Patient Information

Introduction
At Birchwood Medical Practice we make every effort to give the best service possible to everyone who attends our practice.  However, we are aware that things can go wrong resulting in a patient feeling they have a genuine cause for complaint.  If this is so we would wish for the matter to be settled as quickly, and as amicably, as possible.

We are continually striving to improve our service. We appreciate that people often do not like to complain, but assure you we do want to know if you are not satisfied. If you have a comment, complaint or suggestion, please tell any member of staff who will assist you. We have a campaign that we believe in called “You Said, We Listened, We Took Action” which is committed to ongoing service improvement.

Receiving of complaints
Who can complain? The Practice may receive a complaint made by, or (with his/her consent) on behalf of a patient, or former patient, who is receiving or has received treatment at the Practice, or:

(a) Where the patient is a child:

• by either parent, or in the absence of both parents, the guardian or other adult who has care of the child;
• by a person duly authorised by a local authority to whose care the child has been committed under the provisions of the Children Act 1989;

(b) Where the patient is incapable of making a complaint; by a relative or other adult who has an interest in his/her welfare.

Your complaint does not have to be in writing. Access to being able to make a complaint is important and ensures that we are receiving feedback as easily as possible.

Please ask our staff member to take the details of your complaint if you are making it verbally.

What is the time limit for making a complaint?
The period for making a complaint is normally:

(a) 12 months from the date on which the event which is the subject of the complaint occurred; or

(b) 12 months from the date on which the event which is the subject of the complaint comes to the complainant’s notice.

To whom should I complain initially?
If you are unhappy with our services please tell a member of our staff.  Often the problem can be sorted out straight away.  We aim to resolve informal complaints within 48 hours.

If you prefer not to talk to the member of staff involved in your care, you can contact the Practice Manager.

Alternatively, you can telephone or write to the Customer Contact Centre of NHS England.  The address and telephone number can be found below.  Please note the Customer Contact Team will only deal with a complaint if it has not been reviewed by the practice

• Tel: 0300 311 22 33
• Email: nhscommissioningboard@hscic.gov.uk
• Post: NHS Commissioning Board, PO Box 16728, Redditch, B97 9PT

NHS Procedure
We will acknowledge your formal verbal or written complaint within three working days and offer you the opportunity to meet face to face to discuss your concern.

We will also ask you what you would like to happen as a result of your complaint, for example, an apology, a new appointment or an explanation. We try whenever possible to speak to you directly about your concerns and may arrange to meet with you to hear first hand your experience.

We will then agree a plan of action and decide upon the timescales in which we will respond to your complaint.

Your complaint will be fully investigated.  This involves finding out what has happened by talking to staff involved and taking any necessary action.

If it is not possible to deal with your complaint within the period agreed, we will write to you explaining the reason for the delay.  The sooner you make a complaint the easier it is to investigate and the more likely it is the complaint can be resolved.

If you are not satisfied with our response
If you remain unhappy following our response, you can complain to the Health Service Ombudsman. The Ombudsman is completely independent of the NHS and Government. You can:

• Visit their ‘Making a complaint page’ to complain online or download a paper form
• Call their Customer Helpline on 0345 015 4033 from 8.30am to 5.30pm, Monday to Friday
• Send a text to their ‘call back’ service 07624 813005
• Dial their textphone (minicom) 0300 061 4298

Keeping your complaint confidential
Any personal data and information collected in relation to your concern or complaint is treated as strictly confidential and only made available to people who are involved in the investigation.

Information about the nature of the complaint is used to monitor the quality of care and may be followed up with the professionals concerned where problems are identified.

The fact that you have complained will not be recorded on your medical records.

ADVOCACY

Some patient’s may find it difficult to make a complaint directly to the Practice or to the NHS.  They can seek advice or get support from the following:

1. Healthwatch is the local champion for patients and the public. They are there to listen to your feedback, and to make sure that local services know what people expect from them. They also want to hear about times when you have experienced excellent care.

Healthwatch Bristol—0117 2690400
www.healthwatchbristol.co.uk
Or you can text them (use ‘Bris’ followed by your message) to: 07860021603

2. SEAP (Support Empower Advocate Promote)

Free confidential help and support to make a complaint-
Contact SEAP on: 0300 3435704
Text: 80800 keyword SEAP
Email: Bristol@seap.org.uk
Website:|www.seap.org.uk

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

The average pay for GPs working in Birchwood Medical Practice in the last financial year was £53,485 before tax and national insurance. This is for 0 full time GP, 7 part time GPs and 0 locum GPs who worked in the practice for more than six months.

There may be occasions where you would like our staff to speak to a member of your family or an advocate regarding your health care.

Your medical records are confidential so for us to do this we would require your signed consent.

Please click here for a consent form that you can download, print, sign and return to the practice should you need to do this.

Birchwood Medical Practice

‘How we use your information’

• We collect and hold data about you for the purpose of providing safe and effective healthcare.
• Your information may be shared with our partner organisations to audit services and provide you with better care.
• Information sharing is subject to strict rules on how it can it is used.
• We will only share you information outside our partner organisations with your consent*
• If you are happy with how we use your information you do not need to do anything.
• If you do not want your information to be used for any purpose beyond providing your care please let us know so we can code your record appropriately.
• You can object to sharing information with other healthcare providers but if this limits your treatment options we will tell you.
• Our guiding principle is that we are holding your information in the strictest confidence.
• For more information about our partner organisation and how your data is being used please see the privacy notice on our website or ask at reception.

*Unless the health & safety of others is at risk, the law requires it OR it is required to carry out a statutory function.

CLICK HERE FOR OUR FULL PRIVACY NOTICE

The practice regularly takes part in medical research.
Your medical records may be used, but all personal details are removed.

SUBJECT ACCESS REQUESTS (SAR)

ALSO KNOWS AS REQUESTS FOR
COPIES OF MEDICAL RECORDS

What is the right of access?

The right of access, commonly referred to as subject access, gives individuals the right to obtain a copy of their personal data as well as other supplementary information. It helps individuals to understand how and why we are using their data, and check we are doing it lawfully. Our privacy notice provides further information about this.

What is an individual entitled to?

Individuals have the right to obtain the following from us:

• Confirmation we are processing their personal data;
• A copy of their personal data; and
• Other supplementary information – this largely corresponds to the information that you should provide in a privacy notice detailed above.

Personal data of the individual

An individual is only entitled to their own personal data, and not to information relating to other people (unless the information is also about them or they are acting on behalf of someone).

How do I make a request for my records (SAR)?

Simply come to the practice and ask for a Subject Access Request (SAR) form. Or phone us and we can arrange for one to be sent to you.

For us to progress your request we will need to have evidence that you are who you say you are! Your medical information is exceptionally personal and sensitive and we have a duty of care to protect it for you.

Please bring in 2 x forms of ID – one must be photographic e.g. passport / driving licence /work ID card.

If we know you we will vouch for you without ID.

Then once you have been identified formally, completed the form and advised us what information you need, we do the following:

• Make copies of the part(s) of your record you have requested.
• Pass the records to the GP to check what is being provided for any redactions – to ensure that information being shared would not cause harm or distress to you.
• The GP returns the paperwork to the admin team to action any redactions. They will also remove any reference to 3rd parties not involved in your care.
• The copy of your record is then ready for you and we will contact you to let you know.
• We will do this within one calendar month of having received the completed SAR and having identified you – unless there is an issue which we will notify you about in advance.
• Once you have taken receipt of your copy record, the practice accepts no responsibility or liability for it or how a patient chooses to use the information contained within it. The patient is responsible for secure storage or onward carriage of the information provided in an intact form where that is necessary.

Can someone else make the request on my behalf?

You may ask someone to make the request on your behalf e.g. friend, solicitor, relative.

In these instances we still have a duty of care to ensure that we identify you as the subject and confirm your consent –  we need to ensure that we provide you with what you actually want.

The Information Commissioner’s Office (ICO) states:

“If you think an individual may not understand what information would be disclosed to a third party who has made a subject access request on their behalf, you may send the response directly to the individual rather than to the third party. The individual may then choose to share the information with the third party after having had a chance to review it.”

Due to the complex, sensitive nature of medical records, we will ask you to complete a SAR Form in line with the procedure above. We will notify you when your record is ready so that you can choose what you wish to share with the 3rd party.

Birchwood Medical Practice accepts no liability for the record(s) once the patient has confirmed receipt and whether they remain intact for onward carriage to the 3rd party who may need to process information held within them.

What happens if I need another copy of my records?

The first copy of your records is provided for free. Any further requests for the same information whether for yourself or a third party would be deemed manifestly excessive and would incur a fee.

The fee is dependent on the amount of work required and relates to the size of the record and also any complexity involved in its review for redaction prior to final copy readiness.

Recent examples have been in the range of £20 to £183 of work undertaken for copy records.

So, please don’t lose your free copy!

Why do GPs charge fees? Your questions answered

The National Health Service provides most health care to most people free of charge, but there are exceptions.

Prescription charges have existed since 1951, and there are a number of other services for which fees are charged. Sometimes the charge is made to cover some of the cost of treatment, for example dental fees. In other cases. In other cases it is because the service isn’t covered by the NHS, for example, medical reports for insurance companies, claims on private health insurance and other letters and forms which require the doctor to review the patient’s medical records.

It is important to understand that GPs are not employed by the NHS, they are self employed, and they have to cover their costs- staff, buildings, heating, lighting etc- in the same way as any small business

The NHS pays the doctor for specific NHS work, but for non-NHS work the fee has to cover the doctor’s costs

What is covered by the NHS and what is not?

The government’s contract with GPs covers medical services to NHS patients. In recent years, more and more organisations have been involving doctors in a whole range of non medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to be sure that information provided is true and accurate

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

• Certain travel vaccinations
• Private medical insurance reports
• Holiday cancellation forms
• Referral for private care forms / letters
• Letters requested by or on behalf of, the patient
• In certain instances fitness to work forms

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

• Medical reports for an insurance company
• Some reports for the DSS/Benefits agency
• Examinations of local authority employees

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

Time spent completing forms and preparing reports takes the GP away from the medical care of his/her patients. Most GPs have a very heavy workload- the majority of our GPs work up to 60 hours a week and paperwork takes up an increasing amount of their time. In addition non-NHS work must be undertaken outside of NHS contracted time.

We aim to complete private requests within 14 calendar days, but this is dependent on NHS requirements which take priority.

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

When a doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. Therefore in order to complete even the simplest of forms, the doctor needs to check the patient’s entire record. Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical Council or even the Police.

Why do some letters cost £15 and others £50 or more?

Each request is very different and some requests can be completed very quickly as the medical history of the patient is very small and known to the GP. However, where a GP has to review a large medical history to ensure accuracy of any comment they make in a letter; or the content of the letter is extensive we must consider how much time it has taken to complete this work. Your cost includes the time the GP takes to review the request, review your medical record, to dictate a letter and the time for the admin team to type up the letter where necessary.

Why am I being charged for a private referral letter when I am saving the NHS money in going private?
Where a private referral request is treated in the same timescales as an NHS referral we do not charge a fee i.e. 7-10 working days. Where a patient requires the letter quicker than this timescale we apply a charge for providing the letter more quickly than would be available if it was an NHS referral.  This is because the request is requiring additional medical secretary time to provide it without detriment to the existing NHS referral workload.

I have had a request for a letter declined – why is that?

All private requests are at the absolute discretion of the GP and they reserve the right to decline a request.

There are also several letter types we do not provide as they are not effective use of GP time and/or they are not necessary:

These include but are not limited to:

• Letters to schools and colleges regarding absence
• Letters regarding sickness absence during the period of self certification
• Letters to schools/nurseries regarding non prescribed medications.
• Please note that where a medication has been prescribed, a copy of the prescription and the medication with the administering instructions is sufficient for a school/nursery and they should not require an additional letter.

We do hope you understand that with so much pressure on NHS financial resources that we cannot provide private work without charge.

Why do GPs charge fees? Your questions answered

The National Health Service provides most health care to most people free of charge, but there are exceptions.

Prescription charges have existed since 1951, and there are a number of other services for which fees are charged. Sometimes the charge is made to cover some of the cost of treatment, for example dental fees. In other cases. In other cases it is because the service isn’t covered by the NHS, for example, medical reports for insurance companies, claims on private health insurance and other letters and forms which require the doctor to review the patient’s medical records.

It is important to understand that GPs are not employed by the NHS, they are self employed, and they have to cover their costs- staff, buildings, heating, lighting etc- in the same way as any small business.

The NHS pays the doctor for specific NHS work, but for non-NHS work the fee has to cover the doctor’s costs.

What is covered by the NHS and what is not?

What is covered by the NHS and what is not?
The government’s contract with GPs covers medical services to NHS patients. In recent years, more and more organisations have been involving doctors in a whole range of non medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to be sure that information provided is true and accurate.

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

• Certain travel vaccinations
• Private medical insurance reports
• Holiday cancellation forms
• Referral for private care forms / letters
• Letters requested by or on behalf of, the patient
• In certain instances fitness to work forms

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

• Medical reports for an insurance company
• Some reports for the DSS/Benefits agency
• Examinations of local authority employees

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

Time spent completing forms and preparing reports takes the GP away from the medical care of his/her patients. Most GPs have a very heavy workload- the majority of our GPs work up to 60 hours a week and paperwork takes up an increasing amount of their time. In addition non-NHS work must be undertaken outside of NHS contracted time.

We aim to complete private requests within 14 calendar days, but this is dependent on NHS requirements which take priority.

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

When a doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. Therefore in order to complete even the simplest of forms, the doctor needs to check the patient’s entire record. Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical Council or even the Police.

Why do some letters cost £15 and others £50 or more?

Each request is very different and some requests can be completed very quickly as the medical history of the patient is very small and known to the GP. However, where a GP has to review a large medical history to ensure accuracy of any comment they make in a letter; or the content of the letter is extensive we must consider how much time it has taken to complete this work. Your cost includes the time the GP takes to review the request, review your medical record, to dictate a letter and the time for the admin team to type up the letter where necessary.

Why am I being charged for a private referral letter when I am saving the NHS money in going private?

Where a private referral request is treated in the same timescales as an NHS referral we do not charge a fee i.e. 7-10 working days. Where a patient requires the letter quicker than this timescale we apply a charge for providing the letter more quickly than would be available if it was an NHS referral.  This is because the request is requiring additional medical secretary time to provide it without detriment to the existing NHS referral workload.

I have had a request for a letter declined – why is that?

All private requests are at the absolute discretion of the GP and they reserve the right to decline a request.

There are also several letter types we do not provide as they are not effective use of GP time and/or they are not necessary.

These include but are not limited to:

• Letters to schools and colleges regarding absence
• Letters regarding sickness absence during the period of self certification
• Letters to schools/nurseries regarding non prescribed medications.
• Please note that where a medication has been prescribed, a copy of the prescription and the medication with the administering instructions is sufficient for a school/nursery and they should not require an additional letter.

We do hope you understand that with so much pressure on NHS financial resources that we cannot provide private work without charge.

Your Confidential Records

You can be assured that your medical records are safe with Birchwood Medical Practice. We will only share data that identifies you under the following circumstances:

• With other health care professionals (hospital or community staff) as part of an agreed plan of treatment
• With your explicit consent, e.g. for participation in research studies
• In circumstances where it is in the interests of your health and you are not able to give consent, e.g. if you are unconscious
• Where we are obliged to divulge information under the Health & Social Care Act 2012, e.g. in the case of a national emergency or pandemic
• Where we are required to do so for health service planning purposes and you have not explicitly opted out of having your data shared (see care.data below)

Our strict rules about confidentiality mean that we will not discuss your medical affairs even with your close family unless you give us permission to do so. This includes details of appointments you have made. If you would like your partner, parent, son/daughter or carer to be able to speak to us on your behalf, you must tell us beforehand.

If you would like access to your computerised and/or paer medical record please contact the practice on 0117 330 4223 / 4225. There will be a charge applied for these services.

USE OF YOUR PATIENT INFORMATION (Care.data)

A new secure NHS IT system will be in place early in 2014 which will take data from GP records for use by other organisations. It is important that the NHS can use patient information for research and future service planning. Some of this is statistical and cannot be linked to individual patients, but in some cases it may include patient confidential data. This will be linked to data from other sources such as hospitals and community services to provide a full picture of the care of individual patients.

Patients’ names will not be used, but postcodes and NHS numbers will, as they allow for comparisons across different areas.

This new scheme is called care.data.

You can find out more information provided by NHS England at www.nhs.uk/caredata.

What can I do if I don’t want my information shared? 

 If you do not want your information shared beyond your GP practice, you have three choices:

• You can choose not to have any information that identifies you shared outside your GP practice, other than when required by law, e.g. in a public health emergency;
• Or you can choose to allow the NHS to use information about you for their own purposes, but not to pass it on to any other organisation. This option will be applied to any information about you from any NHS source, including hospitals;
• Or you can opt for both of these choices – this will give you the greatest amount of security but will prevent the NHS from using helpful information for future health service planning.

Please contact the surgery if you are not happy for your information to be shared, and we can make a note in your medical record.

What is Birchwood Medical Practice doing to inform patients of this change?

To make sure that as many patients as possible know about the scheme and have the opportunity to make a choice, Birchwood Medical Practice are taking the following steps:

All staff fully aware to support you with any queries you may have

Posters and leaflets in the surgery

Information on website and links above to NHS websites for further information

Leaflet included with prescriptions

Summary Care Record

All of our patients who have not chosen to opt out have a Summary Care Record that can be accessed, with the patient’s consent, by hospital and out of hours staff. The record contains details of name, address, known allergies and current medication. It does not contain any information about present or past diagnoses. It may only be accessed without your consent if you are unconscious or otherwise unable to give consent.

You may choose to opt out of having a Summary Care Record. The websites below will help you to decide on the risks and benefits.

 http://www.nhscarerecords.nhs.uk/

http://www.nhscarerecords.nhs.uk/faqs

If you would like to opt out, please print off and complete the following consent form and return it to the surgery. 

Consent Form (Opens PDF file)

National Diabetes Audit (NDA)

Birchwood Medical Practice is taking part in an important national project about people at risk of diabetes and diabetes care and treatment in the NHS. The project is called the National Diabetes Audit (NDA). The NDA has always collected patient identifiable data from health care providers since it began in 2004.

Patients do not need to be individually consented but we want to raise awareness of the NDA.This is known as ‘fair processing’.

If you have diabetes, non-diabetic hyperglycaemia, impaired glucose tolerance or pre-diabetes, your GP practice will share information about your diabetes care and treatment with the NDA. The type of information, and how it is shared, is controlled by law and enforced by strict rules of confidentiality and security.

Taking part in the NDA shows that this GP practice is committed to reducing diabetes and improving care for people with diabetes.

If you do not want your information to be used, please inform the receptionist, your GP or nurse. This will not affect your care.

Click here for more information on the patient leaflet.

As an employer, the practice has a duty of care for the health, safety and wellbeing of its staff. The practice also has a legal responsibility to provide a safe and secure working environment for staff.

All patients and staff are expected to behave in an acceptable, respectful manner.

The practice follows the NHS guidance concerning Zero Tolerance.

Any incident in which an employee is abused, threatened or assaulted in circumstances relating to their work is unacceptable and not tolerated.

This includes the serious or persistent use of verbal abuse, aggressive tone and/or language and swearing/foul language.

Staff should not be left upset and distressed following an interaction with a patient.

All instances of actual physical abuse on any doctor or member of staff, by a patient or their relatives will be reported to the police as an assault.

We expect all patients to be responsible and avoid attending the surgery under the influence of alcohol or illegal drugs. Any alteration of prescriptions is illegal and will not be tolerated.

If you are seriously unhappy with the quality of service you have the right to register with another practice without notifying us. Similarly, on the very rare occasions when a patient breaches this policy, we have the right to remove the patient from our Practice list.

Examples of Unacceptable Standards of Behaviour

In exceptional circumstances, a breakdown may occur between a doctor and their patient. If the breakdown is of a serious nature e.g. serious physical or verbal abuse to any member of the practice team, the doctors may feel that the doctor/patient relationship has been compromised. Steps may be taken to have the patient removed immediately from the practice list. Where possible, conciliation would always be the preferred route. Reasons for removal will be given in writing.

Where we deem an incident is not serious enough to warrant immediate removal, we will issue a first and final warning.

You will be removed from our patient list immediately when we have needed police assistance.

The following are example of when you may be issued with a first and final warning or removed from our patient list dependent on the severity of the incident.

• Violence.
• Excessive noise eg recurrent loud or intrusive conversation or shouting.
• Threatening or abusive language involving swearing or offensive remarks.
• Racial or sexual remarks.
• Aggressive, forceful tone and/or language that upsets staff.
• Malicious allegations relating to members of staff, other patients or visitors.
• Offensive gestures or behaviours.
• Abusing alcohol or drugs on practice premises.
• Drug dealing on practice premises.
• Wilful damage to practice property.
• Threats or threatening behaviour.
• Theft.

This list is not exhaustive and there may be other occasions where we have cause to issue a warning or remove you from our patient list.

We trust this policy is clear and supports a mutually respectful environment for patients and staff.