Policies - The Surgery

Chaperone Policy

The Surgery prides itself in maintaining professional standards. For certain examinations during consultations an impartial observer (a “chaperone”) will be required.

This chaperone will be a Practice Nurse or Health Care Assistant who is familiar with the procedure and be available to reassure and raise any concerns on your behalf. If a nurse is unavailable at the time of your consultation then your examination may be re-scheduled for another time.

You are free to decline any examination or choose an alternative examiner or chaperone. You may also request a chaperone for any examination or consultation if one is not offered to you. The GP may not undertake an examination if a chaperone is declined.

The role of a Chaperone:

Maintains professional boundaries during intimate examinations.
Acknowledges a patient’s vulnerability.
Provides emotional comfort and reassurance.
Assists in the examination.
Assists with undressing patients, if required.

Confidentiality

The practice complies with the Data Protection Act. All information about patients is confidential: from the most sensitive diagnosis, to the fact of having visited the surgery or being registered at the Practice. All patients can expect that their personal information will not be disclosed without their permission except in the most exceptional of circumstances, when somebody is at grave risk of serious harm.

All members of the primary health care team (from reception to doctors) in the course of their duties will have access to your medical records. They all adhere to the highest standards of maintaining confidentiality.

As our reception area is a little public, if you wish to discuss something of a confidential nature please mention it to one of the receptionists who will make arrangements for you to have the necessary privacy.

Under 16s:

The duty of confidentiality owed to a person under 16 is as great as the duty owed to any other person. Young people aged under 16 years can choose to see health professionals, without informing their parents or carers. If a GP considers that the young person is competent to make decisions about their health, then the GP can give advice, prescribe and treat the young person without seeking further consent.

However, in terms of good practice, health professionals will encourage young people to discuss issues with a parent or carer. As with older people, sometimes the law requires us to report information to appropriate authorities in order to protect young people or members of the public.

Useful Websites:

Freedom of Information

The Freedom of Information Act creates a right of access to recorded information and obliges a public authority to:

Have a publication scheme in place
Allow public access to information held by public authorities.

The Act covers any recorded organisational information such as reports, policies or strategies, that is held by a public authority in England, Wales and Northern Ireland, and by UK-wide public authorities based in Scotland, however it does not cover personal information such as patient records which are covered by the Data Protection Act.

Public authorities include government departments, local authorities, the NHS, state schools and police forces.

The Act is enforced by the Information Commissioner who regulates both the Freedom of Information Act and the Data Protection Act.

The Surgery publication scheme

A publication scheme requires an authority to make information available to the public as part of its normal business activities. The scheme lists information under seven broad classes, which are:

who we are and what we do
what we spend and how we spend it
what our priorities are and how we are doing it
how we make decisions
our policies and procedures
lists and registers
the services we offer

You can request our publication scheme leaflet at the surgery.

Who can request information?

Under the Act, any individual, anywhere in the world, is able to make a request to a practice for information. An applicant is entitled to be informed in writing, by the practice, whether the practice holds information of the description specified in the request and if that is the case, have the information communicated to him. An individual can request information, regardless of whether he/she is the subject of the information or affected by its use.

How should requests be made?

Requests must:

be made in writing (this can be electronically e.g. email/fax)
state the name of the applicant and an address for correspondence
describe the information requested.

What cannot be requested?

Personal data about staff and patients covered under Data Protection Act.

For more information see these websites:

General Data Protection Act

What is GDPR?

General Data Protection Regulations (GDPR) is a piece of legislation that superseded the Data Protection Act 1998 on Friday 25th May 2018 and covers anywhere in the world in which data about EU Citizens is processed.

GDPR is similar to the Data Protection Act (DPA) 1998, which the practice already complies with, but strengthens many of the DPA’s principles. The main changes are:

Practices must comply with subject access requests.
Where we need your consent to process data, this consent must be freely given, specific, informed and unambiguous.
There are new, special protections for patient data.
The Information Commissioner’s Office must be notified within 72 hours of a data breach.
Higher fines for data breaches – up to 20 million euros.

What does this mean for you?

The GDPR sets out the key principles about processing personal date for staff and patients;

Data must be processed lawfully, fairly and transparently.
It must be collected for specific, explicit and legitimate purposes.
It must be limited to what is necessary for the purposes for which it is processed.
Information must be accurate and kept up to date.
Data must be held securely.
It can only be retained for as long as is necessary for the reasons it was collected.

There are also stronger rights for patients regarding the information that practices hold about them. These include;

Being informed about how their data is used.
Patients to have access to their own data.
Patients can ask to have incorrect information changed.
Restrict how their data is used.
Move their patient data from one health organisation to another.
The right to object their patient information being processed (in certain circumstances).

We will use your data to:

Book/cancel appointments
Appointment reminders
Direct contact to discuss treatment and appointments
Referrals to hospitals/specialists with your consent

What is ‘Patient Data’?

Patient data is information that relates to a single person, such as his/her diagnosis, name, age, earlier medical history etc.

What is ‘Consent’?

Consent is permission from a patient and is defined as “any freely given specific and informed indication of their wishes by which the data subject signifies their agreement to personal data relating to them being processed.”

The changes in GDPR mean that we must get explicit permission from patients when using their data in order to protect your right to privacy. We may ask you to provide consent to do certain things, like contact you or record certain information about you for your clinical records.

Individuals also have the right to withdraw their consent at any time.

More details can be found by visiting the ICO website.

GP Earnings

What is GDPR?

GDPR is similar to the Data Protection Act (DPA) 1998, which the practice already complies with, but strengthens many of the DPA’s principles. The main changes are:

Practices must comply with subject access requests.
Where we need your consent to process data, this consent must be freely given, specific, informed and unambiguous.
There are new, special protections for patient data.
The Information Commissioner’s Office must be notified within 72 hours of a data breach.
Higher fines for data breaches – up to 20 million euros.

What does this mean for you?

The GDPR sets out the key principles about processing personal date for staff and patients;

Data must be processed lawfully, fairly and transparently.
It must be collected for specific, explicit and legitimate purposes.
It must be limited to what is necessary for the purposes for which it is processed.
Information must be accurate and kept up to date.
Data must be held securely.
It can only be retained for as long as is necessary for the reasons it was collected.

There are also stronger rights for patients regarding the information that practices hold about them. These include;

Being informed about how their data is used.
Patients to have access to their own data.
Patients can ask to have incorrect information changed.
Restrict how their data is used.
Move their patient data from one health organisation to another.
The right to object their patient information being processed (in certain circumstances).

We will use your data to:

Book/cancel appointments
Appointment reminders
Direct contact to discuss treatment and appointments
Referrals to hospitals/specialists with your consent

What is ‘Patient Data’?

Patient data is information that relates to a single person, such as his/her diagnosis, name, age, earlier medical history etc.

What is ‘Consent’?

Individuals also have the right to withdraw their consent at any time.

More details can be found by visiting the ICO website.

Infection Control

We aim to keep our surgery clean and tidy and offer a safe environment to our patients and staff. We are proud of our modern, purpose built Practice and endeavour to keep it clean and well maintained at all times.

If you have any concerns about cleanliness or infection control, please report these to our Reception staff.

Our GPs and nursing staff follow our Infection Control Policy to ensure the care we deliver and the equipment we use is safe.

We take additional measures to ensure we maintain the highest standards:

Encourage staff and patients to raise any issues or report any incidents relating to cleanliness and infection control. We can discuss these and identify improvements we can make to avoid any future problems.
Carry out an annual infection control audit to make sure our infection control procedures are working.
Provide annual staff updates and training on cleanliness and infection control
Review our policies and procedures to make sure they are adequate and meet national guidance.
Maintain the premises and equipment to a high standard within the available financial resources and ensure that all reasonable steps are taken to reduce or remove all infection risk.
Use washable or disposable materials for items such as couch rolls, modesty curtains, floor coverings, towels etc., and ensure that these are laundered, cleaned or changed frequently to minimise risk of infection.
Make Alcohol Hand Rub Gel available throughout the building

Named GP

New Patient Policy

Where it is clinically appropriate and practical to register, we now accept new registrations from patients who work in the local area but reside outside of our registration area. Patients registered this way would not be entitled to home visit from the practice, however they will be able to contact NHS 111 in order to be seen by a practice closer to where they live.

For further information about this type of registration, please contact us on 0208 902 0055 or feel free to come into the practice.

Safeguarding Policy

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.

Statement of Intent

New contractual requirements came into force from 1 April 2014 requiring that GP Practices should make available a statement of intent in relation to the following IT developments:

Summary Care Record (SCR)
GP to GP Record Transfers
Patient Online Access to Their GP Record
Data for commissioning and other secondary care purposes

The same contractual obligations require that we have a statement of intent regarding these developments in place and publicised by 30 September 2014.

Please find below details of the practices stance with regards to these points.

Summary Care Record (SCR)

NHS England require practices to enable successful automated uploads of any changes to patient’s summary information, at least on a daily basis, to the summary care record (SCR) or have published plans in place to achieve this by 31st of March 2015.

Having your Summary Care Record (SCR) available will help anyone treating you without your full medical record. They will have access to information about any medication you may be taking and any drugs that you have a recorded allergy or sensitivity to.

Of course, if you do not want your medical records to be available in this way then you will need to let us know so that we can update your record. You can do this via the opt out form.
The practice confirms that your SCR is automatically updated on at least a daily basis to ensure that your information is as up to date as it can possibly be.

GP to GP Record Transfers

NHS England require practices to utilise the GP2GP facility for the transfer of patient records between practices, when a patient registers or de-registers (not for temporary registration).
It is very important that you are registered with a doctor at all times. If you leave your GP and register with a new GP, your medical records will be removed from your previous doctor and forwarded on to your new GP via NHS England. It can take your paper records up to two weeks to reach your new surgery.

With GP to GP record transfers your electronic record is transferred to your new practice much sooner.

The practice confirms that GP to GP transfers are already active and we send and receive patient records via this system.

Patient Online Access to Their GP Record

NHS England require practices to promote and offer the facility to enable patients online access to appointments, prescriptions, allergies and adverse reactions or have published plans in place to achieve this by 31st of March 2015.

We currently offer the facility for booking and cancelling appointments and also for ordering your repeat prescriptions and viewing a summary of your medical records on-line. If you do not already have a user name and password for this system – please register your interest with our reception staff.

Data for commissioning and other secondary care purposes

It is already a requirement of the Health and Social Care Act that practices must meet the reasonable data requirements of commissioners and other health and social care organisations through appropriate and safe data sharing for secondary uses, as specified in the technical specification for care data.

At our practice we have specific arrangements in place to allow patients to “opt out” of care.data which allows for the removal of data from the practice. Please see the page about care data on our website

The Practice confirm these arrangements are in place and that we undertake annual training and audits to ensure that all our data is handled correctly and safely via the Information Governance Toolkit.

Suggestions Comments And Complaints

We continually seek to improve and develop our services. We would like to hear from you if you have a suggestion on how we can enhance your experience with us, or if you would like to say well done to a member of our team.

All feedback received throughout the week is discussed and shared in our weekly staff meetings.

Your feedback is extremely valuable to us so please take the time to share your thoughts and suggestions where possible. You can either write to us or contact us by phone.

Summary Care Record

About your Summary Care Record

Your Summary Care Record contains important information about any medicines you are taking, any allergies you suffer from and any bad reactions to medicines that you have previously experienced.

Allowing authorised healthcare staff to have access to this information will improve decision making by doctors and other healthcare professionals and has prevented mistakes being made when patients are being cared for in an emergency or when their GP practice is closed.

Your Summary Care Record also includes your name, address, date of birth and your unique NHS Number to help identify you correctly.

You may want to add other details about your care to your Summary Care Record. This will only happen if both you and your GP agree to do this. You should discuss your wishes with your GP practice.

Healthcare staff will have access to this information, so that they can provide safer care, whenever or wherever you need it, anywhere in England.

FAQs

Who can see my Summary Care Record?

Healthcare staff who have access to your Summary Care Record:

need to be directly involved in caring for you
need to have an NHS Smartcard with a chip and passcode
will only see the information they need to do their job and
will have their details recorded every time they look at your record

Healthcare staff will ask for your permission every time they need to look at your Summary Care Record. If they cannot ask you (for example if you are unconscious or otherwise unable to communicate), healthcare staff may look at your record without asking you, because they consider that this is in your best interest.

If they have to do this, this decision will be recorded and checked to ensure that the access was appropriate.

What are my choices?

You can choose to have a Summary Care Record or you can choose to opt out.

If you choose to have a Summary Care Record and are registered with a GP practice, you do not need to do anything as a Summary Care Record is created for you.

If you choose to opt out of having a Summary Care Record and do not want a SCR, you need to let your GP practice know by filling in and returning an opt-out form. Opt-out forms can be downloaded from the website or from your GP practice.

If you are unsure if you have already opted out, you should talk to the staff at your GP practice. You can change your mind at any time by simply informing your GP practice and either filling in an opt-out form or asking your GP practice to create a Summary Care Record for you.

Children and the Summary Care Record

If you are the parent or guardian of a child under 16, you should make this information available to them and support the child to come to a decision as to whether to have a Summary Care Record or not.

If you believe that your child should opt-out of having a Summary Care Record, we strongly recommend that you discuss this with your child’s GP. This will allow your child’s GP to highlight the consequences of opting-out, prior to you finalising your decision.

Where can I get more information?

For more information about Summary Care Records you can:

talk to the staff at your GP practice
phone the Health and Social Care Information Centre on 0300 303 5678
Read the Summary Care Record patient information

Your Rights and Responsibilities

Patient’s Rights

We are committed to giving you the best possible service. This will be achieved by working together. Help us to help you. You have a right to, and the practice will try to ensure that:

You will be treated with courtesy and respect
You will be treated as a partner in the care and attention that you receive
All aspects of your visit will be dealt with in privacy and confidence
You will be seen by a doctor of your choice subject to availability
In an emergency, out of normal opening hours, if you telephone the practice you will be given the number to receive assistance, which will require no more than one further call
You can bring someone with you, however you may be asked to be seen on your own during the consultation
Repeat prescriptions will normally be available for collection within two working days of your request
Information about our services on offer will be made available to you by way of posters, notice boards and newsletters
You have the right to see your medical records or have a copy subject to certain laws.

Patient’s Responsibilities

With these rights come responsibilities and for patients we would respectfully request that you:

Treat practice staff and doctors with the same consideration and courtesy that you would like yourself. Remember that they are trying to help you
Please ensure that you order your repeat medication in plenty of time allowing 48 working hours.
Please ensure that you have a basic first aid kit at home and initiate minor illness and self-care for you and your family.
Please attend any specialist appointments that have been arranged for you or cancel them if your condition has resolved or you no longer wish to attend
Please follow up any test or investigations done for you with the person who has requested the investigation
Attend appointments on time and check in with Reception
Patients who are more than 20 minutes late for their appointment may not be seen.
If you are unable to make your appointment or no longer need it, please give the practice adequate notice that you wish to cancel. Appointments are heavily in demand and missed appointments waste time and delay more urgent patients receiving the treatment they need
An appointment is for one person only. Where another family member needs to be seen or discussed, another appointment should be made
Patients should make every effort to present at the surgery to ensure the best use of nursing and medical time. Home visits should be medically justifiable and not requested for social convenience
Please inform us when you move home, change your name or telephone number, so that we can keep our records correct and up to date
Read the practice leaflets and other information that we give you. They are there to help you use our services. If you do not understand their content please tell us
Let us have your views. Your ideas and suggestions whether complimentary or critical are important in helping us to provide a first class, safe, friendly service in pleasant surroundings.

NHS Constitution

The NHS Constitution establishes the principles and values of the NHS in England. For more information see these websites:

Zero Tolerance Policy

The practice fully supports the NHS Zero Tolerance Policy. The aim of this policy is to tackle the increasing problem of violence against staff working in the NHS and ensures that doctors and their staff have a right to care for others without fear of being attacked or abused.

We understand that ill patients do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint. We ask you to treat your doctors and their staff courteously and act reasonably.

All incidents will be followed up and you will be sent a formal warning after a second incident or removed from the practice list after a third incident if your behaviour has been unreasonable.

However, aggressive behaviour, be it violent or verbal abusive, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police will be contacted if an incident is taking place and the patient is posing a threat to staff or other patients.

Removal from the Practice List

A good patient-doctor relationship, based on mutual respect and trust, is the cornerstone of good patient care. The removal of patients from our list is an exceptional and rare event and is a last resort in an impaired patient-practice relationship. When trust has irretrievably broken down, it is in the patient’s interest, just as much as that of The Surgery, that they should find a new practice. An exception to this is on immediate removal on the grounds of violence e.g. when the Police are involved.

Removing other members of the household

In rare cases, however, because of the possible need to visit patients at home it may be necessary to terminate responsibility for other members of the family or the entire household. The prospect of visiting patients where a relative who is no longer a patient of the practice by virtue of their unacceptable behaviour resides, or being regularly confronted by the removed patient, may make it too difficult for the practice to continue to look after the whole family. This is particularly likely where the patient has been removed because of violence or threatening behaviour and keeping the other family members could put doctors or their staff at risk.