Practice Policies & Patient Information

Access to Medical Records

Date of Policy: 21 May 2024

Author: Lucie Lehane

Review Date: May 2025

Patients are entitled to view their medical records under the Access to Medical Records Act and the Data Protection Act 1998, though some checks need to be made. In particular, the practice needs to make a judgement that there is nothing in the record that could be harmful to the patient, and that there is no third party information (e.g. names and information about others)

We strongly encourage patient to register for on-line access which provides patient with greater flexibility and instant access to their records. Patients can access their medical records online by registering to NHS App or Patient Access or similar application.

The patient should be encouraged to download NHS App and verify their identity via the app.

Patient needs to fill out the application form online via our website attaching selfie photo holding their ID. Alternatively, patient can also complete the paper application form at the practice.

If patient does not have a photo ID, staff member can verify their identity by asking questions from the medical records.

If patient requires access to their full medical records, they can request it via email or by filling out “Enhanced Access to medical records” form at reception. Patient identity needs to be verified.

Access to records can only be granted to third parties with full written consent from the patient, which must be signed and dated. A record of this should be kept.

Patients may select to request on-line access to their records (preferred method) or for a printed copy.

We do not charge patients for print outs of notes, unless the requests are excessive, any charge in such situation needs to be agreed with Practice Manager.

If a request is deemed manifestly unfounded or excessive, the practice can refuse to respond to such requests. This will be done on a case by case basis and is in accordance with Data Protection Act 2018.

Patients should provide photo ID (such as a photo driving licence or passport / national identity card) in order to view their notes. If patients request the access to all notes including free text and all documents, or asks for all copies, the notes should be checked by senior administrator. If there is sensitive information in there, third party information or when in doubt, the notes need to be reviewed by a named GP, and if sensitive information found, then an appointment would be offered with a GP to go through the notes before releasing them to a patient.

Receptionists should follow Access to Medical Records Flowchart for step by step instructions

Requests for access must be fulfilled within 1 calendar month from receiving the request.

Patients may request amendments or corrections to be noted. Entries should never be deleted or removed, instead a note should be made that the patient requests an amendment. This can only be approved by named GP. For more guidance see https://transform.england.nhs.uk/information-governance/guidance/amending-patient-and-service-user-records/

From 3^rd May 2023 all patients registered (with few exceptions assessed by named GPs in view of patient safeguarding) have future (prospective) records access enabled. This means access to information and data added to the patient record from 3^rd May 2023 onwards or from the date that a patient joined the practice or from a date when access has previously been granted.

Patients who have had future (prospective) access set up before the change will continue to be able to view this information.

Medical records of deceased patients stay at the practice. If requested, please follow the guidance: https://transform.england.nhs.uk/information-governance/guidance/access-to-the-health-and-care-records-of-deceased-people/

MP 21/05/2024

Care Quality Commission

The Care Quality Commission (CQC) makes sure hospitals, care homes, dental and GP surgeries, and all other care services in England provide people with safe, effective, compassionate and high-quality care, and encourages them to make improvements where possible.

They do this by inspecting services and publishing the results on their website: www.cqc.org.uk

You can use the results to help you make better decisions about the care you, or someone you care for, receives.

Our CQC Inspection

Our practice is inspected by the Care Quality Commission (CQC) to ensure we are meeting essential standards of quality and safety.

This widget provides a summary of the results of the latest checks carried out by the CQC.

Chaperones

Confidentiality

The practice complies with the Data Protection Act 2018. 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

Data Processing

Privacy Notice

What information do we collect about you?

We only collect the information (“data”) that we need to help us keep you healthy – such as your name, address, next of kin, records of appointments, visits, telephone calls, your health record, treatment and medicines, test results, X-rays and any other information to enable us to care for you.

How do we use your information?

- We share your medical records with other health professionals who are involved in providing you with care and treatment. This is only ever on a need-to-know basis and event by event.

- Some of your data is automatically copied to the Shared Care Summary Record.

- We share some of your data with local out-of-hours provider

- Data about you is used to manage national screening campaigns such as flu, cervical cytology and diabetes prevention.

- Your data about you is used to manage the NHS and make payments.

- We share information when the law requires us to, for instance when we are inspected or reporting certain illnesses or safeguarding vulnerable people

- Your data is used to check the quality of care provided by the NHS.

- We may also share medical records for medical research

Enhanced Access Privacy Notice

Streatham PCN is made up of a number of GP Practices and has been created for members practices to work collaboratively to deliver the requirements of the PCN Directed Enhanced Service Contract.

The following practices are part of Streatham PCN:

- Palace Road Surgery

- Streatham Hill Group Practice

- Valley Road Surgery

- The Exchange Surgery

- Streatham Common Practice

- The Vale Surgery

As part of the PCN DES service, we are required to provide Enhanced Access to patients registered with practices in the PCN. Enhanced Access is patient appointments outside core practice hours – that is between 6.30-8.00 pm on weekdays, and on Saturdays 9.00 am till 5.00pm. We have chosen to also offer some appointments between 7.00 am-8.00 am on weekdays. We have also chosen to subcontract some of the provision of these appointments to our local GP federation (Lambeth GP Federation), who have previously provided access hubs in the area.

The Enhanced Access service for our patients requires the following:

An interoperable Clinical IT solution and
Data Sharing between the PCN practices and the GP Federation

To enable us to provide our Enhanced Access Service to you, clinicians from other practices in our PCN and working for our local Federation will at times have access to your full GP record, but only when providing direct care to you.

People who have access to your information will only normally have access to information that they need to fulfil their roles. For example, admin staff will normally only see your name, address, contact details, appointment history and registration details in order to book appointments; the practice nurses will normally have access to your immunisation, treatment, significant active and important past histories, your allergies and relevant recent contacts whilst any GP you see or speak to will normally have access to everything in your record.

1. Controller Contact Details

The controller of your data when it is in your practice clinical record will be your registered GP practice. The Exchange Surgery, Lucie Lehane, Practice Manager/ IG Lead, [email protected], 2-6 Gracefield Gardens, SW16 2ST, London.

The controller of your data when it is in the GP Federation clinical record system is Lambeth GP Federation, 1 Alleyn Park, London, SE21 8AU.

2. Data Protection Officer Contact Details

Rezaur Choudhury, GP Data Protection Officer, [email protected].

3. Purpose of the Processing

To provide our patients with direct care.

4. The Lawfulness Conditions and Special Categories

The processing of personal data in the delivery of direct care and for providers’ administrative purposes in this surgery and in support of direct care elsewhere is supported under the following Article 6 and 9 conditions of the GDPR:

Article 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’.
Article 9(2)(h) ‘necessary for the purposes of preventative or occupational medicine for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services…”

We will also recognise your rights established under UK case law collectively known as the “Common Law Duty of Confidentiality”.

5. Recipient or Categories of Recipients of the Shared Data

6. Rights to Object

You have the right under Article 21 of the GDPR to object to your personal information being processed. Please contact the Practice if you wish to object to the processing of your data. You should be aware that this is a right to raise an objection which is not the same as having an absolute right to have your wishes granted in every circumstance.

GP Practices process personal data under Article 6(1)(c) on a lawful and legitimate basis where the organisation is obliged under law to comply with:

The General Data Protection Regulations (GDPR)
The Freedom of Information Act
The NHS Constitution
The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009

By complying with these laws, the Practice has compelling legitimate grounds for the processing which override the interests, rights and freedoms in the right to object.

7. Right to Access and Correct

Under GDPR and the Data Protection Act 2018, you have the right to see or be given a copy of any personal data we hold about you. To gain access to a copy of your information, you will need to make a Subject Access Request (SAR) to the Practice you are normally registered with.

You also have the right to have incorrect data held about you corrected.

8. Retention Period

The data will be retained for the period as specified in the national NHS records retention schedule.

9. Right to Complain

You have the right to complain to the Information Commissioner’s Office or call their helpline on 0303 123 1113 (local rate) or 01625 545 745 (national rate).

The NHS App

We use the NHS Account Messaging Service provided by NHS England to send you messages relating to your health and care. You need to be an NHS App user to receive these messages. Further information about the service can be found at the privacy notice for the NHS App managed by NHS England.

Data Provision Notices

NHS Digital has powers, under sections 259(1)(a) and 259(1)(b) of the 2012 Health and Social Care Act 2012, which requires health and social care bodies in England to provide NHS England with certain datasets.

The DPN makes it clear whether an organisation is legally required to supply the data or is being requested to do so only.

In either case, when data is provided in response to a requirement or a request made under section 259, the data can be supplied without breaching the common law duty of confidentiality.

For more information about Dara Provision Notices, please see https://digital.nhs.uk/about-nhs-digital/corporate-information-and-documents/directions-and-data-provision-notices/data-provision-notices-dpns

COVID-19 Public Health Directions 2020

NHS England established the OpenSAFELY service Trusted Research Environment (TRE). It supports the use of data for COVID-19 purposes only including research, clinical audit, service evaluation and health surveillance.

NHS England has been directed by the Government to establish and operate the OpenSAFELY service. This service provides a Trusted Research Environment that supports COVID-19 research and analysis.

Each GP practice remains the controller of its own patient data but is required to let researchers run queries on pseudonymised patient data. This means identifiers are removed and replaced with a pseudonym, through OpenSAFELY.

Only researchers approved by NHS England are allowed to run these queries and they will not be able to access information that directly or indirectly identifies individuals.

For more information about OpenSAFELY

GP Connect Privacy Notice

We use a facility called GP Connect to support your direct care. GP Connect makes patient information available to all appropriate clinicians when and where they need it, to support direct patients care, leading to improvements in both care and outcomes.

GP Connect is not used for any purpose other than direct care.

Authorised Clinicians such as GPs, NHS 111 Clinicians, Care Home Nurses (if you are in a Care Home), Secondary Care Trusts, Social Care Clinicians are able to access the GP records of the patients they are treating via a secure NHS Digital service called GP connect.

The NHS 111 service (and other services determined locally e.g. Other GP practices in a Primary Care Network) will be able to book appointments for patients at GP practices and other local services.

Legal basis for sharing this data

In order for your Personal Data to be shared or processed, an appropriate “legal basis” needs to be in place and recorded. The legal bases for direct care via GP Connect is the same as the legal bases for the care you would receive from your own GP, or another healthcare provider:

for the processing of personal data: Article 6.1 (e) of the UK GDPR: “processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller”.
for the processing of “Special Category Data” (which includes your medical information): Article 9.2 (h) of the UK GDPR: “processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services”.

Your rights

Because the legal bases used for your care using GP Connect are the same as used in other direct care situations, the legal rights you have over this data under UK GDPR will also be the same- these are listed elsewhere in our privacy notice.

Find out more about GP Connect

London Care Record – One London

What is the London Care Record?

The London Care Record is a secure view of your health and care information.

It lets health and care professionals involved in your care see important details about your health when and where they need them.

It can show doctors, nurses and other care professionals any conditions you have, your test results, medicines you take, anything you’re allergic to and plans for your care.

Having a single, secure view of your information helps speed up communication between care professionals across London, and beyond

This helps to improve the safety of care and can save lives.

OneLondon is working to ensure as many health and care staff as possible can access the London Care Record and that it provides them with the information they need.

The SEL ICS Privacy Notice for the London Care Record has now been published on the ICS website: The London Care Record – South East London ICS (selondonics.org)

Find out more about the London Care Record see www.onelondon.online.

South East London ICS Privacy Policy

The Exchange Surgery is commissioned by South East London ICS. ICS collects, processes and protects the personal data of its service users.

For more information on the onelondon data sharing framework visit https://www.selondonics.org/who-we-are/our-work/digital-and-data/data-services/

How we use your Health and Care Data

How we use your data

Summary Care Record Supplementary Transparency Notice

During the height of the pandemic changes were made to the Summary Care Record (SCR) to make additional patient information available to all appropriate clinicians when and where they needed it, to support direct patients care, leading to improvements in both care and outcomes.

These changes to the SCR will remain in place, unless you decide otherwise.

Regardless of your past decisions about your Summary Care Record preferences, you will still have the same options that you currently have in place to opt out of having a Summary Care Record, including the opportunity to opt-back in to having a Summary Care Record or opt back in to allow sharing of Additional Information.

You can exercise these choices by doing the following:

Choose to have a Summary Care Record with all information shared. This means that any authorised, registered and regulated health and care professionals will be able to see a detailed Summary Care Record, including Core and Additional Information, if they need to provide you with direct care.
Choose to have a Summary Care Record with Core information only. This means that any authorised, registered and regulated health and care professionals will be able to see limited information about allergies and medications in your Summary Care Record if they need to provide you with direct care.
Choose to opt-out of having a Summary Care Record altogether. This means that you do not want any information shared with other authorised, registered and regulated health and care professionals involved in your direct care. You will not be able to change this preference at the time if you require direct care away from your GP practice. This means that no authorised, registered and regulated health and care professionals will be able to see information held in your GP records if they need to provide you with direct care, including in an emergency.

To make these changes, you should inform your GP practice or complete this form and return it to your GP practice.

Legal basis for sharing this data

In order for your Personal Data to be shared or processed, an appropriate ‘legal basis’ needs to be in place and recorded. The legal bases for direct care via SCR is the same as the legal bases for the care you would receive from your own GP, or another healthcare provider:

for the processing of personal data: Article 6.1 (e) of the UK GDPR: ‘processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller’.
for the processing of ‘Special Category Data’ (which includes your medical information): Article 9.2 (h) of the UK GDPR: ‘processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services’.

Your rights

Because the legal bases used for your care via SCR are the same as used in other direct care situations, the legal rights you have over this data under UK GDPR will also be the same- these are listed elsewhere in our privacy notice.

Find out more about SCR.

Don’t want to share?

All our patients can choose not to share their information. Should you wish to opt out of data collection, please contact a member of staff, alternatively,

Patients can set their opt-out preferences at www.nhs.uk/your-nhs-data-matters You will need their NHS number and a valid email address or telephone number which is on the GP record or on the Personal Demographics Service database to register their decision to opt out. Patients who are unable to use the online facility can use a phone helpline to manage their choice 0300 303 5678. A paper print-and-post form is also available at www.nhs.uk – Other ways to make a choice about sharing data.

Alternatively, please contact a member of staff for support.

Have a question?

If you have any questions, ask a member of the surgery team. You can:

Contact the practice’s data controller via email at [email protected]. GP practices are data controllers for the data they hold about their patients

Ask to speak to the practice manager Lucie Lehane who is also Data Protection Champion for The Exchange Surgery.

Data Protection Officer (DPO) contact for The Exchange Surgery: [email protected]

GP DPO Service Lead: David Birkinshaw

If you’re not happy about how we manage your information

We really want to make sure you’re happy, but we understand that sometimes things can go wrong. If you are unhappy with any part of our data-processing methods, you can complain. For more information, visit ico.org.uk and select ‘Raising a concern’.

We always make sure the information we give you is up-to-date. Any updates will be published on our website, in our newsletter and leaflets, and on our posters. This policy will be reviewed in May 2019.

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AccurRX – Privacy Notice

As part of the Digital First National programme of work, GP Practices are required to provide a tool for patients to access primary care services. The aim of the Accurx platform is to improve communications between healthcare staff and patients resulting in improved outcomes and productivity. The platform facilitates digital communications between the practice and our patients. Using the Accurx platform will require the processing of special category data by Accurx, their sub-processors and by default the GP Practice as a Controller. This will include; exchanging and storing messages in relation to patients and medical staff, performing video consultations (these will not be recorded or stored) between healthcare staff and their patients This will allow you to respond to the Practice in multiple ways such as; free text, questionnaires and submitting images/documents. If you have a non-urgent healthcare concern or need to contact the Practice for any medical or admin reason, click on the online via our website or via NHS app or via NHS website. Fill out the online form, which will then be reviewed and processed by our healthcare professionals to decide the right care for you. We will respond to every online request 2 workings days Accurx is approved by NHS England to be used by GP practices and the other systems involved in patient care. NHS England has a lengthy assurance process to make sure they meet the highest standards of safety and security. Your data is safe and is shared only with your GP Practice for the purposes of your direct care. Your data is stored and sent securely using industry best practices, and Accurx only collect the data that is necessary to allow your GP Practice to provide you with care. The Practice uses the following Accurx features: · SMS, Friends and Family test, online consultations, video consultations, AccuMail and Record Views Accurx’s privacy notice can be found on their website here: Accurx \| Privacy Policy
1) Controller contact details	The Exchange Surgery, 2-8 Gracefield Gardens, SW16 2ST London
2) Data Protection Officer contact details	GP Data Protection Officer [email protected]
3) Purpose of the processing	The aim of the Accurx platform is to improve communications between healthcare staff and patients resulting in improved outcomes and productivity. The platform facilitates digital communications between the practice and our patients.
4) Lawful basis for processing	Under UK GDPR and DPA 2018 – 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’. 9(2)(h) ‘…medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems…’
5) Recipient or categories of recipients of the shared data	Data may be shared with Accurx, and their sub-processors such as cloud services used for Accurx’s own storage, communications, security, engineering, and similar purposes.
6) Rights to object	You have the right under Article 21 of the UK GDPR to object to your personal information being processed. Please contact the Practice if you wish to object to the processing of your data. You should be aware that this is a right to raise an objection which is not the same as having an absolute right to have your wishes granted in every circumstance.
7) Right to access and correct	You have the right to access copies of the data that is being shared and have any inaccuracies corrected. There is no right to have accurate medical records deleted except when ordered by a court of Law.
8) Retention period	The data will be retained for active use during the processing and thereafter according to NHS Policies and the law.
9) Right to Complain.	You have the right to complain to us about the way your data is handled or processed. To so, please contact the Practice using the following details: The Exchange Surgery, 2-8 Gracefield Gardens, SW16 2ST, London If you remain unsatisfied with our response, you have a right to complain to the Information Commissioner’s Office. To do so, you can use this linkhttps://ico.org.uk/make-a-complaint/data-protection-complaints/or call their helpline Tel: 0303 123 1113 (local rate) or 01625 545 745 (national rate) There are National Offices for Scotland, Northern Ireland and Wales, (see ICO website)

Disability Access

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.

Disabled Facilities

The Exchange Surgery has disabled toilets.

Wheelchair Access

The Exchange Surgery has wheelchair access along with step free access.

Hard of Hearing/Deaf

If you or a family member is hard of hearing or deaf, please ask reception online for further information. For more information, please visit these websites:

Blind/Partially Sighted

If you or a family member is blind or partially sighted, please ask reception online for further information. For more advice and support for blind people please visit the following websites:

Guide Dogs

If you or your family require a guide dog, please visit the following website:

Guide Dogs

Other Disabilities

For more advice and support for people with disabilities, please visit the following websites:

Feedback and Complaints

How was your experience at the surgery?

We hope you had a good experience when accessing our services. We value all feedback from patients and greatly appreciate positive comments submitted to us and shared with others.

If you have any ideas, comments or suggestions please feel free to speak to any member of staff, or ask for a card at reception which you can then put into the suggestion box, or write to Lucie Lehane

You can also leave us a Google Review. Please do not submit complaints on google or social media channels, as we are unable to respond to them in a meaningful way.

You can leave us your comments in a number of ways:

If you wish to submit your feedback directly to us or you have a complaint to make, you can:

Send us an email to [email protected]
Call us on 0203 474 6410 to leave your complaint with a receptionist
Come to the practice and ask for Feedback and Complaints Form

Complaints

If you have a complaint or are concerned about the care you have received from the doctors, nurses or any of the staff working in this practice, please let us know. We value comments and we rely on feedback from our patients in order to improve our service.

We hope that most problems can be sorted out easily and quickly, preferably at the time they arise and with the person concerned. If your problem cannot be sorted out in this way and you wish to make a complaint, we would like you to let us know as soon as possible ideally within a matter of days or at most a few weeks because this will enable us to establish what happened more easily. If it is not possible to do that, please let us have details of your complaint:

Within 12 months of the incident that caused the problem.
Within 12 months of discovering that you have a problem, if more than 12 months

You can ask for an appointment with the Practice Manager to discuss your concerns. She will explain the complaints procedure to you and will make sure that your concerns are dealt with promptly.

You can make a complaint:

In person – ask to speak to the practice manager.
In writing – some complaints may be easier to explain in writing. Please give as much information as can, then send your complaint to the practice for the attention of the practice manager as soon as possible.

What We Will Do

Our complaints procedure is designed to make sure that we settle any complaints as quickly as possible.

We will acknowledge your complaint within 3 working days and aim to have investigated your complaint as soon as possible. We aim to have looked into your complaint within 10 working days. We shall then be in a position to offer you an explanation, or a meeting with the people involved.

When we look into your complaint, we shall aim to:

Find out what happened and what went wrong.
Make it possible for you to discuss the problem with those concerned, if you would like this.
Make sure you receive an apology, where appropriate.
Identify what we can do to make sure the problem doesn’t happen again.

At the end of the investigation your complaint will be discussed with you in detail, either in person or in writing.

Complaining On Behalf Of Someone Else

We keep strictly to the rules of medical confidentiality. If you are complaining on behalf of someone else, we have to know that you have his or her permission to do so. A consent form signed by the person concerned will be needed, unless they are incapable (because of illness) of providing this. Please let us know if this is the case.

Complaining to the commissioners

If you feel that you cannot raise your complaint with us, you can phone or write to the complaints department at South East London Integrated Care System. Their staff will aim try to sort out complaints and can make enquiries on your behalf.

Their contact details are:

Email: [email protected]
Tel: 0800 328 9712 or 0208 176 5337

Alternatively you can speak to the NHS Complaints Advocacy service (POhWER) that can assist you in making a complaint. They are available on the telephone on 0203 553 5960 via email at [email protected]

Taking your Complaint Further

If you are not happy with the way your complaint has been handled you can contact:

The Parliamentary and Health Service Ombudsman
Millbank Tower,

Millbank
London,

SW1P 4QP

Tel.: 0345 0154033

Website: www.ombudsman.org.uk

For more information about how to complain to the NHS, including other services, please see https://www.nhs.uk/using-the-nhs/about-the-nhs/how-to-complain-to-the-nhs/

Freedom of Information

Information about the GPs and the practice required for disclosure under the Freedom of Information Act 2000 can be made available to the public.

There are seven classes of information:

Who we are and what we do
What we spend and how we spend it
What our priorities are and how we are doing
How we make decisions
Our policies and procedures
Lists and registers
Services the practice offers

This 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 2018.

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

This is enforced by the Information Commissioner who regulates both the Freedom of Information Act 2000 and the Data Protection Act 2018.

All requests for such information should be made to the reception.

GP Earnings

Named GP

Every patient has a named GP. This doctor has an important role to play in your healthcare. Some patients will already be aware of their named GP but if you would like to know, please just ask a receptionist. You can also request a change of your name GP.

Very little will change with your direct care. Your named GP does not have to be the doctor you see most recently, and you should continue to book appointments as usual.

The named GP is designed to reassure patients there is a doctor to provide an oversight into your care. The responsibilities of your named GP will be to:

Take the lead responsibility for ensuring that the surgery provides all the appropriate services you need
Ensure health and social care professionals deliver a care package that meets your needs
Ensure your physical and psychological needs are recognised and responded to by the relevant clinicians in the practice
Ensure you have access to a health check if requested

It does not mean the named GP:

Takes responsibility for the work of other doctors or health professionals. If you have concerns, you must raise it with them in the first instance
Is available other than at their normal working hours
Is personally available throughout the working week
Be the only GP or clinician who will provide care to you

It does not mean that you can insist on appointment with your named GP unless one is available in the normal way.

You must continue to book appointments with the practice in the same way. If you require an appointment with a GP urgently and are unable to book it with your ‘named GP’ please book in with another available doctor.

Non-NHS Work

Why does my GP charge a fee for medical reports and letters?

Please “Contact Us Online” to request a medical report or a GP letter. Please do not book an appointment with a GP, unless instructed.

The NHS provides certain services which GPs offer and for which we are paid to offer by the NHS. The practice has a primary duty to provide services for the management of patients who are ill.

However, there are many things which patients request from GPs which are not covered by this. GPs do not have to carry out non-NHS work on behalf of their patients. However, we undertake some work as we appreciate that this service is valuable and of use to patients. Non-NHS services are chargeable.

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

Accident/sickness insurance certificates
Private medical insurance reports
Statements of fact relating to general health e.g. fit to run a marathon
Holiday cancellation claim forms
Referral for private care forms (i.e. BUPA forms, Vitality forms)

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

Medical reports for an insurance company
Some reports for the DSS/benefits agency
Examinations of occupational health
Requests from solicitors for patient record

When medical reports are provided they are a private service and as such, have to be completed in the GPs own time outside of their paid NHS working hours. These services incur a fee and we set our fees with reference to the British Medical Association guidance on private fees.

What if I cannot afford to pay a fee?

The practice recognises that many of our patients may have significant financial difficulties and would not wish to increase their financial stress. For this reason the practice offers two levels of support:

Provide the patient with a summary of their medical record including key diagnosis and current medications as previously recorded and read coded in their medical record. There is no charge for this level of support.
Provide a specific letter or report to patients for a fee.

Whilst we understand the financial pressures patients may be experiencing, we receive a high volume of these requests and set all of our fees based on the time the GP takes to complete the work, so that we are equitable to all patients and our doctors. We are not able to negotiate our rates or offer reduced prices.

Why does it sometimes take my GP a some 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, so many GPs find they are already doing extra NHS paperwork on their days off, in the evenings or at weekends. The time taken to complete a form will depend on their NHS workload and how many reports or letters have been requested by other patients at that time. We will try our hardest to turn around private work as efficiently as possible, but we cannot guarantee the work will always be done as rapidly as a patient hopes, and it may take up to 2 weeks.

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, 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.

What fee should I expect to pay?

We have provided below details of our fees. Whenever we receive a request for a letter or report the doctor will review the request to work out how long they need to complete the report and therefore what fee to charge.

We will always tell the patient what the fee will be before the report is completed, so they can decide whether they want to go ahead.

Fees

Service item	Standard fee
Electronic print out of records	Free
Very short letter/certificate	£20
Housing letter	£25
Private Sick note	£25
Holiday Cancellation Certificate	£30
Firearms Renewal Form	£30
Freedom from infection certificate, eg for school, travel or employment	£30
Health club/fitness certificate	£30
School fees	£30
Sickness/accident claim form	£30
Private medical/insurance form	£30
Proforma report with no examination (travel/health insurance)	£50
Written report with no examination	£50
Fitness for sports event with exam	£60
Medical report (solicitor / health insurance / employer) Any supplementary report / info requested in addition to initial report.	£85.00 – £100.00 (depending on the complexity of the patient’s medical history £25.00
DVLA/HGV/PCV appointment without eye test	£100

Online Access for Patients

If you wish to, you can use the internet to book appointments with a GP, request repeat prescriptions for any medications you take regularly and look at your medical record online.

Being able to see your record online might help you to manage your medical conditions. It also means that you can access it from anywhere in the world should you require medical treatment on holiday.

If you decide not to join or wish to withdraw, this is your choice and practice staff will continue to treat you in the same way as before. This decision will not affect the quality of your care.

You will be given login details, so you will need to think of a password which is unique to you. This will ensure that only you are able to access your record – unless you choose to share your details with a family member or carer.

The practice has the right to remove online access to services for anyone that doesn’t use them responsibly.

If signed up, you can get access to:

Booking GP appointments online
Repeat prescriptions online
Viewing your GP records online

From 3rd May 2023, patients will have automatic access to their prospective (future) consultations.

It will be your responsibility to keep your login details and password safe and secure. If you know or suspect that your record has been accessed by someone who does not have your permission to see it, then you should change your password immediately.

If you can’t do this for some reason, we recommend that you contact the practice so that they can remove online access until you are able to reset your password.

If you print out any information from your record, it is also your responsibility to keep this secure. If you are at all worried about keeping printed copies safe, we recommend that you do not make copies at all.

How to sign up

1. Download NHS App

Did you know that patients can access online services directly via the NHS App, without the need to request access from The Exchange Surgery?

The NHS App is a simple and secure way to access a range of NHS services on your smartphone or tablet. You can also access NHS App services from the browser on your desktop or laptop computer. To find out more go to www.nhs.uk/apps-library/nhs-app

After you download the app, you will need to set up an NHS login and prove who you are as follows:

1. take a photo of your I.D.
2. record your face using your device
3. enter your NHS number if you know it

If your device supports fingerprint detection or facial recognition, you can use it to log in to the NHS App each time, instead of using a password and security code.

If you have any issues using or downloading the app, please check the NHS App help and support page.

2. Fill out our Register for Online Services form

If you want to be able to access your medical record, order repeat prescriptions and book appointments online, please register for online services by completing our Register for Online Services form.

Online Access for Adults

You will need to provide photo ID when you sign up. Please allow two working days for us to process your request.

To complete your online registration, we request that you upload a photo of yourself holding a proof of your ID, with both your face and the ID clearly visible in the photo.

The ID must be either a passport or a driving licence which is currently in date.

Alternatively, you can bring your ID to the practice for staff member to verify you. If you do not have a photo ID, please come to the practice and speak to our receptionist to verify your identity.

If you are requesting proxy access, we require proof of ID for both yourself and the patient.

Online Access for Children under 11 years old

Parents and guardians of children who are under 11 years old can request access to full medical records and it is essential to establish that they have parental responsibility and right of access to the child’s record.

Follow same steps as you would for adults
ID documents needed are: child birth certificate and parent’s photo ID

Advise parent/guardian that access to medical records and requesting medication will be revoked upon child’s 11th birthday. Once child reaches 11 years old, they can make a request to review records and be approved on case to case basis by named GP and manager.

Online Access for Children 11-13 years old by proxy

Please request proxy access again online. The named GP will review the child’s records to approve the request. Access will be given until 13th birthday only. Please allow 10 working days to process the request.

Online Access for Children 13-15 years old by proxy

To grant proxy access we need the child’s consent.

You can fill out a request online on our website and a member of staff will call your child to confirm their consent. If your child has a mobile number, please confirm it, so we can call your child directly after school hours.

Alternatively, your child can fill out the Teenage Proxy Access Request Form at the reception in person.

The named GP will review the child’s records to approve the request. Access will be given until 16th birthday only. Please allow 10 working days to process the request.

Online Access for Children 16 years and over by proxy

After their 16th birthday young people who have the NHS App and an NHS Login will have automatic access to all GP Online Services, including future information recorded into their notes.

Online Access for Adults by proxy

We encourage patients to have access to their own records, but anyone can consent to proxy access to GP online services.

Fill out this form:

Consent to proxy access to GP online services

Enhanced Access to medical records

Sometimes you might need access to your full medical records. We encourage patients to access them online. Please send us an email to [email protected] to request this, attaching a photo with you holding a photo ID. Alternatively, you can fill out the Enhanced Access form at the practice and bring your photo ID so we can verify your identity.

When we receive your request, we have to check with the doctor who usually sees you, that nothing in your notes could harm either your (or someone else’s) physical or mental state. Or if there is information from, or about, a 3rd party who has not given consent. We have a legal right to decide not to disclose these parts of your medical records to you.

Your records will not be ready for you to view on the same day. We will arrange a time within 21 days for you to view your records.

You can also request a printout of all your records or parts of your records. Please consider your request carefully and request only the necessary information.

Before you apply for online access to your record, there are some other things to consider.

Although the chances of any of these things happening are very small, you will be asked that you have read and understood the following before you are given login details.

Things to consider

Forgotten history

There may be something you have forgotten about in your record that you might find upsetting.

Abnormal results or bad news

If your GP has given you access to test results or letters, you may see something that you find upsetting to you. This may occur before you have spoken to your doctor or while the surgery is closed and you cannot contact them.

Choosing to share your information with someone

It’s up to you whether or not you share your information with others – perhaps family members or carers. It’s your choice, but also your responsibility to keep the information safe and secure.

Coercion

If you think you may be pressured into revealing details from your patient record to someone else against your will, it is best that you do not register for access at this time.

Misunderstood information

Your medical record is designed to be used by clinical professionals to ensure that you receive the best possible care. Some of the information within your medical record may be highly technical, written by specialists and not easily understood. If you require further clarification, please contact the surgery for a clearer explanation.

Information about someone else

If you spot something in the record that is not about you or notice any other errors, please log out of the system immediately and contact the practice as soon as possible.

More information

For more information about keeping your healthcare records safe and secure, you will find a helpful leaflet produced by the NHS in conjunction with the British Computer Society:

Keeping your online health and social care records safe and secure

Please also see our Access to medical Records Policy.

Rights and Responsibilities

We are here to help you, but to do this we sometimes need your assistance. Here we explain the ways in which you can help the surgery provide a better service for all patients.

Patient Health

Patients should respect their health and therefore seek to maintain a healthy lifestyle and minimise their health risks.

Patient Conduct

Patients should value the members of the practice team as professional advisers. This includes extending the same courtesy and politeness as they would expect to receive.

No Smoking

We are committed to a policy of promoting good health and preventing disease. There should be no smoking on the premises to ensure a smoke-free environment.

Repeat Prescriptions

Requests for repeat prescriptions take 2 working days and should be made in good time to avoid unnecessary delay in treatment. Requests should be made using the computer-generated right side of your prescription or alternatively a request may be made in writing to the surgery. For safety reasons, requests for repeat medication will not be taken over the telephone however they can be requested via our website.

Help and Advice

Requests for help or advice for non urgent conditions should be made within normal surgery opening hours. The out-of-hours service operated by NHS 111 should only be used in the case of urgent medical conditions and not for routine problems or enquiries.

Appointment Attendance

The patient should do everything possible to keep appointments. The surgery should be notified as soon as possible if you are unable to attend so that the appointment can be given to another patient. Failing to turn up for appointments without notifying the surgery in advance could stop possible urgent cases from receiving earlier medical attention.

Patient Privacy

Whilst privacy is respected by all staff, it would be helpful if patients would indicate the nature of the appointment ie blood tests, vaccinations, smears, etc so that we can advise on the best member of the team to consult.

Home Visits

Home visits should be regarded as a service for the genuinely housebound or seriously ill. They are time consuming and their misuse would disadvantage those in genuine need.

New Patients

If you are a new patient please be ready to tell us details of your past medical history, including illnesses, medication, hospital admissions and other relevant details. Make sure you have registered all members of your household.

Moving House

If you move house or are planning to in the near future, you should notify the surgery of your new address as soon as possible. Remember that in case of emergency we may need to contact you urgently.

Effective Use of Resources

We place importance on the effective use of resources, patients found repeatedly failing to attend appointments without prior notification, abusing the home visits or NHS 111 out-of-hours service, or repeatedly phoning in to request repeat prescriptions will have their registration status reviewed.

Summary Care Record

The current Central NHS Computer System is called the Summary Care Record (SCR). It is an electronic record which contains information about the medicines you take, allergies you suffer from and any bad reactions to medicines you have had.

Why do I need a Summary Care Record?

Storing information in one place makes it easier for healthcare staff to treat you in an emergency, or when your GP practice is closed. This information could make a difference to how a doctor decides to care for you, for example, which medicines they choose to prescribe for you.

You may need to be treated by health and care professionals that do not know your medical history. Essential details about your healthcare can be difficult to remember, particularly when you are unwell or have complex care needs. Having an SCR means that when you need healthcare you can be helped to recall vital information.

SCRs can help the staff involved in your care make better and safer decisions about how best to treat you.

You can choose to have additional information included in your SCR, which can enhance the care you receive. This information includes:

Your illnesses and health problems.
Operations and vaccinations you have had in the past.
How you would like to be treated – such as where you would prefer to receive care.
What support you might need.
Who should be contacted for more information about you.

Who can see it?

Only healthcare staff involved in your care can see your Summary Care Record.

How do I know if I have one?

If you are registered with a GP practice in England you will have a Summary Care Record (SCR), unless you have previously chosen not to have one. Over half of the population of England now have a Summary Care Record. You can find out whether Summary Care Records have come to your area by looking at our interactive map or by asking your GP. It includes important information about your health:

Medicines you are taking.
Allergies you suffer from.
Any bad reactions to medicines.

Do I have to have one?

No, it is not compulsory. If you choose to opt-out of the scheme, then you will need to complete our online Summary Care Record Opt Out form.

For further information visit the NHS Care Records website.

Zero Tolerance

The Practice takes it very seriously if a member of staff or one of the doctors or nursing team is treated in an abusive or violent way.

The Practice supports the government’s ‘Zero Tolerance’ campaign for Health Service Staff. This states that GPs and their staff have a right to care for others without fear of being attacked or abused. To successfully provide these services a mutual respect between all the staff and patients has to be in place. All our staff aim to be polite, helpful, and sensitive to all patients’ individual needs and circumstances. They would respectfully remind patients that very often staff could be confronted with a multitude of varying and sometimes difficult tasks and situations, all at the same time. The staff 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.

However, aggressive behaviour, be it violent or abusive, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police being contacted.

In order for the practice to maintain good relations with their patients the practice would like to ask all its patients to read and take note of the occasional types of behaviour that would be found unacceptable:

Using bad language or swearing at practice staff
Any physical violence towards any member of the Primary Health Care Team or other patients, such as pushing or shoving
Verbal abuse towards the staff in any form including verbally insulting the staff
Racial abuse and sexual harassment will not be tolerated within this practice
Persistent or unrealistic demands that cause stress to staff will not be accepted. Requests will be met wherever possible and explanations given when they cannot
Causing damage/stealing from the Practice’s premises, staff or patients
Obtaining drugs and/or medical services fraudulently

We ask you to treat your GPs and their staff courteously at all times.

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 practice, 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.