We make every effort to give the best service possible to everyone who attends our practice.

However, we are aware that things can sometimes not go as expected, 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.

Please view our Complaints Procedure.

Please view our Complaints Information Leaflet.

If you would like to make a formal complaint, please utilise the Formal Complaints Form.

The Practice complies with data protection and access to medical records legislation. Identifiable information about you will be shared with others in the following circumstances:

• To provide further medical treatment for you e.g. from district nurses and hospital services.

• To help you get other services e.g. from the social work department. This requires your consent.

• When we have a duty to others e.g. in child protection cases anonymised patient information will also be used at local and national level to help the Health Board and Government plan services e.g. for diabetic care.

If you do not wish anonymous information about you to be used in such a way, please let us know.

Reception and administration staff require access to your medical records in order to do their jobs. These members of staff are bound by the same rules of confidentiality as the medical staff. The Practice Privacy Notice is given below. However, the only website this Privacy notice applies to is the Surgery’s website. If you use a link to any other website from the Surgery’s website then you will need to read their respective privacy notice. We take no responsibility (legal or otherwise) for the content of other websites.

Please view our Privacy Notices, and Privacy Notice Information Leaflets:

Herefordshire practices, their doctors & staff, working as part of the NHS, need and want to share patient data in various ways in order to improve the services and care that we provide. But we also want to ensure we continue to protect your confidential and personal information.

In the last few years there have been a number of national schemes in addition to an increasing number of independently and separately organised local schemes proposed & implemented where data will be automatically extracted from GP computer systems & sent elsewhere, unless the patient has opted out. Further data extractions for new purposes are due to occur soon. Some of these data extractions are to help the patient if they are seen elsewhere in the country. Some are purely for analysis of health care to improve the NHS services.

For many of these schemes, GP practices have a legal obligation to allow their data to be extracted. The only power they have as the data controllers of your medical record is to ensure that you are aware of where your medical records may be sent and why. Patients however can block their data from being extracted in most if not all cases.

Summary Care Records

This is a national database that is intended to provide basic health information to all providers who need it. It is intended that your demographics (personal details such as name, DOB, address etc) as well as basic medical information about you, (initially just drugs taken, documented allergies and any “end of life” decisions) would be stored and made accessible to anyone needing it within the NHS, for example if you were seen in a Accident and Emergency department in another area of the country. You can ask to “opt out” of the SCR if you wish by asking the practice to amend your records. See below for how to do this. However, you need to think carefully before opting out here as the SCR allows doctors throughout the country to access your basic information if they need which will help them look after you, particularly if you are brought in unconscious. Many GP Practices would recommend to their patients that they should not block SCR data extraction to take place.

Risk Stratification

Herefordshire Clinical Commissioning Group are introducing a system called Risk Stratification within Herefordshire GP practices. This system uses confidential information from your medical record to identify patients who may need more care and support. We particularly want to be able to identify people at high risk of emergency hospital admission so we can offer more care to help improve their health and try to avoid a hospital admission. Identifying each person’s risk of future admission is called Risk Stratification. The information from your record along with your postcode and NHS number will be sent to a secure system where it can be linked with information from hospitals if you have been in hospital recently. Your personal results can only be seen by those caring for you in your own GP practice. Anonymised information which does not identify you can also be used to help those planning NHS services in Herefordshire – but they will not be able to link this information to you as an individual in any way.

Risk Stratification Opt Out Form

Local Health Record Network

GP practices in many areas of the country and many Clinical Commissioning Groups (CCGs) are now starting to establish their own local databases of patient information to try to improve communication between different services such as Health Services & Social Services, in order to help plan local care. They bring together information held on computers in Health care and in Social care. They are designed to give staff working in these areas faster access to relevant patient information. Anyone needing to see your record will ask you first. You must agree before your record can be seen and this occurs each time you are seen. In addition anyone accessing a patient’s records will have their details recorded so it’s possible to see who has opened each record. In Hereford this is known as the “Local Health Record Network” provided by Taurus Healthcare Ltd. Key benefits of this scheme are will be things such as:

• Safeguarding Children: poor information sharing has been highlighted as a significant risk in recent cases.

• Frail Elderly: sharing information when someone is vulnerable.

• Urgent care: if someone is not able to give vital information in a critical situation.

You can opt out of having your medical records extracted & uploaded to any such local database and information on how to do this is shown below. And if you have not opted out you still need to give consent each time your record is accessed.

Data Held On You In Other Databases

There are several other agencies, including parts of the NHS, which will hold identifiable data on you, for example, local A&E departments, local hospitals, Mental Health trusts, Social Services etc. These various agencies will also be sending “patient identifiable” data to the HSCIC. Although you cannot stop these agencies from sending data on you to the HSCIC, you can block its onward transmission to other agencies for “secondary use”. Your GP practice does this by adding a specific code to your GP record. Then, when the HSCIC interrogates your GP record to check permission to extract your data for care.data purposes, it will “see” this secondary use blocking code & will therefore block the sending of data on you from them to other agencies – whether or not you have also had the code added to prohibit extraction for care.data purposes. If you ask your GP practice to add the blocking code for this “secondary use” purpose, not only will it prevent data on you held by other places (like hospitals) being used for secondary purposes but it will also block the data on you held in your GP practice from being used for these purposes as well.

National Audits

The HSCIC is also overseeing a number of nationally run data extractions to help with various specific disease areas such as Diabetes, Kidney disease, Dementia etc. A separate code needs to be added to your GP record to block extraction of data related to any of these audits.

Opting Out Of Any Of These Schemes

It is possible to “opt out” from any or all of the data sharing projects if you wish. For most of the data extraction schemes described above, simply complete the form at the end of this document & give it to your GP practice. Do think carefully about each scheme as to whether you really want to block each one. For example, the Summary Care Record and also some local schemes are designed to help health care workers and social services to look after you better, sometimes in emergency situations.

Will Opting Out Of One Data Extraction Opt Out Of All?

No, each of the codes that can be added by your GP practice has certain blocking effects, but blocking all types of data extraction from your own GP record will require more than one code to be added to your record. For example, one particular code blocks the care.data scheme from extracting data from your record. It also blocks the national clinical audits. Blocking any local care record scheme from extracting data will require yet another code, as will wanting to block the Summary Care Record data extraction. Finally, if you wish to prevent the HSCIC releasing / sharing non-identifiable data on you, both the data that care.data themselves have extracted from your GP record and also data sent to them about you by other sources like hospitals, to other agencies (a process called “secondary use”), then a further code will need to be added.

Are There Any Implications Of Refusing These Data Extractions?

Disclaimer: All information in this document was correct at the time of writing (April 2014, updated August 2016) but guidance given to practices and requirements of GPs to engage with future data extractions and sharing may be subject to change, as stipulated by NHS England or other statutory bodies.

View this information in the Full Document.

Please view our GDPR Privacy Notice.

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

The average pay for GPs working in Ledbury Health Partnership in the last financial year was £69,017 before tax and National Insurance.

This is for no full time GPs, 8 part time GPs, and no locum GPs who worked in the practice for more than six months.

The NHS operate a zero tolerance policy with regard to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons. Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.

The practice takes any bullying/threatening or undermining remarks about staff on Social Media very seriously and this will not be tolerated, any such action may result in reporting the patient to the police in regard to sections 2, 2A, 4 or 4A Protection from Harassment Act 1997, or offences under the Malicious Communications Act 1988 and Communications Act 2003. Those accused of an offence under the Malicious Communications Act 1988 and Communications Act 2003 are unlikely to be familiar with the legal system and unaware that what may have been thought of as an innocent message on social media can have life-changing consequences, including imprisonment.

Potential Offences Under The Malicious Communications Act 1988

Under this area of law, communication is defined as any person who sends a letter, electronic communication or article of any description to another person which conveys the following:

• A message that is indecent or grossly offensive
• A threat
• Information that is false and is known or believed to be false by the sender

This also includes any article or electronic communication that is, in whole or part, of an indecent or grossly offensive nature.

The above only applies if the sender’s purpose, or one of their purposes, was to cause distress or anxiety to the recipient. The mental state of the sender is a key element of the offence and the prosecution must prove their case beyond reasonable doubt. In other words, they must make the court or jury sure that a person intended, or one of their intentions was, to cause distress or anxiety.

A person found guilty could face a prison term not exceeding two years on indictment or up to 12-month custody at the Magistrates’ Court.

Potential Offences Under The Communications Act 2003

Offences that fall under section 127 of the Communications Act 2003 include the following:

• A person sending any public electronic communications network a message or other content that is grossly offensive or of an indecent, obscene or menacing character

• A person causes any such message or content to be sent A person can also be found guilty of an offence under the Communications Act if they intend to cause annoyance, inconvenience or needless anxiety to another by:
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• Sending a message that is known to be false via a public electronic communications network;

• Causing such a message to be sent; or

• Persistently making use of a public electronic communications network

• Similar to offences under the Malicious Communications Act, one offence under the Communication Act 2003 requires the content of a message to be ‘grossly offensive’, ‘indecent’, ‘obscene’ or of a ‘menacing character’. However, the mental element of the offence is broader as it includes circumstances where a person should have awareness or recognition that sending the message may create insult or a risk of insult to the person to whom the message relates.

In addition, an offence will be committed under section 127(2) of the Act where a person had specific intent to cause annoyance, inconvenience or anxiety with a message that is false.