Accessible Information
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.
Chaperone Policy
This Policy is designed to protect both patients and staff from abuse or allegations of abuse, and to assist patients in making an informed choice about their examinations and consultations.
Guidelines
Clinicians (male and female) will consider whether an intimate or personal examination of the patient (either male or female) is justified, or whether the nature of the consultation poses a risk of misunderstanding.
- The Clinician will give the patient a clear explanation of what the examination will involve
- They will always adopt a professional and considerate manner and be careful with humour as a way of relaxing a nervous situation, as it can easily be misinterpreted
- The patient will always be provided with adequate privacy to undress and dress
- A suitable sign will be clearly on display in each Consulting or Treatment Room offering the Chaperone Service.
The above guidelines are to remove the potential for misunderstanding. However, there will still be times when either the Clinician, or the patient, feels uncomfortable, and it would then be appropriate to consider using a Chaperone.
Patients who request a Chaperone will never be examined without a Chaperone being present. If necessary, where a Chaperone is not available, the consultation/examination will be rearranged for a mutually convenient time when a Chaperone can be present.
Complaints and claims have not been limited to Doctors treating/examining patients of the opposite gender – there are many examples of alleged assault by female and male doctors on people of the same gender.
Consideration will always be given by staff to the possibility of a malicious accusation by a patient, and a Chaperone organised if there is any potential for this.
There may be occasions when a Chaperone is needed for a home visit in which case the following procedure will be followed.
Who can act as a Chaperone?
A variety of people can act as a Chaperone in the practice, but staff undertaking a formal Chaperone role will have been trained in the competencies required. Where possible, Chaperones will be clinical staff familiar with procedural aspects of personal examination.
Where the Practice determines that non-clinical staff will act in this capacity, the patient will be asked to agree to the presence of a non-Clinician in the examination, and for confirmation that they are at ease with this. The staff member will be trained in the procedural aspects of personal examinations, be comfortable acting in the role of Chaperone, and be confident in the scope and extent of their role. They will also have received instruction on where to sit/stand and what to watch and listen for. A Chaperone will document in the patient notes that they were present, and detail any issues arising.
Confidentiality
- The Chaperone will only be present for the examination itself, with most of the discussion with the patient taking place while the Chaperone is not present.
- Patients are reassured that all Practice staff understand their responsibility not to divulge confidential information.
Procedure
- The Clinician will contact reception to request a Chaperone
- Where no Chaperone is available, a Clinician may offer to delay the examination to a date when one will be available, as long as the delay would not have an adverse effect on the patient’s health
- If a Clinician wishes to conduct an examination with a Chaperone present but the patient does not agree to this, the Clinician will explain clearly why they want a Chaperone to be present. The Clinician may choose to consider referring the patient to a colleague who would be willing to examine them without a Chaperone, as long as the delay would not have an adverse effect on the patient’s health
- The Clinician will record in the notes that the Chaperone is present, and identify the Chaperone
- The Chaperone will enter the room discreetly and remain in the room until the Clinician has finished the examination
- A Chaperone will attend inside the curtain/screened-off area at the head of the examination couch and observe the procedure
- To prevent embarrassment, the Chaperone will not enter into conversation with the patient or GP unless requested to do so, or make any mention of the consultation afterwards
- The Chaperone will make a record in the patient’s notes after examination. The record will either state that there were no problems, or give details of any concerns or incidents that occurred. The Chaperone must be aware of the procedure to follow if any concerns require to be raised
- The patient can refuse a Chaperone, and if so this must be recorded in the patient’s medical record.
Clinical Research
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.
Complaints
We make every effort to give the best service possible to everyone who attends our Practice.
However, we are aware that things can go wrong, resulting in a patient feeling that they have a genuine cause for complaint. If this is so, we would like the matter to be settled as quickly, and as amicably, as possible.
To have your complaint investigated, you need to complain within 12 months of the event happening, or as soon as you first become aware of the issue you want to complain about.
The time limit can be extended in special circumstances.
How to make a compliment or complaint
Whether you are happy or unhappy with the care and treatment that you have received, please get in touch and let us know your views.
Receiving compliments and complaints is important to ensuring good quality local healthcare in our Practice – helping us to find out more about what we’re getting right and what we can improve.
We hope this will help you to make your feelings and experiences known to the appropriate people. Should you have a complaint we hope this page will give you more information about what to do, who to contact and what happens next.
How do I raise a concern / informal complaint?
You can speak to any member of staff initially with your complaint. This gives you the opportunity to resolve any concern you may have without it going through a formal process.
Most complaints are best resolved within the practice and these should be made via the Practice Manager.
Formal Complaint
What we will do
We will contact you about your complaint within three working days and offer to discuss with you the best way to investigate it, including the time scales for a reply. We will aim to offer you an explanation within that time frame. Or a meeting with the people involved.
- Find out what happened and what went wrong
- Invite you to discuss the problem with those involved, if you would like this
- Apologise where this is appropriate
- Identify what we can do to make sure that the problem does not happen again.
If you feel you do not want to contact the surgery directly, then you can contact the NHS Complaints team on:
NHS England
PO Box 16738
Redditch
B97 9PT
If you are making a complaint please state: ‘For the attention of the complaints team’ in the subject line.
In General
If you have a complaint to make, you can either contact the Practice Manager or ask the Receptionist for a copy of our Complaints Procedure. We will endeavour to:
- acknowledge any letter or Complaints Form within 3 working days of receiving it.
- deal with the matter as promptly as possible – usually within 20 working days – dependent on the nature of the complaint.
Who can complain
- Complainants may be current or former patients, or their nominated or elected representatives (who have been given consent to act on the patients behalf).
- Patients over the age of 16 whose mental capacity is unimpaired should normally complain themselves or authorise someone to bring a complaint on their behalf.
- Children under the age of 16 can also make their own complaint, if they’re able to do so.
If a patient lacks capacity to make decisions, their representative must be able to demonstrate sufficient interest in the patient’s welfare and be an appropriate person to act on their behalf. This could be a partner, relative or someone appointed under the Mental Capacity Act 2005 with lasting power of attorney.
Appropriate person
In certain circumstances, we need to check that a representative is the appropriate person to make a complaint.
- For example, if the complaint involves a child, we must satisfy ourselves that there are reasonable grounds for the representative to complain, rather than the child concerned.
- If the patient is a child or a patient who lacks capacity, we must also be satisfied that the representative is acting in the patient’s best interests.
If we are not satisfied that the representative is an appropriate person we will not consider the complaint, and will give the representative the reasons for our decision in writing.
Time limits
A complaint must be made within 12 months, either from the date of the incident or from when the complainant first knew about it.
The regulations state that a responsible body should only consider a complaint after this time limit if:
- the complainant has good reason for doing so, and
- it’s still possible to investigate the complaint fairly and effectively, despite the delay.
Procedure
We have a two stage complaints procedure. We will always try to deal with your complaint quickly however if it is clear that the matter will need a detailed investigation, we will notify you and then keep you updated on our progress.
Stage one – Early, local resolution
- We will try to resolve your complaint within five working days if possible.
- If you are dissatisfied with our response, you can ask us to escalate your complaint to Stage Two.
Stage Two – Investigation
- We will look at your complaint at this stage if you are dissatisfied with our response at Stage One.
- We also escalate some complaints straight to this stage, if it is clear that they are complex or need detailed investigation.
- We will acknowledge your complaint within 3 working days and we will give you our decision as soon as possible. This will be no more that 20 working days unless there is clearly a good reason for needing more time to respond.
Complain to the Ombudsman
If, after receiving our final decision, you remain dissatisfied you may take your complaint to the Ombudsman.
The Ombudsman is independent of the NHS and free to use. It can help resolve your complaint, and tell the NHS how to put things right if it has got them wrong.
The Ombudsman only has legal powers to investigate certain complaints. You must have received a final response from the Practice before the Ombudsman can look at your complaint and it will generally not look into your complaint if it happened more than 12 months ago, unless there are exceptional circumstances.
Address:
Parliamentary & Health Service Ombudsman
Tower 30
Millbank
London SW1P 4QP
Phone: 0345 015 4033
Confidentiality
All complaints will be treated in the strictest confidence.
Where the investigation of the complaint requires consideration of the patient’s medical records, we will inform the patient or person acting on his/her behalf if the investigation will involve disclosure of information contained in those records to a person other than the Practice or an employee of the Practice.
We keep a record of all complaints and copies of all correspondence relating to complaints, but such records will be kept separate from patients’ medical records.
Consent Protocol
Consent to treatment is the principle that a person must give permission before they receive any type of medical treatment, test or examination and is generally requested on the basis that an explanation of the required treatment, test or procedure has been received from a Clinician.
Consent from a patient is needed regardless of the procedure, whether it’s a physical examination, organ donation or something else.
The principle of consent is an important part of medical ethics and international human rights law.
Defining consent
For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision.
These terms are explained below:
- voluntary– the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family
- informed– the person must be given all of the information in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment doesn’t go ahead
- capacity– the person must be capable of giving consent, which means they understand the information given to them and they can use it to make an informed decision
If an adult has the capacity to make a voluntary and informed decision to consent to or refuse a particular treatment, their decision must be respected.This is still the case even if refusing treatment would result in their death, or the death of their unborn child.
If a person doesn’t have the capacity to make a decision about their treatment, the Healthcare Professionals treating them can go ahead and give treatment if they believe it’s in the person’s best interests.
Clinicians must however take reasonable steps to seek advice from the patient’s friends or relatives before making these decisions.
Read more about assessing the capacity to consent.
How consent is given
Consent can be given:
- verbally– for example, by saying you are happy to have an X-ray
- in writing– for example, by signing a Consent Form for surgery to be performed
Someone could also give non-verbal consent, as long as they understand the treatment or examination about to take place – for example, holding out an arm for a blood test.
Consent should be given to the Healthcare Professional directly responsible for the person’s current treatment, such as:
- a Nurse arranging a blood test
- a GP prescribing new medication
- a Surgeon planning an operation
If someone is going to have a major medical procedure such as an operation, their consent should ideally be secured plenty of time in advance, so that they have time to obtain information about the procedure and ask questions.
If a patient changes their mind at any point before the procedure, they are entitled to withdraw their previous consent.
Consent from children and young people
If they’re able to, consent is usually given by patients themselves. However, someone with parental responsibility may need to give consent for a child up to the age of 16 to have treatment.
Read more about the rules of consent applying to children and young people.
When consent isn’t needed
There are a few exceptions when treatment may be able to go ahead without the person’s consent, even if they’re capable of giving their permission.
It may not be necessary to obtain consent if a person:
- requires emergency treatment to save their life, but they’re incapacitated (for example, they’re unconscious) – the reasons why treatment was necessary should be fully explained once they’ve recovered
- immediately requires an additional emergency procedure during an operation – there has to be a clear medical reason why it would be unsafe to wait to obtain consent, and it can’t be simply for convenience
- with a severe mental health condition such as schizophrenia, bipolar disorder or dementia, lacks the capacity to consent to the treatment of their mental health (under the Mental Health Act 1983) – in these cases, treatment for unrelated physical conditions still requires consent, which the patient may be able to provide, despite their mental illness
- requires Hospital treatment for a severe mental health condition, but self-harmed or attempted suicide while competent and is refusing treatment (under the Mental Health Act 1983) – the person’s nearest relative or an approved Social Worker must make an application for the person to be forcibly kept in Hospital, and two Doctors must assess the person’s condition
- is a risk to public health as a result of rabies, cholera or tuberculosis (TB)
- is severely ill and living in unhygienic conditions (under the National Assistance Act 1948) – a person who is severely ill or infirm and is living in unsanitary conditions can be taken to a place of care without their consent
You can always talk to the clinician providing you with care if you have any concerns in relation to consent.
Consent and life-sustaining treatments
A person may be being kept alive with supportive treatments – such as lung ventilation – without having made an advance decision based on information which outlined the care that they may have refused to receive.
In these cases, a decision about continuing or stopping treatment needs to be made based on what that person’s best interests are believed to be.
To help reach a decision, the Healthcare Professionals responsible for the person’s care should discuss the issue with the relatives and friends of the person receiving the treatment.
They should consider, among other things:
- what the person’s quality of life will be if treatment is continued
- how long the person may live if treatment is continued
- whether there’s any chance of the person recovering
Treatment can be withdrawn if there’s an agreement that continuing treatment isn’t in the person’s best interests.
The case will be referred to the Courts before further action is taken if:
- an agreement can’t be reached
- a decision has to be made on whether to withdraw treatment from someone who has been in a state of impaired consciousness for a long time (usually at least 12 months)
It’s important to note the difference between withdrawing a person’s life support and taking a deliberate action to make them die. For example, injecting a lethal drug would illegal.
Complaints
If you believe you’ve received treatment you didn’t consent to, you can make an official complaint, please write to the Practice Manager, who will assist you with this process.
Consent to Treatment
You have the right to accept or refuse treatment that is offered to you, and not to be given any physical examination or treatment unless you have given valid consent. If you do not have the capacity to do so, consent must be obtained from a person legally able to act on your behalf, or the treatment must be in your best interests.
Your valid consent (agreement to the course of action) is needed for the treatment that’s offered to you before any physical examinations or treatment can be given. If you haven’t given your consent, you can accept or refuse treatment that’s offered to you.
It’s important to be involved in decisions about your treatment and to be given information to help you choose the right treatment. When making treatment choices, you’ll often discuss the options with your doctor or another healthcare professional.
Data Opt Out
The data held in your GP medical records is shared with other healthcare professionals for the purposes of your individual care. It is also shared with other organisations to support health and care planning and research.
If you do not want your personally identifiable patient data to be shared outside of your GP practice for purposes except your own care, you can register an opt-out with your GP practice. This is known as a Type 1 Opt-out.
Type 1 Opt-outs may be discontinued in the future. If this happens then they may be turned into a National Data Opt-out. Your GP practice will tell you if this is going to happen and if you need to do anything.
More information about the National Data
Opt-out is here: https://www.nhs.uk/your-nhs-data-matters/
You can use this form to:
Register a Type 1 Opt-out, for yourself or for a dependent (if you are the parent
or legal guardian of the patient) (to Opt-out)
Withdraw an existing Type 1 Opt-out, for yourself or a dependent (if you are
the parent or legal guardian of the patient) if you have changed your
preference (Opt-in).
This decision will not affect individual care and you can change your choice at any
time, using this form. This form, once completed, should be sent to your GP practice
by email or post.
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.
Equality and Diversity
Our Policy is designed to ensure and promote equality and inclusion, supporting the ethos and requirements of the Equality Act 2010 for all visitors to our Practice.
We are committed to:
- ensuring that all visitors are treated with dignity and respect
- promoting equality of opportunity between men and women
- not tolerating any discrimination or perceived discrimination against, or harassment of, any visitor for reason of age, sex, gender, marital status, pregnancy, race, ethnicity, disability, sexual orientation, religion or belief
- providing the same treatment and services (including the ability to register with the Practice) to any visitor irrespective of age, sex, marital status, pregnancy, race, ethnicity, disability, sexual orientation, medical condition, religion or belief
- This Policy applies to the general public, including all patients and their families, visitors and contractors
Procedure
Discrimination by the Practice or Visitors / patients against you
If you feel discriminated against:
- You should bring the matter to the attention of the Practice Manager
- The Practice Manager will investigate the matter thoroughly and confidentially within 14 working days
- The Practice Manager will establish the facts and decide whether or not discrimination has taken place, and advise you of the outcome of the investigation within 14 working days
- If you are not satisfied with the outcome, you should raise a formal complaint through our Complaints Procedure
Discrimination against our Practice staff
The Practice will not tolerate any form of discrimination or harassment of our staff by any visitor. Any visitor who expresses any form of discrimination against or harassment of any member of our staff will be required to leave the Practice premises immediately. If the visitor is a patient they may also, at the discretion of the Practice Management, be removed from the Practice list if any such behaviour occurs.
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 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.
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 020 8830 2396 or feel free to come into the practice.
Our Statement
- 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
Quality Assurance
Our Practice aims to provide quality, consistent primary care for all patients. We strive to meet the high standards expected in any clinical setting and we expect all members of our Team to work to these standards to help us achieve our aim.
The policies, systems and processes in place in our Practice reflect our professional and legal responsibilities and follow recognised standards of good practice. We evaluate our Practice on a regular basis, through audit, peer review and patient feedback and monitor the effectiveness of our quality assurance procedures.
Quality standards and procedures
To assist our Team in providing our patients with care of a consistent quality we will:
- Provide a safe and welcoming environment
- Ensure all members of our Team are appropriately trained
- Provide patients with information about the Practice and the care available, and ensure the patient understands the terms under which care is offered
- Explain all treatment options and agree clinical decisions with the patient(s), explaining the possible risks involved with each option
- Obtain valid consent for all treatment
- Refer to Specialists for investigation or treatment as appropriate and without undue delay
- Maintain contemporaneous clinical records with an up-to-date medical history for all patients
- Provide secure storage of patients records to maintain confidentiality
- Explain the procedure to follow for raising a complaint about the service, identifying the Practice contact
To provide our patients with a Team that provides care of a consistent quality we will:
- Provide a safe working environment through hazard identification and risk assessment
- Provide relevant training for all new Team members
- Provide Job Descriptions and Contracts of Employment
- Agree terms for all non-employed contractors working at the Practice
- Maintain staff records, ensuring they are kept as up-to-date as possible
- Ensure staff are notified where all Practice policies and procedures are stored and accessed
Registration Policy
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:
- Passport
- 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 Patient 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.
Health
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.
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.
Social Media Policy
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.
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 online 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.
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 Rights And Resposibiities
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).
ZERO TOLERANCE
It is our policy to be helpful and polite to all our patients regardless of age, ethnic origin, disability, gender or sexual orientation. We expect the same courtesy from our patients. Discriminatory, unsocial, threatening, violent or abusive behaviour towards staff, other patients or the premises will not be tolerated. The Practice will take action in these circumstances, which may involve the Police and result in the removal of the patient from our Practice list.
In England, please refer to NHS Constitution your rights and responsibilities for further information.
Health A-Z
Zero Tolerence
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.