Introduction

In accordance with the General Data Protection Regulation, patients (data subjects) have the right to access their data and any supplementary information held by The Surgery Kingstone this is commonly known as a data subject request (DSAR). Data subjects have a right to receive;

• Confirmation that their data is being processed
• Access to their personal data
• Access to any other supplementary information held about them

Options for access

1. Patient Access As of April 2016, Practices have been obliged to allow patients access to their health record online. Patient Access enables patients to book/cancel appointments, order repeat medication and view coded information held in their health record.

Coded information viewable online includes: allergies/adverse reactions, medication, immunisations, test results, values (e.g height, weight), problems/diagnoses, signs & symptoms and referral codes.

Signing up for Patient Access is straightforward, you need to visit the Practice with evidence of your identity and a secure account will be set up. For more information on how online access works please see our website or ask at Reception.

2.Copies of medical records You can make a request to be provided with copies of your health record. To do so, you must submit a Data Subject Access Request (DSAR) form; this is available to download on the Practice website. Alternatively, a paper copy of the DSAR is available from Reception. You will need to return the completed DSAR to the Practice with evidence of your identity. Patients do not have to pay a fee for copies of their records.

Time frame

Once the DSAR form is submitted and identity has been verified, The Surgery Kingstone will process the request. The maximum time permitted to process DSARs is one calendar month. However, if the information request is complex we are allowed to extend this by a further two months. We have to notify you and explain the reason why an extension is necessary within one month of receiving the DSAR.

Exemptions

There may be occasions when the data controller will withhold information kept in the health record, particularly if the disclosure of such information is likely to cause undue stress or harm to you or any other person.

Data controller

The Surgery Kingstone is the data controller for medical records of registered patients. Should you have any questions relating to accessing your medical records, please ask to discuss this with Practice Manager.

If you would like to request access to personal information, please complete the following form.

We aim to provide a personal, friendly and high quality service; if you have any complaints or suggestions to improve our service, please fill in one of our comments forms, available in the waiting room, or speak to or email our Practice Manager via kingstone.surgery@nhs.net.

Alternatively, speak to one of the GP partners. We will treat any complaint seriously and will aim to resolve it as soon as possible.

NHS England can advise you about your complaint on behalf of the Herefordshire and Worcestershire Integrated Care Board (ICB). This service is free of charge. The team can be contacted at:

• Post: Patient and Stakeholder Liaison Team
  NHS Herefordshire and Worcestershire
  Kirkham House
  John Comyn Drive
  Perdiswell
  Worcester
  WR3 7NS
• Telephone: 0330 053 4356
• E-mail: hwicb.kingstonecomplaints@nhs.net

You may also contact the Independent Health Complaints Advocacy Service (IHCAS) for help with making your complaint. In Herefordshire, this service is provided by Onside Advocacy, a local charity, which is a free and independent service and totally independent of the NHS. It provides free, confidential support, help and advice to NHS patients or their representatives on all aspects of complaints relating to the NHS. Click here for a guide to making an NHS complaint, made by Onside Advocacy. Contact details:

• Address: Onside IHCA, Williamson House, 14 Charles Street, Worcester, WR1 2AQ
• Tel: 01905 27525 (09:00 – 17:00 Monday – Thursday and 09:00 – 16:00 on a Friday)
• Email: gateway@onside-advocacy.org.uk

Your medical information is personal to you and often contains sensitive information that you may not wish to be shared with others. This is a controversial area but you can decide whether or not this is shared.

Summary Care Record

The idea of this is that information about your medications and allergies could be seen by staff in hospitals all over the country. You would have to be asked at the time and you could say no if you wish.

Local Health Record Network

This is a local scheme to share information about you and your medical conditions within the county, at out of hours centres and the County Hospital. It has not yet started, and you would have to be asked and agree each time your records were accessed. We support this system.

National Data Opt-Out

Your health and care information is used to improve your individual care. It is also used to help the NHS research new treatments, decide where to put GP clinics and plan for the number of doctors and nurses in your local hospital. You can choose to opt-out of sharing your confidential patient information for research and planning by visiting www.nhs.uk/your-nhs-data-matters or telephoning 0300 303 5678. Please note we cannot process an opt-out on your behalf. You will need your NHS number to opt out.

 Herefordshire & Worcestershire Shared Care Record – Privacy Policy (July 2022) 

Parties signatory to the Collaborative Shared Care Record DSA

Privacy Notice

If you wish to opt out of any of these then please tell us. We are happy to accept a phone call or a message in person and do not need a form.

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

The average pay for GPs working in Kingstone surgery in the last financial year was £49,406 before tax and National Insurance. This is for 1 full time GP, 5 part time GPs and 1 locum GP who have worked in the practice for more than six months.

NHS England require that the net earnings of doctors engaged in the practice is publicised, and the required disclosure is shown below. However, it should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice and should not be used to form any judgement about GP earnings, nor to make any comparison with any other practice.

Sharing records to improve patient care in Herefordshire
Herefordshire patients will soon benefit from an improved digital sharing system called
Herefordshire One Record.

This will enable sharing of patient records between GPs and other health care
professionals in the county to ensure patients get the best possible treatment when
needed.

Patient information is often only available within a single organisation. Herefordshire
One Record will allow health care professionals in multiple organisations in
Herefordshire to view patient records.

• The following organisations will soon have access to the electronic systems to share
  information:
• Herefordshire GP Practices
• Wye Valley NHS Trust
• St Michael’s Hospice
• Taurus Healthcare (for extended and out-of-hours GP services)

In addition, 2gether NHS Foundation Trust will also have access to view the records
shared by the above organisations. For more information, please click on the link below

https://www.herefordshireccg.nhs.uk/news-events/346-sharing-records-to-improve-patient-care-inhere

Infection Prevention and Control is the work an organisation does to identify potential risks for spread of infection between patients (and between patients and staff) and to take measures to reduce that risk.

The Practice takes its responsibility to do this very seriously. All staff take responsibility for their own role in this and all staff receive regular training in their role in Infection Prevention Control.

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 annually to make sure they are adequate and meet
the national guidance.
• Maintain the premises and equipment to a high standard and ensure that all reasonable
steps are taken to reduce or remove all infection risk.
• Equipment is disposable where possible e.g. couch rolls, privacy curtains, hand towels
etc.
• All other non-disposable equipment is cleaned according to the manufacturer’s
guidelines to reduce the risk of infection.
• Make Alcohol Hand Rub Gel available throughout the practice for staff and visitors.
Purpose of annual statement In line with the Department of health, the Health and Social Care Act 2008: Code of Practice on Prevention and Control of Infection and its Related Guidance (2015), the practice annual statement will be generated each year.
It will summarise:
• Any infection transmission incidents and any action taken (these will have been reported
in accordance with our Significant Events Report procedures).
• Details of any infection control audits undertaken and actions taken.
• Details of any infection control risk assessments undertaken.
• Details of staff training.
• Any review and update of policies, procedures and guidelines.
Infection Prevention Control leads (IPC) Leads
Nurse Lead/ Infection Prevention Control Lead: Sonia Trickett
Practice Manager: Dee Price
Infection Transmission incidents (Significant Events):
Significant Events (which may involve examples of good practice as well as challenging events) are investigated in detail to see what can be learnt and to indicate any changes that might lead to future improvements. All significant events are reviewed and discussed in the monthly clinical meetings with GPs/Nurses/Surgery leads and learning cascaded to all staff.
Infection control is also discussed at the all staff team biannual meeting
During 2023 Kingstone Surgery had no Significant Events reported relating to Infection
Prevention Control.
Infection Prevention Control Audit and Actions
The latest Annual Infection Prevention Control Audit was completed in December 2023. This involves comprehensive review of all aspects of infection prevention control within the surgery.

As a result of this audit, the following changes were made at Kingstone Surgery:
• Reminder to staff to have a clear desk policy for adequately cleaning of desks and work
spaces each day and declutter spaces.
• Reminder to all staff that it is their responsibility to clean any equipment and the area they
are working appropriately.
• Direct meeting with cleaning staff to review their cleaning processes, schedule. Clearly labelled colour coded cleaning equipment for specific areas of the building
• Regular reviews of staff Infection Prevention Control training schedules.
• Minimal handling of patient specimens by reception staff, to utilise the specimen bag when
patient hand over and samples
• Monthly audit performed
• PPE holders in all clinical rooms

Kingstone Surgery will continue to undertake the following audits in 2024:
• Annual Comprehensive Infection Prevention Control Environment, policies and practices
audit and action plan
• Building Audit
• Hand Hygiene Audit
• Audit of Sharps Policy
• Aseptic Technique competency Audits
• Waste Management Audit

Training
All our staff attend annual training on-line for infection Prevention and Control.

Policies
All infection Prevention Control related policies are in date for this year 2024.
Policies relating to Infection prevention control are available to all staff and are accessible. They are reviewed and updated annually and are amended on an on-going basis as current advice, guidance and legislation changes.

COVID 19
During the Covid 19 Pandemic, as a practice we responded quickly and efficiently to the new Government Guidelines and followed strategic operational plans:
Patients triaged by phone and only asked to attend the surgery if the clinician felt the
appointment was urgent.

PPE – Personal Protective Equipment was readily available to protect our patients and staff, face masks were worn by all staff moving about the building and in shared office spaces, everyone was encouraged to observe social distancing rules at all times
As the pandemic progressed further changes were made throughout the building.
Protocols were implemented and many patients were reviewed in their cars and telephone
consultations were key.
Staff reviewed patients in Full PPE including FFP3 masks.
Home visits were conducted in full PPE.

Although restrictions have now eased for the country – we continue advise if symptoms of
upper respiratory infections present then use of a fresh face mask and handwashing/alcohol gel for anyone entering the building. Face masks and correct PPE is still worn when the clinician feels this is appropriate. Face masks are provided on request for anyone from reception.

If you have any concerns about cleanliness or infection control within Kingstone Surgery, please
report this to our reception staff.
Sonia Trickett
Infection Control Lead
12th March 2024
Approved and Reviewed by Charlie Rankin – Practice Manager

All personal health information is treated with the utmost confidentiality, in accordance with current legislation. Under the General Data Protection Regulations, you are entitled to know what information we hold about you and you can contact the Practice Manager to do this. Please also refer to our following privacy notices:

• Data Protection Privacy Notice
• Fair Processing & Privacy Notice
• Privacy Notice for Children

We aim to treat our patients courteously at all times and expect our patients to treat our staff in a similarly respectful way. We take seriously any threatening, abusive or violent behaviour against any of our staff or patients. If a patient is violent or abusive, they will be warned to stop their behaviour. If they persist, we may exercise our right to take action to have them removed, immediately if necessary, from our list of patients.

How can I see a private consultant or clinician?

Most private specialists will want a referral letter from your NHS GP. This is usually to make sure that you are booked to see an appropriate clinician and they have your full health information. We will do a private referral letter free of charge. We will have to charge for any insurance forms.

What happens if the private doctor prescribes me medication?

You will need to pay for this medication privately (ie you will not get an NHS prescription).

Sometimes private doctors ask NHS GPs to carry on prescribing after the first prescription. We can only do this if it is a medication we are competent and trained to prescribe. Specialist medication that needs ‘shared care’ between GP and the specialist consultant, cannot be prescribed by GPs in Kingstone. A more in depth explanation is below in blue.

What happens after my private consultation?

We hope your specialist will write you a letter summarising your consultation, and will cc us into this. This is important both for your information, and for ours. it will ensure smooth tied in care. If this does not happen, please contact their secretary and request this

ZERO TOLERANCE

The Practice takes it very seriously if a member of staff or one of the doctors or nursing team is treated in an abusive or violent way.

The Practice supports the government’s ‘Zero Tolerance’ campaign for Health Service Staff. This states that GPs and their staff have a right to care for others without fear of being attacked or abused. To successfully provide these services a mutual respect between all the staff and patients has to be in place. All our staff aim to be polite, helpful, and sensitive to all patients’ individual needs and circumstances. They would respectfully remind patients that very often staff could be confronted with a multitude of varying and sometimes difficult tasks and situations, all at the same time.  The staff 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.

However, aggressive behaviour, be it violent or abusive, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police being contacted.

In order for the practice to maintain good relations with their patients the practice would like to ask all its patients to read and take note of the occasional types of behaviour that would be found unacceptable:

• Using bad language or swearing at practice staff
• Any physical violence towards any member of the Primary Health Care Team or other patients, such as pushing or shoving
• Verbal abuse towards the staff in any form including verbally insulting the staff
• Racial abuse and sexual harassment will not be tolerated within this practice
• Persistent or unrealistic demands that cause stress to staff will not be accepted. Requests will be met wherever possible and explanations given when they cannot
• Causing damage/stealing from the Practice’s premises, staff or patients
• Obtaining drugs and/or medical services fraudulently

We ask you to treat your GPs and their staff courteously at all times.

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. We will normally provide a written warning letter via a letter about the impact of a behaviour and the potential that action could be taken, including reporting the behaviour to the police if it is deemed to be unlawful discrimination or hate crime. When trust has irretrievably broken down, it is in the patient’s interest, just as much as that of the practice, 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.

Reference:

https://www.bma.org.uk/media/5144/bma-guidance-on-how-to-deal-with-discrimination-from-patients-march-2022.pdf