Practice Policies

The General Data Protection Regulation (“GDPR”) came into force in 2018. All applications for access to medical records of living persons are now made under the GDPR.

For deceased persons applications are made under sections of the 1990 Access to Health Records Act. These sections provide the right of access to the health records of deceased individuals for their personal representative and others having a claim under the estate of the deceased.

A patient has the right to apply for access to their health records. This is called a Subject Access Request (“SAR”). A SAR can mean viewing or having a copy of the record. Provided an appropriate SAR is made the Practice is obliged to comply with SAR subject to certain exceptions (see below) within 30 days. However, the Practice also has a duty to maintain the confidentiality of patient information and to satisfy itself that the applicant is entitled to have access before releasing information.

We cannot charge for a SAR. We can charge for multiple requests for the same information where these are deemed to be onerous. Remember a SAR relates to the subject. If two parties make a SAR for the same record then we can charge for the second of these.

Applications for health record of a living person

An application for access to health records may be made in any of the circumstances explained below.

The patient:

• Requests may be made by letter, email, telephone or in person.

Children aged 16 years or over:

• Provided the child is mentally competent then they are entitled to request or refuse access to their records in the same way as an adult.

Children Under 16 Years:

• Individuals with parental responsibility for someone under 16 years of age will have the right to request access to those medical records.
• A person with parental responsibility is either:
  • The birth mother, or
  • The birth father (if married to the mother at the time of child’s birth or subsequently) or,
  • An individual given parental responsibility by a court.
    (This is not an exhaustive list but contains the most common circumstances).

If the appropriate health professional considers that a child patient is Gillick competent (i.e. has sufficient maturity and understanding to make decisions about disclosure of their records) then the child should be asked for his or her consent before disclosure is given to someone with parental responsibility.

If the child is not Gillick competent and there is more than one person with parental responsibility, each may independently exercise their right of access. Technically, if a child lives with, for example, its mother and the father applies for access to the child’s records, there is no “obligation” to inform the mother. In practical terms, however, this may not be possible and both parents should be made aware of access requests unless there is a good reason not to do so.

In all circumstances good practice dictates that a Gillick competent child should be encouraged to involve parents or other legal guardians in any treatment/disclosure decisions.

Patient Representatives:

• A patient can give written authorisation for a person (for example a solicitor or relative) to make an application on their behalf. The Practice may withhold access if it is of the view that the patient authorising the access has not understood the meaning of the authorisation. In this situation the Practice will check with the patient. Where a solicitor or other representative is making the request, ensure that you have patient signed consent and sufficient information to clearly identify the patient. Where a solicitor has asked for a patient’s entire medical record Farnham Road Practice will contact the patient to confirm that this is the patient’s wish.

Court Representatives:

• A person appointed by the court to manage the affairs of a patient who is incapable of managing his or her own affairs may make an application. Access may be denied where the GP is of the opinion that the patient underwent relevant examinations or investigations in the expectation that the information would not be disclosed to the applicant.

Children and Family Court Advisory and Support Service (CAFCASS):

• Where CAFCASS has been appointed to write a report to advise a judge in relation to child welfare issues, Farnham Road Practice will attempt to comply by providing factual information as requested. Before records are disclosed, the patient’s or parent’s consent (as set out above) should be obtained. If this is not possible, and in the absence of a court order, the Practice will need to balance its duty of confidentiality against the need for disclosure without consent where this is necessary:
  • To protect the vital interests of the patient or others, or
  • To prevent or detect any unlawful act where disclosure is in the substantial public interest (e.g. serious crime), and
  • Because seeking consent would prejudice those purposes.

The relevant health professional should provide factual information and their response should be forward to the Child Protection Team who will approve the report.

Amendments to or Deletions from Records:

• If a patient feels information recorded on their health record is incorrect then they should firstly make an informal approach to the health professional concerned to discuss the situation in an attempt to have the records amended. If this is unsuccessful then they may pursue a complaint under the NHS Complaints procedure in an attempt to have the information corrected or erased. The patient has the ‘right’ under the DPA to request that the personal information contained within the medical records is rectified, blocked, erased or destroyed if this is inaccurately recorded. Medical information should not be deleted. If information is factually incorrect, or has changed, then the new information should be added and a note included explaining that this supersedes the original information.

Application for Access to a Deceased Patient’s Medical Records

• Where a patient has died, the patient’s personal representative or any person who may have a claim arising out of the patient’s death may make an application.

The personal representative (Executor) does not need to provide any explanation for a request and may request a copy of the entire medical record.

A person who was a claim arising out of a patient’s death needs to explain the nature of the claim and specify the medical information required. Access shall not be given to any part of the record which, in the GP’s opinion, would disclose information which is not relevant to the claim. The timeline for a response commences when the GP is satisfied that the information supplied by the claimant is sufficient.

Grounds for refusing disclosure to health records

The GP should refuse to disclose all or part of the health record if they are of the view that:

• Disclosure would be likely to cause serious harm to the physical or mental health of the patient or any other person;
• The records refer to another individual who can be identified from that information (apart from a health professional). This is unless that other individual’s consent is obtained or the records can be anonymised or it is reasonable in all circumstances to comply with the request without that individual’s consent, taking into account any duty of confidentiality owed to the third party; or if
• The request is being made for a child’s records by someone with parental responsibility or for an incapacitated person’s record by someone with power to manage their affairs, and the:
  • Information was given by the patient in the exception that it would not be disclosed to the person making the request, or
  • The patient has expressly indicated it should not be disclosed to that person

Informing of the decision not to disclose

If a decision is taken that the record should not be disclosed, a letter must be sent by recorded delivery to the patient or their representative stating that disclosure would be likely to cause serious harm to the physical or mental health of the patient, or to any other person. The general position is that the practice should inform the patient if records are to be withheld on the above basis.

If however, the appropriate health professional thinks that telling the patient:

• Will effectively amount to divulging that information, or
• Is likely to cause serious physical or mental harm to the patient or another individual

Then the GP can decide not to inform the patient, in which case an explanatory note should be made in the file.

Although there is no right of appeal to such a decision, it is the Practice’s policy to give the patient the opportunity to have their case investigated by invoking the complaints procedure.

The patient must be informed in writing that help will be offered to them if they wish to do this. In addition, the patient may complain to the Information Commissioner for an independent ruling on whether non-disclosure is proper.

Disclosure of a Deceased Patient’s Medical Records

The same procedure used for disclosing a living patient’s records should be followed when there is a request for access to a deceased patient’s records. Access should not be given if:

• The appropriate health professional is of the view that this information is likely to cause serious harm to the physical or mental health of any individual; or
• The records contain information relating to or provided by an individual (other than the patient or a health professional) who could be identified from that information (unless that individual has consented or can be anonymised): or
• The record contains a note made at the request of the patient before his/her death that she/he does not wish access to be given on application. (If while still alive, the patient asks for information about his/her right to restrict access after death, this should be provided together with an opportunity to express this wish in the notes);
• The holder is of the opinion that the deceased person gave information or underwent
  investigations with the expectation that the information would not be disclosed to the applicant.
• The practice considers that any part of the record is not relevant to any claim arising from the death of the patient.

Practices should treat all requests as potential claims for negligence. Farnham Road Practice will keep a central record of all requests to ensure that requests are cross-referenced with any complaints or incidents and that the deadlines for the response are monitored and adhered to.
Before the Practice discloses or provides copies of medical records the patient’s doctor must have been consulted and he or she must check the records and authorised the release, or part-release.

Disclosure of the record

Once the appropriate documentation has been received and disclosure approved, the copy of the health record may be sent to the patient or their representative in a sealed envelope by recorded delivery. The record should be sent to a named individual, marked confidential, for addressee only and the sender’s name should be written on the reverse of the envelope. Originals should not be sent.

Confidential information should not be sent by fax and only by e-mail if an encrypted service is available. A written consent from the patient to have the information transmitted by email must be obtained. A note should be made in the file of what has been disclosed to whom and on what grounds.

Charges and Timescales

Copies of records should be supplied with 21 days of receiving a valid and complete access request. Where further information is required by the practice to enable it to identify the record or validate the request, this must be requested within 14 days of receipt of the application and the timescale for responding begins on receipt of the full information.

PST will provide information on charges for patients to access their medical records.

Patients Living Abroad

Former patients living outside of the UK have the same rights to apply for access to their UK health records. (Same process applies)

Requests made by telephone

No patient information may be disclosed to members of the public by telephone. If staff need to provide information to other health providers the person requesting the information must be called back and the identity of the person requesting the information must be confirmed.

Requests made by the police

In all cases the practice can release confidential information if the patient has given his/her consent and understands the consequences of making that decision. There is, however, no legal obligation to disclose information to the police unless there is a court order or this is required under statute, or there is a risk to the patient or other members of the public that is deemed sufficient to breach confidentiality.

Introduction

The purpose of the policy is to set out the approach at the Farnham Road Medical Group to offering Chaperones to patients.

This policy is relevant to anyone who provides clinical care at or for Farnham Road Practice. Individuals on training placements on the premises must also adhere to this.

This policy will be monitored and reviewed annually by the Adult Safeguarding Lead.

This policy should be read in conjunction with the “Guidelines for Chaperones”, at the appendix.

Policy

All Chaperones must be trained to Level 3 Adult Safeguarding and be up to date with their Enhanced Disclosure and Barring Service check. This therefore means that it will usually be necessary to ask a Clinician to chaperone.

Whenever possible the chaperone should be of the same sex as the patient (although this might be difficult to achieve for male patients).

The patient being the same sex as the clinician should not preclude the patient being offered a
Chaperone.

Should the patient request a clinician of the same sex for examination purposes and should this not be possible at the time, then the patient will have the opportunity to postpone the examination to a later date when it is convenient for their examination to be carried out.

Chaperones should be offered to patients in the following circumstances:

• For intimate examinations or procedures;
• If the patient requests a chaperone at any time;
• When the clinician feels that the patient might be more comfortable to have a chaperone;
• When the clinician feels that it is in their (the clinician’s) best interest to have a chaperone.

(Be aware that in some cultures even for a non-intimate examination by ‘western’ standards
the patient might prefer to be offered a Chaperone)

Role of the Chaperone:

• Providing the patient reassurance
• Helping the patient to undress or prepare, or helping with clothing or covers
• Assist with procedures (if a nurse or healthcare assistant)
• Helping with instruments
• Witnessing a procedure
• ‘Protecting’ a clinician
• Being able to identify unusual or unacceptable behaviour relating to a procedure or the
  consultation
• Being able to identify whether the implied or implicit consent given at the start of the
  procedure remains valid throughout, and determine whether the attitude of the patient or the clinician has changed

The Clinician will:

• Ask if the patient would like a trained chaperone during their examination/procedure;
• Inform the chaperone about the examination;
• Document in the medical records the name and attendance of a chaperone, or that a chaperone was declined.

The Chaperone will:

• Introduce themselves;
• Ask if the patient has given consent to the Chaperone’s presence;
• Ask if the patient requires any further information about the nature of the examination;
• Ask if the patient has given consent to the examination/procedure.
• The Chaperone will stand within the privacy curtain and do all they can to make the patient feel comfortable. They should make eye contact with the patient without making them feel uncomfortable. They will reassure the patient if they sense signs of distress or discomfort and ask if you require the clinician to pause or stop.

At the end of the examination / procedure the Chaperone will:

• Ask the patient if they require assistance in getting dressed
• Provide privacy and dignity whilst they get dressed
• Ask when the patient is happy for them to leave the room
• Be available should the patient wish to speak with them after the examination/ procedure and before they have left the practice

Notices asking patients if they would like a chaperone should be on display in every clinical room.

(Appendix A) in English and other appropriate languages.

Reference: GMC – Maintaining Boundaries – Intimate Examinations 2013

1. Introduction

1.1. Context

This document outlines our commitment to dealing with complaints about the service provided by Farnham Road Medical Group across all its sites. (Farnham Road Surgery/ Weekes Drive Surgery / 242 Wexham Road Surgery / Avenue Medical Centre). It also provides information about how we manage, respond to and learn from complaints made about our service. It meets the requirements of the Local Authority Social Services and National Health Service Complaints [England] Regulations (2009).

The key issues taken into consideration when formulating this policy are that a complainant
needs to:

• Know how to complain;
• Feel confident that their complaint will be dealt with seriously.
• Understand that their concerns will be investigated, and they will be informed of the findings of that investigation.
• Trust that Farnham Road Medical Group will learn from complaints, feedback and praise and apply those lessons whilst also learning from and sharing best practice

1.2. Definition of a Complaint/Concern

Definition of a complaint or concern:

• A complaint or concern is an expression of dissatisfaction about an act, omission or decision of Farnham Road Practice, either verbal or written, and whether justified or not, which requires a response.

1.3. Scope

This policy applies to the handling of complaints or concerns relating to facilities/services
provided by Farnham Road Medical Group. This would include clinical care, as well as non clinical services.

1.4. Complaints that cannot be dealt with under this policy

The following complaints will not be dealt with under this policy:

• A complaint which is made orally and resolved to the complainant’s satisfaction no later than the next working day.
• A complaint arising out of an alleged failure to comply with a request for information under the Freedom of Information Act 2000.

2. Who can make a Complaint

Farnham Road Medical Group endeavours to provide a high level of care at all times and hopes that whilst you are a patient at the surgery you will not have reason to complain. However, when required, it is necessary for you to know how to take your complaint forward.

If you find it difficult to make a formal complaint on your own, you can ask someone else to help you or do this for you. This can be one of your family or friends.

1. A complaint may be made by the patient who is affected by the action, or it may be made by a person acting on behalf of a patient in any case where that person:
   • is a child; (an individual who has not attained the age of 18) in the case of a child,
     we must be satisfied that there are reasonable grounds for the complaint being
     made by a representative of the child, and furthermore that the representative is
     making the complaint in the best interests of the child.
   • has died; in the case of a person who has died, the complainant must be the personal representative of the deceased, we may request evidence to substantiate the complainant’s claim to have a right to the information.
2. Has given consent to a third party acting on their behalf; in the case of a third party
   pursuing a complaint on behalf of the patient affected we will request the following
   information:
   • Name and address of the person making the complaint;
   • Name and either date of birth or address of the affected person; and – Contact details of the affected person so that we can contact them for confirmation that they consent to the third party acting on their behalf. This will be documented in the complaint file and confirmation will be issued to both the person making the complaint and the person affected.
3. Has delegated authority to act on their behalf, for example in the form of a registered Power of Attorney which must cover health affairs.
4. A carer (only where we have record of consent)
5. A key support worker (only where we have record of consent)

Please note we keep strictly to the rules of patient confidentiality. If you are not the patient
but are complaining on their behalf, we must have consent from the patient stating they agree
for you to do this. We also need to know from the patient to whom the response should be sent.

3. Time Scale for Complaints

Complaints should be made within 12 months of the incident occurring or within 12 months
of the date of discovering a problem that has arisen in respect of a particular incident.

4. How to Complain

A complaint can be made:

• Practice feedback form
• By email: frimleyicb.complaintsfrp@nhs.net
• By post:
  The Complaints Team,
  Farnham Road Surgery,
  301 Farnham Road,
  Slough,
  Berkshire,
  SL2 1HD
• By telephone: 01753 520917

5. Complaints Handling

All complaints are acknowledged no later than three working days after the day the complaint
is received. We aim to respond fully to each complaint in a timely manner. Initially this will be up to 3 months (4 weeks in simpler complaints). Where this may require in depth investigation, we aim to keep the complainant informed of expected timeframes. In certain circumstances, we will offer the complainant an opportunity to have a meeting with the one of the Managers and if necessary/applicable the staff member who the complaint is about or clinical governance lead.

The complainant can expect that:

• They will be kept up to date with the progress of their complaint.
• They can expect to receive a reflective response with a view to find solutions, to find remedial actions or prevent future recurrence.
• They will be informed of any learning to be shared with the practice.

6. Referrals to the Commissioner or Health Service Ombudsman

If a complainant remains dissatisfied with the handling of the complaint by Farnham Road Practice, they can refer the matter to the commissioner of services in the first instance. If the complainant remains unsatisfied, they can then refer onward to the ombudsman, an independent body of government and the NHS.

South East Complaints Hub
NHS Frimley ICB
Aldershot Centre for Health Hospital Hill, Aldershot, Hampshire, GU11 1AY
Phone number: 0300 561 0290
Email address: Frimleyicb.southeastcomplaints@nhs.net

Health Service Ombudsman
Millbank Tower, Millbank, London, SW1P 4QP
Call 0345 015 4033 or visit www.ombudsman.org.uk for more information.

7. Confidentiality

Complaints are handled in the strictest of confidence in accordance with the Farnham Road
Medical Group Confidentiality guideline. Information is shared only with those who have a demonstrable need to have access to it. The designated Complaint lead is responsible for ensuring that confidentiality is maintained. Confidentiality will be maintained such that only managers and staff who are involved in the investigation know the contents of the case. Anyone disclosing information to others who are not directly involved in the matter may be dealt with under disciplinary procedures.

8. Consent

By making a complaint a patient consents to the complaint and information used in investigating the complaint to be shared with those members of the Farnham Road Medical Group team who are dealing with the complaint.

9. Complaints Practice protocol

Acknowledge in writing within three working days of receipt of a complaint. An acknowledgement letter should inform the complainant:

• Who is the named contact for the complaint
• Provide a brief explanation of the intended investigation
• State approximately how long the investigation will take
• Reassure the patient that the practice will continue to meet its obligation to provide ongoing healthcare irrespective of any complaint
• We will refer patients to the complaints policy
• The complaints manager needs to check to see who has raised the complaint. If it is not the patient then consent from the patient must be obtained, or his/her guardian or carer. The patient will be advised of the outcome or reason for delay if a further period of time is required to complete an investigation.
• Complaint by phone/in person
  • Any person receiving a complaint should listen and make sure that they have
    understood the patient’s complaint and an attempt will be made to resolve the issue by the next working day. The patient may be contacted again to clarify anything that is unclear.
• If a complaint cannot be resolved immediately then this will be escalated to the
  complaints team.
• As soon as it is reasonably possible after completing the investigation, Farnham Road Medical Group will send a formal response in writing to the complainant which will be signed by the Complaints Manager and / or the Clinical Governance Lead.
• We endeavour to meet the following standards in responding to a complaint:
  • An explanation of how the complaint has been investigated
  • An apology that the complainant had reason to complain
  • Address all concerns raised
  • To inform the complainant of action taken
  • To summarise the conclusions reached
  • Where possible provide an explanation of learning to rectify and prevent reoccurrence.
  • Where appropriate offer the complainant an opportunity to meet a member of the complaints cell to discuss their concerns further.
  • There should be clear signposting to the Health Service Ombudsman in the event that the complainant remains unsatisfied.

10. Record Keeping

Keeping clear and accurate records of complaints is important and we retain these records for a period of ten years where litigation has not commenced

11. Monitoring and Reporting

Complaints are reviewed quarterly at one of the practice weekly meetings. An annual report will be produced for the Managing Partners, which will detail:

• Number of complaints received
• Number of complaints upheld
• Key themes
• Lessons learnt and actions taken
• Number of cases referred to the Parliamentary and Health Service Ombudsman.

The Complaint Lead is responsible for monitoring performance and will review complaints
quarterly:

• Complaints will be reviewed at practice clinical meetings
• Patient Participation Groups across all sites will be provided with opportunity to meet with clinical governance lead and the Complaints Manager to discuss complaints data. We will use their feedback to improve the way we learn from the complaints that we receive.

12. Compliance and Review

The policy and procedures laid down in this document will be monitored by the Clinical Governance Lead.

This policy will be kept under review considering operational experience and national guidance.

The practice complies with data protection and access to medical records legislation. Identifiable information about you will be shared with others in the following circumstances:

• To provide further medical treatment for you e.g. from district nurses and hospital services.
• To help you get other services e.g. from the social work department. This requires your consent.
• When we have a duty to others e.g. in child protection cases anonymised patient information will also be used at local and national level to help the Health Board and Government plan services e.g. for diabetic care.

If you do not wish anonymous information about you to be used in such a way, please let us know.

Reception and administration staff require access to your medical records in order to do their jobs. These members of staff are bound by the same rules of confidentiality as the medical staff.

This policy should be read in conjunction with the staff handbook. Where there are differences between these two documents the staff handbook will be the reference document.

The practice is committed to both eliminating discrimination and welcoming diversity amongst our workforce and in relation to our patients and service users.

The practice and its staff will not discriminate on grounds of gender, marital status, race, ethnic origin, colour, nationality, national origin, disability, sexual orientation, religion or age.

All employees, whether part-time, full-time or temporary, will be treated fairly and with respect. Selection for employment, promotion, training or any other benefit will be on the basis of aptitude and ability. All employees will be helped and encouraged to develop their full potential to meet practice and personal needs.

The practice will:

• create an environment in which individual differences and the contributions of staff are recognised and valued.
• ensure that every employee has a working environment that promotes dignity and respect
• ensure that no form of intimidation, bullying or harassment is tolerated
• provide training, development and progression opportunities to all staff
• promote equality in the workplace as good management practice
• review all employment practices and procedures to ensure fairness
• regard breaches of the equality policy as misconduct which could lead to disciplinary proceedings
• review the policy annually.

Please see Staff handbook page 21 for information on the Practice’s Equal Opportunities and Valuing Diversity policy.

Information about the General Practitoners and the practice required for disclosure under this act can be made available to the public. All requests for such information should be made to the practice manager.

Please contact reception for our full Freedom of Information policy.

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 Farnham Road Practice in the last financial year was £51,568 before tax and National Insurance. This is for 2 full time GPs, 21 part time GPs and 15 Locums who worked in the practice for more than six months.

Purpose

This annual statement summarises:

• Any infection transmission incidents and any action taken (these will have been reported in accordance with our Significant Events Reporting procedures)
• Details of any infection control audits undertaken and actions taken.
• Details of any infection control risk assessments undertaken.
• Details of staff training.
• Any review and update of policies, procedures and guidelines.

Background

The infection prevention and control lead for Farnham Road Practice is Claudette Gumbs.

Learning events

Cold chain incidents:

• (Wexham Road Surgery 25.9.23) Refrigerated stock was not placed in fridge on day of delivery. Learning discussed at Clinical Governance meeting on 2.10.23. All staff involved reminded of the need to place refrigerated stock in fridge immediately.
• (Avenue Medical Centre) Electricity at site turned off over weekend unexpectedly by landlord. Vaccine fridges exceeded maximum temperature. Met with landlord to insist that practice is informed of all planned, and potential, electrical work before event.

Other:

• (Farnham Road Practice) Clinical waste bin was not locked when checked at 7am. Nursing team and cleaners informed and confirmed everyone has access to the bin key
• (Farnham Road Practice) urine sample was placed into a vaccine fridge by a clinician instead of into the sample fridge. All staff reminded that samples go in the sample fridge.

Audits

The following audits have been completed in the year:

• Personal protective equipment (putting on and removing PPE)
• Environmental cleanliness
• Hand Hygiene
• Hand washing technique (clinical staff – quarterly, all staff – annual)
• Fridge cleaning
• Vaccine storage
• Aseptic technique
• Wound dressing
• Sharps bins (correct assembly, labelling and storage)

No specific actions were noted from recent audits. The annual ICB infection control audit is being arranged.

Risk Assessments

A number of risk assessments were carried out and the following items noted:

• Clinical waste bags not consistently having practice name and code attached. Labels, or tags, are now generated for cleaners to use.
• 3 posters in waiting areas were not laminated. All posters are now laminated and staff
  reminded of the need to laminate new posters.
• Floor in the FRS admin corridor was cracked. This has not been replaced.
• Some bins in FRS had broken lids. These bins have been replaced.

Staff training

At the time of the publication 94% of staff were in date for infection control training. Of those staff who were not up to date with training just under half were 6 months or less out-of-date. The individuals were informed, and completion of mandatory annual training is being monitored.

Person responsible for review of this policy: Registered Manager

Introduction

This policy sets out the Farnham Road Medical Group (FRMG) provisions to ensure that patients are afforded privacy and dignity, and are treated respectfully in circumstances where there is the potential for embarrassment, loss of confidentiality, and/ or for the patient to feel ‘ill at ease’.

The requirement to respect patients is the responsibility of all staff, not just those in direct clinical contact with the patient.

Provisions

Patients will not be discriminated against for any reason.

All staff must give all patients respect and not stereotype anyone, irrespective of any perceived characteristics.

All staff should be particularly aware of and alert for vulnerable patients. These patients might need additional help and support:

• With using the telephone and/ or and routes of accessing appointments or practice systems
• Communication difficulties:
  • Hearing impairment
  • Visual impairment
  • Functional illiteracy in written English (they might need literature or written communication in another language or not have any written communication from us
  • No broadband access
  • Not possessing a Smart Mobile Phone
• Financial difficulties
• Disabilities that make access to the surgery and our services more difficult
• House bound patients
• Trans and gender fluid patients
  Staff should be particularly aware that patients’ health needs might not match their gender (for example Trans Men with a cervix still need to be invited for a cervical smear)
  • Patients might prefer to use pronouns such as “they/ them”, xe/xem/xyr” or they might change day-to-day

Reception

• Patients will be referred to with respect even in private discussions in the surgery
• Patients will be addressed by their preferred method and titles (e.g. Mr, Mrs, etc.)
• Patients will be offered, where available, the choice of a private space in which to hold confidential discussions
• A sign will be displayed in reception to offer the facility of a private discussion with a receptionist if required
• Guide dogs will be permitted in all parts of the building
• A hearing loop will be available, and staff trained in its use
• Under no circumstances will staff enter through a closed consultation room/ treatment room door without first knocking and waiting for permission to enter (if occupied), or pausing to determine that the room is empty

Consultations

• Patients will be allowed free choice of gender of doctor and nurse, where available, and will be able to wait or delay an appointment to see their choice of clinician. When clinically urgent patients will be encouraged to see a clinician appropriate for their ‘best care’ however undue pressure is not appropriate
• Consultations will not be interrupted unless there is an emergency, in which case the clinician in the room will be telephoned as a first step, before knocking at the door and awaiting specific permission from the clinician to enter
• A Chaperone will be offered where an examination is to take place. See Chaperone Policy
• Clinical staff will be sensitive to the needs of the individual and will ensure that they are comfortable in complying with any requests with the potential to cause embarrassment
• Patients will be afforded as much time and privacy as is required to recover from the delivery of ‘bad news’, and clinical staff will, where possible, anticipate this need and arrange their appointments accordingly
• Patients will be able to dress and undress privately in a treatment room or, where a separate treatment room is not available, a screen will be provided for that purpose. Patients using this facility will be requested to advise the clinician when they are ready to be seen, and they will be afforded sufficient time to do this bearing in mind infirmity etc.
• A clean single-use sheet will be available in each examination/ treatment room, changed after each patient, and the patient will be advised of its availability
• Washing facilities will be offered to the patient if required
• Clinicians and staff will allow ‘personal space’ where possible and respect this
• Patients will be given adequate opportunity, time and privacy for the provision of samples on the premises without feeling under duress or time limitation (where possible given any appropriate infection control measures in place at the time)
• The area used for dressing/ undressing will be equipped with coat / clothes hangers, pegs, or similar for clothes, and will have a chair with arms at a suitable height and design available and suitable for the patient to use
• Patients with difficulty in understanding due to language may have a family member or friend available to assist. FRMG will offer the services of an interpreter where requested or required
• Communication by staff with patients will be individual according to the needs of the individual patient (e.g. those with speech difficulties, hearing, or learning difficulties may need specific approach)
• Areas used by patients for dressing/ undressing will be secure from interruption or ingress (i.e. there will be no unlocked door to either a corridor or to any room not occupied by the consulter who is attending that patient)
• Patients who may have difficulty in undressing may be offered the services of a second (same gender) clinician or trained Chaperone to assist
• Patients will be requested only to remove a minimum of clothing necessary for the examination
• Consultations in the patient’s home will be sensitive to the location and any other persons who may be present or may overhear

Post – Consultation

• Clinicians and staff will respect the dignity of patients and will not discuss issues arising from consultations, procedures, documentation, etc. unless in a confidential clinical setting appropriate to the care of the patient (respectful of the patient even when not there

Your information, what you need to know

This privacy notice explains why we collect information about you, how that information will 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. 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 will collect information about you which helps us respond to your queries or secure specialist services. We will keep your information in written form and/or in digital form.

Our Commitment to Data Privacy and Confidentiality Issues

As a GP practice, all of our GPs, staff and associated practitioners are committed to protecting your privacy and will only process data in accordance with the Data Protection Legislation. This includes the General Data Protection Regulation (EU) 2016/679  (GDPR) now known as the UK GDPR, the Data Protection Act (DPA) 2018, the Law Enforcement Directive (Directive (EU) 2016/680) (LED) and any applicable national Laws implementing them as amended from time to time. The legislation requires us to process personal data only if there is a legitimate basis for doing so and that any processing must be fair and lawful.

In addition, consideration will also be given to all applicable Law concerning privacy, confidentiality, the processing and sharing of personal data including the Human Rights Act 1998, the Health and Social Care Act 2012 as amended by the Health and Social Care (Safety and Quality) Act 2015, the common law duty of confidentiality and the Privacy and Electronic Communications (EC Directive) Regulations.

Data we collect about you

Records which this GP Practice will hold or share about you will include the following:

• Personal Data – means any information relating to an identified or identifiable natural person (‘data subject’); an identifiable natural person is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person.
• Special Categories of Personal Data – this term describes personal data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, and the processing of genetic data, biometric data for the purpose of uniquely identifying a natural person, data concerning health or data concerning a natural person’s sex life or sexual orientation.
• Confidential Patient Information – this term describes information or data relating to their health and other matters disclosed to another (e.g. patient to clinician) in circumstances where it is reasonable to expect that the information will be held in confidence. Including both information ‘given in confidence’ and ‘that which is owed a duty of confidence’. As described in the Confidentiality: NHS code of Practice: Department of Health guidance on confidentiality 2003.
• Pseudonymised – The process of distinguishing individuals in a dataset by using a unique identifier which does not reveal their ‘real world’ identity.
• Anonymised – Data in a form that does not identify individuals and where identification through its combination with other data is not likely to take place.
• Aggregated – Statistical data about several individuals that has been combined to show general trends or values without identifying individuals within the data.

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 or without your permission when the practice is closed. Where your record is accessed without your permission it is necessary for them to have a legitimate basis in law. This is explained further in the Local Information Sharing at Appendix A.

Whenever you use a health or care service, such as attending Accident & Emergency or using Community Care services, important information about you is collected in a patient record for that service. Collecting this information helps to ensure you get the best possible care and treatment.

The information collected about you when you use these services can also be used and provided to other organisations for purposes beyond your individual care, for instance to help with:

• improving the quality and standards of care provided by the service
• research into the development of new treatments and care pathways
• preventing illness and diseases
• monitoring safety
• planning services
• risk stratification
• Population Health Management

This may only take place when there is a clear legal basis to use this information. All these uses help to provide better health and care for you, your family and future generations. Confidential patient information about your health and care is only used like this where allowed by law or with consent.

Pseudonymised or anonymised data is generally used for research and planning so that you cannot be identified.

A full list of details including the legal basis, any Data Processor involvement and the purposes for processing information can be found in Appendix A, available by contacting reception.

How long do we hold information for?

All records held by the Practice will be kept for the duration specified by national guidance from NHS Digital, Health and Social Care Records Code of Practice. Once information that we hold has been identified for destruction it will be disposed of in the most appropriate way for the type of information it is. Personal confidential and commercially confidential information will be disposed of by approved and secure confidential waste procedures. We keep a record of retention schedules within our information asset registers, in line with the Records Management Code of Practice for Health and Social Care 2021.

Individuals Rights under UK GDPR

Under UK GDPR 2016 the Law provides the following rights for individuals. The NHS upholds these rights in a number of ways.

1. The right to be informed
2. The right of access
3. The right to rectification
4. The right to erasure (not an absolute right) only applies in certain circumstances
5. The right to restrict processing
6. The right to data portability
7. The right to object
8. Rights in relation to automated decision making and profiling.

Your right to opt out of data sharing and processing

The NHS Constitution states ‘You have a right to request that your personal and confidential information is not used beyond your own care and treatment and to have your objections considered’.

Type 1 Opt Out

This is an objection that prevents an individual’s personal confidential information from being shared outside of their general practice except when it is being used for the purposes of their individual direct care, or in particular circumstances required by law, such as a public health emergency like an outbreak of a pandemic disease. If patients wish to apply a Type 1 Opt Out to their record they should make their wishes know to the practice manager.

National data opt-out

The national data opt-out was introduced on 25 May 2018, enabling patients to opt-out from the use of their data for research or planning purposes, in line with the recommendations of the National Data Guardian in her Review of Data Security, Consent and Opt-Outs.

The national data opt-out replaces the previous ‘type 2’ opt-out, which required NHS Digital not to use a patient’s confidential patient information for purposes beyond their individual care. Any patient that had a type 2 opt-out recorded on or before 11 October 2018 has had it automatically converted to a national data opt-out. Those aged 13 or over were sent a letter giving them more information and a leaflet explaining the national data opt-out. For more information go to: National data opt out programme.

To find out more or to register your choice to opt out, please visit www.nhs.uk/your-nhs-data-matters.

On this web page 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 access the system to view, 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

Right of Access to your information (Subject Access Request)

Under Data Protection Legislation everybody has the right of access to, or request a copy of, information we hold that can identify them, this includes medical records. There are some safeguards regarding what patients will have access to and they may find information has been redacted or removed for the following reasons;

• It may be deemed to risk causing harm to the patient or others
• The information within the record may relate to third parties who are entitled to their confidentiality, or who have not given their permission for the information to be shared.

Patients do not need to give a reason to see their data. And requests can be made verbally or in writing. Although we may ask them to complete a form in order that we can ensure that they have the correct information required.

Where multiple copies of the same information is requested the surgery may charge a reasonable fee for the additional copies.

Patients will need to provide proof of identity to receive this information.

Patients may also request to have online access to their data, they may do this via the NHS APP, or via the practices system.

COVID Passport access

Patients may access their Covid passport via the link, the practice cannot provide this document as it is not held in the practice record. If you have any issues gaining access to your Covid Passport or letter you should call: 119

Change of Detail

It is important that you tell the surgery if any of your contact details such as your name or address have changed, or if any of your other contacts details are incorrect including third party emergency contact details. It is important that we are made aware of any changes immediately in order that no information is shared in error.

Mobile telephone number

If you provide us with your mobile phone number, we will use this to send you text reminders about your appointments or other health screening information. Please let us know if you do not wish to receive text reminders on your mobile.

Email address

Where you have provided us with your email address, with your consent we will use this to send you information relating to your health and the services we provide. If you do not wish to receive communications by email please let us know.

Notification

Data Protection Legislation requires organisations to register a notification with the Information Commissioner to describe the purposes for which they process personal and sensitive information.

We are registered as a Data Controller and our registration can be viewed online in the public register at:http://ico.org.uk/what_we_cover/register_of_data_controllers

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

Data Protection Officer

Should you have any data protection questions or concerns, please contact our Data Protection Officer, Laura Taw at: laurataw@nhs.net

What is the right to know?

The Freedom of Information Act 2000 (FOIA) gives people a general right of access to information held by or on behalf of public authorities, promoting a culture of openness and accountability across the public sector. You can request any non-personal information that the GP Practice holds, that does not fall under an exemption. You may not ask for information that is covered by the Data Protection Legislation under FOIA. However you can request this under a right of access request – see section above ‘Access to your information’.

Right to Complain

If you have concerns or are unhappy about any of our services, please contact:

1. Farnham Road Medical Group data controller via email at secure.frp@nhs.net GP practices are data controllers for the data they hold about their patients.
2. Write to the data controller at Farnham Road Practice, 301 Farnham Road, Slough, SL2 1HD
3. Fill in the our Complaint Form
4. Ask to speak to Stuart Pavelin, or Dr Muki Sritharan.

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

Phone: 0303 123 1113
Website: https://ico.org.uk/global/contact-us

The NHS Care Record Guarantee

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

The NHS Constitution

The NHS Constitution establishes the principles and values of the NHS in England. It sets out the rights patients, the public and staff are entitled to. These rights cover how patients access health services, the quality of care you’ll receive, the treatments and programs available to you, confidentiality, information and your right to complain if things go wrong: https://www.gov.uk/government/publications/the-nhs-constitution-for-england

FRMG follows the NHS Records Management Code of Practice.

The Records Management Code of Practice for Health and Social Care a guide for you to use in relation to the practice of managing records. It is relevant to organisations working within, or under contract to, the NHS in England. The Code also applies to adult social care and public health functions commissioned or delivered by local authorities.

The Code provides a framework for consistent and effective records management based on established standards. It includes guidelines on topics such as legal, professional, organisational and individual responsibilities when managing records. It also advises on how to design and implement a records management system including advice on organising, storing, retaining and deleting records.

It applies to all records regardless of the media they are held on. Wherever possible organisations should be moving away from paper towards digital records.

For guidance on retention periods, storage and methods of disposal for different types of record please follow this link: Records Management Code of Practice – NHS Transformation Directorate (england.nhs.uk)

This policy sets out the process to be followed in the recruitment of all staff.

APPLICABILITY

The policy applies to all employees involved in recruitment and applies to recruitment for new posts and replacement staff, applies for permanent. Fixed term or temporary contacts and applies to both full-time and part-time posts.

THE POLICY

• The Practice will select the successful candidate on the basis of the best person for the job.
• The Practice will invest time and care in the selection process to give all candidates the initial opportunity to progress equally through the recruitment process.
• The Practice will ensure that its recruitment process is free from discrimination and follows the principles and ethos of the Equality Act 2010.

THE PROCEDURE

The following procedure will be adopted for all recruitment campaigns:

• Preparation of a business case for the recruitment to be agreed by SLT.
• Preparation of a job description for the vacancy.
• Agreement of the job description by SLT.
• Preparation of a Person Specification.
• Briefing for staff on the handling of enquiries with basic background and procedural
  information.
• Preparation of an initial candidate scoring document.
• Agree process and roles for handling enquiries and managing the recruitment process
• Receipt of applications. All to be acknowledged within agreed timeframe.
• Screening of candidates and selection of first round candidates.
• Issue of written interview invitations.
• Interviewing by selected panel.
• Consideration of the need for second interviews.
• Selecting or re-interviews.
• Verbally offer the job subject to the receipt of satisfactory references, DBS check, certificates and other items as agreed.
  • An enhanced DBS check is mandatory for all clinical roles. For non-clinical roles a standard, or enhanced, DBS check is required where the role will, or may, involve the member of staff being in one-to-one encounters with patients or where the role involves interactions with a patient in potentially more intimate situations, for example acting as a chaperone
  • Where the candidate has a DBS certificate from another NHS organization, or
    other reputable organization, and the certificate date is within 6 months of the employment start date, then the Practice may decide to accept this DBS certificate. The Practice will perform its own DBS check should the individual’s role change or should other circumstances require it.
• Ask for authority to approach referees.
• Issue written offer letter to include key terms – salary, leave, probationary period, start date if agreed, conditions, e.g. acceptable references.
• Take references/medicals
• When satisfactory references and DBS check have been received, confirm to candidate that the job offer is firm and unconditional. Agree start date.
• If references are unsatisfactory then this is discussed by Practice Manager, General Manager and Managing Partner (if appropriate) prior to deciding how proceed
• If DBS check shows criminal convictions, then this will be discussed HR Partner and, or, SLT (if appropriate) prior to deciding how proceed
• Advise unsuccessful interviewees by letter.
• Advise non-interviewed candidates by email or letter.

PROFESSIONAL REGISTRATION

Certain roles, doctors, nurses, pharmacists, require specific registrations. These must be checked as part of the recruitment process.

The main steps are to:

• Check registration with professional body is current
• Check that candidate is on the performers list (doctors)
• Check whether the candidate is subject to practising restrictions
• Check whether there are any investigations recorded against them
• Confirm that suitable professional indemnity is in place (doctors – practice arranges indemnity for nurses)
• Original documentation should be checked when available. Where this is not available, alternative methods of verification may be considered based on the importance and relevance to the qualification to the overall role.
• The following main organisations generally can provide an on-line checking facility, although some employer pre-registration may be required.

GMC

The GMC can confirm a doctor’s name and address, gender, qualifications, registration number along with registration status and renewal date. They may also confirm any current conditions placed on the doctor, warnings or suspensions. On line checking is available.

NMC

Registration information is available including renewal date, conditions of practice, registration status, cautions and suspensions, however the on line system does not indicate current investigations, although this is available by written request.

There is a new Central NHS Computer System called the Summary Care Record (SCR). It is an electronic record which contains information about the medicines you take, allergies you suffer from and any bad reactions to medicines you have had.

Why do I need a Summary Care Record?

Storing information in one place makes it easier for healthcare staff to treat you in an emergency, or when your GP practice is closed.

This information could make a difference to how a doctor decides to care for you, for example which medicines they choose to prescribe for you.

Who can see it?

Only healthcare staff involved in your care can see your Summary Care Record.

How do I know if I have one?

Over half of the population of England now have a Summary Care Record. You can find out whether Summary Care Records have come to your area by asking your GP.

Do I have to have one?

No, it is not compulsory. If you choose to opt out of the scheme, then you will need to complete a form and bring it along to the surgery. Please visit Summary Care Record – NHS England Digital for further information and the opt out form.

The NHS operate a zero tolerance policy with regard to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons.

Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.