Practice Policies & Patient Information
Our staff are committed to providing quality healthcare for the benefit of all of our patients.
View our policies to see how this is achieved.
Accessing someone else’s information
Accessing someone else’s information
As a parent, family member or carer, you may be able to access services for someone else. We call this having proxy access. We can set this up for you if you are both registered with us.
To requests proxy access:
- collect a proxy access form from reception from 10am to 6pm
Linked profiles in your NHS account
Once proxy access is set up, you can access the other person’s profile in your NHS account, using the NHS App or website.
The NHS website has information about using linked profiles to access services for someone else.
Chaperones
The Surgery prides itself in maintaining professional standards. For certain examinations during consultations an impartial observer (a “Chaperone”) will be required.
This impartial observer will be a practice Nurse, Health Care Assistant or a member of our reception team who is familiar with the procedure and be available to reassure and raise any concerns on your behalf. If a nurse in unavailable at the time of your consultation then your examination may be re-scheduled for another time.
You are free to decline any examination or chose an alternative examiner or chaperone. You may also request a chaperone for any examination or consultation if one is not offered to you. The GP may not undertake an examination if a chaperone is declined.
The role of a Chaperone:
• Maintains professional boundaries during intimate examinations.
• Acknowledges a patient’s vulnerability.
• Provides emotional comfort and reassurance.
• Assists in the examination.
• Assists with undressing patients, if required.
Confidentiality
What do we record?
Information about you, your medical treatment, and family background may be recorded, either on paper or in computer files, as part of providing you with health services. This information is vital to the proper operation of the NHS, and is needed to give you and others the best possible healthcare.
What you can do?
Please read the rest of this notice in order to better understand how we use medical information about you. For further details please see information leaflet entitled “Your Information” displayed in the Practice or ask receptionist for details.
Other Agencies
The NHS is not the only government service to provide you with care, and it will be necessary for us to provide other agencies with appropriate information, but only with your consent (or that of your relatives if you are too ill).
How do we protect your information?
The sensitivity of patient information is well understood within the NHS. All staff and contractors are trained to respect their duty of confidentiality to you. We keep paper and electronic records securely to prevent unauthorised access or misuse. Wherever practicable, we also remove references to personal details such as your name and address, and often restrict it further to reduce the chances of anyone identifying a record as relating to you.
Other questions?
You can have a say in how the NHS uses information about you. If you want to find out more or have any concerns you can phone NHS Direct on 0845 4647 and request a booklet giving more details; go online at www.nhs.uk\confidentiality; or you can contact the Patient Liaison Team at the following address: Bromley PCT, Bassetts House, Broadwater Gardens, Orpington, Kent BR6 7UA. Tel. No. 01689 853339
Freedom of Information
The ICO has published a new Model Publication Scheme that all public authorities are required to adopt by 1st January 2009.
Model Publication Scheme – further information
How information about you helps us to provide better care.
Confidential information from your medical records can be used by the NHS to improve the services offered so we can provide the best possible care for everyone. This information along with your postcode and NHS number but not your name, are sent to a secure system where it can be linked with other health information. This allows those planning NHS services or carrying out medical research to use information from different parts of the NHS in a way which does not identify you. You have a choice. If you are happy for your information to be used in this way you do not have to do anything. If you have any concerns or wish to prevent this from happening, please see the leaflet “How information about you helps us to provide better care” in the waiting Room.
Useful Websites
Disability Access
If you have any special needs please let our staff know so that we can help and ensure you get the same support in the future.
Wheelchair access
Our premises have easy access, wide corridors, no steps, and a toilet for the disabled.
If you have any difficulty in using our facility do please ask a member of staff who will be pleased to assist you.
Disabled Parking – Blue Badge Scheme
The Blue Badge scheme is for people with severe mobility problems. It allows Blue Badge holders to park close to where they need to go.
Loop System
We have a loop induction system please ask reception for more details. For more information on the loop hearing system visit Hearing Link website.
• The Deaf Health Charity – SignHealth
• Royal Association for Deaf People
• National Deaf Children’s Society
Blind/Partially Sighted
If you or family members are blind or partially sighted we will try our best to provide help and assistance for you. If we cannot provide leaflets we will be very happy to explain and research information that you require. Just ask at reception and staff will either help directly or pass your request on to the Practice Manager.
For more advice and support for blind people please see the following websites:
• Royal National Institute of Blind People (RIND)
Guide Dogs
Guide dogs are welcome at the surgery with a bowl of water available upon request.
Other Disability Websites
• Disabled People, your Rights, Benefits, Carers and the Equality Act
• Living with a Disability NHS Choice
• Mencap
Freedom of Information
The Freedom of Information Act creates a right of access to recorded information and obliges a public authority to:
• Have a publication scheme in place
• Allow public access to information held by public authorities.
The Act covers any recorded organisational information such as reports, policies or strategies, that is held by a public authority in England, Wales and Northern Ireland, and by UK-wide public authorities based in Scotland, however it does not cover personal information such as patient records which are covered by the Data Protection Act.
Public authorities include government departments, local authorities, the NHS, state schools and police forces.
The Act is enforced by the Information Commissioner who regulates both the Freedom of Information Act and the Data Protection Act.
The Surgery publication scheme
A publication scheme requires an authority to make information available to the public as part of its normal business activities. The scheme lists information under seven broad classes, which are:
• who we are and what we do
• what we spend and how we spend it
• what our priorities are and how we are doing it
• how we make decisions
• our policies and procedures
• lists and registers
• the services we offer
You can request our publication scheme leaflet at the surgery.
Who can request information?
Under the Act, any individual, anywhere in the world, is able to make a request to a practice for information. An applicant is entitled to be informed in writing, by the practice, whether the practice holds information of the description specified in the request and if that is the case, have the information communicated to him. An individual can request information, regardless of whether he/she is the subject of the information or affected by its use.
How should requests be made?
Requests must:
• be made in writing (this can be electronically e.g. email/fax)
• state the name of the applicant and an address for correspondence
• describe the information requested.
What cannot be requested?
Personal data about staff and patients covered under Data Protection Act.
For more information see these websites:
GP Earnings
All GP practices are required to declare the mean earnings (e.g. average pay) for GPs working to deliver NHS services to patients at each practice.
The average pay for GPs working at The Bromley Common Practice in the last financial year was £108,512 last year (up to 31/3/20), before tax and National Insurance. This is for 1 full time GP and 4 part time GPs.
Please Note: NHS England require that the net earnings of doctors engaged in the practice is publicised, and the required disclosure is shown above. However it should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice, and should not be used to form any judgement about GP earnings, nor to make any comparison with any other practice.”
How We Use Your Information
To Provide You with Treatment
Doctors need to make notes about any diagnosis, test results, treatments including drugs prescriptions, and other information that you may provide, that seems relevant to the treatment of your condition. We need to keep this information in order to provide proper care for you (for later treatment, or if you should be seen by another doctor) and to allow others to check the treatment that you have received.
Nurses and other health professionals also need access to these records, and will add their own notes, as part of the overall healthcare provision. Secretaries, receptionists, and other clerical staff need access to some of your records in order to do administrative tasks, such as: booking appointments and communicating with you and other parts of the NHS.
Your doctor may also need to provide information under certain Acts of Parliament (e.g. the Communicable Diseases Act 1978, which is necessary to prevent the outbreak of certain highly contagious diseases) to protect you and others.
The Health Service
In order to manage the NHS, some restricted information concerning treatments, drugs prescribed, numbers of patients seen etc. is needed, and hospitals and general practices must provide this information in returns to various central bodies. This information has personal details such as your name and address removed wherever possible. It is necessary from time to time to check these returns to prevent fraud as part of the NHS’s statutory obligations. This may result in your being contacted by an NHS Fraud Office to see if you will consent to your records being checked. Only if you provide your consent will the auditors be allowed to access your records.
Teaching Clinicians
Some medical files are needed to teach student clinicians. Without such materials, new doctors and nurses would be not be properly prepared to treat you.
Planning
We need to be able to plan ahead about treatments, patient numbers, etc., but this uses summary information, not personal information.
Medical Research
Some medical research will require your direct involvement (especially if taking part in clinical trials) in which case the circumstances will be fully explained to you, and your express consent required. If you do not consent, then you will not be included in the trial.
Other researchers only require access to medical statistics, and can greatly improve our understanding of health, and how to treat patients more effectively. Generally, researchers only need information about groups of people, so that no individual information is apparent. In some cases, they need individual records, but wherever we can we will provide these in an anonymous form (so individuals cannot be identified). Sometimes, researchers need access to individual medical files. We will contact you first for your consent (and before this the researchers must present their case before an Ethics Committee to check that their research is appropriate and worthwhile). Rarely, it may not be practicable (or even possible) to contact individuals for their consent, in which case the researchers must make their case before a Confidentiality Committee to show that there is enough benefit to the public at large to justify this.
How do we manage your information?
We need to be able to move electronic information from system to system, extracting the data and modifying it for the next system. Occasionally, tests will need to be made on the data to check that it has been transferred correctly. This will only be done under carefully controlled conditions and all employees and contractors will be under strict contractual obligations to protect your confidentiality.
Incident Reporting
Practice staff should use the new GP e-form to report all patient safety incidents and near misses whether they result in harm or not.
These reports are used to spot any emerging patterns of similar incidents or anything of particular concern.
This will help protect patients by raising awareness of the risks through shared learning with general practices and other health providers across the country.
Infection Control Statement
We aim to keep our surgery clean and tidy and offer a safe environment to our patients and staff. We are proud of our modern, purpose built Practice and endeavour to keep it clean and well maintained at all times.
If you have any concerns about cleanliness or infection control, please report these to our Reception staff.
Our GPs and nursing staff follow our Infection Control Policy to ensure the care we deliver and the equipment we use is safe.
We take additional measures to ensure we maintain the highest standards:
- Encourage staff and patients to raise any issues or report any incidents relating to cleanliness and infection control. We can discuss these and identify improvements we can make to avoid any future problems.
- Carry out an annual infection control audit to make sure our infection control procedures are working.
- Provide annual staff updates and training on cleanliness and infection control
- Review our policies and procedures to make sure they are adequate and meet national guidance.
- Maintain the premises and equipment to a high standard within the available financial resources and ensure that all reasonable steps are taken to reduce or remove all infection risk.
- Use washable or disposable materials for items such as couch rolls, modesty curtains, floor coverings, towels etc., and ensure that these are laundered, cleaned or changed frequently to minimise risk of infection.
- Make Alcohol Hand Rub Gel available throughout the building
London Care Record GP Short Privacy Notice
This practice uses a shared record system called the London Care Record. The London Care Record is a secure view of your health and care information and lets health and care professionals involved in your care see important details about your health when and where they need them. Having a single, secure view of your information helps speed up communication between care professionals across London, improves the safety of care and can save lives.
London Care Record can only be lawfully looked at by staff who are directly involved in your care. Your information isn’t available to anyone who doesn’t need it to provide treatment, care and support to you. Your details are kept safe and won’t be made public, passed on to a third party who is not directly involved in your care, used for advertising or sold. For more information please read the London Care Record privacy notice for South East London here: The London Care Record – South East London ICS (selondonics.org)
Opting out of the London Care Record
You have the right to object to your information being available through London Care Record. Although patients have the right to object and request restrictions on sharing their records, there may be instances where this request will not be upheld due to a clinical need as determined by the direct care giver. Please discuss this with your GP/ health and social care worker and you can find further information in this London Care Record leaflet.
For further information and advice about data protection or your right to object to sharing your data you can contact the team at Lewisham and Greenwich Trust who manage the London Care Record for South East London www.lewishamandgreenwich.nhs.uk/london-care-record or you can call 020 3192 6011 and leave your name and number for someone to contact you.
If you have already requested to stop sharing on ConnectCare/Local Care Record in South East London, then you will not have to request this again for London Care Record.
Named GP
Each of our GP’s take a section of the alphabet for patients’ surnames and generally see these patients, for consistency purposes and will do any referrals onto specialists for these patients.
If you would like to book with your ‘named’ GP please see the list below.
However this is optional and you are free to book with the GP of your choice.
PATIENT ALPHABET SPLIT FROM 1st June 2023
| GP | ALPHABET |
| Dr Savi | C D F G I |
| Dr Vinyas | J L P W X Y Z |
| Dr Sriwardhana | H S T |
| Dr Kulkarni | K M N O Q U V |
| Dr Patel | A B R E |
New Patient Policy
We do not at present accept new registration from patients who reside outside of our registration area.
For further information about this type of registration, please contact us on 020 8466 9017 or feel free to come into the practice.
Non-NHS Work
What is non-NHS work and why is there a fee?
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 because the service is not covered by the NHS, for example, producing medical reports for insurance companies, to whom it may concern letters. The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. It is important to understand that many GPs are not employed by the NHS; they are self-employed and they have to cover their costs – staff, buildings, heating, lightning, etc. – in the same way as any small business.
In recent years, however, 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 ensure that information provided to them is true and accurate.
Examples of non-NHS services for which GPs can charge their own NHS patients are:
- accident/sickness certificates for insurance purposes
- school fee and holiday insurance certificates
- reports for health clubs to certify that patients are fit to exercise
- private prescriptions for travel purposes
Examples of non-NHS services for which GPs can charge other institutions are:
- life assurance and income protection reports for insurance companies
- reports for the Department for Work and Pensions (DWP) in connection with
- disability living allowance and attendance allowance
- medical reports for local authorities in connection with adoption and fostering
- copies of records for solicitors
Do GPs have to do non-NHS work for their patients?
With certain limited exceptions, for example a GP confirming that one of their patients is not fit for jury service, GPs do not have to carry out non-NHS work on behalf of their patients. Whilst GPs will always attempt to assist their patients with the completion of forms, they are not required to do such non-NHS work.
Is it true that the BMA sets fees for non-NHS work?
The British Medical Association (BMA) suggest fees that GPs may charge their patients for non-NHS work (i.e. work not covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested by them are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates they suggest.
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 or her patients. Most GPs have a very heavy workload and paperwork takes up an increasing amount of their time. Our GPs do non-NHS work out of NHS time at evenings or weekends so that NHS patient care does not suffer.
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. In order to complete even the simplest of forms, therefore, the doctor might have to check the patient’s ENTIRE medical record. Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council (the doctors’ regulatory body) or even the Police.
If you are a new patient we may not have your medical records so the doctor must wait for these before completing the form.
What will I be charged?
It is recommended that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual doctors to decide how much they will charge. The surgery has a list of fees based on these suggested fees which is available on request.
What can I do to help?
- Not all documents need a signature by a doctor, for example passport applications. You can ask another person in a position of trust to sign such documents free of charge. Read the information that comes with these types of forms carefully before requesting your GP to complete them.
- If you have several forms requiring completion, present them all at once and ask your GP if he or she is prepared to complete them at the same time to speed up the process.
- Do not expect your GP to process forms overnight: urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this may cost more. Usually non-NHS work will take 2 weeks.
Please click here to view non-NHS fees
Privacy Notice – Accurx
| As part of the Digital First National programme of work, GP Practices are required to provide a tool for patients to access primary care services.
The aim of the Accurx platform is to improve communications between healthcare staff and patients resulting in improved outcomes and productivity. The platform facilitates digital communications between the practice and our patients. If you have a non-urgent healthcare concern or need to contact the Practice for any medical or admin reason, click on the online via our website or via NHS app or via NHS website. Fill out the online form, which will then be reviewed and processed by our healthcare professionals to decide the right care for you. We will respond to online requests within 2 working days for medical queries and 5 working days for admin queries. Accurx is approved by NHS England to be used by GP practices and the other systems involved in patient care. NHS England has a lengthy assurance process to make sure they meet the highest standards of safety and security. Your data is safe and is shared only with your GP Practice for the purposes of your direct care. Your data is stored and sent securely using industry best practices, and Accurx only collect the data that is necessary to allow your GP Practice to provide you with care. The Practice uses the following Accurx features: · Online consultations · Video consultations · AccuMail · SMS · Friends and Family test · Record Views The Accurx privacy notice can be found on their website here: Accurx | Privacy Policy. |
|
| 1) Controller
contact details
|
Bromley Common Practice
|
| 2) Data Protection Officer contact details | GP Data Protection Officer |
| 3) Purpose of the processing | The aim of the Accurx platform is to improve communications between healthcare staff and patients resulting in improved outcomes and productivity. The platform facilitates digital communications between the practice and our patients. |
| 4) Lawful basis for processing | Under UK GDPR and DPA 2018 –
6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’. 9(2)(h) ‘…medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems…’ |
| 5) Recipient or categories of recipients of the shared data | Data may be shared with Accurx, and their sub-processors such as cloud services used for Accurx’ own storage, communications, security, engineering, and similar purposes. |
| 6) Rights to object | You have the right under Article 21 of the UK GDPR to object to your personal information being processed. Please contact the Practice if you wish to object to the processing of your data. You should be aware that this is a right to raise an objection which is not the same as having an absolute right to have your wishes granted in every circumstance. |
| 7) Right to access and correct | You have the right to access copies of the data that is being shared and have any inaccuracies corrected. There is no right to have accurate medical records deleted except when ordered by a court of Law. |
| 8) Retention period | The data will be retained for active use during the processing and thereafter according to NHS Policies and the law. |
| 9) Right to Complain. | You have the right to complain to us about the way your data is handled or processed. To so, please contact the Practice using the following details:
Bromley Common Practice Crown Medical Centre, 3 Mackintosh Street, Bromley BR2 9GT
If you remain unsatisfied with our response, you have a right to complain to the Information Commissioner’s Office. To do so, you can use this link https://ico.org.uk/make-a-complaint/data-protection-complaints/ or call their helpline Tel: 0303 123 1113 (local rate) or 01625 545 745 (national rate) There are National Offices for Scotland, Northern Ireland and Wales, (see ICO website). |
Registration Policy
Safe Surgeries – New Patient Registration Policy
Introduction
Patient registration is determined by the provisions of the practice GMS or PMS contract and terms of service. This policy is based on the NHS England Standard General Medical Service Contract, the General Medical Services Contract Regulations, Primary Medical Care Policy and Guidance Manual (PGM) and CQC guidance.
Practices are assumed to have open lists unless they have complied with the procedures for list closure as detailed in the General Medical Services Contracts Regulations. Where a practice has an open list it is required to:
- accept the registration of a new patient unless it has fair and reasonable grounds for not doing so
- accept allocations by the ICB to its list.
The practice can formally close their list to new patients by requesting permission from its commissioner. Formal list closure lasts between three to twelve months, and cannot last less than three months.
In some cases, it may be possible to request an ‘informal’ or ‘temporary’ list closure, lasting less than three months, for example where staffing difficulties result in suspension of registrations being necessary. GMS and PMS contracts do not allow for these types of list closures, but taking into consideration possible risk to patient care, the practice can discuss these circumstances with their commissioner, who can either provide further support or approve temporary closure, if appropriate.
Patient Choice of GP Practice
From 5th January 2015, all GP practices in England are free to register new patients who live outside their practice boundary area, without obligation to provide home visits. This will provide patients with greater choice and aims to improve the quality of access to GP services.
Patients may wish to register as out of area patients to:
- register with a practice in more convenient locations, such as a practice near their work or closer to their children’s schools, or they reside within the area during the week, but their permanent address is in another area
- stay registered with their current GP if they have moved home but do not want to change GP
- register in an area with better access to services
These new arrangements are voluntary for GP practices. If the practice has no capacity at the time, or feels it is not clinically appropriate or practical for patients to be registered so far away from their home address, they can still refuse registration for out of area patients. The practice should explain their reason for refusing registration to patients. When registration is refused, patient choice is not fully realised.
Digital registration and PMS1 new form
An online registration service and corresponding paper form, developed by NHS England is now available to all practices in England to use. More information here.
All GP surgeries in England must offer the national NHSE ‘Register for a GP surgery’ service and new paper registration form from 31st October 2024. The GMS1 form is being phased out and will not be available to order, or access online from 31 October 2024.
It is possible for patients to register via paper form or digital/online and practices should make clear to patients the different ways in which they can register with the practice. Updates to the GP contract in 2022/2023 removed the need for a patient to provide a wet signature for registration. The new PRF1 paper form which aligns with the online service is available here.
New Patient Acceptance/Refusal
Practices should ensure there is equitable access for all patients who wish to register with them. Registration should be available to all patients every day rather than on particular days and throughout the practice’s advertised opening hours. Where possible, it is good practice for practices to provide pre-registration documentation in advance, e.g. to help patients understand the practice and the services they deliver.
The practice will accept patients onto its list while it remains “open”. If the list is closed, the practice will only accept registrations of immediate family members of patients who are already registered and only if such relatives reside permanently at the registered patient’s address.
Under the terms of their primary medical services contracts, GP practices cannot refuse an application to join its list of NHS patients on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.
The practice will, however, refuse registration if the commissioner has agreed that they can close their list to new patients. The practice can also refuse registration (subject to a partners’ discussion and agreement) if:
- The patient lives outside the practice boundary
- If they have other reasonable grounds
The reason for refusal will be in writing and recorded in a permanent record for that purpose. This excludes temporary residents, where no record is necessary. The permanent record will consist of the original PMS1 registration form endorsed with the reason for refusal, together with a copy of the refusal letter, filed in surname order. Where a PMS1 has not been completed, a “dummy” PMS1 will be prepared and filed. The record is subject to inspection by the ICB, who may require the practice to justify a refusal to register.
ID and Proof of Address
There is no regulatory requirement to prove identity, address, immigration status or the provision of an NHS number in order to register. ID and/or proof of address may be requested to assist with the administrative process, but the practice must apply the same process for requesting documents to all patients requesting registration equally.
The majority of patients will not find it difficult to produce documents. However, there will be some patients who do live in the practice area, but are legitimately unable to produce any of the listed documentation. Examples include:
- People fleeing domestic abuse staying with friends, family or in a shelter
- People living on a boat, in unstable accommodation or street homeless
- People staying long term with friends but who aren’t receiving bills
- People working in exploitative situations whose employer has taken their documents
- People who have submitted their documents to the Home Office as part of an application
- People trafficked into the country who had their documents taken on arrival
- Children born in the UK to parents without documentation.
Reasonable exceptions need to be considered and the individual registered with sensitivity to their situation. As there is no requirement under the regulations to produce identity or residence information, the patient MUST be registered on application unless the practice has reasonable grounds to decline, as outlined above. Lack of ID/ proof of residence would not be considered reasonable grounds to refuse to register a patient and access to appointments should not be withheld in these circumstances. If a patient cannot produce any supportive documentation but states that they reside within the practice boundary then practices should accept the registration.
Where necessary, (e.g. homeless patients), the practice may use the practice address to register the patient, putting CO (care of) at the start of the address (as per CQC and PCSE advice). If possible, the practice should try to ensure they have a way of contacting the patient if they need to (for example with test results).
If a practice suspects a patient of fraud (such as using fake ID) then they should register and treat the patient but hand the matter over to the NHS Counter Fraud Authority (NHSCFA).
- NHS Counter Fraud Authority Reporting Line: 0800 028 4060
- report to the NHSCFA using the online NHS fraud reporting tool
- by post to the NHS Counter Fraud Authority, Skipton House, 80 London Road, London, SE1 6LH
Access to online services
Should any patient request online access, then confirmation of identify is required via the following methods:
- Documentation
- Personal vouching
- Vouching with confirmation of information held in the patient record
More detail can be found in the guidance here.
Temporary Residents
If a patient is resident in the practice area for more than 24 hours, but less than three months, they should be offered the option of registering as a temporary patient. In some cases (e.g. someone housed in temporary accommodation) a prospective patient may not know how long they will reside in the area.
Please note: If there is uncertainty around the length of time a patient will reside in the practice area, NHS England advises that the patient should be registered as a permanent patient. For example, asylum seekers residing in Home Office accommodation should be registered as permanent patients.
Emergency Treatment
All GP practices have a contractual duty to provide emergency treatment and immediately necessary treatment free of charge for up to 14 days. This applies to any person within their practice area who:
- Has been refused application for inclusion in the practice’s list of patients
- Is not registered with another provider of essential services
- Has had their application for acceptance as temporary resident rejected
Support and Additional Needs
If a prospective patient requires additional support in order to register, the practice will do its best to accommodate this. This includes (but is not limited to):
- Walking them through the registration process in a more private area of the practice
- Using a translator/ interpreter
- Noting any accessibility requirements on the patient’s record so that the practice team is aware and can support them as necessary.
Once the patient is registered, the patient may benefit from other forms of support, including but not limited to:
- Provision of double appointments
- Reducing/ increasing prescription duration as necessary
- Promoting clear boundaries for consultations
- Providing fast access to a named GP
- Waiving normal charges for housing letters or medical reports
Ensuring services are accessible to everyone who needs them is mandatory. This includes following the Accessible Information Standard and provision of interpreting and translation services.
Registering Vulnerable Groups
Children
If a child under the age of 16 attempts to register alone, or with an adult who does not have parental responsibility for the child, the safeguarding lead Dr Savithri Wijayatilake should be informed.
It is recommended that the GP practice gains assurance by:
- Obtaining proof of identity for each child registering (e.g. a passport, or birth certificate). If a child does not have any form of ID, this should not prevent them from being registered. In this case, register the child, but ensure that the safeguarding lead is made aware of the registration.
- Ensuring that an adult with parental responsibility is present at registration (and that they can prove parental responsibility).
- Offering a child a new patient health check
- Obtaining supporting documentation from other official sources (e.g. previous GP, social workers etc).
Where any doubt exists, the GP surgery’s safeguarding lead is to be informed and appropriate actions taken.
People with Insecure Immigration Status
Everyone in England, regardless of their immigration status, is entitled to free primary care and to register with a GP. This includes temporary visitors/ tourists, asylum seekers, refugees and other vulnerable migrants. A patient does not need to be ‘ordinarily resident’ in the country to be eligible for NHS primary medical services – this only applies to secondary (hospital) care. In effect, therefore, anybody in England may register and consult with a GP without charge.
When registering a patient, do not ask about their immigration status, or to see proof of it. People seeking asylum should be registered as permanent patients.
The PMS1 registration form includes supplementary questions about immigration status. These questions are optional – patients do not have to complete this section if they do not want to and this should be communicated clearly to patients. If a patient does opt to complete this section, they should not be asked to provide proof for the information they have provided.
People Experiencing Homelessness
Individuals experiencing homelessness, those without a fixed address, or afraid to share their address, should be registered under either:
- an address of their choosing (e.g. a friend’s address, religious institution, or community centre). Advise the patient that they may receive confidential medical letters to this address, and that they should have the occupier’s consent
- under the practice address. When registering the patient, enter the full address, including postcode for the GP practice, putting ‘Care of’ at the start of the address. Writing ‘no fixed abode’ in any field will cause the registration request to be rejected.
Ensure that patients are advised to regularly check for post at the address they are registered at, so as not to miss any important medical correspondence (e.g. secondary care appointments).
Duty to refer
The Homelessness Reduction Act (2017) came into force in 2018. It places renewed emphasis on homelessness prevention. Section 10 requires public authorities in England to notify a local housing authority (LHA) of service users they think may be homeless or at risk of becoming homeless.
This statutory duty to refer applies to:
- NHS organisations that provide inpatient care
- emergency departments
- urgent treatment centres.
It is not mandatory for primary care providers. However, it is still beneficial for GP practices to refer patients who are homeless, or are at risk of becoming homeless, to a local housing authority for further support.
Referrals must include:
- the service user name
- their contact details and
- an agreed reason for referring the user.
You can refer without consent to safeguard children and vulnerable adults. Guidance on the duty to refer can be found here.
Patients About to be Released from Prison
The process for registering patients prior to their release from the “secure residential estate” which includes prison, immigration removal centres, young offender institutions or secure training centres, is outlined here.
Veterans
Ex-service personnel or reservists will be provided with copies of their medical records by DPHC (Defence Primary Health Care) on leaving the Armed Forces and becoming a veteran. These records should be given to their new GP practice on registering.
Armed Forces veterans are entitled to priority treatment if their injury or condition came about because of their service (subject to clinical need). This is regardless of whether they receive a war pension. Further guidance can be found here and here.
When registering veterans, the following SNOMED code should be entered at the time of registration: Military veteran SCTID: 753651000000107. Having this code will enable access to specialist care or charity support as necessary for the patient.
Mental Capacity Act
If a person is unable to register because they are unable to make decisions about their care, registration can be done by:
- A relative
- The main carer
- A lasting power of attorney
- A person appointed by a court under the Mental Capacity Act
NHS Health Checks and New Patient Health Checks
All newly registered patients should be offered a New Patient Health Check. Some patients may also be entitled to an NHS Health Check. It is a contractual requirement that once registered all patients must be invited to participate in a new patient check however neither registration nor clinical appointments should be delayed because of the unavailability of a new patient check appointment.
Please also see translated patient health questionnaires for people seeking asylum and refugees which can be shared during registration to improve efficiency and effectiveness of New Patient Health Checks.
Using the New Patient Questionnaire (or a locally-developed version), Health Care Practitioners should record on clinical systems, using the above SNOMED codes, whether the Initial Health Assessment has taken place or been declined.
- 1874651000000105 | Initial health assessment using New Patient Questionnaire for newly arrived migrants in the United Kingdom (procedure)
- 1874641000000107 | Initial health assessment using New Patient Questionnaire for newly arrived migrants in the United Kingdom declined (situation)
Further Resources and Guidance
- NHS guidance:
– How to register with a GP surgery
– Asylum seeker and refugee one–page registration guide
– Primary Medical Care Policy and Guidance Manual (PGM) - BMA support:
– Guidance on patient registration
– Toolkit for asylum seekers and refugees - PCSE support:
– PCSE guidance on registration
– PCSE contact details and enquiries form - CQC guidance:
– Registration mythbusters
– Registration of migrants, asylum seekers and refugees
– People experiencing homelessness - OHID Migrant Health Guide
- Doctors of the World
– Safe Surgeries network
– Quick reference poster for reception staff
– Patient health questionnaires for refugees and people seeking asylum
Sign up for updates, events and resources. More information on the Safe Surgeries programme can be found at https://www.doctorsoftheworld.org.uk/safesurgeries/.
Contact us at safesurgeries@doctorsoftheworld.org.uk.
Statement of Intent
New contractual requirements came into force from 1 April 2014 requiring that GP Practices should make available a statement of intent in relation to the following IT developments:
- Summary Care Record (SCR)
- GP to GP Record Transfers
- Patient Online Access to Their GP Record
- Data for commissioning and other secondary care purposes
The same contractual obligations require that we have a statement of intent regarding these developments in place and publicised by 30 September 2014.
Please find below details of the practices stance with regards to these points.
Summary Care Record (SCR)
NHS England require practices to enable successful automated uploads of any changes to patient’s summary information, at least on a daily basis, to the summary care record (SCR) or have published plans in place to achieve this by 31st of March 2015.
Having your Summary Care Record (SCR) available will help anyone treating you without your full medical record. They will have access to information about any medication you may be taking and any drugs that you have a recorded allergy or sensitivity to.
Of course, if you do not want your medical records to be available in this way then you will need to let us know so that we can update your record. You can do this via the opt out form.
The practice confirms that your SCR is automatically updated on at least a daily basis to ensure that your information is as up to date as it can possibly be.
GP to GP Record Transfers
NHS England require practices to utilise the GP2GP facility for the transfer of patient records between practices, when a patient registers or de-registers (not for temporary registration).
It is very important that you are registered with a doctor at all times. If you leave your GP and register with a new GP, your medical records will be removed from your previous doctor and forwarded on to your new GP via NHS England. It can take your paper records up to two weeks to reach your new surgery.
With GP to GP record transfers your electronic record is transferred to your new practice much sooner.
The practice confirms that GP to GP transfers are already active and we send and receive patient records via this system.
Patient Online Access to Their GP Record
NHS England require practices to promote and offer the facility to enable patients online access to appointments, prescriptions, allergies and adverse reactions or have published plans in place to achieve this by 31st of March 2015.
We currently offer the facility for booking and cancelling appointments and also for ordering your repeat prescriptions and viewing a summary of your medical records on-line. If you do not already have a user name and password for this system – please register your interest with our reception staff.
Data for commissioning and other secondary care purposes
It is already a requirement of the Health and Social Care Act that practices must meet the reasonable data requirements of commissioners and other health and social care organisations through appropriate and safe data sharing for secondary uses, as specified in the technical specification for care data.
At our practice we have specific arrangements in place to allow patients to “opt out” of care.data which allows for the removal of data from the practice. Please see the page about care data on our website
The Practice confirm these arrangements are in place and that we undertake annual training and audits to ensure that all our data is handled correctly and safely via the Information Governance Toolkit.
Suggestions, Comments and Complaints
We make every effort to give the best service possible to everyone who attends our practice.
In the majority of cases the best way to resolve your concerns as quickly as possible is with the front line staff or the service or organisation that you are complaining about.
However, we are aware that things can go wrong resulting in a patient feeling that 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.
Simply contact the Practice Manager preferably in writing via our Contact Us page or by completing a complaints form available in surgery, and she/he will set all the necessary wheels in motion. Alternatively please visit our feedback form if you have any suggestions.
We are continually striving to improve our service. Any helpful suggestions would be much appreciated and a suggestion box is located in the waiting area.
Summary Care Records
About your Summary Care Record
Your Summary Care Record contains important information about any medicines you are taking, any allergies you suffer from and any bad reactions to medicines that you have previously experienced.
Allowing authorised healthcare staff to have access to this information will improve decision making by doctors and other healthcare professionals and has prevented mistakes being made when patients are being cared for in an emergency or when their GP practice is closed.
Your Summary Care Record also includes your name, address, date of birth and your unique NHS Number to help identify you correctly.
You may want to add other details about your care to your Summary Care Record. This will only happen if both you and your GP agree to do this. You should discuss your wishes with your GP practice.
Healthcare staff will have access to this information, so that they can provide safer care, whenever or wherever you need it, anywhere in England.
FAQs
Who can see my Summary Care Record?
Healthcare staff who have access to your Summary Care Record:
• need to be directly involved in caring for you
• need to have an NHS Smartcard with a chip and passcode
• will only see the information they need to do their job and
• will have their details recorded every time they look at your record
Healthcare staff will ask for your permission every time they need to look at your Summary Care Record. If they cannot ask you (for example if you are unconscious or otherwise unable to communicate), healthcare staff may look at your record without asking you, because they consider that this is in your best interest.
If they have to do this, this decision will be recorded and checked to ensure that the access was appropriate.
What are my choices?
You can choose to have a Summary Care Record or you can choose to opt out.
If you choose to have a Summary Care Record and are registered with a GP practice, you do not need to do anything as a Summary Care Record is created for you.
If you choose to opt out of having a Summary Care Record and do not want a SCR, you need to let your GP practice know by filling in and returning an opt-out form which can be optained from your GP practice.
If you are unsure if you have already opted out, you should talk to the staff at your GP practice.
You can change your mind at any time by simply informing your GP and they can create a Summary Care Record for you.
Children and the Summary Care Record
If you are the parent or guardian of a child under 16, you should make this information available to them and support the child to come to a decision as to whether to have a Summary Care Record or not.
If you believe that your child should opt-out of having a Summary Care Record, we strongly recommend that you discuss this with your child’s GP. This will allow your child’s GP to highlight the consequences of opting-out, prior to you finalising your decision.
Where can I get more information?
For more information about Summary Care Records you can:
• talk to the staff at your GP practice
• phone the Health and Social Care Information Centre on 0300 303 5678
• Read the Summary Care Record patient information
Training Practice
The Surgery is an approved training practice for the training of General Practice Registrars (GPRs). Being an approved training practice means that:
- patients can directly contribute to the training of future GPs
- patients who consult with the GPR will have longer consultations
- it keeps all doctors and nurses keep in touch with new medical developments and skills
- It improves all doctors and nurse’s consultation and training skills
- It ensures that clinical standards and standards of medical record keeping are maintained
- It helps with recruitment of high quality doctors to the practice for job vacancies
GPRs are doctors in training who are qualified doctors and have already worked in hospitals as junior doctors for at least 3 years and have now decided that they would like to specialise in General Practice.
In order to qualify as a GP all doctors have to complete Postgraduate Specialist Training which includes at least 18 months training in General Practice.
The practice will be regularly assessed for its suitability for postgraduate training in general practice. This process includes an inspection of medical records for quality, NOT content. If you object to your record being seen for this process then you must let us know in writing so these notes can be withdrawn.
An essential component of training in all medical practice is the use of video and consultations with the both the GPR and the trainer present. We hope that all our patients will be willing to take part in these educational consultations to help us all in improving and maintaining our medical and consultation skills. All video recordings are strictly confidential and are used for teaching only. We will not video your consultation without your consent. Please inform Reception if you would prefer not to participate.
Your Rights and Responsibilities
Patient’s Rights
We are committed to giving you the best possible service. This will be achieved by working together. Help us to help you. You have a right to, and the practice will try to ensure that:
- You will be treated with courtesy and respect
- You will be treated as a partner in the care and attention that you receive
- All aspects of your visit will be dealt with in privacy and confidence
- You will be seen by a doctor of your choice subject to availability
- In an emergency, out of normal opening hours, if you telephone the practice you will be given the number to receive assistance, which will require no more than one further call
- You can bring someone with you, however you may be asked to be seen on your own during the consultation
- Repeat prescriptions will normally be available for collection within two working days of your request
- Information about our services on offer will be made available to you by way of posters, notice boards and newsletters
- You have the right to see your medical records or have a copy subject to certain laws.
Patient’s Responsibilities
With these rights come responsibilities and for patients we would respectfully request that you:
- Treat practice staff and doctors with the same consideration and courtesy that you would like yourself. Remember that they are trying to help you
- Please ensure that you order your repeat medication in plenty of time allowing 48 working hours.
- Please ensure that you have a basic first aid kit at home and initiate minor illness and self-care for you and your family.
- Please attend any specialist appointments that have been arranged for you or cancel them if your condition has resolved or you no longer wish to attend
- Please follow up any test or investigations done for you with the person who has requested the investigation
- Attend appointments on time and check in with Reception
- Patients who are more than 20 minutes late for their appointment may not be seen.
- If you are unable to make your appointment or no longer need it, please give the practice adequate notice that you wish to cancel. Appointments are heavily in demand and missed appointments waste time and delay more urgent patients receiving the treatment they need
- An appointment is for one person only. Where another family member needs to be seen or discussed, another appointment should be made
- Patients should make every effort to be present at the surgery to ensure the best use of nursing and medical time. Home visits should be medically justifiable and not requested for social convenience
- Please inform us when you move home, change your name or telephone number, so that we can keep our records correct and up to date
- Read the practice leaflets and other information that we give you. They are there to help you use our services. If you do not understand their content please tell us
- Let us have your views. Your ideas and suggestions, whether complimentary or critical, are important in helping us to provide a first class, safe, friendly service in pleasant surroundings.
NHS Constitution
The NHS Constitution establishes the principles and values of the NHS in England. For more information see these websites:
Zero Tolerance
The practice fully supports the NHS Zero Tolerance Policy. The aim of this policy is to tackle the increasing problem of violence against staff working in the NHS and ensures that doctors and their staff have a right to care for others without fear of being attacked or abused.
We understand that ill patients do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint. We ask you to treat your doctors and their staff courteously and act reasonably.
All incidents will be followed up and you will be sent a formal warning after a second incident or removed from the practice list after a third incident if your behaviour has been unreasonable.
However, aggressive behaviour, be it violent or verbal abusive, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police will be contacted if an incident is taking place and the patient is posing a threat to staff or other patients.
Removal from the Practice List
A good patient-doctor relationship, based on mutual respect and trust, is the cornerstone of good patient care. The removal of patients from our list is an exceptional and rare event and is a last resort in an impaired patient-practice relationship. When trust has irretrievably broken down, it is in the patient’s interest, just as much as that of The Surgery, that they should find a new practice. An exception to this is on immediate removal on the grounds of violence e.g. when the Police are involved.
Removing other members of the household
In rare cases, however, because of the possible need to visit patients at home it may be necessary to terminate responsibility for other members of the family or the entire household. The prospect of visiting patients where a relative who is no longer a patient of the practice by virtue of their unacceptable behaviour resides, or being regularly confronted by the removed patient, may make it too difficult for the practice to continue to look after the whole family. This is particularly likely where the patient has been removed because of violence or threatening behaviour and keeping the other family members could put doctors or their staff at risk.