Practice Policies

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.

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.

Interpreting Service

We can arrange for a meeting with the Practice Manager and an Interpreter for any patient whose first language is not English and needs help with their complaint.

How to make a compliment or complaint

Whether you are happy or unhappy with the care and treatment that you have received, please get in touch and let us know your views.

Receiving compliments and complaints is important to ensuring good quality local healthcare in our Practice – helping us to find out more about what we’re getting right and what we can improve.

We hope this will help you to make your feelings and experiences known to the appropriate people. Should you have a complaint we hope this page will give you more information about what to do, who to contact and what happens next.

How do I raise a concern / informal complaint?

You can speak to any member of staff initially with your complaint. This gives you the opportunity to resolve any concern you may have without it going through a formal process.

Most complaints are best resolved within the practice and these should be made via the Practice Manager. Alternatively, you may write to us at the surgery or email our Practice on [email protected].

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:

1. acknowledge any letter or Complaints Form within 3 working days of receiving it.
2. 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

E: email the Ombudsman 

Other organisations that can help you make a complaint about health services

Confidentiality

All complaints will be treated in the strictest confidence.

Where the investigation of the complaint requires consideration of the patient’s medical records, we will inform the patient or person acting on his/her behalf if the investigation will involve disclosure of information contained in those records to a person other than the Practice or an employee of the Practice.

We keep a record of all complaints and copies of all correspondence relating to complaints, but such records will be kept separate from patients’ medical records.

Statistics and reporting

The Practice must submit to the local primary care organisation periodically/at agreed intervals details of the number of complaints received and actioned.

Give feedback or make a complaint

You can complain to a member of staff at the NHS service you went to, such as a GP surgery or hospital, or you can complain to the organisation in charge.

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.

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.

Wheelchair access

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.

Loop system

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

Blind/partially sighted

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.org.uk
• Blind in Business
• British Blind Sport

Guide Dogs

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.

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.

The NHS is the UK’s state health service which provides treatment for UK residents. Some services are free, other have to be paid for.

The regulations that govern who can and can’t receive treatment are complex and may change.

If you have any questions relating to entitlement to treatment under the NHS please contact the Practice.

Free Services

GP and Nurse consultations in primary care, treatment provided by a GP and other primary care services are free of charge to all, whether registering as an NHS patient, or as a temporary patient (which is when the patient is in the area for more than 24 hours and less than 3 months).

For secondary care services, the UK’s healthcare system is a residence based one, which means entitlement to free healthcare is based on living lawfully in the UK on an approved and settled basis. The measure of residence that the UK uses to determine entitlement to free NHS healthcare is known as ‘ordinary residence’. This requires non-EEA nationals subject to immigration control, to also have the immigration status of ‘indefinite leave to remain’. Individuals who are not ordinarily resident in the UK may be required to pay for their care when they are in England. However, some services and some individuals are exempt from payment.

The following NHS treatment is available to anyone:

• Treatment in an emergency (but not follow up treatment)
• Treatment of certain communicable diseases
• Compulsory psychiatric treatment

GPs are the first point of contact for virtually all NHS patients:

• They can direct you to other NHS services and are experts in family medicine, preventative care, health education, and treating people with multiple and long-term conditions
• If you’re planning to live and work in England, you need to register with a local GP
• Being registered with a GP Practice does not in itself mean you’ll be entitled to free NHS hospital treatment
• You’ll need to fill out a GMS1 form (PDF, 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

Medical emergencies

If you need immediate medical assistance (e.g. because of an accident) telephone 999. The call is free. An Operator will ask you which emergency service you require (Fire, Police or Ambulance). You will need to tell the emergency services what has happened and where you are. If someone is injured and needs to go to Hospital, an ambulance will be sent out to pick the patient up and take them to the nearest Hospital that has an Accident & Emergency Department.

If you need urgent treatment but are well enough to travel please make your own way to the nearest Accident & Emergency Department.

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.

All GP practices are required to declare the mean earnings (eg 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 71,140

This is for 2 full time GPs, 8 part time GPs and 6 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.

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.

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.

Smoking is not permitted either within the Practice premises or in the Practice car park.

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

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.

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:

1. Physical violence to staff, Doctors or other patients
2. Threat of violence to staff, Doctors or other patients
3. Abusive or disruptive behaviour including when under the influence of alcohol or drugs
4. Theft from the Surgery, staff, Doctors or other patients
5. Criminal damage to the Surgery
6. Dangerous dogs posing a real or potential hazard on home visits
7. Altering documents e.g. prescriptions, insurance certificates
8. Defamation of Doctors or staff
9. Misuse of appointments
10. Misuse of home visits
11. Moving outwith the area
12. 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.

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.

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.

These staff:

• 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.

Confidentiality

For information on how the NHS will collect, store and allow access to your electronic records visit NHS UK.

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

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.

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.