Do you find it hard to understand your doctor or social worker? Do they speak too fast? Or give you letters that are hard to read?

There is a rule for health and social care services.

The rule says they have to communicate with you in a way you can understand.

The rule is called the accessible information standard.

At Reepham and Aylsham Medical Practice we may communicate with you in the following ways:

• Via email
• By sending a letter
• Speaking with you over the telephone
• Talking to you in person at the surgery

Your communication needs and preferences are extremely important to us and we will always try our best to communicate with you, in a way you can understand.

To help us achieve this we must ask you a few questions.

What support do you need from us?

You can choose what support you ask for, here are some ideas to help you:

• Use easy words to understand and don’t speak to fast
• Explain everything in a way that you can understand
• Give you a longer appointment
• Request your appointment when your supporter/carer can come
• Give you letters and leaflets in easy read or large print
• You can choose your preferred method of contact (email, telephone, letter)
• Communication support for appointments (e.g. interpreter or sign language)
• Additional support to communicate (e.g. hearing aids or lip reading)

Do you give consent for us to inform other services what support you need?

If we send a referral for you to be seen by another service, like the hospital, we can tell the service what support you need.

If you do not give consent, we will not share this information.

Tell us what support you need

By writing down what support you need, we can add a note to your record. Whenever you communicate with a member of the team at the practice, they will be able to see your preferences on your record. If you are unable to write down what support you need, please inform a member of the team and we can help you.

The Data Protection Act 1998 (Section 7) specifies the rights of access by a patient to their medical records (data subject).

The data subject is the person whose information is within the system and who has rights of access as determined under the Data Protection Act 1998.

The data controller of the patient’s medical records/specific data and the system, in this case, is the Reepham & Aylsham Medical Practice.

Provision of information to third parties

Information will not normally be released to other family members without written patient consent.

Also, when a request is made on behalf of a person who is deceased, there are special rules regarding release of the deceased patient’s records. Please make contact with the Practice Manager for advice in these circumstances.

A third party is a body or person other than the patient (data subject) who requests access or to whom information is released.

Process for making a subject access request

A Subject Access Request (SAR) can be made using any format to the practice and will be considered on an individual basis. Our preference is for the below form to be used to support us in locating the information you are requesting:

Subject Access Request Form

• Your request will be actioned once it is received at the practice and within 28 days. We will notify you of any reasonable cause for delay that may exceed this timeframe.
• Where an application is declined, a reason will be given. In some circumstances, some parts of the record may be withheld, this will be clearly visible to the applicant.
• Your usual doctor will review your records before we can authorise release.
• We are unable to meet requests for immediate access.

It is the policy of the practice to respect the privacy, dignity, religious and cultural beliefs of our patients.

All patients are entitled to have a chaperone present for any consultation, examination or procedure where they consider one is appropriate or required. The chaperone may be a family member or a friend, but on occasions a formal chaperone, a member of staff specially trained in this role, may be preferred.

Patients are advised to ask for a chaperone if required, at the time of booking an appointment, so that arrangements can be made and the appointment is not delayed. However, if the request is not made until the time of the appointment, the Practice will always do its utmost to provide a formal chaperone if the patient has not brought a friend or relative with them.

On occasions, a doctor or nurse may also request a chaperone to be present. This should be discussed with the patient in advance of the appointment, if at all possible.

All staff are aware of and have received appropriate information in relation to our Chaperone Policy.

All clinicians are trained chaperones; they all understand their role and responsibilities and are competent to perform that role.

There is no common definition of a chaperone and their role varies considerably depending on the needs of the patient, the healthcare professional and the examination being carried out.

Their role can be considered in any of the following areas:

• Emotional comfort and reassurance to patients
• Assist in intimate examination (e.g. during IUCD insertion)
• Assist in undressing
• Act as interpreter
• Protection to the healthcare professional against allegations / attack)

Chaperones are most often required or requested where a male examiner is carrying out an intimate examination or procedure on a female patient, but the designation of the chaperone will depend on the role expected of them, whether participating in the procedure or providing a supportive role.

Healthcare professionals should note that they are at an increased risk of their actions being misconstrued or misrepresented, if they conduct intimate examinations where no other person is present.

If you feel you would like a chaperone to be present during a physical examination by a doctor or any other health professional, or if you would prefer to be examined by a doctor or health professional of the same sex as yourself, please let us know and we will do our best to comply with your wishes.

To share your compliments with us, you can do this via Healthwatch, Norfolk, a local independent and impartial, health and social care champion who actively supports the collection and sharing of feedback to improve standards of care.

We also kindly ask you to respond to our text messages which may be sent after an appointment with us at the practice requesting details of your experience.

If you would like to make a general suggestion to our team, you can email us at [email protected] (please do not use this address to contact us relating to any patient/medical queries, instead refer to our usual methods of contact).

Your feedback is extremely important to us as it helps us to see what we are doing well and areas for improvement.

Making a complaint

We do try our best to run the practice as smoothly and efficiently as possible. If you do have a problem, we will hope to sort it out quickly and easily for you with the person concerned or one of the management team.

Where you are not able to resolve your complaint in this way and wish to make a formal complaint you should do so, preferably in writing, as soon as possible after the event and ideally within a few days as this helps us to establish what happened more easily. In any event, this should be within 12 months of the date of the event that you are complaining about, or as soon as the matter first came to your attention.

State your case clearly, giving as much detail as you can. If you are a registered patient, you can complain about your own care. You have the right to complain about someone else’s treatment with their written authority, please obtain a complaint form from reception.

Send your written complaint to:

Wendy Dicks
Practice Manager
Reepham & Aylsham Medical Practice
The Surgery,
60 Hungate Street
Aylsham, Norfolk, NR11 6AA

What we do next

We look to settle complaints as soon as possible.

We will acknowledge receipt within three working days and aim to have looked into the matter within ten working days. You may then receive a formal reply in writing, or you may be invited to meet with the person(s) concerned to attempt to resolve the issue. If the matter is likely to take longer than this, we will let you know and keep you informed as the investigation progresses.

When looking into a complaint we will investigate the matter to see what happened and why, our aim is to see if there is something we can learn from this and make it possible for you to discuss the issue with those involved, if you would like to do so.

Complaining on behalf of someone else

We keep to the strict rules of medical and personal confidentiality. If you wish to make a complaint and are not the patient involved, we will require the written consent of the patient to confirm that they are unhappy with their treatment and that we can communicate with someone else about it on their behalf.

Where the patient is incapable of providing consent due to illness or accident, it may still be possible to deal with the complaint. Please provide the precise details of the circumstances which prevent this in your complaint.

Please note that we are unable to discuss any issue relating to someone else without their express permission, which must be in writing, unless the circumstances above apply.

We may still need to correspond directly with the patient or may be able to deal directly with the third party, this will depend on the wording of the authority provided.

When the investigations are complete your complaint will be determined and a final response sent to you.

Where your complaint involves more than one organisation (e.g. social services) we will liaise with them, so that you receive one coordinated reply. We may need your consent to do this. Where your complaint has been sent initially to an incorrect organisation, we may seek your consent to forward this to the correct person to deal with.

The final response letter will include details of the result of your complaint and also your right to escalate the matter further, if you remain dissatisfied with the response.

If you are dissatisfied with the outcome and complaining to other authorities

The majority of complaints are resolved locally at practice level. However, if you remain dissatisfied with the outcome or you feel you cannot raise your complaint with us you may contact:

FAO Complaints Team
NHS Norfolk and Waveney Integrated Care Board
County Hall
Martineau Lane
Norwich
NR1 2DL
Email: [email protected]

The Health Service Ombudsman
Complaints helpline: 0345 015 4033 (open 08:30 – 17:30, Monday to Friday)

If you remain dissatisfied with the outcome you may refer the matter to:

NHS England’s Customer Contact Centre
NHS England
PO Box 16738
Redditch
B97 9PT
Tel: 0300 311 2233
Email: [email protected]

If you remain dissatisfied after contacting NHS England you can address your concerns to:

The Parliamentary and Health Service Ombudsman
Millbank Tower
Millbank
London
SW1P 4QP
Tel: 0345 0154033

08:30-17:30 Monday to Friday

Email:[email protected] or you can contact them at www.ombudsman.org.uk

The Independent Complaints Advocacy Service (ICAS) supports patients and those carers wishing to pursue a complaint about their NHS treatment or care. The contact number for ICAS in the East of England for, Cambridge, Norfolk and Suffolk is 0300 456 2370. The address should you wish to write to them is:

PoHWER
PO Box 140 43
Birmingham B6 9BL

You may also approach PALS for help or advice:

The Patient Advice and Liaison Service (PALS) is based at Norfolk and Norwich University Hospital trust. They provide confidential advice and support, helping you to sort out any concerns you may have about the care we provide, guiding you through the different services available from the NHS.

Norfolk & Norwich University Hospital
Colney Lane
Norwich
NR4 7UY

Tel: 01603 289035/36/45

Contacting the care quality commission (CQC)

If you have a genuine concern about a staff member or a regulated activity carried out by the practice, then you can contact the care quality commission on 03000 616161 or visit their website.

It can be distressing if a friend or relative refuses to get medical help.

However, unless they require treatment under the Mental Health Act, confidentiality means it is often difficult to help them get treatment.

You could make an appointment to discuss your concerns with that person’s doctor. You can raise concerns about your friend or relative’s health with their GP without their consent, but because of patient confidentiality, the GP won’t be able to discuss any details.

While this information can be helpful, it’s likely the doctor will only listen to what they are told and say little in response.

This is not rudeness or a sign your concerns are being ignored, but simply helping to protect the confidentiality of the other party.

You don’t have to belong to the same GP practice as your friend or relative to do this.

You could talk to your friend or relative directly if you wish to discuss their condition or treatment. Tell them about your concerns about their health, and offer help and support.

At the Reepham and Aylsham Medical Practice, if you have concerns regarding a family member or friend you can raise these concerns in the following way:

• Speak to a Receptionist who can ask the patients GP to contact you.
• Book an appointment to see the GP.
• Book an appointment to see the Practice Manager.
• Write to the GP/Practice Manager with your concerns.

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.

What happens to my information?

We have a computer system called SystmOne which holds the medical records of all our patients. This is totally confidential and the only people who access the notes are those health professionals and administration staff who need to do so to assist with your care. If we need to refer you to the hospital for treatment then the information that is relevant to your care will be shared with those professionals who are being asked to help you.

Useful Websites

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

If you need to cancel an appointment, please let us know.

Did you know that not all appointments are 10 minutes? they can vary from 5 minutes to 60 minutes.

Have you recently not attended an appointment? Every appointment that is missed is valuable time that could be used to treat other patients who need medical attention.

What should I do if I need to cancel or amend my appointment?

Please cancel your appointment online. Alternatively, you can contact the surgery between 08:00-18:30.

What we do to remind you of your appointment

We offer an SMS messaging service and can send text message reminders to you the day before your appointment, if you have not updated your records recently with your mobile number, please use our change of details form. We also courtesy call everybody who does not receive an SMS.

Please read this page carefully. It will give you information about the sharing of your electronic patient record and the choices you need to make.

We share your medical records with other services involved in your health and care. For full details, please read the leaflets below:

What is SystmOne?

SystmOne is a clinical computer system produced by a company called TPP. It lets NHS staff record patient information securely onto a computer. This information can then be shared with other clinicians so that everyone caring for you is fully informed about your medical history, including medication and allergies.

SystmOne is currently used in GP practices, Child Health services, Community services, Prisons, Hospitals, Urgent Care & Out of Hours services, Palliative care services and many more.

Introduction

Today, electronic records are kept in all the places where you receive healthcare. These places can usually only share information from your record by letter, email, fax or phone. At times, this can slow down your treatment and mean information is hard to access.

Your care service, however, uses a unique computer system called SystmOne that allows the sharing of full electronic records across different healthcare care services.

We are telling you about this as you register with a new NHS care service so that you can think about your choices:

• You can choose to share your electronic record with other care services.
• You can choose not to share your electronic record with other care services.

How is my decision recorded?

SystmOne has two settings to allow you to control how your medical information is shared:

Sharing OUT

This controls whether your information entered at this service can be shared with other NHS services (i.e. made shareable).

Sharing IN

This controls whether information that has been made shareable at other NHS care services can be viewed by this care service or not  (i.e. shared in).

How does this work?

Imagine you’re receiving care from 3 different NHS services: your GP, a District Nurse and a smoking clinic. You want your GP and nurse to share information with each other and you want both of them to know your progress at the smoking clinic. However you don’t want the smoking clinic to see any of your other medical information.

Your sharing settings would be:

• The GP can share information IN and OUT
• The District Nurse can share IN and OUT
• The smoking clinic can only share information OUT but not IN

When you are first or next seen at the care service, you’ll be asked the following questions:

Do you consent to the information that is recorded about you here being made available to other NHS care services that care for you and also use SystmOne?

If you answer YES

Clinicians at other services that care for you and use SystmOne will be able to see the information recorded here. For example, a district nurse that visits you would be able to see the data entered by your GP.

If you answer NO

The clinician will be prevented from sharing the information entered with other services caring for you.

Do you consent to allow this care service to view information about you that has been recorded at other services where you also receive care? (You must have separately consented for information to be ‘shared out’ of those services)

 If you answer YES

This care service will be able to view information recorded on your patient record by other NHS services.

If you answer NO

This care service will not see any information recorded at any other NHS service (even if those services have the consent to share information out).

Note: You can still request for individual entries in your patient record to be marked as ‘Private’. These will not be visible at any care service other than the one that recorded the information.

Why is this necessary?

These settings allow you to decide who can see the information on your electronic record. It also allows for joined up care across different NHS settings which gives the best care and service to you.

Note: In some serious situations, for example if you are unconscious, clinicians will be able to access your electronic record without first asking for your permission. Use of this is monitored.

Don’t Forget!

These settings apply to any NHS service using SystmOne where you are currently receiving care. You can also change your sharing preferences at any time – just speak to a member of staff at this care service.

The Reepham and Aylsham Medical Practice recognises that many people in our society experience discrimination or lack of opportunity for reasons that are not fair. These include race, religion, creed, colour, national and ethnic origin, political beliefs, gender, sexual orientation, age, disability (including mental illness), HIV status, responsibility for dependants, geographical area, social class, income level and criminal record.

The Reepham and Aylsham Medical Practice is committed to a Policy of Equality of Opportunity which respects the identity, rights and value of each individual, be they a patient or a member of staff.

Please make the practice manager aware if you have any concerns that equality and diversity issues have not been respected.

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

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

What cannot be requested?

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

For more information visit the following websites:

• Legislation GOV.UK
• Information Commissioner’s Office

Your Information

Reepham and Aylsham Medical Practice. takes privacy seriously and we want to provide you with information about your rights, who we share your information with and how we keep it secure.

Please use the links below to find more information about the practice and data protection.

• Transparency
• Telephone Recording
• Case Finding (ECLIPSE)
• Norfolk Information Sharing
• Processor List

Photographs

During COVID-19 we may ask you to send a photograph of you bruise / skin condition that you are concerned about whilst we conduct virtual consultations. This photograph will be used by the clinician to determine any medical treatment necessary and will be added to your medical record.

Please note that, where this is sent via email, it may not be secure we therefore ask that you only include your NHS number alongside your photograph in the email. The photograph should only be of the area requested and no other person should be visible in the shot.

As part of the commitment to more personalised care for patients, NHS Employers and the General Practitioners Committee of the British Medical Association have agreed that all patients will have a named accountable GP.

The named GP will:

• Take lead responsibility for ensuring that all appropriate services required under the contract with the practice are delivered to you.
• Where required, based on the professional judgement of the ‘named’ GP, work with relevant associated health and social care professionals to deliver a multidisciplinary care package that meets your needs.
• Ensure that your physical and psychological needs are recognised and responded to by the relevant clinicians in the practice.
• Ensure that patients over 75 years of age have access to a health check if requested, which is already a requirement of the GP contract regulations.

The practice will ensure that there is a named accountable GP assigned to each patient.

New patients will be allocated a GP at the time of registration.

Your named accountable GP will be the same as your usual GP however this does not affect your ability to see any GP of your choice as you currently do.

Your named GP will not be available at all times and if your needs are urgent, you may need to discuss them with an alternative doctor. All of your records are available to every GP in the surgery.

This notice applies to all of our patients including children.

We have made every effort to make patients aware of who their named GP is, however if you are unsure, please ask the receptionist team at the practice.

Most of the Practice’s clinical and non-clinical services are provided without cost under the NHS. However, there are some items for which we charge, as they are not provided under the NHS.

For private fees please contact the practice.

Why does my doctor charge fees?

Please view the below link to the British Medical Association website for more information:

• www.bma.org.uk/why-does-my-doctor-charge-fees

Your Information.

Your Rights.

Our Responsibilities.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Your Rights

When it comes to your health information, you have certain rights. This section explains your right and our responsibilities to help you.

Get a copy of your health records

• You can ask to see or get a copy of your health records and other health information we have about you.
• We will provide a copy or a summary of your health records, usually within 30 days of your request. We will only charge an administration fee for this if a request is unfounded, excessive or repeat requests are made for the same information.

Ask us to correct health records

• You can ask us to correct your health records, if you think they are incorrect or incomplete.
• We will usually comply to rectify data within 30 days. If the request is complex we may request more time.

Ask us for information on how we use

• Please ask a member of the team for a copy of our privacy notice. This sets out the type of data we hold, why and what we do with your data.
• We will consider all reasonable request and must say ‘yes’, if you tell us you would be in danger if we do not.

Ask us to limit what we use or share

• You can request for us not to use or share certain health information for treatment or our operations.
• Sometimes we are not required to agree to your request, and we may say ‘no’ if it would affect your care and then there is a legal basis to do so.

Get a list of those with whom we’ve shared your information

• You can ask us to provide a list of who we share your information with in order to provide healthcare to you.

Our uses and disclosures

How do we typically use or share your health information?

We work with a number of other NHS and partner agencies to provide healthcare services to you.

Help manage the health care treatment you

• We will use your health information and share it with professionals who are treating you.

Example: The hospital sends us information about your diagnosis and treatment plan, so we can arrange additional services.

Run our organisation

• We will use your information to run our organisation and contact you, to assist in providing your care.

Example: We use health information about you to develop better services for you.

Research

• We do participate in research and may use your information to identify you as a possible participant.
• However, we will not share this information or engage you in a research project without your explicit consent.

Help with public health and safety issues

We can share health information about you for certain situations such as:

• Preventing disease.
• Reporting adverse reactions to medications.
• Reporting suspected safeguarding situations e.g. abuse, neglect, or domestic violence.
• Preventing or reducing a serious threat to anyone’s health or safety.

Comply with the law

• We acknowledge that processing or sharing your data may only be carried out, where a lawful basis exists.
• Where no lawful basis applies, we may seek to rely on your consent in order to process or share your data.
• You will be given clear instructions where your consent is required, informed of the consequences and of your right to withdraw your consent at any time.

Anyone who receives information from us is also under legal duty to keep your data confidential and secure.

Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs, that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in the notice and give you a copy of it.
• We will not use or share your information other than as described here, unless you tell us we can. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

Your choices

For certain health information, you can tell us your choices about what we share.

If you have a clear preference for how we share your information in the situations described, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in providing for your care.
• Share information with someone you have granted medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest or the interest of public safety.

In order to provide for your care, we may share your information for the following purposes:

• If it is appropriate in the provision of your care or required to satisfy our statutory function and legal obligations.
• And if you are able to but have not informed us otherwise.

Concerns or complaints

If you feel we have not complied with your rights as laid out by data protection laws, you can make a complaint.

If you do wish to make a formal complaint you should do so, preferably in writing, as soon as possible after the event and ideally within a few days as this helps us establish what happened more easily.

Send your written complaint to:

Wendy Dicks
Practice Manager
60 Hungate Street
Aylsham
Norfolk
NR11 6AA

Terms of this Notice

This notice does not provide exhaustive details of all the aspects of the collection and use of your personal information by the practice. However, we are happy to provide any additional information or explanation if needed.

We can change the terms of this notice and the changes will apply to all information we have about you. If we do change the terms of notice, we will update our policy accordingly.

Serious Mental Illness (SMI) Register

Aiming to Improve physical healthcare for people living with severe mental illness (SMI) by ensuring that by 2020/21, 280,000 people living with severe mental illness (SMI) have their physical health needs met by increasing early detection and expanding access to evidence based physical care assessment and intervention each year.

Your practice is involved by sharing information with mental health services in the community about patients with SMI. A register is maintained that allows your practice and the mental health teams to monitor the health checks provided to patients with SMI.

More Information about the Severe Mental Illness Register

For more information about your rights or information sharing – see the main privacy notice page.

Diabetic Eye Screening

Diabetic eye screening is a key part of diabetes care. People with diabetes are at risk of damage from diabetic retinopathy, a condition that can lead to sight loss if it’s not treated.

The practice regularly identifies patients within their clinical system that are eligible for eye screening and sends their details to a partner called Health Intelligence who will invite them to be screened by the eye screening service. Health Intelligence staff are committed to confidentiality and there is an Information Sharing Agreement in place to ensure that personal data is used in a lawful and appropriate way.

More Information about the National Agenda

More Information about how Health Intelligence Use my Information

Summary Care Record Consent Project

As a patient, you currently have a Summary Care Record (SCR) containing key information about the medicines you are taking, allergies you suffer from and any reactions to medicines

you have had in the past. Should an illness or injury occur this information is used, with your consent, to assist healthcare staff such as hospital doctors, district nurses or pharmacy staff that may be unfamiliar with your medical history to make better and safer decisions about how best to treat you.

Patients have been given the option to include “additional information” into the Summary Care Record, this will add information relating to illnesses and any health problems, vaccinations, operations, and how patients would like to be treated.

More Information about Summary Care Records

For more information about your rights or information sharing – see the main privacy notice page.

Child Health Immunisations – Provide

To deliver the Child Health Information Service (CHIS) across Essex and East Anglia, one of the key responsibilities is producing immunisation reminders and appointments on behalf of GP Practices.

The practice allows Provide to extract immunisation history from their clinical systems for each child under the age of six years of age registered with the Practice.

Provide will then invite the patient to attend immunisation appointments.

Provide staff are bound by confidentiality in the same way that practice staff are and there is a Data Processing Contract in place to ensure that personal data is used in a lawful and appropriate way.

More Information about Provide

More Information about Immunisations

For more information about your rights or information sharing – see the main privacy notice page.

GP Connect (IC24)

The GP Connect programme uses technology to allow different clinical systems to communicate so that health and social care staff in different teams and locations can;

• View a patient’s GP practice record
• Manage GP appointments
• Import or download data on a patient’s medicines and allergies

This will save time for clinicians, and provide better, more convenient care for patients and allows more information for appointments made outside of usual hours.

More Information about GP Connect

For more information about your rights or information sharing – see the main privacy notice page.

Social Prescribing (Norfolk)

Social prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services.

Social prescribing enables patients to find non-clinical solutions to improve their own health and wellbeing by supporting them to connect with their local community.

This can include advice and information on local services and connecting individuals to social activities, clubs, groups, and like-minded individuals in their community. The practice will do this by employing someone to act as a ‘link’ between the practice, the patient and non-clinical services within the community.

Current providers in the Norfolk and Waveney area include:

• Norfolk Citizens Advice Bureau
• North Norfolk District Council

Depending on where they are in the county, the GP practice will refer patients to one of these providers and will send basic information such as name, NHS No, address, date of birth and background to their health and wellbeing needs.

The providers are bound by confidentiality in the same way that practice staff are and there is a Data Sharing Agreement in place to ensure that personal data is used in a lawful and appropriate way.

More Information about Social Prescribing

For more information about your rights or information sharing – see the main privacy notice page.

North Norfolk Risk Stratification (Gemima)

Risk stratification is a process that is used across the NHS.The process uses technology to search the records in clinical systems and find information that tells your GP practice who might need extra care or support.

This might be because they have complicated health conditions or because they are at risk of developing conditions.

The information from your GP record will be combined with other information about when you have been to hospital or used other community services and will be used by the local NHS Clinical Commissioning Group (CCG) to plan and buy healthcare services for the local area.

The CCG will not have access to any information that identifies individual patients and instead, will use a code so they will not be able to see particular patients directly.

More Information about Risk Stratification

NSFT Learning Disability Service and GP Practices LD (Waveney Area) Suffolk

The Adult Learning Disability Community Team (Waveney) service as commissioned by the Great Yarmouth and Waveney CCG has been re-modelled. As part of this redesign, the service is developing a project whereby the team link more directly to GP practices in the Waveney area to offer support, advice and training. As part of this project, the team is tasked to assist GP practices in ensuring that their Learning Disability registers are accurate.

This allows health and social care providers to ensure that patients with Learning Disabilities are receiving the correct support.

GP practices will be required to share information with Norfolk and Suffolk Foundation Trust (NSFT).

NSFT are bound by confidentiality in the same way that practice staff are and there is a Data Sharing Agreement in place to ensure that personal data is used in a lawful and appropriate way.

More Information about the NHS and Learning Disabilities

Sharing When Required By Law

Sometimes we will be required by law to share your information and will not always be able to discuss this with you directly. Examples might be for the purposes of detection or prevention of crime, where it is in the wider public interest, to safeguard children or vulnerable adults, reporting infectious diseases or where required by court order.

Care Quality Commission Access to Health Records

CQC has powers under the Health and Social Care Act 2008 to access and use your health information where it is necessary to carry out their functions as a regulator.

This means that inspectors may ask to look at certain records to decide whether we are providing safe, good quality care.

More information about the CQC can be obtained on their website https://www.cqc.org.uk/about-us/our-policies/privacy-statement

​Information Access and Rights

Data protection law provides you with a number of rights that the practice is committed to supporting you with;

Right to Access

You have the right to obtain:

• Confirmation that your information is being used, stored or shared by the practice
• A copy of information held about you

​We will respond to your request within one month of receipt or will tell you when it might take longer.

​We are required to validate your identity including the identity of someone making a request on your behalf

​Right to Object or Withdrawn Consent

We mainly use, store and share your information because we are permitted in order to deliver your healthcare but you do have a right to object to us doing this.

​Where we are using, storing and sharing your information based on explicit consent you have provided, you have a right to withdraw that consent at any time.

​Our Data Protection Officer will be happy to speak with you about any concerns you have.

​Right to Correction

If information about you is incorrect, you are entitled to request that we correct it

There may be occasions, where we are required by law to maintain the original information – our Data Protection Officer will talk to you about this and you may request that the information is not used during this time

​We will respond to your request within one month of receipt or will tell you when it might take longer.

​Right to Complain

You also have the right to make complaints and request investigations into the way your information is used. Please contact our Data Protection Officer or visit the link below for more information.

​For more detailed information on your rights visit https://ico.org.uk/for-organisations/guide-to-the-general-data-protection-regulation-gdpr/individual-rights/

​​Case Finding and Profiling

Sometimes your information will be used to identify whether you need particular support from us.

​Those involved in your care might look at particular ‘indicators’ (such as particular conditions) and contact you or take action for healthcare purposes.

For example, this might be to prevent you from having to visit accident and emergency by supporting you in your own home or in the community.

​We will use automated technology to help us to identify people that might require support but ultimately, the decision about how or whether to provide extra support you is made by those involved in your care.

​Our Data Protection Officer will be happy to speak to you about this if you have concerns or objections.

Sharing Partners Across Norfolk and Waveney

Our practice routinely shares information with other health and social care organisations across the county.

We have signed an ‘Information Sharing Agreement’ to ensure that all sharing partners agree to secure practice when sharing your information.

Information Technology

The practice will use third parties to provide services that involve your information such as:

• Removal and destruction of confidential waste
• Provision of clinical systems
• Provision of connectivity and servers
• Digital dictation services

​​Data analytics or warehousing (these allow us to make decisions about care or see how effectively the practice is run – personal data will never be sold or made available to organisations not related to your care delivery)

​We have contracts in place with these third parties that prevent them from using it in any other way that instructed. These contracts also require them to maintain good standards of security to ensure your confidentiality.

​How Do We Keep Your Information Safe?

We are committed to ensuring the security and confidentiality of your information.

There are a number of ways we do this:

• Staff receive annual training about protecting and using personal data
• Policies are in place for staff to follow and are regularly reviewed
• ​We check that only the minimum amount of data is shared or accessed
• ​We use ‘smart cards’ to access systems, this helps to ensure that the right people are accessing data – people with a ‘need to know’
• ​We use encrypted emails and storage which would make it difficult for someone to ‘intercept’ your information
• ​We report and manage incidents to make sure we learn from them and improve
• ​We put in place contracts that require providers and suppliers to protect your data as well
• ​We do not send your data outside of the EEA

We may share information with the following main partner organisations:

• Strategic health authorities
• NHS trusts (hospitals and primary care trusts)
• Special health authorities and the ambulance service.

We may also share your information with your consent and subject to strict sharing protocols about how it will be used with:

• Social services
• Education services
• Local authorities
• Voluntary sector providers and the private sector.

The practice also takes part in the NHS summary care records programme.

For more information, please ask reception.

Why we share your medical record

 In the national health service, we aim to provide you with the highest quality of healthcare. To do this, we must keep records about you, your health and the care we have provided or plan to provide to you.

These records may include:

• Basic details about you, such as address, date of birth, next of kin
• Contact we have had with you such as clinical visits
• Notes and reports about your health
• Details and records about your treatment and care
• Results of x-rays, laboratory test etc.
• Relevant information from people who care for you and know you well, such as health care professionals and relatives.

It is good practice for people in the NHS who provide care to:

• Discuss and agree with you what they are going to record about you.
• Give you a copy of letters they are writing about you.
• Show you what they have recorded about you, if you ask.

How your records are used

The people who care for you use your records to:

• Provide a good basis for all health decisions made by you and care professionals.
• Allow you to work with those providing care.
• Make sure your care is safe and effective.
• Work effectively with others providing you with care.

Others may also need to use records about you to:

• Check the quality of care (such as clinical audit)
• Protect the health of the general public
• Keep track of NHS spending
• Manage the health service
• Help investigate any concerns or complaints you or your family have about your health care.
• Teach health care workers
• Help with research

Some information will be held centrally to be used for statistical purposes. In these instances we take strict measures to ensure that individual patients cannot be identified.

We use anonymous information, wherever possible, but on occasions we may use personally identifiable information for essential NHS purposes such as research and auditing. However, this information will only be used with your consent unless the law requires us to pass on the information.

You Have the Right

You have the right to confidentiality under the Human Rights Act 1998 and the common law duty of confidence (the disability discrimination and the race relations acts may also apply).

You also have the right to ask for a copy of all records about you (you may have to pay a fee).

Your request must be made in writing to the organisation holding your information.

• There may be a charge to have a printed copy of the information held about you.
• We are required to respond to you within 40 days.
• You will need to give adequate information (for example: full name, address, date of birth NHS number etc.)
• You will be required to provide id before any information is released to you. 

If you think anything is inaccurate or incorrect, please inform the organisation holding your information.

The Data Protection Act 1998 requires organisations to notify the information commissioner of the purposes for which they process personal information.

The details are publicly available from the information commissioner:

Wycliffe house
Water Lane
Wilmslow
Cheshire
SK9 5AF
Tel: 01625 545745
Website: www.ico.gov.uk

How we keep your records confidential

Everyone working for the NHS has a legal duty to keep information about you confidential.

We have a duty to:

• Maintain full and accurate records of the care we provide to you.
• Keep records about you confidential, secure and accurate.
• Provide information in a format that is accessible to you (i.e. in large type if you are partially sighted).

We will not share information that identifies you for any reason, unless:

• You ask us to do so
• We ask and you give us specific permission
• We have to do this by law
• We have special permission for health or research purposes
• We have special permission because the interests of the public are thought to be of greater importance than your confidentiality.

Our guiding principle is that we are holding your records in strict confidence.

Who are our partner organisations?

We may share information with the following main partner organisations:

• NHS England
• NHS trusts (Hospitals, etc)
• Special health authorities
• Ambulance service

We may also share your information, with your consent and subject to strict sharing protocols about how it will be used, with:

• Social services
• Education services
• Local authorities
• Voluntary sector providers
• Private sector

Anyone who receives information from us also has a legal duty to keep it confidential.

If you need further information or assistance, please contact the practice manager.

Care professionals in England use an electronic record called the Summary Care Record (SCR). This can provide those involved in your care with faster secure access to key information from your GP record. For more information talk to the staff at your GP practice or visit www.hscic.gov.uk/scr/patients.

You can also visit the NHS Digital website or call them on 0300 303 5678.

What is a Summary Care Record(SCR)?

If you are registered with a GP practice in England, you will already have an SCR unless you have previously chosen not to have one.

It includes the following basic information:

• Medicines you are taking,
• Allergies you suffer from,
• Any bad reactions to medicines,
• Your name,
• Your address,
• Your date of birth,
• Your NHS Number.

What choices do you have?

You can now choose to include more information in your SCR, such as significant medical history (past and present), information about management of long term conditions, immunisations and patient preferences such as end of life care information, particular care needs and communication preferences. If you would like to do this, talk to your GP practice as it can only be added with your permission.

Remember, you can change your mind about your SCR at any time. Talk to your GP practice if you want to discuss your option to add more information or decide you no longer want an SCR.

Who can see my SCR?

Only authorised care professional staff in England who are involved in your direct care can have access to your SCR. Your SCR will not be used for any other purposes.

These staff:

• Need to have a Smartcard with a chip and passcode,
• Will only see the information they need to do their job,
• Will have their details recorded every time they look at your record.

Care professionals will ask for your permission if they need to look at your SCR. If they cannot ask you because you are unconscious or otherwise unable to communicate, they may decide to look at your record because doing so is in your best interest. This access is recorded and checked to ensure that it is appropriate.

SCRs for children

If you are the parent or guardian of a child under 16, and feel they are able to understand this information you should show it to them. You can then support them to come to a decision about having an SCR and whether to include additional information.

Enhanced Summary Care Record

Care professionals in England use an electronic record called the Summary Care Record (SCR). This can provide those involved in your care with faster secure access to key information from your GP record.

You can sign up using our enhanced summary care record opt-in form.

What is Additional Information?

Additional information can be added to your SCR by your GP practice and is a summary of information about your medical history.

It can include the following:

• Your long term health conditions such as asthma, diabetes, heart problems or rare medical conditions.
• Your relevant medical history – clinical procedures that you have had, why you
  need a particular medicine, the care you are currently receiving and clinical advice to support your future care.
• Your healthcare needs and personal preferences – you may have particular communication needs, a long term condition that needs to be managed in a particular way, or you may have made legal decisions or have preferences about your care that you would like to be known.
• Immunisations – details of previous vaccinations, such as tetanus and routine childhood jabs.

How will additional information help me?

Essential details about your healthcare can be very difficult to remember, particularly when you are unwell. Having additional information in your SCR means that when you need healthcare, you will be helped to recall this vital information. There are already clear benefits for your care from having medication, allergy and adverse reaction information available through your SCR. If you choose to add additional information, this can further increase the quality of your care.

Additional information can also empower you if you need some help to communicate your complex care needs.

Adding more information to your Summary Care Record

Please note that specific sensitive information such as any fertility treatments, sexually transmitted infections, pregnancy terminations or gender reassignment will not be included, unless you specifically ask for any of these items to be included.

How do I include additional information in my SCR?

Your GP practice may recognise that having additional information in your SCR will be of benefit to you and may suggest this change. Alternatively, you can discuss your wishes with your GP practice and agree that information should be added to your SCR.

Additional information will only be included in your SCR after discussion between you and your GP practice, and only if you give your permission.

Once you have chosen to add additional information to your SCR, your GP practice will continue to do this and keep it up to date. Remember that you can change your mind at any time by simply informing your GP practice.

Children and the SCR

If you are the parent or guardian of a child under 16 and feel that they are old enough to understand, then you should make the information in this leaflet available to them and support them to come to a decision as to whether to supplement their SCR with additional information. If your child cannot understand and you believe that they may benefit from additional information in their SCR, then you can discuss this with your GP practice.

Vulnerable Patients and Carers

Certain vulnerable patient groups such as those with dementia or with detailed and complex health problems can particularly benefit from additional information in their SCR. If you are a carer for another person and believe that they may benefit from additional information in their SCR, then you can discuss this with them and their GP practice.

Where can I get more information?

For more information about Summary Care Records you can:

• Talk to the staff at your GP practice
• Visit: https://digital.nhs.uk/services/summary-care-records-scr/
• Phone the Health and Social Care Information Centre on 0300 303 5678

Consent

All records are entirely confidential and we aim to keep them fully up to date. Please do not ask for information about relatives or friends. We cannot discuss any matters with anyone other than a patient or guardian of someone under the age of 16, unless we have their written permission.

If you require consent for a friend or relative, and they would be happy to give consent, please contact reception for more information.

Any young person has the right to seek advice from a health professional, doctor or nurse on their own or with a friend without their parent or another adult knowing about it.

• We do not have the right to tell anybody about what you have discussed with us, without your permission. However some decisions may be difficult and mean that the support of a trusted adult is important. For this reason we do try to encourage you to discuss things with a trusted adult or parent where possible.
• When you are seen by a doctor or nurse, the decision to offer you treatment/medication without an adult being present depends on how happy we are that you fully understand a) what the treatment means and the advice given, b) the options that you have been given regarding different types of treatment c) whether or not you understand possible risks or side effects of the treatment and finally that you know to come back to us if you have any problems.
• Being able to agree to treatment on your own is not dependent on your age it is dependent on your understanding of what is being offered.

Young people in the care system often have worries about what information is being given to different people about them. Your information would only be shared with those who really need to know and with your knowledge and permission so that you have control over your own information.

• Limitations to confidentiality – this part is very important. We have what is called a ‘duty of care’ to you which means that we must be sure that you are safe and that decisions you are making or advice and treatment that we are giving is in the best interests of your health and wellbeing and that of other people.
• If the doctor or nurse that you are seeing has a concern that you may be in danger or putting others in danger we have a duty to disclose that information without your consent to an appropriate person who will look into the situation.
• People under the age of 13 years old are not legally capable of agreeing to have sex or be involved in sexual activity. This means that the nurse or doctor may feel that to protect you this information needs to be shared with an appropriate person. This would normally be done with your knowledge and the doctor or nurse would help support you through this time and fully explain the reasons why this is needed so that you understand.

We take your privacy very seriously. We are registered with the Information Commissioner’s Office as a Data Controller and our registration number can be found by searching the ICO Register using this link.

We aim to provide you with the highest quality health care. To do this we must keep records about you, your health and the care we have provided or plan to provide to you.

Your doctor and other health professionals caring for you, such as nurses or physiotherapists, keep records about your health and treatment so that they are able to provide you with the best possible care.

These records are called your ‘health care record’ and may be stored in paper form or on computer and electronic systems and may include Personal Data;

• basic details about you, such as address, date of birth, NHS number, and next of kin

as well as Sensitive Personal Data:

• ​contact we have had with you, such as clinical visits
• notes and reports about your health
• details and records about your treatment and care
• results of x-rays, laboratory tests etc

Healthcare providers are permitted to collect, store, use and share this information under Data Protection Legislation which has a specific section related to healthcare information.

​If you have any questions or wish to make a request in relation to your information, please contact us using the details on our main page or contact our Data Protection Officer at [email protected].

​Our Data Protection Officer service is provided by Kafico Ltd. When we ask for their support, we will aim to remove any reference to individual patients. Where this is not possible, we will use the minimum necessary to allow us to obtain advice and support.

​You can find out more about Kafico Ltd, including their privacy policy at https://www.kafico.co.uk/privacy-policy

Children and Young People

Young people from aged 13 (and sometimes younger) are allowed to make decisions about how their health information is shared

​A parent or guardian may apply for access to young person’s information

​If a young person does not consent – we may not provide access to the adult.

If the young person does not have the capacity to understand, we may provide access to the adult because it is in the young person’s best interest to do so

​Young people can ask us to keep certain parts of their information confidential

​If the young person is making decisions about their information that puts them at risk – we may notify adults with parental rights

What We Do With Your Information

• Refer you to other healthcare providers when you need other service or tests​
• Discuss or share information about your health or care with other health or social care providers
• ​Share samples with laboratories for testing (like blood samples)
• Share test results with hospitals or community services (like blood test results)
• Allow out of hours or extended hours GPs to look at your health record when you are going to an appointment
• Send prescriptions to a pharmacy
• ​​Text patients in relation to healthcare services
• ​​Samples are provided to the courier for delivery to pathology​​
• Share reports with the coroner
• ​​Receive reports of appointments you have attended elsewhere such as with the community nurse or if you have had a stay in hospital
• ​​Produce medical reports on request from third parties such as the DVLA or your employer
• ​​Movement of Patient records to Primary Care Support England

What Else Do We Use Your Information For?

Along with activities related directly to your care, we also use information in ways which allow us to check that care is safe and provide data for the improvement and planning of services.

• Quality / payment / performance reports are provided to service commissioners
• ​​As part of clinical research – information that identifies you will be removed, unless you have consented to being identified
• ​​Undertaking clinical audits locally to ensure safety and efficiency
• ​​Supporting staff training​​
• Incident and complaint management

Introduction

The NHS is founded on a common set of principles and values that bind together the communities and people it serves, patients & public and the staff who work for it.

This constitution establishes the principles and values of the NHS in England.

It sets out rights to which patients, public and staff are entitled and pledges what the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively.

All NHS bodies and private and third sector providers supplying NHS services are required by law to take account of this constitution in their decisions and actions.

The constitution will be renewed every ten years, with the involvement of the public, patients and staff.

Making it available to patients

The text of the constitution will be incorporated into this practice website and also put on the notice board in the waiting area of the surgeries.

Principles

The practice:

• Provides a comprehensive service, available to all irrespective of age, disability, gender reassignment, race, religion or belief, sex or sexual orientation and has a duty to respect their human rights.
• Promotes equality through the service, providing and to paying particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population.
• Provides access to services based on clinical need, not on an individual’s ability to pay.
• Aspires to the highest standards of excellence and professionalism, providing safe and effective high-quality care focused on patient experience.
• Ensures that it is effectively lead and managed and its staff receive relevant education, training and development.
• Its services reflect the needs and preferences of patients, their families and carers who will be involved in and consulted on all decisions about their care and treatment.
• Ensures that it works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population.
• Is accountable to the public, communities and patients that it serves.

Patient rights

Patients have the right:

• To receive NHS services free of charge, apart from certain limited exceptions sanctioned by parliament.
• To access NHS services and not be refused access on unreasonable grounds.
• To expect the Practice to assess the health requirements of the local community and to commission and put in place the services to meet those needs as considered necessary.
• In certain circumstances to go to other European economic area countries or Switzerland for treatment which would be available through the NHS.
• Not to be unlawfully discriminated against in the provision of NHS services including on grounds of gender, race, religion or belief, sexual orientation, disability (including learning disability or mental illness) or age.
• To access services within maximum waiting times, or to be offered a range of alternative providers if this is not possible.
• To be treated with a professional standard of care, by appropriately qualified and experienced staff, in a properly approved or registered organisation that meets required levels of safety and quality.
• To be treated with dignity and respect, in accordance with their human rights.
• To accept or refuse treatment that is offered, and not to be given any physical examination or treatment unless valid consent has been given.
• To be given information about their proposed treatment in advance, including any significant risks and any alternative treatments which may be available, and the risks involved in doing nothing.
• To privacy and confidentiality and to expect the practice to keep their confidential information safe and secure.
• To access to their own health records.
• To choose their GP practice, and to be accepted by that practice unless there are reasonable grounds to refuse, in which case they will be informed of those reasons.
• To express a preference for using a particular doctor within their GP practice.
• To make choices about their NHS care and to information to support these choices.
• To be involved in discussions and decisions about their healthcare, and to be given information to enable them to do this.
• To be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services.
• To have any complaint you make about NHS services dealt with efficiently, to have it properly investigated, know the outcome and escalate the complaint to the independent health service ombudsman.
• To make a claim for judicial review if they think they have been directly affected by an unlawful act or decision of an NHS body.
• To compensation where they have been harmed by negligent treatment.

Patient Responsibilities

• To make a significant contribution to their own and their family’s, good health and wellbeing and to take some personal responsibility for it.
• To treat NHS staff and other patients with respect and recognise that causing a nuisance or disturbance on NHS premises could result in prosecution.
• To provide accurate information about their health, condition and status.
• To keep appointments, or cancel within reasonable time.
• To follow the course of treatment which they have agreed, and talk to their clinician if they find this difficult.
• To participate in important public health programmes such as vaccination.
• To ensure that those closest to them are aware of their wishes about organ donation.
• To give feedback, both positive and negative, about the treatment and care they have received, including any adverse reactions they may have had.

Practice staff rights

Practice staff have the right:

• To a good working environment with flexible working opportunities, consistent with the needs of patients and with the way that people live their lives.
• To have a fair pay and contract framework.
• To be involved and represented in the workplace.
• To have healthy and safe working conditions and an environment free from harassment, bullying or violence.
• To be treated fairly, equally and free from discrimination.
• To raise an internal grievance and if necessary seek redress, where it is felt that a right has not been upheld.

Practice staff responsibilities

Practice staff have the duty:

• To accept professional accountability and maintain the standards of professional practice as set by the appropriate regulatory body applicable to their profession or role.
• To take reasonable care of health and safety at work for themselves, their team and others, and to cooperate with employers to ensure compliance with health and safety requirements.
• To act in accordance with the express and implied terms of their contract of employment.
• Not to discriminate against patients or staff and to adhere to equal opportunities, equality and human rights legislation.
• To protect the confidentiality of personal information that they hold unless to do so would put anyone at risk of significant harm.
• To be honest and truthful when applying for a job and in carrying out that job.

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.

Respect us, we are here to help!