Aim: To use the latest innovations in smartphone technology to help patients find and use apps to manage conditions and make better lifestyle choices in a way that is convenient for them.

The surgery is an integral part of the health care system and view the use of apps as a complimentary means of promoting patient self-help and support through digital tools. We want to encourage the patient to take an active role in managing their healthcare condition. We do not aim to use apps to replace the role of a qualified medical practitioner, nor to remove monitoring of chronic conditions from within the surgery setting. We do recognise that in the passage of time we may be able to directly use the information and data collected and stored by our patients through apps as part of their ongoing health plan.

Approved Apps
There are European regulations about medical apps and the assurance that an app meets essential criteria, we will endeavour to include only medical apps, including web apps which bear the CE mark. We will include on our website NHS Digital Apps showcased on the NHS Public Health Site as NHS approved or ‘being tested in the NHS.

The surgery (surgeries in cluster for voting purposes) will remain objective, impartial and even-handed in selection of apps listed in the app library. The surgery will make any such selection based on merit alone and will not directly benefit financially from apps for which a fee is charged. Any financial arrangement for use of apps is an agreement made between the patient and supplier and the surgery will not seek to influence any such decision for financial gain.

A medical app is one that diagnoses, supports diagnosis or clinical decisions, makes calculations to determine diagnosis or treatment, or are used for any medical purpose that are classed as ‘medical devices’. A medical app does not need to link to the patient’s records or capture the patient’s name or NHS number; if it uses patient specific information, it is a medical app and it needs a CE mark.

What is NOT a medical app?
Apps that have only administrative functions, eg to book an appointment or request a prescription. Apps that give general guidance or are not marketed as medical apps, such as generic calculators on mobile phone apps that do not provide personalised advice.

Consultation & Planning
The addition of new apps to the website will be by majority decision and will meet the criteria for medical apps as stated above. Review of website apps will take place three monthly, removal of apps will be by majority decision – except in exceptional  circumstances where content, information or advice is known to be incorrect, damaging and controversial or may be used for extortion.

Reporting issues or problems with apps
The Medicines and Healthcare Products Regulatory Agency (MHRA) are the body to report any known problem with apps used for medical purposes (such as calculation errors) and should be reported to MHRA online at www.mhra.gov.uk.

Disclaimer
The surgery or the approving body is not the owner, manager or supplier of the tools/apps listed on the website. The surgery or the approving body has set standards for reviewing the tools/apps as detailed in this policy, but this does not mean that we or the approving body has itself reviewed all aspects of the tool/app, or version of the same tool/app. The named supplier listed is the entity solely responsible for the tool/app. The surgery or the approving body is not responsible or liable for any advice, or any other information, services or products that you obtain through the use of the tool/apps listed our website.

The Digital Apps on this website are intended to provide supportive relevant information only. They do not provide medical advice and is not a substitute for a medical consultation. For less urgent health needs, contact your GP or local pharmacist in the usual way. If you have an urgent medical need you should call 111. If a life is at risk, call 999.

Policy Created: 14.11.2017
Policy Reviewed: 24/09/2019
For Review: 24.09.2022

The Surgery prides itself in maintaining professional standards. For certain examinations during consultations an impartial observer (a “Chaperone”) may be requested by the clinician or patient.

This impartial observer will be a suitable qualified trained professional, who is familiar with the procedure and be available to reassure and raise any concerns on your behalf. If a chaperone is unavailable at the time of your consultation then your examination may be re-scheduled for another time.

You are free to decline any examination or chose an alternative examiner or chaperone. You may also request a chaperone for any examination or consultation if one is not offered to you. The GP may not undertake an examination if a chaperone is declined.

The role of a Chaperone:

• Maintains professional boundaries during intimate examinations.
• Acknowledges a patient’s vulnerability.
• Provides emotional comfort and reassurance.
• Assists in the examination.

The practice complies with the Data Protection Act.  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. All patients can expect that their personal information will not be disclosed without their permission except in the most exceptional of circumstances, when somebody is at grave risk of serious harm.

All members of the primary health care team (from reception to doctors) in the course of their duties will have access to your medical records. They all adhere to the highest standards of maintaining confidentiality.

As our reception area is a little public, if you wish to discuss something of a confidential nature please mention it to one of the receptionists who will make arrangements for you to have the necessary privacy.

Under 16s

The duty of confidentiality owed to a person under 16 is as great as the duty owed to any other person. Young people aged under 16 years can choose to see health professionals, without informing their parents or carers. If a GP considers that the young person is competent to make decisions about their health, then the GP can give advice, prescribe and treat the young person without seeking further consent.

However, in terms of good practice, health professionals will encourage young people to discuss issues with a parent or carer. As with older people, sometimes the law requires us to report information to appropriate authorities in order to protect young people or members of the public.

Useful Websites

• Confidentiality NHS Code of Practice
• Confidentiality and Mental Health
• Confidentiality Guidance

Policy on the prescribing of benzodiazepine medications for Fear of Flying, dental appointments, scans or other investigations.

We do not prescribe diazepam outside of its terms of license. This includes as a sedative for fear of flying or medical procedures under specialist care. This policy decision has been made by the GP Partners and is adhered to by all prescribers working across the practice.

Benzodiazepines (including diazepam, lorazepam, temazepam, clonazepam) are medicines that have been in use since the 1960s for a wide range of conditions, such as alcohol withdrawal, epilepsy, and muscle spasms. They are strongly sedating drugs that have negative effects on memory, coordination, concentration, and reaction times. They are addictive and withdrawal can lead to seizures, hallucinations, agitation, and confusion.

Unfortunately, benzodiazepines have widely become drugs of abuse, and as a result they are controlled in the UK as Class C, Schedule 4 drugs. This means there are restrictions on when and how much can be prescribed under the Controlled Substances Act, and inappropriate use, supply or possession of these medications is illegal in the UK under the Misuse of Drugs Act.

Fear of Flying

Many people approach their GP practice asking for diazepam to help with fear of flying, or to sleep during a flight. There are several good reasons why prescribing diazepam is not recommended, and as a result we no longer prescribe diazepam for

We do not prescribe diazepam outside of its terms of license. This includes as a sedative for fear of flying or medical procedures under specialist care. This policy decision has been made by the GP Partners and is adhered to by all prescribers working across the practice.

Benzodiazepines (including diazepam, lorazepam, temazepam, clonazepam) are medicines that have been in use since the 1960s for a wide range of conditions, such as alcohol withdrawal, epilepsy, and muscle spasms. They are strongly sedating drugs that have negative effects on memory, coordination, concentration, and reaction times. They are addictive and withdrawal can lead to seizures, hallucinations, agitation, and confusion.

Unfortunately, benzodiazepines have widely become drugs of abuse, and as a result they are controlled in the UK as Class C, Schedule 4 drugs. This means there are restrictions on when and how much can be prescribed under the Controlled Substances Act, and inappropriate use, supply or possession of these medications is illegal in the UK under the Misuse of Drugs Act.

Fear of Flying

Many people approach their GP practice asking for diazepam to help with fear of flying, or to sleep during a flight. There are several good reasons why prescribing diazepam is not recommended, and as a result we no longer prescribe diazepam for patients who wish to use this for a fear of flying.

Reasons 

1. The national prescribing guidelines followed by GPs (the British National Formulary – BNF) states that all benzodiazepines are ‘contraindicated’ (not allowed) in treatment of phobias (fear conditions, such as fear of flying). It also states that the use of benzodiazepines to treat short-term anxiety is ‘inappropriate’. Benzodiazepines are only licensed for short-term use in a generalised anxiety crisis – but if this is the case for you, you should seek proper care and support for your mental health, and it would not be advisable to go on a flight. Your GP would be taking a significant legal risk by prescribing against these national guidelines.
2. Diazepam is a sedative, so it makes you sleepier. If an emergency occurred during the flight, this could impair your ability to concentrate, follow instructions, or react to the situation. This could seriously affect the safety of you and the people around you. Such incidents are rare but they do occur, and it can be fatal if you are unable to evacuate the plane properly (an example event is flight BA28M, where 55 people sadly died while the plane burned while sat on Manchester Airport runway, and the official AAIB incident report specifically commented on evacuation delays contributing to the deaths). No-one else on board a plane will evacuate for you – the cabin crew are there to guide an evacuation, but you need to be responsible for yourself.
   As a result, many airlines consider sedative medications as a reason why someone would not be allowed on a plane, in a similar way that someone who has consumed excessive alcohol may be removed from a plane.
3. Sedative drugs can make you fall asleep; however, the sleep is an unnatural non-REM sleep. Your movements during this type of sleep are reduced and this can place you at an even higher risk of developing blood clots in the legs (deep vein thrombosis – a DVT) or lungs (pulmonary embolism – a PE). These blood clots are very dangerous and can even be fatal. This risk further
   increases if your flight is over 4 hours long.
4. Going on an aeroplane normally involves your blood oxygen levels decreasing from around 98% to as low as 90%, due to the air pressure decrease at cruising altitudes. Normally your body compensates for this by altering the rate and depth of your breathing. However, benzodiazepines work to depress your breathing and this can put you at risk of hypoxia (excessively low blood oxygen), especially if you have lung problems already, which can be very dangerous.
5. Most people feel sleepy when they take diazepam, but a small proportion of people experience the opposite effect and can become aggressive. This is called a paradoxical effect, and it can be unexpectedly inconsistent, even if diazepam has been used in the past. Alongside aggression and agitation, this response can cause disinhibition and make you behave in ways you normally wouldn’t. This could also impact on your safety and the safety of your fellow passengers or could lead you to get in trouble with the law. Recently, a passenger in this situation was detained by the aircrew, arrested after an emergency landing, given jail time, and was also fined for the costs of redirecting the plane.
6. In several countries, diazepam and similar drugs are illegal (Greece, Japan, and many Middle Eastern countries including the UAE are just some examples). They would be confiscated, and you might find yourself in trouble with the police for being in control of an illegal substance, even if it has been prescribed by a doctor in the UK. This has led to people spending time in a jail a foreign country.
7. Diazepam has a long half-life, which means it stays in your system for a significant time. If your job requires you to submit random drug testing, you may fail these tests.
8. There is a possible link between occasional use of benzodiazepines and earlier onset of dementia in later life.

What you can do 
A fear of flying is frightening and can be debilitating. However, there are much better and effective ways of tackling the problem. We recommend you tackle your problem with a Fear of Flying Course, which are aviation-industry approved and are run by
several airlines. These courses are far more effective than diazepam and have none of the undesirable effects. Also, the positive effects of the courses continue after the courses have been completed.

• Easy Jet : www.fearlessflyer.easyjet.com  Tel: 0203 813 1644
• British Airways : http://flyingwithconfidence.com/courses/venues Tel: 01252 793 250
• Virgin Atlantic : https://flyingwithoutfear.co.uk/collections  Tel: 01423 714 900

Fly And Be Calm is an instant download audio course which includes instructions, a fear removal tool and two hypnotic tracks. You can find this at: https://flyandbecalm.co.uk/

Alternatively, you could contact your local psychology therapy provider to consider having Cognitive Behavioural Therapy (CBT). Details of the local Healthy Minds service for Oldham can be found here: https://www.penninecare.nhs.uk/healthymindsoldham

Ultimately, if you still feel unable to fly, then it may be appropriate to consider alternative routes of transport.

If you still wish to consider diazepam for fear of flying, we suggest consulting with a private GP or a private travel clinic, who may be able to help you further. These services are private and not offered by the NHS. The private clinics may then liaise with the airlines directly to arrange a medically-trained escort for a passenger who is taking sedative medications, which can be expensive.

Medical and dental procedures

We do not provide sedative medications such as diazepam for use in other situations, such as for dental/hospital procedures or scans. The Royal College of Radiologists sets out clear guidance for sedation in hospital radiology departments (https://www.rcr.ac.uk/system/files/publication/field_publication_files/bfcr182_safe_se dation.pdf) which states “Safe and effective analgesia and sedation should be delivered by an appropriately trained and credentialed team with good access to anaesthetics, pre-procedure assessment, sedation plan and checklist, with appropriate monitoring and availability of resuscitation equipment and reversal agents.”

The Intercollegiate Advisory Committee for Sedation in Dentistry has a similar guideline (https://www.saad.org.uk/IACSD%202020.pdf) which states “The monitoring and discharge requirements for oral sedation are the same as for intravenous sedation. Oral sedation must only be administered in the place where the dental treatment is provided and must only be carried out by practitioners who are already competent in intravenous sedation.”

As a result, responsibility for this type of treatment lies with your dentist or hospital staff, and not your GP. If you feel this is required, we suggest consulting with your dentist or the hospital teams in good time before any scans or treatments occur.

References: 
https://bnf.nice.org.uk/drugs/diazepam/ 

https://bnf.nice.org.uk/treatment-summaries/hypnotics-and-anxiolytics/ 

Acute and delayed effects of Alprazolam on flight phobics during exposure. Behav Res Ther. 1997 Sep;35(9):831-41

https://travelhealthpro.org.uk/factsheet/43/medicines-abroad

If you have any special needs please let our staff know so that we can help and ensure you get the same support in the future.

Wheelchair access

Where possible, a wheelchair will be made available for patient’s use, at their own risk, should you require one whilst visiting our premises.

Loop System

We have a loop induction system at the reception desk to assist the hearing impaired. For more information on the loop hearing system visit Hearing Link website.

• British Deaf Association
• The Deaf Health Charity – SignHealth
• Action Hearing Loss
• Royal Association for Deaf People
• National Deaf Children’s Society

Blind/Partially Sighted

If you or family members are blind or partially sighted we can give you a CD or large print of our practice leaflet upon request. Please ask Reception for further information.

For more advice and support for blind people please access the following websites:

• Royal National Institute of Blind People (RIND)
• Action for Blind People
• Blind.org.uk
• British Blind Sport
  

Guide Dogs

Guide dogs are welcome at the surgery but we ask that you be aware of other patients and staff who may have an allergy or fear of dogs.

Further Information:

• Guide Dogs

Other Disability Websites

• BID Services
• Disability Go
• Disabled People, your Rights, Benefits, Carers and the Equality Act
• Disability Rights UK
• Living with a Disability NHS Choices
• Disability Action
• Mencap

It is NHS policy to treat all patients and employees fairly and equally regardless of their gender, sexual orientation, marital status, race, colour, nationality, ethnic or national origin, religion, age or disability.

Equality is based on the legal obligation to comply with anti-discrimination legislation. Equality protects people from being discriminated against on the grounds of group membership i.e. sex, race disability, sexual orientation, belief, or age.

Diversity implies a wide range of conditions and characteristics. Diversity encompasses visible and non-visible individual differences. It can be seen in the makeup of patients and the workforce in terms of gender, ethnic minorities, disabled people etc.

The Freedom of Information Act creates a right of access to recorded information.

The Act covers any recorded organisational information such as reports, policies or strategies, that is held by a public authority in England, Wales and Northern Ireland, and by UK-wide public authorities based in Scotland, however it does not cover personal information such as patient records which are covered by the Data Protection Act.

Public authorities include government departments, local authorities, the NHS, state schools and police forces.

The Act is enforced by the Information Commissioner who regulates both the Freedom of Information Act and the Data Protection Act.

Who can request information?

Under the Act, any individual, anywhere in the world, is able to make a request to a practice for information. An applicant is entitled to be informed in writing, by the practice, whether the practice holds information of the description specified in the request and if that is the case, have the information communicated to him. An individual can request information, regardless of whether he/she is the subject of the information or affected by its use. 

How should requests be made?

Requests must:

• be made in writing (this can be electronically e.g. email/fax)
• state the name of the applicant and an address for correspondence
• describe the information requested.

What cannot be requested?

Personal data about staff and patients covered under Data Protection Act. For more information see these websites:

• Legislation GOV.UK
• Information Commissioners Office

Wootton Vale Privacy Notice

Wootton Vale Covid-19 Privacy Notice

How we use your information

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 who worked for six months or more in in the
last financial year was £57,311 before Tax and National Insurance. This
is for 4 full-time GP’s and 3 locum GP’s.

Wootton Vale Healthy Living Centre Infection Control Annual Statement – July 2023

Seeking Advice from NHS 111 – British Sign Language

Using your computer and webcam, or the InterpreterNow app on your smartphone or tablet, you can make a video call to a BSL interpreter. Please visit the InterpreterNow website for further information.

The interpreter telephones an NHS 111 adviser and relays your conversation with them. The NHS 111 adviser will ask you questions to assess your symptoms, then give you the healthcare advice you need or direct you straightaway to the local service that can help you best.

If NHS 111 advisers think you need an ambulance they will immediately arrange one for you.

This service is available every day.

Translation and BSL for Consultations With Your Doctor or Nurse

The practice is able to make arrangements for an interpreter to join your GP consultation over the telephone, please advise reception when booking your appointment if an interpreter is required so that arrangements can be made.

If you require a sign-language interpreter this can be arranged in person provided sufficient notice has been given.

We have allocated a Named Accountable GP for all of our registered patients. If you do not know who your named GP is, please ask a member of our reception team. Unfortunately, we are unable to notify patients in writing of any change of GP due to the costs involved.

NHS Digital is developing a new system to support the national data opt-out which will give patients more control over how confidential patient information is used. The system will offer patients and the public the opportunity to make an informed choice about whether they wish their confidential patient information to be used just for their individual care and treatment or also used for research and planning purposes.

Patients and the public who decide they do not want their confidential patient information used for planning and research purposes will be able to set their national data opt-out choice online.

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. NHS Digital will never sell your data. There are strict rules about how NHS can use your data. It’s only shared securely and safely. Shared data helps the NHS. It has been used to find the first treatment for coronavirus and for vaccine research.

If you’re happy with your confidential patient information being used for research and planning you do not need to do anything.

Any choice you make will not impact your individual care. Please click on the link to find out more and opt out if you wish to do so.

https://www.nhs.uk/your-nhs-data-matters/

For further opt-out information, please visit the NHS Digital site:

• digital.nhs.uk/opt-out-programme

And if you would like to opt-out, you can follow the process using the link below;

• www.nhs.uk/manage-your-choice

Our practice policy on this subject is available to review below:

• National Data Opt-Out Policy

Local Data Opt-Out Program

If you wish to register a local data opt out with your GP practice before data sharing starts with NHS Digital, this should be done by downloading the Type 1 Opt Out form and retuning it to your GP practice. If you have previously registered a Type 1 Opt-out and you would like to withdraw this, you can also use the form to do this.

New contractual requirements came into force from 1 April 2014 requiring that GP Practices should make available a statement of intent in relation to the following IT developments:

• Summary Care Record (SCR)
• GP to GP Record Transfers
• Patient Online Access to  their GP Record
• Data for commissioning and other secondary care purposes

The same contractual obligations require that we have a statement of intent regarding these developments in place and publicised by 30 September 2014.

Please find below details of the practices stance with regards to these points.

Summary Care Record (SCR)

NHS England require practices to enable successful automated uploads of any changes to patient’s summary information, at least on a daily basis, to the summary care record (SCR) or have published plans in place to achieve this by 31st of March 2015.

Having your Summary Care Record (SCR) 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 that you have a recorded allergy or sensitivity to.

Of course, if you do not want your medical records to be available in this way then you will need to let us know so that we can update your record. You can do this via the opt out form. The practice confirms that your SCR is automatically updated on at least a daily basis to ensure that your information is as up to date as it can possibly be.

GP to GP Record Transfers

NHS England require practices to utilise the GP2GP facility for the transfer of patient records between practices, when a patient registers or de-registers (not for temporary registration).
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. It can take your paper records at least two weeks to reach your new surgery.

With GP to GP record transfers your electronic record is transferred to your new practice much sooner.

The practice confirms that GP to GP transfers are already active and we send and receive patient records via this system.

Patient Online Access to their GP Record

NHS England require practices to promote and offer the facility to enable patients online access to appointments, prescriptions, allergies and adverse reactions or have published plans in place to have achieved this by 31st of March 2015.

We currently offer the facility for booking and cancelling appointments and also for ordering your repeat prescriptions and viewing a summary of your medical records on-line. If you do not already have a user name and password for this system – please register your interest with our reception staff, who will advise you of the identity requirements we need.

Data for commissioning and other secondary care purposes

It is already a requirement of the Health and Social Care Act that practices must meet the reasonable data requirements of commissioners and other health and social care organisations through appropriate and safe data sharing for secondary uses, as specified in the technical specification for care data.

NHS England have commissioned a modern data service on behalf of the entire health and social care system.  This involves the anonymised extraction of key clinical information to inform national trends and decision making around the commissioning of new services.  By default you are opted in.  If you would like to access further information please go to www.nhs.uk/caredata or telephone 0300 4563531. If you would like to opt out, please advise the reception team when you are next at the practice.

The Practice confirm these arrangements are in place and that we undertake annual training and audits to ensure that all our data is handled correctly and safely via the Information Governance Toolkit.

About your Summary Care Record

Your Summary Care Record contains important information about any medicines you are taking, any allergies you suffer from and any bad reactions to medicines that you have previously experienced.

Allowing authorised healthcare staff to have access to this information will improve decision making by doctors and other healthcare professionals and has prevented mistakes being made when patients are being cared for in an emergency or when their GP practice is closed. Your Summary Care Record also includes your name, address, date of birth and your unique NHS Number to help identify you correctly.

Healthcare staff will have access to this information, so that they can provide safer care, whenever or wherever you need it, anywhere in England.

FAQs

Who can see my Summary Care Record?

Healthcare staff who have access to your Summary Care Record:

• need to be directly involved in caring for you
• need to have an NHS Smartcard with a chip and passcode
• will only see the information they need to do their job and
• will have their details recorded every time they look at your record

Healthcare staff will ask for your permission every time they need to look at your Summary Care Record. If they cannot ask you (for example if you are unconscious or otherwise unable to communicate), healthcare staff may look at your record without asking you, because they consider that this is in your best interest.

If they have to do this, this decision will be recorded and checked to ensure that the access was appropriate.

What are my choices?

You can choose to have a Summary Care Record or you can choose to opt out.

If you choose to have a Summary Care Record and are registered with a GP practice, you do not need to do anything as a Summary Care Record is created for you.

If you choose to opt out of having a Summary Care Record and do not want a SCR, you need to let your GP practice know by filling in and returning an opt-out form. Opt-out forms can be downloaded from the website or from your GP practice.

If you are unsure if you have already opted out, you should talk to the staff at your GP practice. You can change your mind at any time by simply informing your GP practice and either filling in an opt-out form or asking your GP practice to create a Summary Care Record for you.

Children and the Summary Care Record

If you are the parent or guardian of a child under 16, you should make this information available to them and support the child to come to a decision as to whether to have a Summary Care Record or not.

If you believe that your child should opt-out of having a Summary Care Record, we strongly recommend that you discuss this with your child’s GP. This will allow your child’s GP to highlight the consequences of opting-out, prior to you finalising your decision.

Where can I get more information?

For more information about Summary Care Records you can

• talk to the staff at your GP practice
• phone the Health and Social Care Information Centre on 0300 303 5678
• Read the Summary Care Record patient information

The practice fully supports the NHS Zero Tolerance Policy. The aim of this policy is to tackle the increasing problem of violence against staff working in the NHS and ensures that doctors and their staff have a right to care for others without fear of being attacked or abused.

We understand that ill patients do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint. We ask you to treat your doctors and their staff courteously and act reasonably.

All incidents will be followed up and you will be sent a formal warning after the first incident or removed from the practice list after a second incident if your behaviour has been unreasonable.

However, aggressive behaviour, be it violent or verbal/abusive, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police will be contacted if an incident is taking place and the patient is posing a threat to staff or other patients, in which case this would result in immediate removal from the practice list.

Removal from the Practice List

A good patient-doctor relationship, based on mutual respect and trust, is the cornerstone of good patient care. The removal of patients from our list is an exceptional and rare event and is a last resort in an impaired patient-practice relationship. When trust has irretrievably broken down, it is in the patient’s interest, just as much as that of The Surgery, that they should find a new practice. An exception to this is on immediate removal on the grounds of violence e.g. when the Police are involved.

Removing other members of the household

In rare cases, however, because of the possible need to visit patients at home it may be necessary to terminate responsibility for other members of the family or the entire household. The prospect of visiting patients where a relative who is no longer a patient of the practice by virtue of their unacceptable behaviour resides, or being regularly confronted by the removed patient, may make it too difficult for the practice to continue to look after the whole family. This is particularly likely where the patient has been removed because of violence or threatening behaviour and keeping the other family members could put doctors or their staff at risk.

We are committed to giving you the best possible service. This will be achieved by working together. Help us to help you. You have a right to, and the practice will try to ensure that:

• You will be treated with courtesy and respect
• You will be treated as a partner in the care and attention that you receive
• All aspects of your visit will be dealt with in privacy and confidence
• You will be seen by a doctor of your choice subject to availability
• In an emergency, out of normal opening hours, if you telephone the practice you will be given the number to receive assistance, which will require no more than one further call
• You can bring someone with you, however you may be asked to be seen on your own during the consultation
• Repeat prescriptions will normally be available for collection within two working days of your request
• Information about our services on offer will be made available to you by way of posters, notice boards and newsletters
• You have the right to see your medical records or have a copy subject to certain laws (note that a fee is payable for a copy of your medical records).
• If you require an interpreter, you must advise reception when you book your appointment of your requirements. Interpreters can usually be arranged for non-emergency appointments.

Patient’s Responsibilities

With these rights come responsibilities and for patients we would respectfully request that you:

• Treat practice staff and doctors with the same consideration and courtesy that you would like yourself. Remember that they are trying to help you
• Please ensure that you order your repeat medication in plenty of time allowing 3 working days
• Please ensure that you have a basic first aid kit at home and initiate minor illness and self-care for you and your family
• Please attend any specialist appointments that have been arranged for you or cancel them if your condition has resolved or you no longer wish to attend
• Please follow up any test or investigations done for you with the person who has requested the investigation
• Attend appointments on time and check in with Reception, or if available please use the check in screen.
• Patients who are late for their appointment may not be seen.
• If you are unable to make your appointment or no longer need it, please give the practice adequate notice that you wish to cancel. Appointments are heavily in demand and missed appointments waste time and delay more urgent patients receiving the treatment they need
• An appointment is for one person only. Where another family member needs to be seen or discussed, another appointment should be made
• Patients should make every effort to present at the surgery to ensure the best use of nursing and medical time. Home visits should be medically justifiable and not requested for social convenience
• Please inform us when you move home, change your name or telephone number, so that we can keep our records correct and up to date
• Read the practice leaflets and other information that we give you. They are there to help you use our services. If you do not understand their content please tell us
• Let us have your views. Your ideas and suggestions whether complimentary or critical are important in helping us to provide a first class, safe, friendly service in pleasant surroundings.

NHS Constitution

The NHS Constitution establishes the principles and values of the NHS in England. For more information see these websites:

• GOV.UK – The NHS Constitution for England
• NHS Choices – NHS Constitution