In accordance with the Data Protection Legislation and Access to Health Records Act, patients may request to see their medical records.

Such requests should be made through the practice manager and may be subject to an administration charge. No information will be released without the patient’s consent unless we are legally obliged to do so.

The Care Quality Commission (CQC) makes sure hospitals, care homes, dental and GP surgeries, and all other care services in England provide people with safe, effective, compassionate and high-quality care, and encourages them to make improvements where possible.

They do this by inspecting services and publishing the results on their website: www.cqc.org.uk

You can use the results to help you make better decisions about the care you, or someone you care for, receives.

Our CQC Inspection

Our practice is inspected by the Care Quality Commission (CQC) to ensure we are meeting essential standards of quality and safety.

This link provides a summary of the results of the latest checks carried out by the CQC.

• The Limes Medical Practice

If you feel you would like a chaperone present at your consultation please inform your doctor/nurse who will be happy to arrange this for you.

The practice prides itself in maintaining professional standards. For certain examinations during consultations an impartial observer (a ‘chaperone’) will be required.

This impartial observer will be a practice nurse or healthcare assistant who is familiar with the procedure and be available to reassure and raise any concerns on your behalf. If a nurse is unavailable at the time of your consultation then your examination may be re-scheduled for another time.

You are free to decline any examination or choose an alternative examiner or chaperone. You may also request a chaperone for any examination or consultation if one is not offered to you. The GP may not undertake an examination if a chaperone is declined.

The role of a Chaperone

A chaperone is there to:

• Maintain professional boundaries during intimate examinations
• Acknowledge a patient’s vulnerability
• Provide emotional comfort and reassurance
• Assist in the examination
• Assist with undressing patients, if required

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

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

If you do not wish anonymous information about you to be used in such a way, please let us know. You can contact us online by contacting the practice.

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

The ICO recognises the unprecedented challenges the NHS and other health professionals are facing during the Coronavirus (COVID-19) pandemic.

The ICO also recognises that ‘Public bodies may require additional collection and sharing of personal data to protect against serious threats to public health.’

The government have also taken action in respect of this and on the 20th March 2020 the Secretary of State for Health and Social Care issued a notice under Regulation 3(4) of The Health Service (Control of Patient Information) Regulations 2002 requiring organisations such as GP practices to use your information to help GP practices and other healthcare organisations to respond to and deal with the COVID-19 pandemic.

In order to look after your healthcare needs during this difficult time, we may urgently need to share your personal information, including medical records, with clinical and non-clinical staff who belong to organisations that are permitted to use your information and need to use it to help deal with the COVID-19 pandemic. This could (amongst other measures) consist of either treating you or a member of your family and enable us and other healthcare organisations to monitor the disease, assess risk and manage the spread of the disease.

Please be assured that we will only share information and health data that is necessary to meet yours and public healthcare needs.

The Secretary of State for Health and Social Care has also stated that these measures are temporary and will expire on the 30th September 2021 unless a further extension is required. Any further extension will be provided in writing and we will communicate the same to you.

Please note that the data protection and electronic communication laws do not stop us from sending public health messages to you, either by phone, text or email as these messages are not direct marketing.

It may also be necessary, where the latest technology allows us to do so, to use your information and health data to facilitate digital consultations and diagnoses and we will always do this with your security in mind.

Your Data Matters to the NHS

Information about your health and care helps us to improve your individual care, speed up diagnosis, plan your local services and research new treatments. The NHS is committed to keeping patient information safe and always being clear about how it is used.

How your data is used

Information about your individual care, such as treatment and diagnoses, is collected about you whenever you use health and care services. It is also used to help us and other organisations for research and planning such as research into new treatments, deciding where to put GP clinics and planning for the number of doctors and nurses in your local hospital. It is only used in this way when there is a clear legal basis to use the information to help improve health and care for you, your family and future generations.

Wherever possible we try to use data that does not identify you, but sometimes it is necessary to use your confidential patient information.

You have a choice

You do not need to do anything if you are happy about how your information is used. If you do not want your confidential patient information to be used for research and planning, you can choose to opt out securely online or through a telephone service. You can change your mind about your choice at any time.

Will choosing this opt-out affect your care and treatment?

No, choosing to opt out will not affect how information is used to support your care and treatment. You will still be invited for screening services, such as screenings for bowel cancer.

What do you need to do?

If you are happy for your confidential patient information to be used for research and planning, you do not need to do anything.

To find out more about the benefits of data sharing, how data is protected, or to make/change your opt-out choice visit www.nhs.uk/your-nhs-data-matters.

How the NHS and care services use your information

The Limes Medical Centre is one of many organisations working in the health and care system to improve care for patients and the public .

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

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

• improving the quality and standards of care provided
• research into the development of new treatments
• preventing illness and diseases
• monitoring safety
• planning services

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

Most of the time, anonymised data is used for research and planning so that you cannot be identified in which case your confidential patient information isn’t needed.

You have a choice about whether you want your confidential patient information to be used in this way. If you are happy with this use of information you do not need to do anything. If you do choose to opt out your confidential patient information will still be used to support your individual care.

To find out more or to register your choice to opt out, please visit www.nhs.uk/your-nhs-data-matters. On this web page you will:

• See what is meant by confidential patient information
• Find examples of when confidential patient information is used for individual care and examples of when it is used for purposes beyond individual care
• Find out more about the benefits of sharing data
• Understand more about who uses the data
• Find out how your data is protected
• Be able to access the system to view, set or change your opt-out setting
• Find the contact telephone number if you want to know any more or to set/change your opt-out by phone
• See the situations where the opt-out will not apply

You can also find out more about how patient information is used at:
www.hra.nhs.uk/information-about-patients (which covers health and care research); and www.understandingpatientdata.org.uk/what-you-need-know (which covers how and why patient information is used, the safeguards and how decisions are made)

You can change your mind about your choice at any time.

Data being used or shared for purposes beyond individual care does not include your data being shared with insurance companies or used for marketing purposes and data would only be used in this way with your specific agreement.

Health and care organisations have until 2020 to put systems and processes in place so they can be compliant with the national data opt-out and apply your choice to any confidential patient information they use or share for purposes beyond your individual care. Our organisation ‘is currently’ compliant with the national data opt-out policy.

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/her. 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 pages:

• Gov.UK – Freedom of Information Act 2000
• Information Commissioners Office – How to access information from a public body

THE LIMES MEDICAL PRACTICE PUBLICATION OF EARNINGS 2023/24

The average pay for GPs working at the surgery in the last financial year before tax and National Insurance was £91,133.

This is for 3 part time GPs who worked in the practice for more than 6 months.

Please note that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice and should not be used to form any judgement about GP earnings, nor to make any comparison with any other practice.

Infection Control Statement

We have allocated a named accountable GP for all of our registered patients. If you do not know who your named GP is, please ask a member of our reception team by contacting us. Unfortunately, we are unable to notify patients in writing of any change of GP due to the costs involved.

• Privacy Notice: CCTV and Telephone Recording
• Practice Privacy Notice

INTRODUCTION

The Limes Medical Centre is committed to providing excellent service and delivering high quality patient services. This policy sets out what a reasonable adjustment is, how to make a reasonable adjustment to us, our duties and responsibilities and what considerations we will take into account when reviewing your request.

We must take reasonable steps in the way that we work to ensure we are compliant with Equality & Diversity legislation and regulations. This policy does not seek to explain how we will approach every situation; it is intended as a general statement of our policy and:

• confirms our commitment to improving accessibility for everybody that we deal with,
• sets out some of the basic principles of our legal duty to provide reasonable adjustments,
• and sets out the factors that we will consider in dealing with requests for reasonable adjustments.

WHAT IS A REASONABLE ADJUSTMENT?

A reasonable adjustment involves making a change to the way that we usually do things to ensure that we are fair to all of our patients. This may involve:

• departing from our usual practice in the way we do things, if we find that the current position places that person at a substantial disadvantage, for instance by allowing more time than we usually would for someone to respond or provide information; or
• providing specialist equipment or additional support, such as a sign language interpreter for a meeting or event; or
• making sure our buildings do not present obstacles for disabled people, for instance by providing a lift or ground level meeting rooms.

We will not make assumptions about whether a disabled person requires any adjustments or about what those adjustments should be. We will discuss the requirements with the person concerned and seek to reach agreement on what may be reasonable in the circumstances.

OUR LEGAL DUTIES IN RELATION TO DISABLED PEOPLE

The Equality Act 2010 requires us to provide reasonable adjustments for disabled people, defined by the Act as those who have a physical or mental impairment which has a substantial and long-term adverse effect on that person’s ability to carry out normal day-to-day activities. This will, in some circumstances, mean that disabled people receive more favourable treatment than non-disabled people, which is lawful in the context of disability.

DUTY TO MAKE REASONABLE ADJUSTMENTS AS A SERVICE PROVIDER

As a service provider, The Limes Medical Centre has a duty to make adjustments as a service provider if the way that we carry out these functions, the absence of an auxiliary aid, or any physical feature places the disabled person at a “substantial disadvantage” compared to someone who is not disabled. The duty requires The Limes Medical Centre to consider what can be done to overcome any such disadvantage, and whether an adjustment can be made which is reasonable in all the circumstances of the case.

REQUESTING REASONABLE ADJUSTMENTS

We will let patients know that we can provide reasonable adjustments, for example in the following ways:

• By asking whether an adjustment might be required over the telephone,
• by including a note on our published documents indicating that we can provide the document in an alternative format on request,
• by publishing this policy on our website,
• and by working with key representative groups and others to raise awareness of this policy, such as our Patient Participation Group (PPG).

As a practice, we implement general adjustments to ensure our services are accessible under the Equality Act 2010. However, specific adjustments are considered on an individual basis and need to be requested by the patient. It is then our legal duty to assess the request and implement it if it is deemed reasonable.

Our usual process for requesting a reasonable adjustment is as follows:

1. The patient submits a request in writing, by email, or verbally. The team will then offer a telephone or face-to-face appointment with a GP.
2. Each request is considered on a case-by-case basis through discussion with the patient, who is the expert in their own needs.
3. The patient is informed of the decision either on the same day or a later date, using their preferred method of communication.
4. If agreed, the adjustment is added as an alert to the patient’s medical record, and consent will be sought to share this with relevant organisations.
5. If the original request is not deemed reasonable, alternative adjustments will be explored.

TYPES OF REASONABLE ADJUSTMENTS WE CAN OFFER

Whilst we will consider each request for reasonable adjustments individually, there are some common adjustments which we will offer as a matter of course and some other adjustments that we can make particular arrangements to provide. The adjustments will always be agreed with the person concerned to avoid making incorrect assumptions about a person’s needs.

Some examples of the simple reasonable adjustments that staff can make may include:

• providing documents or correspondence in a larger font size
• providing documents on coloured paper or with a specific colour contrast which can often help people with conditions such as dyslexia
• Online triage service- patients are able to complete a request for clinical and non-clinical issues online using SystmConnect our triage service
• allowing a person who has a learning disability or mental health problems more time than would usually be allowed to provide further information—except where there is a statutory deadline which we have no power to change
• using email or the telephone in preference to hard copy letters where appropriate, which may assist those with a vision impairment
• speaking clearly to the people who we deal with and offering additional time to cover the issues they need to discuss—this will help everyone understand our processes and procedures
• using plain English appropriate to the person we are dealing with and avoiding jargon
• arranging meetings in rooms which have appropriate facilities.

Some other arrangements that we can provide will include:

• providing a sign language interpreter.
• communicating with people through their representative (whether or not this is a legal representative) or advocate, if requested and approved by them,
• arranging home visits for those who have mobility difficulties. A minority of requests may require more detailed consideration and our approach to these requests is discussed in the section below.

OUR RESPONSE TO REQUESTS FOR REASONABLE ADJUSTMENT

In the majority of cases, we will be able to agree and deliver the required reasonable adjustments with a minimum of delay. In some cases, we may need to consider in more detail how best to overcome the difficulty a disabled person may be experiencing. For example, where the adjustment requested may be difficult to provide or where it may interfere with our statutory or regulatory obligations.

HOW DO WE DECIDE WHAT IS REASONABLE?

The Equality Act does not define what is “reasonable” but guidance from the Equality and Human Rights Commission suggests that the most relevant factors are:

Will the adjustment help in overcoming the difficulty that the disabled person may have? The adjustment should be designed to fully address the disadvantage it is meant to overcome—for example providing a meeting room which is accessible by wheelchair may not properly overcome the barriers faced by the wheelchair user if there are no disabled toilet facilities also available.

How practical is it to provide the adjustment? What are the resource implications of making the adjustment? How much will it cost and is this proportionate to the adjustment being requested. Also any health & safety implications.

Would the adjustment cause disruption to others? For example, it would not usually be reasonable for a fee earner to drop all other cases and devote all their time to one person, as others would inevitably suffer. The amount of extra time provided must therefore be “reasonable” in all the circumstances.

MONITORING

The Limes Medical Centre will record and monitor the reasonable adjustments that have been requested and made. It will be recorded in patient record to trigger alert flags reminding staff of the patient’s reasonable adjustments. All staff are responsible for asking patients if they have any reasonable adjustments and updating the records accordingly. This will allow us to review the services we provide and help us identify whether there are any wider steps that we can take to improve our services.

SHARING YOUR REASONABLE ADJUSTMENTS WITH OTHER HEALTHCARE PROVIDERS

The NHS has introduced the Reasonable Adjustments Digital Flag tool. This enables practices to record patients’ reasonable adjustments using an approved NHS template with an option to share with other healthcare providers upon consent from the patient to do so. Your consent will enable other healthcare providers to offer the agreed reasonable adjustment when you attend other health related appointments, for example at the hospital.

You can read more about our complaints procedure in our leaflet:

• The Limes Medical Centre – Complaints Procedure

If you would like to provide feedback online, you can do so by completing the Feedback and Complaints triage.

We do not respond to complaints posted on the NHS Choices website.

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

Why do I need a Summary Care Record?

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

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

Who can see it?

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

How do I know if I have one?

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

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. You can also opt-out online by contacting the practice.

More Information

For further information visit the “your health records” page on the NHS website.

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.

Help us to help you

We aim to provide the best possible service to our patients and hope you will feel that we achieve that aim.

The care of your health is a partnership between yourself and the primary health care team. The success of that partnership depends on an understanding of each other’s needs and co-operation between us.

Doctor’s Responsibilities

• You will be greeted courteously
• You have a right to confidentiality in line with our Confidentiality policy
• You have the right to see your medical records subject to the limitations of the law
• You will be seen the same day, if your problem is urgent
• You will be seen by your doctor whenever possible
• You will be informed if there will be a delay of more than 20 minutes for your appointment
• You will be referred to a consultant when your GP thinks it necessary
• You will be given the result of any test or investigation on request or at your next appointment. More information can be found on the Test Results page
• Your repeat prescription will be ready for collection two working days after your request. For more information, please view the Prescriptions page
• Your suggestions and comments about the services offered will be considered sympathetically and any complaint dealt with quickly. To make a complaint, or for more information on the process, please visit the Suggestions, Comments and Complaints page

Patient’s Responsibilities

• Please treat all surgery staff with the same respect – we are all just doing our job
• Do not ask for information about anyone other than yourself.
• Tell us of any change of name or address, so that our records are accurate. You can inform us of any changes to your details by completing the Change of Personal Details form
• Only request an urgent appointment if appropriate. Home visits should only be requested if you are too ill to attend the surgery and night visits should be for emergencies only – the doctor on-call will be at work as usual the next day. For more information, please view the Appointments page
• Please cancel your appointment if you are unable to attend. You can do this online.
• Please be punctual but be prepared to wait if your own consultation is delayed by an unexpected emergency
• Please allow sufficient time for your consultant’s letter of the results of any tests to reach us
• You will be advised of the usual length of time to wait
• Use the tear-off slip to request your repeat prescription whenever possible. Please attend for review when asked, before your next prescription is due
• Do let us know whenever you feel we have not met our responsibility to you
• We would, of course, be pleased to hear when you feel praise is due