Practice Policies & Patient Information

Chaperone Policy

Confidentiality

STAFF CONFIDENTIALITY POLICY AND AGREEMENT

Introduction

The aims of the policy are to ensure

all information held at the Practice about patients is confidential, whether held electronically or in hard copy
sexual orientation, gender identity and trans status are protected data
other information about the Practice (for example its financial matters, staff records) is confidential
all staff are aware of their responsibilities for safeguarding confidentiality and preserving information security
all staff understand their responsibilities when sharing information with both NHS and non-NHS organisations

Staff will, by necessity, have access to such confidential information from time to time

Applicability

The policy applies to all employees and partners, and also applies to other people who work at the practice e.g. self-employed staff, temporary staff and contractors – collectively referred to herein as ‘workers’.

Policy

All information about patients is confidential: from the most sensitive diagnosis, to the fact of having visited the surgery or being registered at the practice. This includes information about patients’ families or others associated with them.
Confidential information may not be health-related. It can include anything that is private and not public knowledge.
Workers should limit any discussion about confidential information to only those who need to know within the practice.
Only the minimum amount of necessary information should be disclosed
The duty of confidentiality owed to a person under 16 is as great as the duty owed to any other person.

Workers must not under any circumstances disclose patient information to anyone outside the practice, except to other health professionals on a need-to-know basis, or where the patient has provided written consent.
Workers must not under any circumstances disclose other confidential information about the practice to anyone outside the practice unless with the express consent of Dr Wong.
All patients can expect that their personal information will not be disclosed without their permission (except in the most exceptional circumstances when disclosure is required when a person is at grave risk of serious harm).
Where disclosure of information is required which is non-routine in nature the patient will, where possible, be fully informed of the nature of the disclosure prior to this being released.
Where the decision is made to disclose information, the decision to do so must be justified and documented.
Person-identifiable information must not be used unless absolutely necessary – anonymised date should be used wherever possible.
Workers must be aware of and conform to the requirements of the Caldicott recommendations.
Electronic transfer of any confidential information, once approved by the [Practice Manager/Senior Partner], must be transmitted via the NHSnet. Workers must take particular care that confidential information is not transmitted in error by email or over the Internet. See also: Electronic Transfer of Patient Data Policy ^[*]
Workers must not take data from the practice’s computer systems (e.g. on a memory stick or removable drive) off the premises unless authorised to do so by Dr Wong.
Where this is the case, the information must be kept on the worker’s person at all times while travelling and kept in a secure, lockable location when taken home or to another location. All information should be held on an encrypted disc, or pendrive
Workers who suspect a breach of confidentiality must inform the [Practice Manager/Senior Partner]
Any breach of confidentiality could be considered a serious disciplinary offence and will be investigated in line with the practice’s disciplinary procedure.
Workers remain bound by a requirement to keep information confidential even if they are no longer employed at the practice. Any breach, or suspected breach, of confidentiality after the worker has left the practice’s employment will be passed to the practice’s lawyers for action

Responsibilities of Practice Staff/Workers

All health professionals must follow their professional codes of practice and the law. This means that they must make every effort to protect confidentiality. It also means that no identifiable information about a patient is passed to anyone or any agency without the express permission of that patient, except when this is essential for providing care or necessary to protect somebody’s health, safety or well-being.

All health professionals are individually accountable for their own actions. They should, however, also work together as a team to ensure that standards of confidentiality are upheld, and that improper disclosures are avoided.

Additionally, Dr Wong, Ashton View Medical Centre, as Employers:

are responsible for ensuring that everybody employed by the practice understands the need for, and maintains, confidentiality.
have overall responsibility for ensuring that systems and mechanisms are in place to protect confidentiality.
have vicarious liability for the actions of those working in the practice – including health professionals and non-clinical staff (i.e. those not employed directly by the practice but who work in the surgery).

Standards of confidentiality apply to all health professionals, administrative and ancillary staff – including receptionists, secretaries, practice manager, cleaners and maintenance staff – who are bound by contracts of employment to maintain confidentiality.

They must not reveal personal information they learn in the course of their work, or due to their presence in the surgery, to anybody outside the practice without the patient’s consent. Nor will they discuss with colleagues any aspect of a patient’s attendance at the surgery in a way that might allow identification of the patient, unless to do so is necessary for the patient’s care.

Gender Recognition Act 2004

The 2004 Gender Recognition Act (GRA) makes it a criminal offence to disclose an individual’s transgender history to a third party without their written consent if that individual holds a Gender Recognition Certificate (GRC). Patients do not need to show a GRC or birth certificate in order for the GRA 2004 to be in effect, so it is best practice to act as though every trans patient has one. This means always obtaining a trans patient’s written consent before sharing details about their social or medical transition, sometimes also called gender reassignment, with other services or individuals. This includes information such as whether a patient is currently taking hormones or whether they have had any genital surgery, as well as information about previous names or the gender they were given at birth. Consent should always be obtained before information relating to the patient being trans is shared in referrals and this information should only be shared where it is clinically relevant, e.g. it would be appropriate when referring a trans man for a pelvic ultrasound but not when referring him to ENT.

If Disclosure is Necessary

If a patient or another person is at grave risk of serious harm that disclosure to an appropriate person would prevent, the relevant health professional can take advice from colleagues within the practice, of from a professional / regulatory / defence body, in order to decide whether disclosure without consent is justified to protect the patient or another person. If a decision is taken to disclose, the patient should always be informed before disclosure is made, unless to do so could be dangerous. If at all possible, any such decisions should be shared with another member of the practice team.

Any decision to disclose information to protect health, safety or well-being will be based on the degree of current or potential harm, not the age of the patient.

Data Protection

We need to hold personal information about you on our computer systems and in paper records to help us to look after your health needs, and your doctor is responsible for their accuracy and safe-keeping. Please help to keep your record up to date by informing us of any changes to your circumstances.

Doctors and staff in the practice have access to your medical records to enable them to do their jobs. From time to time information may be shared with others involved in your care if it is necessary. Anyone with access to your record if properly trained in confidentiality issues and is governed by both legal and contractual duty to keep your details private.

All information about you is held securely and appropriate safe guards are in place to prevent accidentals loss.

In some circumstances we may be required by law to release your details to statutory or other official bodies, for example if a court order is presented, or in the case of public health issues. In other circumstance you may be required to give written consent before information is released – such as for medical reports for insurance, solicitors etc.

To ensure your privacy, we will not disclose information over the telephone or fax unless we are sure that we are talking to you. Information will not be disclosed to family, friends or spouses unless we have prior written consent, and we do not, leave messages with others.

You have a right to see your records if you wish. Please ask at reception if you would like further details about our patient information leaflet. An appointment may be required. In some circumstances a fee may be payable.

Disabled Access

GP Earnings

From April 2016 it has become a contractual requirement for all GP practices to publish the mean net earnings of the partners, salaried GPs and locums who have worked in the practice for over six months, on their Practice website.

The average pay for GPs working at Ashton View Medical centre in the last financial year 2022/23 was £46,172 before tax and National insurance. This is for 1 Full-time and 1 Part time doctor who worked at the practice for more than 6 months.

IT Policy

This practice is committed to preserving, as far as is practical, the security of data used by our information systems. This means that we will take all reasonable actions to;

Maintain the Confidentiality of all data within the practice by:

Ensuring that only authorised persons can gain access to our systems
Not disclosing information to anyone who has no right to see it

Maintain the integrity of all data within the practice by:

Taking care over input
Ensuring that all changes are reported and monitored
Checking that the correct record is on the screen before updating
Reporting all apparent errors and ensuring that they are resolved

Maintain the availability of all data by:

Ensuring that all equipment is protected from intruders
Ensuring that backups are taken at regular, predetermined intervals
Ensuring that contingency is provided for possible failure or equipment theft and that any such contingency plans are tested and kept up to date

Additionally we will take all reasonable measures to comply with our legal responsibilities under:

Personal Data

The following IT systems are in use at the practice:

Referral Management (using NHS numbers in referrals)
Electronic Appointment Booking (the facility to book routine appointments online and, similarly, to cancel appointments
Online booking of repeat prescriptions
Summary Care Record (uploading details of your current medication and allergies to the national “spine” so that these are available for doctors involved in your care elsewhere)
GP to GP transfers (the electronic transfer of records from practice to practice when you re-register
Patient Access to records (the facility to view your medical records online).

If you are not already registered for online access and would like to be please complete our online form.

If you would like access to your medical records enabled or would like to opt out of the local or national summary care record, please contact reception.

Practice Training Closure Dates

This privacy notice lets you know what happens to any personal data that you give to us, or any that we may collect from or about you.

This privacy notice applies to personal information processed by or on behalf of the practice.

This Notice explains

Who we are, how we use your information and our Data Protection Officer
What kinds of personal information about you do we process?
What are the legal grounds for our processing of your personal information (including when we share it with others)?
What should you do if your personal information changes?
For how long your personal information is retained by us?
What are your rights under data protection laws?

The General Data Protection Regulation (GDPR) became law on 24th May 2016. This is a single EU-wide regulation on the protection of confidential and sensitive information. It enters into force in the UK on the 25th May 2018, repealing the Data Protection Act (1998).

For the purpose of applicable data protection legislation (including but not limited to the General Data Protection Regulation (Regulation (EU) 2016/679) (the “GDPR”), and the Data Protection Act 2018 (currently in Bill format before Parliament) the practice responsible for your personal data.

This Notice describes how we collect, use and process your personal data, and how, in doing so, we comply with our legal obligations to you. Your privacy is important to us, and we are committed to protecting and safeguarding your data privacy rights

How we use your information and the law.

The practice will be what’s known as the ‘Controller’ of the personal data you provide to us.

We collect basic personal data about you which does not include any special types of information or location-based information. This does however include name, address, contact details such as email and mobile number etc.

We will also collect sensitive confidential data known as “special category personal data”, in the form of health information, religious belief (if required in a healthcare setting) ethnicity, and sex during the services we provide to you and or linked to your healthcare through other health providers or third parties.

Why do we need your information?

The health care professionals who provide you with care maintain records about your health and any treatment or care you have received previously (e.g. NHS Trust, GP Surgery, Walk-in clinic, etc.). These records help to provide you with the best possible healthcare.

NHS health records may be electronic, on paper or a mixture of both, and we use a combination of working practices and technology to ensure that your information is kept confidential and secure. Records which the Practice hold about you may include the following information;

Details about you, such as your address, carer, legal representative, emergency contact details
Any contact the surgery has had with you, such as appointments, clinic visits, emergency appointments, etc.
Notes and reports about your health
Details about your treatment and care
Results of investigations such as laboratory tests, x-rays etc
Relevant information from other health professionals, relatives or those who care for you

To ensure you receive the best possible care, your records are used to facilitate the care you receive. Information held about you may be used to help protect the health of the public and to help us manage the NHS. Information may be used within the GP practice for clinical audit to monitor the quality of the service provided.

How do we lawfully use your data?

We need to know your personal, sensitive and confidential data in order to provide you with Healthcare services as a General Practice, under the General Data Protection Regulation we will be lawfully using your information in accordance with: –

Article 6, e) processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller;”

Article 9, (h) processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems

This Privacy Notice applies to the personal data of our patients and the data you have given us about your carers/family members.

Risk Stratification

Risk stratification data tools are increasingly being used in the NHS to help determine a person’s risk of suffering a condition, preventing an unplanned or (re)admission and identifying a need for preventive intervention. Information about you is collected from a number of sources including NHS Trusts and from this GP Practice. A risk score is then arrived at through an analysis of your de-identified information is only provided back to your GP as data controller in an identifiable form. Risk stratification enables your GP to focus on preventing ill health and not just the treatment of sickness. If necessary, your GP may be able to offer you additional services. Please note that you have the right to opt out of your data being used in this way.

Medicines Management

The Practice may conduct Medicines Management Reviews of medications prescribed to its patients. This service performs a review of prescribed medications to ensure patients receive the most appropriate, up to date and cost-effective treatments.

How do we maintain the confidentiality of your records?

We are committed to protecting your privacy and will only use information collected lawfully in accordance with:

Data Protection Act 2018
The General Data Protection Regulations 2016
Human Rights Act 1998
Common Law Duty of Confidentiality
Health and Social Care Act 2012
NHS Codes of Confidentiality, Information Security and Records Management
Information: To Share or Not to Share Review

Every member of staff who works for an NHS organisation has a legal obligation to keep information about you confidential.

We will only ever use or pass on information about you if others involved in your care have a genuine need for it. We will not disclose your information to any third party without your permission unless there are exceptional circumstances (i.e. life or death situations), where the law requires information to be passed on and / or in accordance with the information sharing principle following Dame Fiona Caldicott’s information sharing review (Information to share or not to share) where “The duty to share information can be as important as the duty to protect patient confidentiality.” This means that health and social care professionals should have the confidence to share information in the best interests of their patients within the framework set out by the Caldicott principles.

Our practice policy is to respect the privacy of our patients, their families and our staff and to maintain compliance with the General Data Protection Regulations (GDPR) and all UK specific Data Protection Requirements. Our policy is to ensure all personal data related to our patients will be protected.

All employees and sub-contractors engaged by our practice are asked to sign a confidentiality agreement. The practice will, if required, sign a separate confidentiality agreement if the client deems it necessary. If a sub-contractor acts as a data processor for the practice an appropriate contract (art 24-28) will be established for the processing of your information.

In Certain circumstances you may have the right to withdraw your consent to the processing of data. Please contact the Data Protection Officer in writing if you wish to withdraw your consent. If some circumstances we may need to store your data after your consent has been withdrawn to comply with a legislative requirement.

Some of this information will be held centrally and used for statistical purposes. Where we do this, we take strict measures to ensure that individual patients cannot be identified. Sometimes your information may be requested to be used for research purposes – the surgery will always gain your consent before releasing the information for this purpose in an identifiable format. In some circumstances you can Opt-out of the surgery sharing any of your information for research purposes.

With your consent we would also like to use your information to

We would however like to use your name, contact details and email address to inform you of services that may benefit you, with your consent only. There may be occasions were authorised research facilities would like you to take part on innovations, research, improving services or identifying trends.

At any stage where we would like to use your data for anything other than the specified purposes and where there is no lawful requirement for us to share or process your data, we will ensure that you have the ability to consent and opt out prior to any data processing taking place. This information is not shared with third parties or used for any marketing and you can unsubscribe at any time via phone, email or by informing the practice DPO as below.

Where do we store your information Electronically?

All the personal data we process is processed by our staff in the UK however for the purposes of IT hosting and maintenance this information may be located on servers within the European Union.

No 3rd parties have access to your personal data unless the law allows them to do so and appropriate safeguards have been put in place. We have a Data Protection regime in place to oversee the effective and secure processing of your personal and or special category (sensitive, confidential) data.

Who are our partner organisations?

We may also have to share your information, subject to strict agreements on how it will be used, with the following organisations;

NHS Trusts / Foundation Trusts
GP’s
eMBED Health
Independent Contractors such as dentists, opticians, pharmacists
Private Sector Providers
Voluntary Sector Providers
Ambulance Trusts
Clinical Commissioning Groups
Social Care Services
NHS England (NHSE) and NHS Digital (NHSD)
Local Authorities
Education Services
Fire and Rescue Services
Police & Judicial Services
Voluntary Sector Providers
Private Sector Providers
Other ‘data processors’ which you will be informed of

You will be informed who your data will be shared with and in some cases asked for consent for this to happen when this is required.

We may also use external companies to process personal information, such as for archiving purposes. These companies are bound by contractual agreements to ensure information is kept confidential and secure. All employees and sub-contractors engaged by our practice are asked to sign a confidentiality agreement. If a sub-contractor acts as a data processor for the practice an appropriate contract (art 24-28) will be established for the processing of your information.

How long will we store your information?

We are required under UK law to keep your information and data for the full retention periods as specified by the NHS Records management code of practice for health and social care and national archives requirements. More information on records retention can be found online at (https://digital.nhs.uk/article/1202/Records-Management-Code-of-Practice-for-Health-and-Social-Care-2016)

How can you access, amend move the personal data that you have given to us?

Even if we already hold your personal data, you still have various rights in relation to it. To get in touch about these, please contact us. We will seek to deal with your request without undue delay, and in any event in accordance with the requirements of any applicable laws. Please note that we may keep a record of your communications to help us resolve any issues which you raise.

Right to object: If we are using your data because we deem it necessary for our legitimate interests to do so, and you do not agree, you have the right to object. We will respond to your request within 30 days (although we may be allowed to extend this period in certain cases). Generally, we will only disagree with you if certain limited conditions apply.

Right to withdraw consent: Where we have obtained your consent to process your personal data for certain activities (for example for a research project), or consent to market to you, you may withdraw your consent at any time.

Right to erasure: In certain situations (for example, where we have processed your data unlawfully), you have the right to request us to “erase” your personal data. We will respond to your request within 30 days (although we may be allowed to extend this period in certain cases) and will only disagree with you if certain limited conditions apply. If we do agree to your request, we will Delete your data but will generally assume that you would prefer us to keep a note of your name on our register of individuals who would prefer not to be contacted. That way, we will minimise the chances of you being contacted in the future where your data are collected in unconnected circumstances. If you would prefer us not to do this, you are free to say so.

Right of data portability: If you wish, you have the right to transfer your data from us to another data controller. We will help with this with a GP to GP data transfer and transfer of your hard copy notes

Access to your personal information

Data Subject Access Requests (DSAR): You have a right under the Data Protection legislation to request access to view or to obtain copies of what information the surgery holds about you and to have it amended should it be inaccurate. To request this, you need to do the following:

Your request should be made to the Practice – for information from the hospital you should write direct to them
There is no charge to have a copy of the information held about you
We are required to respond to you within one month
You will need to give adequate information (for example full name, address, date of birth, NHS number and details of your request) so that your identity can be verified, and your records located information we hold about you at any time.

What should you do if your personal information changes?

You should tell us so that we can update our records please contact the Practice Manager as soon as any of your details change, this is especially important for changes of address or contact details (such as your mobile phone number), the practice will from time to time ask you to confirm that the information we currently hold is accurate and up-to-date.

Summary Care Record

Your patient record is held securely and confidentially on the electronic system at your GP practice. If you require treatment in another NHS healthcare setting such as an Emergency Department or Minor Injury Unit, 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 via: The Summary Care Record, used nationally across England

The information will be used only by authorised health care professionals directly involved in your care. Your permission will be asked before the information is accessed, unless the clinician is unable to ask you and there is a clinical reason for access.

If you would like to opt out, please ask reception for our opt out form.

A parent or guardian can request to opt out children under 16 but ultimately it is the GP’s decision whether to create the records or not, because of their duty of care to the child. If you are the parent or guardian of a child under 16 and feel that they are able to understand, then you should make this information available to them.

Who Has Access?

Across all health care settings, including urgent care, community care and outpatient departments in England.

Information Source

GP record

Content

Your current medications
Any allergies you have
Any bad reactions you have had to medicines
Additional information (upon request to your GP)

For more information visit:

www.digital.nhs.uk

Violence Policy

The NHS operate a zero tolerance policy with regard to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons. Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.