Policies on this page:
- DNA Policy
- Chaperone Policy
- Confidentiality of records
- Access to your own records
- Your Medical Record
- Freedom of information
- Violence Policy
- Gifts and Donations
Did not attend (DNA) policy
Approximately 120 appointments per month are ‘Did Not Attend’ (DNA), i.e. the patient does not turn up for the appointment or is late and does not contact the surgery in advance to cancel/change appointment. The effects of these are:
- An increase in the waiting time for appointments
- Frustration for both staff and patients
- A waste of resources
If patient does not attend his or her first appointment without cancelling they may be phoned and verbally warned.
If patients cancel and do not give at least 1 hour notice it will be counted as a non-attendance.
If a patient fails to attend 1st pre-booked appointments a 1st informal warning letter will be sent to the patient, advising them that a further occurrence could risk removal from the Practice.
If the patient fails to attend two further appointments, the matter will be discussed with the principal doctors as to whether the patient will be removed from the Practice list, in which case a final removal letter will be issued.
Warning letters are valid for a period of 12 months. Removal based on warnings greater than 12 months old will be invalid – in this case a further formal warning and period of grace will be required.
Derby Family Medical Centre 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 interpreter
- Protection to the healthcare professional against allegations / attack)
Confidentiality of records
All employees and professionals at the practice have a legal duty to keep all information held confidential. The practice complies with the principles of the Data Protection Act 1998. The practice will not release any information from the medical records without the patient’s consent except under the following cases:
- Where we are obliged by law to do so
- Where we have specific consent or instruction to do so
- Where a solicitor acting on your behalf requests us to do so
- Where it is necessary for us to give details to another health professional so that they can have care
- Where we believe that not to do so would cause serious harm to your health or safety or theta of others and you are unable or unwilling to give consent
- Where the CCG requests us to do so in order that they can satisfy themselves that they are providing a safe and efficient service within the terms of our contract with them
- Where information can be extracted by us from your record and made unidentifiable, for the purpose of medical research (including research into drug safety) or audit (i.e. checking we have done things properly).
In cases of 6 & 7 above, you may ask us not to reveal information from your record for these purposes. If you would like us not to reveal, at any time in the future, information from your records in these circumstances, please ask at reception for a form to sign so that we are aware of your wishes.
Access to your own records
You have a right to see your medical record held on computer according to the Data Protection Act. If you wish to see your records you must make a request in writing. A fee will be charged. In some circumstances your right to see some details may be limited in your own interests or for other reasons. On line Access will be available to some of your detailed coded records from April 2016 but practice would like written request for this also.
Your medical record
Your doctor and other health professionals caring for you keep records about your health and any treatment you receive. The practice is computerised and all medical consultations and laboratory results are stored on the practice computer system. Your old written records are also stored securely at the practice. These records contain basic details such as address and date of birth, and also a record of all consultations with the practice and other correspondence from NHS organisations or social services. Your records are used to guide professionals in the care they provide to you and to address fully any concerns in the event of complaint.
Freedom of Information
Information about the General Practioners and the practice required for disclosure under this act can be made available to the public. All requests for such information should be made to the practice manager.
The practice aims to provide a high quality service to all the patients. We understand that occasionally you may not be satisfied with the service you receive. If you have a complaint about any aspect of the service offered by the practice please write to the practice manager detailing your complaint. If you are complaining on beahlf of another person then a consent form needs to be signed.
The manager will acknowledge receipt of your letter within 3 working days and will then conduct a thorough investigation. You will be informed of the outcome of the investigation and any further action within 10 -30 days. You will have an opportunity to discuss the matter after the investigation if you so wish.
If you are not satisfied with the outcome you can contact:
You can contact the Customer Contact Centre:
Post: NHS England
PO Box 16738
Telephone: 0300 311 22 33
If patients are not satisfied with the way their complaint has been dealt with by the provider or commissioner, they can contact the Parliamentary and Health Service Ombudsman (PHSO)
The Parliamentary and Health Service Ombudsman or
POhWER NHS Complaints Advocacy
The NHS operate a zero tolerance policy with regard to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons. Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.
Gifts and Donations Policy
The practice has a strict gifts policy and does not accept money or gifts over the value £100.
This policy sets out the practice approach to the acceptance and handling of gifts and / or donations to both the practice as an entity, and to individual partners and staff within it, made by patients, and follows BMA Guidance on accepting gifts updated August 2007.
The requirement to register gifts is contained within the Health and Social Care Act 2001. Under the General Medical Services contract GPs are obliged to declare any gift from a patient worth more than £100. This rule also applies to gifts received by spouses of partners or staff. Primary Care Organisations can request sight of Gift Registers, which must contain specified information (on the draft register below).
This policy applies to gifts from patients, relatives of patients or from any person who provides services to a contractor or its patients in connection with the medical services contract.
The value of multiple gifts received from an individual patient will be monitored to ensure that at all times the acceptance of them is both prudent and reasonable.
In accordance with General Medical Council guidelines GPs are to be made aware of the following provisions:
- The requirement to be open and honest in any financial dealings with patients
- That patients must not be encouraged to give, lend or bequeath money or gifts
- That pressure must not be placed on patients or relatives to make donations to people
- or organisations
- That they must not ask for or accept inducements, gifts or hospitality which may be seen to effect judgements, nor should these be offered to colleagues.
The policy of this practice is that all gifts or donations from patients, whether in cash or in goods, and made to the practice, its partners, or its staff or spouses of these persons are to be declared and entered into the Gifts Register (see below). In addition the following will apply:
Gifts to Individuals
GPs are not permitted to accept personal cash gifts of any amount other than genuine professional fees.
GPs and individual members of staff may retain personal non-cash gifts made by patients which are of a trivial nature – guide value up to £25.00.
Personal non-cash gifts in excess of the guide value made to an individual should be politely refused.
Cash gifts offered to individuals should be declined.
Gifts to Specific Staff Groups
Gifts made to a particular group of staff (e.g. receptionists) may be accepted up to a guide value of £100. This gift will be used for the benefit of that specific staff group but not directly distributed amongst them. The Register entry will reflect a group distribution. This may include cash gifts which will be used to the benefit of the staff group.
Gifts in excess of the guide value should be politely refused. Where this is a cash gift this may be accepted up to the value limit, with the balance (if the patient agrees) to a charity selected by the staff group.
Gifts to the Practice
Gifts may be accepted up to a guide value of £100. This gift will be used for the benefit of the staff within the practice, but not be directly distributed.
Gifts in excess of the guide value should be politely refused. Where this is a cash gift this may be accepted up to the value limit with the balance (if the patient agrees) to a charity selected by the staff.
The general provisions outlined above will apply. Where the nature of the gift falls outside the limits above they should be referred to the manager who will determine the correct course of action, however the following should be noted in particular:
Gifts addressed to individuals are the personal property of the individual concerned, often in recognition of good service, and as such should be conveyed to that person to deal with as above.
Gifts addressed to groups of staff, or to the practice in general, are to remain on the premises to be used on the premises. They are not to be distributed or shared out to individuals. They are not to be taken home. These are then available to all staff (within a group if appropriate) to open and be used on a shared basis during the year. Generally, all non-personally addressed gifts will be pooled for use.
These provisions apply to the receipt of funds, or the offer of funds, to the practice from an individual, charity, patient group, or other benefactor, who is looking to support the practice in the purchase of equipment or facilities. These guidelines are in accordance with the recommendations of the British Medical Association (BMA) Fundraising Guidelines (April 1995).
Patients must not be placed under a perceived obligation to contribute. Voluntary funds from patients may be construed as a charge for treatment and would therefore breach Terms of Service. Fundraising activity must not impose either direct or indirect pressure on patients to contribute. Collecting boxes in waiting rooms are not acceptable. It is “unethical for charities or voluntary organisations to be encouraged to raise money for equipment which forms part of the indirect expenses element of GP remuneration”. Also “where a practice wishes to become involved in fundraising…..a charitable trust should be established … acceptable to the Charity Commissioners”. (BMA Fundraising for GP Practices).
The policy if this practice is that funds of this nature are not accepted.
The acceptance of hospitality (e.g. representatives) must not be sufficient to influence judgement in any way, or to present conflict of interest. Drug company sponsorship of events is acceptable; however fees must not be accepted to see representatives. The level of sponsorship should not be open to misinterpretation, and the value of all acceptances must be entered into the Gifts Register as a “sponsored event”.
Income tax on gifts received from patients is generally not chargeable to tax if all the following provisions are met:
- Is goods or a voucher only exchangeable for goods (not cash)
- The donor is not the employer or a person connected to the employer
- The gift is not made in recognition of a service performed in the course of employment or anticipation of the service
- The gift has not been procured by the employer or person connected
- The cost of the gift(s) made by the same donor to the employee does not exceed £150 in any tax year
Anyone receiving a gift of significant value is recommended to approach their tax office for guidance.
A gift made to an employee’s family will be treated as a gift to the employee.
Where the annual value exceeds £150 tax will be payable
For the full tax implications and provisions refer to Inland Revenue Guideline SE21715 – Benefits: Gifts in Kind from Third Parties