Policies & Procedures

Aim: To use the latest innovations in smartphone technology to help patients find and use apps to manage conditions and make better lifestyle choices in a way that is convenient for them.

The surgery is an integral part of the health care system and view the use of apps as a complimentary means of promoting patient self-help and support through digital tools. We want to encourage the patient to take an active role in managing their healthcare condition. We do not aim to use apps to replace the role of a qualified medical practitioner, nor to remove monitoring of chronic conditions from within the surgery setting. We do recognise that in the passage of time we may be able to directly use the information and data collected and stored by our patients through apps as part of their ongoing health plan.

Approved Apps

There are European regulations about medical apps and the assurance that an app meets essential criteria, we will endeavour to include only medical apps, including web apps which bear the CE mark. We will include on our website NHS Digital Apps showcased on the NHS Public Health Site as NHS approved or ‘being tested in the NHS.

The surgery (surgeries in cluster for voting purposes) will remain objective, impartial and even-handed in selection of apps listed in the app library. The surgery will make any such selection based on merit alone and will not directly benefit financially from apps for which a fee is charged. Any financial arrangement for use of apps is an agreement made between the patient and supplier and the surgery will not seek to influence any such decision for financial gain.

A medical app is one that diagnoses, supports diagnosis or clinical decisions, makes calculations to determine diagnosis or treatment, or are used for any medical purpose that are classed as ‘medical devices’. A medical app does not need to link to the patient’s records or capture the patient’s name or NHS number; if it uses patient specific information, it is a medical app and it needs a CE mark.

What is NOT a medical app?

Apps that have only administrative functions, eg to book an appointment or request a prescription. Apps that give general guidance or are not marketed as medical apps, such as generic calculators on mobile phone apps that do not provide personalised advice.

Consultation & Planning

The addition of new apps to the website will be by majority decision and will meet the criteria for medical apps as stated above. Review of website apps will take place three monthly, removal of apps will be by majority decision – except in exceptional  circumstances where content, information or advice is known to be incorrect, damaging and controversial or may be used for extortion.

Reporting issues or problems with apps

The Medicines and Healthcare Products Regulatory Agency (MHRA) are the body to report any known problem with apps used for medical purposes (such as calculation errors) and should be reported to MHRA online at www.mhra.gov.uk.

Disclaimer

The surgery or the approving body is not the owner, manager or supplier of the tools/apps listed on the website. The surgery or the approving body has set standards for reviewing the tools/apps as detailed in this policy, but this does not mean that we or the approving body has itself reviewed all aspects of the tool/app, or version of the same tool/app. The named supplier listed is the entity solely responsible for the tool/app. The surgery or the approving body is not responsible or liable for any advice, or any other information, services or products that you obtain through the use of the tool/apps listed our website.

The Digital Apps on this website are intended to provide supportive relevant information only. They do not provide medical advice and is not a substitute for a medical consultation. For less urgent health needs, contact your GP or local pharmacist in the usual way. If you have an urgent medical need you should call 111. If a life is at risk, call 999.

The Surgery prides itself in maintaining professional standards. For certain examinations during consultations an impartial observer (a “Chaperone”) may be requested by the clinician or patient.

This impartial observer will be a suitable qualified trained professional, who is familiar with the procedure and be available to reassure and raise any concerns on your behalf. If a chaperone 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 chose 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.

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.

Under 16s

The duty of confidentiality owed to a person under 16 is as great as the duty owed to any other person. Young people aged under 16 years can choose to see health professionals, without informing their parents or carers. If a GP considers that the young person is competent to make decisions about their health, then the GP can give advice, prescribe and treat the young person without seeking further consent.

However, in terms of good practice, health professionals will encourage young people to discuss issues with a parent or carer. As with older people, sometimes the law requires us to report information to appropriate authorities in order to protect young people or members of the public.

Useful Websites

Confidentiality NHS Code of Practice

Confidentiality and Mental Health

Confidentiality Guidance

It is NHS policy to treat all patients and employees fairly and equally regardless of their gender, sexual orientation, marital status, race, colour, nationality, ethnic or national origin, religion, age or disability.

Equality is based on the legal obligation to comply with anti-discrimination legislation. Equality protects people from being discriminated against on the grounds of group membership i.e. sex, race disability, sexual orientation, belief, or age.

Diversity implies a wide range of conditions and characteristics. Diversity encompasses visible and non-visible individual differences. It can be seen in the makeup of patients and the workforce in terms of gender, ethnic minorities, disabled people, trans identity etc.

The Freedom of Information Act creates a right of access to recorded information.

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.

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

Seeking Advice from NHS 111 – British Sign Language

Using your computer and webcam, or the InterpreterNow app on your smartphone or tablet, you can make a video call to a BSL interpreter. Please visit the InterpreterNow website for further information.

The interpreter telephones an NHS 111 adviser and relays your conversation with them. The NHS 111 adviser will ask you questions to assess your symptoms, then give you the healthcare advice you need or direct you straightaway to the local service that can help you best.

If NHS 111 advisers think you need an ambulance they will immediately arrange one for you.

This service is available every day.

Translation and BSL for Consultations With Your Doctor or Nurse

The practice is able to make arrangements for an interpreter to join your GP consultation over the telephone, please advise reception when booking your appointment if an interpreter is required so that arrangements can be made.

If you require a sign-language interpreter this can be arranged in person provided sufficient notice has been given.

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. Unfortunately, we are unable to notify patients in writing of any change of GP due to the costs involved.

NHS Digital is developing a new system to support the national data opt-out which will give patients more control over how confidential patient information is used. The system will offer patients and the public the opportunity to make an informed choice about whether they wish their confidential patient information to be used just for their individual care and treatment or also used for research and planning purposes.

Patients and the public who decide they do not want their confidential patient information used for planning and research purposes will be able to set their national data opt-out choice online.

Your health records contain a type of data called confidential patient information. This data can be used to help with research and planning. You can choose to stop your confidential patient information being used for research and planning. You can also make a choice for someone else like your children under the age of 13. NHS Digital will never sell your data. There are strict rules about how NHS can use your data. It’s only shared securely and safely. Shared data helps the NHS. It has been used to find the first treatment for coronavirus and for vaccine research.

If you’re happy with your confidential patient information being used for research and planning you do not need to do anything.

Any choice you make will not impact your individual care. Please click on the link to find out more and opt out if you wish to do so.

https://www.nhs.uk/your-nhs-data-matters/

For further opt-out information, please visit the NHS Digital site:

digital.nhs.uk/opt-out-programme

And if you would like to opt-out, you can follow the process using the link below;

www.nhs.uk/manage-your-choice

Our practice policy on this subject is available to review below:

National Data Opt-Out Policy

Local Data Opt-Out Program

If you wish to register a local data opt out with your GP practice before data sharing starts with NHS Digital, this should be done by downloading the Type 1 Opt Out form and retuning it to your GP practice. If you have previously registered a Type 1 Opt-out and you would like to withdraw this, you can also use the form to do this.

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

Data for commissioning and other secondary care purposes

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 require 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 at least two weeks to reach your new surgery.

With GP to GP 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 have achieved 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, who will advise you of the identity requirements we need.

Data for commissioning and other secondary care purposes

It is already a requirement of the Health and Social Care Act that practices must meet the reasonable data requirements of commissioners and other health and social care organisations through appropriate and safe data sharing for secondary uses, as specified in the technical specification for care data.

NHS England have commissioned a modern data service on behalf of the entire health and social care system.  This involves the anonymised extraction of key clinical information to inform national trends and decision making around the commissioning of new services.  By default you are opted in.  If you would like to access further information please go to www.nhs.uk/caredata or telephone 0300 4563531. If you would like to opt out, please advise the reception team when you are next at the practice.

The Practice confirm these arrangements are in place and that we undertake annual training and audits to ensure that all our data is handled correctly and safely via the Information Governance Toolkit.

We welcome all comments on the services provided by the Practice.

We are continually looking to turn our patients’ feedback into real improvements in the services we provide. We use it to focus on the things that matter most to our patients, carers and their families. We would like to hear from you if you have a suggestion on how we can do things better to improve our patients’ experiences. We’d also like to hear from you if you are pleased with the service you’ve received. Please fill in our feedback form. We’ll let the staff involved know and share the good practice across our teams.

 As well as online, you may write to us or contact us by phone. Our details can be found on our Contact Us page.

About your Summary Care Record

Your Summary Care Record contains important information about any medicines you are taking, any allergies you suffer from and any bad reactions to medicines that you have previously experienced.

Allowing authorised healthcare staff to have access to this information will improve decision making by doctors and other healthcare professionals and has prevented mistakes being made when patients are being cared for in an emergency or when their GP practice is closed. Your Summary Care Record also includes your name, address, date of birth and your unique NHS Number to help identify you correctly.

Healthcare staff will have access to this information, so that they can provide safer care, whenever or wherever you need it, anywhere in England.

FAQs

Who can see my Summary Care Record?

Healthcare staff who have access to your Summary Care Record:

need to be directly involved in caring for you

need to have an NHS Smartcard with a chip and passcode

will only see the information they need to do their job and

will have their details recorded every time they look at your record

Healthcare staff will ask for your permission every time they need to look at your Summary Care Record. If they cannot ask you (for example if you are unconscious or otherwise unable to communicate), healthcare staff may look at your record without asking you, because they consider that this is in your best interest.

If they have to do this, this decision will be recorded and checked to ensure that the access was appropriate.

What are my choices?

You can choose to have a Summary Care Record or you can choose to opt out.

If you choose to have a Summary Care Record and are registered with a GP practice, you do not need to do anything as a Summary Care Record is created for you.

If you choose to opt out of having a Summary Care Record and do not want a SCR, you need to let your GP practice know by filling in and returning an opt-out form. Opt-out forms can be downloaded from the website or from your GP practice.

If you are unsure if you have already opted out, you should talk to the staff at your GP practice. You can change your mind at any time by simply informing your GP practice and either filling in an opt-out form or asking your GP practice to create a Summary Care Record for you.

Children and the Summary Care Record

If you are the parent or guardian of a child under 16, you should make this information available to them and support the child to come to a decision as to whether to have a Summary Care Record or not.

If you believe that your child should opt-out of having a Summary Care Record, we strongly recommend that you discuss this with your child’s GP. This will allow your child’s GP to highlight the consequences of opting-out, prior to you finalising your decision.

Where can I get more information?

For more information about Summary Care Records you can

talk to the staff at your GP practice

phone the Health and Social Care Information Centre on 0300 303 5678

Read the Summary Care Record patient information

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. If you wish to obtain a copy through a Subject Access Request, please contact our medical secretaries’ team who will supply you with an application form and details of ID required. Alternatively sign up to online services by visiting any of our reception desks. Certain types of ID will be required.

If you require an interpreter, you must advise reception when you book your appointment of your requirements. Interpreters can usually be arranged for non-emergency appointments.

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 3 working days

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, or if available please use the check in screen.

Patients who are 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 Choices – NHS Constitution

NHS England requires that the net earnings of doctors engaged in the practice is publicised, and the required disclosure is shown below. 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.

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, before tax and National Insurance, for GPs working in Harrold Medical Practice in the last financial year was £67,546, for 2 full time GPs and 2 part time GPs.

This practice operates a zero tolerance policy towards harassment and abuse of staff, visitors or patients, which includes (but is not limited to) homophobia, biphobia, transphobia, racism, sexism, ageism, or harassment or abuse on basis of disability, marriage or civil partnership, pregnancy or maternity, religion or belief.

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 the first incident or removed from the practice list after a second 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, in which case this would result in immediate removal from the practice list.

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.

The above policy also applies to patients and visitors to the practice as well as staff.

This accessibility statement applies to Harrold Medical Practice. This website is run by Harrold Medical Practice. We want as many people as possible to be able to use this website. For example, that means you should be able to:

change colours, contrast levels and fonts

zoom in up to 300% without the text spilling off the screen

navigate most of the website using just a keyboard

navigate most of the website using speech recognition software

listen to most of the website using a screen reader (including the most recent versions of JAWS, NVDA and VoiceOver)

We’ve also made the website text as simple as possible to understand.

AbilityNet has advice on making your device easier to use if you have a disability.

We know some parts of this website are not fully accessible:

the text will not reflow in a single column when you change the size of the browser window

you cannot modify the line height or spacing of text

most older PDF documents are not fully accessible to screen reader software

live video streams do not have captions

some of our online forms are difficult to navigate using just a keyboard

you cannot skip to the main content when using a screen reader

there’s a limit to how far you can magnify the map on our ‘contact us’ page

Feedback and contact information

If you need information on this website in a different format like accessible PDF, large print, easy read, audio recording or braille:

call: 01234 720225

We’ll consider your request and get back to you in 7 days.

If you cannot view the map on our ‘contact us’ page, call or email us for directions.

We’re always looking to improve the accessibility of this website. If you find any problems not listed on this page or think we’re not meeting accessibility requirements, contact:

call: 01234 720225

Reporting accessibility problems with this website

We’re always looking to improve the accessibility of this website. If you find any problems not listed on this page or think we’re not meeting accessibility requirements, contact:

call: 01234 720225

Enforcement procedure

The Equality and Human Rights Commission (EHRC) is responsible for enforcing the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018 (the ‘accessibility regulations’). If you’re not happy with how we respond to your complaint, contact the Equality Advisory and Support Service (EASS).

Contacting us by phone or visiting us in person

We provide a text relay service for people who are D/deaf, hearing impaired or have a speech impediment.

Our offices have audio induction loops, or if you contact us before your visit we can arrange a British Sign Language (BSL) interpreter.

Compliance

This website is partially compliant with the Web Content Accessibility Guidelines version 2.1 AA standard, due to ‘the non-compliances and exemptions’ listed below.

Non-accessible content

The content listed below is non-accessible for the following reasons:

This site may contain older PDFs and Word documents do not meet accessibility standards – for example, they may not be structured so they’re accessible to a screen reader. This does not meet WCAG 2.1 success criterion 4.1.2

Disproportionate burden

Google Maps – There’s a limit to how far you can magnify the embedded Google Map on our ‘contact us’ page. The code for this map is supplied by Google and we are unable to make amendments to it.

Preparation of this accessibility statement

This statement was prepared on 27/05/2022 and was updated on 28/05/2023.

Site compliance was checked using a combination of manual testing and third party tools, including:

WAVE Web Accessibility Evaluation Tool (https://wave.webaim.org/)

WebAIM Contrast Checker (https://webaim.org/resources/contrastchecker/)

HTML_CodeSniffer (https://squizlabs.github.io/HTML_CodeSniffer/)

Pa11y – Automated accessibility testing (https://pa11y.org/)

axe – Web Accessibility Testing (https://www.deque.com/axe/

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.