Benzodiazepines are medicines such as diazepam and temazepam and nitrazepam. Z drugs are medicines such as zopiclone and zolpidem.

Prescribing Policy For Benzodiazepines and “Z” Drugs

Prescriber’s in this practice will prescribe benzodiazepines and “Z” drugs in line with national and locally developed guidelines:

First-line treatment should be non-pharmacological measures.

Where benzodiazepines or “Z” drug treatment is indicated, options may include;

 Diazepam, zopiclone, zolpidem or temazepam

For patients who have not received these drugs regularly, we will only prescribe these medicines for a maximum of 14 days and at the lowest effective dose. The following guidance published by NICE will apply (1):

• The indication for starting such medication will be documented.
• Other possible causes of sleep disturbance will be recorded ( eg. Pain, chronic breathlessness, depression) and treated appropriately.
• All patients will receive advice on non-drug therapies for anxiety and insomnia, available via text.
• Patients will be advised on the potential problems of dependence (i.e addiction).
• A second prescription will not be issued without a follow-up appointment.
• Benzodiazepines or “Z” drugs should not be taken for more than 2 – 4 weeks (including tapering off).

If being prescribed for back spasm (2)

• The dose is diazepam 2 mg up to three times a day when required to relieve muscle spasm. If necessary, the dose can be titrated up to 5 mg three times a day. A short course (2–5 days) is recommended because the risk of adverse effects is high, and habituation can occur.
• Use caution if considering prescribing diazepam in elderly or frail people — the manufacturer advises halving the recommended dose.

Patients who are already on a regular benzodiazepine or “Z” drug prescription will be assessed and if appropriate, counselling for a withdrawal scheme with the aim to gradually reduce drug dosage to zero.

Patients who are unable or unwilling to reduce drug dosage via a managed withdrawal scheme (or who use more than one drug of abuse, or who are dependent on alcohol) will be referred to the substance misuse service

Prescriptions for hypnotics and anxiolytics should not be routinely available on repeat. However, the practice recognises that there may be a small minority of people who need to be on a small maintenance dose of benzodiazepine. Examples are people:

• With severe mental health problems under the care of a psychiatrist.
• On benzodiazepines for the treatment of epilepsy
• Who are seriously or terminally ill.

Policy for the requests of Benzodiazepines to treat phobias, such s fear of flying.

Diazepam will not be prescribed for the treatment of phobias such as fear of flying. According to the BNF Diazepam is contraindicated (not appropriate) to be prescribed for phobic states (3).

Benzodiazepines are only licensed short term for a crisis in generalised anxiety. If you are in crisis, you should be getting expert care and support for your mental health and not going on a flight.

Diazepam is a sedative, which means when prescribed it may cause you to feel sleepy and more relaxed. If there is an emergency during the flight, it may impair the ability to concentrate, follow instruction and react to situations. This could have serious safety implications for the patient and those around them.

Many people find benzodiazepines like diazepam sedating, however, an uncommon side effect is agitation and a rare side effect is increased aggression. This may cause you to behave in a way in which you wouldn’t normally. A change in behaviour may negatively impact your safety as well as that of other passengers.

We appreciate that fear of flying is very real and very frightening. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines. We have listed a number of these below.

Easy Jet   Easyjet fearless flyer course

British Airways BA flying with confidence course

Virgin Virigin flying without fear course

Misuse of Medication

Benzodiazepines and Z drugs have the potential for misuse. They may result in dependence, where any risk factors are identified for a patient an appointment with a GP or pharmacist will be made before any further medication is prescribed.

We will always respect your privacy, dignity and your religious and cultural beliefs particularly when intimate examinations are advisable – these will only be carried out with your express agreement and you will be offered a chaperone to attend the examination if you so wish.

You may also request a chaperone when making the appointment or on arrival at the surgery (please let the receptionist know) or at any time during the consultation.

You can be assured that anything you discuss with any member of the surgery staff, whether doctor, nurse or receptionist, will remain confidential. Even if you are under 16, nothing will be said to anyone, including parents, other family members, care workers or teachers, without your permission. The only reason why we might want to consider passing on confidential information without your permission would be to protect either you or someone else from serious harm. In this situation, we would always try to discuss this with you first.

If you have any worries or queries about confidentiality, please ask a member of staff.

If you would like to discuss matters of a confidential nature, either with our receptionists or a member of the dispensary team, we have a side room available in reception for this purpose.

We need to hold personal information about you on our computer systems and in paper records to help us to look after your health needs, and your doctor is responsible for their accuracy and safe-keeping. Please help to keep your record up to date by informing us of any changes to your circumstances.

Doctors and staff in the practice have access to your medical records to enable them to do their jobs. From time to time information may be shared with others involved in your care if it is necessary. Anyone with access to your record is properly trained in confidentiality issues and is governed by both legal and contractual duty to keep your details private.

All information about you is held securely and appropriate safeguards are in place to prevent accidental loss.

In some circumstances, we may be required by law to release your details to statutory or other official bodies, for example, if a court order is presented, or in the case of public health issues. In other circumstance, you may be required to give written consent before information is released – such as for medical reports for insurance, solicitors etc.

To ensure your privacy, we will not disclose information over the telephone or fax unless we are sure that we are talking to you. Information will not be disclosed to family, friends or spouses unless we have prior written consent, and we do not leave messages with others.

You have a right to see your records if you wish. Please ask at reception if you would like further details about our patient information leaflet. An appointment may be required. In some circumstances, a fee may be payable.

There is access through the main door. We have a wheelchair available for use in surgery.

Hearing Difficulties

If you are experiencing hearing difficulties when being called in to see the doctor or nurse, please do let us know in order for us to set up an alert on your medical records and personally collect you from the waiting room. Alternatively, we do have the facility of a portable induction loop. If you would like to use this, please ask reception for assistance.

There is a Central NHS Computer System called the Emergency Care Summary (ECS). The Emergency Care Summary is meant to help emergency doctors and nurses help you when you contact them when the surgery is closed. It will contain information on your medications and allergies.

Your information will be extracted from practices such as ours and held securely on central NHS databases.

As with all systems, there are pros and cons to think about. When you speak to an emergency doctor you might overlook something that is important and if they have access to your medical record it might avoid mistakes or problems, although even then, you should be asked to give your consent each time a member of NHS Staff wishes to access your record unless you are medically unable to do so.

On the other hand, you may have strong views about sharing your personal information and wish to keep your information at the level of this practice. If you don’t want an Emergency Care Summary to be made for you, tell your GP surgery. Don’t forget that if you do have an Emergency Care Summary, you will be asked if staff can look at it every time they need to. You don’t have to agree to this.

Updated: 31/03/2020

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 for GPs working at Colton Mill & The Grange Medical Centre in the last financial year was £81,886 before tax and National Insurance. This is for 2 full-time GP’s and 7 part-time GPs and no locums who worked in the practice for more than six months.

This notice explains how Colton Mill and The Grange Medical Practice will collect, look after, use or otherwise process your personal data.

“Personal data” is information relating to you as a living, identifiable individual

How is My Information Collected and Looked After?

When is my Information Shared?

We are committed to protecting your privacy and will only use information collected lawfully in accordance with:

• Data Protection legislation.
• Human Rights Act 1998.
• Common-Law Duty of Confidentiality.
• Health and Social Care Act 2012.
• NHS Codes of Confidentiality, Information Security and Records Management.
• Information: To Share or Not to Share Review.

How long does the practice hold my information?

As long as you are registered as a patient with Colton Mill and The Grange Medical Practice your paper records are held at the practice along with your GP electronic record. If you register with a new practice, they will initiate the process to transfer your records. The electronic record is transferred to the new practice across a secure NHS data-sharing network and all practices aim to process such transfers within a maximum of 8 working days.

The paper records are then transferred via Primary Care Services England (operated on behalf of NHS England by Capita) which can take longer. Primary Care Services England also look after the records of any patient not currently registered with a practice and the records of anyone who has died.

Once your records have been forwarded to your new practice (or after your death forwarded to Primary Care Services England), a cached version of your electronic record is retained in the practice and classified as “inactive”. If anyone has a reason to access an inactive record, they are required to formally record that reason and this action is audited regularly to ensure that all access to inactive records is valid and appropriate.

We may access this for clinical audit (measuring performance), serious incident reviews, or statutory report completion (e.g., for HM Coroner).

Change of Details

It is important that you tell the person treating you if any of your details such as your name or address have changed or if any of your details such as date of birth is incorrect in order for this to be amended. You have a responsibility to inform us of any changes so our records are accurate and up to date for you.

How can I see what information you hold about me?

You have a right under data protection legislation to request to see what information the practice holds about you. You also have the right to ask for inaccuracies to be corrected and in some circumstances, you have the right to request that we stop processing your data. Some of these rights are not automatic and we reserve the right to discuss with you why we might not comply with a request from you to exercise them.

If you make a Subject Access Request, we will:

• Describe the information we hold about you.
• Tell you why we are holding that information.
• Tell you who it might be shared with.
• At your request, provide a copy of the information in an easy to read form.

In order to request this, you need to do the following:

• Your request must be made in writing – for information from the hospital you should write directly to them.
• We will provide electronic copies (via online access, by email or on CDROM) free of charge.
• We are required to respond to you within 1 month.

You will need to give enough information (for example full name, address, date of birth, NHS number and details of your request) so that your identity can be verified and your records located.

In some circumstances, there may be a charge to have a printed copy of the information held about you. If this is the case, this will be discussed with you before any charge is made.

If you would like to make a Subject Access Request or have any further questions, please contact our Administration Team.

How is my Information Used?

For provision of direct care:

In the practice, individual staff will only look at what they need in order to carry out such tasks as booking appointments, making referrals, giving health advice or provide you with care.

Sometimes your information may be used to run automated calculations. These can be as simple as calculating your Body Mass Index but they can be more complex and used to calculate some risks to your health that we should consider with you. The ones we use in practice include Qrisk (cardiovascular risk assessment – usually following an NHS Healthcheck), Qdiabetes (diabetes risk assessment) and eFI (electronic frailty index). Whenever we use these profiling tools, we assess the outcome on a case-by-case basis.

No decisions about individual care are made solely on the outcomes of these tools but they are used to help us assess and discuss your possible future health and care needs with you.

We share information about you with other health professionals where they have a genuine need for it to support your care, as follows.

For Commissioning and Healthcare Planning Purposes:

In some cases, for example, when looking at population healthcare needs, some of your data may be shared (usually in such a way that you cannot be identified from it). The following organisations may use data in this way to inform policy or make decisions about the general provision of healthcare, either locally or nationally.

• Leeds City Council: Public Health, Adult or Child Social Care Services.
• Embed Health Consortium (NHS commissioning support unit).
• Leeds Clinical Commissioning Group.
• NHS Digital (Formerly known as (HSCIC).
• ResearchOne Database.
• Other data processors which you will be informed of as appropriate.

In order to comply with its legal obligations, we may send data to NHS Digital when directed by the Secretary of State for Health under the Health and Social Care Act 2012.

This practice contributes to national clinical audits and will send the data which are required by NHS Digital when the law allows. This may include demographic data, such as date of birth, and information about your health which is recorded in coded form, for example, the clinical code for diabetes or high blood pressure.

For Research Purposes:

Research data is usually shared in a way that individual patients are non-identifiable. Occasionally where research requires identifiable information you may be asked for your explicit consent to participate in specific research projects. The surgery will always gain your consent before releasing any information for this purpose.

Where specific information is asked for, such as under the National Diabetes Audit, you have the choice to opt of the audit.

For safeguarding purposes, life or death situations or other circumstances when we are required to share information:

We may also disclose your information to others in exceptional circumstances (ie life or death situations) or in accordance with Dame Fiona Caldicott’s information sharing review (Information to share or not to share).

For example, your information may be shared in the following circumstances:

• When we have a duty to others e.g. in child protection cases.
• Where we are required by law to share certain information such as the birth of a new baby, infectious diseases that may put you or others at risk or where a Court has decided we must.

When you request to see your information or ask us to share it with someone else:

If you ask us to share your data, often with an insurance company, solicitor, employer or similar third party, we will only do so with your explicit consent. Usually, the requesting organisation will ask you to confirm your consent, often in writing or electronically. We check that consent before releasing any data and you can choose to see the information before we send it.

Please see the section Sharing your Information for more details of how your personal data is shared electronically within the NHS locally & nationally and your choices about being included in these sharing agreements.

Objections/Concerns/Complaints

If you are happy for your data to be extracted and used for the purposes described in this notice then you do not need to do anything.

Should you have any concerns about how your information is managed at the practice, please contact Andrea Mann, Practice Manager. If you are still unhappy following a review by the GP practice, you can then complain to the Information Commissioners Office (ICO) via their website www.ico.org.uk, casework@ico.org.uk, telephone: 0303 123 1113 (local rate) or 01625 545 745.

This practice is committed to preserving, as far as is practical, the security of data used by our information systems. This means that we will take all reasonable actions to;

Maintain the confidentiality of all data within the practice by:

• Ensuring that only authorised persons can gain access to our systems
• Not disclosing information to anyone who has no right to see it

Maintain the integrity of all data within the practice by:

• Taking care of input
• Ensuring that all changes are reported and monitored
• Checking that the correct record is on the screen before updating
• Reporting all apparent errors and ensuring that they are resolved

Maintain the availability of all data by:

• Ensuring that all equipment is protected from intruders
• Ensuring that backups are taken at regular, predetermined intervals
• Ensuring that contingency is provided for possible failure or equipment theft and that any such contingency plans are tested and kept up to date

Additionally, we will take all reasonable measures to comply with our legal responsibilities under:

• The Data Protection Act (2018)
• The Health and Safety at Work Act (1992)
• The Access to Health Records Act (1990)

All patients, including children, are allocated a named accountable GP. This may be different from the GP that patients normally see but overall responsibility for patient care has not changed. This is largely a role of oversight, with the requirements being introduced to reassure patients that they have one GP within the practice who is responsible for ensuring that this work is carried out on their behalf

Over 75 Health Check

Patients over 75 years will be informed of their named accountable GP and will be invited for a free NHS Health Check with a Health Care Assistant.

The NHS Health Check is a new initiative to improve overall health and well-being in the community. Its aim is to improve the care and support given to the over 75’s population. This will provide assessment and screening of patients health and social care issues based on questions and measurements. Following this patients will receive personalised advice and if needed, an onward referral or signposting to appropriate support services.

If you are already registered with the Practice and are aged 75 years or over and do not have any long-term conditions, please contact the surgery to book in for an NHS Health Check, if you have not done so already.

Opiates are the strongest pain killers we are able to prescribe and can be very effective at treating acute, severe pain caused by injury, surgery or cancer pain.  However, the role of opiates in chronic pain (pain lasting a long period of time) is less clear. For most people opiates are NOT effective for chronic pain.

Opiates include such medicines as codeine, dihydrocodeine, morphine, oxycodone, buprenorphine and fentanyl.

Opiates are to be considered for pain management only when all other medications and non-medication options have been explored. https://livewellwithpain.co.uk/.

Opiates can be helpful initially in reducing the feeling of pain in acute situations such as after an injury where you may have broken a bone. They may be used in hospital after major surgery Yet we would expect the pain to improve relatively quickly as the broken bone or injury repairs.

Acute prescriptions for opiates will not exceed 7 day’s supply, which is the expected duration of pain severe enough to require opioids.

In those instances where opiates are the most suitable option of analgesia for a patient, (for example in the elderly, where another analgesia is not suitable,) then a clinical decision will be made and the prescriber will prescribe the minimum effective dose for a specified period of time, with planned to follow up, before any further prescriptions can be issued.

For chronic pain the benefits of opiates are limited. Recent clinical evidence shows that the use of opiates for the management of chronic pain is ineffective and has the potential to be harmful (1).

We understand chronic pain can have a severe impact on your quality of life and many people who suffer from chronic pain long for a quick solution to eradicate pain completely. The purpose of this information is to inform you that long-term opiates are often not the solution and it is important you understand the risks associated with such medications.

• Tolerance and Increased Pain

When opiates are only prescribed for a short period of time, the body doesn’t have time to adapt and therefore you experience pain relief from the opiates. This initial feeling of relief is often experienced when the dose or strength of the opiate is increased.

However, when taken regularly for long periods of time you will find the relief from the pain is only short-lived and may wear off completely. This is because the body adapts to the medication. This may lead to patients requesting more and more dose increases and higher and higher quantities. Taking such high doses and strengths of opiates can result in potentially harmful effects on the body.

• Addiction

Opiate medication is addictive. It is unusual for someone with acute, short term pain to become addicted to opiates if they follow the prescribing advice of the clinician and take the minimum effective dose for the shortest period of time. However, longer-term use of opiates can lead to addiction.

If you believe you are addicted to opiate medication then please arrange an appointment with the GP or pharmacist at the surgery. We can help support you with a reduction plan which is safe. We would not advice stopping your opiate medication abruptly.

Further information can also be found at FORWARD LEEDS Forward Leeds self-referral form.

Chronic pain is complex and there are often other factors that contribute to the cause of pain. Some of these may be physical; others may be emotional and social. If you believe there are other factors that may be contributing to your pain please arrange for an appointment with a GP or pharmacist.

• Misuse of Medication

Opiates have the potential for misuse. They may cause physical dependence, where any of the risk factors are identified for a patient an appointment with a GP or pharmacist will be made before any further medication is prescribed.

Side Effects

When you first start taking opiate-based medication some people get side effects such as:

• Dizziness
• Drowsiness
• Nausea and/ or vomiting
• confusion

These symptoms normally settle after a few days.  Other ongoing side effects of opiates include:

• Constipation that can require laxatives
• Reduced libido (sex drive), erectile dysfunction and irregular periods
• Itchy skin
• Weight gain
• reduced fertility,
• Increased levels of pain
• Mood changes, agitation
• Loss of interest and concentration
• Difficulty breathing especially at night.

There is also an increasing awareness that people can die from opiate use.  This is not really a problem with weak opiates such as codeine on its own. Yet this can be an issue when more than one opiate is prescribed or when prescribed in higher doses or with other drugs that affect breathing like benzodiazepines or gabapentin or pregabalin the risk is increased.

• Driving

Please see the DVLA website for information on driving when taking prescription medicines such as opioids. DVLA advice drug- driving.

• Alcohol

If you are taking an opiate do not drink alcohol.

Lost prescriptions will not be replaced.

If you take higher doses than prescribed and run out of medication before the next prescription is due, you will NOT be prescribed extra tablets.

These medicines are controlled drugs and will not be prescribed early.

Prescription waiting time reminder.

The practice endeavours to fulfil the following.

Prescription Requests

Prescription requests take up to two full working days to action. Please be aware this will only lead to a prescription if it is appropriate to prescribe.

Please refrain from waiting in the reception area for the prescription process to take place. It will not result in prescriptions being fulfilled any quicker.

Thank you for your co-operation.

Want to reduce your opiate medication or other pain meds?

If you are taking regular opiates or other pain killers and you want to stop them then please contact the surgery to arrange an appointment with a GP or pharmacist. Please do not stop your medication abruptly as this may make you feel unwell.

• NICE, Medicines optimisation in chronic pain, online, updated 1/9/2019. Accessed 18/1/21. https://www.nice.org.uk/advice/KTT21/chapter/Evidence-context.

Sharing Your Medical Record

The following IT systems are in use at the practice:

• Referral Management (using NHS numbers in referrals).
• Electronic Appointment Booking (the facility to book routine appointments online and, similarly, to cancel appointments.
• Online booking of repeat prescriptions.
• Summary Care Record (uploading details of your current medication and allergies to the national “spine” so that these are available for doctors involved in your care elsewhere).
• GP to GP transfers (the electronic transfer of records from practice to practice when you re-register.
• Patient Access to records (the facility to view your medical records online).

If you are not already registered for online access and would like to be please complete our online form.

If you would like access to your medical records enabled or would like to opt-out of the local or national summary care record, please contact reception.

Pregabalin and gabapentin are used to treat some types of persistent pain. They are often prescribed for nerve pain, such as burning, shooting or stabbing pain. These medicines belong to a group of medicines called anticonvulsants which are also used to treat epilepsy.  You may notice that information from the manufacturer may not mention your type of pain.

Pregabalin and Gabapentin work by changing the way that nerves send messages to your brain. If the messages are reduced, then the pain will be reduced.

• When commenced for neuropathic pain or fibromyalgia, the medication will be prescribed for a test period to ascertain if they are effective.
• Normally, the starting dose is small and may be taken between one and three times a day, but the dose will be gradually increased.
• A follow-up appointment should be made to assess how well the medicine is working.
• The prescriber may advise gradually increasing the dose up to the maximum tolerated within the suggested dose range.
• If you do not notice any improvement in your symptoms after taking one of these medicines for approximately 6-8 weeks then the medication will be gradually reduced and stopped.
• If the medication is successful, it will be reviewed on an annual basis to ascertain ongoing effectiveness.

Alcohol

• Alcohol increases the sedative effects of pregabalin and gabapentin, it is best not to drink alcohol when you start taking it. Once settled on a steady dose, you may drink alcohol in moderation but it may make you more drowsy than normal. (1)

Driving

•  

  Please see the DVLA website for information on driving when taking prescription medicines such as opioids. DVLA advice drug- driving.

Addiction

•  

  If you believe you are addicted to gabapentin or pregabalin medication then please arrange an appointment with the GP or pharmacist at the surgery. We can help support you with a reduction plan which is safe. We would not advice stopping this medication abruptly.

  Further information can also be found at FORWARD LEEDS Forward Leeds self-referral form.

Misuse of Medication

Pregabalin and gabapentin have the potential for misuse. They may cause physical dependence, such as insomnia, weight gain, mood swings, double vision nausea and vomiting. Where any of the risk factors are identified for a patient an appointment with a GP or pharmacist will be made before any further medication is prescribed.

Lost prescriptions will not be replaced.
If you take higher doses than prescribed and run out of medication before the next prescription is due, you will NOT  be prescribed extra tablets.

These medicines are controlled drugs and will not be prescribed early.

Prescription waiting time reminder.

The practice endeavours to fulfil the following.

Prescription Requests

Prescription requests take up to two full working days to action. Please be aware this will only lead to a prescription if it is appropriate to prescribe.

Please refrain from waiting in the reception area for the prescription process to take place. It will not result in prescriptions being fulfilled any quicker.

Thank you for your co-operation.

• Faculty of pain medicine from the royal college of anaesthetists, Version 3.1 2017, online, accessed 1/2/21.

This privacy notice lets you know what happens to any personal data that you give to us, or any that we may collect from or about you.

This privacy notice applies to personal information processed by or on behalf of the practice.

This Notice explains

• Who we are, how we use your information and our Data Protection Officer
• What kinds of personal information about you do we process?
• What are the legal grounds for our processing of your personal information (including when we share it with others)?
• What should you do if your personal information changes?
• For how long your personal information is retained by us?
• What are your rights under data protection laws?

The General Data Protection Regulation (GDPR) became law on 24th May 2016. This is a single EU-wide regulation on the protection of confidential and sensitive information. It enters into force in the UK on the 25th May 2018, repealing the Data Protection Act (1998).

For the purpose of applicable data protection legislation (including but not limited to the General Data Protection Regulation (Regulation (EU) 2016/679) (the “GDPR”), and the Data Protection Act 2018 (currently in Bill format before Parliament) the practice responsible for your personal data.

This Notice describes how we collect, use and process your personal data, and how, in doing so, we comply with our legal obligations to you. Your privacy is important to us, and we are committed to protecting and safeguarding your data privacy rights

How we use Your Information and the Law.

The practice will be what’s known as the ‘Controller of the personal data you provide to us.

We collect basic personal data about you which does not include any special types of information or location-based information. This does however include name, address, contact details such as email and mobile number etc.

We will also collect sensitive confidential data known as “special category personal data”, in the form of health information, religious belief (if required in a healthcare setting) ethnicity, and sex during the services we provide to you and or linked to your healthcare through other health providers or third parties.

Why do we Need Your Information?

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

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

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

To ensure you receive the best possible care, your records are used to facilitate the care you receive. Information held about you may be used to help protect the health of the public and to help us manage the NHS. Information may be used within the GP practice for clinical audit to monitor the quality of the service provided.

How do we Lawfully Use Your Data?

We need to know your personal, sensitive and confidential data in order to provide you with Healthcare services as a General Practice, under the General Data Protection Regulation we will be lawfully using your information in accordance with: –

Article 6, e) processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller;”

Article 9, (h) processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems

This Privacy Notice applies to the personal data of our patients and the data you have given us about your carers/family members.

Risk Stratification

Risk stratification data tools are increasingly being used in the NHS to help determine a person’s risk of suffering a condition, preventing an unplanned or (re)admission and identifying a need for preventive intervention. Information about you is collected from a number of sources including NHS Trusts and from this GP Practice. A risk score is then arrived at through an analysis of your de-identified information is only provided back to your GP as a data controller in an identifiable form. Risk stratification enables your GP to focus on preventing ill health and not just the treatment of sickness. If necessary, your GP may be able to offer you additional services. Please note that you have the right to opt-out of your data being used in this way.

Medicines Management

The Practice may conduct Medicines Management Reviews of medications prescribed to its patients. This service performs a review of prescribed medications to ensure patients receive the most appropriate, up to date and cost-effective treatments.

How do we Maintain the Confidentiality of Your Records?

We are committed to protecting your privacy and will only use information collected lawfully in accordance with:

• Data Protection Act 2018
• The General Data Protection Regulations 2016
• Human Rights Act 1998
• Common-Law Duty of Confidentiality
• Health and Social Care Act 2012
• NHS Codes of Confidentiality, Information Security and Records Management
• Information: To Share or Not to Share Review

Every member of staff who works for an NHS organisation has a legal obligation to keep information about you confidential.

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

Our practice policy is to respect the privacy of our patients, their families and our staff and to maintain compliance with the General Data Protection Regulations (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 and sub-contractors engaged by our practice are asked to sign a confidentiality agreement. The practice will, if required, sign a separate confidentiality agreement if the client deems it necessary. If a sub-contractor acts as a data processor for the practice an appropriate contract (art 24-28) will be established for the processing of your information.

In certain circumstances, you may have the right to withdraw your consent to the processing of data. Please contact the Data Protection Officer in writing if you wish to withdraw your consent. In some circumstances, we may need to store your data after your consent has been withdrawn to comply with a legislative requirement.

Some of this information will be held centrally and used for statistical purposes. Where we do this, we take strict measures to ensure that individual patients cannot be identified. Sometimes your information may be requested to be used for research purposes – the surgery will always gain your consent before releasing the information for this purpose in an identifiable format.  In some circumstances, you can Opt-out of the surgery sharing any of your information for research purposes.

With Your Consent, we Would Also Like to Use Your Information to

We would however like to use your name, contact details and email address to inform you of services that may benefit you, with your consent only. There may be occasions where authorised research facilities would like you to take part in innovations, research, improving services or identifying trends.

At any stage where we would like to use your data for anything other than the specified purposes and where there is no lawful requirement for us to share or process your data, we will ensure that you have the ability to consent and opt-out prior to any data processing taking place. This information is not shared with third parties or used for any marketing and you can unsubscribe at any time via phone, email or by informing the practice DPO as below.

Where do we Store Your Information Electronically?

All the personal data we process is processed by our staff in the UK however for the purposes of IT hosting and maintenance this information may be located on servers within the European Union.

No 3rd parties have access to your personal data unless the law allows them to do so and appropriate safeguards have been put in place. We have a Data Protection regime in place to oversee the effective and secure processing of your personal and or special category (sensitive, confidential) data.

Who are Our Partner Organisations?

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

• NHS Trusts / Foundation Trusts
• GP’s
• eMBED Health
• Independent Contractors such as dentists, opticians, pharmacists
• Private Sector Providers
• Voluntary Sector Providers
• Ambulance Trusts
• Clinical Commissioning Groups
• Social Care Services
• NHS England (NHSE) and NHS Digital (NHSD)
• Local Authorities
• Education Services
• Fire and Rescue Services
• Police & Judicial Services
• Voluntary Sector Providers
• Private Sector Providers
• Other ‘data processors’ which you will be informed of

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

We may also use external companies to process personal information, such as for archiving purposes. These companies are bound by contractual agreements to ensure information is kept confidential and secure. All employees and sub-contractors engaged by our practice are asked to sign a confidentiality agreement. If a sub-contractor acts as a data processor for the practice an appropriate contract (art 24-28) will be established for the processing of your information.

How Long Will We Store Your Information?

We are required under UK law to keep your information and data for the full retention periods as specified by the NHS Records management code of practice for health and social care and national archives requirements. More information on records retention can be found online at (https://digital.nhs.uk/article/1202/Records-Management-Code-of-Practice-for-Health-and-Social-Care-2016).

How can You Access, Amend Move the Personal Data That you Have Given to us?

Even if we already hold your personal data, you still have various rights in relation to it. To get in touch about these, please contact us. We will seek to deal with your request without undue delay, and in any event in accordance with the requirements of any applicable laws. Please note that we may keep a record of your communications to help us resolve any issues which you raise.

Right to object: If we are using your data because we deem it necessary for our legitimate interests to do so, and you do not agree, you have the right to object. We will respond to your request within 30 days (although we may be allowed to extend this period in certain cases). Generally, we will only disagree with you if certain limited conditions apply.

Right to withdraw consent: Where we have obtained your consent to process your personal data for certain activities (for example for a research project), or consent to market to you, you may withdraw your consent at any time.

Right to erasure: In certain situations (for example, where we have processed your data unlawfully), you have the right to request us to “erase” your personal data. We will respond to your request within 30 days (although we may be allowed to extend this period in certain cases) and will only disagree with you if certain limited conditions apply. If we do agree to your request, we will Delete your data but will generally assume that you would prefer us to keep a note of your name on our register of individuals who would prefer not to be contacted. That way, we will minimise the chances of you being contacted in the future where your data are collected in unconnected circumstances. If you would prefer us not to do this, you are free to say so.

Right of data portability: If you wish, you have the right to transfer your data from us to another data controller. We will help with this with a GP to GP data transfer and transfer of your hard copy notes

Access to Your Personal Information

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

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

What Should you do if Your Personal Information Changes?

You should tell us so that we can update our records please contact the Practice Manager as soon as any of your details change, this is especially important for changes of address or contact details (such as your mobile phone number), the practice will from time to time ask you to confirm that the information we currently hold is accurate and up-to-date.

How Can my Information be Viewed Outside of Colton Mill and The Grange Medical Practice?

Your health information can be shared both locally and nationally at differing levels of detail.

For Direct Care Locally in Leeds:

Leeds Care Record Patients in Leeds are able to benefit from the sharing of information via the Leeds Care Record. These shares contact details, diagnosis list, medications, allergies, test results, referrals & letters and care plans between health professionals in Leeds. Information is shared by GP practices, the hospital trusts, Community and Mental Health services, and Social Care.

You have the right to object to your Leeds Care Record being shared by contacting them directly. Details are available via their website.

You can opt-in and out of these sharing agreements whenever you choose. Details of these schemes are as follows:

Nationally for Direct Care:

Summary Care Record – sharing your information for your care across the NHS.

Your core Summary Care Record is created when you register at a GP practice (although you should be given the option to opt-in/out during your registration). If you do not express a preference, it is currently assumed that your consent is implied.

The Summary Care Record shares only your contact details, medications and allergies with other healthcare professionals involved in your care.

You can also choose to share a Summary Care Record with Additional Information. These shares contact details, medications, allergies, diagnosis list, care plans, end of life care and immunisations with other healthcare professionals. Sensitive data is excluded. A Summary Care Record with Additional Information will only be created for you if you explicitly choose this option. All current and past information is shared for each category.

Choosing to share a summary care record with additional information is thought to be of great benefit if you are admitted to a hospital locally or elsewhere in the UK.

You can opt-out of sharing any of your information in a Summary Care Record. If you decide not to share this will not affect your entitlement to care. However, it could result in the delivery of your care being less efficient as other health professionals will not have access to these parts of your medical history.

The General Data Protection Regulations state that you have a right to access personal information that Colton Mill and The Grange Medical Centre holds about you. There are three main areas of legislation that allow the right of the individual to request such personal information, and they are:

• The Data Protection Act 1998
• The Access to Health Records Act 1990
• The Medical Reports Act 1988

How do I Requesting Access to the Information You Hold About me?

• All requests must be in writing to the Data Controller at Colton Mill and The Grange Medical Centre.
• Verbal requests can be accepted where the individual is unable to put the request in writing – this must be noted on the patient record.
• Proof of identity must be provided to satisfy the Data Controller and to enable them to locate the correct information.
• For requests made on behalf of another, the Data Controller must be satisfied that correct and adequate consent has been provided.
• The Data Controller needs to check whether the entire individual’s health record information is required or just certain information.
• Where an information request has been previously fulfilled, the Data Controller does not have to honour the same request again unless a reasonable time period has elapsed. It is up to the Data Controller to ascertain what constitutes reasonable.

How Long Will it Take to Get my Data?

Requests for health records information will be recorded internally and processed within 30 days (unless under exceptional circumstances – the applicant must be informed where a longer period is required).

Will I Have to Pay to Access my Data?

We do not charge for subject access requests.

Will You Object or Restrict any Information?

The Data Controller has the right to object or restrict the use of your personal information for the following reasons:

• The information released may cause serious harm to the physical or mental health or condition of the individual or any other person.
• The disclosure would also reveal information relating to or provided by a third person who has not consented to that disclosure.

A reason for denial of information does not have to be given to the individual, but must be recorded.

Can I Access Information About my Children?

• Parents will normally have parental responsibility for accessing the health records of their children.
• The Data Controller will need to obtain the consent of the child where necessary (16 and 17-year-olds are seen as adults in relation to confidentiality, and their consent would be necessary).
• Children under 16 who have the capacity and understanding for decision-making need to have their confidentiality respected.

To request access- please complete the form below and return it to the practice.

GPs in Training

Our practice is approved to train fully qualified doctors who wish to specialise in general practice. Our GP registrar will have had 2-4 years of experience as a qualified hospital doctor working in various specialities. They consult patients on their own, under the mentorship of our trainer, Dr xxxxx. Occasionally we ask permission to video a consultation. You will always be asked in advance and are given the option not to take part, and this will not affect your care in any way. No recording will be taken without your consent and the camera will be switched off on request. These videos are used only for educational purposes with the doctor doing the consultation and are destroyed after use.

Dr xxxxx is currently the GP registrar at the practice.

Medical Students

Medical students are sometimes attached to the practice for 2 – 3 weeks as part of their training. If you do not wish a student to be present during your consultation, please inform the receptionist.

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.