Unacceptable Actions Policy

We believe that patients have a right to be heard, understood and respected. We work hard to be open and accessible to everyone. Occasionally, the behaviour or actions of individuals using our Practice makes it very difficult for us to deal with their issue or complaint. In a small number of cases the actions of individuals become unacceptable because they involve abuse of our staff or our process. When this happens we have to take action to protect our staff, and must also consider the impact of the individuals behaviour on our ability to do our work and provide a service to others. This Policy explains how we will approach these situations.

Section 1 – What actions does the Practice consider to be unacceptable?

People may act out of character in times of trouble or distress. There may have been upsetting or distressing circumstances leading up to us being made aware of an issue or complaint. We do not view behaviour as unacceptable just because a patient is forceful or determined. In fact, we accept that being persistent may sometimes be a positive advantage when pursuing an issue or complaint. However, we do consider actions that result in unreasonable demands on our Practice or unreasonable behaviour towards Practice staff to be unacceptable. It is these actions that we aim to manage under this Policy.

Section 2 – Aggressive or abusive behaviour

We understand that patients may be angry about the issues they have raised with the Practice. If that anger escalates into aggression towards Practice staff, we consider that unacceptable. Any violence or abuse towards staff will not be accepted. Violence is not restricted to acts of aggression that may result in physical harm. It also includes behaviour or language (whether verbal or written) that may cause staff to feel offended, afraid, threatened or abused. We will judge each situation individually, and appreciate individuals who come to us may be upset.

Language which is designed to insult or degrade, is derogatory, racist, sexist, transphobic, or homophobic or which makes serious allegations that individuals have committed criminal, corrupt, perverse or unprofessional conduct of any kind, without any evidence, is unacceptable.

We may decide that comments aimed not at us, but at third parties, are unacceptable because of the effect that listening or reading them may have on our staff.

Section 3 – Unreasonable demands

A demand becomes unacceptable when it starts to (or when complying with the demand would) impact substantially on the work of the Practice. Examples of actions grouped under this heading include:

Repeatedly demanding responses within an unreasonable timescale
Repeatedly requesting early supplies of medication
Repeatedly requesting further supplies of stolen medication, without the required Police Incident number
Repeatedly ordering prescriptions outwith the set timeframe
Insisting on seeing or speaking to a particular member of staff when that is not possible
Repeatedly changing the substance of an issue or complaint or raising unrelated concerns
Repeatedly insisting on a course of medical treatment for which there is no clinical evidence
Not ensuring that a review appointment is in place, prior to ongoing medication finishing
An example of such impact would be that the demand takes up an excessive amount of staff time and in so doing disadvantages other patients

Section 4 – Unreasonable levels of contact

Sometimes the volume and duration of contact made to our Practice by an individual causes problems. This can occur over a short period, for example, a number of calls in one day or one hour. It may occur over the life-span of an issue when a patient repeatedly makes long telephone calls to us, or inundates us with letters or copies of information that have been sent already or that are irrelevant to the issue. We consider that the level of contact has become unacceptable when the amount of time spent talking to a patient on the telephone, or responding to, reviewing and filing emails or written correspondence impacts on our ability to deal with that issue, or with other Patients’ needs.

Section 5 – Unreasonable refusal to co-operate

When we are looking at an issue or complaint, we will ask the patient to work with us. This can include agreeing with us the issues or complaint we will look at; providing us with further information, evidence or comments on request; or helping us by summarising their concerns or completing a form for us.

Sometimes, a patient repeatedly refuses to cooperate and this makes it difficult for us to proceed. We will always seek to assist someone if they have a specific, genuine difficulty complying with a request. However, we consider it is unreasonable to bring an issue to us and then not respond to reasonable requests.

Section 6 – Unreasonable use of the complaints process

Individuals with complaints about the Practice have the right to pursue their concerns through a range of means. They also have the right to complain more than once about the Practice, if subsequent incidents occur. This contact becomes unreasonable when the effect of the repeated complaints is to harass, or to prevent us from pursuing a legitimate aim or implementing a legitimate decision. We consider access to a complaints system to be important and it will only be in exceptional circumstances that we would consider such repeated use is unacceptable – but we reserve the right to do so in such cases.

Section 7 – Examples of how we manage aggressive or abusive behaviour

The threat or use of physical violence, verbal abuse or harassment towards the Practice staff is likely to result in a warning from the Senior Management Team. We may report incidents to the Police – this will always be the case if physical violence is used or threatened.
Practice staff will end telephone calls if they consider the caller aggressive, abusive or offensive. Practice staff have the right to make this decision, to tell the caller that their behaviour is unacceptable and end the call if the behaviour persists.
We will not respond to correspondence (in any format) that contains statements that are abusive to staff or contain allegations that lack substantive evidence. Where we can, we will return the correspondence. We will explain why and say that we consider the language used to be offensive, unnecessary and unhelpful and ask the sender to stop using such language. We will state that we will not respond to their correspondence if the action or behaviour continues and may consider issuing a warning to the Patient.

Section 8 – Examples of how we deal with other categories of unreasonable behaviour

We have to take action when unreasonable behaviour impairs the functioning of our Practice. We aim to do this in a way that allows a Patient to progress through our process. We will try to ensure that any action we take is the minimum required to solve the problem, taking into account relevant personal circumstances including the seriousness of the issue(s) or complaint and the needs of the individual.

Section 9 – Other actions we may take

Where a patient repeatedly phones, visits the Practice, raises repeated issues, or sends large numbers of documents where their relevance isn’t clear, we may decide to:

limit contact to telephone calls from the patient at set times on set days, about the issues raised
restrict contact to a nominated member of the Practice staff who will deal with future calls or correspondence from the patient about their issues
see the patient by appointment only
restrict contact from the patient to writing only regarding the issues raised
return any documents to the patient or, in extreme cases, advise the patient that further irrelevant documents will be destroyed
take any other action that we consider appropriate

Where we consider continued correspondence on a wide range of issues to be excessive, we may tell the patient that only a certain number of issues will be considered in a given period and ask them to limit or focus their requests accordingly. In exceptional cases, we reserve the right to refuse to consider an issue, or future issues or complaints from an individual. We will take into account the impact on the individual and also whether there would be a broader public interest in considering the issue or complaint further. We will always tell the patient what action we are taking and why.

Section 10 – The process we follow to make decisions about unreasonable behaviour

Any member of the Practice staff who directly experiences aggressive or abusive behaviour from a Patient has the authority to deal immediately with that behaviour in a manner they consider appropriate to the situation and in line with this Policy
With the exception of such immediate decisions taken at the time of an incident, decisions to issue a warning or remove patients from our Practice List are only taken after careful consideration of the situation by the Senior Management
Wherever possible, we will give a patient the opportunity to change their behaviour or actions before a decision is taken

Section 11 – How we let people know we have made this decision

When a Practice employee makes an immediate decision in response to offensive, aggressive or abusive behaviour, the patient is advised at the time of the incident. When a decision has been made by Senior Management, a patient will always be given the reason in writing as to why a decision has been made to issue a warning (including the
duration and terms of the warning) or remove them from the Practice list. This ensures that the patient has a record of the decision.

Section 12 – How we record and review a decision to issue a warning

We record all incidents of unacceptable actions by patients. Where it is decided to issue a warning to a patient, an entry noting this is made in the relevant file and on appropriate computer records. Each quarter a report on all restrictions will be presented to our Senior Management Team so that they can ensure the policy is being applied appropriately. A decision to issue a warning to a patient as described above may be reconsidered either on request or on review.

Section 13 – The process for appealing a decision

It is important that a decision can be reconsidered. A patient can appeal a decision about the issuance of a warning or removal from the Practice list. If they do this, we will only consider arguments that relate to the warning or removal, and not to either the issue or complaint made to us, or to our decision to close a complaint.

An appeal could include, for example, a patient saying that: their actions were wrongly identified as unacceptable; the warning was disproportionate; or that it will adversely impact on the individual because of personal circumstances.

The Practice Manager or a GP Partner who was not involved in the original decision will consider the appeal. They have discretion to quash or vary the warning as they think best. They will make their decision based on the evidence available to them. They must advise the patient in writing that either the warning or removal still applies or a different course of action has been agreed. We may review the warning periodically or on further request after a period of time has passed. Each case is different.

This policy is subject to review

Safeguarding Children

Our Primary Care Team is committed to safeguarding children. The safety and welfare of children who come into contact with our services either directly or indirectly is paramount, and all staff have a responsibility to ensure that Best Practice is followed, including compliance with statutory requirements.

We are committed to a Best Practice which safeguards children and young people irrespective of their background, and which recognises that a child may be abused regardless of their age, gender, religious beliefs, racial origin or ethnic identity, culture, class, disability or sexual orientation.

The Primary Care Team are committed to working within agreed policies and procedures and in partnership with other agencies, to ensure that the risks of harm to a child or young person are minimised. This work may include direct and indirect contact with children, access to patient’s details and communication via email or text message/telephone.

Our Surgery is supported by the CCG who have designated Nurses and Doctors in post who offer professional expertise and advice regarding safeguarding children.

Further information about Safeguarding

Named GP Policy

As part of the NHS commitment to providing more personalised care, from June 2015 all practices are required to provide all their Patients with a named GP who will have overall responsibility for the care and support that our surgery provides.

This will not impact your experience at the practice, the provision of appointments, your treatment, or which GP you can see
You may wonder why your allocated GP is not necessarily the one you see most regularly. Please be assured that you can still access all of our medical team in exactly the same way as before
Having a named GP does not guarantee you will always be seen by that GP
Please note that the GP responsible for your care may be subject to change and reallocation in the future

You do not need to take any further action, but if you have any questions or wish to know your named GP, please speak to a member of the reception team.

What does ‘accountable’ mean?

This is largely a role of oversight, with the requirements being introduced to reassure patients that they have one GP within the practice who is responsible for ensuring that this work is carried out on their behalf.

What are the named GP’s responsibilities to 75s and over?

This is unchanged from 2014-2015; for patients aged 75 and over the named accountable GP is responsible for:

working with relevant associated health and social care professionals to deliver a multi-disciplinary care package that meets the needs of the patient
ensuring that these patients have access to a health check as set out in section 7.9 of the GMS Contract Regulations.

Does the requirement mean 24-hour responsibility for patients? No. The named GP will not:

take on vicarious responsibility for the work of other doctors or health professional
take on 24-hour responsibility for the patient, or have to change their working hours. The requirement does not imply personal availability for GPs throughout the working week
be the only GP or clinician who will provide care to that patient

Can patients choose their own named GP

In the first instance, patients should simply be allocated a named GP. However, if a patient requests a particular GP, reasonable efforts should be made to accommodate their preference, recognising that there are occasions when the practice may not feel the patient’s preference is suitable.

Do patients have to see the named GP when they book an appointment with the practice?

No. Patients can and should feel free to choose to see any GP or nurse in the practice in line with current arrangements. However, some practices may see this change as a way to encourage and promote a greater degree of continuity of care for patients.

Equality and Diversity

Our Policy is designed to ensure and promote equality and inclusion, supporting the ethos and requirements of the Equality Act 2010 for all visitors to our Practice.

We are committed to:

ensuring that all visitors are treated with dignity and respect
promoting equality of opportunity between men and women
not tolerating any discrimination or perceived discrimination against, or harassment of, any visitor for reason of age, sex, gender, marital status, pregnancy, race, ethnicity, disability, sexual orientation, religion or belief
providing the same treatment and services (including the ability to register with the Practice) to any visitor irrespective of age, sex, marital status, pregnancy, race, ethnicity, disability, sexual orientation, medical condition, religion or belief
This Policy applies to the general public, including all patients and their families, visitors and contractors

Procedure

Discrimination by the Practice or Visitors / patients against you

If you feel discriminated against:

You should bring the matter to the attention of the Practice Manager
The Practice Manager will investigate the matter thoroughly and confidentially within 14 working days
The Practice Manager will establish the facts and decide whether or not discrimination has taken place, and advise you of the outcome of the investigation within 14 working days
If you are not satisfied with the outcome, you should raise a formal complaint through our Complaints Procedure

Discrimination against our Practice staff

The Practice will not tolerate any form of discrimination or harassment of our staff by any visitor. Any visitor who expresses any form of discrimination against or harassment of any member of our staff will be required to leave the Practice premises immediately. If the visitor is a patient they may also, at the discretion of the Practice Management, be removed from the Practice list if any such behaviour occurs.

Duty of Candour

We share a common purpose with our partners in health and social care – and that is to provide high quality care and ensure the best possible outcomes for the people who use our services. Promoting improvement is at the heart of what we do.

We endeavour to provide a first class service at all times but sometimes things go wrong and our service may fall below our expected levels.

In order to comply with Regulation 20 of the Health and Social Care Act 2008 (Regulations 2014) we pledge to:

Have a culture of openness and honesty at all levels
Inform patients in a timely manner when safety incidents have occurred which may affect them
Provide a written and truthful account of the incident, explaining any investigations and enquiries made
Provide a written apology
Provide support if you are affected directly by an incident.

Consent Protocol

Consent to treatment is the principle that a person must give permission before they receive any type of medical treatment, test or examination and is generally requested on the basis that an explanation of the required treatment, test or procedure has been received from a Clinician.

Consent from a patient is needed regardless of the procedure, whether it’s a physical examination, organ donation or something else.

The principle of consent is an important part of medical ethics and international human rights law.

Defining consent

For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision.

These terms are explained below:

voluntary– the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family
informed– the person must be given all of the information in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment doesn’t go ahead
capacity– the person must be capable of giving consent, which means they understand the information given to them and they can use it to make an informed decision

If an adult has the capacity to make a voluntary and informed decision to consent to or refuse a particular treatment, their decision must be respected.This is still the case even if refusing treatment would result in their death, or the death of their unborn child.

If a person doesn’t have the capacity to make a decision about their treatment, the Healthcare Professionals treating them can go ahead and give treatment if they believe it’s in the person’s best interests.

Clinicians must however take reasonable steps to seek advice from the patient’s friends or relatives before making these decisions.

How consent is given

Consent can be given:

verbally– for example, by saying you are happy to have an X-ray
in writing– for example, by signing a Consent Form for surgery to be performed

Someone could also give non-verbal consent, as long as they understand the treatment or examination about to take place – for example, holding out an arm for a blood test.

Consent should be given to the Healthcare Professional directly responsible for the person’s current treatment, such as:

a Nurse arranging a blood test
a GP prescribing new medication
a Surgeon planning an operation

If someone is going to have a major medical procedure such as an operation, their consent should ideally be secured plenty of time in advance, so that they have time to obtain information about the procedure and ask questions.

If a patient changes their mind at any point before the procedure, they are entitled to withdraw their previous consent.

Consent from children and young people

If they’re able to, consent is usually given by patients themselves. However, someone with parental responsibility may need to give consent for a child up to the age of 16 to have treatment.

When consent isn’t needed

There are a few exceptions when treatment may be able to go ahead without the person’s consent, even if they’re capable of giving their permission.

It may not be necessary to obtain consent if a person:

requires emergency treatment to save their life, but they’re incapacitated (for example, they’re unconscious) – the reasons why treatment was necessary should be fully explained once they’ve recovered
immediately requires an additional emergency procedure during an operation – there has to be a clear medical reason why it would be unsafe to wait to obtain consent, and it can’t be simply for convenience
with a severe mental health condition such as schizophrenia, bipolar disorder or dementia, lacks the capacity to consent to the treatment of their mental health (under the Mental Health Act 1983) – in these cases, treatment for unrelated physical conditions still requires consent, which the patient may be able to provide, despite their mental illness
requires Hospital treatment for a severe mental health condition, but self-harmed or attempted suicide while competent and is refusing treatment (under the Mental Health Act 1983) – the person’s nearest relative or an approved Social Worker must make an application for the person to be forcibly kept in Hospital, and two Doctors must assess the person’s condition
is a risk to public health as a result of rabies, cholera or tuberculosis (TB)
is severely ill and living in unhygienic conditions (under the National Assistance Act 1948) – a person who is severely ill or infirm and is living in unsanitary conditions can be taken to a place of care without their consent

You can always talk to the clinician providing you with care if you have any concerns in relation to consent.

Consent and life-sustaining treatments

A person may be being kept alive with supportive treatments – such as lung ventilation – without having made an advance decision based on information which outlined the care that they may have refused to receive.

In these cases, a decision about continuing or stopping treatment needs to be made based on what that person’s best interests are believed to be.

To help reach a decision, the Healthcare Professionals responsible for the person’s care should discuss the issue with the relatives and friends of the person receiving the treatment.

They should consider, among other things:

what the person’s quality of life will be if treatment is continued
how long the person may live if treatment is continued
whether there’s any chance of the person recovering

Treatment can be withdrawn if there’s an agreement that continuing treatment isn’t in the person’s best interests.

The case will be referred to the Courts before further action is taken if:

an agreement can’t be reached
a decision has to be made on whether to withdraw treatment from someone who has been in a state of impaired consciousness for a long time (usually at least 12 months)

It’s important to note the difference between withdrawing a person’s life support and taking a deliberate action to make them die. For example, injecting a lethal drug would illegal.

Complaints

If you believe you’ve received treatment you didn’t consent to, you can make an official complaint, please write to the Practice Manager, who will assist you with this process.

NHS England Consent – Further information

Clinical Research

Clinical Trials help Doctors understand how to treat a particular disease or condition. It may benefit you, or others like you, in the future.

If you take part in a Clinical Trial, you may be one of the first people to benefit from a new treatment.

However, if you do take part you should also be aware that there is a chance that the new treatment turns out to be no better, or worse, than the existing standard treatment.

Chaperones

Our Practice is committed to providing a safe, comfortable environment where patients and staff can be confident that best practice is being followed at all times; the safety of everyone is of paramount importance.

All medical consultations, examinations and investigations are potentially distressing. Patients can find examinations, investigations or photography involving the breasts, genitalia or rectum particularly intrusive (these examinations are collectively referred to as ‘intimate examinations’). Consultations involving dimmed lights, the need for patients to undress or intensive periods of being touched may also make a patient feel vulnerable.

Chaperoning is the process of having a third person present during such consultations to provide support, both emotional and sometimes physical, to the patient, to provide practical support to the Doctor as required, and also to protect the Doctor against allegations of improper behaviour during such consultations.

Privacy Policy

Our Practice aims to ensure the highest standard of medical care for our patients and we are committed to protecting and respecting your privacy. To do this we keep records about you, your health and the care we have provided, or plan to provide, to you. This Privacy Policy does not provide exhaustive details of all aspect of the collection and use of personal information by the practice. However, we are happy to provide any additional information or explanation needed.

Introduction

This is a notice to inform you of our Policy about all information that we record about you. It sets out the conditions under which we may process any information that we collect from you, or that you provide to us. It covers information that could identify you (personal information) and information that could not. In the context of the law and this notice, ‘process’ means collect, store, transfer, use or otherwise act on information
We regret that if there are one or more points below with which you are not happy, your only recourse is to leave our website immediately
We take seriously the protection of your privacy and confidentiality. We understand that all visitors to our website are entitled to know that their personal data will not be used for any purpose unintended by them, and will not accidentally fall into the hands of a third party.
We undertake to preserve the confidentiality of all information you provide to us, and hope that you reciprocate
Our Policy complies with UK law accordingly implemented, including that required by the EU General Data Protection Regulation (GDPR)
The Law requires us to tell you about your rights and our obligations to you with regards to the processing and control of your personal data. We do this now, by requesting that you read the information provided at Know Your Privacy Rights
Except as set out below, we do not share, sell or disclose to a third party, any information collected through our website.

What is GDPR?

The GDPR is the replacement for the Data Protection Act and comes into effect on the 25th of May 2018. Although it is European legislation the UK will be adopting GDPR into UK law even after Brexit. This youtube video helps explain some of the changes with the GDPR.

Caldicott Guardian

The Caldicott Guardian/IG Lead is responsible for;

Ensuring implementation of the Caldicott Principles and Data Security Standards with respect to Patient Confidential Data
Ensuring that the Practice processes satisfy the highest practical standards for handling patient information and provide advice and support to Practice staff as required
Ensuring that patient identifiable information is shared appropriately and in a secure manner. The Caldicott Guardian will liaise where there are reported incidents of person identifiable data loss or identified threats and vulnerabilities in Practice information systems to mitigate the risk.

The aim of the Caldicott Guardian is to ensure the organisation implements the Caldicott principles and data security standards; there is no need to appoint a Caldicott Guardian, but there is a need to have an Information Governance lead (sometimes referred to as a Caldicott lead) who, if they are not a clinician, will need support from a clinically qualified individual.

Care Quality Commission (CQC)

The CQC regulates health and social care services to ensure that safe care is provided. The Law says that we must report certain serious events to the CQC, for example, when patient safety has been put at risk.

Information about the Care Quality Care Commission (CQC)

CCTV

Please note this policy is only applicable if CCTV has been installed.

Closed circuit TV is installed at our premises. This is for the purposes of staff, patient and premises security. Cameras are located at various places on the premises and images from the cameras are recorded. The use of CCTV falls within the scope of the Data Protection Act. Images from cameras and recordings are held on a computer system and held in secure storage with controlled access for the required statutory period.

Child Health Information

We wish to make sure that your child has the opportunity to have immunisations and health checks when they are due. We share information about childhood immunisations, the 6-8 week new baby check and breast-feeding status with our NHS Trust health visitors and school nurses.

Clinical Audit & Research

Clinical Audit

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

Clinical Research

We fully respect your confidentiality and will not share your medical information with any identifiable data (no names, full postcodes, NHS numbers or full dates of birth).

If you have requested that you data is not to be shared outside the practice then your information will not be included in these statistics. However sometimes your information may be requested to be used for research purposes – we will always ask your permission before releasing your information for this purpose.

If you have any queries about this please ask to speak to the Practice Manager.

Complaining

When we receive a complaint, we record all the information you have given to us.

We use that information to resolve your complaint.

If your complaint reasonably requires us to contact some other person, we may decide to give to that other person some of the information contained in your complaint. We do this as infrequently as possible, but it is a matter for our sole discretion as to whether we do give information, and if we do, what that information is.

We may also compile statistics showing information obtained from this source to assess the level of service we provide, but not in a way that could identify you or any other person.

How you can complain

If you are happy for your data to be extracted and used for the purposes described in this privacy notice then you do not need to do anything. If you have any concerns about how your data is shared then please contact the Practice.

If you are not happy with our Privacy Policy or if have a complaint then you should tell us by writing to us
If a dispute is not settled then we hope you will agree to attempt to resolve it by engaging in good faith with us in a process of mediation or arbitration
If you are in any way dissatisfied about how we process your personal information, you have a right to lodge a complaint with the Information Commissioner’s Office. This can be done at ICO concerns
The Information Commissioner
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Phone: 0303 123 1113

Confidentiality

Confidentiality Statement

We are committed to maintaining confidentiality and protecting the information we hold about you. We adhere to the General Data Protection Regulation (GDPR), the NHS Codes of Confidentiality and Security, as well as guidance issued by the Information Commissioner’s Office (ICO). You have a right to access the information we hold about you, and if you would like to access this information, you will need to write to the practice requesting the information. Furthermore, should you identify any inaccuracies; you have a right to have the inaccurate data corrected.

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

All staff in the Practice sign a Confidentiality Agreement that explicitly makes clear their duties in relation to personal health information and the consequences of breaching that duty.

Please be aware that your information will be accessed by non-clinical Practice staff in order to perform tasks enabling the functioning of the Practice. These include, but not limited to:

typing referral letters to Hospital Consultants or allied Healthcare Professionals
opening letters from Hospitals and Consultants
scanning clinical letters, radiology reports and any other documents not available in electronic format
photocopying or printing documents for referral to Consultants
handling, printing, photocopying and postage of medical legal and insurance reports and of associated documents.

How we keep your information confidential and safe

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

The health records we use may be electronic, on paper or a mixture of both, and we use a combination of working practices and technology to ensure that your information is kept confidential and secure. Your records are backed up securely in line with NHS standard procedures. We ensure that the information we hold is kept in secure locations, is protected by appropriate security and access is restricted to authorised personnel. We also make sure external data processors that support us are legally and contractually bound to operate and prove security arrangements are in place where data that could or does identify a person are processed. We are committed to protecting your privacy and will only use information collected lawfully in accordance with:

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

We have a senior person responsible for protecting the confidentiality of patient information and enabling appropriate information sharing. This person is called the Caldicott Guardian.

We are registered with the Information Commissioner’s Office (ICO) as a data controller which describes the purposes for which we process personal data. A copy of the registration is available from the ICO’s web site by searching on our name.

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

COVID-19 supplementary notice

The health and social care system is facing significant pressures due to the coronavirus outbreak. Health and care information is essential to deliver care to individuals, to support health and social care services and to protect public health. Information will also be vital in researching, monitoring, tracking and managing the outbreak. In the current emergency, it has become even more important to share health and care information across relevant organisations.

This notice describes how GPs and other health and social care organisations may use your information within the health and social care system to protect you and others during the Coronavirus (COVID-19) outbreak with regard to your Summary Care Record.

Further information regarding COVID-19 supplementary privacy notice from NHS UK

Data Controller

The Data Protection Act 2018 requires organisations to register a notification with the Information Commissioner to describe the purposes for which they process personal and sensitive information.
We are registered as the data controller and our registration can be viewed online in the public register at: Register of fee payers.

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

Data Processor

Data processors are responsible for the processing of personal data on behalf of the data controller. Processors must ensure that processing is lawful and that at least one of the following applies:

The data subject has given consent to the processing of his/her personal data for one or more specific purposes
Processing is necessary for the performance of a contract to which the data subject is party, or in order to take steps at the request of the data subject prior to entering into a contract
Processing is necessary for compliance with a legal obligation to which the controller is subject
Processing is necessary in order to protect the vital interests of the data subject or another natural person
Processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller
Processing is necessary for the purposes of the legitimate interests pursued by the controller or by a third party, except where such interests are overridden by the interests or fundamental rights and freedoms of the data subject which require protection of personal data, in particular where the data subject is a child

At our Practice all staff are classed as data processors as their individual roles will require them to access and process personal data.

Data Protection Officer (DPO)

The Data Protection Officer is responsible for ensuring the Practice remains compliant at all times with Data Protection, Privacy & Electronic Communications Regulations, Freedom of Information Act and the Environmental Information Regulations. The Data Protection Officer shall:

Lead on the provision of expert advice to the Practice on all matters concerning the Data Protection Act, compliance, best practice and setting and maintaining standards
Inform and advise the organisation and its employees of their data protection obligations under the GDPR
Monitor the organisation’s compliance with the GDPR and internal data protection policies and procedures. This will include monitoring the assignment of responsibilities, awareness training, and training of staff involved in processing operations and related audits
Advise on the necessity of data protection impact assessments (DPIAs), the manner of their implementation and outcomes
Serve as the contact point to the data protection authorities for all data protection issues, including data breach reporting.

The DPO will be independent and an expert in data protection. The DPO will be the Practice’s point of contact with the Information Commissioner’s Office. The DPO can be contacted via the contact details at the top of this notice. Please address your request for the attention of the Data Protection Officer (DPO).

Please contact the Data Protection Officer if:

You have any questions about how your information is being held
If you require access to your information or if you wish to make a change to your
information
If you wish to make a complaint about anything to do with the personal and healthcare
information we hold about you
Or any other query relating to this Policy and your rights as a patient.

Data Retention

We manage patient records in line with the Records Management NHS Code of Practice for Health and Social Care, which sets the required standards of practice in the management of records for those who work within or under contract to NHS organisations in England. This is based on current legal requirements and professional best practice. If you transfer to another GP and we are asked to transfer your records we will do this to ensure your care is continued. Currently the NHS is required to keep GP records for 10 years after a patient has died. Exceptions to these rules are detailed in the code of practice.

Data Subject Access Requests (DSAR)

Data Subject Access Requests (DSAR): You have a right under the Data Protection legislation to
request access to view or to obtain copies of what information the surgery holds about you and to have it amended should it be inaccurate. To request this, you need to do the following:

Your request should be made to the Practice – for information from the hospital you should write direct to them
There is no charge to have a copy of the information held about you
We are required to respond to you within one month
You will need to give adequate information (for example full name, address, date of birth, NHS number and details of your request) so that your identity can be verified, and your records located information we hold about you at any time.

Department for Work and Pensions

Our Practice is legally required to provide anonymised data on patients who have been issued with a fit note under the Fit for Work scheme. The purpose is to provide the Department for Work and Pensions with information from Fit Notes to improve the monitoring of public health and commissioning and quality of health services.

Identifying patients who might be at risk of certain diseases

Your medical records will be searched by a computer programme so that we can identify patients who might be at high risk from certain diseases such as heart disease or unplanned admissions to hospital.

This means we can offer patients additional care or support as early as possible.

This process will involve linking information from your GP record with information from other health or social care services you have used.

Information which identifies you will only be seen by this practice.

Individual Funding Request

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

Invoice Validation

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

Job application and employment

If you send us information in connection with a job application, we may keep it for up to three years in case we decide to contact you at a later date.

If we employ you, we collect information about you and your work from time to time throughout the period of your employment. This information will be used only for purposes directly relevant to your employment. After your employment has ended, we will keep your file for six years before destroying or deleting it.

Keeping your records up to date

GDPR requires that the information we hold about you is accurate and current. We rely on our patients to tell us if they have moved house, or had medical treatment abroad. For our part, we will update your medical records at each consultation with a doctor or a nurse (either face to face, or by telephone), and with any relevant information we receive from hospital, community or social services providers (e.g. new diagnoses, change in circumstances).

Medicines Management

CCG’s and some GP Federations operate Pharmacist and prescribing advice services to support local GP practices with prescribing queries, which may require identifiable information to be shared. These Pharmacists work with your usual GP to provide advice on medicines and prescribing queries, and review prescribing of medicines to ensure that it is appropriate for your needs, is safe and also cost-effective. Where specialist prescribing support is required, the CCG Medicines Management Team may order medications on behalf of your GP Practice to support your care.

Supporting Locally Commissioned Services, CCGs support GP Practices by auditing anonymised data to monitor locally commissioned services, measure prevalence and support data quality. The data does not include identifiable information.

Mobile phone

If you provide us with your mobile phone number, we may use this to send you reminders about any appointments or other health screening information being carried out. This may be by telephone call or SMS text messaging, ( if this service is available). Please contact the reception if you wish to ‘opt-out’ of this service and this information will be added to your records.

National Fraud Initiative – Cabinet Office

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

National Registries

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

National Screening

The NHS provides national screening programmes so that certain diseases can be detected at an early stage. These currently apply to bowel cancer, breast cancer, aortic aneurysms and diabetic retinal screening service. The law allows us to share your contact information with Public Health England so that you can be invited to the relevant screening programme.

More information can be found at: Population screening programmes, or if you prefer please contact the Practice. Please contact the Practice if you do not wish to participate in any National Screening programmes offered.

National Data Opt-Out – General Practice Data for Planning and Research (GPDPR)

NHS Digital want to collect

data about diagnoses, symptoms, observations, test results, medications, allergies, immunisations, referrals, recalls and appointments, including information about physical, mental and sexual health
data on sex, ethnicity and sexual orientation
data about staff who have treated patients in a pseudonymised way (which is still personal data, as the data can be linked back.

Further information about General Practice Data for Planning and Research (GPDPR) and opting out can be found at NHS Digital

Opt-out of information sharing

Opt-outs

You have a right to object to your information being shared. Should you wish to opt out of data collection, please contact a member of staff who will be able to explain how you can opt out and prevent the sharing of your information; this is done by registering a Type 1 opt-out, preventing your information from being shared outside this Practice.

If you have previously opted-out of any data sharing arrangements, your opt-out I will continue to be valid.

Other Matters

Use of our website by children

If you are under 18, you may use our website only with consent from a parent or guardian
We collect data about all users of and visitors to these areas regardless of age, and we anticipate that some of those users and visitors will be children
Such child users and visitors will inevitably visit other parts of the site and will be subject to whatever on-site information they find, wherever they visit

Encryption of data sent between us

We use Secure Sockets Layer (SSL) certificates to verify our identity to your browser and to encrypt any data you give us.

Whenever information is transferred between us, you can check that it is done so using SSL by looking for a closed padlock symbol or other trust mark in your browser’s URL bar or toolbar.

NHS APP

The NHS App is a nationally run service that allows individuals to access a range of services within the Practice and beyond. NHS England and NHS Digital are joint data controllers of the NHS App and any personal data that is necessary for accessing the App. The data controller or processor of your personal data within a service accessed via the App will depend on the organisation accessed. Please see the NHS App privacy notice for further information

NHS Digital

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

Our legal basis for sharing data with NHS Digital

NHS Digital has been legally directed to collect and analyse patient data from all GP practices in England to support the coronavirus response for the duration of the outbreak. NHS Digital will become the controller under the General Data Protection Regulation 2016 (GDPR) of the personal data collected and analysed jointly with the Secretary of State for Health and Social Care, who has directed NHS Digital to collect and analyse this data under the COVID-19 Public Health Directions 2020 (COVID-19 Direction).

All GP practices in England are legally required to share data with NHS Digital for this purpose under the Health and Social Care Act 2012 (2012 Act). More information about this requirement is contained in the data provision notice issued by NHS Digital to GP practices.

Under GDPR our legal basis for sharing this personal data with NHS Digital is Article 6(1)(c) – legal obligation. Our legal basis for sharing personal data relating to health, is Article 9(2)(g) – substantial public interest, for the purposes of NHS Digital exercising its statutory functions under the COVID-19 Direction.

The type of personal data we are sharing with NHS Digital

The data being shared with NHS Digital will include information about patients who are currently registered with a GP practice or who have a date of death on or after 1 November 2019 whose record contains coded information relevant to coronavirus planning and research. The data contains NHS Number, postcode, address, surname, forename, sex, ethnicity, date of birth and date of death for those patients. It will also include coded health data which is held in your GP record such as details of:

diagnoses and findings
medications and other prescribed items
investigations, tests and results
treatments and outcomes
vaccinations and immunisations

How NHS Digital will use and share your data

NHS Digital will analyse the data they collect and securely and lawfully share data with other appropriate organisations, including health and care organisations, bodies engaged in disease surveillance and research organisations for coronavirus response purposes only. These purposes include protecting public health, planning and providing health, social care and public services, identifying coronavirus trends and risks to public health, monitoring and managing the outbreak and carrying out of vital coronavirus research and clinical trials. The British Medical Association, the Royal College of General Practitioners and the National Data Guardian are all supportive of this initiative.

NHS Digital has various legal powers to share data for purposes relating to the coronavirus response. It is also required to share data in certain circumstances set out in the COVID-19 Direction and to share confidential patient information to support the response under a legal notice issued to it by the Secretary of State under the Health Service (Control of Patient Information) Regulations 2002 (COPI Regulations).

Legal notices under the COPI Regulations have also been issued to other health and social care organisations requiring those organisations to process and share confidential patient information to respond to the coronavirus outbreak. Any information used or shared during the outbreak under these legal notices or the COPI Regulations will be limited to the period of the outbreak unless there is another legal basis for organisations to continue to use the information.

Data which is shared by NHS Digital will be subject to robust rules relating to privacy, security and confidentiality and only the minimum amount of data necessary to achieve the coronavirus purpose will be shared. Organisations using your data will also need to have a clear legal basis to do so and will enter into a data sharing agreement with NHS Digital. Information about the data that NHS Digital shares, including who with and for what purpose will be published in the NHS Digital data release register.

For more information about how NHS Digital will use your data please see the NHS Digital Transparency Notice for GP Data for Pandemic Planning and Research (COVID-19).

National Data Opt-Out

The application of the National Data Opt-Out to information shared by NHS Digital will be considered on a case by case basis and may or may not apply depending on the specific purposes for which the data is to be used. This is because during this period of emergency, the National Data Opt-Out will not generally apply where data is used to support the coronavirus outbreak, due to the public interest and legal requirements to share information.

Your rights over your personal data

To read more about the health and care information NHS Digital collects, its legal basis for collecting this information and what choices and rights you have in relation to the processing by NHS Digital of your personal data, see:

Payments

Contract holding GPs in the UK receive payments from their respective governments on a tiered basis. Most of the income is derived from baseline capitation payments made according to the number of patients registered with the practice on quarterly payment days. These amount paid per patient per quarter varies according to the age, sex and other demographic details for each patient. There are also graduated payments made according to the practice’s achievement of certain agreed national quality targets known as the Quality and Outcomes Framework (QUOF), for instance the proportion of diabetic patients who have had an annual review. Practices can also receive payments for participating in agreed national or local enhanced services, for instance opening early in the morning or late at night or at the weekends. Practices can also receive payments for certain national initiatives such as immunisation programs and practices may also receive incomes relating to a variety of non patient related elements such as premises. Finally there are short term initiatives and projects that practices can take part in. Practices or GPs may also receive income for participating in the education of medical students, junior doctors and GPs themselves as well as research.

In order to make patient based payments basic and relevant necessary data about you needs to be sent to the various payment services. The release of this data is required by English laws – NHS England’s powers to commission health services under the NHS Act 2006 or to delegate such powers to CCGs and the GMS regulations 2004 (73)1).

Prescriptions

Processing of prescriptions

We process prescription requests on a daily basis. This involves our staff accessing information held about you on our computer database, to produce prescription(s) that you, your carer, nominated person, or Pharmacy has requested. Prescriptions can be requested using various methods: by telephone, online via our computer system, Electronic prescriptions, by post, in writing, via fax (if available) or in person. Please refer to our Prescription Procedure for further information. If using the postal service always allow extra time so you do not run out of your medication.

Collection/uplift of prescriptions

We will always ask for your details when a prescription uplift request is received; this could be your name, date of birth and address, medication you requested, or Community Health Index Number (which uniquely identifies you). This ensures that we can produce your prescription(s) efficiently, and reduces the risk of an incorrect prescription being given to you or your nominated person/carer/Pharmacy.

Please allow the allotted time before uplifting your prescription. Prescriptions can be collected/sent via the following methods:

In person
Via your nominated choice of person/organisation, this could be your carer, pharmacy, family member or friend (please be aware if you are not uplifting your own prescription we may ask for proof of identification from that person before we issue your Prescription, and we may also require a signature for our own records)
Post – if using the postal service, please always allow extra time when ordering your medication, as we cannot guarantee postal delivery schedules
Home delivery service – some Pharmacies may deliver your prescription directly to your home; please check with your local Pharmacist to see if they can provide this service for you

Processing of information

The basis on which we process information about you

The Law requires us to determine under which of six defined bases we process different categories of your personal information, and to notify you of the basis for each category. If a basis on which we process your personal information is no longer relevant then we shall immediately stop processing your data. If the basis changes then, if required by Law, we shall notify you of the change and of any new basis under which we have determined that we can continue to process your information.

Lawful basis for processing

The legal basis will be

Article 6(1)(c) “processing is necessary for compliance with a legal obligation to which the controller is subject.”

And

Article 9(2)(h) “processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services on the basis of Union or Member State law or pursuant to contract with a health professional and subject to the conditions and safeguards ”

Information we process because we have a contractual obligation with you

When you join our Practice, receive medical services from us, or otherwise agree to our terms and conditions, a contract is formed between you and us. In order to carry out our obligations under that contract we must process the information you give us. Some of this information may be personal information.

We may use it in order to:

verify your identity for security purposes
provide you with our services
provide you with suggestions and advice and how to obtain the most from using our website

We process this information on the basis there is a contract between us, or that you have requested we use the information before we enter into a legal contract. Additionally, we may aggregate this information in a general way and use it to provide class information, for example to monitor our performance with respect to a particular service we provide. If we use it for this purpose, you as an individual will not be personally identifiable.

We shall continue to process this information until the contract between us ends or is terminated by either party under the terms of the contract.

Why do we collect this information?

The NHS Act 2006 and the Health and Social Care Act 2012 invests statutory functions on GP Practices to promote and provide the health service in England, improve quality of services, reduce inequalities, conduct research, review performance of services and deliver education and training. To do this we will need to process your information in accordance with current data protection legislation to:

Protect your vital interests;
Pursue our legitimate interests as a provider of medical care, particularly where the individual is a child or a vulnerable adult;
Perform tasks in the public’s interest;
Deliver preventative medicine, medical diagnosis, medical research; and
Manage the health and social care system and services.

About the personal information we use

We use personal information on different groups of individuals including:

Patients
Staff
Contractors
Suppliers
Complainants, enquirers
Survey respondents
Professional experts and consultants
Individual captured by CCTV

The personal information we use includes information that identifies you like your name, address, date of birth and postcode. We also use more sensitive types of personal information, including information about racial or ethnic origin; political opinions; religious or philosophical beliefs; trade union membership; genetic and biometric data, health; sex life or sexual orientation. The information we use can relate to personal and family details; education, training and employment details; financial details; lifestyle and social circumstances; goods and services; visual images; details held in the patient record; responses to surveys.

Information we process with your consent

Through certain actions when otherwise there is no contractual relationship between us, such as when you browse our website or ask us to provide you with more information about our business, including job opportunities and our services, you provide your consent to us to process information that may be personal information.

Wherever possible, we aim to obtain your explicit consent to process this information, for example, by asking you to agree to our use of cookies.

Sometimes you might give your consent implicitly, such as when you send us a message by e-mail to which you would reasonably expect us to reply.

Except where you have consented to our use of your information for a specific purpose, we do not use your information in any way that would identify you personally. We may aggregate it in a general way and use it to provide class information, for example to monitor the performance of a particular page on our website.

We continue to process your information on this basis until you withdraw your consent or it can be reasonably assumed that your consent no longer exists.

You may withdraw your consent at any time by instructing us in writing. However, if you do so, you may not be able to use our website or our services further.

Information we process for the purposes of legitimate interests

We may process information on the basis there is a legitimate interest, either to you or to us, of doing so.

Where we process your information on this basis, we do after having given careful consideration to:

whether the same objective could be achieved through other means
whether processing (or not processing) might cause you harm
whether you would expect us to process your data, and whether you would consider it reasonable to do so

For example, we may process your data on this basis for the purposes of:

record-keeping for the proper and necessary administration of our business or profession
responding to unsolicited communication from you to which we believe you would expect a response
protecting and asserting the legal rights of any party
insuring against or obtaining professional advice that is required to manage business or professional risk
protecting your interests where we believe we have a duty to do so

Information we process because we have a legal obligation

We are subject to the Law like everyone else. Sometimes, we must process your information in order to comply with a statutory obligation.

For example, we may be required to give information to legal authorities if they so request or if they have the proper authorisation such as a search warrant or court order.

This may include your personal information.

Information we process may be categorised as special category data

Special category data is personal data which the GDPR says is more sensitive, and so needs more protection. For example information about an individuals:

race
ethnic origin
health
sex life or
sexual orientation

We may process this information for the purposes of medical diagnosis, provision of health treatment and management of the health of our patients and the community we serve.

Specific uses of information you provide to us

Healthcare Professionals who provide you with care maintain records about your health and any treatment or care you have received previously (e.g. NHS Trust, GP Surgery, Walk-in clinic, etc.). These records are used to help to provide you with the best possible healthcare.

NHS healthcare records may be electronic, on paper or a mixture of both, and we use a combination of working practices and technology to ensure that your information is kept confidential and secure. Records we hold about you may include the following information;

Details about you, such as your name, address, carers, legal representatives and emergency contact details
Any contact the Surgery has had with you, such as appointments, clinic visits, emergency appointments, etc.
Notes and reports about your health
Details about your treatment and care
Results of investigations such as laboratory tests, x-rays, etc.
Relevant information from other Healthcare Professionals, relatives or those who care for you

To ensure you receive the best possible care, your records are used to facilitate the care you receive. Information held about you may be used to help protect the health of the public and to help us manage the NHS. Information may be used within our GP Practice for clinical audit to monitor the quality of the service provided. Some of this information will be held centrally and used for statistical purposes. Where we do this, we take strict measures to ensure that individual patients cannot be identified.

Sometimes your information may be requested to be used for research purposes – the Surgery will always gain your consent before releasing the information for this purpose.

Who else may ask to access your information

The Court can insist that we disclose medical records to them
Solicitors often ask for medical reports. These will always be accompanied by your signed consent for us to disclose information. We will not normally release details about other people that are contained in your records (e.g. wife, children parents etc.) unless we also have their consent
Social Services – The Benefits Agency and others may require medical reports on you from time to time. These will often be accompanied by your signed consent to disclose information. Failure to cooperate with these agencies can lead to loss of benefit or other support. However, if we have not received your signed consent we will not normally disclose information about you
Insurance Companies frequently ask for medical reports on prospective clients. These are always accompanied by your signed Consent Form. We will only disclose the relevant medical information as per your consent. You have the right, should you request it, to see reports prepared for Insurance Companies or employers before they are sent. We may contact you on receipt of a third party request to discuss your consent and clarify what will be shared
If you have any questions about the above points please contact the Practice.

Access to to your own information

Confirmation that your personal information is being held or used by us
Access to your personal information
Additional information about how we use your personal information

Although we must provide this information free of charge, if your request is considered unfounded or excessive, or if you request the same information more than once, we may charge a reasonable fee.

If you would like to access your personal information, you can do this by submitting a written request to the Practice at the address shown at the top of this page.

Once we have received your request and you have provided us with enough information for us to locate your personal information, we will respond to your request without delay, within one month (30 days). However If your request is complex we may take longer, by up to two months, to respond. If this is the case we will tell you and explain the reason for the delay.

Rights to object

You have the right under Article 21 of the GDPR to object to your personal information being processed. Please contact the Practice if you wish to object to the processing of your data. You should be aware that this is a right to raise an objection which is not the same as having an absolute right to have your wishes granted in every circumstance.

GP Practices process personal data under Article 6(1)(c) on a lawful and legitimate basis where the organisation is obliged under law to comply with

The General Data Protection Regulations (GDPR)
The Freedom of Information Act
The NHS Constitution
The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009
By complying with these laws, the Practice has compelling legitimate grounds for the processing which override the interests, rights and freedoms in the right to object.

The right to rectification

If the personal information we hold about you is inaccurate or incomplete you have the right to have this corrected.

If it is agreed that your personal information is inaccurate or incomplete we will aim to amend your records accordingly, normally within one month, or within two months where the request is complex. However, we will contact you as quickly as possible to explain this further if the need to extend our timescales applies to your request. Unless there is a risk to patient safety, we can restrict access to your records to ensure that the inaccurate or incomplete information is not used until amended.

If for any reason we have shared your information with anyone else, such as for a referral to another service, we will notify them of the changes required to ensure their records are accurate.
If on consideration of your request we do not consider the personal information to be inaccurate then we will add a comment to your record stating your concerns about the information. If this is the case we will contact you within one month to explain our reasons for this.

Public Health

Public health encompasses everything from national smoking and alcohol policies, the management of epidemics such as flu, the control of large scale infections such as TB and Hepatitis B to local outbreaks of food poisoning or Measles. Certain illnesses are also notifiable; the doctors treating the patient are required by law to inform the Public Health Authorities, for instance Scarlet Fever.

This will necessarily mean the subjects personal and health information being shared with the Public Health organisations.

Some of the relevant legislation includes: the Health Protection (Notification) Regulations 2010 (SI 2010/659), the Health Protection (Local Authority Powers) Regulations 2010 (SI 2010/657) , the Health Protection (Part 2A Orders) Regulations 2010 (SI 2010/658) , Public Health (Control of Disease) Act 1984, Public Health (Infectious Diseases) Regulations 1988 and The Health Service (Control of Patient Information) Regulations 2002

Registering for NHS care

All patients who receive NHS care are registered on a national database
This database holds your name, address, date of birth and NHS Number but it does not hold information about the care you receive
The database is held by NHS Digital, a national organisation which has legal responsibilities to collect NHS data.
More information can be found at NHS Digital or you can telephone general enquiries on 0300 303 5678
NHS England’s privacy notice
NHS App privacy policy

Risk Stratification

‘Risk stratification for case finding’ is a process for identifying and managing patients who have or may be at-risk of health conditions (such as diabetes) or who are most likely to need healthcare services (such as people with frailty). Risk stratification tools used in the NHS help determine a person’s risk of suffering a particular condition and enable us to focus on preventing ill health before it develops.
Information about you is collected from a number of sources including NHS Trusts, GP Federations and your GP Practice. A risk score is then arrived at through an analysis of your de-identified information. This can help us identify and offer you additional services to improve your health. Risk-stratification data may also be used to improve local services and commission new services, where there is an identified need. In this area, risk stratification may be commissioned by the our NHS Clinical Commissioning Group (OCCG). Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for risk stratification purposes.

Further information about risk stratification.

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

Safeguarding

The Practice is dedicated to ensuring that the principles and duties of safeguarding adults and children are holistically, consistently and conscientiously applied with the wellbeing of all, at the heart of what we do.

Our legal basis for processing For the General Data Protection Regulation (GDPR) purposes is: –

Article 6(1)(e) ‘…exercise of official authority…’.

For the processing of special categories data, the basis is: –

Article 9(2)(b) – ‘processing is necessary for the purposes of carrying out the obligations and exercising specific rights of the controller or of the data subject in the field of employment and social security and social protection law…’

Sending a message to our Practice Team

When you contact us, whether by telephone, through our website or by e-mail, we collect the data you have given to us in order to reply with the information you need. We record your request and our reply in order to increase the efficiency of our Practice. We keep personally identifiable information associated with your message, such as your name and email address so as to be able to track our communications with you to provide a high quality service.

Sharing of information

Local Information Sharing

Your GP electronic patient record is held securely and confidentially on an electronic system managed by your registered GP Practice. If you require attention from a local Healthcare Professional outside of your usual practice services, such as in an Evening and Weekend GP Access Clinic, GP Federation Service, Emergency Department, Minor Injury Unit or Out Of Hours service, the professionals treating you are better able to give you safe and effective care if some of the information from your GP record is available to them.

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

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

Disclosure and sharing of your information

Information we obtain from third parties

We sometimes receive data that is indirectly made up from your personal information from third parties whose services we use. No such information is personally identifiable to you.

Information provided on the understanding that it will be shared with a third party

We will only ever use or pass on information about you if others involved in your care have a genuine need for it. We will not disclose your information to any third party without your permission unless there are exceptional circumstances (i.e. life or death situations), where the law requires information to be passed on and / or in accordance with the new information sharing principle following Dame Fiona Caldicott’s information sharing review (Information to share or not to share) where “The duty to share information can be as important as the duty to protect patient confidentiality.” This means that Health and Social Care Professionals should have the confidence to share information in the best interests of their patients within the framework set out by the Caldicott principles. They should be supported by the policies of their employers, regulators and professional bodies.

Who are our partner organisations?

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

NHS Trusts / Foundation Trusts
GPs
NHS Commissioning Support Units
Independent Contractors such as Dentists, Opticians & Pharmacists
Private Sector Providers
Voluntary Sector Providers
Ambulance Trusts
Clinical Commissioning Groups
Social Care Services
Health and Social Care Information Centre (HSCIC)
Local Authorities
Education Services
Fire and Rescue Services
Police & Judicial Services
Voluntary Sector Providers
Private Sector Providers
Other ‘data processors’ which you will be informed of

You will be informed who your data will be shared with and in some cases asked for explicit consent for this to happen, when required.

We may also use external companies to process personal information, such as for archiving purposes. These companies are bound by contractual agreements to ensure information is kept confidential and secure.

What to do if you don’t want your information shared

Please tell us if you don’t want your information to be shared – either in some or all circumstances. We can make a note on your record that will ensure that your records can only be accessed by a health professional in the Practice (i.e. no administrative staff will be able to look at your records) or we can block your health data so that it can’t be accessed by other health service bodies e.g. Electronic Care Record.

Information submitted online

The practice website allows for the submission of some personal information for the purposes of updating your medical record e.g. new contact details. The service is provided by accredited suppliers, and all information submitted is covered by the same regulations as all other patient information.

Patient Rights (as the Data Subject)The right to erasure

The right to erasure is also known as “the right to be forgotten” and in general refers to an individual’s right to request the deletion or removal of personal information where there is no compelling reason for the Practice to continue using it.

As with other rights, there are particular conditions around this right and it does not provide individuals with an absolute right to be forgotten.

Individuals have the right to have their personal information deleted or removed in the following circumstances:

When it is no longer necessary for the purpose for which it was collected
When the Practice no longer have a legal basis for using you your personal information, for example if you gave us consent to use your personal information in a specific way, and you withdraw your consent, we would need to stop using your information and erase it unless we had an overriding reason to continue to use it
When you object to the Practice using your personal information and there is no overriding legitimate interest for us to continue using it.
If we have used your personal information unlawfully
If there is a legal obligation to erase your personal information for example by court order

The Practice can refuse to deal with your request for erasure when we use your personal information for the following reasons:

to comply with a legal obligation for the performance of a public interest task or exercise of official authority
for public health purposes in the public interest
archiving purposes in the public interest, scientific research historical research or statistical purpose
the exercise or defence of legal claims

The right to restrict processing

You have the right to control how we use your personal information in some circumstances. This is known as the right to restriction. When processing is restricted, the Practice is permitted to store your personal information, but not further use it until an agreement is reached with you about further processing. We can retain enough information about you to ensure that your request for restriction is respected in the future.

Examples of ways you can restrict our processing would be:

If you challenge the accuracy of your personal information, stop using it until we check its accuracy
If you object to processing which is necessary for the performance of our tasks in the public interest or for the purpose of legitimate interests, we will restrict our processing while we consider whether our legitimate grounds override your individual interests, rights and freedoms
If our use of your personal information is found to be unlawful and you ask for restriction instead of full erasure we will restrict our processing
If we no longer need your personal information but you need it to establish, exercise or defend a legal claim, we will restrict our processing.

If we have shared your personal information with any individuals or organisations, if we restrict our processing, we will tell those individuals or organisations about our restriction if it is possible and not an unreasonable amount of effort.
Whenever we decide to lift a restriction on processing we will tell you.

Direct Care Emergencies

There are occasions when intervention is necessary in order to save or protect a patient’s life or to prevent them from serious immediate harm, for instance during a collapse or diabetic coma or serious injury or accident. In many of these circumstances the patient may be unconscious or too ill to communicate.

In these circumstances we have an overriding duty to try to protect and treat the patient. If necessary we will share your information and possibly sensitive confidential information with other emergency healthcare services, the police or fire brigade, so that you can receive the best treatment.

Social Prescribing

Social Prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services. NHS England describes social prescribing as “enabling all local agencies to refer people to a link worker”. Link workers – known locally as Community Connectors – give people time, and focus on what matters to the person. They connect people to community groups and agencies for practical and emotional support. If you have an appointment with a Community Connector, only limited information would be passed on. There are agreements in place to protect your data.

Summary Care Record (SCR)

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

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

Please be aware that if you choose to opt-out of SCR, NHS Healthcare Staff caring for you outside of this Surgery may not be aware of your current medications, allergies you suffer from and any bad reactions to medicines you have had, in order to treat you safely in an emergency. Your records will stay as they are now with information being shared by letter, email, fax or phone.

You have the option to opt out of the summary care record, if you wish to do this please contact the surgery and we will update your record accordingly.

The NHS Care Record Guarantee

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

NHS digital looking after information and data

The NHS Constitution

The NHS Constitution establishes the principles and values of the NHS in England. It sets out the rights patients, the public and staff are entitled to. These rights cover how patients access healthcare services, the quality of care received, the treatments and programmes available, confidentiality, information and a patient’s right to complain if things go wrong.

Use of Information

Use of information we collect through automated systems when you visit our website

Cookies

Cookies are small text files that are placed on your computer’s hard drive by your web browser when you visit any website. They allow information gathered on one web page to be stored until it is needed for use on another, allowing a website to provide you with a personalised experience and the website owner with statistics about how you use the website so that it can be improved.

Some cookies may last for a defined period of time, such as one day or until you close your browser. Others last indefinitely.

Your web browser should allow you to delete any you choose. It also should allow you to prevent or limit their use.

Our website uses cookies. They are placed by software that operates on our servers, and by software operated by third parties whose services we use.

If you choose not to use cookies or you prevent their use through your browser settings, you will not be able to use all the functionality of our website.

We use cookies in the following ways:

to track how you use our website
to record whether you have seen specific messages we display on our website
to keep you signed in our site
to record your answers to surveys and questionnaires on our site while you complete them

Personal identifiers from your browsing activity

Requests by your web browser to our servers for web pages and other content on our website are recorded.

We record information such as your geographical location, your Internet service provider and your IP address. We also record information about the software you are using to browse our website, such as the type of computer or device and the screen resolution.

We use this information in aggregate to assess the popularity of the webpages on our website and how we perform in providing content to you.

If combined with other information we know about you from previous visits, the data possibly could be used to identify you personally, even if you are not signed in to our website.

Data may be processed outside the European Union

Our website is hosted in the United Kingdom.

We may also use outsourced services in countries outside the European Union from time to time in other aspects of our business.

Accordingly data obtained within the UK or any other country could be processed outside the European Union.

For example online patient forms on our website are encrypted and delivered securely to the NHS system by an email service provider based in the United States of America. Their systems comply with provisions certified under the EU-U.S. and Swiss-U.S. Privacy Shield frameworks, a mechanism for cross border transfer of personal data.

Video and Telephone Consultations

As an alternative to face to face appointments, there may be instances where we may offer you an appointment via telephone or video consultation. By accepting the invitation and entering the consultation you are consenting to this. Your personal/confidential patient information shared on the consultation will be safeguarded in the same way it would with any other consultation with relevant information added to your patient record.

Video or audio consultations/appointments are not typically recorded, but if are, your permission will be sought as to the purpose and use of the recording i.e.: for direct care purposes: diagnosis, treatment or care. Recordings will be stored as part of your patient record in line with NHS Digital Record Management Code of Practice (2016).

If, as part of the consultation, still images or photographs are taken/obtained and are to be kept, they will be securely stored as part of your patient record in line with NHS Digital Record Management Code of Practice (2016).

If the recording/images are to be used for any other reason than what the original permission was obtained for, then further permission would be required prior to that use.

If recordings or still images obtained are no longer needed (i.e.: adequately described in the clinical notes) then the recording/ images will be confidentially and securely destroyed as per our policies and in line with NHS Digital’s guidance.

Your Rights

The right of access

Individuals have the right to access their personal data and a request can be made verbally or in writing. We have one month to respond to a request and in most circumstances we cannot charge a fee.

The right to rectification

The GDPR includes a right for individuals to have inaccurate personal data rectified or completed if it is incomplete. We have one month to respond to a request and in some circumstances, we may refuse this request.

The right to data portability

The right to data portability allows individuals to obtain and re-use their personal information for their own purposes across different services. It allows them to move, copy or transfer personal information easily from one IT environment to another in a safe and secure way. For example: it enables consumers to take advantage or applications and services which can use their information to find them a better deal. The right to data portability only applies when the individual has submitted their personal information directly, through electronic means to our Practice. This means that in most circumstances the right to data portability does not apply within the Practice.

Rights related to automated decision making and profiling

You have the right to object to any instances where a decision is made about you solely by automated means without any human involvement, including profiling.

The Practice does not undertake any decision-making about you using wholly automated means.

Invoking your rights

If you wish to invoke any of the data subject rights then please write to The Practice Manager, at the above address.

Your Data

Your health records contain a type of data called confidential patient information. This data can be used to help with research and planning.

You can choose to stop your confidential patient information being used for research and planning. You can also make a choice for someone else like your children under the age of 13

To find out more about the benefits of data sharing, how data is protected, or to make/change your opt-out choice visit NHS your data matters.

Compliance with the Law

Our Privacy Policy has been compiled so as to comply with the Law of every country or legal jurisdiction in which we aim to do business. If you think it fails to satisfy the Law of your jurisdiction, we would like to hear from you.

However, ultimately it is your choice as to whether you wish to use our website.

Further Information – Understanding Patient Data

Understanding Patient Data’ supports better conversations about the uses of health information. Our aim is to explain how and why data can be used for care and research, what’s allowed and what’s not, and how personal information is kept safe. We work with patients, charities and Healthcare Professionals to champion responsible use of data.

Further information & guidance

Review of this Privacy Policy

We may update this Privacy Notice from time to time as necessary. The terms that apply to you are those posted here on our website on the day you use our website. We advise you to print a copy for your records.

If you have any question regarding our Privacy Policy, please contact us.

Summary Care Records (SCR)

Summary Care Records (SCR) are an electronic record of important patient information, created from GP medical records. They can be seen and used by authorised staff involved in a patient’s direct care, both within the Practice as well as in other areas of the healthcare system.

Your 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.

What is an 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

It also includes your name, address, date of birth and unique NHS Number which helps to identify you correctly.

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.

Your SCR is available to authorised healthcare staff providing your care anywhere in England, but they will ask your permission before they look at it. This means that if you have an accident or become ill, healthcare staff treating you will have immediate access to important information about your health.

This Practice supports SCR however, as a patient you have a choice:

If you would like an SCR you do not need to do anything and an SCR will be created for you
If you do NOT want an SCR please complete the online SCR opt out form, or alternatively if you wish you can download the Form and hand it in to the Practice

Remember, you can change your mind about your SCR at any time. Talk to our Practice if you want to discuss your option to add more information or decide you no longer want an SCR. If you do nothing we will assume you are happy for us to create a SCR for you.

Vulnerable patients and carers

Having an SCR that includes extra information can be of particular benefit to patients with detailed and complex health problems. If you are a carer for someone and believe that this may benefit them, you could discuss it with them and their GP Practice.

Who can see my SCR?

Only authorised, professional healthcare 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

Healthcare 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. You may request to opt them out of SAR; any opt-out requests on behalf of children will be carefully considered.

Confidentiality

For information on how the NHS will collect, store and allow access to your electronic records visit NHS UK.