You are entitled to have a chaperone present for any consultation, examination or procedure and this would be a specially trained member of staff. If you would like the practice to provide a chaperone, please try to request this in advance so that arrangements can be made and avoid the need for the appointment to be rescheduled. Your healthcare professional may also require a chaperone to be present for certain consultations. This impartial observer will be a practice nurse or health care assistant who is familiar with the procedure and be available to reassure and raise any concerns on your behalf. You are free to decline any examination or chose an alternative examiner or chaperone.

Clinical governance describes the structures, processes and culture needed to ensure that healthcare organisations – and all individuals within them – can assure the quality of the care they provide and are continuously seeking to improve it. The main components of clinical governance include: risk management, clinical audit, education training and CPD, evidence-based care, patient and carer involvement and staffing and management. If you would like further details on our clinical governance policy, please contact the practice manager.

The purpose of this protocol is to set out the practice’s approach to consent and the way in
which the principles of consent will be put into practice. Where possible, a clinician must be satisfied that a patient understands and consents to a proposed treatment, immunisations or investigation.

Implied Consent
Implied consent will be assumed for many routine physical contacts with
patients. Where implied consent is to be assumed by the clinician, in all cases, the following will apply: an explanation will be given to the patient about what he/she is about to do and why. In all cases where the patient is under 18 years of age, a verbal confirmation of consent will be obtained and briefly entered into the medical record. Where there is a significant risk to the patient an ‘Expressed Consent’ will be obtained in all cases (see below).

Expressed Consent
Expressed consent (written or verbal) will be obtained for any procedure that carries a risk that the patient is likely to consider a substantial risk. A note will be made in the medical record detailing the discussion about the consent and the risks. A consent form may be used for the patient to express consent (see below).

Obtaining Consent
Consent (implied or expressed) will be obtained prior to the procedure. The clinician will ensure that the patient is competent to provide a consent (16 years or over) or has ‘Gillick Competence’ if under 16 years (has ‘sufficient understanding and maturity to enable
them to understand fully what is proposed’). For children under 16 years, someone with parental responsibility should give consent on the child’s behalf by signing accordingly on the consent form.

NHS England aims to link information from all the different places where you receive care, such as hospital, community service and us your GP Surgery. This will allow them to compare the care you received in one area against the care you received in another.

Information will be held in a secure environment called the Health and Social Care Information Centre (HSCIC). The role of the HSCIC is to ensure that high quality data is used appropriately to improve patient care. The HSCIC has legal powers to collect and analyse data from all providers of NHS care. They are committed, and legally bound, to the very highest standards of privacy and confidentiality to ensure that your confidential information is protected at all times.

This data can also be used, with permission, for research purposes. If you do not wish to share data for research, you can opt out by contacting the practice.

• You can object to information containing data that identifies you from leaving the Practice. This will prevent identifiable information held in your record from being sent to the HSCIC secure environment. It will also prevent those who have gained special legal approval from using your health information forresearch.
• You can also object to any information containing data that identifies you from leaving the HSCIC secure environment. This includes information from all places you receive NHS care, such as hospitals. If you object, confidential information will not leave the HSCIC and will not be used, except in very rare circumstances for example in the event of a public health emergency.

For more information visit: www.england.nhs.uk/caredata

The law requires Doctors to provide some very limited information about certain things. The law says, for example, that Doctors must provide information to local authorities about some infectious diseases, e.g. if you had food poisoning. Very rarely, Doctors may be required to disclose information in order to detect a serious crime. Likewise, a court order can require Doctors to disclose certain information during a court case.

Summary Care Record (SCR)

If you decide to have a SCR, it will contain important information about any medicines you are taking, allergies you suffer from and any bad reactions to medicines that you have had. This does not include diagnosis or procedures.

Giving healthcare staff access to this information can prevent mistakes being made when caring for you in an emergency or when your GP practice is closed. Your Summary Care Record will also include your name, address, date of birth and your unique NHS Number to help identify you correctly. If you and your GP decide to include more information it can be added, but only with your express permission.

For more information:

• Phone 0300 123 3020
• or visit: digital.nhs.uk

SystmOne Data Sharing

The practice uses a clinical computer system called SystmOne to store your medical information. The system is also used by other GP practices, Child Health Services, Community Services, Hospitals, Out of Hours, Palliative Care services and many more. This means your information can be shared with other clinicians so that everyone caring for you is fully informed about your medical history including medication and allergies. You can control how your medical information is shared with other organisations that use this system.

1. Sharing Out – This controls whether your information stored in the practice can be shared with other NHS services (i.e. made shareable)
2. Sharing In – This controls whether information made shareable at other NHS care services can be viewed by us, your GP practice, or not. (i.e. shared in)

Benefits of sharing information

Sharing information can help improve understanding, responses to different treatments and potential solutions. Information will also help to:

• Provide better information to out of hours and emergency services
• Prevent Prescribing of medication to which you may already have an allergy
• Make more informed prescribing decisions about drugs and dosages Avoid unnecessary duplication in prescribing
• Increase clinician confidence when providing care
• Results of investigations, such as X-rays and laboratory tests
• Reduce referrals, ambulance journey admissions, tests, time wastage and visits to healthcare premises
• Find out basic details about you, such as address and next of kin.

Do I have a choice?

Yes. You have the right to prevent confidential information about you from being shared or used for any purpose other than providing your care, except in special circumstances. If you do not want information that identifies you to be shared outside this Practice, complete the sheet enclosed in this leaflet. This will prevent your confidential information being used other than where necessary by law.

Objecting on behalf of others

If you are a carer and have a Lasting Power of Attorney for health and welfare then you can object on behalf of the patient who lacks capacity. If you do not hold a Lasting Power of Attorney then you can raise your specific concerns with the patient’s GP.

If you have parental responsibility and your child is not able to make an informed decision for themselves, then you can make a decision about information sharing on behalf of your child. If your child is competent then this must be their decision.

Our practice is committed to providing equality of opportunity and anti-oppressive practice. The organisation will not tolerate any kind of discrimination, harassment or oppressive practices and is committed to stopping it.

The organisation wishes to secure genuine equality of opportunity whether required by legislation or not, in all aspects of its activities.

It applies to the provision of services, all aspects of employment from recruitment, selection and training of staff and volunteers, to conditions of service and reasons of termination of employment.

The individual responsibility of everyone connected to and acting on behalf of the organisation.

We aim to ensure that:

• No person is treated less favourably than another on grounds of:
  • age
  • gender
  • marital status
  • physical or mental disability
  • race
  • responsibility for dependants
  • sexual orientation
  • caring responsibilities
  • political affiliation
  • religious belief
  • offending background
  • or any other improper ground
• All employees and job applications are treated fairly and consistently and are not subject to unjustifiable requirements or conditions.
• Services provided to the public do not disadvantage patients on any of the grounds
  detailed above.

The Freedom of Information Act creates a right of access to recorded information and obliges a public authority to:

• have a publication scheme in place
• allow public access to information held by public authorities.

The Act covers any recorded organisational information such as reports, policies or strategies, that is held by a public authority in England, Wales and Northern Ireland, and by UK-wide public authorities based in Scotland, however it does not cover personal information such as patient records which are covered by the Data Protection Act.

Public authorities include government departments, local authorities, the NHS, state schools and police forces.

The Act is enforced by the Information Commissioner who regulates both the Freedom of
Information Act and the Data Protection Act.

The Surgery publication scheme

A publication scheme requires an authority to make information available to the public as part of its normal business activities. The scheme lists information under seven broad classes, which are:

• who we are and what we do
• what we spend and how we spend it
• what our priorities are and how we are doing it
• how we make decisions
• our policies and procedures
• lists and registers
• the services we offer

You can request our publication scheme leaflet at the surgery.

Who can request information?

Under the Act, any individual, anywhere in the world, is able to make a request to a practice for information. An applicant is entitled to be informed in writing, by the practice, whether the practice holds information of the description specified in the request and if that is the case, have the information communicated to him. An individual can request information, regardless of whether he/she is the subject of the information or affected by its use.

How should requests be made?

Requests must:

• be made in writing (this can be electronically e.g. email/fax)
• state the name of the applicant and an address for correspondence
• describe the information requested.

What cannot be requested?

Personal data about staff and patients covered under Data Protection Act.
For more information see these websites:

• Legislation GOV.UK
• Information Commissioners Office

All GP practices are required to declare the mean net earnings (eg. Average pay) for GPs working to deliver NHS services to patients at each practice.  This is required in the interests of the greater public accountability recognising GP pay is ultimately funded from tax paid by the public.

The average pay for GPs working in Westfield Surgery in the last financial year was £47,666 before tax and national insurance.  This is for 0 full time GP, 6 part time GPs and 0 locum GPs who worked in the practice for more than six months

We aim to keep our surgery clean and tidy and offer a safe environment to our patients and staff and endeavour to keep it clean and well maintained at all times.

If you have any concerns about cleanliness or infection control, please report these to
our reception staff.

Our GPs and nursing staff follow our Infection Control Policy to ensure the care we deliver and the equipment we use is safe.

We take additional measures to ensure we maintain the highest standards:

• Encourage staff and patients to raise any issues or report any incidents relating to
  cleanliness and infection control.  We can discuss these and identify improvements we can make to avoid any future problems.
• Carry out an annual infection control audit to make sure our infection control procedures are working.
• Provide annual staff updates and training on cleanliness and infection control
• Review our policies and procedures to make sure they are adequate and meet national guidance.
• Maintain the premises and equipment to a high standard within the available financial resources and ensure that all reasonable steps are taken to reduce or remove all infection risk.
• Use washable or disposable materials for items such as couch rolls, modesty curtains, floor coverings, towels etc., and ensure that these are laundered, cleaned or changed frequently to minimise risk of infection.
• Make alcohol hand rub gel available throughout the building

The impact of patients failing to attend appointment can be significant and may result in you not being able to see a particular GP on the day that you wish to.

In an attempt to try and resolve this, the practice has developed the following policy:

• If you fail to attend two consecutive appointments without informing us, we will write to you asking whether there are specific problems preventing you from letting us know.
• If you fail to attend a further appointment, you may be removed from the practice list and have to find an alternative.

The NHS wants to make sure you and your family have the best care now and in the future. Your health and adult social care information supports your individual care. It also helps us to research, plan and improve health and care services in England.

There are very strict rules on how this data can and cannot be used, and you have clear data rights. We are committed to keeping patient information safe and will always be clear on how it is used.

You can choose whether or not your confidential patient information is used for research and planning.

Your confidential patient information

Confidential patient information identifies you and says something about your health, care or treatment. You would expect this information to be kept private. Information that only identifies you like your name and address is not confidential patient information and may still be used.  For example, to contact you if your GP practice is merging with another.

Using your confidential patient information

Your confidential patient information is used in two different ways:

Your individual care

Health and care professionals may use your confidential patient information to help with your treatment and care.  For example, when you visit your GP, they may access your records for important information about your health.

Research and planning

Confidential patient information is also used to:

• • plan and improve health and care services

• • research and develop cures for serious illnesses

Most of the time, anonymised data is used for research and planning.  So your confidential patient information isn’t always needed.

Where you have a choice

If you don’t want your confidential patient information to be used for research and planning, you can opt out of this. If you do opt out, there are some specific situations where your data may still be used.  Data that does not identify you may still also be used.  Your confidential patient information will still be used to support your individual care. Any preference you set using this service will not change this.  If you opt out, your decision will only apply within the health and care system in England. Your opt-out will not apply to your health data where you have accessed health or care services outside of England, such as in Scotland and Wales.

Manage your choice

You may use our online service, or request a print-and-post form, to make or change your choice at any time. You can also request assistance or make your choice using our telephone service. If you do not wish to opt out, you don’t have to do anything at all.

You can also manage a choice on behalf of another individual by proxy. For example, if you are a parent or guardian of a child under the age of 13.

Please click on the following link if you wish to Manage your choice

More information can also be viewed at www.nhs.uk/your-nhs-data-matters

What is non-NHS work and why is there a fee?

The National Health Service provides most health care to most people free of charge, but there are exceptions: prescription charges have existed since 1951 and there are a number of other services for which fees are charged.

Sometimes the charge is because the service is not covered by the NHS, for example, providing copies of health records or producing medical reports for insurance companies, solicitors or employers.

The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. It is important to understand that many GPs are not employed by the NHS; they are self- employed and they have to cover their costs – staff, buildings, heating, lighting, etc. – in the same way as any small business.

In recent years, however, more and more organisations have been involving doctors in a whole range of non-medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to ensure that information provided to them is true and accurate.

Examples of non-NHS services for which GPs can charge their own NHS patients are:

• accident/sickness certificates for insurance purposes
• school fee and holiday insurance certificates
• reports for health clubs to certify that patients are fit to exercise
• private prescriptions for travel purposes

Examples of non-NHS services for which GPs can charge other institutions are:

• life assurance and income protection reports for insurance companies
• reports for the Department for Work and Pensions (DWP) in connection with
• disability living allowance and attendance allowance
• medical reports for local authorities in connection with adoption and fostering
• copies of records for solicitors

Do GPs have to do non-NHS work for their patients?

With certain limited exceptions, for example a GP confirming that one of their patients is not fit for jury service, GPs do not have to carry out non-NHS work on behalf of their patients. Whilst GPs will always attempt to assist their patients with the completion of forms, they are not required to do such non-NHS work.

Is it true that the British Medical Association (BMA) sets fees for non-NHS work?

The BMA suggest fees that GPs may charge their patients for non-NHS work (i.e. work not
covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested by them are intended for guidance only; they are not
recommendations and a doctor is not obliged to charge the rates they suggest.

Why does it sometimes take my GP a long time to complete my form?

Time spent completing forms and preparing reports takes the GP away from the medical care of his or her patients. Most GPs have a very heavy workload and paperwork takes up an increasing amount of their time. Our GPs do non-NHS work out of NHS time at evenings or weekends so, that NHS patient care does suffer.

I only need the doctor’s signature – what is the problem?

When a GP signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. In order to complete even the simplest of forms, therefore, the doctor might have to check the patient’s ENTIRE medical record. Carelessness or an inaccurate report can have serious consequences for the GP with the General Medical Council (the doctors’ regulatory body) or even the Police.

If you are a new patient we may not have your medical records so the doctor must wait for these before completing the form.

What will I be charged?

It is recommended that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual doctors to decide how much they will charge. The surgery has a list of fees based on these suggested fees which is available on request.

What can I do to help?

• Not all documents need a signature by a doctor, for example passport applications. You can ask another person in a position of trust to sign such documents free of charge. Read the information that comes with these types of forms carefully before requesting your GP to complete them.
• If you have several forms requiring completion, present them all at once and ask your GP if he or she is prepared to complete them at the same time to speed up the process.
• Do not expect your GP to process forms overnight: urgent requests may mean that a
  doctor has to make special arrangements to process the form quickly, and this may cost more. Usually non-NHS work will take 2 weeks.

View/ Download our Privacy Notice.

We are committed to protecting your privacy. You can access our website without giving us any information about yourself. But sometimes we do need information to provide services that you request, and this statement of privacy explains data collection and use in those situations.

In general, you can visit our web site without telling us who you are and without revealing any information about yourself. However there may be occasions when you choose to give us personal information, for example, when you choose to contact us or request information from us. We will ask you when we need information that personally identifies you or allows us to contact you.

We collect the personal data that you may volunteer while using our services. We do not collect information about our visitors from other sources, such as public records or bodies, or private organisations. We do not collect or use personal data for any purpose other than that indicated below:

• To send you confirmation of requests that you have made to us
• To send you information when you request it.

We intend to protect the quality and integrity of your personally identifiable information and we have implemented appropriate technical and organisational measures to do so. We ensure that your personal data will not be disclosed to State institutions and authorities except if required by law or other regulation.

We do not use cookies on this website therefore you will not see a message asking you to choose to accept or decline cookies.

Our website may contain links to other websites of interest. However, once you have used these links to leave our site, you should be aware that we don’t have any control over the other website. Therefore, we cannot be responsible for the protection and privacy of any information which you provide whilst visiting these sites.

View / Download our Private Fees.

Everyone has the human right to live a life that is free from abuse and neglect. Safeguarding means protecting vulnerable adults and children who are at risk and need support, and is fundamental to ensuring high-quality health and social care. If you are concerned that someone is at risk of abuse, don’t hesitate to report your concern with the Virgin Care ASIST team on 01225 396000. You can find more support and advice about services in B&NES, including how to report concerns, here.

People who may be particularly vulnerable to abuse include:

• disabled people who have physical or sensory impairments
• people who have learning difficulties
• people who experience mental ill health
• older people
• children
• people who live in care homes
• people with acquired brain damage
• People who misuse substances.

New contractual requirements came into force from 1 April 2014 requiring that GP Practices should make available a statement of intent in relation to the following IT developments:

• Summary Care Record (SCR)
• GP to GP Record Transfers
• Patient Online Access to Their GP Record

The same contractual obligations require that we have a statement of intent regarding these developments in place and publicised by 30 September 2014.

Please find below details of the practices stance with regards to these points.

Summary Care Record (SCR)

NHS England require practices to enable successful automated uploads of any changes to
patient’s summary information, at least on a daily basis, to the summary care record (SCR) or have published plans in place to achieve this by 31st of March 2015.

Having your Summary Care Record (SCR) available will help anyone treating you without your full medical record. They will have access to information about any medication you may be taking and any drugs that you have a recorded allergy or sensitivity to.

Of course, if you do not want your medical records to be available in this way then you will need to let us know so that we can update your record. You can do this via the opt out form. The practice confirms that your SCR is automatically updated on at least a daily basis to ensure that your information is as up to date as it can possibly be.

GP to GP Record Transfers

NHS England requires practices to utilise the GP2GP facility for the transfer of patient records between practices, when a patient registers or de-registers (not for temporary registration). It is very important that you are registered with a doctor at all times. If you leave your GP and register with a new GP, your medical records will be removed from your previous doctor and forwarded on to your new GP via NHS England. It can take your paper records up to two weeks to reach your new surgery.

With GP2GP record transfers your electronic record is transferred to your new practice much sooner.

The practice confirms that GP to GP transfers are already active and we send and receive
patient records via this system.

Patient Online Access to Their GP Record

NHS England require practices to promote and offer the facility to enable patients online access to appointments, prescriptions, allergies and adverse reactions or have published plans in place to achieve this by 31st of March 2015.

We currently offer the facility for booking and cancelling appointments and also for ordering your repeat prescriptions and viewing a summary of your medical records on-line. If you do not already have a user name and password for this system – please register your interest with our reception staff.

The Surgery is an approved training practice for the training of General Practice Registrars
(GPRs). Being an approved training practice means that:

• patients can directly contribute to the training of future GPs
• patients who consult with the GPR will have longer consultations
• it keeps all doctors and nurses in touch with new medical developments and skills
• it improves all doctors and nurse’s consultation and training skills
• it ensures that clinical standards and standards of medical record keeping are maintained
• it helps with recruitment of high quality doctors to the practice for job vacancies

GPRs are qualified doctors in training who have already worked in hospitals as junior doctors for at least 3 years and have now decided that they would like to specialise in General Practice.

In order to qualify as a GP all doctors have to complete Postgraduate Specialist Training which includes at least 18 months training in General Practice.

Very occasionally, as part of an essential component of training in all medical practice, your consultation may be filmed and reviewed later by the trainer and GPR. We hope that all our patients will be willing to take part in these educational consultations to help us all in improving and maintaining our medical and consultation skills. All video recordings are strictly confidential and are used for teaching only. We will not video your consultation without your consent.

Patient’s Rights

We are committed to giving you the best possible service. This will be achieved by working
together. Help us to help you. You have a right to, and the practice will try to ensure that:

• You will be treated with courtesy and respect
• You will be treated as a partner in the care and attention that you receive
• All aspects of your visit will be dealt with in privacy and confidence
• You will be seen by a doctor of your choice subject to availability
• In an emergency, out of normal opening hours, if you telephone the practice you will be given the number to receive assistance, which will require no more than one further call
• You can bring someone with you, however you may be asked to be seen on your own
  during the consultation
• Repeat prescriptions will normally be available for collection within two working days of your request
• Information about our services on offer will be made available to you by way of posters, notice boards and newsletters
• You have the right to see your medical records or have a copy subject to certain laws.

Patient’s Responsibilities

With these rights come responsibilities and for patients we would respectfully request that you:

• Treat practice staff and doctors with the same consideration and courtesy that you would like yourself. Remember that they are trying to help you
• Please ensure that you order your repeat medication in plenty of time allowing 48 working hours.
• Please ensure that you have a basic first aid kit at home and initiate minor illness and
  self-care for you and your family.
• Please attend any specialist appointments that have been arranged for you or cancel
  them if your condition has resolved or you no longer wish to attend
• Please follow up any test or investigations done for you with the person who has
  requested the investigation
• Attend appointments on time and check in with Reception
• Patients who are more than 10 minutes late for their appointment may not be seen.
• If you are unable to make your appointment or no longer need it, please give the practice adequate notice that you wish to cancel. Appointments are heavily in demand and missed appointments waste time and delay more urgent patients receiving the treatment they need
• An appointment is for one person only. Where another family member needs to be seen or discussed, another appointment should be made
• Patients should make every effort to present at the surgery to ensure the best use of
  nursing and medical time. Home visits should be medically justifiable and not requested for social convenience
• Please inform us when you move home, change your name or telephone number, so that we can keep our records correct and up to date
• Read the practice leaflets and other information that we give you. They are there to help you use our services. If you do not understand their content please tell us
• Let us have your views. Your ideas and suggestions whether complimentary or critical are important in helping us to provide a first class, safe, friendly service in pleasant surroundings.

NHS Constitution

The NHS Constitution establishes the principles and values of the NHS in England. For more information see these websites:

• GOV.UK – The NHS Constitution for England
• NHS Constitution

The practice fully supports the NHS Zero Tolerance Policy. The aim of this policy is to tackle the increasing problem of violence against staff working in the NHS and ensures that doctors and their staff have a right to care for others without fear of being attacked or abused.

We understand that ill patients do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint. We ask you to treat your doctors and their staff courteously and act reasonably.

All incidents will be followed up and you will be sent a formal warning after a second incident or removed from the practice list after a third incident if your behaviour has been unreasonable.

However, aggressive behaviour, be it violent or verbal abusive, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police will be contacted if an incident is taking place and the patient is posing a threat to staff or other patients.

Removal from the Practice List

A good patient-doctor relationship, based on mutual respect and trust, is the cornerstone of good patient care. The removal of patients from our list is an exceptional and rare event and is a last resort in an impaired patient-practice relationship. When trust has irretrievably broken down, it is in the patient’s interest, just as much as that of The Surgery, that they should find a new practice. An exception to this is on immediate removal on the grounds of violence e.g. when the Police are involved.

Removing other members of the household

In rare cases, however, because of the possible need to visit patients at home it may be
necessary to terminate responsibility for other members of the family or the entire household. The prospect of visiting patients where a relative who is no longer a patient of the practice by virtue of their unacceptable behaviour resides, or being regularly confronted by the removed patient, may make it too difficult for the practice to continue to look after the whole family. This is particularly likely where the patient has been removed because of violence or threatening behaviour and keeping the other family members could put doctors or their staff at risk.