Practice Policies & Patient Information
Chaperone Policy
All patients have the rights to a chaperone during their appointments.
If you would like to have a chaperone present during an examination or consultation, please arrange this with any member of our clinical team.
Cheshire Care Record
Sharing your health and social care information to give you better care.
The Cheshire Care Record is a collaboration between all GP, hospital, community, mental health and social care services provided across Cheshire.
If you have already told your GP that you don’t want your health data to be shared, you may wish to reconsider and ask your GP to share your data locally so that a Cheshire Care Record can be created for you.
Whether you are visiting your GP, attending hospital, or being seen in your own home or health centre by a community nurse or social worker, we want you to get the best care. We can only do this if all the health and social care professionals involved in your care have access to the information they need to make informed decisions with you.
For more information you can visit website Cheshire Care Record or download the Cheshire Care Record Leaflet
Complaints, Compliments, Comments and Suggestions
Complaints
As a Practice we all try hard to provide the best possible service for our patients with the resources available. If you are dissatisfied with any of our services, please speak to the Patient Services Manager in the first instance.
If you are dissatisfied with the response, please put your complaint in writing, addressed to Dr Mike Mullin, Executive Partner, or Amanda Skelding-Jones, Business Manager. We will look into your complaint and send you a written acknowledgement within three working days. Once your complaint has been investigated we will then write to you again with an explanation or suggest a meeting.
We feel it is much better for grievances to be tackled as soon as possible and, ideally, directly between the parties involved, as misunderstandings can be more readily resolved in this way.
If you don’t want to make a complaint to the practice, you can contact the commissioner of the service NHS Cheshire & Merseyside integrated care board;
Writing: Patient Experience Team No 1 Lakeside, 920 Centre Park Square, Warrington, WA11QY;
E-mail [email protected]
Telephone 0800 132 996
Comments and Suggestions
We welcome comments and suggestions about our services and have a suggestion box in the waiting room for this purpose.
Alternatively, please ask to speak to either the Patient Services Manager or Business Manager or write to them at Danebridge Medical Practice, 29 London Road, Northwich, Cheshire CW9 5HR
The Care Quality Commission (CQC), the health and social care regulator welcomes comments about the operation of NHS services and can be contacted 03000 61 61 61 or by emailing [email protected] or by using their online form which can be found at www.cqc.org.uk
CQC Report
Please visit the link below to view our CQC Report:
GDPR Privacy Notice
This privacy notice explains why Danebridge Medical Practice, hereafter known as ‘the Practice’, collects information about you, how it is kept secure and how that information is used. This notice will explain: The General Data Protection Regulation (GDPR) became law on 25 May 2018. This regulation protects the personal and sensitive data of a living individual. It is currently known as the UK GDPR 2021 after the United Kingdom withdrew from the European Union on 31 January 2020. As your registered GP practice, we are the data controller for any personal and sensitive data we hold about you. We are committed to protecting your privacy and will only use information collected lawfully in accordance with: Healthcare professionals within the NHS and who provide you with care are required by law to maintain your medical records with details of any care or treatment you received. This information will be used to aid clinicians to make decisions, either individually or jointly, about your health and to make sure it is safe and effective. Other reasons include: The healthcare professionals who provide you with care maintain records about your health and any treatment or care you have received previously or elsewhere (eg NHS hospital Trust, another GP surgery, Out of Hours service, Accident & Emergency Department, etc). These records help to provide you with the best possible healthcare. Information we hold about you may include the following: Every member of staff who works for an NHS organisation has a legal obligation to keep information about you confidential. We maintain our duty of confidentiality by conducting annual training and awareness, ensuring access to personal data is limited to the appropriate staff and information is only shared with organisations and individuals that have a legitimate and legal basis for access. 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, or where the law requires information to be passed on, for example: Our practice policy is to respect the privacy of our patients, their families and our staff, and to maintain compliance with the UK GDPR and all UK specific Data Protection Requirements. Our policy is to ensure all personal data related to our patients will be protected. All employees must sign a confidentiality agreement as part of their condition of employment. We also ensure that data processors who support us are legally and contractually bound to operate and prove security arrangements are in place where data which could or does identify a person are processed. Third party processors include: We will email or text you regarding matters of medical care, such as appointment reminders and, if appropriate, test results, unless you have separately given the practice your explicit consent to do so. We maintain our duty of confidentiality to you and will only use or share information with others if they have a genuine need for it. We will not share your information to a third party without your permission, unless there are exceptional circumstances, ie life and death, or where the law requires us to share your information. Confidential patient data will be shared within the healthcare team at the practice, including nursing staff, administration staff (prescription, secretaries, reception, finance) and with other healthcare professionals to whom a patient is referred. The practice uses data processors to perform certain administrative tasks for us, particularly where these involve large numbers of patients. Details of the data processors are listed below: These screen programmes include: The following information is used for risk stratification: This information will be used to: Several data sharing schemes are active locally, enabling healthcare professionals working outside of the surgery to view information from your GP record. These schemes are as follows: The shared record means patients do not have to repeat their medical history at every care setting. Your record will be automatically setup to be shared with the organisations listed above, however you have the right to ask your GP to stop your record from being shared or only allow access to parts of your record. Your electronic health record contains lots of information about you. In most cases, particularly for patients with complex conditions and care arrangements, this means that you get the best care and means that the person involved in your care has all the information about you. The shared record means patients do not have to repeat their medical history at every care setting. We are sometimes legally obliged to disclose information about patients to relevant authorities. In these circumstances the minimum identifiable information that is essential to serve that legal purpose will be disclosed. The organisation will also have a professional and contractual duty of confidentiality. Data will be anonymised if possible before disclosure if this would service the purpose for which the data is required. Organisations which we are legally obliged to release patient data to include: · NHS Digital (eg the National Diabetes Audit) · Care Quality Commission · Driver and Vehicle Licensing Agency · General Medical Council · His Majesty’s Revenue & Customs · NHS Counter Fraud · Police · The Courts · UK Health Security Agency and Office for Health Improvement and Disparities · Local Authorities (Social Services) · The Health Service Ombudsman · Medical defence organisation – in the event of an actual or possible legal proceedings The practice can release information from your medical records to relevant organisations, only with your explicit consent. These include: · Your employer · Insurance companies · Solicitors · Local Authorities (the Council) · Police · Community services – district nurses, rehabilitation services, telehealth and OOH hospital services · Child health services which undertaken routine treatment or health screening · Urgent care organisations, minor injury units · Community hospitals · Palliative care hospitals · Care homes · Mental health Trusts · NHS hospitals · Social care organisations · NHS commissioning support units · Independent contractors, ie dentists, opticians, pharmacists · Private sector providers · Voluntary sector providers · Local ambulance Trust · Integrated Care Board · Education services · Fire and Rescue services You have the right to withdraw your consent at any time for any instance of processing, provided consent is the legal basis for the processing. Please contact your GP Practice for further information and to raise your objection. You have a choice about whether you want your confidential patient information to be used in this way. If you are happy with this use of information you do not need to do anything. If you do choose to opt out, your confidential patient information will still be used to support your individual care. Your practice has systems and processes in place to comply with the National Data Opt-out and apply your choice to any confidential patient information they use or share for purposes beyond your individual care. To find out more or to register your choice to opt out, please visit https://www.nhs.uk/your-nhs-data-matters/ or telephone 0300 3035678. On the webpage you will: · See what is meant by confidential patient information · Find examples of when confidential patient information is used for individual care and examples of when it is used for purposes beyond individual care · Find out more about the benefits of sharing data · Understand more about who uses the data · Find out how your data is protected · Be able to set or change your opt-out setting · Find the contact telephone number if you want to know any more or to set/change your opt-out by phone · See the situations where the opt-out will not apply, i.e. where here is a legal requirement or where it is in the public interest to share (go to more exemptions for further information) You can also find out more about how patient information is used at: https://www.hra.nhs.uk/information-about-patients/ (which covers health and care research). https://understandingpatientdata.org.uk/what-you-need-know (which covers how and why patient information is used, the safeguards and how decisions are made) You can change your mind about your choice at any time. Data being used or shared for purposes beyond individual care does not include your data being shared with insurance companies or used for marketing purposes and data would only be used in this way with your specific agreement. We need to know your personal, sensitive, and confidential data so that we can provide you with healthcare services as a General Practice. Under the new rules called General Data Protection Regulation (GDPR) there are different reason why we may process your data, however we mostly rely upon: Article 6(1)(e): Official Authority; and Article 9(2)(h): Provision of health For much of our processing, in particular: · Maintaining your electronic GP record · Sharing information from, or allowing access to, your GP record, for healthcare professionals involved in providing you with direct medical care · Referrals for specific healthcare purposes · The NHS data sharing schemes · Our data processors · Organising your prescriptions, including sending them to your chosen pharmacist · Some permissive disclosures of information We also rely upon: · Article 6(1)(d): Vital interests – to share information with another healthcare professional in a medical emergency · Article 6(1)(c): Legal obligation – Mandatory disclosure of information to NHS Digital and CQC, etc · Article 6(1)(a): Consent – Certain permissive disclosures of information, ie insurance companies · Article 9(2)(j): Research – for accredited research undertaken in the surgery, with your explicit consent. The UK GDPR allows you to ask for any information the practice holds about you, including your medical records. It also allows you to ask the practice to rectify any factually inaccurate information and object to how your information is shared with other organisations (opt-out). Data being used or shared for purposes beyond individual direct care does not include your data being shared with insurance companies or used for marketing purposes and data would only be used in this way with your specific agreement. The practice holds both personal and sensitive data (health records) about you. If you need to review a copy of your historical medical records, you can contact the surgery to make a ‘Subject Access Request’. Please note, if you receive a copy, there may be information that has been hidden. Under UK GDPR the practice is legally permitted to apply specific restrictions to the released information. The most common restrictions include: · Information about other people (known as ‘third party’ data) unless you provided the information, or they have consented to the release of their data held within your medical records · Information which may cause serious physical or mental harm to you or another living person. For some Subject Access Request cases, a GP will perform a ‘serious harms test’. If the GP has any cause to believe that specific information will cause you or someone else serious harm, it will not be released. You have the right to have any factual inaccuracies about you in your medical record corrected. Please contact the surgery with your request. If you do not wish to share your information with organisations who are not responsible for your direct care, you can opt-out of the sharing schemes. For further information about opting out, please visit Your NHS Matters. Where the practice has obtained your consent to process your personal data for certain activities, (eg preparation for a subject access request for a third party), you have the right to withdraw your consent at any time. From 1 November 2023, if you have online access to your medical records, you will be given access to your full records (from 1 November 2023). This means you will have access to free texts, letters, and documents once they have been reviewed and filed by the GP. Please note that this will not affect proxy access. If you move practice, access to your full medical records will commence from the date you register with the new practice. There will be limited legitimate reasons why access to prospective medical records will not be given or will be reduced and they are based on safeguarding. If the release of information is likely to cause serious harm to the physical or mental health to you or another individual, the GP could refuse or reduce access to prospective records; third party information may also not be disclosed if deemed necessary. On occasion, it may be necessary for a patient to be reviewed before access is granted, if access can be given without a risk of serious harm. 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 such as date of birth is incorrect for this to be amended. You have a responsibility to inform us as soon as possible of any changes so our records are accurate and up to date for you. The NHS Records Management Code of Practice 2021 identifies will replace the 2016 version. specific retention periods which are listed in Appendix II: Retention Schedule. Please see https://www.nhsx.nhs.uk/information-governance/guidance/records-management-code/records-management-code-of-practice-2021/ for a copy of the 2021 NHS retention period policy. If you have any concerns about how your data is managed, please contact the Practice Manager in the first instance. For independent advice about data protection, privacy and data sharing issues, you can contact: The Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire, SK9 5AF Tel: 0303 123 1113 Web: www.ico.org.uk If you have any concerns about how your data is shared or would like to know more about your rights in respect of your personal data held by the practice, please contact the Data Protection Officer. Any queries about data protection issues should be addressed to: Sharon Forrester-Wild Emal: [email protected] Tel: 07946 593082
Introduction
Why do we collect your information?
What information do we collect?
How do we keep your information safe and secure?
Why do we share your information, and who do we share it with?
Data processors
Data sharing schemes
Mandatory disclosure of information
Permissive disclosure of information
Don’t want to share your information?
Legal basis for processing your personal data
Your data rights
Right of access
Right to rectification
Right to object
Right to withdraw consent
Your access to your future health records
What should you do if your personal information changes?
How long will we store your data?
How can you complain?
Further information
Data Protection Officer
GP Net Earnings
HS England require that the net earnings of doctors engaged in the practice is publicised, and the requirement 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 the doctors spend working in the practice and should not be used to form any judgement about GP earnings, nor to make any comparison with other Practice.
All GP practices are required to declare the mean earnings ( e.g. average pay) for GPs working to deliver NHS services to patients at each practice. The average pay for GPs working in Danebridge Medical Practice in the 2021/22 financial year was £80,076 before tax and national insurance. This is for 2 Full Time GPs, 17 Part Time GPs and 2 Locum GPs who worked in the practice for more than 6 months.
Medication Requests for Flying
June 2023
We are occasionally asked by patients to prescribe sedating medication for flying.
We regret that henceforth we are not able to facilitate these requests on the grounds of patient safety and our need to prioritise the delivery of NHS care on the basis of patients’ clinical needs.
Sedating medication, e.g. benzodiazepines such as diazepam, can render someone either paradoxically aggressive, or less able to follow instructions in an emergency, thus putting crew and other passengers at risk.
Sleeping tablets similarly have no indication for flying, and again could make a passenger difficult to rouse or transfer if there was a genuine in-flight emergency. Sometimes passengers mix these medications with alcohol, with deleterious consequences. We would not wish you to to be barred from a flight or face prosecution, or find yourself incapacitated due to the unpredictable effects of said medication. The drug driving legislation which came into effect in recent years would also potentially prohibit onward driving from an airport.
Flight anxiety should be treated by Cognitive Behavioural Therapy – a form of counselling, which has long lasting benefits and is safe. Airline carriers offer excellent courses for free, so do speak with your flight provider to arrange to go on a course well in advance of when you know you will be flying.
It is not within the remit of the NHS to render someone fit to travel on a voluntary holiday or business trip, and due to the inexorable demands currently facing general practice, we make no apology for prioritising NHS care for patients on the basis of their clinical need.
We acknowledge there may be occasion when you have previously received a prescription for this purpose. We regret that we will be unable to agree to such requests henceforth. This is a joint decision, unanimously made by all senior clinical staff within the practice.
Patients are reminded that they are able to arrange a consultation at a private travel clinic should they wish to pursue the option of in-flight medication further, but we cannot accommodate their request and so would politely ask that they respect this universal practice policy from June 2023.
No Smoking Policy
Please be aware that all our sites operate a strict non-smoking policy and smoking is not permitted anywhere within our buildings nor immediately in front of the entrance ways.
Many thanks for your cooperation.
Online access to records
The NHS wants to give people better ways to see their personal health information online. We know that people want to be able to access their health records. It can help you see test results faster. It also lets you read and review notes from your appointments in your own time.
We’re now letting you see all the information within your health record. If you are over 16 and have an online account, such as through the NHS App, NHS website, or other GP online services and apps, you will now automatically be able to see all future information entered on your medical record.
This means that you will be able to see records from your appointments, as well as test results and any letters that are saved on your records. This only applies to records from your doctor (GP), not from hospitals or other specialists, although you will be able to see any letters that hospitals or specialists send to your doctor (GP). You will only be able to see information from 4th October 2023 or from the date of your online registration.
Your doctor may talk to you to discuss test results before you are able to see some of your information on the app. Your doctor may also talk to you before you are given full record access to make sure that having access is of benefit to you. If you are concerned that seeing your records is not right for you, you should speak to your practice.
These changes only apply to people with online accounts. If you do not want an online account, you can still access your GP health record by requesting this information via reception. The changes also only apply to personal information about you. If you are a carer and would like to see information about someone you care for, speak to reception staff.
The NHS App, website and other online services are all very secure. You’ll need to make sure you protect your login details. Do not share your password with anyone as they will then have access to your personal information.
If you do not want to see your health record, or if you would like more information about these changes, please speak to your GP or reception staff.
If you wish to register for an online account you can do this online with the NHS app About the NHS App – NHS (www.nhs.uk)
Patients Rights and Responsibilities
Patients at this practice are entitled to:
• Be provided with services in a courteous, civil and co-operative manner.
• An explanation of, and advice on, their medical condition and any proposed treatment.
• A referral for specialist medical opinion or other second opinion in appropriate circumstances after discussion.
• Confidentiality of medical records maintained by the practice subject to the provisions for disclosure imposed or allowed by law.
• Access to their own personal health records, in accordance with the General Data Protection Regulations (GDPR). (Please contact the Practice Manager if you wish to view your records.)
• Have any formal complaint against the practice investigated and dealt with fairly, and according to the practice complaints procedure.
• Request (either in writing or verbally) to be seen by a particular doctor. We shall endeavour to comply with this request, but need not do so if the preferred doctor is not able to, or has reasonable grounds for refusing.
• Patients aged 16-74 who have not been seen at the practice for three years can request a health check with a nurse or healthcare assistant.
• Patients who are over 75 can request an annual health check with a nurse or healthcare assistant.
Patients’ Responsibilities
The practice would like you to:
• Behave with civility and courtesy at all times.
• Inform the practice if you change your telephone number or name and address.
• Please make appointments that you know you can keep, and arrive on time. If for some reason you are unable to keep your appointment please make sure you inform the practice as soon as possible.
• Ask for a GP home visit only if you are too ill to go to the surgery. If possible telephone before 10.00am.
• Read your practice booklet or visit our website www.danebridge.org.uk. This will help you get the best from the services available.
• Be patient if the doctors are running late – on another occasion it might be you who needs the extra time.
• Not to ask for another member of the family to be seen at your appointment without making prior arrangements.
The practice will not accept:
• Rudeness, threats or aggressive behaviour directed towards practitioners, staff or other patients.
• Repeated abuse of its facilities including emergency or out-of-hours service.
Sedatives For Scans / Procedures Performed By Organisations External To Danebridge Medical Practice
We are unable to prescribe sedatives, such as diazepam, for any procedure or scan being undertaken outside of Danebridge Medical Practice, this includes MRI scans and dental procedures.
If you feel you need sedation in such circumstances, please speak to the team undertaking the procedure or scan, as they are responsible for providing this if needed.
Sedatives are medicines which make patients sleepy and relaxed. There are several reasons why healthcare practitioners at Danebridge Medical Practice do not prescribe these medicines for procedures outside of our practice:
- GPs are not trained to provide the correct level of sedation for a procedure / scan. Providing too little sedation won’t help you, providing too much sedation can make you too sleepy, which could lead to the procedure being cancelled. Too much sedation can dangerously affect your breathing. After taking a sedative for a procedure or scan, you will need to be closely monitored to keep you safe.
- Although diazepam makes most people who take it sleepy, in some rare situations it can have an opposite effect and make people aggressive or agitated.
- Scans and hospital procedures are often delayed, therefore the team performing he procedure or scan should provide the sedation, to ensure you become sleepy and relaxed at the right time.
Feel free to show this policy to your hospital team or dentist.
Further Information
For more information, please see the following patient information leaflet published by the Royal College of Anaesthetists:
http://rcoa.ac.uk/sites/default/files/documents/2022-06/12-SedationExp2021web.pdf (link checked October 2022)
The following links provide further information:
Sedation, analgesia and anaesthesia in the radiology department – Royal College of Radiologists
https://www.rcr.ac.uk/system/files/publication/field_publication_files/bfcr182_safe_sedation.pdf (link checked October 2022)
Safe Sedation Practice for Healthcare Professionals: Standards and Guidance – Academy of Medical Royal Colleges
Zero Tolerance
The NHS has a zero-tolerance policy towards all violence and aggression. This policy is for the protection of all NHS colleagues, but also the protection of other patients, their families, visitors etc. In order to ensure that this zero-tolerance approach is adhered to, it is essential to have robust policies and procedures in place. In General Practice, this will need to cover a variety of situations in which incidents could occur. Generally speaking, the majority of patients behave in acceptable or manageable way, however the incidence of excessively aggressive or violent attacks in the GP practice is increasing.
The practice recognises that there can be contributory reasons for patients behaving in difficult or challenging ways, however where this tips over into aggression or violence, the practice will adopt a zero-tolerance approach.
Danebridge Medical Practice aims to provide high quality healthcare and we will treat all patients with respect and dignity. In return we expect all our colleagues to be treated with respect. We will not tolerate abusive language or threatening behaviour against any team member. Such behaviour may result in the offender being denied access to the service and / or further measures as appropriate.
In order for the practice to maintain positive relations we would like to ask all patients to note the types of behaviour that would be found unacceptable:
- Verbally abusive, offensive or intimidating in their behaviour
- Threatening or subjecting others to physical violence
- Causing damage / stealing from the Practice’s premises, colleagues or patients
- Obtaining drugs and/or medical services fraudulently
- Banging on desks or shouting loudly in an intimidating manner
- Any form of harassment, including those related to race and sex
- Making excessive demands and / or maintaining certain expectations and failing to accept that these are unreasonable (e.g., wanting an immediate appointments and becoming aggressive when this is not possible)
- Insisting that a colleague is dismissed
- Insisting that treatment is carried out on demands
- Constantly requesting a different clinician or health care professional.
Removal from the practice list
In rare circumstances, the trust between the healthcare professional and a patient may break down, and the clinician may find it necessary to end the professional relationship. For example, this may occur if a patient has been violent, has stolen from the premises, or has persistently acted inconsiderately or unreasonably.”
If patients have been violent to any team members or have threatened colleagues’ safety, the incident will be reported to the Police. Patients may also be referred to the Special Allocation Service, which provides primary care medical services in a secure environment.
Even in these circumstances, the practice will inform the patient of the reasons leading to removal from the practice list, unless one or more of the following apply:
- it would be harmful to the mental or physical health of the patient
- it would put practice team or patients at risk
- it would not be reasonably practicable to do so.
The practice will record this in the patient’s records and set out the circumstances leading to removal. Family members should not be struck off GP lists, unless there is a threat to the practice from the ex-patient as a result of keeping these patients on.