they didn’t want other people to see their records after their death.
Accessing deceased records
Before you get access to these records, you may be asked for:
- proof of your identity
- proof of your relationship to the person who has died
Viewing deceased records
You won’t be able to see information that could:
- cause serious harm to your or someone else’s physical or mental health
- identify another person (except members of NHS staff who have treated the patient), unless that person gives their permission
- If you have a claim as a result of that person’s death, you can only see information that is relevant to the claim.
1(9) Hospital Records
To see your Hospital records, you will have to contact your local Hospital.
1(10) Power of attorney
Your health records are confidential, and members of your family are not allowed to see them, unless you give them written permission, or they have power of attorney.
A lasting power of attorney is a legal document that allows you to appoint someone to make decisions for you, should you become incapable of making decisions yourself.
The person you appoint is known as your attorney. An attorney can make decisions about your finances, property, and welfare. It is very important that you trust the person you appoint so that they do not abuse their responsibility. A legal power of attorney must be registered with the Office of the Public Guardian before it can be used.
If you wish to see the health records of someone who has died, you will have to apply under the Access to Medical Records Act 1990. You can only apply if you:
- are that person’s next of kin, are their legal executor (the person named in a will who is in charge of dealing with the property and finances of the deceased person),
- have the permission of the next of kin or have obtained written permission from the deceased person before they died.
- To access the records of a deceased person, you must go through the same process as a living patient. This means either contacting the Practice or the Hospital where the records are stored.
If you think that information in your health records is incorrect, or you need to update your personal details (name, address, phone number), approach the relevant health professional informally and ask to have the record amended. Some Hospitals and GP Surgeries have online forms for updating your details.
If this doesn’t work, you can formally request that the information be amended under the NHS complaints procedure.
All NHS trusts, NHS England, CCGs, GPs, Dentists, Opticians and Pharmacists have a complaints procedure. If you want to make a complaint, go to the organisation concerned and ask for a copy of their complaints procedure.
Alternatively, you can complain to the Information Commissioner (the person responsible for regulating and enforcing the Data Protection Act), at:
The Information Commissioner’s Office (ICO),
Wycliffe House,
Water Lane,
Wilmslow,
Cheshire,
SK9 5AF
Telephone: 01625 545745
If your request to have your records amended is refused, the record holder must attach a statement of your views to the record.
The National Care Record Service (NCRS)
Important information regarding your NHS medical records – Summary Care Record
The National Care Record Service (NCRS) is the way in which health professionals now access the Summary Care Record (SCR). The SCR has not changed, it is just the way SCRs are accessed that has changed.
For more information about NCRS please see: National Care Records Service
Information for patients who wish to opt out of having a summary care record, including an opt out form is available here: Opting out
Unacceptable Actions Policy
We believe that patients have a right to be heard, understood and respected. We work hard to be open and accessible to everyone.
Occasionally, the behaviour or actions of individuals using our Practice makes it very difficult for us to deal with their issue or complaint. In a small number of cases the actions of individuals become unacceptable because they involve abuse of our staff or our process. When this happens we have to take action to protect our staff, and must also consider the impact of the individuals behaviour on our ability to do our work and provide a service to others.
This Policy explains how we will approach these situations.
Section 1 – What actions does the Practice consider to be unacceptable?
People may act out of character in times of trouble or distress. There may have been upsetting or distressing circumstances leading up to us being made aware of an issue or complaint.
We do not view behaviour as unacceptable just because a patient is forceful or determined. In fact, we accept that being persistent may sometimes be a positive advantage when pursuing an issue or complaint. However, we do consider actions that result in unreasonable demands on our Practice or unreasonable behaviour towards Practice staff to be unacceptable. It is these actions that we aim to manage under this Policy.
Section 2 – Aggressive or abusive behaviour
We understand that patients may be angry about the issues they have raised with the Practice. If that anger escalates into aggression towards Practice staff, we consider that unacceptable.
Any violence or abuse towards staff will not be accepted. Violence is not restricted to acts of aggression that may result in physical harm. It also includes behaviour or language (whether verbal or written) that may cause staff to feel offended, afraid, threatened or abused. We will judge each situation individually, and appreciate individuals who come to us may be upset.
Language which is designed to insult or degrade, is derogatory, racist, sexist, transphobic, or homophobic or which makes serious allegations that individuals have committed criminal, corrupt, perverse or unprofessional conduct of any kind, without any evidence, is unacceptable.
We may decide that comments aimed not at us, but at third parties, are unacceptable because of the effect that listening or reading them may have on our staff.
Section 3 – Unreasonable demands
A demand becomes unacceptable when it starts to (or when complying with the demand would) impact substantially on the work of the Practice. Examples of actions grouped under this heading include:
- Repeatedly demanding responses within an unreasonable timescale
- Repeatedly requesting early supplies of medication
- Repeatedly requesting further supplies of stolen medication, without the required Police Incident number
- Repeatedly ordering prescriptions outwith the set timeframe
- Insisting on seeing or speaking to a particular member of staff when that is not possible
- Repeatedly changing the substance of an issue or complaint or raising unrelated concerns
- Repeatedly insisting on a course of medical treatment for which there is no clinical evidence
- Not ensuring that a review appointment is in place, prior to ongoing medication finishing
- An example of such impact would be that the demand takes up an excessive amount of staff time and in so doing disadvantages other patients
Section 4 – Unreasonable levels of contact
Sometimes the volume and duration of contact made to our Practice by an individual causes problems. This can occur over a short period, for example, a number of calls in one day or one hour. It may occur over the life-span of an issue when a patient repeatedly makes long telephone calls to us, or inundates us with letters or copies of information that have been sent already or that are irrelevant to the issue.
We consider that the level of contact has become unacceptable when the amount of time spent talking to a patient on the telephone, or responding to, reviewing and filing emails or written correspondence impacts on our ability to deal with that issue, or with other Patients’ needs.
Section 5 – Unreasonable refusal to co-operate
When we are looking at an issue or complaint, we will ask the patient to work with us. This can include agreeing with us the issues or complaint we will look at; providing us with further information, evidence or comments on request; or helping us by summarising their concerns or completing a form for us.
Sometimes, a patient repeatedly refuses to cooperate and this makes it difficult for us to proceed. We will always seek to assist someone if they have a specific, genuine difficulty complying with a request. However, we consider it is unreasonable to bring an issue to us and then not respond to reasonable requests.
Section 6 – Unreasonable use of the complaints process
Individuals with complaints about the Practice have the right to pursue their concerns through a range of means. They also have the right to complain more than once about the Practice, if subsequent incidents occur.
This contact becomes unreasonable when the effect of the repeated complaints is to harass, or to prevent us from pursuing a legitimate aim or implementing a legitimate decision.
We consider access to a complaints system to be important and it will only be in exceptional circumstances that we would consider such repeated use is unacceptable – but we reserve the right to do so in such cases.
Section 7 – Examples of how we manage aggressive or abusive behaviour
- The threat or use of physical violence, verbal abuse or harassment towards the Practice staff is likely to result in a warning from the Senior Management Team. We may report incidents to the Police – this will always be the case if physical violence is used or threatened.
- Practice staff will end telephone calls if they consider the caller aggressive, abusive or offensive. Practice staff have the right to make this decision, to tell the caller that their behaviour is unacceptable and end the call if the behaviour persists.
- We will not respond to correspondence (in any format) that contains statements that are abusive to staff or contain allegations that lack substantive evidence. Where we can, we will return the correspondence. We will explain why and say that we consider the language used to be offensive, unnecessary and unhelpful and ask the sender to stop using such language. We will state that we will not respond to their correspondence if the action or behaviour continues and may consider issuing a warning to the Patient.
Section 8 – Examples of how we deal with other categories of unreasonable behaviour
We have to take action when unreasonable behaviour impairs the functioning of our Practice. We aim to do this in a way that allows a Patient to progress through our process. We will try to ensure that any action we take is the minimum required to solve the problem, taking into account relevant personal circumstances including the seriousness of the issue(s) or complaint and the needs of the individual.
Section 9 – Other actions we may take
Where a patient repeatedly phones, visits the Practice, raises repeated issues, or sends large numbers of documents where their relevance isn’t clear, we may decide to:
- limit contact to telephone calls from the patient at set times on set days, about the issues raised
- restrict contact to a nominated member of the Practice staff who will deal with future calls or correspondence from the patient about their issues
- see the patient by appointment only
- restrict contact from the patient to writing only regarding the issues raised
- return any documents to the patient or, in extreme cases, advise the patient that further irrelevant documents will be destroyed
- take any other action that we consider appropriate
Where we consider continued correspondence on a wide range of issues to be excessive, we may tell the patient that only a certain number of issues will be considered in a given period and ask them to limit or focus their requests accordingly.
In exceptional cases, we reserve the right to refuse to consider an issue, or future issues or complaints from an individual. We will take into account the impact on the individual and also whether there would be a broader public interest in considering the issue or complaint further.
We will always tell the patient what action we are taking and why.
Section 10 – The process we follow to make decisions about unreasonable behaviour
- Any member of the Practice staff who directly experiences aggressive or abusive behaviour from a Patient has the authority to deal immediately with that behaviour in a manner they consider appropriate to the situation and in line with this Policy
- With the exception of such immediate decisions taken at the time of an incident, decisions to issue a warning or remove patients from our Practice List are only taken after careful consideration of the situation by the Senior Management
- Wherever possible, we will give a patient the opportunity to change their behaviour or actions before a decision is taken
Section 11 – How we let people know we have made this decision
When a Practice employee makes an immediate decision in response to offensive, aggressive or abusive behaviour, the patient is advised at the time of the incident.
When a decision has been made by Senior Management, a patient will always be given the reason in writing as to why a decision has been made to issue a warning (including the duration and terms of the warning) or remove them from the Practice list. This ensures that the patient has a record of the decision.
Section 12 – How we record and review a decision to issue a warning
We record all incidents of unacceptable actions by patients. Where it is decided to issue a warning to a patient, an entry noting this is made in the relevant file and on appropriate computer records.
Each quarter a report on all restrictions will be presented to our Senior Management Team so that they can ensure the policy is being applied appropriately.
A decision to issue a warning to a patient as described above may be reconsidered either on request or on review.
Section 13 – The process for appealing a decision
It is important that a decision can be reconsidered. A patient can appeal a decision about the issuance of a warning or removal from the Practice list. If they do this, we will only consider arguments that relate to the warning or removal, and not to either the issue or complaint made to us, or to our decision to close a complaint.
An appeal could include, for example, a patient saying that: their actions were wrongly identified as unacceptable; the warning was disproportionate; or that it will adversely impact on the individual because of personal circumstances.
The Practice Manager or a GP Partner who was not involved in the original decision will consider the appeal. They have discretion to quash or vary the warning as they think best. They will make their decision based on the evidence available to them. They must advise the patient in writing that either the warning or removal still applies or a different course of action has been agreed. We may review the warning periodically or on further request after a period of time has passed. Each case is different.
This policy is subject to review.
Your NHS Data Matters
Your Data Matters to the NHS
Information about your health and care helps us to improve your individual care, speed up diagnosis, plan your local services and research new treatments. The NHS is committed to keeping patient information safe, and will always be clear about how it is used.
How your data is used
Information about your individual care such as treatment and diagnoses is collected about you whenever you use health and care services. It is also used to help both the Practice and other organisations for research and planning, for example research into new treatments, deciding where to put GP clinics and planning for the number of Doctors and Nurses in your local Hospital. It is only used in this way when there is a clear legal basis to use the information to help improve health and care for you, your family and future generations.
Wherever possible we try to use data that does not identify you, but sometimes it is necessary to use your confidential patient information.
You have a choice
You do not need to do anything if you are happy about how your information is used. However, if you do not want your confidential patient information to be used for research and planning, you can choose to opt out securely, either online or through a telephone service. You can change your mind about your choice at any time.
Will choosing this opt-out affect your care and treatment?
No, choosing to opt out will not affect how information is used to support your care and treatment. You will still be invited for screening services, such as screenings for bowel cancer.
What do you need to do?
If you are happy for your confidential patient information to be used for research and planning, you do not need to do anything.
To find out more about the benefits of data sharing, how data is protected, or to make/change your opt-out choice visit Your NHS data matters.
Your Rights and Responsibilities
Attending a busy GP Practice as a patient can be an anxious and worrying time for you. We aim to make your time here as short and as simple as possible and the following should help to explain what you, as a patient, can expect from our staff and what we, the staff, can expect from you.
Your Doctor’s Responsibilities
- To treat you with respect and courtesy at all times
- To treat you as an individual, and to discuss with you the care and treatment we can provide
- To give you full information on the services we offer
- To give you the most appropriate care by suitably qualified staff
- To provide you with emergency care when you need it
- To refer you to a suitable Consultant when necessary
- To give you access to your health records, subject to any limitations in the law
Your Responsibilities as a Patient
- To treat all staff with respect and courtesy at all times
- To tell us if you are unsure about the treatment we are offering you
- To ask for a home visit only when you are unable to attend the Practice through illness or infirmity
- To request such a visit before 10am, if possible
- To ask for an out-of- hours visit only when necessary
- Please ensure that you order your repeat medication in plenty of time allowing 48 working hours for your request to be processed
- To keep to your appointment time (note: if you are more than 10 minutes late for your appointment you may not be seen)
- To notify us at least 24 hours prior to an appointment if you cannot attend
- To notify us of any changes to your personal details (e.g. name, address, telephone number, mobile numbers etc).
Zero Tolerance
It is our policy to be helpful and polite to all our patients regardless of age, ethnic origin, disability, gender or sexual orientation. We expect the same courtesy from our patients. Discriminatory, unsocial, threatening, violent or abusive behaviour towards staff, other patients or the premises will not be tolerated. The Practice will take action in these circumstances, which may involve the Police and result in the removal of the patient from our Practice list.
In England, please refer to NHS Constitution your rights and responsibilities for further information.