Practice Policies & Patient Information
Chaperones
The Surgery prides itself in maintaining professional standards. For certain examinations during consultations an impartial observer (a “Chaperone”).
This impartial observer will be familiar with the procedure and be available to reassure and raise any concerns on your behalf. If 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 chose 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.
Complaints Leaflet
Confidentiality
The practice complies with the Data Protection Act. All information about patients is confidential: from the most sensitive diagnosis, to the fact of having visited the surgery or being registered at the Practice. All patients can expect that their personal information will not be disclosed without their permission except in the most exceptional of circumstances, when somebody is at grave risk of serious harm.
All members of the primary health care team (from reception to doctors) in the course of their duties will have access to your medical records. They all adhere to the highest standards of maintaining confidentiality.
As our reception area is a little public, if you wish to discuss something of a confidential nature please mention it to one of the receptionists who will make arrangements for you to have the necessary privacy.
Under 16s
The duty of confidentiality owed to a person under 16 is as great as the duty owed to any other person. Young people aged under 16 years can choose to see health professionals, without informing their parents or carers. If a GP considers that the young person is competent to make decisions about their health, then the GP can give advice, prescribe and treat the young person without seeking further consent.
However, in terms of good practice, health professionals will encourage young people to discuss issues with a parent or carer. As with older people, sometimes the law requires us to report information to appropriate authorities in order to protect young people or members of the public.
Useful Websites
Freedom of Information
The Freedom of Information Act creates a right of access to recorded information and obliges a public authority to:
- Have a publication scheme in place
- Allow public access to information held by public authorities.
The Act covers any recorded organisational information such as reports, policies or strategies, that is held by a public authority in England, Wales and Northern Ireland, and by UK-wide public authorities based in Scotland, however it does not cover personal information such as patient records which are covered by the Data Protection Act.
Public authorities include government departments, local authorities, the NHS, state schools and police forces.
The Act is enforced by the Information Commissioner who regulates both the Freedom of Information Act and the Data Protection Act.
The Surgery publication scheme
A publication scheme requires an authority to make information available to the public as part of its normal business activities. The scheme lists information under seven broad classes, which are:
- who we are and what we do
- what we spend and how we spend it
- what our priorities are and how we are doing it
- how we make decisions
- our policies and procedures
- lists and registers
- the services we offer
You can request our publication scheme leaflet at the surgery.
Who can Request Information?
Under the Act, any individual, anywhere in the world, is able to make a request to a practice for information. An applicant is entitled to be informed in writing, by the practice, whether the practice holds information of the description specified in the request and if that is the case, have the information communicated to him. An individual can request information, regardless of whether he/she is the subject of the information or affected by its use.
How Should Requests be Made?
Requests must:
- be made in writing (this can be electronically e.g. email)
- 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:
GP Earnings
All GP Practices are required to declare mean earnings (i.e. average pay) for GPs working to deliver NHS services to patients at each practice.
The average pay for GPs working in the practice of Wallace House Surgery in the last financial year was £51,717 before tax and National Insurance.
This is for 4 full time GPs, 5 part time GPs and 1 locum GP who worked in the practice for more than six months.
Housing/Benefit Letters
The Wallace House Practice is committed to supporting our patients. All requests for letters for benefits, council or any other third parties, we will only complete with a formal request from the third party.
Please note all requests from the third party will require the patients formal consent.
We will only complete factual responses. We are not allowed to give an opinion. If in doubt we will refuse to complete the request and may issue a copy of medical records instead with your consent.
Be aware we charge for any requests and copies of records and requests can take up to 28 days.
Housing Applications
If you are intending to apply for a council home for health reasons, you do not need a doctor’s letter.
The Council will write, in confidence, to your doctor if further information is required.
GPs receive frequent requests for medical letters and reports in support of housing applications from a variety of sources – the local authority, housing associations, directly from patients and from patients via Citizens Advice Bureau. The arrangements for seeking GP reports and for payment vary from local authority area to local authority area, and even when clearly agreed are often not implemented by local authority staff. However, all requests should come via the Housing Association and not the patient.
Information in support an application based on health grounds should be supplied by the applicant using a form provided by the Housing Department (self-assessment). This should not require any input from the GP/practice.
Only if additional information is required, should the Housing Department Medical Officer obtain it from the applicant’s doctor, preferably using a standard form, provided the patient has given written consent.
The Medical Officer should seek information which is only available to the GP, for example:
- the diagnosis
- severity of the illness
- medication
Infection Control Statement
We aim to keep our surgery clean and tidy and offer a safe environment to our patients and staff and endeavour to keep it clean and well maintained at all times.
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:
- 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
My Care Record
The people caring for you need access to your health and care record in order to make the best decisions about your diagnosis and treatment. For this to happen more quickly and to improve the care you receive, a new process has been put in place. With your permission, My Care Record will provide health and care professionals directly involved in your care, access to the most up-to-date information about you. To find out more please go to www.mycarerecord.org.uk.
Fair Processing Notice
How we use your information
What is My Care Record?
In west Essex and Hertfordshire, providers of health and social care services are working more closely together to better coordinate the delivery of care to people supported by local commissioners.
My Care Record is a programme which allows people to give health and care professionals their permission to access their medical records during their treatment.
The people caring for you need to access about your health and care record in order to make the best decisions about your diagnosis and treatment. This could include GPs, hospital-based clinicians, nurses, health visitors and social workers.
To enable this to happen more quickly and to improve the care you receive, a new process has been put in place. This will allow your information to be accessed by different health and care organisations, using existing computer systems.
Your record will only be accessed by health and care professionals involved in your care.
Information will only be accessed with your permission – where applicable – and while you are receiving direct treatment by a health and care professional.
Information accessed through My Care Record is treated to the same security standards as all confidential information.
What information will be made available?
The record accessed is your health and care record. Examples of information that will be available include:
- Name, address, NHS Number and phone number
- Medications
- Test results and investigations
- Correspondence
- Clinical history
- Emergency department treatment
- Future and past appointments
- Health plans and alerts
- Mental health alerts and diagnoses
- Social care lead coordinator and your care plan.
How is this information used?
The information available in the record from your care provider is in a chronological order so that your care provider can see a relevant history of your care. They will always update their own care record with any new information. This helps them to make better decisions about your care. Access is only with your explicit permission.
The organisations that could be involved in the service are:
- GP practices in west Essex and Hertfordshire
- Princess Alexandra Hospital Trust
- Essex Partnership University NHS Trust (EPUT)
- Hertfordshire Community NHS Trust
- Hertfordshire Partnership University NHS Foundation Trust
- East of England Ambulance
- IC24 (111 provider)
- Out of hours providers (such as PELC, HUC)
- Essex County Council and their care providers (such as Essex Cares)
- Hertfordshire County Council
- Other local hospitals (such as Addenbrooke’s, Whipps Cross, Broomfield, East and North Hertfordshire and West Hertfordshire Trusts)
You can tell your care provider if you don’t want them to make your information available by completing a form available on www.mycarerecord.org.uk or by asking your care provider for one. Your record will be edited and no information will be available to access.
Access to your information
My Care Record is simply a reflection of your individual records held by the organisations above and therefore you should contact them directly if you wish to have a copy of the information held about you. The contact details for each organisation’s Data Protection Officer or Team is below.
Contact Details for Data Protection Officers
- West Essex CCG on behalf of My Care Record
Building 3, Spencer Close, St Margaret’s Hospital, The Plain, Epping, CM16 6TN
Tel: 01992 566140
Email: weccg.comms@nhs.net - Princess Alexandra Hospital
Medical Records Manager, The Princess Alexandra Hospital NHS Trust, Hamstel Road, Harlow, Essex, CM20 1QX
Tel: 01279 827341
Email: health.records@pah.nhs.uk - Essex Partnership University NHS Trust (EPUT)
Access to Records team, Mental Health Unit, Basildon Hospital, Nethermayne, Basildon, Essex, SS15 6NL
Tel: 01268 246873 / 246889 - Essex Social Care
Transparency Team, Essex County Council, PO Box 11, County Hall, Chelmsford, CM1 1QH - Hertfordshire Community NHS Trust
Access to records, Hertfordshire community NHS Trust, Unit 1a, Howard Court, 14 Tewin Road, Welwyn Garden City, AL7 1BW - Hertfordshire Social Care
Data Protection Team, Hertfordshire County Council, CHO150, County Hall, Pegs Lane,
Hertford, SG13 8DF - Hertfordshire Partnership University NHS Foundation Trust
Records and Access to Information Team, Hertfordshire Partnership NHS Foundation Trust,
99 Waverley Road, St Albans, AL3 5TL
Tel: 01727 804707 / 804228
Please contact your own General Practice directly for a copy of your GP record.
For further information on My Care Record please visit www.mycarerecord.org.uk.
Named GP
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 changes of GP due to the costs involved.
NHS Constitution
The NHS Constitution establishes the principles and values of the NHS in England. For more information see these websites:
Non-NHS Work
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?
Whilst GPs will always attempt to assist their patients with the completion of forms, they are not required to do such non-NHS work.
With certain limited exceptions, for example a GP confirming that one of their patients is not fit for jury service.
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.
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.
- Once payment has been received for non NHS work we aim to complete this work within a 4 week time frame.
- We do offer a fast track fee for urgent requests however each case is reviewed by the duty team to ensure that this is possible on the day. We do have the right to decline this service.
Privacy Notice
We understand how important it is to keep your personal information safe and secure and we take this very seriously. We have taken steps to make sure your personal information is looked after in the best possible way and we review this regularly.
Please read our Privacy Notice carefully, as it contains important information about how we use the personal and healthcare information we collect on your behalf.
Statement of Intent
New contractual requirements came into force from 1 April 2014 requiring that GP Practices should make available a statement of intent in relation to the following IT developments:
- Summary Care Record (SCR)
- GP to GP Record Transfers
- Patient Online Access to Their GP Record
- Data for commissioning and other secondary care purposes
The same contractual obligations require that we have a statement of intent regarding these developments in place and published 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 online. If you do not already have a username 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.
Summary Care Records
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 have the choice of what information you would like to share and with whom. Authorised healthcare staff can only view your SCR with your permission. The information shared will solely be used for the benefit of your care.
Your options are outlined below:
- Express consent for medication, allergies and adverse reactions only. You wish to share information about medication, allergies and adverse reactions only.
- Express consent for medication, allergies, adverse reactions and additional information. You wish to share information about medication, allergies and adverse reactions and further medical information that includes: Your significant illnesses and health problems, operations and vaccinations you have had in the past, how you would like to be treated (such as where you would prefer to receive care), what support you might need and who should be contacted for more information about you.
- Express dissent for Summary Care Record (opt out). Select this option, if you DO NOT want any information shared with other healthcare professionals involved in your care.
Please note that it is not compulsory for you to complete a consent form. If you choose not to complete a form, a Summary Care Record containing information about your medication, allergies and adverse reactions and additional further medical information will be 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 an opt-out form.
If you are unsure if you have already opted out, you should talk to the staff the 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
Zero Tolerance
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 single formal warning. Should another incident occur this may impact on doctor and patient relationship and result in your removal from our practice list.
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.