Practice Policies & Patient Information

Chaperones

The surgery prides itself in maintaining professional standards. For certain examinations during consultations an impartial observer (a “chaperone”) may be required.

This impartial observer will be a trained member of staff and will be available to reassure and raise any concerns on your behalf.

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:

Maintains professional boundaries during intimate examinations.
Acknowledges a patient’s vulnerability.
Provides emotional comfort and reassurance.
Assists in the examination.
Assists with undressing patients, if required.

Confidentiality

The practice complies with the Data Protection Act. All information about patients is confidential: from the most sensitive diagnosis, to the fact of having visited the surgery or being registered at the practice. All patients can expect that their personal information will not be disclosed without their permission except in the most exceptional of circumstances, when somebody is at grave risk of serious harm.

All members of the primary health care team (from reception to doctors) in the course of their duties will have access to your medical records. They all adhere to the highest standards of maintaining confidentiality.

As our reception area is a little public, if you wish to discuss something of a confidential nature please mention it to one of the receptionists who will make arrangements for you to have the necessary privacy.

What happens to my information?

We have a computer system called SystmOne which holds the medical records of all our patients. This is totally confidential and the only people who access the notes are those health professionals and administration staff who need to do so to assist with your care. If we need to refer you to the hospital for treatment then the information that is relevant to your care will be shared with those professionals who are being asked to help you.

What does it mean for you?

Any young person has the right to seek advice from a health professional; doctor or nurse on their own or with a friend without their parent or another adult knowing about it.

We do not have the right to tell anybody about what you have discussed with us, without your permission. However some decisions may be difficult and mean that the support of a trusted adult is important. For this reason we do try to encourage you to discuss things with a trusted adult or parent where possible.
When you are seen by a doctor or nurse, the decision to offer you treatment/medication without an adult being present depends on how happy we are that you fully understand a) what the treatment means and the advice given, b) the options that you have been given regarding different types of treatment c) whether or not you understand possible risks or side effects of the treatment and finally that you know to come back to us if you have any problems.
Being able to agree to treatment on your own is not dependent on your age it is dependent on your understanding of what is being offered.

Under 16s

Young people in the care system often have worries about what information is being given to different people about them. Your information would only be shared with those who really need to know and with your knowledge and permission so that you have control over your own information.

Limitations to confidentiality – this part is very important. We have what is called a ‘duty of care’ to you which means that we must be sure that you are safe and that decisions you are making or advice and treatment that we are giving is in the best interests of your health and wellbeing and that of other people.
If the doctor or nurse that you are seeing has a concern that you may be in danger or putting others in danger we have a duty to disclose that information without your consent to an appropriate person who will look into the situation.
People under the age of 13 years old are not legally capable of agreeing to have sex or be involved in sexual activity. This means that the nurse or doctor may feel that to protect you this information needs to be shared with an appropriate person. This would normally be done with your knowledge and the doctor or nurse would help support you through this time and fully explain the reasons why this is needed so that you understand.

Useful Websites

Disability Access

Freedom of Information

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:

GDPR/Privacy Notices

GP Earnings

All GP practices are required to declare the mean earnings (e.g. average pay) for GPs working to deliver NHS services to patients at each practice.

The average pay for GPs working in The Market Surgery in the last financial year was £54,985 before tax and National Insurance. This is for 1 full time GP, 7 part time GPs and 3 locum GPs who worked in the practice for more than six months.

However, it should be noted 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 aim to keep our surgery clean and tidy and offer a safe environment to our patients and staff. We are proud of our modern, purpose built practice 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 regular 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.

Named GP

As part of the commitment to more personalised care for patients, NHS Employers and the General Practitioners Committee of the British Medical Association have agreed that all patients will have a named accountable GP.

The named GP will:

Take lead responsibility for ensuring that all appropriate services required under the contract with the practice are delivered to you
Where required, based on the professional judgement of the ‘named’ GP, work with relevant associated health and social care professionals to deliver a multidisciplinary care package that meets your needs.
Ensure that your physical and psychological needs are recognised and responded to by the relevant clinicians in the practice
Ensure that patients over 75 years of age have access to a health check if requested, which is already a requirement of the GP contract regulations.

The practice will ensure that there is a named accountable GP assigned to each patient.

New patients will be allocated a GP at the time of registration.

Your named accountable GP will be the same as your usual GP however this does not affect your ability to see any GP of your choice as you currently do.

Non-NHS Work

Most of the doctor and nurses services are provided without cost under the NHS. However, there are some items, for which we charge, as they are not provided under the NHS.

Private Medical – HGV, PSV, Taxi – £110
Private Medical – Insurance Claim/Report – £110
Private Medical – DVLA – £102
Report from Medical Records – £90
Insurance Report – e.g. Accident (Services aimed at restoring individuals health) – £60
Insurance Report – e.g. Life Insurance – £90
Holiday Cancellation – £45
To Whom It May Concern Letter – £20/£35
Power of Attorney – See patient and complete form – £120
Power of Attorney – Complete form – £75
Flight Letter – Medication (Stamp on script free) – £10
Private GP Appointment – £50
Private Nurse Appointment – £30
Fire Arms Report (Patient to pay) – £48

Practice Charter

You will be treated with courtesy and respect by all practice personnel.
An urgent appointment with a doctor or nurse practitioner will be available on the same day.
A non-urgent appointment with a doctor will be offered within 24 hours.
Our standard is to see 80% of patients within 20 minutes of their appointment time. If you have waited longer than this please ask the receptionist for an explanation.
We aim to answer the telephone within six rings.
An appointment with a practice nurse will be available within three working days.
Requests for repeat prescriptions will be dealt with within 48 hours. All comments and suggestions about the service are welcome. Please use the online feedback form.
If you have a complaint please contact us using the above form. Your complaint will be dealt with in a professional and efficient manner.
We wish to make The Market Surgery, Aylsham as accessible as possible. If you have hearing, visual or physical difficulties please let the receptionist know so that we can enable you to fully use our services.

Rights and Responsibilities

How Market Surgery implements the NHS constitution

Principles

The practice:

Provides a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and maternity or marital or civil partnership status, and has a duty to respect their human rights.
Promotes equality through the services it provides, paying particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population.
Provides access to services based on clinical need, not on an individual’s ability to pay.
Aspires to the highest standards of excellence and professionalism, providing safe, secure and effective high-quality care focused on patient experience.
Ensures that it is effectively led and managed, and that staff receive necessary education, training and development.
Ensures that in line with the Armed Forces Covenant, those in the armed forces, reservists, their families and veterans are not disadvantaged in accessing health services in the area they reside.
Ensures its services reflect the needs and preferences of patients, their families and carers, who will be involved in and consulted on all decisions about their care and treatment.
Ensures that it works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population.
Is accountable to the public, communities and patients that it serves.
Implements a system of responsibility and accountability for taking decisions that is transparent and clear to the public, patients and staff.

Patient Rights

Patients have the right:

To receive NHS services free of charge, apart from certain limited exceptions sanctioned by parliament.
To access NHS services and not be refused access on unreasonable grounds.
To receive care and treatment that is appropriate to them, meets their needs and reflects their preferences.
To expect the practice to assess the health requirements of the local community and to commission and put in place the services to meet those needs as considered necessary.
In certain circumstances to go to other European Economic Area countries or Switzerland for treatment which would be available through the NHS.
Not to be unlawfully discriminated against in the provision of NHS services, including on grounds of gender, race, disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and maternity or marital or civil partnership status.
To access services within maximum waiting times, or to be offered a range of alternative providers if this is not possible.
To be treated with a professional standard of care, by appropriately qualified and experienced staff, in a properly approved or registered organisation that meets required levels of safety and quality.
To be cared for in a clean, safe, secure and suitable environment.
To be treated with dignity and respect, in accordance with their human rights.
To be protected from abuse and neglect, and care and treatment that is degrading.
To accept or refuse treatment that is offered, and not to be given any physical examination or treatment unless valid consent has been given.
To be given information about their proposed treatment in advance, including any significant risks and any alternative treatments which may be available, and the risks involved in doing nothing.
To access their own health records and to have any factual inaccuracies corrected.
To privacy and confidentiality and to expect the practice to keep their confidential information safe and secure.
To be informed about how their information is used.
To request that their confidential information is not used beyond their own care and treatment, and to have their objections considered, and where their wishes cannot be followed, to be told the reasons including the legal basis.
To choose their GP practice, and to be accepted by that practice unless there are reasonable grounds to refuse, in which case they will be informed of those reasons.
To express a preference for using a particular doctor within their GP practice, and for the practice to try to comply.
To transparent, accessible and comparable data on the quality of local healthcare providers, and on outcomes, as compared to others nationally.
To make choices about their NHS care and to information to support these choices.
To be involved in discussions and decisions about their healthcare, and to be given information to enable them to do this.
To an open and transparent relationship with the organisation providing their care.
To be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services.
To have any complaint they make about NHS services dealt with efficiently, to have it properly investigated, know the outcome and escalate the complaint to the independent Parliamentary and Health Service Ombudsman or Local Government Ombudsman.
To discuss the manner in which any complaint is to be handled.
To be kept informed of progress and to know the outcome of any investigation into a complaint.
To make a claim for judicial review if they think they have been directly affected by an unlawful act or decision of an NHS body.
To compensation where they have been harmed by negligent treatment.

Patient Responsibilities

To make a significant contribution to their own, and their family’s, good health and well-being, and take some personal responsibility for it.
To treat NHS staff and other patients with respect and recognise that causing a nuisance or disturbance on NHS premises could result in prosecution.
To provide accurate information about their health, condition and status.
To keep appointments, or cancel within reasonable time.
To follow the course of treatment which they have agreed, and talk to their clinician if they find this difficult.
To participate in important public health programmes such as vaccination.
To ensure that those closest to them are aware of their wishes about organ donation.
Patients are encouraged to give feedback – both positive and negative – about the treatment and care they have received, including any adverse reactions they may have had.

Practice Staff Rights

Practice staff have the right:

To a good working environment with flexible working opportunities, consistent with the needs of patients and with the way that people live their lives.
To have a fair pay and contract framework.
To be involved and represented in the workplace.
To have healthy and safe working conditions and an environment free from harassment, bullying or violence.
To be treated fairly, equally and free from discrimination.
To in certain circumstances take a complaint about their employer to an Employment Tribunal.
To raise any concern with their employer, whether it is about safety, malpractice or other risk, in the public interest.

NHS Pledge to Staff Members

The NHS Commits:

To provide a positive working environment for staff and to promote supportive, open cultures that help staff do their job to the best of their ability.
To provide all staff with clear roles and responsibilities and rewarding jobs for teams and individuals that make a difference to patients, their families and carers and communities.
To provide all staff with personal development, access to appropriate training for their jobs and line management support to fulfil their potential.
To provide support and opportunities for staff to maintain their health, well-being and safety.
To engage staff in decisions that affect them and the services they provide, individually, through representative organisations and through local partnership working arrangements. All staff will be empowered to put forward ways to deliver better and safer services for patients and their families.
To have a process for staff to raise an internal grievance.
To encourage and support all staff in raising concerns at the earliest reasonable opportunity about safety, malpractice or wrongdoing at work, responding to and, where necessary, investigating the concerns raised and acting consistently with the Employment Rights Act 1996.

Practice Staff Responsibilities

Practice staff have the duty:

To accept professional accountability and maintain the standards of professional practice as set by the appropriate regulatory body applicable to their profession or role.
To take reasonable care of health and safety at work for themselves, their team and others, and to co-operate with employers to ensure compliance with health and safety requirements.
To act in accordance with the express and implied terms of their contract of employment.
Not to discriminate against patients or staff and to adhere to equal opportunities and equality and human rights legislation.
To protect the confidentiality of personal information that they hold unless to do so would put anyone at risk of significant harm.
To be honest and truthful in applying for a job and in carrying out that job.

Suggestions, Comments and Complaints

For any suggestions, comments or complaints please use our feedback process.

Complaints

If you have a complaint or concern about the service you have received from the doctors or any of the personnel working in this practice, please let us know. We operate a practice complaint procedure as part of an NHS complaints system, which meets national criteria.

We hope that we can sort most problems out easily and quickly, often at the time they arise and with the person concerned. If you wish to make a formal complaint, please do so as soon as possible – ideally within a matter of a few days. This will enable us to establish what happened more easily. If doing that is not possible your complaint should be submitted within 12 months of the incident that caused the problem; or within 12 months of discovering that you have a problem. You can address your complaint in writing to the Practice Manager. You should be as specific and concise as possible.

We will acknowledge your complaint within 3 working days and aim to have fully investigated within 10 working days of the date it was received. If we expect it to take longer we will explain the reason for the delay and tell you when we expect to finish. When we look into your complaint, we will investigate the circumstances; make it possible for you to discuss the problem with those concerned; make sure you receive an apology if this is appropriate, and take steps to make sure any problem does not arise again.

You will receive a final letter setting out the result of any practice investigation.

Taking it Further

If you remain dissatisfied with the outcome you may refer the matter to the Norfolk and Waveney ICB.

E-mail: nwicb.complaintsservice@nhs.net

In writing: Complaints Manager, NHS Norfolk and Waveney Integrated Care Board, County Hall, Martineau Lane, Norwich, NR1 2DL

Telephone: 01603 595857 (This is an answer machine service – please leave a message requesting a call back).

If you remain dissatisfied after contacting NHS Norfolk you can address your concerns to:

The Parliamentary and Health Service Ombudsman
Millbank Tower
Millbank
London
SW1P 4QP

Telephone: 0345 0154033

Website: www.ombudsman.org.uk

Summary Care Records

The summary care record will initially consist of basic information from the patient record such as your date of birth and address, details of allergies, current prescriptions and bad reactions to medicines. Then, each time a patient uses an NHS service, more information may be added to it.

In Norfolk the majority of patients already have a Summary Care Records created, and these can be accessed – with patient consent – by the NNUH / A&E dept, the Out of Hours Services, 111 and the Ambulance Service.

Adding more information to your Summary Care Record

For more information you can visit the Summary Care Record NHS page.

To enhance your summary care record just ask our reception team or fill in one of our online forms

Additional information can be added to your SCR by your GP practice and is a summary of information about your medical history. It can include the following:

Your long term health conditions such as asthma, diabetes, heart problems or rare medical conditions.
Your relevant medical history – clinical procedures that you have had, why you need a particular medicine, the care you are currently receiving and clinical advice to support your future care.
Your healthcare needs and personal preferences – you may have particular communication needs, a long term condition that needs to be managed in a particular way, or you may have made legal decisions or have preferences about your care that you would like to be known.
Immunisations – details of previous vaccinations, such as tetanus and routine childhood jabs.

Please note: specific sensitive information such as any fertility treatments, sexually transmitted infections, pregnancy terminations or gender reassignment will not be included, unless you specifically ask for any of these items to be included.

How will additional information help me?

Essential details about your healthcare can be very difficult to remember, particularly when you are unwell. Having additional information in your SCR means that when you need healthcare, you will be helped to recall this vital information.

There are already clear benefits for your care from having medication, allergy and adverse reaction information available through your SCR. If you choose to add additional information, this can further increase the quality of your care. Additional information can also empower you if you need some help to communicate your complex care needs.

For more information about the “Enhanced Summary Care Record” please see the hscic information leaflet.

Other forms and Information

If you wish to opt out of the Summary Care Record scheme please complete our online opt-out form.

If you wish to sign up to the Enhanced Summary Care Record please use our online Enhanced Summary Care Record opt-in form.

Training Practice

Telephone Calls

We record all telephone calls that are made to and from the surgery for internal training and quality monitoring purposes. These will be treated confidentially and are not released outside the surgery.

Video Recording

As part of our work as a practice, we are proud to be involved in the training of the doctors of the future. This may be GP registrars (fully qualified medical doctors who are undertaking a period of extra training in order to qualify as a GP) or medical students, from the University of East Anglia Medical School in Norwich or Cambridge University.

On occasion you may be asked if you will allow your consultation with a GP or one of our GP registrars to be ‘video-recorded’ for teaching purposes. Such a recording would normally be seen only by the registrar and one or more of the GP partners. Rarely we may also seek your permission for the registrar to submit the recording for external assessment for their competence.

Video recording will only ever be done with your explicit consent, and you may request that the recording be deleted afterwards if you do not wish it to be viewed in the way described. You do have the right to refuse. No examinations are filmed.

GP Registrar

We are fortunate in being a training practice which means we may also have GP registrar doctors with us who are planning to go into general practice. These appointments are usually for six months but can sometimes be up to a year. We benefit greatly from these doctors’ recent hospital experience, so please accept them as a part of our team.

Medical Students

When visiting the practice, you may also meet fourth or fifth year medical students from the UEA or fifth or sixth year students from Cambridge University. They also accompany the doctor on their house calls. These students are going through a very important part of their medical training and your co-operation is extremely valuable and much appreciated. However, no intrusion on the privacy of the consultation will take place against the wishes of the patient. Remember all the partners at the practice were medical students themselves once and were very grateful themselves to see patients at that stage of their career.

Zero Tolerance

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.

About Our Surgery