Accessible Information Standard (NHS England)

The Accessible Information Standard is an NHS England initiative that tells organisations how to ensure that disabled patients and their carers receive information in formats that they can understand, as well as receiving appropriate support to help them to communicate. Such formats could include large print, braille or easy-read
documents.

A disabled person is defined as “Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.”

The five basic steps that make up the standard are:

• Ask: Identify / find out if an individual has any communication / information needs. Patients should be asked what their individual needs are – this should be done when new patients register, and for existing patients as and when opportunities present themselves, e.g. during phone calls, and by sharing
  information materials in the practice in posters, leaflets etc.
• Record: Record those needs in a clear, unambiguous and standardised way using clinical coding and free text where appropriate.
• Alert / flag / highlight: Ensure that recorded needs are ‘highly visible’ – electronic records should have an attached flag or alert, while paper records should be clearly marked.
• Share: Include information about individuals’ information / communication needs as part of existing data sharing processes (and in line with existing information governance frameworks).
• Act: Take steps to ensure that individuals receive information which they can access and understand, and receive communication support if they need it.

The practice will ask patients if they have any information or communication needs, and find out how best to meet their needs. This information will be recorded clearly and in a set way.

The practice will highlight or “flag” individuals’ files or notes so it is clear that they have information or communication needs, as well as highlighting how those needs should be met. It is good practice to take existing data held by the practice that indicates which patients are more likely to have information or communication needs. This will aid in proactively targeting such individuals to identify and record their needs in line with the Accessible Information Standard.

Practices are not expected to work backwards through existing patients’ records in order to identify their communication needs. The needs will be identified at the point of registration for new patients, and opportunistically for existing patients.

Exclusions to the Standard

Standards for signage in the practice, the provision of information in foreign languages, and meeting individuals’ preferences for being communicated with in a particular way (e.g. requesting a print letter rather than an email) have been determined to be outside the scope of the standard.

Accessible Information Standard Deadlines

As of 1 April 2016, all organisations that provide NHS or publicly funded adult social care must identify and record information and communication needs with service users:

• At the first interaction or registration with their service
• As part of on-going routine interaction with the service by existing service users
• As of 31 July 2016, all organisations that provide NHS or publicly funded adult social care must have fully implemented and conform to the Accessible information Standard.

For further information: NHS England – Accessible Information Standard

Introduction

This policy is designed to protect both patients and staff from abuse or allegations of abuse and to assist patients to make an informed choice about their examinations and consultations.

Guidelines

Clinicians (male and female) should consider whether an intimate or personal examination of the patient (either male or female) is justified, or whether the nature of the consultation poses a risk of misunderstanding.

• The clinician should give the patient a clear explanation of what the examination will involve.
• Always adopt a professional and considerate manner – be careful with humour as a way of relaxing a nervous situation as it can easily be misinterpreted.
• Always ensure that the patient is provided with adequate privacy to undress and dress.
• Ensure that a suitable sign is clearly on display in each consulting or treatment room offering the chaperone service if required.

This should remove the potential for misunderstanding. However, there will still be times when either the clinician, or the patient, feels uncomfortable, and it would be appropriate to consider using a chaperone. Patients who request a chaperone should never be examined without a chaperone being present. If necessary, where a chaperone is not available, the consultation / examination should be rearranged for a mutually convenient time when a chaperone can be present.

Complaints and claims have not been limited to male doctors with female patients – there are many examples of alleged homosexual assault by female and male doctors. Consideration should also be given to the possibility of a malicious accusation by a patient.

There may be rare occasions when a chaperone is needed for a home visit. The following procedure should still be followed.

Who can act as a chaperone?

A variety of people can act as a chaperone in the practice. Where possible, it is strongly recommended that chaperones should be clinical staff familiar with procedural aspects of personal examination. Where suitable clinical staff members are not available the examination should be deferred.

Where the practice determine that non-clinical staff will act in this capacity the patient must agree to the presence of a non-clinician in the examination, and be at ease with this. The staff member should be trained in the procedural aspects of personal examinations, comfortable in acting in the role of chaperone, and be confident in the scope and extent of their role. They will have received instruction on where to stand and what to watch and instructions to that effect will be laid down in writing by the practice.

Confidentiality 

• The chaperone should only be present for the examination itself, and most discussion with the patient should take place while the chaperone is not present.
• Patients should be reassured that all practice staff understand their responsibility not to divulge confidential information.

Click here to link to the latest GMC guidelines for intimate examinations: Intimate examinations and chaperones – professional standards – GMC (gmc-uk.org).

Procedure

• The clinician will contact the HCA/Nurse to request a chaperone.
• The clinician will record in the notes that the chaperone is present, and identify the chaperone.
• Where no chaperone is available the examination will not take place – the patient should not normally be permitted to dispense with the chaperone once a desire to have one present has been expressed.
  • The chaperone will enter the room discreetly and remain in room until the clinician has finished the examination.
• The chaperone will normally attend inside the curtain at the head of the examination couch and watch the procedure.
• To prevent embarrassment, the chaperone should not enter into conversation with the patient or GP unless requested to do so, or make any mention of the consultation afterwards.
• The chaperone will make a record in the patient’s notes after examination. The record will state that there were no problems, or give details of any concerns or incidents that occurred.
• The patient can refuse a chaperone, and if so this must be recorded in the patient’s medical record

Patient Complaint

If you have a complaint or concern about the service you have received from the doctors or any of the personnel working in this practice, please let us know. We operate a Practice Complaint Procedure as part of an NHS complaint system, which meets national criteria.

How to Complain

We hope that we can sort most problems out easily and quickly, often at the time they arise and with the person concerned. If you wish to make a formal complaint, please do so AS SOON AS POSSIBLE – ideally within a matter of a few days. This will enable us to establish what happened more easily. If doing that is not possible your complaint should be submitted within 12 months of the incident that caused the problem; or within 12 months of discovering that you have a problem.

You should address your complaint:

• In person – ask to speak to the Practice Manager.
• In writing – some complaints may be easier to explain in writing – please give as much information as you can, then send your complaint to the practice for the attention of the Patient Communications Manager (you can use the attached form). The Patient Communications Manager will make sure that we deal with your concerns promptly and in the correct way. You should be as specific and concise as possible.

Complaining on behalf of someone else

We keep strictly to the rules of medical confidentiality (a separate leaflet giving more detail on confidentiality is available on request). If you are not the patient, but are complaining on their behalf, you must have their permission to do so. An authority signed by the person concerned will be needed, unless they are incapable (because of illness or infirmity) of providing this. A Third Party Consent Form is provided below.

What will we do

We will acknowledge your complaint within 3 working days and aim to carry out a full investigation as soon as possible. If we expect our investigation to take some time we will explain the reason for the delay and tell you when we expect to finish.

When we look into your complaint, we will:

• investigate the circumstances
• make it possible for you to discuss the problem with those concerned
• make sure you receive an apology if this is appropriate, and
• take steps to make sure any problem does not arise again.

You will receive a final letter setting out the result of any practice investigations.

Taking it further

We hope that, if you have a problem, you will use our practice complaints procedure. We believe that this will give us the best change of putting right whatever has gone wrong and the opportunity to improve our practice. However, if you feel you cannot raise your complaint with us or you are dissatisfied with the way we are dealing with your complaint, you may refer the matter to:

• By Post:
  NHS England, PO Box 16738, Redditch, B97 9PT
• Electronically:
  england.contactus@nhs.net – please write “For the attention of the Complaints Manager in the subject line.
• By Telephone:
  0300 311 2233 (Monday to Friday 9am to 5pm except Wednesdays when open at 9.30am, excluding Bank Holidays

Publication of GP net earnings 2020/21

Published March 2021

NHS England requires 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.

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 Brookside Health Centre in the last financial year was £58,327 before tax and National Insurance. This is for 2 full time GPs, 1 part time GP and 5 Locums who worked in the practice for more than six months.

Privacy Notice

Patient Confidentiality

The practice complies with GDPR legislation.  Identifiable information about you will be shared with others in the following circumstances:

• To provide further medical treatment for you, e.g. from district nurses and hospital services.
• To help you get other services, e.g. from the Social Work Department. This requires your consent.
• When we have a duty to others, e.g. in child protection cases. Anonymised patient information will also be used at local and national level to help the Health Board and Government plan services, e.g. for diabetic care.

If you do not wish anonymous information about you to be used in such a way, please let us know.

Reception and administration staff require access to your medical records in order to do their jobs.  These  members of staff are bound by the same rules of confidentiality as the medical staff.

Patient Rights & Responsibilities

Users of the National Health Service have rights. The following explains what they are. They fall into three main categories.

Legislated Rights

Rights that have been written into law by means of Parliamentary Acts or Bills. (For example, UK GDPR and DPA 2018). As a patient of the NHS you have 7 rights.

• You are entitled to receive health care on the basis of clinical need, regardless of your income.
• You are entitled to be registered with a Medical practice. You are entitled to change your practice at any time. You do not have to give a reason for your decision.
• You are legally entitled to accept or refuse treatment as you see fit. This includes examinations, tests, diagnostic procedures, medication, operations, etc.
• You can refuse to be involved in research trials. If you do not agree to be involved in research trials, you can withdraw at any time.
• You are entitled to equal treatment regardless of race, gender, age or disability.
• You have a right to information on GP practices in your area and the services they provide. All practices must provide an information leaflet.
• You have a right to confidentiality. Personal information about your health is confidential and should only be disclosed to those who need that information to provide you with effective treatment, you can consent to share with other individuals outside of the NHS

Access to your Health Records.

You have a legal entitlement to see a copy of the records held about you. All records stored on computer can be accessed. If you wish to see your records you should apply in to the practice for a Subject Access Request.

Guideline Rights

• You are entitled to have reasonable access to high quality service and facilities.
• You are entitled to information on what is wrong with you and the treatment options available. Ask questions. You should be given truthful, clear answers.
• You are entitled to ask for a second opinion on your diagnosis or treatment.
• You can ask to have someone with you (friend, relative, interpreter) at any time. You may find this beneficial, particularly if you are asking questions or need moral support.

Human Rights

It is your right to be treated as a human being by another human being and as they would wish to be treated themselves, i.e. with dignity, politeness, respect and consideration. These may not necessarily be covered legally or even be contained in guidelines, but human rights will come into many of the areas mentioned above and are certainly just as important.

Consent

A doctor, nurse, or anyone else looking after your health, has to have your agreement before they can examine or treat you. This policy applies to both children and adults. Your consent will be sought before any of your information is shared with any individual not connected with your direct health care.

Patient Responsibilities

Patients, too, have certain responsibilities:

• Keeping appointments:  Please try to arrive on time. If you are unable to attend an appointment, please inform the clinic or surgery in good time. Address. If you move house, change address or telephone number, or the postcode is changed, please inform your GP practice or outpatient clinic.
• Treat all healthcare staff in a reasonable, courteous manner.
• Use emergency services in a responsible manner. Please use the out-of-hours services for emergencies only and not for routine care.
• Take care with medicines. Medicines are for one person only and should not be shared. Keep them safely away from children and in the original container. Take any unwanted medicines to a chemist for safe disposal.

General

Practice365 strives to ensure that its services are accessible to people with disabilities. Practice365 has invested a significant amount of resources to help ensure that its websites are made easier to use and more accessible for people with disabilities, with the strong belief that every person has the right to live with dignity, equality, comfort and independence.

This accessibility statement applies to websites hosted by Practice365.co.uk.

Accessibility on Practice365

We want as many people as possible to be able to use this website. For example, that means you should be able to:

• change colours, contrast levels and fonts
• zoom in up to 300% without the text spilling off the screen
• navigate most of the website using just a keyboard
• navigate most of the website using speech recognition software
• listen to most of the website using a screen reader (including the most recent versions of JAWS, NVDA and VoiceOver)

We’ve also made the website text as simple as possible to understand.

AbilityNet has advice on making your device easier to use if you have a disability.

How accessible this website is

We know some parts of this website are not fully accessible:

• most older PDF documents are not fully accessible to screen reader software

Enabling the Accessibility Menu

Disclaimer

Practice365 continues its efforts to constantly improve the accessibility of its site and services in the belief that it is our collective moral obligation to allow seamless, accessible and unhindered use also for those of us with disabilities.

Here For You

If you are experiencing difficulty with any content on Practice365 website, widget, any of its services or require assistance with any part of our site or software, please contact us during normal business hours as detailed below and we will be happy to assist.

Contacting Us

If you wish to report a problem, have any questions or need assistance, please email us at hello@iatropartners.co.uk

Enforcement procedure

The Equality and Human Rights Commission (EHRC) is responsible for enforcing the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018 (the ‘accessibility regulations’). If you’re not happy with how we respond to your complaint, contact the Equality Advisory and Support Service (EASS). If you are based in Northern Ireland, please reefer to Equalities Commission for Northern Ireland (ECNI) instead of the EASS and EHRC.

Zero Tolerance Policy

Violence and Aggression

We require everyone to treat our Patient Co-ordinators and staff with dignity and respect at all times.  Any callers who fail to do so will have the call terminated without warning.

This practice does not tolerate violence or aggression in any form.  A patient committing an act of violence or aggression will be reported to the police and they will be removed from our list of patients.

Alternative arrangements for the care of violent or aggressive patients will be provided by the IOW ICB.