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Policies

We are required to implement and publish a number of policies. The Care Quality Commission and the Gloucestershire NHS Clinical Commissioning Group from time to time inspect us. Our main polices are listed below.


Consent

Consent for a non-intimate examination, such as taking blood pressure, is generally implied. This means permission will not be sought.

Consent for an intimate examination requires expressed (verbal) consent. This means permission will be sought.

Consent for a minor operation requires written consent. You will be counselled so that informed consent is obtained.

Consent Leaflet (From the Department of Health, Social Services and Public Safety)

 


Parental Consent Protocol 

People aged 16 or over are entitled to consent to their own treatment, and this can only be overruled in exceptional circumstances.

Like adults, young people (aged 16 or 17) are presumed to have sufficient capacity to decide on their own medical treatment, unless there is significant evidence to suggest otherwise.

Children under the age of 16 are presumed to lack capacity, but can consent to their own treatment if it is thought that they have enough intelligence, competence and understanding to fully appreciate what is involved in their treatment. Otherwise, someone with "parental responsibility" can consent for them.

When their consent can be overruled

If a young person refuses treatment, and by doing so this may lead to their death or a severe permanent injury, their decision can be overruled by the Court of Protection. This is the legal body that oversees the operation of the Mental Capacity Act (2005).

The parents of a young person who has refused treatment may consent for them, but it is usually thought best to go through the courts in such situations.

Parental responsibility

If a child who is under 16 does not have the capacity to consent, someone with parental responsibility can consent for them, but that person must have the capacity to give consent.

If a parent refuses to give consent to a particular treatment, this decision can be overruled by the courts if treatment is thought to be in the best interests of the child.

If one person with parental responsibility gives consent and another does not, the healthcare professionals can choose to accept the consent and perform the treatment in most cases. If the people with parental responsibility disagree about what is in the child’s best interests, the courts can make a decision.

In an emergency, where treatment is vital, and waiting to obtain parental consent would place the child at risk, treatment can proceed without consent (see when consent isn't needed for more information).

When Consent isn’t needed

If a child requires emergency treatment to save their life, and they are unable to give consent as a result of being incapacitated (for example, they are unconscious), treatment will be carried out.

In these cases, the reasons why treatment was necessary will be fully explained once they have recovered.

Who has parental responsibility?

A person with parental responsibility for a child could be:

  • the child’s mother or father
  • the child’s legally appointed guardian
  • a person with a residence order concerning the child
  • a local authority designated to care for the child
  • a local authority or person with an emergency protection order for the child

Requesting parental consent

A child may present at surgery for a consultation which requires treatment, such as a minor illness appointment, vaccination/immunization and may not be accompanied by an adult who has parental consent.

The accompanying adult may bring a letter of consent to treatment which can be accepted by the healthcare professional. This letter should be noted in the child’s records as a journal entry and a copy scanned into the records.

If the child presents without written confirmation of parental consent the healthcare professional should obtain parental consent by telephone if possible, if it is in the child’s best interests to be treated at that appointment.

For routine matters or if the adult with parental responsibility cannot be contacted the appointment should be rebooked.

If there is a need for urgent or emergency treatment should be discussed with the on call doctor in reference to the section in this protocol – ‘When consent isn’t needed’.

  


Online Access for Children and Young People

 

Children Aged Under 14

Online access for children under the age of 14 will be granted to those with parental responsibility so that they can book appointments and use the repeat prescription ordering service on their behalf.  Parental online access will end once the child reaches the age of 14.

Children Aged 14 - 16

Children over the age of 14 can consent to their own treatment if they're believed to have enough intelligence, competence and understanding to fully appreciate what's involved in their treatment. This is known as being Gillick competent, and extends to the decision to give or withhold consent for the release of medical records. 

A child under the age of 16 must be recorded as being Gillick competent before they are able to give consent for a parent or other legal guardian to have access to their online account, or to have an online account of their own.

This assessment must be made by a GP, in person.

In all circumstances, good practice dictates that a Gillick competent child should be encouraged to involve parents or other legal guardians in any treatment/disclosure decisions.

Please see the NHS guide to Gillick competence here:

https://www.nhs.uk/conditions/consent-to-treatment/children


Childhood Vaccinations and Examinations

If a relative is taking your child for their vaccinations or examinations, they must have a letter written and signed by you.

Relatives or friends (including fathers who don't have parental responsibility) need permission from the person who has parental responsibility.

If your child attends surgery without a parent with parental consent and no written confirmation is available, we will try to contact you to obtain this. If we are unable to confirm consent, we will need to arrange for your child to attend for another appointment.


 

Under 16s SystmOnline and Messaging

At 14 years of age the surgery disables parent's access to the SystmOnline account unless further consent is given in case a child wants to contact the surgery privately.

At 14 years of age the surgery disables children's automatic text reminders unless further consent is given in case a child wants to contact the surgery privately.


Call Recording

We record all telephone calls into and out of the Practice. These recordings are held on a dedicated and secure PC, and are only accessed when there are concerns about a call (such as in relation to a complaint, a query is raised or where threats are received).  A recording at the start of every phone call to the Practice informs patients and other callers that their call will be recorded.


 

Chaperones, Patient Dignity and Respect

Our Practice is committed to providing a safe, comfortable environment where patients and staff can be confident that best practice is being followed at all times and the safety of everyone is of paramount importance. All patients are entitled to have a chaperone present for any consultation, examination or procedure where they feel one is required.

We will provide a chaperone for certain examinations and procedures undertaken at the practice, and have a quiet room if you wish to speak to a receptionist away from the main reception desk. 

Your healthcare professional may also require a chaperone to be present for certain consultations in accordance with our chaperone policy.

Please see our chaperone policy for further details.


 

Breast Feeding

The practice encourages and supports patients who visit the surgery and wish to breastfeed their babies.  We will not discriminate against any woman in her chosen method of infant feeding, and will fully support them.  Mothers who would prefer privacy to breastfeed are invited to speak to the Receptionist.


Equality, Diversity and Human Rights

The Practice aims to promote equality and diversity and value the benefits this brings. It is our aim to ensure that all staff feel valued and have a fair and equitable quality of working life.

The Practice is committed to the principles contained in the Human Rights Act. We aim to ensure that our employment policies protect the rights and interests of our staff and ensure that they are treated in a fair, dignified and equitable way when employed at the Practice.

 


Suggestions and Practice Feedback

The Partners and staff at Overton Park Surgery aim to provide you with an excellent standard of care, and we welcome your views and constructive suggestions. If you have not had a good experience at the Practice, we invite you to tell us.

You can leave comments, suggestion or complaints via our online feedback link in Contact Details, or contact the Practice Manager, Mark Thatcher.

For full details on our complaints procedure, please see our Patient Complaints leaflet


Sending appointment reminders and normal results by text.

Our receptionists may ask for verbal consent to use your mobile phone for texting..

The surgery encourages patients to allow us to use SystmOne to automatically send to your mobile phone appointment confirmations and an appointment reminder the day before your appointment.

We may also use this service to remind you to make an appointment for a review with your doctor or one of the nurses.

Your doctor may send you normal results via text. However we prefer to write to you or speak to you if the results are significantly abnormal. Ask your GP to send your results via text or ask your GP to register your for detailed access to SystmOnline when you are arranging the test.


Fair Processing and Privacy Notice

Being transparent and providing accessible information to patients about how we will use your personal information is a key element of the Data Protection Act 2018 and the EU General Data Protection Regulations (GDPR).

This notice reminds you of your rights, and describes how Overton Park will use your information for lawful purposes in order to deliver your care and the effective management of the local NHS system.

Available to download as a PDF:  Privacy and Fair Use Notice


General Data Protection Regulations 2018

What information is an individual entitled to under the GDPR?

Under the GDPR, individuals have the right to obtain:

  • confirmation that their data is being processed;
  • access to their personal data; and
  • other supplementary information – this largely corresponds to the information that should be provided in a privacy notice.

What is the purpose of the right of access under GDPR?

The GDPR clarifies that the reason for allowing individuals to access their personal data is so that they are aware of and can verify the lawfulness of the processing.

Can GP surgery charge a fee for dealing with a subject access request?

The Practice must provide a copy of the information free of charge. However, a ‘reasonable fee’ can be charged when a request is manifestly unfounded or excessive, particularly if it is repetitive. A reasonable fee can be charged to comply with requests for further copies of the same information. This does not mean that the surgery can charge for all subsequent access requests. The fee must be based on the administrative cost of providing the information.

How long does the Surgery have to comply?

Information must be provided without delay and at the latest within one month of receipt. The surgery will be able to extend the period of compliance by a further two months where requests are complex or numerous. If this is the case, the surgery must inform the individual within one month of the receipt of the request and explain why the extension is necessary.

What if the request is manifestly unfounded or excessive?

Where requests are manifestly unfounded or excessive, in particular because they are repetitive, the surgery can:

  • charge a reasonable fee taking into account the administrative costs of providing the information; or
  • refuse to respond.

Where the surgery refuses to respond to a request, it must explain why to the individual, informing them of their right to complain to the supervisory authority and to a judicial remedy without undue delay and at the latest within one month.

How should the information be provided?

The surgery must verify the identity of the person making the request, using ‘reasonable means’. If the request is made electronically, it should provide the information in a commonly used electronic format.

What about requests for large amounts of personal data?

Where the surgery processes a large quantity of information about an individual, the GDPR permits the practice to ask the individual to specify the information the request relates to. The GDPR does not include an exemption for requests that relate to large amounts of data, but you may be able to consider whether the request is manifestly unfounded or excessive.

Please request in writing to the Secretary for printed copies, or request access to your detailed coded record in your SystmOnline account. If you do not yet have SystmOnline, please speak to our Receptionists.

If the request is to view vaccinations, you can view these online or ask for a print-out at Reception.

Freedom of Information (FOIA) 1988

The Freedom of Information (FOI) Act gives a general right of access to all types of recorded information held by public authorities, with full access granted in January 2005. The Act sets out exemptions to that right and places certain obligations on public authorities.

The FOIA will be affected by the European General Data Protection Regulation (‘GDPR’), which is due to come into effect on 25th May 2018.

For details of the practice scheme please, download our Publication Scheme


Confidentiality

The surgery Caldicott Guardian is Doctor Julian Wilson. The surgery Data Protection Officer is Mark Thatcher.

Your rights are protected as we are registered under the Data Protection Act 1998 (DPA)/GDPR. The Act provides a framework which governs the processing of information that identifies living individuals.

The NHS Confidentiality Code of Practice (COP) applies only to patient information. It incorporates the requirements of the DPA and other relevant legislation together with the recommendations of the Caldicott report and medical ethical considerations, in some cases extending statutory requirements and provides detailed specific guidance.

All staff in the Practice are bound contractually to maintain Patient confidentiality and any proven breach of this will be treated extremely seriously.

We respect your right to privacy and keep all your health information confidential and secure. Confidentiality also extends to Patients' family members. Medical information relating to you will not be divulged to a family member or anyone else, without your written consent.

As we are a computerised Practice, all our patient records are kept on computer and can assure patients of complete confidentiality.

It is important that the NHS keeps accurate and up-to-date records about your health and treatment so that those treating you can give you the best possible advice and care. However, for the effective functioning of a multi-disciplinary team it is sometimes necessary that medical information about you is shared between members of the practice team.

We follow the guidance issued by the GMC in 'Confidentiality: Protecting and Providing Information' which explains circumstances in which information may be disclosed.

This information is only available to those involved in your care and you should never be asked for personal medical information by anyone not involved in your care.

You have a right to know what information we hold about you. If you would like to see your records, please speak to Reception about online access, or put a request in writing to the Secretary.


Sharing your health care records

Your patient record will be held securely and confidentially on our electronic system.

If you require treatment in another NHS healthcare setting such as an Emergency Department or Improved Access Clinic, those treating you would be better able to give you appropriate care if some of the information from the GP practice were available to them. This information can now be shared electronically (with your permission) via:-

  • Joining Up Your Information (JUYI) -used locally across Gloucestershire.
  • NHS Summary Care Record (SCR) -used nationally across England.

The information will be used only by authorised healthcare professionals directly involved in your care. Your permission will be asked each time before the information is accessed, unless the clinician is unable to ask you and there is a clinical reason for access. The doctors at Underwood Surgery recommend you consent to the sharing of information to ensure you receive the best possible care.

Parents, guardians or someone with power of attorney can ask for people in their care to be opted out, but ultimately it is the GP’s decision whether to share information, or not, because of their duty of care.

If you are caring for someone and feel that they are able to understand, then you should make the information about the different methods of sharing available to them.

Differences between the JUYI Gloucestershire Shared Record and Summary Care Records

JUYI Gloucestershire shared health and social care information

Summary Care Record

Shared

Across Gloucestershire

Across health care settings, including urgent care, community care and outpatient departments

With GPs, and with NHS clinicians employed by Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire Care Services NHS Trust (Community hospitals and community-based services, such as district nursing), 2gether NHS Foundation Trust (mental health services), South Western Ambulance Service NHS Foundation Trust.

Gloucestershire social care.

Across England

Across health care settings, including urgent care, community care and outpatient departments

With GPs, and with clinicians employed by any NHS Trust or organisation involved in your care across England

Information source

GP record

Other medical records held by different NHS organisations in Gloucestershire

Gloucestershire.social care.

GP record

Content

Your current medications

Any allergies you have

Any bad reactions you have had to medicines

Your medical history and diagnoses

Test results and X-ray reports

Your vaccination history

General health readings su



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