Chaperone Policy

Bredon Hill Surgery 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.

This Chaperone Policy adheres to local and national guidance and policy –i.e.:

‘NCGST Guidance on the role and effective use of chaperones in Primary and Community Care settings’.

All patients are entitled to have a chaperone present for any consultation, examination, or procedure where they consider one is required. The chaperone may be a family member or friend, but on occasions, a formal chaperone may be preferred.

Patients are advised to ask for a chaperone if required, at the time of booking an appointment, if possible so that arrangements can be made and the appointment is not delayed in any way. The Healthcare Professional may also require a chaperone to be present for certain consultations.

All staff are aware of and have received appropriate information in relation to this Chaperone Policy.

All trained chaperones understand their role and responsibilities and are competent to perform that role.

There is no common definition of a chaperone and their role varies considerably depending on the needs of the patient, the healthcare professional, and the examination being carried out.

Their role can be considered in any of the following areas:

• Emotional comfort and reassurance to patients.
• Assist in examination (e.g. during IUCD insertion).
• Assist in undressing.
• Act as an interpreter.
• Protection to the healthcare professional against allegations/attack)

Checklist for Consultations Involving Intimate Examinations

• Chaperones are most often required or requested where a male examiner is carrying out an intimate examination or procedure on a female patient, but the designation of the chaperone will depend on the role expected of them, whether participating in the procedure or providing a supportive role.
• Establish there is a genuine need for an intimate examination and discuss this with the patient and whether a formal chaperone (such as a nurse) is needed.
• Explain to the patient why an examination is necessary and give the patient an opportunity to ask questions. The chaperone would normally be the same sex as the patient and the patient will have the opportunity to decline a particular person as a chaperone if that person is considered not acceptable for any reason.
• Offer a chaperone or invite the patient to have a family member/friend present.
• If the patient does not want a chaperone, record that the offer was made and declined in the patient’s notes.
• Obtain the patient’s consent before the examination and be prepared to discontinue the examination at any stage at the patient’s request.
• Record that permission has been obtained in the patient’s notes.
• Once the chaperone has entered the room, they should be introduced by name and the patient allowed privacy to undress/dress. Use drapes/curtains where possible to maintain dignity. There should be no undue delay prior to examination once the patient has removed any clothing.
• Explain what is being done at each stage of the examination, the outcome when it is complete and what is proposed to be done next. Keep discussion relevant and avoid personal comments.
• If a chaperone has been present, record that fact and the identity of the chaperone in the patient’s notes.
• During the examination, the chaperone may be needed to offer reassurance, remain alert to any indication of distress but should be courteous at all times.
• Record any other relevant issues or concerns in the patient’s notes, immediately following the consultation.
• Chaperones should only attend the part of the consultation that is necessary – other verbal communication should be carried out when the chaperone has left.
• Any request that the examination be discontinued should be respected.
• Healthcare professionals should note that they are at an increased risk of their actions being misconstrued or misrepresented if they conduct intimate examinations where no other person is present.

Statement of Purpose – Bredon Hill Surgery

CQC Provider ID  1-199766312

Address
Main Road
Bredon, Tewkesbury
Glos GL20 7QN

Telephone 01684 773444

Email contact [email protected]

Legal Status Partnership

Full Names of the Partners

Dr Jeremy John Pawley – Registered Manager for all regulated activities

Dr Simon John Hill – Registered Manager for all regulated activities

Our Locations

Bredon Hill Surgery at address above

PRACTICE AIMS

• Bredon Hill Surgery aims to provide high quality General Practice Services to any patient living or staying within our practice area
• Bredon Hill Surgery aims to provide our service in a timely, professional and caring fashion
• Bredon Hill Surgery continually strives to improve the quality of the services we offer

PRACTICE OBJECTIVES

We will achieve these aims by:

• Treating all our patients with respect and dignity. Involving them in decision making and encouraging them to take responsibility for their own health
• Being courteous, approachable and accommodating
• Listening to the concerns of patients, their families and carers and take action where needed
• Involving other health professionals in the care of our patients and communicating effectively with them
• Ensuring that all members of the Practice team have the appropriate skills and training to carry out their duties competently and professionally in a safe and supportive environment
• Communicating clearly and regularly with our patients using a range of media, and to invite on-going feedback using our website, patient surveys and the Patient Participation Group
• Promoting the uptake of evidence based treatments and procedures
• Promoting equality of access to health care for all our registered population
• Fostering an innovative approach to the development of primary care through clinical teaching, audit and research
• Maintaining the confidentiality of patient information at all times

THE PRACTICE POPULATION

The practice is the only Primary Care Facility serving the patients of Bredon. We provide general practice services to any patient living or staying within our area of Bredon and outlying villages. We cover an area stretching from the north part of Tewkesbury to Eckington and around Bredon Hill to Ashton-under-Hill.

The practice has been operating from our purpose-built premises at Main Road since 1989.  Our premises have disabled access and parking facilities.  We have a dispensary and dispense medications to around 95% of our patients.

We have a large population of elderly patients when compared to the county average, resulting in problems with social isolation, but with low levels of deprivation.  The patient list has been gradually increasing in size and the practice now has over 5500 patients.

IMPROVING HEALTH

The practice has a strong clinical team which consists of Doctors, a Pharmacist, Practice Nurses, Healthcare Assistants and associations with health visitors, midwives and mental health nurses. We also work closely with a wider team of community nurses and allied professions who are dedicated to the support of elderly, vulnerable or frail patients in their own home or care home setting.

The Surgery is part of The Vale of Evesham Primary Care Network (comprising seven local practices – the others are Abbey Medical Practice, Barn Close Surgery, DeMontfort Medical Centre, Grey Gable Surgery, Merstow Green Medical Practice and Riverside Surgery).

STAFF

Four doctors work from our surgery, providing general medical care.  We have 2 male partners working 7 clinical sessions each per week. We also have two female part time salaried GPs who work 6 and 4 clinical sessions per week.

The nursing staff working within the practice comprises of, three part time Practice Nurses, plus two part-time Health Care Assistants and a phlebotomist.

We employ a Clinical Pharmacist, whose role is to support with the management of chronic diseases, minor illnesses, medication related queries from patients, the dispensary and other prescribing related activities.

The Community nursing team (Neighbourhood Team) is comprised of ANPs, District Nurses, Physios, Occupational therapists and a mental health practitioner. They are based in Evesham but cover our practice area. We work with the local midwifery and health visiting teams from Gloucestershire and Worcestershire.

The Practice Manager manages all operational, financial, personnel, strategic, and health and safety matters within the Practice. She is supported by an Assistant Practice Manager, the Lead Nurse, Senior Dispenser, and a team of administrative staff who undertake reception, secretarial and other administrative duties.

EQUIPMENT AND FACILITIES

The practice has a wide range of modern medical equipment, and our policy is to extend the range as often as possible, and as need arises and resources allow.  The equipment is maintained in line with regulations.

We are a paper-light practice, and use the EMIS web computer system.  We offer our patients on-line appointment booking and prescription requesting.Patients are also able to request on-line access to their medical records.

CARE QUALITY COMMISSION

The services we provide are categorised as follows: 

• Doctors consultation services
• Doctors treatment service
• Diagnostic and screening services

The regulated activities provided under the Registered Managers Dr Jeremy Pawley and Dr Simon Hill are:

• Treatment of disease and disorder
• Surgical procedures (GP minor surgery only)
• Diagnostic and screening procedures
• Nursing Care
• Family Planning

In line with the General Data Protection Regulations Bredon Hill Surgery has a Data Protection Notice for Patients, a copy of which can be sent to you via email or post. Please contact the surgery on 01684 773444 or email your request to the practice to receive this information.

Your Data Matters

Information about your health and care help the NHS to improve your individual care, speed up diagnosis, plan your local services and speed up new treatments.

The strict rules about how this data can and cannot be used have been strengthened. The NHS is committed to keeping patient information safe and always being clear about how it is used.

You can choose if your confidential data is used for research and planning. To find out more you can visit https://www.nhs.uk/your-nhs-data-matters.

Patient Confidentiality

We ask you for personal information so that you can receive care an treatment. This information is recorded on our computer system and we are registered under the Data Protection Act.

We understand how important confidentiality is to our patients and we provide complete confidentiality between you and us at all times.

We receive a large amount of correspondence everyday and it is the job of the receptionists to distribute to the relevant people in the practice. The receptionists will open letters to GP’s, even those marked confidential and take the appropriate action. Please be advised that everything is dealt with in the strictest of confidence and all members of staff adhere to our confidentiality policy.

If you wish a third party to receive information about yourself, please ask the reception team to complete a form for you.

The Freedom of Information Act 2000 obliges the practice to produce a Publication Scheme. A Publication Scheme is a guide to the ‘classes’ of information the practice intends to routinely make available.

Please visit https://www.england.nhs.uk/contact-us/foi/

Publication of GP Net Earnings

All GP Practices are required to declare the mean earnings (i.e. average pay) for GPs working to deliver NHS services to patients at each Practice.  The average pay for GPs working at the Bredon Hill Surgery in the financial year ended 31 March 2022 was £33,881 before tax, national insurance and superannuation.  This is the average pay for four part-time GPs and five part-time Locums who worked in the Practice for more than six months during that year.

• Two part-time partners (Jeremy and Simon)
• Two part-time salaried GPs (Drs Purvis and Cooke)
• Five part-time locums (Drs Pygott, Twemlow, Remfree, Lynch-Blosse and Cusack)

You can view our privacy notices via the links below:

• Bredon Hill Surgery Privacy Notice
• Candidate Privacy Notice
• Employee Privacy Notice
• Child Privacy Notice
• COVID Privacy Notice

(Please be advised you do need access to online services and/or medical records to proceed – applications are available at reception).

Proxy access refers to access to online services for somebody acting on behalf of you (the patient) with your consent.

A person given access to your online services does not need to be registered as a patient of Bredon Hill Surgery but must apply to us for proxy access to be granted.

Access can be granted to anyone of your (the patient’s) choice – e.g a family member, partner, carer, etc and you can grant access to more than one person.

You may wish to allow another person to use online services for different reasons including:

• If you are unwell and need help managing your medical conditions; speech or memory difficulties or perhaps you are planning for the future and may have appointed someone to hold a lasting power of attorney for health and social care.

• You (the patient) can choose the online services you want the person acting on your behalf to have access to. The choice of online services is usually booking appointments, ordering repeat medication, and looking at GP records.

• You (the patient) and the person acting on your behalf will need to complete a form  – please contact reception.

Please be advised the person acting on your behalf will need to return the form in person and the receptionist will request to see photo identification (driving license/passport and proof of residence e.g a utility bill.

Patient Guide – Giving another person access to your GP online services

• Patient Online Records Access – Patient Information Leaflet

When a patient is no longer able to make a decision for themselves another person, often a partner or close family member can be given legal responsibility for decisions concerning their life by the courts  – Health and Welfare Lasting Power of Attorney. Under these circumstances, the request is reviewed by your usual GP.

There may be times when a GP could refuse the chosen person access. Whilst this is rare, the GP will always put the best interests of you (the patient) first. The GP will discuss any refusal with you or in the case of impaired capacity, with their representative.

Examples of reasons for refusal are:

• The GP does not think it is in your best interests to have the chosen person use online services;
• Online services have been abused by the patient or chosen person in the past;
• The GP is concerned that the chosen person will not keep the information safe.

Bredon Hill Surgery can remove access to your online services for a number of reasons including:

• If we believe you are being forced to share your records;
• The chosen person is deemed to have misused information;
• Death.

Withdrawing Consent

You (the patient) have the right to remove access to your online services from your chosen person at any time – please contact reception.

Proxy Access for Children

A child aged 13 and above, who the practice has assessed to have the required level of competency for decision making, can be granted access to their online records and can also grant consent to a parent or carer to have proxy access.

When a child is not deemed to have the competency and is over the age of 13, a parent may apply for access without the child’s consent and will be registered as a proxy user.

Access to Medical Record

An application for access to a medical record may be made by:

• The patient,
• A person authorised in writing to make the application (such as solicitor or insurance company),
• A person having parental responsibility for a child: any person appointed by a court to manage the patients’ affairs.
• Where a patient is deceased the patient next of kin or authorised Representative.

We will always ensure that we have the patients informed consent to release copies of medical records and on occasion, we may write to a patient to confirm that they are fully aware of what information they have consented to be released. This will generally apply in situations where we get requests from solicitors.

Please refer to the page where fees payable for requests made by third party Non-NHS Services that may apply.

You can now use the new NHS App, a simple and secure way to access a range of NHS services on your smartphone or tablet.

You can use the NHS App to check your symptoms and get instant advice, book appointments, order repeat prescriptions, view your GP medical record, and more.

If you already use Patient Access you can continue to use it. You can use the NHS App as well.

For more information go to www.nhs.uk/nhsapp‘

There is a Central NHS Computer System called the Summary Care Record (SCR).  The Summary Care Record is designed to assist doctors and nurses care for you by providing essential medical information about you.

Initially, it will only contain your medication and allergies.

Staff who work in the NHS can access the SCR. It may also contain your medical summary, information from hospitals, out of hours services, and letters from specialists.

Your information will be extracted from practices such as ours and held on central NHS databases.

As with all systems, there are pros and cons to think about.

When you speak to an emergency doctor you may overlook something that is important, however, if they have access to your medical record this might be avoided.

You should be asked to give your consent each time a member of NHS Staff wishes to access your record unless you are medically unable to do so.

You may have strong views about sharing your personal information and wish to keep your information only at the level of your GP practice.

Connecting for Health (CfH), the government agency responsible for the Summary Care Record has agreed with doctors’ leaders that new patients registering with a practice should be able to decide whether or not their information is uploaded to the Central NHS Computer System.

For existing patients, it is assumed that you consent for your record to be uploaded to the Central NHS Computer System unless you actively opt-out.

For further information visit the HSCIC Website.

If you choose to opt-out of the scheme, then you will need to complete an opt-out form and bring it along to the surgery.  For a copy of the opt-out form please see the ‘Our Documents’ page in our website.

Shared Care Record  to ensure better, safer care

The new shared care record system combines all your health information from different organisations involved in your health care, such as GP practices, hospitals, ambulance and social care services.

This enables health professionals to easily view your records and see all details of the care and treatment you’ve received, so you receive better, safer care.

If you DO NOT want you records to be available to view through the Shared Care Record, you can let us know via the website address below

FOR MORE INFORMATION VISIT: https://herefordshireandworcestershireccg.nhs.uk/health-services/shared-care-record

We are now able to pass on simple messages, e.g. to make an appointment, information, or links to other services via a new text messaging service. For this, to work, we must have your up-to-date contact details.

About Health Records

Health records play an important role in modern healthcare. They have two main functions, which are described as either primary or secondary.

Primary Function of Health Records

The primary function of healthcare records is to record important clinical information, which may need to be accessed by the healthcare professionals involved in your care. Information contained in health records includes:

• The treatments you have received,
• Whether you have any allergies,
• Whether you’re currently taking medication,
• Whether you have previously had any adverse reactions to certain medications,
• Whether you have any chronic (long-lasting) health conditions, such as diabetes or asthma,
• The results of any health tests you have had, such as blood pressure tests,
• Any lifestyle information that may be clinically relevant, such as whether you smoke, and
• Personal information, such as your age and address.

Secondary Function of Health Records

Health records can be used to improve public health and the services provided by the NHS, such as treatments for cancer or diabetes. Health records can also be used:

• To determine how well a particular hospital or specialist unit is performing,
• To track the spread of, or risk factors for, a particular disease (epidemiology), and
• In clinical research, to determine whether certain treatments are more effective than others.

When health records are used in this way, your personal details are not given to the people who are carrying out the research. Only the relevant clinical data is given, for example, the number of people who were admitted to hospital every year due to a heart attack.

Risk Stratification

Your data may also be used to determine your risk factor for future health issues, hospital admissions or care needs. If we use your data in this way you can be reassured that it will be anonymised.

Types of Health Record

Health records take many forms and can be on paper or electronic. Different types of health record include:

• Consultation notes, which your GP takes during an appointment,
• Hospital admission records, including the reason you were admitted to the hospital,
• The treatment you will receive and any other relevant clinical and personal information,
• Hospital discharge records, which will include the results of treatment and whether any follow-up appointments or care are required,
• Test results,
• X-rays,
• Photographs, and
• Image slides, such as those produced by a magnetic resonance imaging (MRI) or computerised tomography (CT) scanner.

Confidentiality

There are strict laws and regulations to ensure that your health records are kept confidential and can only be accessed by health professionals directly involved in your care.

There are a number of different laws that relate to health records. The two most important laws are:

• Data Protection Act (1998), and
• Human Rights Act (1998).

Under the terms of the Data Protection Act (1998), organisations such as the NHS must ensure that any personal information it gathers in the course of its work is:

• Only used for the stated purpose of gathering the information (which in this case would be to ensure that you receive a good standard of healthcare), and
• Kept secure.

It is a criminal offense to breach the Data Protection Act (1998) and doing so can result in imprisonment.

The Human Rights Act (1998) also states that everyone has the right to have their private life respected. This includes the right to keep your health records confidential.

Important Changes

The NHS is currently making some important changes to how it will store and use health records over the next few years. See the Service description section for more information.

Data Extraction

For more information please follow the links below.

• Sharing your information

Care.data – modern data service for the NHS

How We Use Your Health Records

Why we collect information about you?

In the National Health Service, we aim to provide you with the highest quality of health care. To do this we must keep records about you, your health, and the care we have provided or plan to provide to you.

These records may include:

• Basic details about you, such as an address, date of birth, next of kin.
• Contact we have had with you such as clinical visits.
• Notes and reports about your health.
• Details and records about your treatment and care.
• Results of x-rays, laboratory tests, etc.
• Relevant information for people who care for you and know you well, such as health professionals and relatives.

It is good practice for people in the NHS who provide care to:

• Discuss and agree with you what they are going to record about you,
• Give you a copy of letters they are writing about you; and,
• Show you what they have recorded about you if you ask.

How Your Records are Used

The people who care for you use your records to:

• Provide a good basis for all health decisions made by you and care professionals.
• Allow you to work with those providing care.
• Make sure your care if safe and effective and;
• Work effectively with others providing you with care.

Others may also need to use records that are about you to:

• Check the quality of care (such as clinical audit).
• Protect the health of the general public.
• Keep track of NHS spending.
• Manage the health service.
• Help investigate any concerns or complaints you or your family have about your health care.
• Teach health workers and,
• Help with research.

Some information will be held centrally to be used for statistical purposes. In these instances, we take strict measures to ensure that individual patients cannot be identified.

We use anonymous information, wherever possible, but on occasions, we may use personally identifiable information for essential NHS purposes such as research and auditing. However, this information will only be used with your consent, unless the law requires us to pass on this information.

You Have the Right

You have the right to confidentiality under the Data Protection Act 1198 (DPA), the Human Rights Act 1998, and the common law duty of confidence (the Disability Discrimination and the Race Relations Acts may also apply).

You have a right to ask for a copy of your records about you.

• Your request must be made in writing to the organisation holding the information.
• There may be a charge to have a printed copy of the information held about you.
• We are required to respond to you in 1 month.
• You will need to give adequate information (for example full name, address, date of birth, NHS number, etc.)

If you think anything is inaccurate or incorrect, please inform the organisation holding your information.

Notification

The Data Protection Act 1998 requires organisations to notify the Information Commissioner of the purposes for which they process personal information.

The details are publically available from the Information Commissioner:

Wycliffe House,

Water Lane,

Wilmslow,

Cheshire,

SK9 5AF

Tel: 01625 545745

www.infomrationcommissioner.gov.uk

How we Keep Your Records Confidential

Everyone working for the NHS has a legal duty to keep information about you confidential

We have a duty to

• Maintain full and accurate records of the care we provide you.
• Keep records about you confidential, secure, and accurate.
• Provide information in a format that is accessible to you (i.e., in large type if you are partially sighted).

We will not share information that identifies you for any reason, unless:

• You ask us to do so;
• We ask and you give us specific permission;
• We have to do this by law;
• We have special permission for health research purposes or
• We have special permission because the interests of the public are thought to be of greater importance than your confidentiality.

Our guiding principle is that we are holding your records in Strict Confidence.

Who are our Partner Organisations?

We may share information with the following main partner organisations:

• Commissioning Support Units.
• NHS Trusts (Hospitals, CCG’s).
• Special Health Authorities.
• Ambulance Service.

We may share your information, with your consent and subject to strict sharing protocols about how it will be used,

With:

• Social Services.
• Education Services.
• Local Authorities.
• Voluntary Sector Providers.

Private Sector

Anyone who receives information from us also has a legal duty to:

Keep it Confidential. 

Staff treating patients have the right to work free from any threat or fear of abuse or violence.

The NHS nationally has agreed on a Zero Tolerance Policy. If any patient is abusive or violent towards any member of staff or any other persons on the practice premises, the practice retains the right to have the patient removed from our list.