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Doctor running late?

We understand that when the Doctor runs late it can be very frustrating and inconvenient for you and we wanted to try to explain some of the reasons why this happens sometimes.

Why do Doctors sometimes run late?

There is no one single answer to why this happens. There can be lots of things that combine to make us run late and are rarely able to tell you why as we need to maintain the confidentiality of all our patients.

- Patients are booked at 10 minute intervals.

- This time includes discussing patient symptoms, possible solutions which may or may not include medication, checking past medical history and recording the consultation in your records. So you can see how easy it is to fall behind schedule as the appointment session goes on.

Below are a few of the more common reasons for doctors running late.

1. Complexity or patients in distress

People come to the GPs for lots of different reasons and this can range from a simple problem which can be comfortably dealt with in 7-8 minutes or a much more complex issue such as has been diagnosed with cancer or serious illness, the loss of a loved one, or feeling that they can’t cope anymore to the extent they are contemplating taking their own life. These are all common occurrences.

1. 2. Multiple problems

Some people come with a number of problems, or remember another problem halfway through the consultation which can make it difficult to keep to time. Please be realistic about which problems can be dealt with during the 10 minute appointment time.

1. 3. Admissions to hospital

When someone is very unwell they may need admitting to a local hospital and the GP may have to do that there and then. This will involve the GP talking to the team at the hospital which can take some time and may require emergency treatment by the GP at the practice, before they are transferred to hospital.

1. 4. Interruptions from other Health Care Providers

GPs are part of a larger health care team and are often contacted by A&E departments, hospital doctors, laboratories, midwives, health visitors, social services etc.

We try to arrange these conversations after booked surgeries, but in emergency/ urgent situations this cannot wait and so your GP may be dealing with one of these teams whilst you’re in the waiting room.

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Commissioner Details

National Data Opt Out

NHS Digital will launch the National Data Opt Out on 25^th May, to coincide with the EU GDPR.

http://www.nhs.uk/your-nhs-data-matters

https://www.nhs.uk/your-nhs-data-matters/manage-your-choice/

You can download a brief fact sheet about NDOO

NATIONAL DATA OPT OUT

NHS Digital has launched the National Data Opt Out on 25^th May, to coincide with the EU GDPR.
www.nhs.uk/your-nhs-data-matters

What is the National Data Opt Out (NDOO)?

The NDOO is a mechanism by which individuals in England can control, to a limited degree, certain aspects of their confidential medical information and, in particular, what NHS Digital can do with it once in their possession.

The NDOO only applies to confidential information, that is medical information that can identify you, for example by containing your name, DOB, address, NHS number etc.

And the NDOO only applies to uses of your confidential medical information for secondary purposes, that is unrelated to, and beyond, the direct medical care that GP surgeries and other healthcare organisations provide you with when you are unwell, or to keep you well.
Secondary purposes include healthcare planning, audit, population analytics, “risk stratification”, research, “commissioning”,commercial and even political uses.

The NDOO is not limited to electronic data and so includes paper records. It simply replaces the Type 2 (9Nu4) opt-out that has been in force for some years, and which you were able to express via your GP surgery.

It is, therefore, nothing new.

If I set, or keep, my NDOO status at “do not share”, what will this mean?

Confidential medical information obtained by NHS Digital from GP surgeries, hospital trusts, mental health providers and social care, will not be released/disseminated/sold by them in a format that can identify you.

In due course, the NDOO will prohibit certain data extractions from your GP record, where this involves confidential medical information, sand where your permission or consent has not been sought before your data was released (so-called section 251 approval).

The NDOO will, eventually, prevent confidential medical information leaving the Cancer Registry, certain other disease registries, the Clinical Practice Research Datalink (CPRD); and

By 2020, hospitals and other healthcare providers.

What will the NDOO not do?

The NDOO will in no way affect the sharing of information for the purposes of an individual’s care and treatment, e.g. where information is shared between a GP surgery and a hospital.
It will not stop your GP using the Electronic Referral Service (eRS), the Electronic Prescription Service (EPS), or GP2GP transfers of medical records.

The NDOO will in no way affect the National Summary Care Record (SCR).
You can opt-out of the SCR via your GP surgery.

The NDOO will in no way affect any local shared care record project or scheme, such as the Hampshire Health Record, the Great North care Record, the Bolton Care Record etc. (except if such schemes additionally process your uploaded information for secondary purposes).
You can opt-out of your local shared care record scheme via your GP surgery.

The NDOO will in no way affect situations where your GP surgery, or other healthcare organisation, is legally required to share your information (such as a court order or when mandated under section 259 of the Health and Social Care Act – but see later).

The NDOO will in no way affect you being invited, when appropriate, for any of the National Screening Programmes, such as cervical/breast/bowel/abdominal aortic aneurysm/diabetic eye screening.
You can opt-out of these separately, if you wish.

The NDOO will in no way affect situations where your GP surgery, or any other healthcare organisation, shares data in an anonymised or aggregate (numbers only) format, in other words where that data cannot identify an individual.

The NDOO will not stop:

Commercial sales of hospital data (HES) by NHS Digital

Lifelong linked medical histories being disseminated by NHS Digital

Onwards release of data by non-NHS bodies (once provided with your information by NHS Digital)

What about Research?

The NDOO will in no way prevent you from taking part in accredited medical research, at your GP surgery/local hospital/other health organisation, where you have given your explicit consent to be involved (i.e. you have been asked first).

The NDOO will in no way prevent you from:

Giving blood

Joining the NHS Organ Donor Register

Signing up to the Anthony Nolan register to donate your blood stem cells or bone marrow

Donating your DNA for medical research

Joining the 100K Genomes project

Taking part in clinical drug trials

Donating your body to medical science after your death

Giving money (in a tax-efficient way) to any medical charity of your choosing

Will the NDOO stop my confidential GP information being uploaded to NHS Digital in the first place?

No.

NHS Digital does not rely upon section 251 approval (any more) for data gathering, preferring instead to make such data collections compulsory under section 259 of the Health and Social Care Act.

However, the existing secondary uses, Type 1 (9Nu0), opt-out that many people have in force on their GP record will prohibit data (confidential and, in some cases, de-identified) from being extracted and uploaded from your GP record to NHS Digital.

In addition, the Type 1 opt-out will also prohibit section 251 approved data extractions, for example for “risk stratification”, as well as the mandatory section 259 extractions.

So how do I maximally limit secondary uses of my medical records, beyond my direct medical care?

Set your NDOO status to “do not share”, see later for how to do this. Or make sure that you have a Type 2 objection in force on your GP record - – do this via your GP surgery; and

Make sure you have a secondary uses, Type 1 (9Nu0) objection in force on your GP record – do this via your GP surgery

Consider contacting your local hospital trust, mental health provider, or social care organisation (local council) that you use (or have used) and express “the right to object” to the dissemination of confidential information about you to NHS Digital, where it is not legally mandated.
For example, you have the right to object where your data might be processed in this way and the organisation concerned is relying on Article 6(1)(e) – Official Authority – as the legal basis under the GDPR.

What about preventing NHS Digital releasing, disseminating, or selling anonymised and pseudonymised data about me?

You cannot – directly. And you have no control over why they are doing this, for what purpose(s), and to which organisation they are giving or selling your information to.

But you can limit how much information NHS Digital gathers about you from healthcare organisations, by maximally limiting the secondary uses of your medical records, as described above.

So how do I set, check, or update my National Data Opt Out status?

If you had previously requested a Type 2 objection to be in force, via your GP surgery, then this will have automatically have set your NDOO status to “do not share”. You will receive a letter from NHS Digital, confirming this, in due course. Any children aged 13yrs or over will receive their own letter as well.

It is not possible to directly view, set or change your NDOO status at your GP surgery, although you set it indirectly by expressing a Type 2 objection to your GP surgery – but only until October 2018.
This will automatically set your NDOO status to “do not share”.

Anyone aged 13yrs or over can set their NDOO status via an online service at www.nhs.uk/your-nhs-data-matters

Anyone aged 12yrs or younger, or if you are acting on behalf of another individual (i.e. as a proxy, perhaps with lasting power of attorney authority) cannot do this online but will have to ring 0300 330 9412 instead (or via other so-called “non-digital” methods).

More information about NHS data sharing, opting-out and objecting, and the NHS databases can be found at www.nhsdatasharing.info

Patient Participation Group (PPG)

Practice Policies

Confidentiality & Medical Records

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.

Data Protection Privacy notice

Freedom of Information

Information about the General Practioners and the practice required for disclosure under this act can be made available to the public. All requests for such information should be made to the practice manager.

Access to Records

In accordance with the Data Protection Act 1998 and Access to Health Records Act, patients may request to see their medical records. Such requests should be made through the practice manager and may be subject to an administration charge. No information will be released without the patient consent unless we are legally obliged to do so.

Complaints

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

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. Our complaints procedure can be viewed and printed off here: Complaints Leaflet

To pursue a complaint please contact the practice manager who will deal with your concerns appropriately. Further written information is available regarding the complaints procedure from reception.

Alternatively, complaints can be directed to NHS England as follows:

Email: england.contactus@nhs.net

Contact No: 0300 311 223

Postal Address:

NHS England

PO Box 16738

Redditch - B97 9PT

Violence Policy

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.

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What to do in the case of a death

When a death occurs in the family, whether it be at home or in hospital, there are many unfamiliar tasks which must be carried out. Sooner or later most of us will be confronted with the need to arrange a funeral which, in the midst of grief, can be a daunting ordeal. The very personal nature of each bereavement dictates that circumstance will vary in most instances, but the following may be of some help in taking the initial steps towards arrangements for the funeral.

Firstly, you will need to obtain a Medical Certificate of Cause of Death from the doctor in attendance at the hospital, or your GP if the death took place at home. In some circumstances this will be issued by the Coroner. All deaths need to be registered by taking the doctor's certificate to the Registrar of Births and Deaths in the subdistrict in which the death occurred. The information required by the Registrar is listed on the accompanying form, under the heading 'Duties of the Informant'.

The Registrar issues a GREEN certificate for the burial or cremation which must be handed to the Funeral Director, who should also be contacted without delay if, for any reason, the death has been referred to the Coroner. In any case, it is wise to contact your Funeral Director at an early stage as preliminary enquiries and provisional arrangements, if so desired, may be made in advance of the registration of the death. Whilst he or she can advise on the local facilities and the technical and logistical problems involved, the initial choice as to whether your loved one is to be buried or cremated is a very personal one and must be made by the family. It is, of course, possible that the deceased may have expressed a wish or left such instruction in their Will. The Funeral Directors will be responsible for making all the arrangements for the funeral and offering advice on such matters as press announcements, charitable donations or flowers, printing, insurance claims and seeking assistance from the Social Fund, if required. He or she will act as professional advisor and confidant and will be responsible for the efficient administration throughout the funeral.

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