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 £63,769 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.

IPC Statement Jan 2021

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.

This policy outlines the procedure for patients travelling abroad for short and long periods of time.

NHS Policy

By law, the NHS ceases to have responsibility for the medical care of patients when they leave the UK.  In addition GPs are not required by their terms of service to provide prescriptions for the treatment of a condition that is not present and may arise while the patient is abroad.

The NHS does accept responsibility for supplying ongoing medication for temporary periods abroad of up to 3 months. However, if a person is going to be abroad for more than 3 months, then they are only entitled (at NHS expense) to a sufficient supply of regular medication in order to get to their destination, where they should the find an alternative supply of that medication.

Patients residing abroad for a period of more than 3 months should be removed from the registered patient list.

Birchwood Medical Practice Policy

Travelling out of the country for LESS than 3 months
For patients who inform us they will be out of the country for less than 3 months, we will provide sufficient medicines for an existing condition (e.g. asthma, diabetes…) for the period while the patient is away where it is safe to do so.  Drugs that require frequent monitoring may not be prescribed where there are safety concerns.  1 months supply only will be issued for drugs normally available over the counter, such as paracetamol.

Travelling out of the country for MORE than 3 months
Patients who inform the NHS they will be leaving the country for more than 3 months will be prescribed sufficient medication to enable them to make alternative arrangements at their destination (up to 3 months supply where safe to do so).

They will also be removed from our patient list. We will be pleased to re-register patients on their return to residence in the UK and can reassure patient that their electronic notes are kept on file for reference on your return.

Patients and relatives should not seek medication for themselves while they are abroad as this constitutes NHS fraud.

Prescriptions for medicines in case of illness while abroad

GPs may provide private prescriptions if it is clinically appropriate and they can be self-administered safely without medical assessment while abroad. These prescriptions are not free.

Patients should be aware that some drugs commonly prescribed in the UK may be illegal in certain countries and you should check with that countries embassy before you travel.

See NHS facts of travel abroad

http://www.nhs.uk/chq/Pages/1755.aspx?CategoryID=73&SubCategoryID=105

https://www.wessexlmcs.com/patientstravellingabroadprescriptionsadvice

https://www.gov.uk/travelling-controlled-drugs

Birchwood Medical Practice (the Surgery)

Privacy Notice for patients aged between 13-16

We understand how important it is to keep your personal information safe and secure and we take this very seriously. We have taken steps to make sure your personal information is looked after in the best possible way, and we review this regularly.

Up until the age of 16 your parents will be able to access your medical information. This means they can discuss your care with staff at the Practice and may request to see copies of your medical information, unless you request us to withhold this information from them.

*If you do not want your parents to have access to your medical information, please speak to a member of the Practice team

Please read this privacy notice (‘Privacy Notice’) carefully, as it contains important information about how we use the personal and healthcare information we collect on your behalf.

ABOUT US

We, at the (‘the Surgery’) situated at Brooklea health Centre are a Data Controller of your information. This means we are responsible for collecting, storing and handling your personal and healthcare information when you register with us as a patient.

There may be times where we also process your information. That means we use it for a particular purpose and, therefore, on those occasions we may also be Data Processors. The purposes for which we use your information are set out in this Privacy Notice.

A privacy notice helps your doctor’s surgery tell you how it uses information it has about you, like your name, address, date of birth and all the notes the doctor or nurse makes about you in your healthcare record.

THE DATA PROTECTION OFFICER

You can contact the Data Protection Officer by emailing Kelly@almc.co.uk  if you have any questions about how your information is being held.

1. If you require access to your information or if you wish to make a change to your information.
2. If you wish to make a complaint about anything to do with the personal and healthcare information, we hold about you.
3. Or any other query relating to this Policy and your rights as a patient.

You can also write to her at the address stated below: –

Kelly-Anne Gast, Avon Local Medical Committee,
14a High Street, Staple Hill, Bristol, BS16 5HP

WHY WE ARE PROVIDING THIS PRIVACY NOTICE  

We are required to provide you with this Privacy Notice by Law. It explains how we use the personal and healthcare information we collect, store and hold about you. The Law says:

1. We must let you know why we collect personal and healthcare information about you;We must let you know how we use any personal and/or healthcare information we hold on you;

   C. We need to inform you in respect of what we do with it;

   D. We need to tell you about who we share it with or pass it on to and why; and

   E. We need to let you know how long we can keep it for.

WHY DO WE NEED ONE?

Your doctor’s surgery needs a privacy notice to make sure it meets the legal requirements which are written in a new document called the General Data Protection Regulation (or GDPR for short).

A privacy notice helps your doctor’s surgery tell you how it uses information it has about you, like your name, address, date of birth and all the notes the doctor or nurse makes about you in your healthcare record

WHAT IS G.D.P.R?

GDPR helps your doctor’s surgery keep the information about you secure. It was introduced on the in 2018, making sure that your doctor, nurse and any other staff at the practice follow the rules and keep your information safe.

WHAT INFORMATION DO WE COLLECT ABOUT YOU?

Don’t worry; we only collect the information we need to help us keep you healthy – such as your name, address, information about your parents or guardians, records of appointments, visits, telephone calls, your health record, treatment and medicines, test results, X-rays and any other information to enable us to care for you.

If you are unclear about how we process or use your personal and healthcare information, or you have any questions about this Privacy Notice or any other issue regarding your personal and healthcare information, then please contact our Data Protection Officer.

NHS Digital sub-contract Amazon Web Services (AWS) to store your patient data. We have been informed that the data will always remain in the UK and will be fully encrypted both in transit and at rest. We have further been advised that AWS offers the very highest levels of security and support. The Practice does not have any influence over how the data is stored as this is decided centrally by NHS Digital.

CALL RECORDING

We may use Telephone Call Recording software for quality and training purposes.  Telephone calls made or received via the Practice Telephony system may be recorded.  We do not record every call.  We have internal policies that all staff must follow in order to protect your data.

OTHER PEOPLE WHO WE PROVIDE YOUR INFORMATION TO:

A Commissioners;
B. Clinical Commissioning Groups;
C. Local authorities;
D. Community health services;

E For the purposes of complying with the law e.g., Police, Solicitors, Insurance Companies.

F Anyone you have given your consent to, to view or receive your record, or part of your record.

G Extended Access – We provide extended access services to our patients which means you can access medical services outside of our normal working hours we have very robust data sharing agreements and other clear arrangements in place to ensure your data is always protected and used for those purposes only.

H Data Extraction by the Clinical Commissioning Group – the clinical commissioning group at times extracts medical information about you, but the information we pass to them via our computer systems cannot identify you to them. This information only refers to you by way of a code, that only your practice can identify (it is pseudo-anonymised). This therefore protects you from anyone who may have access to this information at the clinical commissioning group from EVER identifying you as a result of seeing the medical information and we will never give them the information that would enable them to do this.

I Severnside Integrated Urgent Care Service-incorporates NHS111, this is an Out of hours service for GP Practices this service ensures that you receive the right level of care for your condition.

J CQC- Care Quality Commission –Regulate and inspect health and social care services across the UK.

Other NHS organisations

The CCG also collects information about whether patients have long term conditions such as diabetes, blood pressure, cholesterol levels and medication. However, this information is anonymous and does not include anything written as notes by the GP and cannot be linked to you.

1. Local Data Sharing Agreements
   1. Sirona Community nurses and other health care professionals can access GP information about people on their caseload who have recently been discharged from hospital, or who are housebound, or who require longer term rehabilitation from the GP record. This information can be read by the healthcare professional to improve the patients care, but they are not able to amend the GP medical record.
   2. Connecting Care* enables a range of health care organisations, including local NHS hospital, the Ambulance Service and the Out of Hours service provided by Brisdoc. This information can be read by the healthcare professional to improve the patients care, but they are not able to amend the GP medical record.
   3. One Care – this agreement allows patients from the surgery to be seen and treated by GPs from other surgeries in the evening and at weekend. The agreement allows a GP in other localities to access the GP record securely and allows information about the consultation to be written into the record.
   4. St Peter’s Hospice – this agreement enables hospice staff to read the records of patients in their care. This information can be read by the healthcare professional to improve the patients care, but they are not able to amend the GP medical record
   5. The practice also shares anonymised data with several research bodies to enable clinical research to be undertaken, but no personally identifiable data is shared.

Please note: if you give another person or organisation consent to access your record, we will need to contact you to verify your consent before we release that record. It is important that you are clear and understand how much and what aspects of your record you give consent to be disclosed.

SPECIAL CATEGORIES

The Law states that personal information about your health falls into a special category of information because it is very sensitive. Reasons that may entitle us to use and process your information may be as follows:

PUBLIC INTEREST: Where we may need to handle your personal information when it is in the public interest. For example, when there is an outbreak of a specific disease and we need to contact you for treatment, or we need to pass your information to relevant organisations to ensure you receive advice and/or treatment.

CONSENT: When you have given us consent.

VITAL INTEREST: If you are incapable of giving consent, and we must use your information to protect your vital interests (e.g., if you have had an accident and you need emergency treatment).

DEFENDING A CLAIM: If we need your information to defend a legal claim against us by you, or by another party.

PROVIDING YOU WITH MEDICAL CARE: Where we need your information to provide you with medical and healthcare service

HOW DO WE USE YOUR INFORMATION?

Your information is taken to help us provide your care. But we might need to share this information with other medical teams, such as hospitals, if you need to be seen by a special doctor or sent for an X-ray. Your doctor’s surgery may be asked to help with exciting medical research; but don’t worry, we will always ask you, or your parents or adults with parental responsibility, if it’s okay to share your information.

HOW DO YOU KEEP MY INFORMATION PRIVATE?

Well, your doctor’s surgery knows that it is very important to protect the information we have about you. We make sure we follow the rules that are written in the GDPR and other important rule books.

WHAT IF I HAVE A LONG-TERM MEDICAL CONDITION?

If you have a long-term medical problem then we know it is important to make sure your information is shared with other healthcare workers to help them help you, making sure you get the care you need when you need it!

WHAT IF I DON’T WANT TO SHARE MY INFORMATION?

All our patients, no matter what their age, can say that they don’t want to share their information.  If you’re under 16 this is something which your parents or adults with parental responsibility will have to decide. They can get more information from a member of staff at the surgery, who can also explain what this means to you.

HOW DO I ACCESS MY RECORDS?

Remember we told you about the GDPR? Well, if you want to see what is written about you, you have a right to access the information we hold about you, but you will need to complete a Subject Access Request (SAR). Your parents or adults with parental responsibility will do this on your behalf if you’re under 16. But if you are over 12, you may be classed as being competent and you may be able to do this yourself.

WHAT DO I DO IF I HAVE A QUESTION?

If you have any questions, your parents or adults with parental responsibility are the best people to ask, however you are also able to do one of the following:

• Contact the practice’s data controller via email at
• Doctors’ surgeries are data controllers for the data they hold about their patients

YOUR SUMMARY CARE RECORD

Your summary care record is an electronic record of your healthcare history (and other relevant personal information) held on a national healthcare records database provided and facilitated by NHS England. This record may be shared with other healthcare professionals and additions to this record may also be made by relevant healthcare professionals and organisations involved in your direct healthcare.

You may have the right to demand that this record is not shared with anyone who is not involved in the provision of your direct healthcare. If you wish to enquire further as to your rights in respect of not sharing information on this record, then please contact our Data Protection Officer.

HOW THE NHS USE YOUR INFORMATION-National Data Opt-Out

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

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

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

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

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

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

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

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

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

You can also find out more about how patient information is used at:

https://www.hra.nhs.uk/information-about-patients/ (which covers health and care research); and

https://understandingpatientdata.org.uk/what-you-need-know (which covers how and why patient information is used, the safeguards and how decisions are made)

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

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

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

What is Population Health Management?

This work is aimed at improving the health of an entire population.

It is about improving the physical and mental health outcomes and wellbeing of people and making sure that access to services is fair and equal. It helps to reduce the occurrence of ill-health and looks at all the wider factors that affect health and care.

The project requires health care organisations to work together with communities and partner agencies. The organisations will share information with each other in order to get a view of health and services for the population in a particular area.

In your area, a population health management programme has been introduced. The programme will combine information from GP practices, community service providers, hospitals and other health and care providers.

How Will my Personal Data be Used?

The information will include information about your health care.

The information will be combined and anything that can identify you (like your name or NHS Number) will be removed and replaced with a code.

This means that the people working with the data will only see the code and cannot see which patient the information relates to.

If we see that an individual might benefit from some additional care or support, we will send the information back to your GP or hospital provider and they will use the code to identify you and offer you services.

The information will be used for a number of healthcare related activities such as;

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

Who Will My Personal Data Be Shared With?

Your GP and hospital providers will send the information they hold on their systems to the South Central and West Commissioning Support Unit, who are part of NHS England.

They will link all the information together in order to review and make decisions about the whole population or particular patients that might need support. During this process any identifiable data will be removed berore it is shared with Optum Healthcare.

Both the Commissioning Support Unit and Optum are required to protect your information and maintain confidentiality in the same way that your doctor or hospital provider is.

Is Using My Information in This Way Lawful?

Health Care Providers are permitted by data protection law to use information where it is ‘necessary for medical purposes’. This includes caring for you directly as well as management of health services more generally.

Some of the work that happens at a national level with your information is required by other parts of the law. For more information, speak to our Data Protection Officer.

Sharing and using your information in this way helps to provide better health and care for you, your family and future generations. Confidential patient information about your health and care is only used like this where allowed by law and in the majority of cases, anonymised data is used so that you cannot be identified.

What will Happen to My Information When the Project is Finished?

Once the 20-week programme has completed the information will be securely destroyed.

Can I Object?

You have a right to object to information being used in this way.

You also have a number of other information rights. See our main privacy policy for more information.

To find out more or to register your choice to opt out, please visit www.nhs.uk/your-nhs-data-matters.

17. LEGAL JUSTIFICATION FOR COLLECTING AND USING YOUR INFORMATION

The Law says we need a legal basis to handle your personal and healthcare information.

CONTRACT: We have a contract with NHS England to deliver healthcare services to you. This contract provides that we are under a legal obligation to ensure that we deliver medical and healthcare services to the public.

CONSENT: Sometimes we also rely on the fact that you give us consent to use your personal and healthcare information so that we can take care of your healthcare needs.

Please note that you have the right to withdraw consent at any time if you no longer wish to receive services from us.

NECESSARY CARE: Providing you with the appropriate healthcare, where necessary. The Law refers to this as ‘protecting your vital interests’ where you may be in a position not to be able to consent.

LAW: Sometimes the Law obliges us to provide your information to an organisation.

18. WHAT DO I DO IF I AM NOT HAPPY WITH HOW YOU HAVE HANDLED MY INFORMATION?

We really want to make sure you’re happy, but we understand that sometimes things can go wrong. If you or your parents or adults with parental responsibility are unhappy with any part of our data-processing methods, you can complain. For more information, visit ico.org.uk and select ‘Raising a concern’. We always make sure the information we give you is up to date. Any updates will be published here on our website, and on our leaflets.

19. COMPLAINTS

If you have a concern about the way we handle your personal data or have a complaint about what we are doing, with your data or how we have used or handled your personal and/or healthcare information, then please contact our Data Protection Officer.

You also have a right to raise any concern or complaint with the UK information regulator:

Information Commissioner’s Office (ICO): https://ico.org.uk/

20. OUR WEBSITE

The only website this Privacy Notice applies to is the Surgery’s website. If you use a link to any other website from the Surgery’s website, then you will need to read their respective privacy notice. We take no responsibility (legal or otherwise) for the content of other websites.

21. CHANGES TO OUR PRIVACY NOTICE

We regularly review and update our Privacy Notice. This Privacy Notice was last updated on 2nd August 2021.

*Please see separate Supplementary temporary Notice in relation to the COVID-19 pandemic below.

SUPPLEMENTARY PRIVACY NOTICE COVID-19  Birchwood Medical Practice

Please read this COVID-19 specific privacy notice (‘Privacy Notice’) carefully, as it contains important information about how we use your personal and healthcare information we collect on your behalf.

This notice explains why we may use your information to protect you, your family and others during the Covid-19 outbreak. It is additional to our main Privacy Notice which is also available on request and available on the practice website.

The health and social care system are facing significant pressures due to the Covid-19 outbreak. Health and care information is essential to deliver care to individuals, to support health and social care services and to protect public health. Information will also be vital in researching, monitoring, tracking and managing the outbreak. In the current emergency it has become even more important to share health and care information across relevant organisations.

Existing law which allows confidential patient information to be used and shared appropriately and lawfully in a public health emergency is being used during this outbreak. Using this law, the Secretary of State has required NHS Digital; NHS England and Improvement; Arm’s Length Bodies (such as Public Health England); local authorities; health organisations and GPs to share confidential patient information to respond to the Covid-19 outbreak.

Any information used or shared during the Covid-19 outbreak will be limited to the period of the outbreak unless there is another legal basis to use the data.  Further information can be found on the www.gov.uk  website.

During this period of emergency, opt-outs will not generally apply to the data used to support the Covid-19 outbreak, due to the public interest in sharing information.

In order to look after your health and care needs, we may share your confidential patient information including health and care records with clinical and non-clinical staff in other health and care providers, for example neighboring GP practices, hospitals and NHS 111. We may also use the details we have to send public health messages to you, either by phone, text or email. [Is there anyone else information will be shared with for individual care? If so, please add here].

During this period of emergency, we may offer you a consultation via telephone or videoconferencing. By accepting the invitation and entering the consultation you are consenting to this. Your personal/confidential patient information will be safeguarded in the same way it would with any other consultation.

We might also need to share your personal/confidential patient information with health and care organisations and other bodies engaged in disease surveillance for the purposes of protecting public health, providing healthcare services to the public and monitoring and managing the outbreak.

In such circumstances where you tell us you’re experiencing Covid-19 symptoms we may need to collect specific health data about you.  Where we need to do so, we will not collect more information than we require, and we will ensure that any information collected is treated with the appropriate safeguards.

We may amend this privacy notice at any time so please review it frequently. The date at the bottom of this page will be amended each time this notice is updated.

CORONOVIRUS PANDEMIC-DATA PROTECTION

HOW WE LOOK AFTER YOUR PERSONAL INFORMATION WHEN WORKING FROM HOME DURING THE COVID-19 PANDEMIC?

In accordance with government guidance and in order to protect the health and safety of our staff during this difficult period we will be requiring all [administrative] staff to work from home.

This means that staff may have access to any necessary personal and/or medical information in order to look after your healthcare needs.

We would like to assure you that our staff will be subject to all relevant security procedures and policies of the Practice to ensure that any information is kept safe, secure and confidential always.

If you have any concerns about how your information may be used, please contact our DPO who will be happy to assist with your enquiry.

YOUR SUMMARY CARE RECORD AND CHANGES DURING COVID-19

Your summary care record is an electronic record of your healthcare history (and other relevant personal information) held on a national healthcare records database provided and facilitated by NHS England. This record may be shared with other healthcare professionals and additions to this record may also be made by relevant healthcare professionals and organisations involved in your direct healthcare.

Considering the current emergency, the Department of Health and Social Care has removed the requirement for a patient’s prior explicit consent to share Additional Information as part of the Summary Care Record.

This is because the Secretary of State for Health and Social Care has issued a legal notice to healthcare bodies requiring them to share confidential patient information with other healthcare bodies where this is required to diagnose, control and prevent the spread of the virus and manage the pandemic. This includes sharing Additional Information through Summary Care Records, unless a patient object to this.

If you have already expressed a preference to only have Core information shared in your Summary Care Record, or to opt-out completely of having a Summary Care Record, these preferences will continue to be respected and this change will not apply to you. For everyone else, the Summary Care Record will be updated to include the Additional Information. This change of requirement will be reviewed after the current coronavirus (COVID-19) pandemic.

WHY HAVE WE MADE THIS CHANGE?

In order to look after your health and care needs, Health and Social Care bodies may share your confidential patient Information contained in your Summary Care Record with clinical and non-clinical staff in other health and care organisations for example, hospitals, NHS 111 and out of hours organisations. These changes will improve the healthcare that you receive away from your usual GP Practice.

YOUR RIGHTS AND YOUR SUMMARY CARE RECORD?

Regardless of your past decisions about your Summary Care Record preferences, you will still have the same options that you currently have in place to opt out of having a Summary Care Record, including the opportunity to opt-back in to having a Summary Care Record or opt back in to allow sharing of Additional Information. You can exercise these rights by doing the following:

1. Choose to have a Summary Care Record with all information shared. This means that any authorised, registered and regulated health and care professionals will be able to see a detailed Summary Care Record, including Core and Additional Information, if they need to provide you with direct care.
2. Choose to have a Summary Care Record with Core information only. This means that any authorised, registered and regulated health and care professionals will be able to see limited information about allergies and medications in your Summary Care Record if they need to provide you with direct care.
3. Choose to opt-out of having a Summary Care Record altogether. This means that you do not want any information shared with other authorised, registered and regulated health and care professionals involved in your direct care. You will not be able to change this preference at the time if you require direct care away from your GP practice. This means that no authorised, registered and regulated health and care professionals will be able to see information held in your GP records if they need to provide you with direct care, including in an emergency. To make these changes, you should inform your GP practice or complete this form and return it to your GP practice.

. **Practice is currently compliant with the national data opt-out policy.

We carefully consider any personal information that we store about you, and we will not keep your information for longer than is necessary for the purposes as set out in this Privacy Notice.

NHS DIGITAL GP DATA FOR PLANNING AND RESEARCH

NHS Digital has been legally directed to collect and analyse healthcare information about patients from their GP record for the duration of the coronavirus emergency period. The British Medical Association, the Royal College of General Practitioners and the National Data Guardian are all supportive of this approach.

NHS Digital will analyse the data and securely and lawfully share data with other appropriate organisations described below for coronavirus response purposes only. These purposes include:

• carrying out vital research into treatments and vaccines for the virus, including clinical trials
• identifying coronavirus trends and risks to public health
• diagnosing and monitoring the effects of coronavirus
• controlling and helping to prevent the spread of the virus
• planning and providing health, social care and other public services in response to coronavirus (COVID-19)
• helping clinicians, scientists, public health bodies and the government to provide guidance and develop policies to respond to the outbreak
• monitoring and managing the outbreak

OUR LAWFUL BASIS FOR PROCESSING THIS INFORMATION

NHS Digital is the controller of the personal data collected and analysed above under the General Data Protection Regulation 2016 (GDPR) jointly with the Secretary of State for Health and Social Care, who has directed NHS Digital to collect, analyse and in certain circumstances disseminate this data under the COVID-19 Public Health Directions 2020 (COVID-19 Directions).

All GP practices in England are legally required to share data with NHS Digital for this purpose under the Health and Social Care Act 2012 (2012 Act). More information about this requirement is contained in the Data Provision Notice issued by NHS Digital to GP practices.

NHS Digital has various powers to share personal data which are explained below under ‘Who we share your personal data with’. Under GDPR our legal basis for collecting and analysing this data is Article 6(1) (c) – legal obligation. Our legal basis for collecting and analysing personal data relating to health will be Article 9(2) (g) – substantial public interest, for the purposes of NHS Digital exercising its statutory functions under the COVID-19 Directions. Our legal basis for sharing personal data under GDPR will depend on the organisation we are sharing the data with and their purposes for using the data. This will include:

• Article 6(1)(c) – legal obligation, for example where the NHS Digital COPI Notice applies
• Article 6(1)(d) – vital interests, for example where it is necessary to protect your or other patients’ vital interests
• Article 6(1)(e) – public task, for example where we are sharing data with another public authority for the purposes of them exercising their statutory or governmental functions
• Article 6(1)(f) – legitimate interests, for example where we are sharing information with a research organisation to carry out vital coronavirus research Our legal basis for sharing personal data under GDPR relating to health will include:
• Article 9(2)(g) – substantial public interest, for the purposes of NHS Digital exercising its statutory functions or for other organisations exercising their governmental or statutory functions
• Article 9(2)(h) – health or social care purposes
• Article 9(2)(I) – public health purposes
• Article 9(2) (j) – scientific research or statistical purposes.

For Further information please visit https://digital.nhs.uk/coronavirus

TEXT AND VIDEO MESSAGING

As mentioned above, during this period of emergency we may offer you a consultation via telephone or videoconferencing. By accepting the invitation and entering the consultation you are consenting to this. Your personal/confidential patient information will be safeguarded in the same way it would with any other consultation.

Because we are obliged to protect any confidential information, we hold about you and we take this very seriously, it is imperative that you let us know immediately if you change any of your contact details.

We may contact you using SMS texting to your mobile phone if we need to notify you about appointments and other services that we provide to you involving your direct care, therefore you must ensure that we have your up-to-date details. This is to ensure we are contacting you and not another person that you may not want us too like your parents.

THE DATA PROTECTION OFFICER

The Data Protection Officer for the Surgery is Kelly-Anne Gast. You can contact her if:

1. You have any questions about how your information is being held.
2. If you require access to your information or if you wish to make a change to your information.
3. If you wish to make a complaint about anything to do with the personal and healthcare information, we hold about you.
4. Or any other query relating to this Policy and your rights as a patient.

Kelly can be contacted here:

kelly@almc.co.uk

CHANGES TO THIS SUPPLMENTARY PRIVACY NOTICE

*We regularly review and update our Privacy Notice. This part of the Privacy Notice was last updated on 02/08/2021 and will only be referred to during the coronavirus pandemic.

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

Privacy Notice

Birchwood Medical Practice (the Surgery)

We understand how important it is to keep your personal information safe and secure and we take this very seriously. We have taken steps to make sure your personal information is looked after in the best possible way and we review this regularly.

Please read this privacy notice (‘Privacy Notice’) carefully, as it contains important information about how we use the personal and healthcare information we collect on your behalf.

20210802 GENERAL PRACTICE PRIVACY NOTICE

We regularly review and update our Privacy Notice. This Privacy Notice was last updated on 02/08/2021

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!

SUPPLEMENTARY PRIVACY NOTICE COVID-19  Birchwood Medical Practice

Please read this COVID-19 specific privacy notice (‘Privacy Notice’) carefully, as it contains important information about how we use the personal and healthcare information we collect on your behalf. This notice describes how we may use your information to protect you and others during the Covid-19 outbreak. It supplements our main Privacy Notice which is also available on request and available on the practice website.

The health and social care system are facing significant pressures due to the Covid-19 outbreak. Health and care information is essential to deliver care to individuals, to support health and social care services and to protect public health. Information will also be vital in researching, monitoring, tracking and managing the outbreak. In the current emergency it has become even more important to share health and care information across relevant organisations.

Existing law which allows confidential patient information to be used and shared appropriately and lawfully in a public health emergency is being used during this outbreak. Using this law, the Secretary of State has required NHS Digital; NHS England and Improvement; Arm’s Length Bodies (such as Public Health England); local authorities; health organisations and GPs to share confidential patient information to respond to the Covid-19 outbreak.

Any information used or shared during the Covid-19 outbreak will be limited to the period of the outbreak unless there is another legal basis to use the data.  Further information can be found on the www.gov.uk  website.

During this period of emergency, opt-outs will not generally apply to the data used to support the Covid-19 outbreak, due to the public interest in sharing information.  This includes National Data Opt-outs.  However, in relation to the Summary Care Record, existing choices will be respected. Where data is used and shared under these laws your right to have personal data erased will also not apply.  It may also take us longer to respond to Subject Access requests, Freedom of Information requests and new opt-out requests whilst we focus our efforts on responding to the outbreak.

In order to look after your health and care needs, we may share your confidential patient information including health and care records with clinical and non-clinical staff in other health and care providers, for example neighboring GP practices, hospitals and NHS 111. We may also use the details we have to send public health messages to you, either by phone, text or email. [Is there anyone else information will be shared with for individual care? If so, please add here].

During this period of emergency, we may offer you a consultation via telephone or videoconferencing. By accepting the invitation and entering the consultation you are consenting to this. Your personal/confidential patient information will be safeguarded in the same way it would with any other consultation.

We will also be required to share personal/confidential patient information with health and care organisations and other bodies engaged in disease surveillance for the purposes of protecting public health, providing healthcare services to the public and monitoring and managing the outbreak.

NHS England and Improvement and NHSX have developed a single, secure store to gather data from across the health and care system to inform the Covid-19 response. This includes data already collected by NHS England, NHS Improvement, Public Health England and NHS Digital. New data will include 999 call data, data about hospital occupancy and A&E capacity data as well as data provided by patients themselves.  All the data held in the platform is subject to strict controls that meet the requirements of data protection legislation.

In such circumstances where you tell us you’re experiencing Covid-19 symptoms we may need to collect specific health data about you.  Where we need to do so, we will not collect more information than we require and we will ensure that any information collected is treated with the appropriate safeguards.

We may amend this privacy notice at any time so please review it frequently. The date at the bottom of this page will be amended each time this notice is updated.

CORONOVIRUS PANDEMIC-DATA PROTECTION

HOW WE LOOK AFTER YOUR PERSONAL INFORMATION WHEN WORKING FROM HOME DURING THE COVID-19 PANDEMIC?

In accordance with government guidance and in order to protect the health and safety of our staff during this difficult period we will be requiring all [administrative] staff to work from home.

This means that staff may have access to any necessary personal and/or medical information in order to look after your healthcare needs.

We would like to assure you that our staff will be subject to all relevant security procedures and policies of the Practice to ensure that any information is kept safe, secure and confidential at all times.

If you have any concerns about how your information may be used please contact our DPO who will be happy to assist with your enquiry.

 YOUR SUMMARY CARE RECORD AND CHANGES DURING COVID-19

Your summary care record is an electronic record of your healthcare history (and other relevant personal information) held on a national healthcare records database provided and facilitated by NHS England. This record may be shared with other healthcare professionals and additions to this record may also be made by relevant healthcare professionals and organisations involved in your direct healthcare.

In light of the current emergency, the Department of Health and Social Care has removed the requirement for a patient’s prior explicit consent to share Additional Information as part of the Summary Care Record.

This is because the Secretary of State for Health and Social Care has issued a legal notice to healthcare bodies requiring them to share confidential patient information with other healthcare bodies where this is required to diagnose, control and prevent the spread of the virus and manage the pandemic. This includes sharing Additional Information through Summary Care Records, unless a patient object to this.

If you have already expressed a preference to only have Core information shared in your Summary Care Record, or to opt-out completely of having a Summary Care Record, these preferences will continue to be respected and this change will not apply to you. For everyone else, the Summary Care Record will be updated to include the Additional Information. This change of requirement will be reviewed after the current coronavirus (COVID-19) pandemic.

WHY WE HAVE MADE THIS CHANGE?

In order to look after your health and care needs, Health and Social Care bodies may share your confidential patient Information contained in your Summary Care Record with clinical and non-clinical staff in other health and care organisations for example, hospitals, NHS 111 and out of hours organisations. These changes will improve the healthcare that you receive away from your usual GP Practice.

YOUR RIGHTS AND YOUR SUMMARY CARE RECORD?

Regardless of your past decisions about your Summary Care Record preferences, you will still have the same options that you currently have in place to opt out of having a Summary Care Record, including the opportunity to opt-back in to having a Summary Care Record or opt back in to allow sharing of Additional Information. You can exercise these rights by doing the following:

1. Choose to have a Summary Care Record with all information shared. This means that any authorised, registered and regulated health and care professionals will be able to see a detailed Summary Care Record, including Core and Additional Information, if they need to provide you with direct care.
2. Choose to have a Summary Care Record with Core information only. This means that any authorised, registered and regulated health and care professionals will be able to see limited information about allergies and medications in your Summary Care Record if they need to provide you with direct care.
3. Choose to opt-out of having a Summary Care Record altogether. This means that you do not want any information shared with other authorised, registered and regulated health and care professionals involved in your direct care. You will not be able to change this preference at the time if you require direct care away from your GP practice. This means that no authorised, registered and regulated health and care professionals will be able to see information held in your GP records if they need to provide you with direct care, including in an emergency. To make these changes, you should inform your GP practice or complete this form and return it to your GP practice.

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

We carefully consider any personal information that we store about you, and we will not keep your information for longer than is necessary for the purposes as set out in this Privacy Notice.

NHS DIGITAL GP DATA FOR PLANNING AND RESEARCH

NHS Digital has been legally directed to collect and analyse healthcare information about patients from their GP record for the duration of the coronavirus emergency period. The British Medical Association, the Royal College of General Practitioners and the National Data Guardian are all supportive of this approach.

NHS Digital will analyse the data and securely and lawfully share data with other appropriate organisations described below for coronavirus response purposes only. These purposes include:

• carrying out vital research into treatments and vaccines for the virus, including clinical trials
• identifying coronavirus trends and risks to public health
• diagnosing and monitoring the effects of coronavirus
• controlling and helping to prevent the spread of the virus
• planning and providing health, social care and other public services in response to coronavirus (COVID-19)
• helping clinicians, scientists, public health bodies and the government to provide guidance and develop policies to respond to the outbreak
• monitoring and managing the outbreak

OUR LAWFUL BASIS FOR PROCESSING THIS INFORMATION

NHS Digital is the controller of the personal data collected and analysed above under the General Data Protection Regulation 2016 (GDPR) jointly with the Secretary of State for Health and Social Care, who has directed NHS Digital to collect, analyse and in certain circumstances disseminate this data under the COVID-19 Public Health Directions 2020 (COVID-19 Directions).

All GP practices in England are legally required to share data with NHS Digital for this purpose under the Health and Social Care Act 2012 (2012 Act). More information about this requirement is contained in the Data Provision Notice issued by NHS Digital to GP practices.

NHS Digital has various powers to share personal data which are explained below under ‘Who we share your personal data with’. Under GDPR our legal basis for collecting and analysing this data is Article 6(1) (c) – legal obligation. Our legal basis for collecting and analysing personal data relating to health will be Article 9(2) (g) – substantial public interest, for the purposes of NHS Digital exercising its statutory functions under the COVID-19 Directions. Our legal basis for sharing personal data under GDPR will depend on the organisation we are sharing the data with and their purposes for using the data. This will include:

• Article 6(1)(c) – legal obligation, for example where the NHS Digital COPI Notice applies
• Article 6(1)(d) – vital interests, for example where it is necessary to protect your or other patients’ vital interests
• Article 6(1)(e) – public task, for example where we are sharing data with another public authority for the purposes of them exercising their statutory or governmental functions
• Article 6(1)(f) – legitimate interests, for example where we are sharing information with a research organisation to carry out vital coronavirus research Our legal basis for sharing personal data under GDPR relating to health will include:
• Article 9(2)(g) – substantial public interest, for the purposes of NHS Digital exercising its statutory functions or for other organisations exercising their governmental or statutory functions
• Article 9(2)(h) – health or social care purposes
• Article 9(2)(I) – public health purposes
• Article 9(2) (j) – scientific research or statistical purposes.

For Further information please visit https://digital.nhs.uk/coronavirus

TEXT AND VIDEO MESSAGING

As mentioned above, during this period of emergency we may offer you a consultation via telephone or videoconferencing. By accepting the invitation and entering the consultation you are consenting to this. Your personal/confidential patient information will be safeguarded in the same way it would with any other consultation.

Because we are obliged to protect any confidential information, we hold about you and we take this very seriously, it is imperative that you let us know immediately if you change any of your contact details.

We may contact you using SMS texting to your mobile phone in the event that we need to notify you about appointments and other services that we provide to you involving your direct care, therefore you must ensure that we have your up-to-date details. This is to ensure we are actually contacting you and not another person that you may not want us too like your parents.

THE DATA PROTECTION OFFICER

The Data Protection Officer for the Surgery is Kelly-Anne Gast. You can contact her if:

• You have any questions about how your information is being held;

1. If you require access to your information or if you wish to make a change to your information;
2. If you wish to make a complaint about anything to do with the personal and healthcare information, we hold about you;
3. Or any other query relating to this Policy and your rights as a patient.

Kelly can be contacted here:

kelly@almc.co.uk

CHANGES TO THIS SUPPLMENTARY PRIVACY NOTICE

*We regularly review and update our Privacy Notice. This Privacy Notice was last updated on 20/05/2020 and will only be referred to during the coronavirus pandemic. This Privacy Notice is only currently valid until September 2020 unless any changes in legislation occur and this notice will have to be extended. The COVID Supplementary Notice Expires Sept 21

NHS England introduced the AIS to help clarify what is reasonable under the Equality Act. It aims to make sure people who have a disability, impairment or sensory loss receive information they can easily read or understand, and get support so they can communicate effectively with health and social care services. It covers patients, their parents and carers.

Since 2016, providers of any NHS funded care must, by law:

1. Identify/ask people if they have any information or communication needs
2. Find out how to meet their needs.
3. Record those needs in a clear and consistent way.
4. Flag their file or notes so it is clear that they have information or communication needs. Record how to meet those needs.
5. Share people’s information and communication needs with other providers of NHS and adult social care. This is only when they have consent or permission to do so.
6. Meet needs. Make sure people receive information they can access and understand. They should receive communication support if they need it.

All staff within the Practice will endeavour to ascertain whether patients have specific needs they require meeting in order for them to be fully involved in their care.

This will be done via the New Patient Registration Form and opportunistically during patient contact.

The information will be transferred to the Patient Record to ensure that their specific needs are identified. The patient’s record will be highlighted so it is clear there are information or communication needs and clearly explain what those needs are. This information will be shared with other NHS organisations if the practice has the consent to do so. The practice will make sure patients get information in an accessible way and communication support if they need it. Patients should be aware that this may not be instant and may take some time to organise depending what the request is.

The New Patient Registration Form has a section where patients can alert the practice to any specific needs they may have.

Specific needs include:

• Sensory impairment, i.e. speech, hearing, sight
• Physical disability
• Mental disability
• Religious or cultural needs
• Translation/interpretation
• Allergies and sensitivities
• Has or is a carer
• Access to premises
• Assistance dog
• Advocacy
• Phobias

If you are not a new patient or if your needs have changed please do use our Patient Feedback page to tell us about your information or communication needs – or call the practice – so we can update them for you.

At Birchwood we use the Language Empire Group to provide interpreter services. They also provide British Sign Language (BSL) support for patients who wish to contact them. Please click this link for more information and be aware that BSL support can take longer to arrange.

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

Your data matters to us at Birchwood Medical Practice. 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 below)
• Please see our privacy notices for detailed information

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. Please ask our Reception Team for a consent form if you require an ongoing arrangement for sharing consent. You can withdraw your consent at any time.

Information about your health and care helps the NHS to improve your individual care, speed up diagnosis, plan your local services and research new treatments.

Here is a video to show you how your data is shared from NHS Digital

You have the right to control how medical information about you is shared, disseminated or sold, for purposes other than your direct medical care – so called secondary uses (or purposes).

Secondary uses include projects involved in risk stratification, population health management, national clinical audits, research, healthcare planning, commissioning of healthcare services by CCGs, commercial and even political uses. You can control your personal confidential information by opting out of data sharing.

About the General Practice Data for Planning and Research (GPDPR) programme

NHS Digital is making improvements to how data is collected from general practice, this new framework for data extraction is called the General Practice Data for Planning and Research data collection (GPDPR). The goal of this new system is to:

• reduce burden on GP practices in managing access to patient data and maintain compliance with relevant data protection legislation
• improve protections through the consistent and rigorous review of all applications for access to patient data
• make it easier for patients to understand how their health and care data is being used, including increasing use of Trusted Secure Environments that avoids data flowing outside the NHS

This new NHS Digital service will collect data from GP practices in England and will analyse, publish statistical data and provide safe, secure, lawful and appropriate access to GP data for health and social care purposes. This will include planning, commissioning, policy development, public health purposes (including COVID-19) and research.

NHS Digital is engaging with the British Medical Association (BMA), Royal College of General Practitioners (RCGP) and the National Data Guardian (NDG) to ensure relevant safeguards are in place for patients and GP practices.

Protecting patient data

All data will be pseudonymised and encrypted by your GP system suppliers on your behalf before it is transferred to NHS Digital. Access to GP data will only be via a Trusted Research Environment (TRE) and never copied or shipped outside the NHS secure environment, except where individuals have consented to their data being accessed, e.g. written consent for a research study.

As with the COVID-19 collection, access to the data will be through the NHS Digital Data Access Request Service (DARS) and will be subject to a robust approvals process, which includes oversight by the Independent Group Advising on Release of Data (IGARD) and a Professional Advisory Group, which is made up of representatives from the BMA and RCGP.

Opt-outs

We want to make the position around opt-out much simpler. While 1 September 2021 has been seen by some as a cut-off date for opt-out, after which data extraction would begin, we want to reassure you that this will not be the case and data extraction will not commence until NHS Digital has met the tests.

They are introducing three changes to the opt-out system which mean that patients will be able to change their opt-out status at any time:

• Patients do not need to register a Type 1 opt-out by 1 September to ensure their GP data will not be uploaded
• NHS Digital will create the technical means to allow GP data that has previously been uploaded to the system via the GPDPR collection to be deleted when someone registers a Type 1 opt-out
• The plan to retire Type 1 opt-outs will be deferred for at least 12 months while we get the new arrangements up and running, and will not be implemented without consultation with the RCGP, the BMA and the National Data Guardian

Together, these changes mean that patients can have confidence that they will have the ability to opt-in or opt-out of the system, and that the dataset will always reflect their current preference. And we will ensure it is easy for them to exercise the choice to opt out.

It is important to know that what you decide now is not a permanent decision. Our aim is to provide you with information to make an informed decision but it is okay to change your mind and we will update your records to reflect your preference.

There are 2 types of data sharing.

Type 1 Opt Out

• What is it?

A type 1 opt out prevents information being shared outside a GP practice for purposes other than direct care. Your individual care will not be affected if you opt out.

• Who do you notify of your decision to opt out

In June 2021 we texted patients the link to this webpage so they had information to enable them to make an informed decision. We followed it up with a further text asking for patients to advise if they wanted to opt out. This exercise is complete but any patient can still ask to opt out or back in at any time.

You can ask for a form at the practice or you can print and sign an opt out form and either bring the original to the practice for processing or take a photo of it and email it to us at bmpractice.reg@nhs.net so that we can update your data sharing preferences. Please note the form and any related text message is only for Type 1 Opt outs – patients need to register a Type 2 Opt out separately – full details further below.

National Data Opt Out

If you do not want NHS Digital to share your identifiable patient data with anyone else for purposes beyond your own care, then you can also register a National Data Opt-out.

• What is it?

A National Data Opt-out (previously known as a Type 2 Opt Out) prevents information being shared outside NHS Digital for purposes beyond the individual’s direct care. Opting out does not affect your individual care.

• NHS Digital will collect data from GP medical records about patients who have registered a National Data Opt-out. The National Data Opt-out applies to identifiable patient data about your health, which is called confidential patient information.
• NHS Digital won’t share any confidential patient information about you – this includes GP data, or other data we hold, such as hospital data – with other organisations, unless there is an exemption to this. For example:- If we have a legal Obligation to share the data or if it is in the public interest.

Click here for  full current information regarding these opt-outs

• Who do you notify of your decision to opt out

National Data Opt Outs are arranged by NHS Digital. If you are aged 13 or older you can go to Make your choice about sharing data from your health records – NHS (www.nhs.uk) and opt out online.

Other ways to make a choice.

You can also make or change a choice for:

• yourself by phone, email or post
• someone else by email or post

NHS Digital Contact Centre phone number: 0300 303 5678 – Monday to Friday, 9am to 5pm (excluding bank holidays).

If you’re a parent or legal guardian and you want to opt your children out, you must complete the opt-out form.

Once you’ve completed the form, you can email it to the Contact Centre – enquiries@nhsdigital.nhs.uk

Alternatively, you can post the form to:

National Data Opt Out

Contact Centre

NHS Digital

HM Government

7 and 8 Wellington Place

Leeds

LS1 4AP

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
• Information available in the practice
• Information on social media
• Information on website and links above  and below to NHS websites for further information

Data Security and Governance

The Government has committed that access to GP data will only be via a Trusted Research Environment (TRE) and never copied or shipped outside the NHS secure environment, except where individuals have consented to their data being accessed e.g. written consent for a research study. This is intended to give both GPs and patients a very high degree of confidence that their data will be safe and their privacy protected.

The TRE will be built in line with best practice developed in projects, such as OpenSAFELY and the Office for National Statistics’ Secure Research Service.

NHS Digital is also committed to adopting a transparent approach, including publishing who has run what query and used which bit of data. They are developing a TRE which will meet their specific needs and act as ‘best in class’.

NHS Digital commits to only begin the data collection once the TRE is in place. Further, they will ensure that the BMA, RCGP and the National Data Guardian have oversight of the proposed arrangements and are satisfied with them before data upload begins.

NHS Digital also confirms the previously published Data Provision Notice for this collection has been withdrawn.

Once the data is collected, it will only be used for the purposes of improving health and care. Patient data is not for sale and will never be for sale.

Transparency, communications and engagement

There has been a great deal of concern regarding the lack of awareness amongst the healthcare system and patients. NHS Digital recognises they need to strengthen engagement, including opportunities for non-digital engagement and communication.

Since the programme has been paused, NHS Digital has been developing an engagement and communications campaign, with the goal of ensuring that the healthcare system and patients are aware and understand what is planned, and can make informed choices. The public rightly look to and trust general practice – through a centrally driven communication campaign, with clear messages, NHS Digital will seek to ensure that the introduction of this collection does not impose an additional burden on practices.

NHS Digital are developing a communications strategy delivered through four phases.

• Listening – where they listen to stakeholders and gather views on how best to communicate with the profession, patients and the public and give them the opportunity to inform the development of the programme in areas such as opt-outs, trusted research environments and other significant areas
• Consultation – a series of events where they can explain the programme, listen and capture feedback and co-design the information campaign
• Demonstration – show how feedback is being used to develop the programme and shape communications to the healthcare system and the public
• Delivery – of an information campaign to inform the healthcare system and the public about changes to how their GP data is used, that utilises the first three phases to ensure the campaign is accessible, has wide reach and is effective

Data saves lives. The vaccine rollout for COVID-19 could not have been achieved without patient data. The discovery that the steroid Dexamethasone could save the lives of one third of the most vulnerable patients with COVID-19 – those on ventilators – could not have been made without patient data from GP practices in England. That insight has gone on to save a million lives around the globe. That is why this programme is so important.

The programme and NHS Digital will be providing further information as the programme progresses. In the meantime, if you have any questions, you can contact the programme at enquiries@nhsdigital.nhs.uk.

The NHS Digital web pages also provide further information at https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/general-practice-data-for-planning-and-research#additional-information-for-gp-practices.

Q&A NHS Digitial & Data Collections

Why NHS Digital collects general practice data?

• NHS Digital is the national custodian for health and care data in England and has responsibility for standardising, collecting, analysing, publishing and sharing data and information from across the health and social care system, including general practice.
• NHS Digital collected patient data from general practices using a service called the General Practice Extraction Service (GPES), now known as GPDPR which has operated for over 10 years and now needs to be replaced.
• NHS Digital has engaged with doctors, patients, data and governance experts to design a new approach to collect data from general practice that:
  • reduces burden on GP practices
  • explains clearly how data is used
  • supports processes that manage and enable lawful access to patient data to improve health and social care

Does NHS Digital sell my Data to third parties?

The NHS shares some data, in which nobody can identify you, with trusted third parties, in order to improve the NHS for you and everyone else.

This includes with:

• NHS planners
• university researchers
• scientists researching medicines

We only share data when there is a proven benefit to the NHS, and access is strictly controlled.

You data won’t be shared with

• Your data is not shared for commercial purposes
• Your data is not shared with insurers
• Your data is not sold

Please see our Privacy Notice for further information on how else your data might be shared by the practice.

Summary Care Record (SCR)

Your Summary Care Record is different to the above sharing for secondary uses. Your SCR is used to assist in provision of care for you. Access to SCR information means that care in other settings is safer, reducing the risk of prescribing errors. It also helps avoid delays to urgent care.

At a minimum, the SCR holds important information about;

• current medication
• allergies and details of any previous bad reactions to medicines
• the name, address, date of birth and NHS number of the patient

Additional Information in the SCR, such as details of long-term conditions, significant medical history, or specific communications needs, is now included by default for patients with an SCR, unless they have previously told the NHS that they did not want this information to be shared. There will also be a temporary change to include COVID-19 specific codes in relation to suspected, confirmed, Shielded Patient List and other COVID-19 related information within the Additional Information.

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.

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.

https://digital.nhs.uk/services/summary-care-records-scr

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

https://digital.nhs.uk/services/summary-care-records-scr/scr-patient-consent-preference-form

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.

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 or threatening behaviour 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 or have made a report to the police.

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.
• Repeated derogatory comments about the practice or individuals either verbally, in writing/digitally or on social media platforms

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.  If you are unhappy with the practice we have a complaints procedure to assist you or you have the choice to register with another practice – there really is no need for unpleasant behaviour with these options available to support you.

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