Practice Policies & Patient Information
Access to Records
In accordance with the Data Protection Act 1998 and Access to Health Records Act, patients may request to see their medical records. Such requests should be made through the practice manager and may be subject to an administration charge. No information will be released without the patient consent unless we are legally obliged to do so.
Anti-discrimination Policy
The Spring Hall Medical Practice does not discriminate on grounds of race, gender, disability, social class, age, sexual orientation or medical condition. The practice does not normally refuse patients. However, it does not tolerate violence, theft or abusive language.
Care Data
CARE.DATA Roll out has been suspended until the Autumn to allow for further consultation.
Information about you and the care you receive is shared, in a secure system, by healthcare staff to support your treatment and care.
It is important that we, the NHS, can use this information to plan and improve services for all patients. We would like to link information from all the different places where you receive care, such as your GP, hospital and community service, to help us provide a full picture. This will allow us to compare the care you received in one area against the care you received in another, so we can see what has worked best.
Information such as your postcode and NHS number, but not your name, will be used to link your records in a secure system, so your identity is protected. Information which does not reveal your identity can then be used by others, such as researchers and those planning health services, to make sure we provide the best care possible for everyone.
You have a choice. If you are happy for your information to be used in this way you do not have to do anything. If you have any concerns or wish to prevent this from happening, please speak to practice staff or download a copy of the leaflet “How information about you helps us to provide better care” below.
We need to make sure that you know this is happening and the choices you have.
Care Quality Commission
The Care Quality Commission (CQC) are the independent regulator of health and adult social care in England.
The CQC make sure health and social care services provide people with safe, effective, compassionate, high-quality care and encourage them to improve.
They monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and publish what is found, including performance ratings to help people choose care.
Our GP Practice has recently undergone a CQC inspection and the results are now freely available on the CQC Website. You can access the report below.
Clinical Practice Research Datalink
This practice contributes to the Clinical Practice Research Datalink
Information in patient records is important for medical research to develop new treatments and test the safety of medicines. This practice supports medical research by sending some of the information from patient records to the Clinical Practice Research Datalink (CPRD).
CPRD is a Government organisation that provides anonymised patient data for research to improve patient and public health. Identifiable data flows to NHS Digital but you cannot be identified from the information sent to CPRD.
If you do not want anonymised information from your patient record to be used in research you can opt out by speaking to one of our team.
For more information about how your data is used visit www.cprd.com/public
Complaints
We make every effort to give the best service possible to everyone who attends our practice.
However, we are aware that things can go wrong resulting in a patient feeling that they have a genuine cause for complaint. If this is so, we would wish for the matter to be settled as quickly, and as amicably, as possible.
To pursue a complaint please review the complaints leaflet (Complaints leaflet Spring Hall March 2023) and complete the form attached. The completed form should be sent for the attention of the practice manager who will investigate your concerns appropriately. Written information is also available regarding the complaint’s procedure from reception. If you wish to email your completed complaints form, the correct email address to send it to is [email protected]
Click here to download our Complaints Policy
Confidentiality & Medical Records
The practice complies with data protection and access to medical records legislation. Identifiable information about you will be shared with others in the following circumstances:
- To provide further medical treatment for you e.g. from district nurses and hospital services.
- To help you get other services e.g. from the social work department. This requires your consent.
- When we have a duty to others e.g. in child protection cases anonymous patient information will also be used at local and national level to help the Health Board and Government plan services e.g. for diabetic care.
If you do not wish anonymous information about you to be used in such a way, please let us know.
Reception and administration staff require access to your medical records in order to do their jobs. These members of staff are bound by the same rules of confidentiality as the medical staff.
Consent policy
Introduction
The purpose of this protocol is to set out the Practice’s approach to consent and the way in which the principles of consent will be put into practise. It is not a detailed legal or procedural resource due to the complexity and nature of the issues surrounding consent.
Where possible, a clinician must be satisfied that a patient understands and consents to a proposed treatment, immunisation or investigation. This will include the nature, purpose, and risks of the procedure, if necessary by the use of drawings, interpreters, videos or other means to ensure that the patient understands, and has enough information to give ‘Informed Consent’.
Implied Consent
Implied consent will be assumed for many routine physical contacts with patients. Where implied consent is to be assumed by the clinician, in all cases, the following will apply:
- An explanation will be given to the patient what he / she is about to do, and why.
- The explanation will be sufficient for the patient to understand the procedure.
- In all cases where the patient is under 18 years of age a verbal confirmation of consent will be obtained and briefly entered into the medical record.
- Where there is a significant risk to the patient an “Expressed Consent” will be obtained in all cases (see below).
Expressed Consent
Expressed consent (written or verbal) will be obtained for any procedure which carries a risk that the patient is likely to consider as being substantial. A note will be made in the medical record detailing the discussion about the consent and the risks. A Consent Form may be used for the patient to express consent (see below).
Obtaining Consent
- Consent (Implied or Expressed) will be obtained prior to the procedure, and prior to any form of sedation.
- The clinician will ensure that the patient is competent to provide a consent (16 years or over) or has “Gillick Competence” if under 16 years. Further information about Gillick Competence and obtaining consent for children is set out below.
- Consent will include the provision of all information relevant to the treatment.
- Questions posed by the patient will be answered honestly, and information necessary for the informed decision will not be withheld unless there is a specific reason to withhold. In all cases where information is withheld then the decision will be recorded in the clinical record.
- The person who obtains the consent will be the person who carries out the procedure (i.e. a nurse carrying out a procedure will not rely on a consent obtained by a doctor unless the nurse was present at the time of the consent).
- The person obtaining consent will be fully qualified and will be knowledgeable about the procedure and the associated risks.
- The scope of the authority provided by the patient will not be exceeded unless in an emergency.
- The practice acknowledges the right of the patient to refuse consent, delay the consent, seek further information, limit the consent, or ask for a chaperone.
- Clinicians will use a Consent Form where procedures carry a degree of risk or where, for other reasons, they consider it appropriate to do so (e.g. malicious patients).
- No alterations will be made to a Consent Form once it has been signed by a patient.
- Clinicians will ensure that consents are freely given and not under duress (e.g. under pressure from other present family members etc.).
- If a patient is mentally competent to give consent but is physically unable to sign the Consent Form the clinician should complete the Form as usual, and ask an independent witness to confirm that the patient has given consent orally or non-verbally.
Other aspects which may be explained by the clinician include:
- Details of the diagnosis, prognosis, and implications if the condition is left untreated
- Options for treatment, including the option not to treat.
- Details of any subsidiary treatments (e.g. pain relief)
- Patient experiences during and after the treatment, including common or potential side effects and the recovery process.
- Probability of success and the possibility of further treatments.
- The option of a second opinion
Immunisations
Informed consent must be obtained prior to giving an immunisation. There is no legal requirement for consent to immunisation to be in writing and a signature on a consent form is not conclusive proof that consent has been given, but serves to record the decision and discussions that have taken place with the patient, or the person giving consent on a child’s behalf.
Consent for children
Everyone aged 16 or more is presumed to be competent to give consent for themselves, unless the opposite is demonstrated. If a child under the age of 16 has “sufficient understanding and intelligence to enable him/her to understand fully what is proposed” (known as Gillick Competence), then he/she will be competent to give consent for him/herself. Young people aged 16 and 17, and legally ‘competent’ younger children, may therefore sign a Consent Form for themselves, but may like a parent to countersign as well.
For children under 16 (except for those who have Gillick Competence as noted above), someone with parental responsibility should give consent on the child’s behalf by signing accordingly on the Consent Form
COVID 19 Privacy Notice
Freedom of Information
Information about the General Practioners and the practice required for disclosure under this act can be made available to the public. All requests for such information should be made to the practice manager.
General Practice Privacy Notice
GDPR Privacy Notice for Patients GP Privacy Notice
GDPR Privacy Notice for Children GDPR Privacy Notice Children
ACR project for patients with diabetes
A programme sponsored by NHS Digital to monitor urine albumin:creatinine ratio (ACR) annually for patients with diabetes. This enables patients with diabetes to test their kidney function from home. We will share your contact details with Healthy.io to enable them to contact you and confirm that you wish them to send you a test kit. This will help identify patients at risk of kidney disease and help us agree any early interventions that can be put in place for the benefit of your care. If you do not wish to be contacted by Healthy.io, you have the opportunity to say so by replying to the initial text message sent from the practice or when Healthy.io contact you. If you do not wish to receive any further information from Healthy.io then they will delete any data that they hold about you and we will continue to manage your care within the Practice. Further information about this is available at: http://bit.ly/testACR.
GP Net Earnings
NHS England require that the net earnings of doctors engaged in the practice is publicised, and the required disclosure is shown below. However it should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice, and should not be used to form any judgement about GP earnings, nor to make any comparison with any other practice.
SPRING HALL GROUP PRACTICE PUBLICATION OF EARNINGS 2022/23
All GP practices are required to declare the mean earnings (e.g. average) for GPs working to deliver NHS services to patients at each practice.
Named GP
All patients regsitered at the practice now have a named GP (the one you are registered with). You are still able to see the GP of your choice as before.
All patients now have a named GP (the one you are registered with) who is responsible for your overall care at the practice. You are still able to see the GP of your choice as before. If you are unsure who your named GP is and have not been contacted yet please call the surgery and the receptionists will be happy to advise.
Patient Data Opt Out – GDPR
National Data Opt Out
Please see the attached document regarding opting out of data sharing.
Statement of Intent – IT & Electronic Patient Records
New contractual requirements came into force on 1 April 2014 requiring that GP practices should make available a statement of intent in relation to the following IT developments.
Statement of Purpose
This is the statement of purpose for Spring Hall Group Practice which details the full name and address of the provider and all branch sites, the legal status of the provider, the aims and objectives of the provider and the range of services provided to its patients.
Summary Care Record
There is a new Central NHS Computer System called the Summary Care Record (SCR). It is an electronic record which contains information about the medicines you take, allergies you suffer from and any bad reactions to medicines you have had.
Why do I need a Summary Care Record?
Storing information in one place makes it easier for healthcare staff to treat you in an emergency, or when your GP practice is closed.
This information could make a difference to how a doctor decides to care for you, for example which medicines they choose to prescribe for you.
Who can see it?
Only healthcare staff involved in your care can see your Summary Care Record.
How do I know if I have one?
Over half of the population of England now have a Summary Care Record. You can find out whether Summary Care Records have come to your area by looking at our interactive map or by asking your GP
Do I have to have one?
No, it is not compulsory. If you choose to opt out of the scheme, then you will need to complete a form and bring it along to the surgery. You can use the form at the foot of this page.
More Information
For further information visit the NHS Care records website
Violence Policy
The NHS operate a zero tolerance policy with regard to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons. Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.