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.
Accessing your Record
A note about Medical Records
Sometimes when people view their medical records they see things recorded in ways that they don’t understand or in which don’t fully record the medical problems that they have or have had.
There are a number of reasons that may account for this:
- It may have been incorrectly recorded or dated. If you are viewing your medical records and something is clearly wrong, please let us know so we can investigate and correct it. If possible, let us know of problems in writing rather than by telephone. Please do not book an appointment just to raise concerns about details in your medical record.
- It may not be able to be exactly recorded due to the limitations of the system used to “code” medical information. Much of the information in medical records is recorded using medical terms that the computer system recognises. Unfortunately the number of computer recognised terms is not as extensive as enormous variety of medical conditions that people have. Rare, very detailed and newly described conditions or procedures are often not available on the coding system so we have to use approximations. We have to accept and work with this.
- Remember that medical terminology does not always have exactly the same meaning as when the words are used in day to day conversation.
We are a baby-friendly Practice. You are welcome to breastfeed your baby; please ask a Receptionist if you would like to sit somewhere private.
NHS England is currently involved in developing a modern information system, to help improve health services.
To discover how information about you helps us to provide better care you can visit the NHS England website or download the leaflets shown below.
Health and Social Care Act 2012
Collection of your personal data under the Health and Social Care Act 2012.
Care Quality Commission (CQC)
The Practice is registered with CQC. The aim of CQC is to ensure that patients can expect all health and adult social care services to meet essential standards of quality. As part of this the CQC will occasionally undertake inspections at the Practice. As part of inspection, the CQC Representative will talk to patients as well as the Practice Team to gather information. To support this they may also access documents and records, including patient information.
NHS England and the Care Quality Commission commit to a common purpose to improve outcomes for patients
NHS England and the Care Quality Commission (CQC) are committed to working together to deliver the statutory duty set out in the Health and Social Care Act 2012 to co-operate and to deliver their common purpose, which is to improve outcomes for patients.
The Partnership Agreement aims to foster a culture in which there is support, challenge, engagement, openness and co-ordination at all levels.
The agreement formalises existing close working between the CQC and NHS England, embedding a shared commitment to work together to achieve three priorities that will facilitate improved outcomes for patients.
NHS England and CQC will:
- Agree an information exchange protocol to share information and intelligence about the quality of care to spot potential problems early and manage risk
- Implement the mechanisms proposed by the National Quality Board (NQB) in their document ‘Quality in the new Health System: Maintaining and Improving Quality from April 2013 (January 2013)’, on how the healthcare system should prevent, identify and respond to serious failures in quality.
- Set the tone for ways of working nationally, locally and in the wider landscape of our organisations and strategic partners in healthcare.
- The agreement between NHS England and CQC cements joint working at national level and sets out the values and behaviours we want to demonstrate through effective joint working.
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
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.
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.
- 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.
- 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 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.
Clinical Trials help Doctors understand how to treat a particular disease or condition. It may benefit you, or others like you, in the future.
If you take part in a Clinical Trial, you may be one of the first people to benefit from a new treatment.
However, if you do take part you should also be aware that there is a chance that the new treatment turns out to be no better, or worse, than the existing standard treatment.
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.
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. Alternatively, you may write to us at the surgery or email our Practice on [email protected].
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:
PO Box 16738
If you are making a complaint please state: ‘For the attention of the complaints team’ in the subject line.
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.
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.
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.
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.
Parliamentary & Health Service Ombudsman
London SW1P 4QP
Phone: 0345 015 4033
Other organisations that can help you make a complaint about health services
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.
We may ask you for information about yourself to ensure that you can receive care and treatment that is right for you. We keep this information, together with details of your care, because it may be needed if we see you again.
We may use some of this information for other reasons: for example, to help us protect the health of the public generally and to see that the NHS runs efficiently, plans for the future, training staff, pays its bills and can account for its actions. Information may also be needed to help educate tomorrow’s clinical staff and to carry out medical and other health research for the benefit of everyone.
Sometimes the law requires us to pass on information, for instance to notify a birth.
You may be receiving care from other people as well as the NHS. So that we can all work together for your benefit, we may need to share some information about you.
We can only use or pass on information about you if people have a genuine need for it in your and everyone’s interest. Whenever we can, we remove details which identify you. The sharing of some types of very sensitive personal information is strictly controlled by law. Anyone who receives information from us is under a legal duty to keep it confidential.
Everyone working for the NHS has a legal duty to keep information about you confidential and you have the right to say no if you do not want information about you given to others.
Please also note that the Primary Care Trust makes routine visits to GP surgeries for the purpose of financial audit. This may involve their representatives needing access to patient records. If you do not wish your records to be used for this purpose, please let us know so that we can make a suitable note on your records.
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 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.
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.
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.
If you have any special needs please let our staff know so that we can help you, and also ensure you get the same support in the future.
The Practice has been specially designed to make it easier for disabled patients to visit; patients also have access to a disabled toilet.
Disabled parking – Blue badge scheme
The Blue Badge Scheme is for people with severe mobility problems. It allows Blue Badge holders to park close to where they need to go. For more information and an Application Form visit your local council office.
We have a loop induction system at Reception to assist the hearing impaired. For more information on the loop hearing system visit Hearing Link website.
- British Deaf Association
- British Sign Language Healthy Mind
- Action Hearing Loss
- Royal Association for Deaf People
- National Deaf Children’s Society
If you or your family members are blind or partially sighted we can give you a large print of our Practice leaflet upon request. Please ask our staff for further information.
For more advice and support for blind people please visit the following websites:
- Royal National Institute of Blind People (RIND)
- Action for Blind People
- Blind in Business
- British Blind Sport
Guide dogs are welcome at the Practice but we ask that you be aware of other patients and staff who may have an allergy or fear of dogs. Please visit the guide dog website for further information.
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.
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, 156kb) 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
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
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?
- 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 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 this LINK.
All GP practices are required to declare the mean earnings (e.g. average) for GPs working to deliver NHS services to patients at each practice.
The average pay for GPs working at the Millway Medical Practice in the last financial year before tax and national insurance is £77,129.
This is for 2 full time GPs, 11 part time GPs and 2 locums who worked in the practice for more than 6 months.
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.
Health and care professionals provide care as a local team. This means that the right people can work together to ensure your care is planned and co-ordinated. They work within strict rules and focus on getting the best outcomes for their patients.
They are ethically accountable to their professional bodies for their actions, including on what is appropriate to share and when. Sharing is subject to strict written agreements and/or contracts on how it will be used with tight controls to maintain confidentiality and security.
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.
NHS Patient Rights
Citizens Advice England provides patients with a full array of information about your rights within the NHS.
Smoking is not permitted either within the Practice premises or in the Practice car park.
The law has changed regards organ donation – the system has changed from and opt in system to an opt out system.
Patient Advice and Liaison Service (PALS)
The Patient Advice and Liaison Service (PALS) offers confidential advice, support and information on health-related matters.
They provide a point of contact for patients, their families and their carers.
We have explained the various services we provide. As an extension of that, our Practice Charter sets out what you can expect from us, and what we in return, expect from you.
The care of your health is a partnership between yourself and the Practice Team. The success of that partnership depends on a number of factors:
- Establishing a shared responsibility to prevent problems before they occur, rather than trying to put them right later.
- Having a clear understanding of each other’s needs.
- Developing regular feedback on how you feel about our services.
Only by such co-operation will we be able to improve our services and achieve the ultimate goal of a healthier community.
Please see our key statement indicators below that reflect the ethos of our Practice philosophy:
- Quality patient care is our key driving motivation
- The guiding working principle is ‘do today’s work today’
- Consider patients’ requests from their perspective
- We will work collaboratively with other agencies in our locality
- We will seek to be flexible in working arrangements
- We use first names in communicating with all our staff
- Staff views will always be considered / respected
- Staff should be encouraged and supported to develop skills useful for the Practice
Please check with the Practice if this service is available.
Giving another person access to your GP online services
Did you know that you can choose to give another person access to your GP online services on your behalf? You don’t need to know how to use these services or have a computer yourself to give another person access.
Who can have access?
You choose who you want to give access to. This could be your carer, partner, parent or another family member. You can also give access to more than one person. Giving access to another person is your choice. No-one can go to your GP surgery and ask for access to your online services without your permission.
You also choose which online services you want each person to use. These are booking appointments, ordering repeat prescriptions and looking at your GP record. You decide whether to let them use one, two or all of the services on your behalf.
Why you may want to give another person access
You may wish to allow another person to use your online services for different reasons.
- You are very unwell or just need help managing your health
- You have a long term condition ,for example diabetes, heart disease, asthma or high blood pressure and would like support with checking test results, ordering repeat prescriptions and understanding your treatment
- You are finding it more difficult to look after yourself, for example due to memory issues or speech difficulties
- You have learning difficulties and want someone else to help you understand your health
- You have a carer who can help you manage your health
- You may be planning for the future or choosing someone to hold lasting power of attorney for health and social care for you
- You are a young person and would like your parent or guardian to look after your health. Some surgeries only allow this for children under the age of 12
- You work away from home or are just busy and need help with booking appointments or ordering repeat prescriptions.
- You are not comfortable with using computers, smart phones, or tablets
For more information on GP online services for carers, see our leaflets ‘GP online services for carers including young carers’ and ‘Giving employed carers access to your GP online services’. These can be found at Getting started with GP online services.
Before giving another person access, you should think about what the benefits will be for you. If you cannot think of any, then you should think very carefully whether allowing them access is the right thing to do. Some of the benefits are:
- You have peace of mind that someone is supporting you with managing your health
- The person you choose can help you make sure the information your surgery has about you is correct, for example your medication and allergies.
- You know that someone else understands your medical information and can provide information when you are unable to. This could be when you are unconscious or too unwell to speak or when you need help explaining or understanding something
- You can benefit from the convenience of using GP online services even if you do not use a computer or do not have access to the internet
- One member of the family can book appointments for everyone in the household and make sure the appointments fit with your family activities
If you have a carer, using GP online services can save them time allowing them to spend more time looking after your needs.
What other patients who use this service had to say
‘I access my son’s online services to order his repeat prescriptions, it is definitely worthwhile and saves a trip to the surgery. As long as I can remember my login details, it is easy to use. I use this service every couple of months when prescriptions are due.’
Andy, Street Lane Practice.
‘My daughter having access to my GP records gives me peace of mind and the knowledge that I am being cared for.’
Freda, Rotherham Road Medical Centre.
‘This online system is brilliant and means I do not have to waste valuable doctors’ time phoning the practice, which is beneficial for all patients at the practice. I can login once a week to see if we have any issues with my three children. The system is secure with passwords and usernames which can be changed at any time for security purposes. I would recommend to all parents and patients that this is the best system to use for all
GP records of your children. A must have item for all parents and patients.’
Mr Thomas, Street Lane Practice.
How it works
The recommended and safest way to give another person access to your online services is for them to have their own username and password. If you use online services yourself, you should not share your username and password with anyone. If you share your username and password, your surgery cannot tell whether you or someone else accessed your online services. This may be a problem if someone else misuses your login details and your surgery has to look into this.
How to sign up
The steps below show how you can give another person access:
- You contact your surgery to let them know you would like to give your chosen person access to your GP online services.You may also choose to register for online services for yourself if you do not already use them
- The Practice will give your chosen person a short form to fill in. You will also need to sign to confirm you agree with the information on the form. You can also choose whether you only want them to book appointments or order prescriptions or use all the services on your behalf. It is up to you
- Your chosen person will need to show your surgery their photo ID and proof of address, for example, a passport or photo driving licence and a bank statement or council tax statement. If they don’t have the required ID, speak to staff at the surgery, who may be able to help confirm their identity in another way
- Staff at the Practice will make a decision on whether to give your chosen person access to your GP online services. If we decide not to give them access, we will discuss their reasons with you
- The staff will give your chosen person their own username and password to use to login to your GP online services.
Things to consider before giving another person access
- Is there any information in your records you would not like anyone to see or know about?
- Can you trust the person to keep your information safe and not share it with others or use it without your permission?
- Is any one forcing you into sharing your online services with them or do you think someone could force you to share it with them? If so, we would advise that you do not give them access. If you have any concerns that someone has access to your online records without your permission, speak to your surgery and they can change your password or stop your online services
- How long would you like your chosen person to have access for? This can be for a short time, for example when you are suffering from a certain illness and you need support with managing your health during that time. It can also be ongoing so they can help you for a long period of time. You can discuss this with the Practice.
Lasting power of attorney for health and welfare or court appointed deputy
When a person is unable to make decisions for themselves, another person, usually a partner or close family member can be given legal responsibility over decisions concerning their life by the courts. This is called Health and Welfare Lasting Power of Attorney. A person with lasting power of attorney can ask the patient’s surgery for access to their online services. The GP will make a decision whether this should be allowed.
If you know that you would never want a particular person to have access to your online services if you become unable to make your own decisions, you should tell your GP and they will never share them with that person.
Why your surgery may refuse to give your chosen person access
On rare occasions, your GP could refuse to allow your chosen person to use GP online services on your behalf. If this happens, your GP will discuss their reasons with you. Some of the reasons your GP could have are:
- Your GP does not think it is in your best interest for your chosen person to use these services on your behalf
- You or your chosen people have misused online services in the past
- The Practice is concerned that your chosen person will not keep your information safe
- The Practice suspects someone is forcing you to give them permission to use your online services
- You are not able to make decisions for yourself.
Why your surgery can stop the service
- We believe your chosen person is forcing you to share your GP records with them or with another person.
- Your chosen person has misused your GP information
- You are no longer able to understand or remember that you gave your chosen person permission to use online services on your behalf
- You have told the Practice in the past that if you become unable to make decisions for yourself, you do not wish for your chosen person or anyone to have permission to your online services
- You have died.
How you can stop the service
You can choose to take away access to your GP online services from your chosen person at any time.To end the service, you need to let your surgery know you would like them to switch off online access for your chosen person and give them the reason.Your surgery will then stop the service and your chosen person will not be able to use their login details to look at your information.
Why you may want to stop access
Some of the reasons you can choose to end the service are:
- You only needed your chosen person to support you for a short time, for example when you were suffering from a certain illness and you needed help with managing your health during that time
- You want to give this responsibility to another person, for example, if you have a new carer or personal assistant
- Your relationship with your chosen person has broken down
- Your chosen person has misused information in your GP records, for example, they have collected medication in your name or they have shared your private information with someone without your permission.
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
RCGP Disease Surveillance Programme
The Practice along with others throughout England and Wales contribute to a surveillance programme which provides information on the incidence of disease.
Information is extracted from the practice computer on a regular basis describing the diseases reported by the doctors, vaccinations given and information about selected prescriptions. This information is collected in a completely anonymous way.
Anybody in England, whether a resident or overseas visitor, may access primary care services at a GP Practice without charge. No documents are required to register with a GP; however, to facilitate the registration process we would request that two forms of identification are produced, ideally if possible, one should be photographic, and one must contain your address. You may be asked to sign a Practice Form to give your permission for us to retain these documents with your electronic patient record.
These documents may be used to confirm your details with our local Health Authority. This also helps to ensure the correct matching of your details to any existing NHS record, enabling previous medical records to transfer smoothly between practices. We appreciate your assistance in this matter.
Types of acceptable photographic evidence:
- Drivers Licence
- Official ID card from Public Services body; or
- Student matriculation card (current year)
Other documents for proof of residency that are acceptable are:
- Recent utility bill (within last 3 months)
- Council Tax document
- Television Licence
- Payslips (last two months)
- Rent book/agreement (Public Body or Private Landlord)
- Bank Statement (Name and address section only required)
- Solicitors Letter (Clearly showing your name and address)
If you are unable to provide photographic evidence then we would request you provide one of the above and one of the following:
- Birth Certificate
- Marriage Certificate
- Divorce Annulment Papers
If you are unable to provide any documentation, then we may still register you. However we may need to contact our Registration Department first, to verify your information with them, and ensure your medical records are not delayed in being transferred to the Practice. This will normally involve a phone call between you, our Registration Department and ourselves. Alternatively we may also email/write to them directly in which case we will require your consent for us to do so.
If you have any questions regarding NHS entitlement, or our Registration Policy please contact the Practice.
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.
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.
Where to find more information
Here are some links to information which may help you make any decisions about your healthcare
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 websites :
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 these sites contains some useful information:
The Absolute CVD Risk/Benefit Calculator
Sharing your Information with Others
Collecting and sharing information is essential to provide safe and effective healthcare.
Appropriate information sharing is an essential part of the provision of safe and effective care. Patients may be put at risk if those who provide their care do not have access to relevant, accurate and up-to-date information about them.
All staff have an ethical and legal duty to keep patient information confidential.
If you do not wish your health information to be shared please notify the Practice in writing, in order that we may update your record.
Patients are reminded that if they are found posting any derogatory, defamotory, 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. 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.
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)
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.
Summary Care Records (SCR)
Summary Care Records (SCR) are an electronic record of important patient information, created from GP medical records. They can be seen and used by authorised staff involved in a patient’s direct care, both within the Practice as well as in other areas of the healthcare system.
Your Summary Care Record
Care professionals in England use an electronic record called the Summary Care Record (SCR). This can provide those involved in your care with faster secure access to key information from your GP record.
The NHS have produced an information leaflet about SCR; this is available using the link below, to either view or download as you wish.
What is an SCR?
If you are registered with a GP Practice in England, you will already have an SCR unless you have previously chosen not to have one.
It includes the following basic information:
- Medicines you are taking
- Allergies you suffer from
- Any bad reactions to medicines
It also includes your name, address, date of birth and unique NHS Number which helps to identify you correctly.
What choices do you have?
You can now choose to include more information in your SCR, such as significant medical history (past and present), information about management of long term conditions, immunisations and patient preferences such as end of life care information, particular care needs and communication preferences.
Your SCR is available to authorised healthcare staff providing your care anywhere in England, but they will ask your permission before they look at it. This means that if you have an accident or become ill, healthcare staff treating you will have immediate access to important information about your health.
This Practice supports SCR however, as a patient you have a choice:
- If you would like an SCR you do not need to do anything and an SCR will be created for you
- If you do NOT want an SCR please complete the online SCR opt out form, or alternatively if you wish you can download the Form and hand it in to the Practice
Remember, you can change your mind about your SCR at any time. Talk to our Practice if you want to discuss your option to add more information or decide you no longer want an SCR. If you do nothing we will assume you are happy for us to create a SCR for you.
Vulnerable patients and carers
Having an SCR that includes extra information can be of particular benefit to patients with detailed and complex health problems. If you are a carer for someone and believe that this may benefit them, you could discuss it with them and their GP Practice.
Who can see my SCR?
Only authorised, professional healthcare staff in England who are involved in your direct care can have access to your SCR. Your SCR will not be used for any other purposes.
- Need to have a Smartcard with a chip and passcode
- Will only see the information they need to do their job
- Will have their details recorded every time they look at your record
Healthcare professionals will ask for your permission if they need to look at your SCR. If they cannot ask you because you are unconscious or otherwise unable to communicate, they may decide to look at your record because doing so is in your best interest. This access is recorded and checked to ensure that it is appropriate.
SCRs for children
If you are the parent or guardian of a child under 16, and feel they are able to understand this information you should show it to them. You can then support them to come to a decision about having an SCR and whether to include additional information. You may request to opt them out of SAR; any opt-out requests on behalf of children will be carefully considered.
For information on how the NHS will collect, store and allow access to your electronic records visit NHS UK.
The NHS Constitution for England
The NHS belongs to the people.
It is there to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives.
It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most.
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.
You can also view/download the leaflet below for your information.
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 10.00 am, 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).
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.
NHS staff should be able to come to work without fear of violence, abuse or harassment from patients or their relatives.
The NHS operate a Zero Tolerance Policy with regard to violence and abuse and the Practice has the right to remove violent patients from their list with immediate effect, in order to safeguard practice staff, patients and other persons. Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.
Where patients are disruptive and display aggressive and/or intimidating behaviour and refuse to leave the premises, staff are instructed to dial 999 for Police assistance, and charges may then be brought against these individuals.