Policies

Roundwood Park Medical Centre prides itself in maintaining professional standards. For certain examinations during consultations an impartial observer (a “Chaperone”) may be required.

This impartial observer will be a Practice Nurse, Health Care Assistant or other trained member of the practice team who be available to reassure and raise any concerns on your behalf. If a chaperone is unavailable at the time of your consultation then your examination may be re-scheduled for another time.

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

The role of a Chaperone:

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

Roundwood Park Medical Centre contributes to the Clinical Practice Research Datalink. More information is available here: https://cprd.com/public

Clinical Practice Research Datalink (CPRD) is a real-world research service supporting retrospective and prospective public health and clinical studies. CPRD research data services are delivered by the Medicines and Healthcare products Regulatory Agency with support from the National Institute for Health and Care Research (NIHR), as part of the Department of Health and Social Care.

CPRD collects anonymised patient data from a network of GP practices across the UK. Primary care data are linked to a range of other health related data to provide a longitudinal, representative UK population health dataset. The data encompass 60 million patients, including 18 million currently registered patients.

For more than 30 years, research using CPRD data and services has informed clinical guidance and best practice, resulting in over 3,000 peer-reviewed publications investigating drug safety, use of medicines, effectiveness of health policy, health care delivery and disease risk factors.

How patient data is used for medical research

Research using CPRD anonymised patient data has provided evidence for drug safety guidance and improved healthcare delivery. More than 3,000 medical and public health research studies have been published using CPRD data.

See examples of how CPRD anonymised data has been used to benefit patient care and public health.

Protecting your confidentiality and privacy

Protecting patient privacy is essential. This is why CPRD never receives information that identifies patients and only provides anonymised health data to approved researchers. Your confidential information is protected in the following ways:

• You cannot be identified from the information sent to CPRD from your GP practice or from any data CPRD receives from other sources.
• CPRD never receives identifying details, such as your name, address, NHS number, date of birth or medical notes
• Data can only be used for research to improve patient and public health
• CPRD must obtain annual ethics and governance approvals to collect and supply data for research
• Researchers must comply with strict terms and conditions to use anonymised CPRD data for research

The ability to link primary care data to other health datasets enables researchers to have a more complete picture of a patient’s medical history. In England, this data linkage is carried out via NHS England, the statutory body legally permitted to receive identifiable patient data. The linkage process involves NHS England receiving and processing identifiable non-clinical information about a patient, on behalf of CPRD. NHS England only sends anonymised linked data to CPRD.

As an additional step to protecting patient confidentiality, we do not share details of the GP practices that contribute data to CPRD. Find out more about how we protect your confidential information on our Safeguarding Patient Data page and Data protection and processing notice web page.

You can opt out

Because you cannot be identified from the data GP practices send to CPRD, GPs do not need to seek individual patient consent when they share data with CPRD.

However, you can opt out of your patient information being shared for research. If you do not want your GP practice to share your health record, let your doctor know if you live in Scotland, Wales or Northern Ireland. If you are in England you can find out more about the National Data Opt-out.

Opting out of sharing your health records will not affect the care that you receive. However, the Government depends on the data collected by CPRD to monitor drug safety and safeguard public health. If large numbers of patients choose not to share their anonymised health information for research, the health information within the CPRD database will not truly represent the UK population.

CPRD is an official supporter of Understanding Patient Data, an initiative that aims to make uses of patient data more visible, understandable and trustworthy, for patients, the public and health professionals.

There is also information on the Understanding Patient Data website: The national data opt-out.

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 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. These can be in writing to the practice, or verbally, either face to face or over the telephone. Our telephone number is 0208 176 8992.

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. We will:

• Find out what happened and what went wrong
• Apologise where this is appropriate
• Identify what we can do to make sure that the problem does not happen again
• Share this learning with our practice team

If you feel you do not want to contact the surgery directly, you (or your nominated representative) may submit a complaint to North West London Integrated Care Board (ICB). Information on how to make a complaint to North West London ICB can be sought from its webpage: https://www.nwlondonicb.nhs.uk/contact-us/patient-feedback-and-complaints , by calling 0203 350 4567 or emailing [email protected]

Complaints are not escalated to an ICB following the practice’s response. A complaint is made to either the practice or to the ICB.

Complaints advocacy:

All health complainants are also entitled to access if they so wish, the NHS Complaints Advocacy Service, should they need assistance with making a complaint.  They can be contacted at www.nhscomplaintsadvocacy.org

Further Actions:

If dissatisfied with the response from either ICB or the practice, then you may wish to escalate their complaint to The Parliamentary and Health Service Ombudsman (PHSO). The PHSO role is to make final decisions on complaints that have not been resolved locally by either the provider or the Integrated Care Board (ICB).

The PHSO may be contacted via telephone on 0345 015 4033. Further details on how to make a complaint to PHSO can be sought at www.ombudsman.org.uk.

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

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

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

Under 16s:

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

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

Useful Websites:

• Confidentiality NHS Code of Practice
• Confidentiality and Mental Health
• Confidentiality Guidance

If you have any special needs please let our staff know so that we can help and ensure that you get the same support in the future.

Accessible Information Standard

The Accessible Information Standard aims to make sure that people who have a disability, impairment or sensory loss get information that they can access and understand, and any communication support that they need from health and care services.

The Standard sets out a specific, consistent approach to identifying, recording, flagging, sharing and meeting the information and communication support needs of patients, service users, carers and parents with a disability, impairment or sensory loss.

Roundwood Park Medical Centre adheres to this standard. We will

• Ask people if they have any information or communication needs, and find out how to meet their needs.
• Record those needs clearly and in a set way.
• Highlight or flag the person’s file or notes so it is clear that they have information or communication needs and how to meet those needs.
• Share information about people’s information and communication needs with other providers of NHS and adult social care, when they have consent or permission to do so.
• Take steps to ensure that people receive information which they can access and understand, and receive communication support if they need it.

Listen to a summary of the Accessible information standard by clicking here

Wheelchair access

Roundwood Park Medical Centre has been specially designed to make it easier for disabled patients to visit. There are no steps at the entrance of the building giving patients easy access. Due to fire regulations, we do have heavy fire doors, however if you have trouble opening these please ask Reception for assistance as they are always happy to help.

There are several dedicated disabled car parking spaces available immediately outside the front entrance of Willesden Centre for Health & Care

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.

Loop System

We have a loop induction system at the reception desk to assist the hearing impaired. For more information on the loop hearing system visit Hearing Link website.

• British Deaf Association
• The Deaf Health Charity – SignHealth
• Action Hearing Loss
• Royal Association for Deaf People
• National Deaf Children’s Society

Blind/Partially Sighted

If you or family members are blind or partially sighted we can give you a CD or large print of our practice leaflet upon request. Please ask Reception for further information.

For more advice and support for blind people please see the following websites:

• Royal National Institute of Blind People (RIND)
• Action for Blind People
• Blind.org.uk
• British Blind Sport

Guide Dogs

Guide dogs are welcome at the surgery but we ask that you be aware of other patients and staff who may have an allergy or fear of dogs.

Further Information:

• Guide Dogs

Other Disability Websites:

• BID Services
• Disability Go
• Disabled People, your Rights, Benefits, Carers and the Equality Act
• Disability Rights UK
• Living with a Disability NHS Choices
• Disability Action
• Mencap

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

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

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

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

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

The Surgery publication scheme

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

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

You can request our publication scheme leaflet at the surgery.

Who can request information?

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

How should requests be made?

Requests must:

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

What cannot be requested?

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

For more information see these websites:

• Legislation GOV.UK
• Information Commissioners Office

What is GDPR?

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

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

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

What does this mean for you?

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

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

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

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

We will use your data to:

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

What is ‘Patient Data’?

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

What is ‘Consent’?

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

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

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

More details can be found by visiting the ICO website.

NHS England require that the net earnings of doctors engaged in the practice is publicised, and the required disclosure is shown below. However it should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice, and should not be used to form any judgement about GP earnings, nor to make any comparison with any other practice.

All GP practices are required to declare the mean earnings (e.g. average pay) for GPs working to deliver NHS services to patients at each practice.

The average pay for GPs working in this practice in the last full financial year was £86,022 before Tax and National insurance. This is for zero full time GPs, 5 part time GPs and zero locum GPs who worked in the practice for more than six months.

We had an external infection control assessment visit from NHS England (the NEL Primary Care Infection Prevention and Control Team) on 29/08/2023.

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

We have allocated a Named Accountable GP for all of our registered patients. If you do not know who your named GP is, please ask a member of our reception team. Unfortunately, we are unable to notify patients in writing of any change of GP due to the costs involved.

Make your choice: Choose if data from your health records is shared – Type 1 (GP) and Type 2 (National Data) Opt Outs

You can choose whether your confidential patient information is used for research and planning. To find out more visit nhs.uk/your-nhs-data-matters.

The national data opt-out was introduced on 25 May 2018, enabling patients to opt out from the use of their data for research or planning purposes, in line with the recommendations of the National Data Guardian in her Review of Data Security, Consent and Opt-Outs.

You do not need to do anything if you are happy about how your confidential patient information is used. You can change your choice at any time.

TYPE 1 Opt-Out: You can tell us if you do not want your confidential patient information held in your GP medical record to be used for purposes other than your individual care. This is commonly called a type 1 opt-out. We will code this on to your GP record.

TYPE 2 Opt-Out: To choose if data from your health records is shared by NHS Digital for research and planning purposes, you must visit: https://www.nhs.uk/your-nhs-data-matters/manage-your-choice/ and follow the instructions. IMPORTANT: You must make your choice via this website for your TYPE 2 (national data) Opt-Out to be correctly recorded.

There have been posts on social media with false information about opting out of sharing your data with the NHS.

Here’s what you need to know:

• There is no 30th September deadline for opting out of sharing your data. You can opt out at any time.
• NHS Digital will never sell your data.
• There are strict rules about how NHS can use your data. It’s only shared securely and safely.
• Shared data helps the NHS. It has been used to find the first treatment for coronavirus and for vaccine research.

Use this service to:

• Choose if your confidential patient information is used for research and planning
• Change or check your current choice

Patients can view or change their national data opt-out choice at any time by using the online service at www.nhs.uk/your-nhs-data-matters or by calling 0300 3035678.

More info here: https://digital.nhs.uk/about-nhs-digital/our-work/keeping-patient-data-safe/how-we-look-after-your-health-and-care-information/your-information-choices/opting-out-of-sharing-your-confidential-patient-information

What is non-NHS work and why is there a fee?

The National Health Service provides most health care to most people free of charge, but there are exceptions: prescription charges have existed since 1951 and there are a number of other services for which fees are charged.

Sometimes the charge is because the service is not covered by the NHS, for example, providing copies of health records or producing medical reports for insurance companies, solicitors or employers.

The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. It is important to understand that many GPs are not employed by the NHS; they are self-employed and they have to cover their costs – staff, buildings, heating, lighting, etc. – in the same way as any small business.

In recent years, however, more and more organisations have been involving doctors in a whole range of non-medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to ensure that information provided to them is true and accurate.

Examples of non-NHS services for which GPs can charge their own NHS patients are:

• accident/sickness certificates for insurance purposes
• school fee and holiday insurance certificates
• reports for health clubs to certify that patients are fit to exercise
• private prescriptions for travel purposes

Examples of non-NHS services for which GPs can charge other institutions are:

• life assurance and income protection reports for insurance companies
• reports for the Department for Work and Pensions (DWP) in connection with
• disability living allowance and attendance allowance
• medical reports for local authorities in connection with adoption and fostering
• copies of records for solicitors

Do GPs have to do non-NHS work for their patients?

With certain limited exceptions, for example a GP confirming that one of their patients is not fit for jury service, GPs do not have to carry out non-NHS work on behalf of their patients. Whilst GPs will always attempt to assist their patients with the completion of forms, they are not required to do such non-NHS work.

Is it true that the BMA sets fees for non-NHS work?

The British Medical Association (BMA) suggest fees that GPs may charge their patients for non-NHS work (i.e. work not covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested by them are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates they suggest.

Why does it sometimes take my GP a long time to complete my form?

Time spent completing forms and preparing reports takes the GP away from the medical care of his or her patients. Most GPs have a very heavy workload and paperwork takes up an increasing amount of their time. Our GPs do non-NHS work out of NHS time at evenings or weekends so that NHS patient care does not suffer.

I only need the doctor’s signature – what is the problem?

When a doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. In order to complete even the simplest of forms, therefore, the doctor might have to check the patient’s ENTIRE medical record. Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council (the doctors’ regulatory body) or even the Police.

If you are a new patient we may not have your medical records so the doctor must wait for these before completing the form.

What will I be charged?

It is recommended that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual doctors to decide how much they will charge. The surgery has a list of fees based on these suggested fees which is available on request.

What can I do to help?

• Not all documents need a signature by a doctor, for example passport applications. You can ask another person in a position of trust to sign such documents free of charge. Read the information that comes with these types of forms carefully before requesting your GP to complete them.
• If you have several forms requiring completion, present them all at once and ask your GP if he or she is prepared to complete them at the same time to speed up the process.
• Do not expect your GP to process forms overnight: urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this may cost more. Usually non-NHS work will take 2 weeks.

Roundwood Park Medical Centre is part of North West London Integrated Care Board (ICB). To find out more about the North West London ICB, visit their website here: https://www.nwlondonicb.nhs.uk/about-us/ICB

Your information, what you need to know

This privacy notice explains why we collect information about you, how that information may be used, how we keep it safe and confidential and what your rights are in relation to this.

Why we collect information about you

Health care professionals who provide you with care are required by law to maintain records about your health and any treatment or care you have received within any NHS organisation. These records help to provide you with the best possible healthcare and help us to protect your safety.

We collect and hold data for providing healthcare services to our patients and running our organisation which includes monitoring the quality of care that we provide. In carrying out this role we may collect information about you which helps us respond to your queries or secure specialist services, including recordings of incoming and outgoing telephone calls. We may keep your information in written form and/or in digital form.

The records may include basic details about you, such as your name and address. They may also contain more sensitive information about your health and also information such as outcomes of needs assessments.

Details we collect about you

The health care professionals who provide you with care maintain records about your health and any treatment or care you have received previously (e.g. from Hospitals, GP Surgeries, A&E, etc.). These records help to provide you with the best possible healthcare.

Records which this GP Practice may hold about you include the following:

• Details about you, such as your address and next of kin
• Any contact the surgery has had with you, such as appointments, telephone consultations, call recordings and home visits
• Notes and reports about your health
• Details about your treatment and care
• Results of investigations, such as laboratory tests, x-rays,
• Relevant information from other health professionals, relatives or your carers

How we keep your information confidential and safe

Everyone working for our organisation is subject to the Common Law Duty of Confidence. Information provided in confidence will only be used for the purposes advised with consent given by the patient, unless there are other circumstances covered by the law. The NHS Digital Code of Practice on Confidential Information applies to all NHS staff and they are required to protect your information, inform you of how your information will be used, and allow you to decide if and how your information can be shared. All our staff are expected to make sure information is kept confidential and receive regular training on how to do this.

The health records we use may be electronic, on paper or a mixture of both, and we use a combination of working practices and technology to ensure that your information is kept confidential and secure. Your records are backed up securely in line with NHS standard procedures. We ensure that the information we hold is kept in secure locations, is protected by appropriate security and access is restricted to authorised personnel.

We also make sure external data processors that support us are legally and contractually bound to operate and prove security arrangements are in place where data that could or does identify a person are processed.

We are committed to protecting your privacy and will only use information collected lawfully in accordance with:

• Data Protection Act 2018
• General Data Protection Regulation
• Human Rights Act
• Common Law Duty of Confidentiality
• NHS Codes of Confidentiality and Information Security
• Health and Social Care Act 2015
• And all applicable legislation

We maintain our duty of confidentiality to you at all times. We will only ever use or pass on information about you if we reasonably believe that others involved in your care have a genuine need for it. We will not disclose your information to any third party without your permission unless there are exceptional circumstances (such as a risk of serious harm to yourself or others) or where the law requires information to be passed on.

How we use your information

Improvements in information technology are also making it possible for us to share data with other healthcare organisations for providing you, your family and your community with better care. For example, it is possible for healthcare professionals in other services to access your record with your permission when the practice is closed. This is explained further in the Local Information Sharing section below.

Under the powers of the Health and Social Care Act 2015, NHS Digital can request personal confidential data from GP Practices without seeking patient consent for a number of specific purposes, which are set out in law. These purposes are explained below.

You may choose to opt-out to personal data being shared for these purposes. When we are about to participate in a new data-sharing project we aim to display prominent notices in the Practice and on our website four weeks before the scheme is due to start.

Instructions will be provided to explain what you have to do to ‘opt-out’ of the new scheme. Please be aware that it may not be possible to opt out of one scheme and not others, so you may have to opt out of all the schemes if you do not wish your data to be shared.

You can object to your personal information being shared with other healthcare providers which will not affect your entitlement to care, but you should be aware that this may, in some instances, affect your care as important information about your health might not be available to healthcare staff in other organisations. If this limits the treatment that you can receive then the practice staff will explain this to you at the time you object.

To ensure you receive the best possible care, your records are used to facilitate the care you receive. Information held about you may be used to help protect the health of the public and to help us manage the NHS.

Child Health Information

We wish to make sure that your child has the opportunity to have immunisations and health checks when they are due. We share information about childhood immunisations, the 6-8 week new baby check and breast-feeding status with NHS CLCH health visitors and school nurses, and with NEL Commissioning Support Unit, who provide the Child Health Information Service on behalf of NHS England.

Clinical audit

Information may be used by the Clinical Commissioning Group for clinical audit to monitor the quality of the service provided to patients with long terms conditions. Some of this information may be held centrally and used for statistical purposes (e.g. the National Diabetes Audit). When this happens, strict measures are taken to ensure that individual patients cannot be identified from the data.

Clinical Research

Sometimes anonymised data may be used for research purposes – but we will normally ask your permission before releasing any information for this purpose which could be used to identify you.

This practice contributes to the Clinical Practice Research Datalink. More information is available here: https://cprd.com/public

In some instances, the Confidentially Advisory Group, part of the Health Research Authority may allow for identifiable information to be shared with researchers without consent of individuals. You may however opt-out of this, details of which can be found below under the ‘National Data Opt-Out’.

Improving Diabetes Care and long-term condition management

Information that does not identify individual patients is used to enable focussed discussions to take place at practice-led local diabetes and long term condition management review meetings between health care professionals. This enables the professionals to improve the management and support of these patients.

Individual Funding Request

An ‘Individual Funding Request’ is a request made on your behalf, with your consent, by a clinician, for funding of specialised healthcare which falls outside the range of services and treatments that CCG has agreed to commission for the local population. An Individual Funding Request is taken under consideration when a case can be set out by a patient’s clinician that there are exceptional clinical circumstances which make the patient’s case different from other patients with the same condition who are at the same stage of their disease, or when the request is for a treatment that is regarded as new or experimental and where there are no other similar patients who would benefit from this treatment. A detailed response, including the criteria considered in arriving at the decision, will be provided to the patient’s clinician.

Invoice Validation

Invoice validation is an important process. It involves using your NHS number to check which Clinical Commissioning Group is responsible for paying for your treatment. Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for invoice validation purposes. We can also use your NHS number to check whether your care has been funded through specialist commissioning, which NHS England will pay for. The process makes sure that the organisations providing your care are paid correctly.

Local Information Sharing

Your GP electronic patient record is held securely and confidentially on an electronic system managed by your registered GP practice. If you require attention from a local health or care professional outside of your usual practice services, such as in an Evening and Weekend GP HUB services, Emergency Department, Minor Injury Unit or Out Of Hours service, the professionals treating you are better able to give you safe and effective care if some of the information from your GP record is available to them. If those services use a TPP clinical system your full SystmOne medical record will only be shared with your express consent.

Where available, this information can be shared electronically with other local healthcare providers via a secure system designed for this purpose. Depending on the service you are using and your health needs, this may involve the healthcare professional accessing a secure system that enables them to view either parts of your GP electronic patient record (e.g. your Summary Care Record) or a secure system that enables them to view your full GP electronic patient record (e.g. TPP SystmOne medical records or EMIS remote consulting system).

In all cases, your information is only accessed and used by authorised staff who are involved in providing or supporting your direct care. Your permission will be asked before the information is accessed, other than in exceptional circumstances (e.g. emergencies) if the healthcare professional is unable to ask you and this is deemed to be in your best interests (which will then be logged).

National Fraud Initiative – Cabinet Office

The use of data by the Cabinet Office for data matching is carried out with statutory authority under Part 6 of the Local Audit and Accountability Act 2014. It does not require the consent of the individuals concerned under the Data Protection Act 2018. Data matching by the Cabinet Office is subject to a Code of Practice. For further information see:

https://www.gov.uk/government/publications/code-of-data-matching-practice-for-national-fraud- initiative

National Registries

National Registries (such as the Learning Disabilities Register) have statutory permission under Section 251 of the NHS Act 2006, to collect and hold service user identifiable information without the need to seek informed consent from each individual service user.

Risk Stratification

‘Risk stratification for case finding’ is a process for identifying and managing patients who have or may be at-risk of health conditions (such as diabetes) or who are most likely to need healthcare services (such as people with frailty). Risk stratification tools used in the NHS help determine a person’s risk of suffering a particular condition and enable us to focus on preventing ill health before it develops.

Information about you is collected from a number of sources including NHS Trusts, GP Federations and your GP Practice. A risk score is then arrived at through an analysis of your de-identified information. This can help us identify and offer you additional services to improve your health.

Risk-stratification data may also be used to improve local services and commission new services, where there is an identified need. In this area, risk stratification may be commissioned by the NWL Clinical Commissioning Groups. Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for risk stratification purposes. Further information about risk stratification is available from: https://www.england.nhs.uk/ourwork/tsd/ig/risk-stratification /

If you do not wish information about you to be included in any risk stratification programmes, please let us know. We can add a code to your records that will stop your information from being used for this purpose. Please be aware that this may limit the ability of healthcare professionals to identify if you have or are at risk of developing certain serious health conditions.

Safeguarding

To ensure that adult and children’s safeguarding matters are managed appropriately, access to identifiable information will be shared in some limited circumstances where it’s legally required for the safety of the individuals concerned.

Summary Care Record (SCR)

The NHS in England uses a national electronic record called the Summary Care Record (SCR) to support patient care. It contains key information from your GP record. Your SCR provides authorised healthcare staff with faster, secure access to essential information about you in an emergency or when you need unplanned care, where such information would otherwise be unavailable.

Summary Care Records are there to improve the safety and quality of your care. SCR core information comprises your allergies, adverse reactions and medications. An SCR with additional information can also include reason for medication, vaccinations, significant diagnoses / problems, significant procedures, anticipatory care information and end of life care information. Additional information can only be added to your SCR with your agreement.

Please be aware that if you choose to opt-out of SCR, NHS healthcare staff caring for you outside of this surgery may not be aware of your current medications, allergies you suffer from and any bad reactions to medicines you have had, in order to treat you safely in an emergency. Your records will stay as they are now with information being shared by letter, email, fax or phone. If you wish to opt- out of having an SCR please return a completed opt-out form to the practice.

Supporting Medicines Management

NWL Clinical Commissioning Groups use pharmacist and prescribing advice services to support local GP practices with prescribing queries, which may require identifiable information to be shared. These pharmacists work with your usual GP to provide advice on medicines and prescribing queries, and review prescribing of medicines to ensure that it is appropriate for your needs, safe and cost-effective. Where specialist prescribing support is required, the CCG medicines management team may provide relating to obtaining medications on behalf of your GP Practice to support your care.

Supporting Locally Commissioned Services

CCGs support GP practices by auditing anonymised data to monitor locally commissioned services, measure prevalence and support data quality. The data does not include identifiable information and is used to support patient care and ensure providers are correctly paid for the services they provide.

Suspected Cancer

Data may be analysed in cases of suspected cancer by The Royal Marsden NHS Trust, The Royal Brompton Hospital, Imperial College Healthcare NHS Trust , Chelsea and Westminster Hospital NHS Foundation Trust, London North West Healthcare NHS Trust and University College London Hospitals NHS Foundation Trust to facilitate the prevention, early diagnosis and management of illness. Measures are taken to ensure the data for analysis does not identify individual patients.

Data Retention

We manage patient records in line with the Records Management NHS Code of Practice for Health and Social Care which sets the required standards of practice in the management of records for those who work within or under contract to NHS organisations in England, based on current legal requirements and professional best practice.

Who are our partner organisations?

We may also have to share your information, subject to strict agreements on how it will be used, with the following types of organisations:

• NHS Trusts
• Specialist Trusts
• GP Federations
• Independent Contractors such as dentists, opticians, pharmacists
• Private Sector Providers
• Voluntary Sector Providers
• Ambulance Trusts
• Clinical Commissioning Groups
• Social Care Services
• Local Authorities
• Education Services
• Fire and Rescue Services
• Police
• Other ‘data processors’

We will not share your full information outside of health partner organisations without your consent unless there are exceptional circumstances such as when the health or safety of others is at risk, where the law requires it or to carry out a statutory function. No information will ever be shared where we do not have a lawful basis to do so.

Within the health partner organisations providing your care (NHS and Specialist Trusts) and in relation to the above mentioned themes – Risk Stratification, Invoice Validation, Supporting Medicines Management, Summary Care Record – your information will be shared unless you choose to opt-out (see below).

This means you will need to express an explicit wish to not have your information shared with the other organisations; otherwise it will be automatically shared. We are required by law to report certain information to the appropriate authorities. This is only provided after formal permission has been given by a qualified health professional. There are occasions when we must pass on information, such as notification of new births, where we encounter infectious diseases which may endanger the safety of others, such as meningitis or measles (but not HIV/AIDS), and where a formal court order has been issued. Our guiding principle is that we are holding your records in strictest confidence.

Right to withdraw consent to share personal information (Opt- Out)

If you are happy for your data to be extracted and used for the purposes described in this privacy notice then you do not need to do anything. If you do not want your information to be used for any purpose beyond providing your care you can choose to opt-out. If you wish to do so, please let us know so we can code your record appropriately. We will respect your decision if you do not wish your information to be used for any purpose other than your care but in some circumstances we may still be legally required to disclose your data.

There are two main types of opt-out.

Type 1 Opt-Out

If you do not want information that identifies you to be shared outside the practice, for purposes beyond your direct care, you can register a ‘Type 1 Opt-Out’. This prevents your personal confidential information from being used other than in particular circumstances required by law, such as a public health emergency like an outbreak of a pandemic disease. Please talk to a member of staff at your Practice to initiate the type 1 opt-out.

National Data Opt-Out

NHS Digital have created a new opt-out system named the National Data Opt-Out which allows individuals to opt-out of their information being used for planning and research purposes. From 25 May 2018, NHS Digital has had to apply this opt-out for all their data flows, and from 2020 all health and care organisations will have to ensure the opt-out is respected. Individuals who previously opted out with a ‘Type 2’ objection will not have to do anything as you will be automatically be opted out.

If you wish to apply the National Opt-Out, please go to NHS Digitals website here https://www.nhs.uk/your-nhs-data-matters/

Access to your information

Under the Data Protection Act 2018 everybody has the right to see, or have a copy, of data we hold that can identify you, with some exceptions. You do not need to give a reason to see your data. If you want to access your data you must make the request in writing or speak to a member of the Practice staff. Under special circumstances, some information may be withheld.

If you wish to have a copy of the information we hold about you, please contact: David Griffiths, Practice Manager

Change of details

It is important that you tell the person treating you if any of your details such as your name or address have changed or if any of your details are incorrect in order for this to be amended. Please inform us of any changes so our records for you are accurate and up to date.

Mobile telephone number

If you provide us with your mobile phone number we may use this to send you reminders about your appointments or other health screening information. Please let us know if you do not wish to receive reminders on your mobile. Telephone calls to and from the practice may be recorded for monitoring purposes. All patients are informed of this each time they contact the practice via telephone.

Notification

The Digital Economy 2017 requires organisations to register a notification with the Information Commissioner to describe the purposes for which they process personal data

We are registered as a data controller and our registration can be viewed online in the public register at: http://ico.org.uk/what_we_cover/register_of_data_controllers

Any changes to this notice will be published on our website and in a prominent area at the Practice.

Complaints

If you have concerns or are unhappy about any of our services, please contact the Practice Manager David Griffiths, 0208 176 8992

For independent advice about data protection, privacy and data-sharing issues, you can contact:

The Information Commissioner

Wycliffe House

Water Lane

Wilmslow Cheshire SK9 5AF

Phone: 0303 123 1113

Website: www.ico.orguk

Information we are required to provide you

The NHS Care Record Guarantee

The NHS Care Record Guarantee for England sets out the rules that govern how patient information is used in the NHS, what control the patient can have over this, the rights individuals have to request copies of their data and how data is protected under the Data Protection Act 2018.

http://systems.digital.nhs.uk/infogov/links/nhscrg.pdf

The NHS Constitution

The NHS Constitution establishes the principles and values of the NHS in England. It sets out the rights patients, the public and staff are entitled to. These rights cover how patients access health services, the quality of care you’ll receive, the treatments and programmes available to you, confidentiality, information and your right to complain if things go wrong. https://www.gov.uk/government/publications/the-nhs-constitution-for-england

NHS Digital

NHS Digital collects health information from the records health and social care providers keep about the care and treatment they give, to promote health or support improvements in the delivery of care services in England.

http://content.digital.nhs.uk/article/4963/What-we-collect

Reviews of and Changes to our Privacy Notice

We will keep our Privacy Notice under regular review.

Giving another person access to your GP online services

Did you know that you can choose to give another person access to your GP online services on your behalf? You don’t need to know how to use these services or have a computer yourself to give another person access.

Who can have access?

You choose who you want to give access to. This could be your carer, partner, parent or another family member. You can also give access to more than one person. Giving access to another person is your choice. No-one can go to your GP surgery and ask for access to your online services without your permission.

You also choose which online services you want each person to use. These are booking appointments, ordering repeat prescriptions and looking at your GP record. You decide whether to let them use one, two or all of the services on your behalf.

Why you may want to give another person access

You may wish to allow another person to use your online services for different reasons. For example:

• You are very unwell or just need help managing your health
• You have a long term condition ,for example diabetes, heart disease, asthma or high blood pressure and would like support with checking test results, ordering repeat prescriptions and understanding your treatment
• You are finding it more difficult to look after yourself, for example due to memory issues or speech difficulties
• You have learning difficulties and want someone else to help you understand your health
• You have a carer who can help you manage your health
• You may be planning for the future or choosing someone to hold lasting power of attorney for health and social care for you
• You are a young person and would like your parent or guardian to look after your health. Some surgeries only allow this for children under the age of 12
• You work away from home or are just busy and need help with booking appointments or ordering repeat prescriptions.
• You are not comfortable with using computers, smart phones, or tablets

For more information on GP online services for carers, see our leaflets ‘GP online services for carers including young carers’ and ‘Giving employed carers access to your GP online services’. These can be found at Getting started with GP online services.

Benefits

Before giving another person access, you should think about what the benefits will be for you. If you cannot think of any, then you should think very carefully whether allowing them access is the right thing to do. Some of the benefits are:

• You have peace of mind that someone is supporting you with managing your health
• The person you choose can help you make sure the information your surgery has about you is correct, for example your medication and allergies.
• You know that someone else understands your medical information and can provide information when you are unable to. This could be when you are unconscious or too unwell to speak or when you need help explaining or understanding something
• You can benefit from the convenience of using GP online services even if you do not use a computer or do not have access to the internet
• One member of the family can book appointments for everyone in the household and make sure the appointments fit with your family activities

If you have a carer, using GP online services can save them time allowing them to spend more time looking after your needs.

How it works

The recommended and safest way to give another person access to your online services is for them to have their own username and password. If you use online services yourself, you should not share your username and password with anyone. If you share your username and password, your surgery cannot tell whether you or someone else accessed your online services. This may be a problem if someone else misuses your login details and your surgery has to look into this.

How to sign up

The steps below show how you can give another person access:

1. You contact your surgery to let them know you would like to give your chosen person access to your GP online services. You may also choose to register for online services for yourself if you do not already use them
2. The Practice will give your chosen person a short form to fill in. You will also need to sign to confirm you agree with the information on the form. You can also choose whether you only want them to book appointments or order prescriptions or use all the services on your behalf. It is up to you
3. Your chosen person will need to show your surgery their photo ID and proof of address, for example, a passport or photo driving licence and a bank statement or council tax statement. If they don’t have the required ID, speak to staff at the surgery, who may be able to help confirm their identity in another way
4. Staff at the Practice will make a decision on whether to give your chosen person access to your GP online services. If we decide not to give them access, we will discuss their reasons with you
5. The staff will give your chosen person their own username and password to use to login to your GP online services.

Things to consider before giving another person access

• Is there any information in your records you would not like anyone to see or know about?
• Can you trust the person to keep your information safe and not share it with others or use it without your permission?
• Is any one forcing you into sharing your online services with them or do you think someone could force you to share it with them? If so, we would advise that you do not give them access. If you have any concerns that someone has access to your online records without your permission, speak to your surgery and they can change your password or stop your online services
• How long would you like your chosen person to have access for? This can be for a short time, for example when you are suffering from a certain illness and you need support with managing your health during that time. It can also be ongoing so they can help you for a long period of time. You can discuss this with the Practice.

Lasting power of attorney for health and welfare or court appointed deputy

When a person is unable to make decisions for themselves, another person, usually a partner or close family member can be given legal responsibility over decisions concerning their life by the courts. This is called Health and Welfare Lasting Power of Attorney. A person with lasting power of attorney can ask the patient’s surgery for access to their online services. The GP will make a decision whether this should be allowed.

If you know that you would never want a particular person to have access to your online services if you become unable to make your own decisions, you should tell your GP and they will never share them with that person.

Why your surgery may refuse to give your chosen person access

On rare occasions, your GP could refuse to allow your chosen person to use GP online services on your behalf. If this happens, your GP will discuss their reasons with you. Some of the reasons your GP could have are:

• Your GP does not think it is in your best interest for your chosen person to use these services on your behalf
• You or your chosen people have misused online services in the past
• The Practice is concerned that your chosen person will not keep your information safe
• The Practice suspects someone is forcing you to give them permission to use your online services
• You are not able to make decisions for yourself.

Why your surgery can stop the service

• We believe your chosen person is forcing you to share your GP records with them or with another person.
• Your chosen person has misused your GP information
• You are no longer able to understand or remember that you gave your chosen person permission to use online services on your behalf
• You have told the Practice in the past that if you become unable to make decisions for yourself, you do not wish for your chosen person or anyone to have permission to your online services
• You have died.

How you can stop the service

You can choose to take away access to your GP online services from your chosen person at any time. To end the service, you need to let your surgery know you would like them to switch off online access for your chosen person and give them the reason. Your surgery will then stop the service and your chosen person will not be able to use their login details to look at your information.

Why you may want to stop access

Some of the reasons you can choose to end the service are:

• You only needed your chosen person to support you for a short time, for example when you were suffering from a certain illness and you needed help with managing your health during that time
• You want to give this responsibility to another person, for example, if you have a new carer or personal assistant
• Your relationship with your chosen person has broken down
• Your chosen person has misused information in your GP records, for example, they have collected medication in your name or they have shared your private information with someone without your permission.

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

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

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

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

Summary Care Record (SCR)

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

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

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

GP to GP Record Transfers

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

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

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

Patient Online Access to Their GP Record

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

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

Data for commissioning and other secondary care purposes

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

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

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

About your Summary Care Record

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

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

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

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

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

FAQs

Who can see my Summary Care Record?

Healthcare staff who have access to your Summary Care Record:

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

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

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

What are my choices?

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

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

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

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

Children and the Summary Care Record

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

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

Where can I get more information?

For more information about Summary Care Records you can:

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

Patient’s Rights

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

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

Patient’s Responsibilities

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

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

NHS Constitution

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

• GOV.UK – The NHS Constitution for England
• NHS Choices – NHS Constitution

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

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

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

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

Removal from the Practice List

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

Removing other members of the household

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