Our Policies

The Surgery prides itself in maintaining professional standards. For certain examinations during consultations an impartial observer, a Chaperone, will be offered.

This impartial observer will be a practice Nurse or Health Care Assistant who is familiar with the procedure and be available to reassure and raise any concerns on your behalf. If a nurse in 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

Assists with undressing patients, if required

Child Safeguarding is the responsibility of everyone and is highly regarded at the Surgery. We make every effort to recognise issues and address concerns as they occur in the practice. By raising safeguarding children issues within the practice all staff will be aware of how they may access advice, understand their role in protection, and understand the importance of effective Inter-agency communication.

It is very important that all Practice staff understand the need for early identification, assessment and intervention when they have concerns about a child.  Case discussion and reflective practice is encouraged.  Child protection issues in general practice require a robust system of note-keeping and recording, message handling and communication of any concerns.   

Key Factors to be aware of in safeguarding children

The welfare of the child is paramount

Be prepared to consult with colleagues

Be prepared to take advice from local experts

Keep comprehensive, clear, contemporaneous records

Be aware of GMC guidance about sharing confidential information

Risk Factors and Identification – Child Sexual Exploitation

A child in need is defined as a child whose vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health or development without the provision of services (section 17, Children’s Act 1989). This includes disabled children. The Children’s Acts 1984 and 2004 define a child as someone who has not reached their 18th birthday. The fact that a child has reached their 16th birthday and may be living independently, working, or be members of the armed forces does not remove their childhood status under the Acts.

Local authority social services departments working with other local authority departments and health services have a duty to safeguard and promote the welfare of children in their area who are in need. If you are considering making a referral to Social Services as a child in need, it is essential to discuss the referral with the child’s parents or carers and to obtain consent for the sharing of information. Social Services will then follow local procedures to undertake an assessment of the child and their family.

Child Protection Plan

Children judged to be at continuing risk have a child protection plan in place, this list is maintained by children’s social care (CSC).CSC, police and health professionals have 24 hour access to this. A child on the register has a “key worker” to whom reference can be made.

Recognising Child Abuse

(for full details please ref to Working Together to Safeguard Children 2013)

There are 4 main categories of child abuse:

Physical abuse

Sexual abuse

Emotional abuse

Neglect/failure to thrive

These are not however exclusive, and a number of abuse types can often coexist.

Physical abuse may include:

Injuries in children under 1 years of age or non-mobile children should be treated with a high degree of care

Hitting, shaking, throwing, poisoning, burning or scalding, or other forms of physical harm

Where a parent or carer deliberately causes ill-health of a child

Single traumatic events or repeated incidents

FGM

Sexual abuse may include:

Forcing or enticing a child under 18 to take part in sexual activities where the child is unaware of what is happening

May include both physical contact acts and non—contact acts

Emotional abuse may include:

Persistent ill-treatment which has an effect on emotional development

Conveyance of a message of being un-loved, worthlessness or inadequacy

May instill a feeling of danger, being afraid

May involve child exploitation or corruption

Living in families where domestic violence is taking place

Neglect may include:

Failure to meet the child’s physical or psychological needs

Failure to provide adequate food or shelter

Failure to protect from physical harm

Neglect of a child’s emotional needs

Common presentations and situations in which child abuse may be suspected include:

Disclosure by a child or young person

Physical signs and symptoms giving rise to suspicion of any category of abuse

The history is inconsistent or changes

A delay in seeking medical help

Extreme or worrying behaviour of a child, taking account of the developmental age of the child

Accumulation of minor incidents giving rise to a level of concern, including frequent A&E attendances

Some other situations which need careful consideration are:

Disclosure by an adult of abusive activities

Girls under 16 presenting with pregnancy or sexually transmitted disease, especially those with learning difficulties

Very young girls requesting contraception, especially emergency contraception

Situations where parental mental health problems may impact on children

Parental/ carer alcohol, drug or substance misuse which may impact on children

Parents with learning difficulties

Violence or domestic abuse in the family (please see separate document in safeguarding folder on domestic violence)

Acuminous separation of parents with alleged allegation

Access to Medical Records under Data Protection Act

Online Access / Making a Subject Access Request (SAR) 

The Data Protection Act gives every living person (or authorised representative) the right to apply for access to their health records.

Online Access to Medical Records

As of March 2016, [Coded information from Medical Records / Full Medical Records] can be accessed as part of the Practice’s online services. For security reasons, you will have to visit the practice to undertake an identity check before you are granted access to these records.

To make a subject access request

A request for your medical health records held at Chiswick Family Practice must be made in writing, this can be done either via email to admin.chiswick@nhs.net or in person at reception. Emails should be address to Monique Luciano, Data Controller.  You can apply using an Application for Access to Medical Records Form, which you can download here, forms are also available from reception.

If you are unable to make the request in writing, please contact the practice for alternative methods of access.

Costs

Under the Data Protection Act you will not normally be charged a fee to view your health records or to be provided with a copy of them unless the request is judged to be unfounded or excessive.

In the event that a request is deemed to be unfounded or excessive, a fee will be incurred based on the administrative cost of providing the information.

Once the data controller has all the required information, and fee where relevant, your request should be fulfilled within one month (in exceptional circumstances where it is not possible to comply within this period, you will be informed of the delay within one month of the request. We will provide you with a timescale of when the information will be made available, which will be no more than three months after the request was made).

Exemptions

In some circumstances, the Act permits the data controller to withhold information held in your health record. These rare cases are:

Where it has been judged that supplying you with the information is likely to cause serious harm to the physical or mental health or condition of you, or any other person, or;

Where providing you with access would disclose information relating to or provided by a third person who had not consented to the disclosure. This exemption does not apply where that third person is a clinician involved in your care.

When making your request for access, it would be helpful if you could provide details of the time-periods and aspects of your health record you require (this is optional, but it may help save practice time and resources).

If you are using an authorised representative, you need to be aware that in doing so, they may gain access to all health records concerning you, which

may not all be relevant. If this is a concern, you should inform your representative of what information you wish them to specifically request when they are applying for access.

GPs have ethical obligations around how patient records are shared, and will explain to patients,

in broad terms, the implications of making a Subject Access Request so they can make an informed decision on whether they wish to exercise their rights under the Data Protection Act.

Complaints

If you have any complaints about any aspect of your application to obtain access to your health records, you should first discuss this with the clinician concerned. If this proves unsuccessful, you can make a complaint through the NHS Complaints Procedure by contacting the Practice Manager.

Further information about the NHS Complaints Procedure is available on the NHS Choices website.

Alternatively you can contact the Information Commissioners Office (responsible for governing Data Protection compliance) –

Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF, Tel 01625 545745 or www.ico.org.uk/

All complaints will be acknowledged within three working days and a full response will be provided within 20 working days. If a complaint is made verbally to the practice, this will be documented and you will be asked to confirm in writing that you agree with what has been recorded.

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

Wheelchair access is available at the front of the surgery and we have toilets for the disabled.

Disabled Parking – Blue Badge Scheme

The Blue Badge scheme is for people with severe mobility problems. It allows Blue Badge holders to park close to where they need to go.

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 see the following websites:

Royal National Institute of Blind People (RIND)

British Wireless for the Blind Fund

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

The Fair Processing Notice is intended to inform you about the type of patient information that GP Practices hold, how that information might be used, with whom we may share that information, and how we ensure it is kept secure.

Fair Processing Notice

Fair Processing Notice

Fair Processing Notice – Whole Systems Integrated Care 

Further Information

Whole Systems dashboard programme – healthiernorthwestlondon.nhs.uk

Your Personal information Choices – content.digital.nhs.uk/yourinfo

How information is used – content.digital.nhs.uk/article

Review of health and care data security and consent – www.gov.uk

Records management code of practice for health and social care – www.gov.uk

Fair Processing NHS England – www.england.nhs.uk

The information Governance Review – www.gov.uk

NHS Choices – Your health and care records – www.nhs.uk

We aim to provide you with the best possible medical service. At times you may feel that we have not achieved this and want to make your feelings known.  Most problems can be sorted out quickly and easily, often at the time they arise with the person concerned and this may be the approach you try first.

Where you are not able to resolve your complaint in this way and wish to make a formal complaint you should do so, preferably within writing, as soon as possible after the event and ideally within a few days as this helps us to establish what happened more easily.  

The period for making a complaint is normally:

12 months from the date on which the event which is the subject of the complaint occurred or

12 months from the date on which the event which is the subject of the complaint comes to the complainant’s notice.

If you are a registered patient you can complain about your own care.  You are unable to complain about someone else’s treatment without their written authority.  We are able to provide you with a separate complaints form to register your complaint and this includes a third-party authority form to enable a complaint to be made by someone else.  Please ask at reception for this.  You can provide this in your own format if you wish.

Please send your written complaint to:

Practice Management, Chiswick Family Practice, GP Surgery @ Acton Gardens, Unit A, Kelton House Corbet Gardens Acton London W3 8TF

Complaining on Behalf of Someone Else

We keep to the strict rules of medical and personal confidentiality.  If you wish to make a complaint but are not the patient involved, we will require the written consent of the patient to confirm that they are unhappy with their treatment and that we can deal with someone else about it.  Please ask at reception for the complaints form which includes a statement of authority that the patient can sign.  Where the patient is incapable of providing consent due to illness or accident it may still be possible to deal with the complaint.  Please provide the precise details of the circumstances which prevent this in your covering letter. Please note that we are unable to discuss any issue relating to someone else without their express permission, which must be in writing, unless the above circumstances apply.

Confidentiality

All complaints must be treated in the strictest confidence.  

Where the investigation of the complaint requires consideration of the patient’s medical records, the Practice Manager must inform the patient or person acting on his or her behalf if the investigation will involve disclosure of information contained in those records to a person other than the practice or an employee of the practice.

The practice must keep a record of all complaints and copies of all correspondence relating to complaints but such records must be kept separate from patients’ medical records.

The practice has an annual review of complaints received within the year and the learning issues or changes to procedures which have arisen are documented.

The Freedom of Information Act creates a right of access to recorded information and obliges a public authority to:

Have a publication scheme in place

Allow public access to information held by public authorities.

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.

The Surgery publication scheme

A publication scheme requires an authority to make information available to the public as part of its normal business activities. The scheme lists information under seven broad classes, which are:

who we are and what we do

what we spend and how we spend it

what our priorities are and how we are doing it

how we make decisions

our policies and procedures

lists and registers

the services we offer

You can request our publication scheme leaflet at the surgery.

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

All GP Practices are required to declare mean earnings (i.e. average pay) for GPs working to deliver NHS services to patients at each practice.

The average pay for GP’s working at Chiswick Family Practice – Dr O’Connell and Dr K Bennett in the last financial year was £24,894 before tax and National Insurance.

This is for 2 full time GPs,  1 part time GP and 3 Locum GPs who worked in the practice for more than six months.

By the end of March 2015 your GP practice will able to send computer held patient records electronically to a patient’s new surgery so they arrive much quicker than the paper notes, helping the doctors and nurses know the best way to treat you. This is called the GP2GP electronic transfer of patient records. The paper notes will continue to be sent via an NHS delivery service.

With GP2GP, your medical record is available to your new doctor within a few minutes of registration, enabling much safer care.

For more information about GP2GP visit the HSCIC website

We aim to keep our surgery clean and tidy and offer a safe environment to our patients and staff. We are proud of our modern, purpose built Practice and endeavour to keep it clean and well maintained at all times.

If you have any concerns about cleanliness or infection control, please report these to our Reception staff.

Our GPs and nursing staff follow our Infection Control Policy to ensure the care we deliver and the equipment we use is safe.

We take additional measures to ensure we maintain the highest standards:

Encourage staff and patients to raise any issues or report any incidents relating to cleanliness and infection control.  We can discuss these and identify improvements we can make to avoid any future problems.

Carry out an annual infection control audit to make sure our infection control procedures are working.

Provide annual staff updates and training on cleanliness and infection control

Review our policies and procedures to make sure they are adequate and meet national guidance.

Maintain the premises and equipment to a high standard within the available financial resources and ensure that all reasonable steps are taken to reduce or remove all infection risk.

Use washable or disposable materials for items such as couch rolls, modesty curtains, floor coverings, towels etc., and ensure that these are laundered, cleaned or changed frequently to minimise risk of infection.

Make Alcohol Hand Rub Gel available throughout the building

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.

What is non-NHS work and why is there a fee?

The National Health Service provides most health care to most people free of charge, but there are exceptions: prescription charges have existed since 1951 and there are a number of other services for which fees are charged.

Sometimes the charge is because the service is not covered by the NHS, for example, providing copies of health records or producing medical reports for insurance companies, solicitors or employers.

The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. It is important to understand that many GPs are not employed by the NHS; they are self-employed and they have to cover their costs – staff, buildings, heating, lighting, etc. – in the same way as any small business.

In recent years, however, more and more organisations have been involving doctors in a whole range of non-medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to ensure that information provided to them is true and accurate.

Examples of non-NHS services for which GPs can charge their own NHS patients are:

accident/sickness certificates for insurance purposes

school fee and holiday insurance certificates

reports for health clubs to certify that patients are fit to exercise

private prescriptions for travel purposes

Examples of non-NHS services for which GPs can charge other institutions are:

life assurance and income protection reports for insurance companies

reports for the Department for Work and Pensions (DWP) in connection with

disability living allowance and attendance allowance

medical reports for local authorities in connection with adoption and fostering

copies of records for solicitors

Do GPs have to do non-NHS work for their patients?

With certain limited exceptions, for example a GP confirming that one of their patients is not fit for jury service, GPs do not have to carry out non-NHS work on behalf of their patients. Whilst GPs will always attempt to assist their patients with the completion of forms, they are not required to do such non-NHS work.

Is it true that the BMA sets fees for non-NHS work?

The British Medical Association (BMA) suggest fees that GPs may charge their patients for non-NHS work (i.e. work not covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested by them are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates they suggest.

Why does it sometimes take my GP a long time to complete my form?

Time spent completing forms and preparing reports takes the GP away from the medical care of his or her patients. Most GPs have a very heavy workload and paperwork takes up an increasing amount of their time. Our GPs do non-NHS work out of NHS time at evenings or weekends so that NHS patient care does not suffer.

I only need the doctor’s signature – what is the problem?

When a doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. In order to complete even the simplest of forms, therefore, the doctor might have to check the patient’s ENTIRE medical record. Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council (the doctors’ regulatory body) or even the Police.

If you are a new patient we may not have your medical records so the doctor must wait for these before completing the form.

What will I be charged?

It is recommended that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual doctors to decide how much they will charge. The surgery has a list of fees based on these suggested fees which is available on request.

What can I do to help?

Not all documents need a signature by a doctor, for example passport applications. You can ask another person in a position of trust to sign such documents free of charge. Read the information that comes with these types of forms carefully before requesting your GP to complete them.

If you have several forms requiring completion, present them all at once and ask your GP if he or she is prepared to complete them at the same time to speed up the process.

Do not expect your GP to process forms overnight: urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this may cost more. Usually non-NHS work will take 2 weeks.

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, Patient Advisors, Nurses, HCAs and 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 patient advisors who will make arrangements for you to speak in private.

Under 14s

The duty of confidentiality owed to a person under 14is as great as the duty owed to any other person. Young people aged under 14 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

Privacy Notice

Subject Access Request Policy

GDPR

Our practice is supporting vital health and care planning and research by sharing your data with NHS Digital. For more information about this see the GP Practice Privacy Notice for General Practice Data for Planning and Research.

CONTEST, the Government’s national counter terrorism strategy, aims to reduce the risk to the United Kingdom and its interests overseas from international terrorism, so that people can go about their lives freely and with confidence.

The strategy has four main work streams:

Pursue: to stop terrorist attacks

Protect: to strengthen our protection against terrorist attack

Prepare: where an attack cannot be stopped, to mitigate its impact

Prevent: to stop people becoming terrorists or supporting terrorism

Prevent aims to stop people from becoming terrorists or supporting terrorism.

The Department of Health (DH) has worked with the Home Office to develop guidance for healthcare organisations to implement Prevent Locally; this is called “Building Partnerships Staying Safe”.  With more than 1 million consultations a day by the NHS it is an area that the DH needs to highlight to all NHS workers.

The Prevent Strategy addresses all forms of terrorism, including extreme right wing views, but continues to prioritise according to the threat posed to our national security.

The aim of Prevent is to stop people from becoming terrorists or supporting terrorism and operates in the pre-criminal space before any criminal activity has taken place. At present, the majority of effort is focused on stopping people from joining or supporting such groups as Al-Qaida and its related groups, and other extremist organisations actively recruit.

The three key objectives of the Prevent Strategy are to:

Challenge the ideology that supports terrorism and those who promote it.

Prevent vulnerable people from being drawn into terrorism and ensure that they are given appropriate advice and support.

Work with sectors and institutions where there are risks of radicalisation

(Health Organisations are expected to be involved in delivering objectives 2 and 3, only).

Why must health organisations engage in the Prevent Strategy?

The Department of Health is a key strategic partner in the Prevent Strategy as Healthcare professionals may meet and treat people who are vulnerable to radicalisation. People with mental health issues or learning disability may be more easily drawn into terrorism.

People Prevent is an on-going initiative and designed to become part of the everyday safeguarding routine for NHS staff.

It does not need new structures to be created but does require that members of staff are informed and have awareness of the Prevent Agenda and how to refer concerns.

Defination of Terms

Terrorism is defined in the Terrorism Act of 2000 (TACT 2000) as an action that endangers or causes serious violence to a person or people, causes serious damage to property or seriously interferes or disrupts an electronic system. The use of threat must be designed to influence the government or to intimidate the public and is made for the purpose of political, religious or ideological gain.

Radicalisation in this protocol refers to the process by which people come to support terrorism and forms of extremism leading to terrorism.

Extremism: is vocal or active opposition to fundamental values including democracy, the rule of the law, individual liberty, and mutual respect and tolerance of different beliefs and faiths.

A Prevent Concern does not have to be proven beyond reasonable doubt; it should however be based on something that raises concern which is assessed by using exiting professional judgement of a health or social care member of staff.

Vulnerability in the context of Prevent is a person who is susceptible to extremists’ messages and is at risk of being drawn into terrorism or supporting terrorism at a point in time. The definition of vulnerable individual from No Secrets (2000) is “who is or may be in need of community care services by reason of mental or other disability, age or illness; and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation”.

The local CCG should have polices in place and should advise practices of their obligations, however it is up to practices to decide when an issue needs to be reported on in the same way as Safeguarding Adults, Children and even Domestic violence.

Patient confidentiality is always key and so disclosing fears and suspicions have to be taken in a responsible manner weighing up the evidence and the person of concern.

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 up to 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 achieve this by 31st of March 2015.

We currently offer the facility for booking, checking and cancelling appointments, ordering repeat prescriptions and viewing a summary of your medical records on-line. We are not currently offering Full Access to your records or the Questionnaire options.

If you would like to set up an Online account you will need to complete and sign an application form and provide photo ID and proof of address. Please bring this in to reception so that an account can be activated for you. You will be prompted to change your password on your first log in.

Full details and the application forms can be found by clicking the Online tab at the top of this page.

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.

At our practice we have specific arrangements in place to allow patients to “opt out” of care.data which allows for the removal of data from the practice. Please see the page about care data on our website

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.

You may want to add other details about your care to your Summary Care Record. This will only happen if both you and your GP agree to do this. You should discuss your wishes with your GP practice.

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 (PDF, 245.9kB). 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 (PDF, 245.9kB) 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

Introduction

The purpose of this document is to set out the policy of the Practice in relation to the protection of vulnerable adults. Further guidance may be available on local inter-agency procedures via the Primary Care Organisation and / or Social Services.

What is a vulnerable adult?

The definition is wide, however this may be regarded as anyone over the age of 18 years who may be unable to protect themselves from abuse, harm or exploitation, which may be by reason of illness, age, mental illness, disability or other types of physical or mental impairment.

Those at risk may live alone, be dependent on others (care homes etc.), elderly, or socially isolated.

Forms of Abuse

Neglect – ignoring mental or physical needs, care, education, or basic life necessities or rights

Bullying – family, carers, friends

Financial – theft or use of money or possessions

Sexual – assault, rape, non-consensual acts (including acts where unable to give consent), touching, indecent exposure

Physical – hitting, assault, man-handling, restraint, pain or forcing medication

Psychological – threats, fear, being controlled, taunts, isolation

Discrimination – abuse based on perceived differences and vulnerabilities

Institutional abuse – in hospitals, care homes, support services or individuals within them, including inappropriate behaviours, discrimination, prejudice, and lack of essential safeguards

Abuse may be deliberate or as a result of lack of attention or thought, and may involve combinations of all or any of the above forms. It may be regular or on an occasional or single event basis, however it will result in some degree of suffering to the individual concerned. Abuse may also take place between one vulnerable adult and another, for example between residents of care homes or other institutions.

Indications

Bruising

Burns

Falls

Apparent lack of personal care

Nervousness or withdrawn

Avoidance of topics of discussion

Inadequate living conditions or confinement to one room in their own home

Inappropriate controlling by carers or family members

Obstacles preventing personal visitors or one-to-one personal discussion

Sudden changes in personality

Lack of freedom to move outside the home, or to be on their own

Refusal by carers to allow the patient into further care or to change environs

Lack of access to own money

Lack of mobility aids when needed

Action Required

Where abuse of a vulnerable adult is suspected the welfare of the patient takes priority. In deciding whether to disclose concerns to a third party or other agency the GP will assess the risk to the patient.

Ideally the matter should be discussed with the patient involved first, and attempt made to obtain consent to refer the matter to the appropriate agency. Where this is not possible, or in the case of emergency where serious harm is to be prevented, the patient’s doctor will balance the need to protect the patient with the duty of confidentiality before deciding whether to refer.

The patient should usually be informed that the doctor intends to disclose information, and advice and support should be offered.

Where time permits, the medical defence organisation will be telephoned before any action is taken.

Due regard will be taken of the patient’s capacity to provide a valid consent.

In assessing the risk to the individual, the following factors will be considered:

Nature of abuse, and severity

Chance of recurrence, and when

Frequency

Vulnerability of the adult (frailty, age, physical condition etc.)

Those involved – family, carers, strangers, visitors etc.

Whether other third parties are also at risk (other members of the same household may being abused at the same time)

Subject to the local procedures in force, consideration will be given to;

Report to Social Services Mental Health team

Report to Police

Report to PCT lead

Contact List

Service

Contact Number

Police (local)

Ealing Police Station: 020 86493573

Or national police service: 999

Community Mental Heath

Avenue House: 020 8483 1720

Out of Hour contact: 0300 1234244

Adult Support Services/ Safeguarding Adult

020 8825 8000

Adult Support Services (out of hours)

Adult Protection Officer

020 8825 5000

Age Concern

020 8567 8017

Social Services

020 8825 8000 / 020 8566 2360

MIND in Ealing

020 8992 0303

Ealing CAMHS

020 8354 8160

Drug Misuse

RISE: 020 8843 5900

020 8825 9888

Medical Defence Organisation

MDU – via doctor/nurse or management membership details

Ealing CCG

3rd Floor, Perceval House

14/16 Uxbridge Road

Ealing, W5 2HL

020 8280 8080

NHS England

North West London Area Team

Patient’s Rights

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.

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 2 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

Patients who are more than 10 minutes 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:

UK – The NHS Constitution for England

NHS Choices – NHS Constitution

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 a second incident or removed from the practice list after a third 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.

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.

This accessibility statement applies to Chiswick Family Practice. This website is run by Chiswick Family Practice. 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.

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

the text will not reflow in a single column when you change the size of the browser window

you cannot modify the line height or spacing of text

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

live video streams do not have captions

some of our online forms are difficult to navigate using just a keyboard

you cannot skip to the main content when using a screen reader

there’s a limit to how far you can magnify the map on our ‘contact us’ page

Feedback and contact information

If you need information on this website in a different format like accessible PDF, large print, easy read, audio recording or braille:

Email: admin.chiswick@nhs.net

Call: 020 8995 8948

We’ll consider your request and get back to you in 7 days.

If you cannot view the map on our ‘contact us’ page, call or email us for directions.

We’re always looking to improve the accessibility of this website. If you find any problems not listed on this page or think we’re not meeting accessibility requirements, contact:

Email: admin.chiswick@nhs.net

Call: 020 8995 8948

Reporting accessibility problems with this website

We’re always looking to improve the accessibility of this website. If you find any problems not listed on this page or think we’re not meeting accessibility requirements, contact:

Email: admin.chiswick@nhs.net

Call: 020 8995 8948

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).

Contacting us by phone or visiting us in person

We provide a text relay service for people who are D/deaf, hearing impaired or have a speech impediment.

Our offices have audio induction loops, or if you contact us before your visit we can arrange a British Sign Language (BSL) interpreter.

Compliance

This website is partially compliant with the Web Content Accessibility Guidelines version 2.1 AA standard, due to ‘the non-compliances and exemptions’ listed below.

Non-accessible content

The content listed below is non-accessible for the following reasons:

This site may contain older PDFs and Word documents do not meet accessibility standards – for example, they may not be structured so they’re accessible to a screen reader. This does not meet WCAG 2.1 success criterion 4.1.2

Disproportionate burden

Google Maps – There’s a limit to how far you can magnify the embedded Google Map on our ‘contact us’ page. The code for this map is supplied by Google and we are unable to make amendments to it.

Preparation of this accessibility statement

This statement was prepared on 27/02/2022 and was updated on 28/02/2023.

Site compliance was checked using a combination of manual testing and third party tools, including:

WAVE Web Accessibility Evaluation Tool (https://wave.webaim.org/)

WebAIM Contrast Checker (https://webaim.org/resources/contrastchecker/)

HTML_CodeSniffer (https://squizlabs.github.io/HTML_CodeSniffer/)

Pa11y – Automated accessibility testing (https://pa11y.org/)

axe – Web Accessibility Testing (https://www.deque.com/axe/

Alert: Join Our PPG

Become a Member of our Patient Participation Group. Your ideas and opinions are greatly valued and may lead to constructive improvements to help maintain our services to ensure our patients are cared for and understood. Register Here