Introduction

The term ‘visitor’ used below refers to anyone (including patients and their family members, other visitors and contractors) making use of the practice’s premises and services (except employees for whom the Equal Opportunities/Anti-Discrimination (Employment) Policy applies).

The Practice:

• will ensure that all visitors are treated with dignity and respect

• will promote equality of opportunity between men and women

• will not tolerate any discrimination against, or harassment of, any visitor for reason of age, sex, marital status, pregnancy, race, ethnicity, disability, sexual orientation, religion or belief

• will provide the same treatment and services (including the ability to register with the practice) to any visitor irrespective of age, sex, marital status, pregnancy, race, ethnicity, disability, sexual orientation, religion or belief

Applicability

This Policy applies to the general public, including all patients and their families, visitors and contractors.

Procedure

Discrimination by the practice against you

If you feel discriminated against:

• you should bring the matter to the attention of the practice manager
  
• the practice managerwill investigate the matter thoroughly and confidentially within 3 working days
  
• the practice manager will establish the facts and decide whether discrimination has taken place and advise you of the outcome of the investigation within 10 working days

If you are not satisfied with the outcome, you should raise a formal complaint through the practice’s Complaints Procedure.

Discrimination against the practice’s staff

The practice will not tolerate any form of discrimination or harassment of our staff by any visitor. Any visitor who expresses any form of discrimination against, or harassment of, any member of our staff, will be required to leave the practice’s premises forthwith. If the visitor is a patient, he/she may be removed from the practice’s list if any such behaviour occurs on more than one occasion.

You can complain to your GP practice:

Talk to the reception staff or to the practice manager and ask them how to make a complaint. They will inform you of the complaints procedure. They may say you can:

• talk to someone
  
• write to us via email
  
• fill in a form

Complain as soon as you can. You must complain within 12 months of the date of the event that you’re complaining about. Ask them when you can expect to hear back from them.

It is fine to make a complaint. No one will treat you badly because of it. But if your complaint concerns an individual, try to speak to the person you are unhappy with first. It may solve the problem.

Be clear that you are complaining. If staff at your GP surgery think you are just giving feedback, your complaint may not be dealt with in the same way. If in doubt, put your complaint in writing.

Or you can complain to NHS England:

If you don’t feel comfortable complaining to your GP practice, you can complain directly to NHS England instead.

When you complain to your GP practice you start a two way conversation. However, when you complain to NHS England the process is more formal. You will probably only get one chance to put your case. Make sure you give them all the relevant information. They will then need to contact the GP practice to investigate.

Email: england.contactus@nhs.net
Write to NHS England, PO Box 16738, Redditch, B97 9PT
Call: 0300 311 22 33

Support making your complaint

If you need support to make a complaint you can contact NHS Complaints Advocacy at VoiceAbility. They can provide you with an advocate; a person who will help you to complain. Your advocate will:

• ensure that you understand your options
  
• help you to achieve the outcome you are seeking

You can ask for an advocate to assist you at any point in your complaint. If you would like an advocate to work with you, contact VoiceAbility’s NHS complaints helpline:

Telephone: 0300 330 5454
Textphone: 0786 002 2939

The website www.nhscomplaintsadvocacy.org has resources to support you to make a complaint by yourself. These are available in a range of languages, as well as Easy Read and large print formats.

What if you’re still not happy?

If you’re unhappy with the result of your complaint you can appeal to the Parliamentary and Health Service Ombudsman. This cannot be your first port of call. You must first complain to either the GP practice or to NHS England. The Ombudsman can only help if:

• the GP practice or NHS England have finished looking at your complaint
  
• or your complaint has not been sorted out after 6 months

Telephone: 0345 015 4033
Email: phso.enquiries@ombudsman.org.uk
www.ombudsman.org.uk/make-a-complaint

By law you need to contact the Ombudsman within a year of the incident you are complaining about. If it was more than a year ago they may still be able to help if there were good reasons for the delay.

Healthwatch Islington

If you are happy with the service at your GP practice, but would like to complain about another health or social care service you use, contact Healthwatch Islington. Healthwatch Islington will let you know who you need to contact in order to make a complaint (or to leave positive feedback) about other services in the borough, for example dentists, pharmacies, opticians, hospitals, mental health services, care homes, day centres, and out of hours services.

Telephone: 020 7832 5828
Email info@healthwatchislington.co.uk
www.healthwatchislington.co.uk

All patient information is kept in strict confidence. We will not divulge information to anyone without your express consent.

Most of our information is held on computers and is retained and used strictly in accordance with the Data Protection Act. Young people under 16 years of age are normally entitled to the same confidentiality as adults, except in special circumstances where the doctor considers that a young person is in danger.

Computers

The practice is computerised and all information held on the computer is kept in accordance with the Data Protection Act. As with other medical records, all the information handled by the computer is completely confidential.

Access to Records

In accordance with the Data Protection Act 1998 and the Access to Health Records Act 1990 patients may request to see their medical records. Such requests are by appointment and may be subject to an administration charge.

No information will ever be released without your consent unless we are legally obliged to do so. If you wish, you may request to see copies of correspondence between your doctor and other medical practitioners (e.g. consultants).

If you wish to receive copies of correspondence, please inform your doctor. As such letters often contain specialised medical terminology; you may need to ask your doctor to explain them.

Please note that copy letters will be sent by post to the address given in your medical record.

Please make sure that your records are accurate and that no one else in your household is likely to see confidential information.

Review/Monitoring

We undertake to review, monitor and continuously improve the service we provide. This will ensure that our commitment to high quality patient care remains constant. Your views are important to us, as is your co-operation in achieving these aims and will help us judge whether we are meeting these standards.

In return we ask you to ensure that your written consent accompanies any request you have authorised for medical information.

Freedom of Information

The ICO has published a new Model Publication Scheme that all public authorities are required to adopt.

Model Publication Scheme

The Beaumont Practice will fulfill its obligations to satisfy the” Statutory duty of candour” as outlined below.

The obligations associated with the statutory duty of candour are contained in regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

According to the key principles The Beaumont Practice will:

• Act in an open and transparent way in relation to care provided to its patients.

• Our staff cooperate with it to ensure the obligation is met.

• As soon as is reasonably practicable after becoming aware of a notifiable patient safety incident, we will tell the patient (or their representative) about it in person.

• The circumstances that give rise to a requirement to tell the patient or their representative about something that has gone wrong are the same as those that are required to be notified without delay to the CQC1. This notification to CQC is separate from and in addition to the statutory duty of candour which requires us to keep copies of correspondence with the patient which we will do.

• We will give patient a full explanation of what is known at the time, including what further enquiries will be carried out. We will also provide an apology and keep a written record of the notification to the patient. We understand that failure to make that notification may amount to a criminal offence.

A notifiable patient safety applies to incidents where something unintended or unexpected has occurred in the care of a patient and appears to have resulted in:

• their death, where this relates to the incident and is not simply due to the natural progression of the illness or condition;

• impairment (of sensory, motor or intellectual function) that has lasted or is likely to last for 28 days continuously;

• changes to the structure of the body (for example, amputation following arterial occlusion);

• prolonged pain or prolonged psychological harm. The pain or psychological harm must be, or likely to be, experienced continuously for 28 days or more;

• shortening of their life expectancy;

• or where the patient requires treatment by a healthcare professional in order to prevent death, or the adverse outcomes listed above.

The Practice has a statutory duty to provide reasonable support to the patient. Reasonable support could be providing an interpreter to ensure discussions are understood, or giving emotional support to the patient following a notifiable patient safety incident.

Once the patient has been told in person about the notifiable patient safety incident, The Practice will provide the patient with a written note of the discussion, and copies of correspondence will be kept.

Following the initial notification, the Practice will give written notification including details of any further enquiries into the incident and their results and an apology. Although the statutory duty of candour applies to organisations, doctors, who are used to having candid discussions with their patients, are most likely to be the organisation’s representative under the statutory duty.

It is important that staff cooperate with the Practice’s policies and procedures, including the requirement to alert the Practice when a notifiable patient safety incident occurs. An area of difficulty may be deciding whether an incident reaches the threshold for notification under the statutory duty. This may be confusing, as the threshold is low for the doctor’s ethical duty (any harm or distress caused to the patient) while the threshold for the statutory duty is higher and complex.

Where The Practice’s Clinicial governance procedures for reporting and investigating incidents are followed, it is unlikely that a notifiable patient safety incident will be overlooked. And in any event, Clinicians must always follow their ethical duty, irrespective of whether the statutory duty applies.

The Beaumont Practice is a long established GP surgery that is committed to preserve and enhance its good reputation for being caring and innovative by providing high quality medical services in a friendly, happy and healthy environment.

We undertake to:

– Treat you with respect and courtesy at all times.
– Our care is completely patient centered
– Offer continuity of care and timely access to reliable health advice
– Pay attention to your physical and environmental needs
– Help and encourage participation so that you make decisions about your health
– Discuss available treatments and refer you on to other experts where necessary
– Act as your advocate and guide through health care services
– We provide clear, understandable information and support for self-care
– Maintain confidentiality in what we discuss and the records we keep on your behalf
– Keep up to date with health and social issues pertaining excellent patient care

In return, we ask you to:

– Keep your appointment and /or let us know as soon as possible if you can’t attend
– Only use urgent out-of-hours services for urgent conditions which can’t wait until the next day or over the weekend
– Be nice to our staff! They do their best for you and respond very well to “please” and “thank you”
– Let us know if you have any suggestions to improve our surgery; we listen
– Let us know when we have done well

Information about you and the care you receive is shared, in a secure system, by healthcare staff to support your treatment and care.

It is important that we, the NHS, can use this information to plan and improve services for all patients. We would like to link information from all the different places where you receive care, such as your GP, hospital and community service, to help us provide a full picture. This will allow us to compare the care you received in one area against the care you received in another, so we can see what has worked best.

Information such as your postcode and NHS number, but not your name, will be used to link your records in a secure system, so your identity is protected. Information which does not reveal your identity can then be used by others, such as researchers and those planning health services, to make sure we provide the best care possible for everyone.

How your information is used and shared is controlled by law and strict rules are in place to protect your privacy.

We need to make sure that you know this is happening and the choices you have.

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.

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 contact reception for further information.

More Information

For further information visit the NHS Care records website or the HSCIC Website.

We want you to feel confident and comfortable when talking to us. Anyone who is not relevant will not know what you have discussed with your GP – this information will be kept completely private.

Parents, family members, care workers, tutors or youth workers will not be contacted about your visit without your permission. Your doctor may talk to you about involving an adult to support you but it’s your choice whether you would like this to happen.

If we think you or another person is at risk of serious harm, we may need to speak to another agency, like Children’s Services. If we need to do this, we will speak to you first so that you can ask any questions you may have.

As an employer, the practice has a duty of care for the health, safety and wellbeing of its staff. The practice also has a legal responsibility to provide a safe and secure working environment for staff. Staff mental health is as important as their physical health.

All patients and staff are expected to behave in an acceptable, respectful manner.

The practice follows the NHS guidance concerning Zero Tolerance.

Any incident in which an employee is abused, threatened or assaulted in circumstances relating to their work is unacceptable and not tolerated.

This includes the serious or persistent use of verbal abuse, aggressive tone and/or language and swearing/foul language.

Staff should not be left upset and distressed following an interaction with a patient.

All instances of actual physical abuse or threatening behaviour on any doctor or member of staff, by a patient or their relatives will be reported to the police as an assault.

We expect all patients to be responsible and avoid attending the surgery under the influence of alcohol or illegal drugs. Any alteration of prescriptions is illegal and will not be tolerated.

The General Medical Council states In Good Medical Practice that: “In rare circumstances, the trust between you (the Practice) and a patient may break down, and you may find it necessary to end the professional relationship. For example, this may occur if a patient has been violent to you or a colleague, has stolen from the premises, or has persistently acted inconsiderately or unreasonably.”

This includes unnecessarily persistent or unrealistic service demands that cause disruption. Examples of this include, but are not limited to :

• Demanding to only speak to a specific team member
• Refusing appointments with an appropriate clinician for the presenting care need i.e. insisting on a GP appointment when seeing a pharmacist or nurse prescriber is most appropriate or refusing to see an available GP for your presenting care need when your preferred GP is unavailable
• Refusing to access the service in the appropriate manner i.e. sending emails/texts instead of using the NHS Digital approved digital consultation service
• Demanding a same day appointment for a routine clinical need – this deprives access to urgent care services for those who genuinely need it
• Contacting individuals directly via social media or personal email instead of through the practice contact channels

The practice has a finite number of available appointments and you may be directed to a clinician who is not a GP, or your preferred GP, but who is appropriately qualified to manage the presenting care need. We provide a named GP service but we cannot always accommodate requests to speak to the same GP due to high patient demand for appointments.

If you are seriously unhappy with the quality of service you have the right to register with another practice without notifying us. Similarly, on the very rare occasions when a patient breaches this policy, we have the right to remove the patient from our Practice list.

Examples of Unacceptable Standards of Behaviour

In exceptional circumstances, a breakdown may occur between a doctor and their patient. If the breakdown is of a serious nature e.g. serious physical or verbal abuse to any member of the practice team, the doctors may feel that the doctor/patient relationship has been compromised. Steps may be taken to have the patient removed immediately from the practice list. Where possible, conciliation would always be the preferred route. Reasons for removal will be given in writing.

Where we deem an incident is not serious enough to warrant immediate removal, we will issue a first and final warning.

You will be removed from our patient list immediately when we have needed police assistance or have made a report to the police.

The following are examples of when you may be issued with a first and final warning or removed from our patient list dependent on the severity of the incident.

• Violence.
• Excessive noise eg recurrent loud or intrusive conversation or shouting.
• Threatening or abusive language involving swearing or offensive remarks.
• Racial or sexual remarks.
• Aggressive, forceful tone and/or language that upsets staff.
• Malicious allegations relating to members of staff, other patients or visitors.
• Offensive gestures or behaviours.
• Abusing alcohol or drugs on practice premises.
• Drug dealing on practice premises.
• Wilful damage to practice property.
• Threats or threatening behaviour.
• Theft.
• Persistent and/or unrealistic demands on the service
• Repeated derogatory comments about the practice or individuals either verbally, in writing/digitally or on social media platforms – this applies to factual and false information as we have a process to feedback dissatisfaction.

This list is not exhaustive and there may be other occasions where we have cause to issue a warning or remove you from our patient list.  If you are unhappy with the practice, we have a complaints procedure to assist you or you have the choice to register with another practice – there really is no need for unpleasant behaviour with these options available to support you.

We trust this policy is clear and supports a mutually respectful environment for patients and staff.