Practice Policies & Patient Information
Access to medical records
What is the Great North record and how it can benefit all of your health needs?
There is a new patient record sharing electronic system enabling all health professionals at various health organisation having access to a summary of your heath record to help with your care. E.g. You go and see a physio based at another organisation they will be able to see your summary and help with your treatment. Your medical records will still be confidential and only be able to be accessed by doctors , nurses and anybody directly involved in your care. You will be asked permission by the health organisation if you consent to allow them to view your Great North Care record.
You can decline or opt out of this record service at anytime.
This helps you by allowing the health professional spend more time on your care, joined up safer care and all your information kept in one place.
What does the Great North Record contain?
- List of diagnosed conditions
- Allergies
- Test results
- Referrals and Discharge Information
- Address and telephone number
What organisations will be able to see my Great North Care Record and who supports it?
- GP Practices
- NHS 111
- NHS Hospitals
- Mental Health Services
- Out-of-Hours Doctors
- Ambulance Services
See more information on the Great North Care Record website.
Accessibility statement
This accessibility statement applies to this website.
This website is run by Livi. We want as many people as possible to be able to use this website. For example, that means you should be able to:
- change colours, contrast levels and fonts
- zoom in up to 300% without the text spilling off the screen
- navigate most of the website using just a keyboard
- navigate most of the website using speech recognition software
- listen to most of the website using a screen reader (for example NVDA)
We’ve also made the website text as simple as possible to understand.
AbilityNet has advice on making your device easier to use if you have a disability.
Feedback and contact information
If you have feedback, or need information on this website in a different format, contact [email protected]
We’ll get back to you in 5 working days.
Reporting accessibility problems with this website
We’re always looking to improve the accessibility of this website. If you find any problems not listed on this page or think we’re not meeting accessibility requirements, contact [email protected]
Enforcement procedure
The Equality and Human Rights Commission (EHRC) is responsible for enforcing the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018 (the ‘accessibility regulations’).
If you’re not happy with how we respond to your complaint, contact the Equality Advisory and Support Service (EASS).
Contacting us by phone or visiting us in person
Our offices have audio induction loops, or if you contact us before your visit we can arrange a British Sign Language (BSL) interpreter.
Contact the practice to find out about audio induction loops and BSL interpreters.
Technical information about this website’s accessibility
We are committed to making its website accessible, in accordance with the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018.
Compliance status
This website is partially compliant with the Web Content Accessibility Guidelines version 2.1 AA standard, due to the non-compliances listed below.
Disproportionate burden
Nothing on the site is a disproportionate burden to fix.
Content that’s not within the scope of the accessibility regulations
No content is outside the scope of the accessibility regulations.
Preparation of this accessibility statement
This statement was prepared on 6 July 2022. It was last reviewed on 6 July 2022.
This website was last tested on 6 July 2022. The test was carried out by Livi.
The website is based on six templates. We took at least one page from each template to test. We chose pages that cover the range of user tasks and functionality on the site.
Benzodiazepine / Z-drug Policy
A controlled substance is generally a drug or chemical whose manufacture, possession, or use is regulated by the government because of the potential for abuse or addiction. Such drugs include those classified as narcotics, stimulants, depressants, hallucinogens, and cannabis.
A list of the most commonly encountered controlled drugs can be found at:
https://www.gov.uk/government/publications/controlled-drugs-list–2
Some patients require strong, potentially addictive medication to help manage their condition(s). Of concern are ‘drugs of dependence’ (e.g. opioid medications, benzodiazepines and Z-drugs), particularly when these are prescribed on an on-going basis.
Due to increasing reports of abuse of prescription drugs and patient behavioural problems, Clifton Court Medical Practice has established a policy to ensure adequate treatment, while reducing the risk of problems with drug prescriptions.
New Patients to the practice who have been prescribed Benzodiazepines/Z drugs by a previous care provider.
Patients New to the practice:
- It may take time to get accurate medical information about new patients. Until such information is available, GP’s may choose not to prescribe any medication. It is our policy that GPs do not prescribe drugs of dependence until they have a full clinical picture.
- GP’s may decide not to continue prescribing a benzodiazepine or Z-drug previously prescribed for patients. It may be determined that such a medication is not suitable. It is our policy that GPs do not prescribe drugs of dependence if they feel that previous prescriptions were inappropriate.
- GP’s will evaluate patients’ conditions and only prescribe a benzodiazepine or Z-drug of the lowest strength for the shortest time necessary. This may be different to the drug prescribed for a patient at a previous GP Practice.
General practice standards:
- If the decision to prescribe is taken after a shared discussion of goals, plans, risks and benefits, patients may be required to confirm consent in writing.
- Patients may be asked to complete a withdrawal programme and sign a withdrawal contract which details our practice’s expectations when prescribing drugs of dependence. This agreement details the patients’ responsibilities as a patient taking a drug of dependence; any prescriptions issues; advice on taking medications; how we will monitor care; and the standards of behaviour that are expected.
- Patients may need to acknowledge that their care requirements may be complex, and that referral for on-going care for all or part of their healthcare may be required. It is our practice policy that patient care is matched with the level of complexity.
- Patients should be reminded that we have a zero tolerance on issues relating to staff abuse.
Sedative prescription requests for fear of flying
The surgery has a practice policy that we do not issue sedative prescriptions, such as diazepam, chlordiazepoxide or zopiclone to alleviate symptoms that patients may experience relating to a fear of flying.
This decision has been made by all of our GP partners; our main reasons are listed below:
- The use of any sedating drug causes longer reaction times and slower thinking which during a flight may put the patient and or other passengers at significant risk of not being able to act in a manner which could save life in the event of an emergency.
- The use of any CNS depressant has the potential to increase the risk of Deep Vein Thrombosis (DVT).
- For some countries it is illegal to import these drugs.
- National guidelines advise that medication should not be used for mild and self-limiting mental health disorders and/or phobias.
- Use of these medications increases the risks of falls and accidents.
What to discuss with the patient when considering use of a benzodiazepine or Z-drug
Ensure the patient is aware that the medication is for short-term use alongside self-care.
Ensure patients are aware of the risks of treatment including Central Nervous System (CNS) depressant effects, including ‘hangover’ effects, unsteadiness, reduced alertness and impaired memory, tolerance, dependence, and withdrawal.
The long-term use of benzodiazepines or Z-drugs is associated with a number of health conditions and an increased risk of death:
- Over-sedation from long-term use can increase the risk of falls and accidents on the road and in the home.
- Poisoning from overdose may contribute to increased mortality risk.
- Long-term use of benzodiazepines or Z-drugs (usually more than 4 weeks) may be associated with:
- Tolerance — a higher dose is required to obtain the initial effect.
- Dependence — the person feels they need the medication to carry out day-to-day activities, and/or withdrawal symptoms occur upon stopping or dose reduction.
- Other effects of long-term use of benzodiazepines include:
- Cognitive effects, anxiety, agoraphobia, emotional blunting, reduced coping skills, and amnesia.
- Reduced social functioning due to effects on memory, reduced ability to remember new people, appointments etc.
- Depression, either for the first time, or aggravation of pre-exisiting depression with possible precipitation of suicidal tendencies.
- Older people are more vulnerable to the CNS depressant effects of benzodiazepines, possibly leading to confusion, night wandering, amnesia, ataxia, and hangover effects. Impaired cognitive function and memory may be wrongly diagnosed as dementia. In the UK, it has been estimated that older adults receive 80% of all prescriptions written for benzodiazepine hypnotics.
- Provide advice related to driving whilst taking the medication
- Warn of potential serious adverse effects if alcohol and other sedative substances are used with the medication.
Benzodiazepine/Z-drug Policy – Issuing Prescriptions
- All new benzodiazepines and Z-drugs will be issued as acute prescriptions.
- Wherever possible, patients will see the same Prescriber for review of the initial prescription.
- Where benzodiazepines and Z-drugs are initiated by an external provider the Practice will only take over prescribing once a written request has been received. GPs are under no obligation to prescribe on the advice or recommendation of an external provider and are reminded that they take on prescribing responsibility if they choose to prescribe. Where the GP chooses to accept this, the remainder of this policy applies, especially with regard to duration and review.
- Where patients are discharged from hospital on Benzodiazepines or Z Drugs the Practice should not automatically add these to the patients’ medications. Patients should be reviewed by the GP prior to any further issue.
- All patients will be reviewed within 2- 4 weeks of initiation of a benzodiazepine/Z-drugs prescription.
- Patients on long-term benzodiazepines/Z-drugs will be reviewed every 6 months.
- All benzodiazepines and Z-drugs will be issued on prescriptions with a maximum duration of 1 month.
- All benzodiazepines and Z-drugs prescriptions will include full directions wherever possible and use of PRN or MDU directions will be avoided.
Practice procedure for lost/stolen Controlled Drug Prescriptions
The loss or theft of a controlled drug prescription must be recorded in the patients’ medical record and a READ code added to enable the Practice to monitor/audit.
If the prescription is stolen, the patient or the Practice must report the incident to the police and obtain a crime number.
The loss or theft of a controlled drug or prescription must be reported to the CD Accountable Officer via cdreporting.co.uk
If Practices need to send out an alert regarding lost or stolen prescriptions, this can be done by sending an alert template to: [email protected].
The Practice must review the patient’s records when considering if it is appropriate to re-issue a prescription. Notes should be assessed to identify if there is a pattern of regularly requesting additional prescriptions. Practices may consider reviewing ordering patterns for immediate family and household members when considering patterns of behaviour. If a pattern is identified this could indicate an underlying problem such as abuse, diversion or a safeguarding issue, report via cdreporting.co.uk and refer as appropriate.
The patient should be invited in for review and the appropriate steps taken.
Practices may issue a small supply of medication to cover the period until the patient attends.
At the review, Practices should review the appropriateness of the current prescription and steps that can be taken to support the patient such as:
- Reducing and withdrawing medication.
- Reducing script duration e.g. weekly prescriptions.
- Discussion about future action should there be further issues.
- Working with the community pharmacy e.g., if prescriptions are being stolen could the pharmacy collect prescriptions on the patient’s behalf, use of EPS.
Existing patients with a regular prescription for Benzodiazepines or Z Drugs.
Patients registered at the Practice who are already receiving regular prescriptions for Benzo’s and Z Drugs will be systematically reviewed.
The pharmacist or GP will identify and audit patients who require review and make appropriate recommendations which may include a reduction to stop regime.
The Practice will support the Patient to reduce and stop Benzo and Z drug medication by following the recommendations, the timely issue of prescriptions as per the reduction plan and adhering to the Practice Policy.
Where a patients’ circumstances are such that a reduction regime would cause undue distress or anxiety at the given time, they will be informed that further attempts will be made to reduce and stop at 6 monthly intervals.
For any patients who repeatedly fail to engage in a reduction plan without appropriate clinical reason, the GP may cease to prescribe, after taking appropriate specialist advice.
Summary of relevant NICE Guidance
Medicines Optimisation Key Therapeutic Topic – Hypnotics (KTT6)
Only use hypnotics if insomnia is severe, using the lowest dose that controls symptoms for the shortest period of time.
Guidance on the use of zaleplon, zolpidem and zopiclone for the short-term management of insomnia (TA77)
Z-drugs and the shorter-acting benzodiazepine hypnotics should only be considered for severe insomnia interfering with normal daily life.
They should be prescribed for short periods of time only, in strict accordance with their licensed indications.
There is no compelling evidence to distinguish between zolpidem, zopiclone or the shorter-acting benzodiazepine hypnotics.
Patients who have not responded to one of these hypnotic drugs should not be prescribed any of the others (switching from one of these hypnotics to another should only occur if a patient experiences adverse effects considered to be directly related to a specific agent).
NICE CKS Insomnia
If a hypnotic is required for insomnia the recommended choices are:
- Non-benzodiazepines (the ‘z-drugs’) – zopiclone, zolpidem, and zaleplon (all are short acting).
- Short-acting benzodiazepines – temazepam, loprazolam, lormetazepam.
- Diazepam is not generally recommended, but it can be useful if insomnia is associated with daytime anxiety,prescribe 5 – 15 mg at bedtime.
- Use the lowest effective dose for the shortest period possible.
Treatment should not continue for longer than 2 weeks.
Sedative drugs other than hypnotics (such as antidepressants, antihistamines, choral hydrate, clomethiazole, and barbiturates) are not recommended for the management of insomnia. Expert opinion from reviews suggests that there is insufficient evidence to support their use, and that the potential for adverse effects is significant.
Generalised anxiety disorder and panic disorder in adults: management (CG113)
Do not offer a benzodiazepine for the treatment of GAD in primary or secondary care except as a short-term measure during crises. Benzodiazepines are associated with a less good outcome in the long term.
Benzodiazepines should not be prescribed for the treatment of individuals with panic disorder.
NICE CKS Anxiety
If a benzodiazepine is required for anxiety the recommended choice is diazepam:
- For anxiety, prescribe 2 mg three times a day.
- If needed, the dose can be increased to 15–30 mg daily in 3 divided doses (half the dose should be prescribed in elderly or debilitated people).
- Caution in the elderly, due to the increased risk of falls — the manufacturer advises halving the recommended doses.
- Prescribe the lowest possible dose for the shortest period of time and review the patient regularly.
Treatment should not exceed 2–4 weeks.
Depression in adults: recognition and management (CG90) and Depression in adults with a chronic physical health problem: recognition and management (CG91)
Benzodiazepines are only to be considered as an option if a person with depression prescribed an SSRI develops the side effects of anxiety, agitation and/or insomnia early in antidepressant treatment and symptoms are problematic.
In this case short-term concomitant treatment with a benzodiazepine is one of several options that can be considered.
If a benzodiazepine is prescribed this should be for no longer than 2 weeks in order to prevent the development of dependence.
Benzodiazepines should not be used in people with chronic symptoms of anxiety.
Benzodiazepines should be used with caution in patients at risk of falls
Social anxiety disorder: recognition, assessment and treatment (CG159)
Do not routinely offer benzodiazepines to treat social anxiety disorder in adults.
Obsessive-compulsive disorder and body dysmorphic disorder: treatment (CG 31)
Anxiolytics should not normally be used to treat OCD or BDD without comorbidity except cautiously for short periods to counter the early activation of SSRIs.
Post-traumatic stress disorder (ng116)
Do not offer drug treatments, including benzodiazepines, to prevent PTSD in adults
Antenatal and postnatal mental health: clinical management and service guidance (CG192)
Do not offer benzodiazepines to women in pregnancy and the postnatal period except for the short‑term treatment of severe anxiety and agitation.
Consider gradually stopping benzodiazepines in women who are planning a pregnancy, pregnant or considering breastfeeding.
NICE CKS BPSD
If challenging behaviour requires urgent treatment (when the person is a danger to themselves or others) and underlying causes (such as discomfort, thirst, or the need for the toilet) have been addressed, advise moving the person to a safe, low-stimulation environment (such as a quiet room) away from others and use of verbal and non-verbal de-escalation techniques (such as active listening, effective verbal responding, pictures, and symbols).
If these measures fail, seek advice from an elderly care psychiatrist, the challenging behaviour team, or an elderly care physician.
Depending on the specific situation, short-term (off-label) use of drugs for behavioural control (such as haloperidol or lorazepam) may be suggested.
Lorazepam (off-label) for the treatment of challenging behaviour associated with dementia should only be used on the advice of a specialist who should specify dose and duration of treatment.
Short-term treatment with lorazepam (off-label use) may be suggested for immediate management of violence, aggression, or extreme agitation in people with dementia when non-pharmacological measures have failed and the person poses a risk to themselves or others. The aim of the treatment is to calm the person and reduce agitation or aggression, not to sedate.
Treatment should start at the lowest possible dose (500 microgram) orally and be titrated slowly in increments, if necessary, to a maximum of 1 mg daily (2 mg daily in exceptional circumstances). One-to-one care of the person should be available while the dose is titrated in a controlled and safe manner.
The person should be reviewed regularly, and lorazepam discontinued as soon as possible.
Did not attend (DNA) policy
What a DNA is
A DNA appointment is when a patient does not turn up for appointments, and does not contact the surgery to cancel or change the appointment.
This creates a significant strain on the NHS.
We understand that there are situations that can make it impossible for you to cancel your appointment, for example being admitted to hospital.
Our DNA policy
- If you fail to attend 2 or more appointments in the the previous month, you will get a warning letter.
- If you’ve had a warning letter and you miss another appointment, you’ll get another letter. This will say that you can only book appointments on the day, and not in advance.
- If you do not attend same day appointments, we will invite you to discuss a contract and an appointment plan. This will include you calling to confirm an appointment, if not it will be cancelled.
Warning letters last 12 months.
Cancelling appointments
To avoid DNA appointments, you can use the NHS app or online services to cancel your appointments.
You can also get a text reminder of your appointment, and you can reply to this to cancel if necessary. Please make sure we have the right mobile number for you.
Contact us
If you would like to discuss DNAs, please contact the surgery.
GP Earnings
NHS England require that the net earnings of doctors engaged in the practice is publicised and the required disclosure is shown below.
However, it should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice and should not be used to for any judgement about GP earnings, nor to make any comparisons with other practices.
The average earnings for GPs working in the Clifton Court Medical Practice in the last financial year ending in 2021/22 was £88,061 before taxation and National Insurance.
This is for 2 full time GPs, 4 part time GPs and 2 locum GPs who worked in the practice for more than 6 months.
Green Impact for Health Statement
This practice is delighted to be signed up to the Green Impact for Health Toolkit and is actively taking steps to reduce our carbon footprint.
The climate emergency is also a health emergency, and health care in the UK contributes 4-5% of the UK’s carbon emissions. We need to enhance the health of today’s population without compromising the health of future generations, and this means operating within the sustainable boundaries of the planet. Fortunately, most of the solutions for the planet also make our health better – for example eating a mainly plant-based diet, engaging in active travel and exercise in nature, avoiding smoking, reducing pollution etc. These all enhance our health and reduce our need for medications, with further benefits to the NHS, your health and the carbon footprint of healthcare. Take a look at www.greenerpractice.co.uk to learn more about this.
Named GP
Patients registered at the Surgery have a named, accountable doctor who is responsible for coordinating their care.
Your named doctor will be allocated to you by the practice.
You can still talk to or make appointments to see any of our doctors or nurses, not just your named GP.
If you have a preference and would like to request a particular doctor at the practice to be your named GP please talk to one of our receptionists.
Patient confidentiality
We respect your right to privacy and keep all your health information confidential and secure. It is important that the NHS keeps accurate and up-to-date records about your health and treatment so that those treating you can give you the best possible care.
This information may be used for management and audit purposes. However, it is usually only available to, and used by, those involved in your care. You have the right to know what information we hold about you. If you would like to see your records please contact the Practice Manager.
Your confidentiality is important to us
You can be sure that anything you discuss with any member of this practice – family doctor, nurse, receptionist – will stay confidential.
Even if you are under 16 nothing will be said to anyone – including parents, other family members, carer workers or tutors – without your permission. The only reason why we might want to consider passing on confidential information without your permission, would be to protect you or someone else from serious harm. We would always try to discuss this with you first.
If you are being treated elsewhere – for example at a hospital or Brook centre – it is best if you allow the doctor or nurse to inform the practice of any treatment you are receiving.
If you have any worries about confidentiality please feel free to ask a member of staff.
Practice vision statement
Our vision, the reason we are here, we see as to provide high quality medical care in a dynamic, forward thinking and innovative practice setting. We will achieve this by developing and maintaining a cohesive team-based approach which is responsive to people’s needs and expectations and reflects, wherever possible, the latest advances in primary care.
Our core aims and values
- Being open and transparent
- Working in a happy and fulfilling environment
- Fairness
- Having respect for one another
- Being accountable for your own roles and responsibilities
- Clear communication
- Recognition for achievements
- Regular team working activities
- Chance to participate and engage in regular team meetings
- To be provided with positive encouragement and support from line managers
- Chance to develop new ideas
- Opportunity for further training and development
We are committed to provide effective and accessible care in a responsive, compassionate manner. We aspire to be an organisation that staff are proud of, building upon our existing team working relationships and levels of mutual support.
We feel our aims and objectives reflect the population demand of our practice and our future direction of travel.
Aims and objectives
Care Navigation: Aim to provide patients with the most appropriate clinician or service during their first point of contact. Signposting to external agencies for the right treatment or support where necessary.
Continuity of Care: Providing patients with a choice of their preferred clinician we feel is important to ensuring patients have continuity of care.
Sharing / Hub Working: Sharing ideas, knowledge and skills with others to improve the services for all patients
Learning and Development: Sharing learning and development through training and significant event analysis.
Training Practice: We are passionate about encouraging newly qualified medical professionals in to primary care. Providing effective supervision and mentoring support to all our team.
Technology: Striving to provide innovative services in digital technology
Patient Engagement: Promotion of our PPG, Friends and Family Test, Survey and feedback forms to receive evaluation of our services and make changes where needed
Privacy policy
Your information, what you need to know
This privacy notice explains why we collect information about you, how that information may be used, how we keep it safe and confidential and what your rights are in relation to this.
Why we collect information about you
Health care professionals who provide you with care are required by law to maintain records about your health and any treatment or care you have received within any NHS organisation. These records help to provide you with the best possible healthcare and help us to protect your safety.
We collect and hold data for the purpose of providing healthcare services to our patients and running our organisation which includes monitoring the quality of care that we provide. In carrying out this role we may collect information about you which helps us respond to your queries or secure specialist services. We may keep your information in written form and/or in digital form. The records may include basic details about you, such as your name and address. They may also contain more sensitive information about your health and also information such as outcomes of needs assessments.
The NHS Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities, which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively.
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 https://digital.nhs.uk/
We keep a Register of all our information processing activities, including those involving the use of personal information. This records lots of metadata including where we get the information from, with whom we share it, the legal basis allowing us to process personal data and the security arrangements in place.
Details we collect about you
The health care professionals who provide you with care maintain records about your health and any treatment or care you have received previously (e.g. from Hospitals, GP Surgeries, A&E, etc.). These records help to provide you with the best possible healthcare. Records which this GP Practice may hold about you may include the following:
- Details about you, such as your address and next of kin
- 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 health professionals, relatives or those who care for you
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 https://digital.nhs.uk/data-and-information/looking-after-information/data-security-and-information-governance/codes-of-practice-for-handling-information-in-health-and-care/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 (UK GDPR)
- 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. The Caldicott Guardian for the practice is Andrea Francis, who can be contacted using the contact details at the top of this document. We also have a Senior Information Risk Owner (SIRO) who is responsible for owning the practice’s information risk. The SIRO is Andrea Francis.
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.
How we use your information
Improvements in information technology are also making it possible for us to share data with other healthcare organisations for the purpose of providing you, your family and your community with better care. For example it is possible for healthcare professionals in other services to access your record with your permission when the practice is closed. This is explained further in the Local Information Sharing section below.
Under the powers of the Health and Social Care Act 2015, NHS Digital can request personal confidential data from GP Practices without seeking patient consent for a number of specific purposes, which are set out in law. These purposes are explained below. You may choose to withdraw your consent to personal data being shared for these purposes.
You can object to your personal information being shared with other healthcare providers but should be aware that this may, in some instances, affect your care as important information about your health might not be available to healthcare staff in other organisations. If this limits the treatment that you can receive then the practice staff will explain this to you at the time you object.
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.
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 NHS] Foundation Trust health visitors and school nurses.
Clinical audit
Information may be used by the Integrated Care Board (ICB) for clinical audit to monitor the quality of the service provided to patients with long terms 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
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.
GP Connect
The GP Connect service allows GP practices and clinical staff to share GP Practice clinical information and data between IT systems, quickly and efficiently via Application Programming Interfaces (APIs). GP Connect is not used for any purpose other than direct care. Further information is available here https://digital.nhs.uk/services/gp-connect/gp-connect-in-your-organisation/gp-connect-privacy-notice
Improving Diabetes Care
Information that does not identify individual patients is used to enable focussed discussions to take place at practice-led local diabetes review meetings between health care professionals. This enables the professionals to improve the management and support of these patients.
Individual Funding Request
An ‘Individual Funding Request’ is a request made on your behalf, with your consent, by a doctor, for funding of specialised healthcare which falls outside the range of services and treatments that the ICB 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 doctor that there are exceptional clinical circumstances which make the patient’s case different from other patients with the same condition 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 your GP.
Invoice Validation
Invoice validation is an important process. It involves using your NHS number to check that the ICB 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.
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 health or care professional outside of your usual practice services, such as a 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 (e.g. Great North Care Record Care Summary or your Summary Care Record) or a secure system that enables them to view your full GP electronic patient record (e.g.SystenOne)
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).
When analysing current health services and proposals for developing future services it is sometimes necessary to link separate individual datasets to be able to produce a comprehensive evaluation. This may involve linking primary care GP data with other data such as secondary uses service (SUS) data (inpatient, outpatient and A&E). In some cases there may also be a need to link local datasets which could include a range of acute-based services such as radiology, physiotherapy, audiology etc, as well as mental health and community-based services such as Improving Access to Psychological Therapies (IAPT), district nursing, podiatry etc. When carrying out this analysis, the linkage of these datasets is always done using a unique identifier that does not reveal a person’s identity. We may also contract with other organisations to process data. These organisations are known as Data Processors. We ensure 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.
Currently, the external data processors we work with include NHS North of England Commissioning Support Unit, which is based at John Snow House, Durham, DH1 3YG and which has been granted a legal basis for processing data for us and which operates under strict controls to ensure your information is handled lawfully.
We record any instances where we transfer personal information to a third country or international organisation. This is very limited and we check and record the safeguards in place to protect the information to be transferred.
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:
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.
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 Integrated Care Board. Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for risk stratification purposes. Further information about risk stratification is available from: https://www.england.nhs.uk/ourwork/tsd/ig/risk-stratification /
If you do not wish information about you to be included in any risk stratification programmes, please let us know. 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
To ensure that adult and children’s safeguarding matters are managed appropriately, access to identifiable information will be shared in some limited circumstances where it’s legally required for the safety of the individuals concerned.
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. If you wish to opt-out of having an SCR please return a completed opt-out form to the practice. Further information is available here https://digital.nhs.uk/services/summary-care-records-scr/summary-care-record-supplementary-transparency-notice
Supporting Medicines Management
The ICB operates pharmacist prescribing advice services to support local GP practices with prescribing queries, which may require identifiable information to be shared. Pharmacists and pharmacy technicians work with your usual GP to provide advice on medicines, prescription ordering processes, prescribing queries, and review prescribing of medicines to ensure that it is appropriate for your individual needs, safe and cost-effective. Where specialist prescribing support is required, the ICB medicines management team may discuss product choice with your GP and your nominated community pharmacist to ensure evidence based cost effective choices are made to support your care.
Supporting Locally Commissioned Services
ICBs 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 and is used to support patient care and ensure providers are correctly paid for the services they provide.
Data Retention
We manage patient records in line with the Records Management NHS Code of Practice 2021 https://www.nhsx.nhs.uk/information-governance/guidance/records-management-code/ 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, based on current legal requirements and professional best practice.
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
- Specialist Trusts
- GP Federations
- Independent Contractors such as dentists, opticians, pharmacists
- Private Sector Providers
- Voluntary Sector Providers
- Ambulance Trusts
- Integrated Care Boards
- Social Care Services
- Local Authorities
- Education Services
- Fire and Rescue Services
- Police
- Other ‘data processors’
- Other Practices which form the Primary Care Network
We will never share your information outside of health partner organisations without your explicit consent unless there are exceptional circumstances such as when the health or safety of others is at risk, where the law requires it or to carry out a statutory function.
Within the health partner organisations and in relation to the above mentioned themes we will assume you are happy to for your information to be shared unless you choose to opt-out (see below). This means you will need to express an explicit wish to not have your information shared with the other organisations; otherwise it will be automatically shared. We are required by law to report certain information to the appropriate authorities. This is only provided after formal permission has been given by a qualified health professional. There are occasions when we must pass on information, such as notification of new births, where we encounter infectious diseases which may endanger the safety of others, such as meningitis or measles (but not HIV/AIDS), and where a formal court order has been issued. Our guiding principle is that we are holding your records in strictest confidence.
Your Rights
Your right to withdraw consent for us to share your personal information
The national data opt-out allows people to opt out of their confidential patient information being used for research and planning. It was introduced on 25 May 2018, providing a facility for individuals to opt-out from the use of their data for research or planning purposes. The national data opt-out replaces the previous ‘type 2’ opt-out, which required NHS Digital not to share a patient’s confidential patient information for purposes beyond their individual care. Any patient that had a type 2 opt-out has had it automatically converted to a national data opt-out from 25 May 2018 and has received a letter giving them more information and a leaflet explaining the new national data opt-out. If a patient wants to change their choice, they can use the new service to do this. You can find out more from the practice or by clicking here https://www.nhs.uk/your-nhs-data-matters/
Your right to opt out
The national data opt-out allows people to opt out of their confidential patient information being used for research and planning. It was introduced on 25 May 2018, providing a facility for individuals to opt-out from the use of their data for research or planning purposes. The national data opt-out replaces the previous ‘type 2’ opt-out, which required NHS Digital not to share a patient’s confidential patient information for purposes beyond their individual care. Any patient that had a type 2 opt-out has had it automatically converted to a national data opt-out from 25 May 2018 and has received a letter giving them more information and a leaflet explaining the new national data opt-out. If a patient wants to change their choice, they can use the new service to do this. You can find out more from by clicking here https://www.nhs.uk/your-nhs-data-matters/
Patients who have a type 1 opt-out
Some patients will have a type 1 opt-out registered with the practice, You can tell the practice if you do not want your confidential patient information held in your GP medical record to be used for purposes other than your individual care. This is commonly called a type 1 opt-out. This opt-out request can only be recorded by your GP practice.
If your wishes cannot be followed, you will be told the reasons (including the legal basis) for that decision. There are certain circumstances where a person is unable to opt out but these are only where the law permits this such as in adult or children’s safeguarding situations.
You have a right in law to refuse or withdraw previously granted consent to the use of your personal information. There are possible consequences of not sharing such as the effect this may have on your care and treatment but these will be explained to you to help with making your decision.
If you wish to exercise your right to opt-out, or to speak to somebody to understand what impact this may have, if any, please contact us using the usual practice contact details.
You can find out more by clicking here https://www.nhs.uk/using-the-nhs/about-the-nhs/opt-out-of-sharing-your-health-records/
Right of Access to Your Personal Information
We will tell you if we use your personal information, what that information is and why we use it. We will also tell you where we obtained the information from and with whom we share your information. Under this right we have to tell you how long we intend to keep your information for.
You are entitled to obtain a copy of the personal information held about you by the practice. You can view this or request copies of the records by making a subject access request. Any request to access or obtain a copy of this information will be considered in line with the data protection legislation. This is generally free of charge unless your request is very complicated and/or unreasonably excessive; if you require further copies of information already provided to you we may charge a reasonable administrative fee. If you want to access your data you can contact us using the contact details at the top of this notice. Under special circumstances, some information may be withheld. If information is requested by a solicitor that includes a report or insurance claim , this should be requested via the Access to medical records policy.
Right to Rectification
This right allows you to ask for any information you believe to be inaccurate or incomplete to be corrected and completed. We are allowed one month from the date of your request in which to perform any such corrections or add supplementary statements. We will communicate any rectification of information to anyone to whom it has been disclosed unless this is not possible or involves disproportionate effort. We will tell you who those recipients are if you ask us.
Right to Erasure
This right is also commonly referred to as the ‘right to be forgotten’. You can request that your information be erased, subject to certain exemptions, if it is no longer needed by us for the original purpose we said we would use it for or if you decide to withdraw your consent or if you object to the use of your information. If it transpires that the information was unlawfully used or is found to infringe the law you can ask for it to be erased. We will erase your information if we have a legal obligation to do so. We will communicate any erasure of information to anyone to whom it has been disclosed unless this is not possible or involves disproportionate effort. We will tell you who those recipients are if you ask us.
Right to Restriction of Processing
Restriction means marking information with the aim of limiting its processing in the future. Under this right you can request we restrict information processing for a period of time if you think the information is inaccurate, while we check its accuracy. If the information is found to have been used unlawfully you can ask for it to be restricted instead of being erased. If we no longer need to keep the information but you need us to keep it in connection with a legal claim you are involved with you can ask us to restrict it. You can also ask us to restrict processing if you have previously objected to us processing it whilst we check whether our legitimate reasons for processing it outweigh your right. Once processing has been restricted we can start to use the information again only if you have consented to this or where it is in connection with a legal claim or if it is to protect the rights of another person or there is a strong public interest. We will tell you before any restriction we have put in place is lifted. We will communicate any restriction of processing to anyone to whom it has been disclosed unless this is not possible or involves disproportionate effort. We will tell you who those recipients are if you ask us.
Right to Data Portability
The purpose of this right is to give a person more control over their personal information. Data Portability means you have the right to receive a copy of personal information which you have given us in a structured, commonly-used, machine-readable format and to have it transferred directly to another ‘controller’ where technically possible. This right only applies to information which is processed by automated means and where you have given consent to the processing or where processing is necessary for the performance of a contract. It does not apply if the processing is needed to comply with a legal obligation, our official duties or is for a task carried out in the public interest. It is therefore unlikely to apply to any of the processing carried out by the practice.
Right to Object
You can object to the processing of your personal information if the processing activity is necessary for the performance of a task carried out in connection with our lawful, official duties or those of a third party, or a task carried out in the public interest. We could refuse to comply with a request only where we could show that there was an overriding legal reason or if we need to process the information in relation to a legal claim.
You also have a separate right to object to processing if it is for direct marketing purposes. We do not use your information in this way but if we did we would tell you about it. This right also includes a specific right to object to research uses except where this is done in the public interest.
Automated Decision-Making, Including Profiling
Profiling means any form of automated processing (i.e. processed by a computer and not a human being) of personal information used to analyse, evaluate or predict things about someone; this can include things like someone’s health, personal preferences, interests, economic situation, reliability, performance at work behaviour, location or movements.
Under this right you can ask not to be subject to a decision made solely by automated means, including any profiling, which affects you in a legal way or has a similar significant effect. Automated decision-making and profiling is not allowed if it involves certain types of information; these ‘special categories’ of information are deemed to carry more sensitivity therefore we cannot use your health information for automated decision-making or profiling unless we have your explicit consent or there is substantial public interest allowing us to do so. We currently do not carry out any automated decision-making, including profiling.
Consent
Where processing is based on consent you have the right to withdraw consent to process your personal data.
Right to Complain to the Information Commissioner’s Office (ICO)
If you have concerns or are unhappy about any of our services, please contact the Practice Manager. For independent advice about data protection, privacy and data-sharing issues, or to complain to the ICO if you think any processing of your personal data infringes data protection legislation you can contact:
The Information Commissioner
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Phone: 0303 123 1113 Website: www.ico.gov.uk
Data Protection Officer (DPO)
As a public authority the practice must appoint a DPO. The DPO is an essential role in facilitating ‘accountability’ and the organisation’s ability to demonstrate compliance with the data protection legislation. The DPO for the practice is Liane Cotterill, who can be contacted via
Liane Cotterill
Senior Governance Manager & Data Protection Officer
North of England Commissioning Support
John Snow House
Durham University Science Park
Stockton Road
County Durham
DH1 3YG
Tel: 01642 745042
Mob: 07796278381
Email: [email protected]
Web: www.necsu.nhs.uk
Change of Details
It is important that you tell the person treating you if any of your details such as your name or address have changed or if any of your details are incorrect in order for this to be amended. Please inform us of any changes so our records for you are accurate and up to date.
Mobile telephone number
If you provide us with your mobile phone number, we may use this to send you reminders about your appointments or other health screening information. Please let us know if you do not wish to receive reminders on your mobile.
Reviews of and Changes to our Privacy Notice
We will keep our Privacy Notice under regular review. This notice was last reviewed on 21st February 2023 and will be reviewed annually.
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 out with 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 lifespan 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 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.
Violent and abusive behaviour
As an employer, the practice has a duty to care for the health and safety of its staff.
The practice also has a legal responsibility to provide a safe and secure working environment for staff.
All patients are expected to behave in an acceptable manner and violent or abusive behaviour towards staff or patients may result in removal from our practice list or even criminal proceedings. The practice follows the NHS guidance concerning zero tolerance.
The practice has a policy of zero tolerance of verbal and physical violence towards GPs, staff or other patients.
The practice will request the removal of any patient from the practice list who is aggressive or abusive towards a doctor, member of staff, other patient, or who damages property.
We report all physical abuse to the police as an assault.
We expect all patients to be responsible and avoid attending the surgery under the influence of alcohol or illegal drugs.
Any alteration of prescriptions is illegal and will not be tolerated.
If you’re unhappy with the quality of service you have the right to register with another practice without notifying us.
On the very rare occasions when a patient repeatedly ignores their responsibilities to the Practice, we have the right to remove the patient from our Practice list.
Unacceptable behaviour
Examples of unacceptable behaviour include:
- violence
- excessive noise e.g. recurrent loud or intrusive conversation or shouting
- threatening or abusive language involving swearing or offence remarks
- derogatory racial or sexual remarks
- malicious allegations relating to members of staff, other patients or visitors
- offensive sexual gestures or behaviours
- abusing alcohol or drugs on practice premises
- drug dealing on practice premises
- wilful damage to practice property
- threats or threatening behaviour
- theft
Zero tolerance
Our staff have the right to be treated with dignity and respect at all times.
They should be able to do their jobs without being physically or verbally abused.
Anyone found abusing the staff in person or on the telephone will be asked to leave the practice.
This behaviour will not be tolerated.
Removal from the patient list
In exceptional circumstances, a breakdown may occur between a doctor and their patient.
If the breakdown is serious, for example physical or verbal abuse to any member of the practice team, the doctors may feel that the relationship has been compromised.
We may take steps to remove the patient from the doctor’s list. Where possible, we prefer to discuss with the patient to try to find a solution.
We give reasons for removal in writing.
Website privacy policy
We are committed to protecting your privacy.
We treat our users’ privacy as we would like our privacy to be treated when browsing the web. Any data we collect, or process, is done for legitimate reasons and carefully considered. We do not disclose any information to third parties, we do however use third parties to carry out analytical processing. These are mentioned in our cookies policy. Any personal information that users provide us with, cannot be seen by third parties.
If you have any questions or concerns which our policies do not address, please get in touch with us.
See our contact details.
Information we collect and use
There are sections in our website where we may ask you for your details to make contact with us. Any information you provide will remain our secured property. Under no circumstances will it be sold or rented to any third party.
Other than the data you choose to provide, we have some cookies which help improve the experience for our site visitors. If you haven’t already, go and check them out in our cookie policy.
How we use your contact information
If you’ve provided us with your contact details through this website, we’ll only use them to get back to you. This might be because you’ve made a request to the surgery for an appointment or a prescription.
Non-NHS Work Fees & Charges List
The National Health Service provides most health care to most people free of charge, but there are exceptions.
Prescription charges have existed since 1951, and there are a number of other services for which fees are charged. Sometimes the charge is made to cover some of the cost of treatment, for example dental fees. In other cases. In other cases it is because the service isn’t covered by the NHS, for example, medical reports for insurance companies, claims on private health insurance and other letters and forms which require the doctor to review the patient’s medical records.
It is important to understand that GPs are not employed by the NHS, they are self employed, and they have to cover their costs – staff, buildings, heating, lighting – in the same way as any small business. The NHS pays the doctor for specific NHS work, but for non-NHS work the fee has to cover the doctor’s costs.
What is covered by the NHS and what is not?
The government’s contract with GPs covers medical services to NHS patients. In recent years, more and more organisations have been involving doctors in a whole range of non medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to be sure that information provided is true and accurate.
Examples of non-NHS services for which GPs can charge their patients:
Certain travel vaccinations
Private medical insurance reports
Holiday cancellation forms
Referral for private care forms / letters
Letters requested by or on behalf of, the patient
In certain instances fitness to work forms
Examples of non-NHS services for which GPs can charge other institutions:
Medical reports for an insurance company
Some reports for the DSS/Benefits agency
Examinations of local authority employees
Why does it sometimes take my GP a long time to complete my form?
Time spent completing forms and preparing reports takes the GP away from the medical care of his/her patients. Most GPs have a very heavy workload- the majority of our GPs work up to 60 hours a week and paperwork takes up an increasing amount of their time. In addition non-NHS work must be undertaken outside of NHS contracted time. We aim to complete private requests within 30 calendar days, but this is dependent on NHS requirements which take priority.
I only need the doctor’s signature-what is the problem?
When a doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. Therefore in order to complete even the simplest of forms, the doctor needs to check the patient’s entire record. Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical Council or even the Police.
Why do some letters cost £25 and others £50 or more?
Each request is very different and some requests can be completed very quickly as the medical history of the patient is very small and known to the GP. However, where a GP has to review a large medical history to ensure accuracy of any comment they make in a letter; or the content of the letter is extensive we must consider how much time it has taken to complete this work. Your cost includes the time the GP takes to review the request, review your medical record, to dictate a letter and the time for the admin team to type up the letter where necessary and printing/postage costs where necessary.
I have had a request for a letter declined – why is that?
All private requests are at the absolute discretion of the GP and they reserve the right to decline a request.
There are also several letter types we do not provide as they are not effective use of GP time and/or they are not necessary.
These include but are not limited to:
Letters to schools and colleges regarding absence
Letters regarding sickness absence during the period of self certification
Letters to schools/nurseries regarding non prescribed medications. (Please note that where a medication has been prescribed, a copy of the prescription and the medication with the administering instructions is sufficient for a school/nursery and they should not require an additional letter).
We may not be able to help where a specialist opinion is necessary e.g. fitness to undertake extreme sports etc
Fees & Charges List
Access to Medical Records Under GDPR – No Charge
To Whom It May Concern Letter – £30.00
Private Sickness Certificate – £30.00
Freedom of Infection Certificate – £40.00
Fitness to Carry Out Sporting Activities – £40.00
Letter regarding Medical Fitness – £40.00
Shotgun Certificate – £60.00
Certificate of Incapacity – £30.00
Assessment of Mental Capacity (No Examination) – £100.00
Assessment of Mental Capacity (Form & Examination) – £175.00
Power of Attorney Examination & Certificate – £80.00
Power of Attorney Witness – £40.00
Private Medical Claim Form (Basic) – £48.00
Private Medical Claim Form (Complex) – £60.00
Report on Proforma – £90.00
Extract from Records – £70.00
Report without examination – £140.00
Examination and Report – £180.00
Short Certificate- £40.00
GP Supplementary Reports – £30.00
Holiday Cancellation Form (Basic) – £30.00
Holiday Cancellation Form (Complex) – £60.00
Vaccination Certificate – £30.00
Letter regarding Medical Fitness – £40.00
Fitness to Fly Letter – £40.00
PADI Fitness for Diving Medical Statement – £50.00
VISA Medical Report for Migrating/Travel – £50.00
Full Physical Medical Examination – £115.00
Childminder OFSTED Declaration Form – £114.00
Initial Health Assessment Form – £100.00
Form AH2 Update Report – £35.00
Full Physical Medical Examination (HGV/PSV/Taxi) – £120.00
Limited Physical Examination with Report – £85.00
DVLA Medical (Over 75) – £60.00
Seat Belt Exemption – £60.00
Private Blood Tests – Available On Request