Policies and Procedures

You can now see your test results and read notes from your appointments in your NHS account.

This will help you see your test results and read notes from your appointments.

What’s changed

You will now be able to see all the information within your health record automatically.

If you are over 16 and have an online NHS account, such as through the NHS App or NHS website, you can now see all your notes from your GP.

For most people, access will be automatic and you won’t need to do anything.

What health information you can see

You will be able to access:

• notes from GP appointments
• test results
• any letters saved on your records

This only applies to records from your GP, not from hospitals or other specialists.

Privacy advice

If you do not want to see your health record or if you have any concerns, please talk to your GP.

The NHS app and website are secure so no one is able to access your information except you.

If you do not have the NHS app or an online account

These changes only apply to people with the NHS app or an online NHS account.

If you do not want an online account, you can still access your health records by asking at reception.

It is difficult to say at what age the child will become competent to make autonomous decisions regarding their healthcare as between the ages of 11-16 this varies from person to person.

In accordance with Article 8 of the General Data Protection Regulation (GDPR) and Part 2, Chapter 2, paragraph 9 of the Data Protection Act 2018 (DPA 2018), from the age of 13, young people are able to provide their own consent and will be able to register for online services.

The procedure for access is the same as per other patients and the form is to be used.

What a DNA is

A DNA appointment is when a patient does not turn up for appointments, and does not contact the surgery to cancel or change the appointment.

This creates a significant strain on the NHS.

We understand that there are situations that can make it impossible for you to cancel your appointment, for example being admitted to hospital.

Our DNA policy

1. If you fail to attend 2 or more appointments in the the previous month, you will get a warning letter.
2. If you’ve had a warning letter and you miss another appointment, you’ll get another letter. This will say that you can only book appointments on the day, and not in advance.
3. If you do not attend same day appointments, we will invite you to discuss a contract and an appointment plan. This will include you calling to confirm an appointment, if not it will be cancelled.

Warning letters last 12 months.

Cancelling appointments

To avoid DNA appointments, you can use the NHS app or online services to cancel your appointments.

You can also get a text reminder of your appointment, and you can reply to this to cancel if necessary. Please make sure we have the right mobile number for you.

Contact us

If you would like to discuss DNAs, please contact the surgery.

Equality and Diversity

The Practice aims to promote equality and diversity and value the benefits this brings. It is our aim to ensure that all staff feel valued and have a fair and equitable quality of working life.

The organisation values the rich diversity, skills and abilities that people from differing backgrounds and experiences bring to the workplace. Implementing and abiding by a policy that provides for diversity and equal opportunities and deters unlawful discrimination is therefore important to this organisation.

Every person working for, or on behalf of, this organisation plays a vital role in implementing its aim to create an inclusive working environment where diversity is welcomed and everyone can work without fear of discrimination.

The purpose of this policy is to set out the aims of the organisation in creating an inclusive working environment, where access to work is based on fair and objective criteria, where there is zero tolerance of unlawful discrimination and clear processes exist in terms of how the organisation supports and works towards its aims.

The organisation also aims to be clear about how it will deal with actions that adversely impact on its stated aims.

A key aspect of creating a diverse workplace, with equal opportunity afforded to all, is the non-toleration of any form of discrimination, direct or indirect, within working arrangements and practices.

The UK General Data Protection Regulation (UK GDPR herein) came into force on 1 January 2021 and is incorporated in the Data Protection Act 2018 (DPA18) at part 2. The UK GDPR applies to all organisations in the UK (with the exception of law enforcement and intelligence agencies) and Lockfield Surgery (LS) must be able to demonstrate compliance at all times. Understanding the requirements of the UK GDPR will ensure that the personal data of both staff and patients is protected accordingly.

At LS, the role of the data controller is to ensure that data is processed in accordance with Article 5 of the UK GDPR. He/she should be able to demonstrate compliance and is responsible for making sure that data is:

• Processed lawfully, fairly and in a transparent manner in relation to the data subject
• Collected for specified, explicit and legitimate purposes and not further processed in a manner that is incompatible with those purposes
• Adequate, relevant and limited to what is necessary in relation to the purposes for which the data is processed
• Accurate and, where necessary, kept up to date; every reasonable step must be taken to ensure that personal data, which is inaccurate, having regard to the purposes for which it is processed, is erased or rectified without delay
• Kept in a form that permits identification of data subjects for no longer than is necessary for the purposes for which the personal data is processed
• Processed in a manner that ensures appropriate security of the personal data, including protection against unauthorised or unlawful processing and against accidental loss, destruction or damage, using appropriate technical or organisational measures

Additional Information

Additional Information in the SCR, such as details of long-term conditions, significant medical history or specific communications needs, is now included by default for patients with an SCR unless they have previously told the NHS that they do not want this information to be shared.

Should a patient not wish to have any additional information shared, they can complete the SCR patient consent preference form.

Further reading can be sought from NHS Digital Additional information on the SCR and a patient information for additional or enhanced summary care records can be found in this poster.

Access to Medical Records

The law states that organisations must, when requested by an individual, give that person access to their personal health information and, occasionally, certain relevant information pertaining to others. In order to do this, they must have procedures in place that allow for easy retrieval and assimilation of this information.

The purpose of this document is to ensure appropriate procedures are in place at Lockfield Surgery (LS)to enable individuals to apply for access to health records (commonly referred to as a medical record), whether online or by requesting a copy, and to enable authorised individuals to apply for access to information held about other people.

Access to medical records can be provided via:

• An online portal linked to the organisation’s webpage
• A variety of NHS approved apps
• A verbal subject access request (SAR)
• A written SAR including email and/or through social media

Sending Text Messages

Convenience allows patients to receive text messages that contain non-sensitive information as part of the routine advice or reminder service at Lockfield surgery.

Whilst this method of communication is time-efficient, improves communication and is particularly beneficial to patients with impaired hearing, the potential to breach patient confidentiality must also be a consideration.

Lockfield surgery uses Accurx to communicate with patients.  All SMS messages are recorded within patients’ healthcare records.

When sending a text message to a patient, staff members must consider the following:

• Consent
• Confidentiality
• Child/age of the recipient
• Content

At Lockfield surgery, consent to communicate via text message is obtained from each patient by means of registration paperwork.

The consent given is noted on the patient’s healthcare record.

Emails

Patients may actively and consistently use email as their preferred method of communication. It is imperative that the patient confirms their email address with Lockfield Surgery enabling LS to verify the accuracy of the information held.

It is the responsibility of the patient to ensure that they provide an up to date email address and all patients must be advised that LS is not responsible for the protection of the information once it has been received by the patient. It is also to be recommended to the patient that they do not use a shared email address for the purpose of communicating with LS so that confidential information will not be seen by family members.

Additionally, patients are to be advised that internet email accounts are not secure and that there is a risk of their email being hacked (albeit a small risk). Again, LS will not accept any responsibility for the loss of confidential information should a patient’s email account be hacked.

Generic Email Address

Will only communicate with patients from the following email address:

[email protected]

Staff are not to communicate with patients from their individual @nhs.net email account. This provides reassurance to patients that the email they have received is legitimate.

LS will ensure it sends an automated response indicating that the email has been received. The following response will be sent:

“This email address is for GENERAL ENQUIRIES and PRESCRIPTIONS and PATIENT PARTICIPATION ENQUIRIES ONLY Many Thanks Lockfield Surgery.

This is not for same day response or enquiries, ring 01902639000 if same day response is needed”.

We respect your right to privacy and keep all your health information confidential and secure. It is important that the NHS keeps accurate and up-to-date records about your health and treatment so that those treating you can give you the best possible care.

This information may be used for management and audit purposes. However, it is usually only available to, and used by, those involved in your care. You have the right to know what information we hold about you. If you would like to see your records please contact the Practice Manager.

Your confidentiality is important to us

You can be sure that anything you discuss with any member of this practice – family doctor, nurse, receptionist – will stay confidential.

Even if you are under 16 nothing will be said to anyone – including parents, other family members, carer workers or tutors – without your permission. The only reason why we might want to consider passing on confidential information without your permission, would be to protect you or someone else from serious harm. We would always try to discuss this with you first.

If you are being treated elsewhere – for example at a hospital or Brook centre – it is best if you allow the doctor or nurse to inform the practice of any treatment you are receiving.

If you have any worries about confidentiality please feel free to ask a member of staff.

Patients aged 40 –74  are entitled to a free NHS health check with a HCA. Patients aged over 75 and have not seen a doctor/nurse in the previous 12 months may request a health check with a HCA. All patients are entitled to have a chaperone present for any consultation, examination or procedure where they consider one is required. All practice staff who are able to act as a chaperone have been fully trained. Responsibilities: Arrive on time for your appointments. Inform the practice of your intention to cancel an appointment in good time.

Once a patient has registered and the request has been processed, they are to be issued with a letter that includes their unique username, password and instructions on how to access the online services.

At Lockfield surgery, patients access online services using the following:

·         Patient Access

·         NHS App

General practice data for planning and research (GPDfPR)

NHS Digital has been collecting data from GPs through its trusted General Practice Extraction Service.

This system is now being replaced with their new General Practice Data for Planning and Research (GPDPR) service, a broader general-purpose collection which will enable faster access to pseudonymised patient data for planners and researchers.

The NHS needs data about the patients it treats in order to plan and deliver its services and to ensure that care and treatment provided is safe and effective. The General Practice Data for Planning and Research data collection will help the NHS to improve health and care services for everyone by collecting patient data that can be used to do this.

GP practices already share patient data for these purposes, but this new data collection will be more efficient and effective.

This means that GPs can get on with looking after their patients, and NHS Digital can provide controlled access to patient data to the NHS and other organisations who need to use it, to improve health and care for everyone.

Opting out of NHS Digital collecting your data (‘Type 1 opt-out’)

If you do not want your identifiable patient data to be shared outside of your GP practice for purposes except for your own care, you can register an opt-out with your GP practice. This is known as a Type 1 opt-out.

Type 1 opt-outs were introduced in 2013 for data sharing from GP practices, but may be discontinued in the future as a new opt-out has since been introduced to cover the broader health and care system, called the National Data Opt-out. If this happens people who have registered a Type 1 Opt-out will be informed.

NHS Digital will not collect any patient data for patients who have already registered a Type 1 opt-out in line with current policy. If this changes patients who have registered a Type 1 opt-out will be informed.

How to register a Type 1 opt-out

To register a Type 1 opt-out you need to do the following.

1. Download the Type 1 opt-out form from the NHS website
2. Complete the form and return it to your GP practice – you can do this by post or email, or leave it in person.

You can also contact us for a form to be sent out to you.

You can register a Type 1 opt-out at any time. You can also change your mind at any time and withdraw a Type 1 opt-out. If you have already registered a Type 1 opt-out with your GP practice your data will not be shared with NHS Digital.

If you have previously registered a Type 1 opt-out and you would like to withdraw this, you can also use the form to do this.

Patients have the right to grant a carer, relative, responsible adult or partner access to their online services. The patient can limit which online services they want the nominated individual to access. Patients are to be advised that they should not share their own login details with anyone. The nominated individual will be issued with separate login details to access the online services for their partner, relative or person they are caring for.

To obtain proxy access a person must be registered for online access at Lockfield surgery where the patient they are acting for is registered.

The nominated individual is to complete the online services registration form. Should Lockfield surgery opt not to grant the person access to your individual record, the Admin Person will contact the patient and advise them of the reasons why this decision has been reached.

Parents may request proxy access to their child’s detailed care records until the child reaches the age of 11, when this will automatically cease. Subsequent proxy access will need to be authorised by the patient (subject to a competency test). In addition, parental proxy access may be reinstated if, after discussion with the parent(s) requesting access, the child’s GP believes that proxy access would be in the child’s best interest.

Patients who wish to register for online services in order to book or cancel appointments, order repeat prescriptions, view summary records and clinical correspondence online are to complete the registration form.

ID verification is required to ensure that access is granted only to the patient or their authorised representative(s). All patients will be requested to provide two forms of ID verification in line with the NHS Good Practice Guidance on Identity Verification, and Lockfield surgery accepts the following forms of ID:

·         Photo ID (passport or driving licence)

·         Proof of address (bank statement or utility bill)

Only the completed registration form will be scanned into the individual’s healthcare record. Staff are to remind patients that GP online services are free and available to all registered patients.

At Lockfield surgery it takes approximately [seven] days to process online service requests.

As an employer, the practice has a duty to care for the health and safety of its staff.

The practice also has a legal responsibility to provide a safe and secure working environment for staff.

All patients are expected to behave in an acceptable manner and violent or abusive behaviour towards staff or patients may result in removal from our practice list or even criminal proceedings. The practice follows the NHS guidance concerning zero tolerance.

The practice has a policy of zero tolerance of verbal and physical violence towards GPs, staff or other patients.

The practice will request the removal of any patient from the practice list who is aggressive or abusive towards a doctor, member of staff, other patient, or who damages property.

We report all physical abuse to the police as an assault.

We expect all patients to be responsible and avoid attending the surgery under the influence of alcohol or illegal drugs.

Any alteration of prescriptions is illegal and will not be tolerated.

If you’re unhappy with the quality of service you have the right to register with another practice without notifying us.

On the very rare occasions when a patient repeatedly ignores their responsibilities to the Practice, we have the right to remove the patient from our Practice list.

Unacceptable behaviour

Examples of unacceptable behaviour include:

• violence
• excessive noise eg recurrent loud or intrusive conversation or shouting
• threatening or abusive language involving swearing or offence remarks
• derogatory racial or sexual remarks
• malicious allegations relating to members of staff, other patients or visitors
• offensive sexual gestures or behaviours
• abusing alcohol or drugs on practice premises
• drug dealing on practice premises
• wilful damage to practice property
• threats or threatening behaviour
• theft

Zero tolerance

Our staff have the right to be treated with dignity and respect at all times.

They should be able to do their jobs without being physically or verbally abused.

Anyone found abusing the staff in person or on the telephone will be asked to leave the practice.

This behaviour will not be tolerated.

Removal from the patient list

In exceptional circumstances, a breakdown may occur between a doctor and their patient.

If the breakdown is serious, for example physical or verbal abuse to any member of the practice team, the doctors may feel that the relationship has been compromised.

We may take steps to remove the patient from the doctor’s list. Where possible, we prefer to discuss with the patient to try to find a solution.

We give reasons for removal in writing.