Access to Medical Records

We keep information about you for your future care and treatment.   We only ever use or pass on information about you if people have a genuine need for it.  Whenever we can, we remove details, which identify you. 

The sharing of some types of very sensitive personal information is strictly controlled by law.   However, sometimes the law requires us to pass on information, for example to notify a birth or an infectious disease.  Anyone who receives information from us is also under a legal duty to keep it confidential. The Practice also operates a “Teenage Friendly” Policy.

You have a right to see your medical records.  To do this you will need to make a written request.  Please ask at reception for the forms you need to complete.

Complaints Procedure

We offer a Practice Complaints Procedure to deal with comments, suggestions and complaints about the service we provide, our aim is to give the highest possible standard of service and we try to deal with any problems quickly and efficiently.

Complaints can be made to the Practice Manager either verbally, in writing or by email and we will aim to investigate and respond to your complaint within an agreed time frame. Further detail about our Complaints procedure can be found in our 'Compliments, Comments and Complaints' leaflet which can accessed from reception.

If you do not wish to complain directly to the practice, you can contact our commissioning body at:

NHS England, PO Box 16738, Redditch, B97 9PT

england.contactus@nhs.net

However, we would ask where possible complaints are directed to the Practice Manager so that they can be dealt with promptly and any necessary actions can be taken to improve our service.

Zero Tolerance of Violent or Aggressive Behaviour

Surgery staff deserve the right to do their jobs without being verbally or physically abused.  Most of out patients respect this right and we thank you for being one of them.  Types of behaviour that will not be tolerated include the following:

• Loud or intrusive conversation or shouting.
• Threatening or abusive language involving excessive swearing or offensive remarks.
• Derogatory remarks of any kind, including comments regarding race, religion, gender, sexuality.
• Malicious allegations relating to members of staff, other patients or visitors.
• Threats or threatening behaviour.
• Physical violence.

The Caxton Surgery has a duty to provide a safe and secure environment.  Violent or abusive behaviour will not be tolerated and decisive action will be taken to protect staff, patients and visitors.

PALS (Patient Advice and Liaison Service)

The NHS employs over a million staff in thousands of locations. It is a large and complex organisation providing a broad range of services. It is not surprising that sometimes you or a loved one may feel bewildered or concerned when using the NHS. And this can be at times when you are feeling at your most vulnerable and anxious.

So, what should you do if you want on the spot help when using the health service? The NHS expects all members of staff to listen and respond to you to the best of their ability. But sometimes, you may wish to talk to someone employed especially to help you. The Patient Advice and Liaison Service, known as PALS, has been introduced to ensure that the NHS listens to patients, their relatives, carers and friends, and answers their questions and resolves their concerns as quickly as possible.

PALS also helps the NHS to improve services by listening to what matters to patients and their loved ones and making changes, when appropriate.

What does PALS do?

In particular, PALS will:

• Provide you with information about the NHS and help you with any other health-related enquiry
• Help resolve concerns or problems when you are using the NHS
• Provide information about the NHS complaints procedure and how to get independent help if you decide you may want to make a complaint
• Provide you with information and help introduce you to agencies and support groups outside the NHS
• Inform you about how you can get more involved in your own healthcare and the NHS locally
• Improve the NHS by listening to your concerns, suggestions and experiences and ensuring that people who design and manage services are aware of the issues you raise
• Provide an early warning system for NHS Trusts and monitoring bodies by identifying problems or gaps in services and reporting them.

How to contact PALS?

The Patient Services Team can be contacted as follows:

Telephone: 0800 030 4563

NHSmail address: stcsu.patientservices@nhs.net

The Caxton Surgery is committed to providing a safe, comfortable environment where patients and staff can be confident that the best practice is being followed at all times and the safety of everyone is of paramount importance.

All patients are entitled to have a chaperone present for any consultation, examination or procedure where they feel one is required.

A chaperone is present as a safeguard for both parties (patient and healthcare professionals) who is a witness to the conduct and the continuing consent of the procedure.

Their role can be to provide emotional comfort and reassurance to a patient, to identify unusual or acceptable behaviour on the part of the healthcare professional or to protect the healthcare professional against unfounded allegations of improper behaviour.

This could be an informal chaperone such as a family member or friend or on occasions you may prefer to a formal chaperone to be present, i.e. a trained member of staff. (Nobody under the age of 18 can act as a chaperone)The practice will provide an appropriately trained chaperone who could be an nurse, health care assistant or receptionist who has completed the formal training.

The patient will always have the opportunity to decline a particular person as chaperone for any reason.  

Wherever possible we would ask you to make this request at the time of booking so that arrangements can be made and your appointment is not delayed in any way. Where this is not possible we will endeavour to provide a formal chaperone at the time of request. However occasionally it may be necessary to reschedule your appointment.  

Your healthcare professional may also require a chaperone to be present for certain consultations in accordance with our chaperone policy

If you would like to see a copy of our chaperone policy or have any questions or comments regarding this please contact the practice manager.

POhWER offers free and confidential information, advice and advocacy, to anyone who needs it, most particularly making sure people who face isolation and/or social exclusion such as elderly people, those in rural communities, those with disabilities and those who experience mental health issues have access to our services.

Their advocates work with people who wish to raise concerns about the care and treatment they have received from the NHS, to support them through the NHS complaints process, with the aim of ensuring their voices are heard and their complaints receive due consideration.

For further information see the leaflets in our waiting room or you can contact POhWER at:

Tel: 0300 456 2370

Email: pohwer@pohwer.net

GMS Contractual Requirement and Statement of Intent Offering and promoting Patient Online services by March 2015

Practice contact details

The Caxton Surgery

Oswald Road

Oswestry

Shropshire

SY11 1RD

01691 654646

caxton.surgery@nhs.net

Current online patient services

GP System Supplier – Emis Web

GMS / PMS 2014-15 Contractual Requirement for Patient online Services

It is a contractual requirement for GP practices to offer and promote to patients: online booking of appointments, ordering of repeat prescriptions and by 31st of March 2015 access to summary information (as a minimum) in their patient record. If you need any guidance, advice or support (including contact details), please visit NHS England’s Patient Online Programme’s web pages for more information http://www.england.nhs.uk/ourwork/pe/patient-online/

[1] Applicable if responding No to question 4L only.

Signed: James Bradbury

Title: Practice Manager

Practice Plan GMS / PMS 2014/2015

Practice contact details                                                     

Surgery Name: The Caxton Surgery

Address: Oswald Road, Oswestry, Shropshire, SY11 1RD                

Telephone: 01691 654646                                                            

Email address: caxton.surgery@nhs.net

Website: http://www.caxtonsurgery.co.uk/

Current online patient services

GP System Supplier -  Emis Web

GP System Version – 4.9.0.0200

Plan to meet GMS / PMS 2014-15 Contractual Requirement for Patient online Service

This practice currently offers patients’ facilities to book, view, amend, cancel and print appointments online.

This practice currently offers the facility for all patients to order online, view and print a list of their repeat prescriptions or medicines and appliances.

This practice plans to offer patients facilities to view on line, export or print any summary information from their record, relating to medications, allergies, adverse reactions and any other items agreed between the practice and individual patient, from 1^st December date, subject to the availability of NHS GP systems and software.

We will publicise and promote our online services to our practice patients through the practice website, practice waiting room leaflets, posters and the Patient Participation Group by 1^st November date.

Introduction

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, immunisation or investigation. This will include the nature, purpose, and risk of the procedure, if necessary by the use of drawings, interpreters, videos or other means to ensure that the patient understands, and has enough information to give ‘informed consent’.

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 what he/she is about to do, and why.

• The explanation will be sufficient for the patient to understand the procedure

• 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 an increased risk to the patient because of the nature of the procedure an ‘Expressed Consent’ will be obtained. (see below)

Expressed Consent

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

Written consent will be obtained for:

• Joint injections

• Incision or excision procedures

Obtaining Consent

• The clinician will ensure that the patient is competent to provide a consent (16 years or over) or has ‘Fraser Competence’ if under 16 years. Consent will include the provision of all information relevant to the treatment. (see appendix 1)

• Questions posed by the patient will be answered honestly, and information necessary for the informed decision will not be withheld unless there is a specific reason to withhold. In all cases where information is withheld then the decision will be recorded in the clinical record.

• The person who obtains the consent will be the person who carries out the procedure (i.e. a nurse carrying out a procedure will not rely on a consent obtained by a nurse unless the nurse was present at the time of the consent)

• The practice acknowledges the right of the patient to refuse consent, delay the consent, seek further information, limit the consent, withdraw consent or ask for a chaperone

• The person obtaining consent will be fully qualified and will be knowledgeable about the procedure and the associated risks

• The practice will review consent in the light of changing patient circumstances and where appropriate re-visit the consent with the patient

• No alterations will be made to a consent form once it has been signed by a patient

• Clinicians will ensure that consents are freely given and not under duress (e.g. under pressure from other present family members etc.)

• If a patient is mentally competent to give consent but physically unable to sign the consent form, the clinician should sign the form as usual, and ask an independent witness to confirm that the patient has given consent orally or non-verbally

Other aspects which may be explained by the clinician include:

• Details of diagnosis, prognosis, and implications if the condition is left untreated

• Options for treatment including the option not to treat

• Details of any subsidiary treatments (e.g. pain relief)

• Patient experiences during and after the treatment, including common or potential side effects and the recovery process

• Probability of success and the possibility of further treatments

• The option of a second opinion

Immunisations

Informed consent must be obtained prior to an immunisation of a registered patient. There is no legal requirement for consent to immunisation to be in writing but patients not registered with the practice who attend for vaccinations privately will be asked to complete a consent form.

People with Parental Responsibility for Consent

There are only certain persons who are legally permitted to give consent for a child. (for e.g. vaccinations) This consent can be written or verbal.

These people are:

• The child’s birth mother

• Both the child’s parents if they were married to each other at the time of conception or birth AND are still married to each other at the time of consultation

• An unmarried genetic father who has acquired parental responsibility via a court order or parental responsibility order

• A genetic father who has married the mother after the birth of the child and is still married to her

• The child’s legal appointed guardian

• A person who has been given a residence order by a court regarding the child

• A local authority designated to have a care order for the child by a court

• A local authority or anyone having an emergency protection order in respect of a child

• Grandparents, foster parents and child minders cannot give consent unless they hold a legally binding court order as above

Appendix 1

Fraser Guidelines

It is considered good practice for doctors and other health professionals to follow the criteria commonly known as the ‘Fraser Guidelines’:

• The young person understands the health professionals advice

• The health professional cannot persuade the young person to inform his or her parent to allow the doctor to inform the parents that he or she is seeking contraceptive advice

• The young person is very likely to begin or continue having intercourse with or without contraceptive treatment

• Unless he or she receives contraceptive advice or treatment, the young person’s physical or mental health or both are likely to suffer;

• The young person’s best interests require the health professional to give contraceptive advice, treatment or both without parental consent

Accessible Information Standard