Access to Medical Records
1.1 Policy Statement
The purpose of this document is to ensure that appropriate procedures are in place at Amersham Health Centre, to enable individuals to apply for access to information held about them, and for authorised individuals, information held about other people. This policy is written in conjunction with the following government legislation:
- The Access to Health Records Act 1990
- The Access to Medical Reports Act 1988
- The General Data Protection Regulation
- The Data Protection Act 2018
- The Freedom of Information Act 2000
- The Data Protection (Subject Access Modification) (Health) Order 2000
This document and any procedures contained within it are contractual and therefore form part of your contract of employment. Employees will be consulted on any modifications or change to the document’s status.
1.3 Training and support
The practice will provide guidance and support to help those to whom it applies understand their rights and responsibilities under this policy. Additional support will be provided to managers and supervisors to enable them to deal more effectively with matters arising from this policy
2.1 Who it applies to
This document applies to all employees of the practice and other individuals performing functions in relation to the practice, such as agency workers, locums and contractors.
2.2 Why and how it applies to them
In accordance with the General Data Protection Regulation individuals have the right to access their data and any supplementary information held by Amersham Health Centre; this is commonly known as a data subject access 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
This policy will outline the procedure to access health records at Amersham Health Centre as follows:
- For an individual, for information about themselves
- For access to the health records of a deceased individual
- Access to health records of an individual by an authorised person (by a court), when the individual does not have the capacity to make such a decision
- Organisations requesting information about an individual for employment or insurance purposes (governed by The Access to Medical Reports Act 1988)
The practice aims to design and implement policies and procedures that meet the diverse needs of our service and workforce, ensuring that none are placed at a disadvantage over others, in accordance with the Equality Act 2010. Consideration has been given to the impact this policy might have in regard to the individual protected characteristics of those to whom it applies.
3.1 Right to access
In accordance with the Access to Health Records Act 1990 individuals have the right to access health records held by a healthcare provider that has treated that individual, and/or to access a summary care record (SCR) created by the individual’s GP. The Data Protection Act (DPA 1998) gives individuals the right to ask for a copy of the information an organisation holds about them; this right is commonly known as a Data Subject Access Request (DSAR). In the case of health records, a request for information has to be made with the organisation that holds the individual’s health records, otherwise known as the data controller.
Amersham Health Centre has mechanisms in place to inform patients of their right to access the information held about them, and how long it will take for a DSAR process to be completed.
With effect from April 2016, NHS practices are, as part of their contractual obligation, to provide patients with access to coded information held within their health records. Such information includes:
- Other (ethnicity, QOF, etc.)
NHS England have published an information leaflet Patient Online which provides further detailed information about this obligation and how patients can access their health record online.
There are occasions when a GP may firmly believe that it is not appropriate to share all the information contained in the individual’s record, particularly if there is potential for such information to cause harm or distress to individuals, or when the record has information relating to a third party.
Patients may request paper copies of health records and, regardless of the preferred method of access, patients and authorised third parties must initially complete a DSAR form. However, patients may request access to their health records informally: any such requests should be annotated within the individuals health record by the clinician dealing with the patient
Requests may be received from the following:
- Competent patients may apply for access to their own records or authorise third party access to their records.
- Children and young people may also apply in the same manner as other competent patients and Amersham Health Centre will not automatically presume a child or young person has capacity under the age of 16. However, those aged 12 or over are expected to have the capacity to consent to medical information being disclosed.
- Parents may apply to access their child’s health record as long as it is not in contradiction to the wishes of the competent child.
- Individuals with a responsibility for adults who lack capacity are not automatically entitled to access the individuals health records. Amersham Health Centre will ensure that the patient’s capacity is judged in relation to particular decisions being made. Any considerations to nominate an authorised individual to make proxy decisions for an individual who lacks capacity will comply with the Mental Capacity Act in England and Wales and the Adults with Incapacity Act Scotland.
- Next of kin have no rights of access to health records.
- Police are not able to access health records without first obtaining a court order or warrant. However, health professionals at Amersham Health Centre may disclose relevant information to the police if the patient has consented or if there is no overriding public interest. For detailed information, see section 4.1.6 of footnote 2.
- Solicitors and insurance companies in most cases will provide the patients signed consent to release information held in their health record. Amersham Health Centre will ensure that patients are fully aware of the information being provided to the solicitor who is acting for that patient. In the case of a solicitor requesting information, the BMA has provided more information here. Amersham Health Centre will ask solicitors to use the appropriate form when requesting information.
- Deceased patients retain the right of confidentiality. There are a number of considerations to be taken into account prior to disclosing the health record of a deceased patient. Such considerations are detailed in the Access to Health Records Act 1990. Under the terms of this Act, Amersham Health Centre will only grant access if you are either:
- A personal representative (executor of the deceased person’s estate) or
- Someone who has a claim resulting from the death
The medical records of the deceased will be passed to Primary Care Support England (PCSE) for storage. Amersham Health Centre can advise you of who you need to contact in such instances. PCSE will retain the GP records of deceased patients for ten years, after which time they will be destroyed. PCSE have provided an application form which can be used to request copies of a deceased patient’s record
In the cases of any third-party requests, Amersham Health Centre will ensure that the patient has consented to the disclosure of this information by means of a valid signature of the patient.
In accordance with the GDPR, patients are entitled to receive a response within the maximum given time frame of one calendar month from the date of submission of the DSAR. In order to ensure full compliance regarding DSARs, Amersham Health Centre will adhere to the guidance provided in the GDPR. In the case of complex or multiple requests, the data controller may extend the response time by a period of two months. In such instances, the data subject must be informed and the reasons for the extension given.
Under The Data Protection (Subject Access Modification) (Health) Order 2000, Amersham Health Centre will ensure that an appropriate healthcare professional manages all access matters. There are a number of such professionals, and wherever possible the individual most recently involved in the care of the patient will review and deal with the request. If for some reason they are unable to manage the request, an appropriate professional will assume responsibility and manage the access request.
Furthermore, to maintain GDPR compliance, the data controller at Amersham Health Centre will ensure that data is processed in accordance with Article 5 of the GDPR and will be able to demonstrate compliance with the regulation (see GDPR policy for detailed information). Data processors at Amersham Health Centre will ensure that the processing of personal data is lawful and at least one of the following applies:
- The data subject has given consent to the processing of his/her personal data for one or more specific purposes
- Processing is necessary for the performance of a contract to which the data subject is party, or in order to take steps at the request of the data subject prior to entering into a contract
- Processing is necessary for compliance with a legal obligation to which the controller is subject
- Processing is necessary in order to protect the vital interests of the data subject or another natural person
3.3 Procedure for access
A DSAR form (Annex A) must be completed and passed to the data controller; all DSARs should be processed free of charge unless they are either complex, repetitive or unfounded (see GDPR Policy). The GDPR states that data subjects should be able to make access requests via email. Amersham Health Centre is compliant with this and data subjects can complete an e-access form and submit the form via email.
Upon receipt of a DSAR, Amersham Health Centre will record the DSAR within the health record of the individual to whom it relates, as well as annotating the DSAR log. Furthermore, once processed, an entry onto the health record should be made, including the date of postage or the date the record was collected by the patient or authorised individual.
Individuals will have to verify their ID at Amersham Health Centre and it is the responsibility of the data controller to verify all requests from data subjects using reasonable measures. The use of the practice’s Data Subject Access Request (DSAR) form supports the data controller in verifying the request. In addition, the data controller is permitted to ask for evidence to identify the data subject, usually by using photographic identification, i.e. a driving licence or passport
A poster explaining how to access health records, for use in waiting-room areas, can be found at Annex D.
3.4 Additional Privacy Information notice
Once the relevant information has been processed and is ready for issue to the patient, it is a requirement, in accordance with Article 15 of the General Data Protection Regulation (GDPR), to provide an Additional Privacy Information notice (APIn).
3.5 Third-party requests
Third-party requests will continue to be received following the introduction of the GDPR. The data controller must be able to satisfy themselves that the person requesting the data has the authority of the data subject.
The responsibility for providing the required authority rests with the third party and is usually in the form of a written statement or consent form, signed by the data subject.
Having a robust system in place will ensure that access to health records is given only to authorised personnel. Patient confidentiality is of the utmost importance and any third-party requests must be accompanied by a valid patient signature. Staff are to adhere to this guidance at all times and where doubt exists, they are to discuss their concerns with Amersham Health Centre.
In accordance with the General Data Protection Regulation, patients (data subjects) have the right to access their data and any supplementary information held by Amersham Health Centre; this is commonly known as a data subject access 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
As of April 2016, practices have been obliged to allow patients access to their health record online. This service will enable the patient to view coded information held in their health record. Prior to accessing this information, you will have to visit the practice and undertake an identity check before being granted access to your records.
In addition, 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 can be submitted electronically and the DSAR form is available on the practice website. Alternatively, a paper copy of the DSAR is available from reception. You will need to submit the form online or return the completed paper copy of the DSAR to the practice. Patients do not have to pay a fee for copies of their records.
Once the DSAR form is submitted, Amersham Health Centre will aim to process the request within 21 days; however, this may not always be possible. The maximum time permitted to process DSARs is one calendar month.
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.
At Amersham Health Centre the data controller is the Practice Manager and should you have any questions relating to accessing your medical records, please ask to discuss this with the practice manager.
This privacy notice (link below) explains why we collect information about you, how that information may be used and how we keep it safe and confidential in accordance with General Data Protection Regulation 2018, and other legislation.
Below is a link to the Buckinghamshire, Oxfordshire and Berkshire West ICB privacy notice which is regularly reviewed and updated and will help answer any questions.
Message for Patients of Amersham Health Centre:
Emails may not be seen on the same day by your doctor. Please do not use this mail box for the following:
URGENT: If you matter is urgent, please speak to a patient coordinator on 01494 434344.
Medical Problems: Please do not use this email box for any type of medical consultation. If your query requires an appointment with a doctor or a nurse please call the surgery on 01494 434 344 to book an appointment with the relevant clinician.
Results: If your query is relating to a recent test please call the surgery on 01494 434 344 and select option 2. If your test was requested by a hospital doctor please contact them.
Appointments: We do not accept requests for appointments via email – please call reception on 01494 434 344.
Prescriptions: Please do not send any prescription request via this email box. If you are requesting a prescription please do so via our website amershamhealthcentre.co.uk and follow the instructions on the prescription tab.
Visits: All visits should be requested by calling 01494 434 344 and select option 3.
Deaf and hard of hearing patients who have difficulty using the phone and rely on email for contact should be registered with the surgery via [email protected]. Your medical records will we updated. They may thereafter access the surgery by this email address for routine issues.
GP Net Earnings
Amersham Health Centre for the year ended 30 June 2021
NHS England example publication of GP Net Earnings for 2021/22
“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
The average pay for GPs who worked for six months or more in
Amersham Health Centre in the last financial year was £88,590 before
Tax and National Insurance. This is for 3 full-time GP’s and 6 part-time
NHS Opt-Out Information
Your health records contain a type of data called confidential patient information. This data can be used to help with research and planning.
You can choose to stop your confidential patient information being used for research and planning. You can also make a choice for someone else like your children under the age of 13.
Your choice will only apply to the health and care system in England. This does not apply to health or care services accessed in Scotland, Wales or Northern Ireland. Below is information including the Opt Out Form.
Amersham Health Centre Philosophy
- Our aims are to offer the highest standard of health care and advice to our patients with the resources available to us.
- We have a team approach to patient care and endeavour to monitor the service provided to patients, to ensure that it meets current standards of excellence.
- We are dedicated to ensuring the Practice staff and Doctors are trained to the highest level and to provide a stimulating and rewarding environment in which to work.
Patient’s Rights to General Medical Services
- To have appropriate drugs and medicine prescribed.
- To be referred to a Consultant acceptable to them when they and their GP thinks it is necessary and to be referred for a second opinion if they and their GP think it is advisable.
- To have access to their health records, subject to any limitations of the law, and to know that those working for the NHS are under a legal duty to keep those records confidential.
- To choose whether to take part in research or general practice training.
- To receive a copy of their doctors practice leaflet, setting out the services that he or she provides.
- To receive a full and prompt reply to any complaints they make about the care they receive at Amersham Health Centre.
Our Practice Charter
- You will be treated with courtesy and respect by all the practice personnel.
- An urgent appointment with a Doctor or Nurse will be available on the same day.
- Our standard is to see 80% of patients within 20 minutes of their appointment time. If you have waited longer than this then please ask the receptionist for an explanation.
- Requests for prescriptions will be dealt with within 72 hours.
- All comments and suggestions about the service are welcome. Please use the box provided in the waiting area.
- If you have a complaint please speak to the Practice Manager. Your complaint will be dealt with in a professional and efficient manner.
- We wish to make Amersham Health Centre as accessible as possible. If you have hearing, visual or physical difficulties please do let the receptionist know so that we can enable you to fully use our services.
- If you are unable to attend for an appointment please let us know so that we can offer it to someone else.
- If you are late for your appointment you may be asked to rebook for another time. Try to let us know in advance if you are going to be unavoidably delayed so that we can make alternative arrangements to help you.
- A home visit should only be requested for those who are unable to come to the surgery because of serious illness or infirmity. Please ring the surgery before 11am if at all possible.
- An urgent appointment is only for an urgent medical problem.
- We would ask you to be patient if the doctor is running late. This is often due to unforeseeable emergencies but please ask for an explanation from the receptionist.
- Make a separate appointment for each patient that needs to be seen. This allows the doctor enough time to treat each patient with the time they deserve.
- Please act in a responsible and courteous manner whilst on the practice premises for the safety and comfort of others.
- Please treat all surgery staff, fellow patients, carers and visitors politely and with respect. Violence or verbal harassment will not be tolerated or accepted.
Hard of Hearing Patients
Those patients who are hard of hearing will be offered a face to face appointment with the GP. We ask that if patients communicate with us via our email system, they included in the content of the email that they are hard of hearing.
Statement of Intent
IT/Electronic Patient Records
Our Statement of Intent
New contractual requirements came into force from 1st April 2014 requiring that GP practices should make available a statement of intent in relation to the following IT developments:-
- Referral Management
- Electronic Appointment Booking
- On line Booking of repeat prescriptions
- Summary Care Record
- GP2GP transfers
- Patient Access to records.
- Enable patient feedback (FFT)
Please find below details of Amersham Health Centre’s stance with regards to these developments:-
All practices must include the NHS Number as the primary identifier in all NHS clinical correspondence issued by the practice.
Electronic appointment booking
Practices are required to promote and offer the facility for all patients, who wish to, to book, view, amend, cancel and print appointments online.
We currently offer the facility for booking and cancelling some appointments on-line. Please come into the Practice and complete a form to register for on line services.
Online booking of repeat prescriptions
Practices are required to promote and offer the facility for all patients, who wish to, to order online, view and print a list of their repeat prescriptions for necessary drugs, medicines or appliances.
We currently offer the facility for ordering repeat prescriptions on-line. Please come into the practice and complete a form to request access and you can then order your repeat medication online.
Interoperable records/Summary Care Record
Practices are required to enable successful automated uploads of any changes to a patient’s summary information, at least on a daily basis to the Summary Care record (SCR). Having your Summary Care Record 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 to which you have a recorded allergy or sensitivity.
Amersham Health Centre is already live with SCR. However, if you do not want your medical records to be available in this way and have not already informed the practice then you will need to let us know and we will update your record. You can do this via the ‘Summary Care Record Opt out form’ which is available from the surgery.
Please visit systems.hscic.gov.uk/scr/patients or more information.
GP2GP record transfers
There is a requirement for GP Practices to utilise the GP2GP facility for the transfer of patient records between practices, when a patient registers or de-registers
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. With GP to GP transfer, your electronic record is transferred to your new practice within 24hrs.
Amersham Health Centre confirms that GP2GP transfers are already active and we send and receive patient records via this system.
Please visit systems.hscic.gov.uk/gp2gp for more information
Patient access to their GP record
Practices are required to promote and offer the facility for patients to view online, export or print any summary of information from their records relating to medications, allergies, adverse reactions and any other items such as ‘additional’ record elements which have been agreed between the practice and the patient i.e. Immunisations & Test results.
Patients can now access some of their medical records online (medications and allergies). Please come into the Practice and complete a form to register for on line services.
Please visit www.england.nhs.uk/ourwork/pe/patient-online/po-public for more information
Information to support patients accessing online services
Patients will be able to access information about online services by visiting the online services pages for our clinical system (see below)
Emis Patient Access Website:
To use the Patient Access, you can come to the surgery to request a user name and password. You will need an e-mail address to register for this service. Once registered, you will need to activate your account via an email link:- Click here to open Patient Access.
How to give feedback to the practice about online services
To give feedback about online services, please write to the Practice Manager, Amersham Health Centre, Chiltern Avenue, Amersham, Bucks HP6 5AY.
Suggestions and Complaints
The Doctors and staff wish to provide the very best possible care. If any patient has a suggestion for improving our service or to make a complaint, please do discuss this with the Practice Manager. We undertake as part of the Patient Charter to deal with any complaint promptly and fully. In addition, your doctor would be pleased to discuss the matter with you.
The Patient Experience Team (PALS) are available to receive compliments, comments, concerns and complaints from the hospital service you have received. They also offer confidential advice, support and information on health-related matters to patients, their families and their carers. To contact PALS tel: 01296316042.
Summary Care Records (SCR)
Your Summary Care Record is a short summary of your GP medical records. It tells other health and care staff who care for you about the medicines you take and your allergies.
This will enable health and care professionals to have better medical information about you when they are treating you at the point of care. This change will apply for the duration of the coronavirus pandemic only. Unless alternative arrangements have been put in place before the end of the emergency period, this change will be reversed.
All patients registered with a GP have a Summary Care Record, unless they have chosen not to have one. The information held in your Summary Care Record gives health and care professionals, away from your usual GP practice, access to information to provide you with safer care, reduce the risk of prescribing errors and improve your patient experience.
Your Summary Care Record contains basic information about allergies and medications and any reactions that you have had to medication in the past.
Some patients, including many with long term health conditions, have previously agreed to have additional information shared as part of their Summary Care Record. This additional information includes information about significant medical history (past and present), reasons for medications, care plan information and immunisations.
During the coronavirus pandemic period, your Summary Care Record will automatically have additional information included from your GP record unless you have previously told the NHS that you did not want this information to be shared.
There will also be a temporary change to include COVID-19 specific codes in relation to suspected, confirmed, Shielded Patient List and other COVID-19 related information within the additional information.
By including this additional information in your SCR, health and care staff can give you better care if you need health care away from your usual GP practice:
- in an emergency
- when you’re on holiday
- when your surgery is closed
- at out-patient clinics
- when you visit a pharmacy
Additional information is included on your SCR
In response to the coronavirus (COVID-19) pandemic we are temporarily removing the requirement to have explicit consent to share the SCR additional information. This change of requirement will be reviewed when the pandemic is over.
You can be reassured that if you have previously opted-out of having a Summary Care Record or have expressly declined to share the additional information in your Summary Care Record, your preference will continue to be respected and applied.
Additional information will include extra information from your GP record, including:
- health problems like dementia or diabetes
- details of your carer
- your treatment preferences
- communication needs, for example if you have hearing difficulties or need an interpreter
This will help medical staff care for you properly, and respect your choices, when you need care away from your GP practice. This is because having more information on your SCR means they will have a better understanding of your needs and preferences.
When you are treated away from your usual doctor’s surgery, the health care staff there can’t see your GP medical records. Looking at your SCR can speed up your care and make sure you are given the right medicines and treatment.
The only people who might see your Summary Care Record are registered and regulated healthcare professionals, for example doctors, nurses, paramedics, pharmacists and staff working under their direct supervision. Your Summary Care record will only be accessed so a healthcare professional can give you individual care. Staff working for organisations that do not provide direct care are not able to view your Summary Care Record.
Before accessing a Summary Care Record healthcare staff will always ask your permission to view it, unless it is a medical emergency and you are unable to give permission.
Protecting your SCR information
Staff will ask your permission to view your SCR (except in an emergency where you are unconscious, for example) and only staff with the right levels of security clearance can access the system, so your information is secure. You can ask an organisation to show you a record of who has looked at your SCR – this is called a Subject Access Request.
The purpose of SCR is to improve the care that you receive, however, if you don’t want to have an SCR you have the option to opt out. If this is your preference please inform your GP or fill in an SCR opt-out form and return it to your GP practice.
Regardless of your past decisions about your Summary Care Record consent preferences, you can change your mind at any time. You can choose any of the following options:
- To have a Summary Care Record with additional information shared. This means that any authorised, registered and regulated health and care professionals will be able to see a enriched Summary Care Record if they need to provide you with direct care.
- To have a Summary Care Record with core information only. This means that any authorised, registered and regulated health and care professionals will be able to see information about allergies and medications only in your Summary Care Record if they need to provide you with direct care.
- To opt-out of having a Summary Care Record altogether. This means that you do not want any information shared with other authorised, registered and regulated health and care professionals involved in your direct care, including in an emergency.
To make these changes, you should inform your GP practice or complete the SCR patient consent preferences form and return it to your GP practice.
More information on your health records
Treating Children and Disclosing Information to Parents
IMPORTANT INFORMATION FOR PARENTS OR THOSE WITH PARENTAL RESPONSIBILITY
If a child is under 12 years old or NOT capable of consenting (to being seen by a doctor, nurse or receiving treatment) themselves, it is vital that we have the CONSENT of a person with PARENTAL RESPONSIBILITY (usually a signed note or letter).
Examples of this would be when a child is brought to the surgery by a grandparent, nanny or sibling).
In an emergency, where treatment is vital and waiting to obtain parental consent would place the child at risk, treatment can proceed without consent.
This is a term used in medical law to decide whether a child (16 years or younger) is able to consent to his or her own medical treatment, without the need for parental permission or knowledge.
What does this mean in practice?
- Children under 16 years old can consent to medical treatment if they understand what is being proposed. It is up to the doctor to decide whether the child has the maturity and the intelligence to fully understand the nature of the treatment, the options, risks and benefits.
A child who has such understanding is considered Gillick competent. The parents cannot overrule the child’s consent when the child is judged to be Gillick competent.
Eg. A 15 year old Gillick competent boy can consent to receiving tetanus immunization even if his parents do not agree.
- Aged 16 and 17 years. A child having reached the age of 16 years can consent to investigation or treatment and cannot be overruled by anyone with parental responsibility (but can be overridden by the Court).
- Once a person reaches their 18th birthday they are assumed to be a competent adult.
- 12 years old is deemed to be about the age when a child can be assessed for competency (Gillick competency).
- If a child is deemed to be competent, then they have the same rights to confidentiality as an adult. In practice this means information cannot be given to someone with parental responsibility eg whether they have attended the surgery, what the consultation was about, unless consent has been given by the child.
- A doctor or nurse will always ask the child if someone with parental responsibility knows they have attended and if they have consent to speak to a parent.
- On many occasions the reason a child has attended alone is often for straightforward reasons, eg parent looking after sibling, a simple problem that a parent thought child could attend by themselves etc. However, even though a child, if the child is deemed Gillick competent, then the child has the same rights as an adult to confidentiality. If the child therefore does not wish a parent to know of their attendance or reason for the attendance, then the health professional is bound by the law not to disclose this information.
Zero Tolerance Policy
As an employer, the practice has a duty of care for the health, safety and wellbeing of its staff. The practice also has a legal responsibility to provide a safe and secure working environment for staff. Staff mental health is as important as their physical health.
All patients and staff are expected to behave in an acceptable, respectful manner.
The practice follows the NHS guidance concerning Zero Tolerance.
Any incident in which an employee is abused, threatened or assaulted in circumstances relating to their work is unacceptable and not tolerated.
This includes the serious or persistent use of verbal abuse, aggressive tone and/or language and swearing/foul language.
Staff should not be left upset and distressed following an interaction with a patient.
All instances of actual physical abuse or threatening behaviour on any doctor or member of staff, by a patient or their relatives will be reported to the police as an assault.
We expect all patients to be responsible and avoid attending the surgery under the influence of alcohol or illegal drugs. Any alteration of prescriptions is illegal and will not be tolerated.
The General Medical Council states In Good Medical Practice that: “In rare circumstances, the trust between you (the Practice) and a patient may break down, and you may find it necessary to end the professional relationship. For example, this may occur if a patient has been violent to you or a colleague, has stolen from the premises, or has persistently acted inconsiderately or unreasonably.”
This includes unnecessarily persistent or unrealistic service demands that cause disruption. Examples of this include, but are not limited to :
- Demanding to only speak to a specific team member
- Refusing appointments with an appropriate clinician for the presenting care need i.e. insisting on a GP appointment when seeing a pharmacist or nurse prescriber is appropriate
- Refusing to access the service in the appropriate manner i.e. sending emails/texts instead of using the NHS Digital approved digital consultation service
- Demanding a same day appointment for a routine clinical need – this deprives access to urgent care services for those who genuinely need it
- Contacting individuals directly via social media or personal email instead of through the practice contact channels
The practice has a finite number of available appointments and you may be directed to a clinician who is not a GP, or your preferred GP, but who is appropriately qualified to manage the presenting care need. We provide a named GP service but we cannot always accommodate requests to speak to the same GP due to high patient demand for appointments.
If you are seriously unhappy with the quality of service you have the right to register with another practice without notifying us. Similarly, on the very rare occasions when a patient breaches this policy, we have the right to remove the patient from our Practice list.
Examples of Unacceptable Standards of Behaviour
In exceptional circumstances, a breakdown may occur between a doctor and their patient. If the breakdown is of a serious nature e.g. serious physical or verbal abuse to any member of the practice team, the doctors may feel that the doctor/patient relationship has been compromised. Steps may be taken to have the patient removed immediately from the practice list. Where possible, conciliation would always be the preferred route. Reasons for removal will be given in writing.
Where we deem an incident is not serious enough to warrant immediate removal, we will issue a first and final warning.
You will be removed from our patient list immediately when we have needed police assistance or have made a report to the police.
The following are example of when you may be issued with a first and final warning or removed from our patient list dependent on the severity of the incident.
- Excessive noise eg recurrent loud or intrusive conversation or shouting.
- Threatening or abusive language involving swearing or offensive remarks.
- Racial or sexual remarks.
- Aggressive, forceful tone and/or language that upsets staff.
- Malicious allegations relating to members of staff, other patients or visitors.
- Offensive gestures or behaviours.
- Abusing alcohol or drugs on practice premises.
- Drug dealing on practice premises.
- Wilful damage to practice property.
- Threats or threatening behaviour.
- Persistent and/or unrealistic demands on the service
- Repeated derogatory comments about the practice or individuals either verbally, in writing/digitally or on social media platforms
This list is not exhaustive and there may be other occasions where we have cause to issue a warning or remove you from our patient list. If you are unhappy with the practice we have a complaints procedure to assist you or you have the choice to register with another practice – there really is no need for unpleasant behaviour with these options available to support you.
We trust this policy is clear and supports a mutually respectful environment for patients and staff.