A health record is any record of information relating to someone’s physical or mental health that has been made by (or on behalf of) a health professional. This could be anything from the notes made by a GP in your local surgery to results of an MRI scan or X-rays. Health records are extremely personal and sensitive.

They can be held electronically or as paper files and are kept by a range of different health professionals both in the NHS and the private sector. How can I access my records.

This is known as a subject access request.

You do not have to give a reason for applying for access to your health records. To save the NHS time and resources, it would be helpful if you would inform us – if you do not need access to your entire health record – of the periods and parts of your health records that you require, along with details which you may feel have relevance (e.g. consultant name, location, diagnosis etc.) You should also be aware that in certain circumstances your right to see some details in your health records may be limited in your own interest or for other reasons (e.g. to protect the privacy of third parties).

Please note:

• You can sign up for patient online services to your GP electronic record (please contact the practice for an application form).
• You can then look at your medical record whenever you want.

If you do wish to make a subject access request then:

• You can do this in writing (letter, email).
• You can make such a request verbally to a member of staff or a doctor or nurse that you are consulting with at the surgery.

Please let us know exactly what information you would like.

We will strive to provide the information within 28 calendar days.

There is usually no fee for this.

For more information, please visit www.ico.org.uk/your-data-matters.

As a parent, family member or carer, you may be able to access services for someone else. We call this having proxy access. We can set this up for you if you are both registered with us.

To requests proxy access:

• fill in this admin request form
• collect a proxy access form from reception from 10am to 6pm

Linked profiles in your NHS account

Once proxy access is set up, you can access the other person’s profile in your NHS account, using the NHS App or website.

The NHS website has information about using linked profiles to access services for someone else.

This practice is not funded to provide comprehensive NHS services for adults with ADHD.

National guidance expects long-term involvement of specialists in reviewing these patients and their medical treatment, but this does not currently happen in Oxfordshire.

Therefore, the practice has taken the difficult decision that any new requests from specialists, both NHS and private, to prescribe ADHD medications to adult patients, will be declined.

We will also be making this clear to providers of ADHD services, at the point we refer patients for a diagnostic assessment. Care of adults already receiving ADHD treatments remains under careful review.

Patients may be able to access the care they need outside of the NHS, for instance by seeking a referral to a private provider from their NHS GP or NHS specialist.

As your NHS GP, we will not enter into “shared care” arrangements with private providers.

Patients should not be left without the care they need, due to a lack of comprehensive NHS funding, and our local representatives have raised this issue with local funding and decision-making groups. If you also wish to raise this issue, you may want to contact the “planned care team” at the local Integrated Care Board, [email protected] , and/or your MP.

Patients are entitled to be accompanied by a chaperone for any consultation, examination or procedure.

If you would like one, please ask at Patient Services, mention it to your GP or contact us using our Contact the Practice form.

Buckinghamshire, Oxfordshire, Berkshire West ICB
First Floor
Unipart House
Garsington Road
Cowley
OX4 2PG

Telephone: 01296 587220

General enquiries email: [email protected]

All patients’ records are confidential. All our staff are trained in accordance with the Data Protection Act 2018 and work under strict rules of confidentiality.

All patient services are provided at ground floor level but if any assistance is required please ask at Patient Services and a member of staff will be happy to help.

The surgery has produced a publication in accordance with the Freedom of Information Act 2000.

If you have a request for any information in line with the Act please contact the practice manager using our Contact the Practice form.

“All GP practices are required to declare the mean earnings (e.g.averagepay) for GPs working to deliver NHS services to patients at each practice.”

The average pay for GPs who worked for six months or more in Hightown Surgery in the last financial year was £49,587 before Tax and National Insurance. This is for 8 part-time GP’s and 4 locum GP’s.

All our patients now have a named, accountable GP, who will be responsible for the care and support that our surgery provides to them. We hope this will provide and continue to promote the continuity of care for our patients. If you’d like to know your named GP is please contact the surgery.

Your named GP will ensure that you receive the best possible level of care and support from our surgery and will work with other relevant healthcare professionals, who are involved in your care, to ensure that your care meets your individual needs.

Even though you have been assigned a GP, you can book appointments with any doctor or nurse at the practice.

Please contact us if you would like to change your named GP.

The National Health Service provides most health care to most people free of charge, but there are exceptions. Some services provided are not covered under our contract with the NHS and therefore attract charges. 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. The NHS pays the doctor for specific NHS work, but not for non NHS. The fee has to cover the doctors costs.

The fees charged are based on the British Medical Association (BMA) suggested scales and our Patient Services team will be happy to advise you about them along with appointment availability.

Examples where a patient can be charged include the following:

• Insurance claim forms
• Prescriptions for taking medication abroad
• Private sick notes
• Letters to third parties
• Vaccination certificates
• Certain travel vaccinations
• Private medical insurance reports
• Holiday cancellation forms
• Referral for private care form
• In certain instances fitness to work forms

Examples where another company can be charged include the following:

• Medical reports for an insurance company
• Some reports for DSS/Benefit agency
• Examinations for local authority employees

Where NHS and Private Care Meet

Patients are increasingly using private health providers. This is often a response to the increasingly long NHS waiting lists and these patients often feel that they are ‘helping’ the NHS by seeking private diagnosis and treatment. Unfortunately, many of these patients don’t realise that the interface between the NHS and private practice is complex.

Private providers may not be regulated in the same way as the NHS, and they may not follow NHS guidelines on diagnosis and management.

From the Thames Valley Commissioning Guidance:

• There is no obligation for the GP to prescribe treatment recommended by a private practitioner if it is contrary to local agreement or outside normal clinical practice.
• The NHS will not normally fund treatment recommended by a private practitioner if they are not usually commissioned in an area.
• Even if the patient can demonstrate they have benefited from private treatment this does not provide grounds for continuing the treatment on the NHS – clinical need should be assessed in the same way that we would assess an NHS patient in our area.
• Retrospective funding is not possible.
• There should be as clear as possible separation between NHS and private care.
• In one individual private consultation the patient must pay for all aspects within that consultation – any drugs prescribed or interventions.
• For ongoing care, the NHS GP can continue to prescribe if it would be normally provided on the NHS for that condition – we as GP’s are then taking on full responsibility for this. If the drug is not normally provided by primary care, we can enter into a ‘shared care agreement’ with ongoing monitoring by the private consultant if this is clearly set out and meant for GP shared care (for example gender services)

Frequently Asked Questions

What is covered by the NHS and what is not?

The government’s contract with GPs covers medical services to NHS patients. In recent years, 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 be sure that information provided is true and accurate

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/her patients. Most GPs have a very heavy workload – the majority of GPs work up to 60 hours a week and paperwork takes up an increasing amount of their time. In addition non-NHS work must be undertaken outside of NHS contracted time.

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. Therefore in order to complete even the simplest of forms, the doctor needs to check the patient’s entire record. Carelessness or an inaccurate report can have serious consequences for the doctor, with the General Medical Council or even the police.

Introduction

This policy outlines the practice’s call recording process.

The purpose of the call recording is to:

• Ensure practice staff act in compliance with procedures
• Ensure quality control
• Training, monitoring and service improvement
• Prevention of crime, misuse and protection of staff

Purpose

The purpose of this policy is to ensure that call recording is managed in line with the Data Protection Act 2018 and the NHS Records Management Code of Practice for Health and Social Care 2016 and data retention requirements. This will generally involve the recording of telephone conversations which is subject to the Telecommunications Act 1984.

The practice will make every reasonable effort to advise callers that their call may be recorded and for what purpose the recording will be used. This will normally be via a pre-recorded message within the telephone system and via the practice’s Privacy Notice. The voice file may be stored within the clinical system or within the telephone system to which the same rules of confidentiality will apply. They will be deleted after 3 years.

Where a patient requests to listen to a recording then this should be allowed with the general provision of data subject access under the Data Protection Act 2018.

Scope

This policy applies to all practice staff including contracted and temporary workers.

All calls via the telephone systems used in the practice will be recorded, including:

• All external incoming calls
• All external outgoing calls made by practice staff
• All internal incoming and outgoing calls made by the practice staff
• Call transfers
• Recording will automatically stop when the practice member terminates the call

Monitoring of Calls

Monitoring of call recordings will be undertaken by the Practice Manager or the Assistant Practice Manager. Any playback of recordings will take place in a private setting and where applicable, individuals should be given the opportunity to listen to the relevant recordings to receive feedback and developmental support.

All recordings and call recordings equipment will be stored securely encrypted, and access to these should be controlled and managed by the Practice Manager and the Assistant Practice Manager.

Access to the recordings is via the telephone system. This is a password protected portal accessed by the Practice Manager and the Assistant Practice Manager only.

Confidentiality

The Data Protection Act allows patients and staff access to information that is held about them and their personal data. This includes recorded telephone calls. Recordings should be stored in such a way that will enable easy access to the information relating to one or more individuals.

Requests for copies of telephone conversations can be made under the Data Protection Act as a ‘subject access request’. This can be in writing or verbal and after assessing whether the information can be released, the requestor can be invited to the practice premises to hear the recording.

If there is a request from an external body relating to the detection and prevention of crime (e.g. police) then requests for information should be directed to the Practice Manager.

Hightown Surgery

Privacy Notice

How we use your information

Your information, what you need to know.

This privacy notice explains why we collect information about you, how that information will be used, how we keep it safe and confidential and what your rights are in relation to this.

Why we collect information about you.

Health care professionals who provide you with care are required by law to maintain records about your health and any treatment or care you have received.  These records help to provide you with the best possible healthcare and help us to protect your safety.

We collect and hold data for the purpose of providing healthcare services to our patients and running our organisation which includes monitoring the quality of care that we provide. In carrying out this role we may collect information about you which helps us respond to your queries or secure specialist services. We may keep your information in written form and/or in digital form.

Our Commitment to Data Privacy and Confidentiality Issues

As a GP practice, all of our GPs, staff and associated practitioners are committed to protecting your privacy and will only process data in accordance with the Data Protection Legislation.  This includes the General Data Protection Regulation (EU) 2016/679 (GDPR) now known as the UK GDPR, the Data Protection Act (DPA) 2018, the Law Enforcement Directive (Directive (EU) 2016/680) (LED) and any applicable national Laws implementing them as amended from time to time.  The legislation requires us to process personal data only if there is a legitimate basis for doing so and that any processing must be fair and lawful.

In addition, consideration will also be given to all applicable Law concerning privacy, confidentiality, the processing and sharing of personal data including the Human Rights Act 1998, the Health and Social Care Act 2012 as amended by the Health and Social Care (Safety and Quality) Act 2015, the common law duty of confidentiality and the Privacy and Electronic Communications (EC Directive) Regulations.

Details we collect about you.

Records which this GP Practice may hold about you will include the following:

• Personal Data – means any information relating to an identified or identifiable natural person (‘data subject’); an identifiable natural person is one who can be identified, directly or indirectly, in particular by reference to an identifier such as a name, an identification number, location data, an online identifier or to one or more factors specific to the physical, physiological, genetic, mental, economic, cultural or social identity of that natural person.

• Special Categories of Personal Data – this term describes personal data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, and the processing of genetic data, biometric data for the purpose of uniquely identifying a natural person, data concerning health or data concerning a natural person’s sex life or sexual orientation.

• Confidential Patient Information – this term describes information or data relating to their health and other matters disclosed to another (e.g., patient to clinician) in circumstances where it is reasonable to expect that the information will be held in confidence. Including both information ‘given in confidence’ and ‘that which is owed a duty of confidence’. As described in the Confidentiality: NHS code of Practice: Department of Health guidance on confidentiality 2003.

• Pseudonymised – The process of distinguishing individuals in a dataset by using a unique identifier which does not reveal their ‘real world’ identity.

• Anonymised – Data in a form that does not identify individuals and where identification through its combination with other data is not likely to take place.

• Aggregated – Statistical data about several individuals that has been combined to show general trends or values without identifying individuals within the data.

How we use your information

Improvements in information technology are also making it possible for us to share data with other healthcare organisations for the purpose of providing you, your family, and your community with better care.  For example, it is possible for healthcare professionals in other services to access your record with or without your permission when the practice is closed.  Where your record is accessed without your permission it is necessary for them to have a legitimate basis in law. This is explained further in the Local Information Sharing at Appendix A.

Whenever you use a health or care service, such as attending Accident & Emergency or using Community Care services, important information about you is collected in a patient record for that service.  Collecting this information helps to ensure you get the best possible care and treatment.

The information collected about you when you use these services can also be used and provided to other organisations for purposes beyond your individual care, for instance to help with:

• improving the quality and standards of care provided by the service.
• research into the development of new treatments and care pathways
• preventing illness and diseases
• monitoring safety
• planning services
• risk stratification
• Population Health Management

Safeguarding of children or vulnerable adults

If we have significant concerns or hear about an individual child or vulnerable adult being at risk of harm, we may share relevant information with other organisations, such as local authorities and the Police, involved in ensuring their safety.

Statutory disclosures

Sometimes we are duty bound by laws to disclose information to organisations such as the Care Quality Commission, the Driver and Vehicle Licencing Agency, the General Medical Council, Her Majesty’s Revenue and Customs and Counter Fraud services. In these circumstances we will always try to inform you before we are required to disclose, and we only disclose the minimum information that the law requires us to do so.

This may only take place when there is a clear legal basis to use this information.  All these uses help to provide better health and care for you, your family and future generations.  Confidential patient information about your health and care is only used like this were allowed by law or with consent.

Pseudonymised or anonymised data is generally used for research and planning so that you cannot be identified.

A full list of details including the legal basis, any Data Processor involvement and the purposes for processing information can be found in Appendix A.

How long do we hold information for?

All records held by the Practice will be kept for the duration specified by national guidance from Records Management Code of Practice – NHSX.  Once information that we hold has been identified for destruction it will be disposed of in the most appropriate way for the type of information it is.  Personal confidential and commercially confidential information will be disposed of by approved and secure confidential waste procedures. We keep a record of retention schedules within our information asset registers, in line with the Records Management Code of Practice for Health and Social Care 2021.

Individuals Rights under UK GDPR

Under UK GDPR 2016 the Law provides the following rights for individuals.  The NHS upholds these rights in a number of ways.

1. The right to be informed.
2. The right of access
3. The right to rectification
4. The right to erasure (not an absolute right) only applies in certain circumstances.
5. The right to restrict processing.
6. The right to data portability
7. The right to object
8. Rights in relation to automated decision making and profiling.

Your right to opt out of data sharing and processing.

The NHS Constitution states, ‘You have a right to request that your personal and confidential information is not used beyond your own care and treatment and to have your objections considered’.

Type 1 Opt Out

This is an objection that prevents an individual’s personal confidential information from being shared outside of their general practice except when it is being used for the purposes of their individual direct care, or in particular circumstances required by law, such as a public health screening or an emergency like an outbreak of a pandemic disease. If patients wish to apply a Type 1 Opt Out to their record, they should make their wishes know to the Practice Manager.

National data opt-out (NDOO)

The national data opt-out was introduced on 25 May 2018, enabling patients to opt-out from the use of their data for research or planning purposes, in line with the recommendations of the National Data Guardian in her Review of Data Security, Consent and Opt-Outs.

The national data opt-out replaces the previous ‘type 2’ opt-out, which required NHS Digital not to use a patient’s confidential patient information for purposes beyond their individual care, for Planning or Research. Any patient that had a type 2 opt-out recorded on or before 11 October 2018 has had it automatically converted to a national data opt-out. Those aged 13 or over were sent a letter giving them more information and a leaflet explaining the national data opt-out.  For more information go to National data opt out programme

To find out more or to register your choice to opt out, please visit www.nhs.uk/your-nhs-data-matters.

On this web page you will:

• See what is meant by confidential patient information.
• Find examples of when confidential patient information is used for individual care and examples of when it is used for purposes beyond individual care.
• Find out more about the benefits of sharing data.
• Understand more about who uses the data.
• Find out how your data is protected.
• Be able to access the system to view, set or change your opt-out setting.
• Find the contact telephone number if you want to know any more or to set/change your opt-out by phone.
• See the situations where the opt-out will not apply.

Right of Access to your information (Subject Access Request)

Under Data Protection Legislation everybody has the right of access to, or request a copy of, information we hold that can identify them, this includes medical records. There are some safeguards regarding what patients will have access to and they may find information has been redacted or removed for the following reasons.

• It may be deemed to risk causing harm to the patient or others.
• The information within the record may relate to third parties who are entitled to their confidentiality, or who have not given their permission for the information to be shared.

Patients do not need to give a reason to see their data. And requests can be made verbally or in writing.  Although we may ask them to complete a form in order that we can ensure that they have the correct information required.

Where multiple copies of the same information is requested, the surgery may charge a reasonable fee for the additional copies.

Patients will need to provide proof of identity to receive this information. We will not share information relating to you with other individuals without your explicit instruction or without sight of a legal document.

Patients may also request to have online access to their data, they may do this via the NHS APP, or NHS Website.

COVID Passport access

Patients may access their Covid passport via the link, the practice cannot provide this document as it is not held in the practice record. If you have any issues gaining access to your Covid Passport or letter you should call: 119.

Change of Detail

It is important that you tell the surgery if any of your contact details such as your name or address have changed, or if any of your other contacts details are incorrect including third party emergency contact details. It is important that we are made aware of any changes immediately in order that no information is shared in error.

Hightown Surgery administration online forms

Mobile telephone number

If you provide us with your mobile phone number, we will use this to send you text reminders about your appointments or other health screening information. Please let us know if you do not wish to receive text reminders on your mobile.

We also 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.

Email address

Where you have provided us with your email address, with your consent we will use this to send you information relating to your health and the services we provide. If you do not wish to receive communications by email, please let us know.

Notification

Data Protection Legislation requires organisations to register a notification with the Information Commissioner to describe the purposes for which they process personal and sensitive information.

We are registered as a Data Controller and our registration can be viewed online in the public register at:  http://ico.org.uk/what_we_cover/register_of_data_controllers

Any changes to this notice will be published on our website and in a prominent area at the Practice.

Data Protection Officer

Should you have any data protection questions or concerns, please contact our Data Protection Officer via the surgery at: [email protected]

What is the right to know?

The Freedom of Information Act 2000 (FOIA) gives people a general right of access to information held by or on behalf of public authorities, promoting a culture of openness and accountability across the public sector. You can request any non-personal information that the GP Practice holds, that does not fall under an exemption. You may not ask for information that is covered by the Data Protection Legislation under FOIA. However, you can request this under a right of access request – see section above ‘Access to your information.’

Right to Complain

If you have concerns or are unhappy about any of our services, please contact the Practice Manager.

For independent advice about data protection, privacy, and data-sharing issues, you can contact:

The Information Commissioner

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

Phone: 0303 123 1113     Website: https://ico.org.uk/global/contact-us

The NHS Constitution

The NHS Constitution establishes the principles and values of the NHS in England. It sets out the rights patients, the public and staff are entitled to. These rights cover how patients access health services, the quality of care you’ll receive, the treatments and programs available to you, confidentiality, information, and your right to complain if things go wrong.

https://www.gov.uk/government/publications/the-nhs-constitution-for-england

Reviews of and Changes to our Privacy Notice

We will keep our Privacy Notice under regular review. This notice was last reviewed in November 2023

Hightown Surgery

Privacy Notice – Appendix A

The Practice will share patient information with these organisations where there is a legal basis to do so.

We will keep our Privacy Notice under regular review. This notice was last reviewed 28^th February 2023

Lawful basis for processing:

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 UK 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…’; and
• 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…”

Important information for patients attending an outpatient appointment (face to face, telephone, or video)

Please note that if the hospital decide you need a sick note, urgent prescription (needed within 7 days) or an onward referral it is THEIR RESPONSIBILITY and contractual obligation to organise it. It will ALWAYS be quicker for them to do this for you than for them to direct you back to us. Unfortunately, not everyone who works in the hospital knows this and we frequently have patients directed back to us in error by the hospital. This is making it more and more difficult for patients to get through to us on the phone or make appointments with us.

Please help us by making sure the hospital organises your sick note (for the whole time you will need to be off), urgent prescription or onward referral.

You can direct them to our website( Hightown Surgery ) or speak to PALS on 0800 328 7971 if you have any problems.

Thank you for helping us improve access to appointments for our patients.

The Hightown Partners

[Updated 23^rd September 2024]

However, we are aware that things can go wrong resulting in a patient feeling that they have a genuine cause for complaint. If this is so, we would wish for the matter to be settled as quickly, and as amicably, as possible.

To pursue a complaint, please complete our Complaints Form and we shall deal with your concerns appropriately. Further written information is available regarding the complaints procedure from Patient Services.

If something has gone well with your care at the surgery please let us know that too.

NHS Complaints Information

If you are not happy with the care or treatment you’ve received from an NHS service, you have the right to make a complaint.

To make a complaint you need to contact either:

• The NHS service that provided your care (e.g. GP practice, dentist or hospital) or;
• The commissioners of the service that provided your care. This will be either your local Clinical Commissioning Group or NHS England.

If you remain dissatisfied after you receive a full response, you can refer your complaint to the Parliamentary Health Service Ombudsman (PHSO). The PHSO is independent from the NHS and can undertake a review of the way in which your complaint has been managed.

If you need any support to make a complaint, or at any point during the complaints process, you can get free, confidential and independent advice from our local NHS complaints advocacy service.

For more information on the complaints procedure and your nearest NHS complaints advocacy service please visit www.nhs.uk or contact your local authority.

• NHS: How to complain to the NHS
• Oxfordshire CCG: Make a complaint

This is a national centralised database of limited medical information (allergies and medication only), extracted and uploaded from your GP record to NHS Digital. That information is then potentially available to medical staff nationwide.

In common with all GP surgeries, Hightown Surgery is required to extract and upload information from GP records to the national Summary Care Record (SCR) database, one of a number of NHS databases. Your Summary Care Record will contain all medication prescribed for you in the preceding 6 months, any repeat medication issued over the preceding 18 months, and any allergies or adverse reactions to medicines.

The information will potentially be available to healthcare professionals across England, for the purpose of your direct clinical care (a “primary” use of your information). The SCR is therefore a nationally available database. The information is extracted and uploaded to NHS Digital, who is therefore the data controller for the Summary Care Record database. There are no secondary uses of the SCR, and data uploaded to the SCR database is neither shared nor used beyond that required to provide direct medical care.

Who Can Access The Summary Care Record?

• Clinicians at SCAS NHS 111 Clinicians in Emergency Operations Centre
• Various departments at hospital
• Our community staff (district nurses, midwives and health visitors)

Community nurses have access to the GP records of our patients (through our EMIS Web clinical system).

If you do not wish to have, or continue to have, a Summary Care Record then you can opt-out at any time using our Summary Care Record Opt-out form. If you do opt-out, your uploaded data will be “blanked”, no one will be able to access it, and no further information about you will be uploaded from your GP record.

If you do opt-out, or if you have already opted out, then you can opt back in at any time and have a Summary Care Record created.

For more information, please visit www.digital.nhs.uk/summary-care-records-scr.

We have been a training practice since 1992. We enjoy and are committed to teaching and see the benefits it brings to patients, the practice, and the profession. We are proud of our successful training record and 3 of our current doctors actually started here as trainees.

We are part of the Banbury GP Vocational Training Scheme within the Oxford Deanery.

The whole practice participates in GP Training, and we also teach a variety of other health professionals; so far including community nurses, health visitor and midwifery students, student counsellor and a pharmacist. We also have Oxford medical students on short term attachments each autumn.

GPs in Training

Doctors who train with us are fully qualified and have selected general practice as their career speciality. They have completed at least 2 years in hospital posts, and some have prior GP experience too.

Postgraduate medical training has recently been modernised so that more doctors have the opportunity to learn in general practice, whatever their final career aspirations. This means we now have the opportunity to expand our teaching role, to include recently qualified doctors who wish to learn more about primary care. They join us for 4-6 months and have a greater level of supervision than our 1-year registrars (for simplicity we refer to them all as registrars).

GP Registrars in Practice

What do registrars do?

Registrars will:

• Sit and observe consultations
• Conduct joint consultations with their supervising GP
• Consult on their own, always with a backup GP
• Occasionally video record their consultations for personal teaching purposes

You may be told you are seeing a GP registrar when you make your appointment, and the doctor will also introduce themselves as a GP registrar when they greet you. You will always be asked if you are happy for a registrar or student to sit in on your consultation but if you are uncomfortable with this please decline.

As a training practice we will always seek your written permission if the registrar is videoing their consultations. Physical examinations will be off camera and you can ask for the camera to be switched off at any time during the consultation.

The videos are only viewed by the GP registrars and their supervising GP’s and are an invaluable tool for teaching consultation skills. Some videos can be used for the RCA examination, so may be viewed by an external examiner (which you will be asked separate permission for).

How does This Benefit Patients?

As a training practice we have to demonstrate and maintain the highest standards of healthcare for our patients, as well as providing an excellent learning environment for GP registrars. We are rigorously externally assessed every 3 years for excellence in organisational, clinical, and educational performance.

Registrars also increase the number of available appointments, bring fresh ideas and enthusiasm, and share the most up to date hospital practice with us.

We feel privileged to be involved in training the doctors of the future and hopefully encouraging them to aspire to be excellent GPs as defined by the Royal College of General Practitioners (RCGP).

Information for potential learners:

• Oxford Deanery

For any further information please contact Dr Kate Smith (trainer) or Mr Stanford Jeffery the practice manager.

Research

The practice has traditionally been involved with primary care research, in particular with Dr Lehman’s work on heart failure and Dr Hin’s on Coeliac Disease and on vitamin B12 deficiency. Dr Hin retired in July 2012 but continued to run a research project on vitamin D deficiency, details of which you may have seen in the surgery and many of you kindly participated in, this concluded in 2014.

We take part in projects run by reputable, outside agencies (often Oxford University or the Oxford Hospitals).

We have also been involved in the ATAFUTA trial for treatments for urinary tract infection and the COMBO trial for use of supportive IT systems for people with bipolar disorder.

It will always be made clear to you if any of your care is linked in any way to research. We are justifiably proud of the achievements so far in this area.

Zero Tolerance Policy – Patient Behaviour

As an employer, Hightown Surgery has a duty of care for the health, safety and wellbeing of its staff. The practice also has a legal responsibility to provide a safe and secure working environment for staff. Staff mental health is as important as their physical health.

All patients and staff are expected to behave in an acceptable, respectful manner.

The practice follows the NHS guidance concerning Zero Tolerance.

Any incident in which an employee is abused, threatened or assaulted in circumstances relating to their work is unacceptable and not tolerated.

This includes the serious or persistent use of verbal abuse, aggressive tone and/or language and swearing/foul language.

Staff should not be left upset and distressed following an interaction with a patient.

All instances of actual physical abuse or threatening behaviour on any doctor or member of staff, by a patient or their relatives will be reported to the police as an assault.

We expect all patients to be responsible and avoid attending the surgery under the influence of alcohol or illegal drugs. Any alteration of prescriptions is illegal and will not be tolerated.

The General Medical Council States In Good Medical Practice that: “In rare circumstances, the trust between you (the Practice) and a patient may break down, and you may find it necessary to end the professional relationship. For example, this may occur if a patient has been violent to you or a colleague, has stolen from the premises, or has persistently acted inconsiderately or unreasonably.”

This includes unnecessarily persistent or unrealistic service demands that cause disruption. Examples of this include, but are not limited to :

• Demanding to only speak to a specific team member
• Refusing appointments with an appropriate clinician for the presenting care need i.e. insisting on a GP appointment when seeing a pharmacist or nurse prescriber is most appropriate or refusing to see an available GP for your presenting care need when your preferred GP is unavailable
• Refusing to access the service in the appropriate manner i.e. sending emails/texts instead of using the NHS Digital approved digital consultation service
• Demanding a same day appointment for a routine clinical need (after triage by trained staff) – this deprives access to urgent care services for those who genuinely need it
• Contacting individuals directly via social media or personal email instead of through the practice contact channels

The practice has a finite number of available appointments, and you may be directed to a clinician who is not a GP, or your preferred GP, but who is appropriately qualified to manage the presenting care need. We provide a named GP service, but we cannot always accommodate requests to speak to the same GP due to high patient demand for appointments.

If you are seriously unhappy with the quality of service you have the right to register with another practice without notifying us. Similarly, on the very rare occasions when a patient breaches this policy, we have the right to remove the patient from our Practice list.

Examples of Unacceptable Standards of Behaviour

 In exceptional circumstances, a breakdown may occur between a doctor and their patient. If the breakdown is of a serious nature e.g. serious physical or verbal abuse to any member of the practice team, the doctors may feel that the doctor/patient relationship has been compromised. Steps may be taken to have the patient removed immediately from the practice list. Where possible, conciliation would always be the preferred route. Reasons for removal will be given in writing.

Where we deem an incident is not serious enough to warrant immediate removal, we will issue a first and final warning.

You will be removed from our patient list immediately when we have needed police assistance or have made a report to the police.

The following are examples of when you may be issued with a first and final warning or removed from our patient list dependent on the severity of the incident.

• Violence.
• Excessive noise e.g. recurrent loud or intrusive conversation or shouting.
• Threatening or abusive language involving swearing or offensive remarks.
• Racial or sexual remarks.
• Aggressive, forceful tone and/or language that upsets staff.
• Malicious allegations relating to members of staff, other patients or visitors.
• Offensive gestures or behaviours.
• Abusing alcohol or drugs on practice premises.
• Drug dealing on practice premises.
• Wilful damage to practice property.
• Threats or threatening behaviour.
• Theft.
• Persistent and/or unrealistic demands on the service
• Repeated derogatory comments about the practice or individuals either verbally, in writing/digitally or on social media platforms – this applies to factual and false information as we have a process to feedback dissatisfaction.

This list is not exhaustive and there may be other occasions where we have cause to issue a warning or remove you from our patient list.  If you are unhappy with the practice we have a complaints procedure to assist you, or you have the choice to register with another practice – there really is no need for unpleasant behaviour with these options available to support you.

We trust this policy is clear and supports a mutually respectful environment for patients and staff.