Our premises are fully accessible to the disabled. We have disabled toilets, wide doors and large rooms to support accessibilty

There are disabled parking bays close to the entrance in the practice car park

A lift is available to community services on the first floor

If you require any additional assistance, please ask at reception

Florence House Medical Practice is committed to providing a safe, comfortable environment where patients and staff can be confident that best practice is being followed at all times and the safety of everyone is of paramount importance.

This policy aims to provide support and protection of both patients and staff during episodes of care within the community, to prevent misinterpretations of actions during consultations, examination and investigations and to assist patients to make an informed choice about their examinations and consultations.

Protocol

Doctors and nurses (both male and female) should consider whether an intimate or personal examination of the person (either male or female) is justified, or whether the nature of the consultation poses a risk of misunderstanding. There may be a rare occasion when an independent witness to a consultation may be prudent.

If so, the doctor or nurse should explain the examination, procedure or consultation and the patient must be offered the choice to have a chaperone present in the room during the examination or consultation. A suitable sign should clearly be on display in each consulting room, treatment room and at reception offering chaperone service if required.

If either the clinician or the patient does not want the examination to go ahead without a chaperone present, or if either of them is uncomfortable with the choice of chaperone, the examination should be postponed to a later date when a suitable chaperone will be available, as long as the delay would not adversely affect the patient’s health.

If the clinician doesn’t want to go ahead without a chaperone present but the patient has said no to having one, the clinician must clearly explain why he/she wants a chaperone present. Ultimately the patient’s clinical needs must take precedence. The clinician must wish to consider referring the patient to a colleague who would be willing to examine them without a chaperone, as long as the delay would not adversely affect the patient’s health.

When a patient refuses a chaperone, this must be recorded in the patient’s medical record.

Any member of staff who does not wish to be a chaperone at the surgery or accompany a doctor or nurse on any or a particular home visit has the right to decline without prejudice, and alternative arrangements will be made.

Definition of a Chaperone

A chaperone is an impartial observer and is present to safeguard for all parties (patients and healthcare professionals) and to witness to continuing consent of the procedure. It is either a health professional or a specifically trained non-clinical staff member such as a receptionist.

A relative or a friend of the patient is not an impartial observer and so would not usually be a suitable chaperone. But the practice should comply with a reasonable request to have such a person present as well as a chaperone

Confidentiality

• The chaperone should only be present for the examination/procedure itself, and most discussion with the patient should take place while the chaperone is not present.
• Patients should be reassured that all practice staff understand their responsibility not to divulge confidential information.

Procedure

• The clinician will contact reception to request a chaperone.
• The clinician will record in the notes that a chaperone was offered and if the offer was accepted/refused, the details of the chaperone and the nature of the examination/procedure.
• Where no chaperone is available the examination will not take place – the patient should not normally be permitted to dispense with the chaperone once a desire to have one present has been expressed.
• The chaperone will enter the room discreetly, introduce themselves and confirm with the patient that their attendance is acceptable. The chaperone will remain in the room until the clinician has finished the examination and the patient is dressed.
• The chaperone will normally attend inside the curtain at the head of the examination couch and watch the procedure.
• To prevent embarrassment, the chaperone should not enter into conversation with the patient or clinician unless requested to do so, or make any mention of the consultation afterwards.
• The chaperone will make a record in the patient’s notes after examination that there were no problems, or details of any concerns or incidents that occurred.
• The clinician should record whether there were any problems, or give details of any concerns or incidents that occurred.
• Any concerns raised by a healthcare professional, patient, carer following episode of care must be documented in the patient’s records as a Significant Event (9g0) and an SAE form completed.
• The patient can refuse a chaperone, and if so this must be recorded in the patient’s medical record.

NB: there may be rare occasions when a chaperone is needed for home visit. The above procedure should still be followed.

Special Cases

Issues Specific to Children

In the case of children, a chaperone would normally be a parent or carer or alternatively someone known and trusted or chosen by the child. Patients may be accompanied by another minor of the same age. Children and their parents or guardians must receive an appropriate explanation of the procedure in order to obtain their co-operation and understanding.

The age of consent is 16 years. A child under 16 who is being assessed as Gillick Competent (Fraser Guidelines) and therefore has sufficient understanding and intelligence to enable him/her to understand fully what is proposed, can accept an examination. If a Gillick Competent child presents in the absence of a parent or guardian or refuses parental presence, the healthcare professional must ascertain if they are capable of understanding the need for examination. In these cases consent should be secured and a formal chaperone should be present for any intimate examinations.

For competent young adults the guidance relating to adults is applicable.

Issues Specific to Ethnicity and Culture

The ethnic, religious and cultural background of some women can make intimate examinations particularly difficult, for example, some patients may have strong cultural or religious beliefs that restrict being touched by others. Patients undergoing examination should be allowed the opportunity to limit the degree of nudity, for example, uncovering only that part of the anatomy that requires investigation or imaging. Wherever possible, particularly in these circumstances, a female healthcare practitioner should perform the procedure.

It would be unwise to proceed with any examination if the healthcare professional is unsure that the patient understands due to a language barrier. If an interpreter is available, they may be able to double as an informal chaperone. In life saving situations every effort should be made to communicate with the patient by whatever means available before proceeding with the examination.

Issues Specific to Patients with Mental Health Problems and Learning Difficulties

For patients with learning difficulties or mental health problems that affect capacity, a familiar individual such as a family member or carer may be the best chaperone. A careful simple and sensitive explanation of the technique is vital. Adult patients with learning difficulties or mental health problems who resist an intimate examination or procedure must be interpreted as refusing to give consent and the procedure must be abandoned, unless the patient has been sectioned. In life-saving situations, the healthcare professional should use professional judgement and where possible discuss with a member of the Mental Health Care Team.

The practice manages the confidentiality of your medical records in accordance with the Data Protection Act 2018. Our Primary Care Trust may require some of this data for auditing and research purposes. You may request that your data is excluded from these audits and research at any time.

At Florence House Medical Practice we pride ourselves on offering the best possible healthcare. Our dedicated and qualified medical and support staff are key to this.

All GP practices are required to declare the mean earnings for GPs working to deliver NHS services to patients at each practice.

The average pay for GPs working at Florence House Medical Practice in the last financial year (2019/20) was £91,550 before tax and National Insurance. This is for 4 GPs and 4 Locum GPs who worked in the practice for more than six months.

Please be aware that the calculation excludes certain types of income and the rules are complex and open to interpretation. It should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice, and should not be used to form any judgement about GP earnings, nor to make any comparison with any other practice.

Florence House Medical Practice has a legal duty to explain how we use any personal information we collect about you, as a registered patient, at the practice.

What Information Do We Collect About You?

We will collect the following types of information from you or about you from a third party (provider organisation) engaged in the delivery of your care:

• Personal data: any information relating to an identifiable person who can be directly or indirectly identified from the data. This includes, but is not limited to name, date of birth, full postcode, address, next of kin and NHS number
• Special category/sensitive data: this could be medical history including details of appointments and contact with you, medication, emergency appointments and admissions, clinical notes, treatments, results of investigations, supportive care arrangements, social care status, race, ethnic origin, genetics and sexual orientation

Your healthcare records contain information about your health and any treatment or care you have received previously. This information will be collected either electronically using secure NHS Mail or a secure electronic transfer over an NHS encrypted network connection. Physical information will also be sent to the practice. This information will be retained within our electronic patient record or within a patient paper records.

We use a combination of technologies and working practices to ensure that we keep your information secure and confidential.

How We Will Use Your Information

Your data is collected for the purpose of providing direct patient care. Information held about you may be used to help protect the health of the public and to help us manage the NHS. Information is also used with the practice for clinical audit to monitor the quality of the service provided. Some of this information will be held centrally and used for statistical purposes. Where we do this, we take strict measures to ensure that individual patients cannot be identified.

We can disclose this information if it is required by law, if you give consent or if it is justified in the public interest. The practice may be requested to support research; however, we will always gain your consent before sharing your information with medical research databases

Processing your information in this way and obtaining your consent ensures that we comply with GDPR articles:

• 6(1)(c) ‘processing is necessary for compliance with a legal obligation to which the controller is subject…’

• 6(1)(e) ‘…necessary for the performance of a task carried out in the public interest or in the exercise of official authority…’, and

• 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…”

Who Will We Share Your Information With

In order to deliver and coordinate your health and social care, we may share or receive information from the following organisations:

• Other GP practices
• NHS trusts/foundation trusts
• NHS commissioning support units
• Independent contractors such as dentists, opticians, pharmacists
• Public Health England
• Private sector providers
• Voluntary sector providers
• Community care services
• Ambulance trusts
• Clinical commissioning group
• Social care services
• NHS Digital
• Local authorities
• Educations services
• Fire and rescue services
• Police and judicial services
• Other “data processors” which you will be informed of
• Third party processors:

When we use a third party service provider to process data on our behalf then we will always have an appropriate agreement in place to ensure that they keep the data secure, that they do not use or share information other than in accordance with our instructions and that they are operating appropriately. Examples of functions that may be carried out by third parties includes:

• Companies that provide IT services and support, including our core clinical systems; systems which manage patient facing services (such as our website and service accessible through the same); data hosting service providers; systems which facilitate appointment bookings or electronic prescription services; document management services etc.
• Delivery services (for example if we were to arrange for delivery of any medicines to you).
• Payment providers (if for example you were paying for a prescription or a service such as travel vaccinations).

Further details regarding specific third party processors can be supplied on request.

You will be informed who your data will be shared with and in some cases, asked for explicit consent for this to happen when this is required.

Your data will not be transferred outside the European Union.

COVID-19

This practice is supporting vital coronavirus (COVID-19) planning and research by sharing your data with NHS Digital.

• NHS Digital has various legal powers to share data for purposes relating to the coronavirus response. It is also required to share data in certain circumstances set out in the COVID-19 Direction and to share confidential patient information to support the response under a legal notice issued to it by the Secretary of State under the Health Service (Control of Patient Information) Regulations 2002 (COPI Regulations).
• Legal notices under the COPI Regulations have also been issued to other health and social care organisations requiring those organisations to process and share confidential patient information to respond to the coronavirus outbreak. Any information used or shared during the outbreak under these legal notices or the COPI Regulations will be limited to the period of the outbreak unless there is another legal basis for organisations to continue to use the information.
• Data which is shared by NHS Digital will be subject to robust rules relating to privacy, security and confidentiality and only the minimum amount of data necessary to achieve the coronavirus purpose will be shared. Organisations using your data will also need to have a clear legal basis to do so and will enter into a data sharing agreement with NHS Digital. Information about the data that NHS Digital shares, including who with and for what purpose will be published in the NHS Digital data release register.
• For more information about how NHS Digital will use your data please see the NHS Digital Transparency Notice for GP Data for Pandemic Planning and Research (COVID-19).

GM Care Record

Keeping your personal data safe is central to the GM Care Record

Each health and care organisation in Greater Manchester collects information about you and keeps records about the care and services they have provided. The GM Care record pulls together the information from these different health and social care records and displays it in one combined record.

How is your personal information kept safe and secure in the GM Care Record?

We ensure the information we hold is kept in secure locations, restrict access to information to authorised personnel only and protect personal and confidential information.

Appropriate technical and security measures in place to protect the GM Care Record include:

• complying with Data Protection Legislation;
• encrypting Personal Data transmitted between partners;
• implementing and maintaining business continuity, disaster recovery and other relevant policies and procedures
• a requirement for organisations to complete the Data Security and Protection (DSP) Toolkit introduced in the National Data Guardian review of data security, consent and objections, and adhere to robust information governance management and accountability arrangements;
• use of ‘user access authentication’ mechanisms to ensure that all instances of access to any Personal Data under the GM Care Record are auditable against an individual accessing the GM Care Record
• ensuring that all employees and contractors who are involved in the processing of Personal Data are suitably trained in maintaining the privacy and security of the Personal Data and are under contractual or statutory obligations of confidentiality concerning the Personal Data.

The NHS Digital Code of Practice on Confidential Information applies to all NHS and care staff, and they are required to protect your information, inform you of how your information will be used, and allow you to decide if and how your information can be shared. All staff with access to Personal Data are trained to ensure information is kept confidential.

Whilst you are automatically enrolled into the GM Care Record as a GM citizen, you have the option to object to your information being shared for individual care and to opt out of your data being used for research and planning. More information about this is available here:  https://healthinnovationmanchester.com/our-work/data-sharing-across-gm/

How the NHS and care services use your information

Florence House Medical Practice is one of many organisations working in the health and care system to improve care for patients and the public.

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.
• Research into the development of new treatments.
• Preventing illness and diseases.
• Monitoring safety.
• Planning services.

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 where allowed by law.

Most of the time, anonymised data is used for research and planning so that you cannot be identified in which case your confidential patient information isn’t needed.

You have a choice about whether you want your confidential patient information to be used in this way. If you are happy with this use of information you do not need to do anything. If you do choose to opt out your confidential patient information will still be used to support your individual care.

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.

You can also find out more about how patient information is used at:

• www.hra.nhs.uk/information-about-patients (which covers health and care research); and
• understandingpatientdata.org.uk/what-you-need-know  (which covers how and why patient information is used, the safeguards and how decisions are made)

You can change your mind about your choice at any time.

Data being used or shared for purposes beyond individual care does not include your data being shared with insurance companies or used for marketing purposes and data would only be used in this way with your specific agreement.

Health and care organisations have until 2020 to put systems and processes in place so they can be compliant with the national data opt-out and apply your choice to any confidential patient information they use or share for purposes beyond your individual care. Our organisation is currently compliant with the national data opt-out policy.

Maintaining Confidentiality

We are committed to maintaining confidentiality and protecting the information we hold about you. We adhere to the General Data Protection Regulation (GDPR), the NHS Codes of Confidentiality and Security, as well as guidance issued by the Information Commissioner’s Office (ICO).

Every member of staff who works for the practice or another NHS organization has a legal obligation to keep information about you confidential.

We will hold your information in accordance with the Records Management Code of Practice for Health and Social Care 2016.

Recording Telephone Calls

Telephone calls to and from the surgery are recorded and processed in accordance with the UK General Data Protection Regulations and the Data Protection Act 2018, calls are recorded for monitoring, training and dispute resolution purposes.

The purpose of call recording is for training and monitoring purposes.  This includes the provision of a record of incoming and outgoing calls which can:

• Identify practice staff training needs
• Protect practice staff from nuisance or abusive calls
• Establish facts relating to incoming/outgoing calls made (e.g. complaints)
• identify any issues in practice processes with a view to improving them (e.g. to aid workforce planning)
• Establish the facts and assist in the resolution of any medico-legal claims made against the practice or its clinicians.

The practice’s welcome telephone message advises callers that their call are recorded and for what purpose the recording is used. This is via a pre-recorded message within the telephone system and via signage at the practice.

General call recordings will be retained for up to 3 years from the date of creation.

The above retention periods are in line with the Records Management Code of Practice for Health and Social Care 2021.

If you do not wish for your calls to be recorded, you will need to specify this at the beginning of the call to the person you are talking to. However, you should be aware that this will have an impact on identifying training needs and/or investigating accurately and efficiently complaints.

Risk Stratification

Risk stratification is a mechanism used to identify and subsequently manage those patients deemed as being at high risk of requiring urgent or emergency care. Usually this includes patients with long-term conditions, e.g. cancer. Your information is collected by a number of sources, including Florence House Medical Practice; this information is processed electronically and given a risk score which is relayed to your GP who can then decide on any necessary actions to ensure that you receive the most appropriate care.

Invoice Validation

Your information may be shared if you have received treatment to determine which Clinical Commissioning Group (CCG) is responsible for paying for your treatment. This information may include your name, address and treatment date. All of this information is held securely and confidentially; it will not be used for any other purpose or shared with any third parties.

Consent

The law sets a high standard for consent. Consent means offering people genuine choice and control over how their data is used. However consent is only one potential lawful basis for processing information. Therefore the practice may not need to seek your explicit consent for every instance of processing and sharing your information, on the condition that the processing is carried out in accordance with this notice.

Florence House Medical Practice will contact you if we are required to share your information for any other purpose which is not mentioned within this notice.

You have the right to object to information being shared between those who are providing you with direct care. This may affect the care you receive – please speak to the practice first

You have the right to object to information being shared for any purpose other than your medical care, such as for research or planning purposes. In this instance, please visit www.nhs/uk/your-nhs-data-matters. You will be able to opt out securely online. Alternatively call 0300 303 5678.

You have the right to write to withdraw your consent at any time for any particular instance of processing, provided consent is the legal basis for the processing.  Please contact the practice manager for further information and to raise your objection.

Access To Your Records

You have a right to access the information we hold about you. This is called a Subject Access Request (SAR). Please ask at reception for a SAR form. You can also make the request via email. You should be aware that some details within your health records may be exempt from disclosure. This will be in the interests of your wellbeing or to protect the identity of a third party. The practice will process your request within one calendar month.

Furthermore, should you identify any inaccuracies you have a right to have the inaccurate data corrected. Please speak with the practice manager should this be the case.

Please complete the attached SAR form (PDF) if you would like to make a subject access request.

Data Controller and Data Protection Officer

As your registered GP practice, we are the data controller for any personal data that we hold about you.

The Data Protection Officer (DPO) for Florence House Medical Practice is Ms Shavarnah Purves – Email: shavarnah.purves@nhs.net or mhcc.ig@nhs.net – telephone: 0161 213 1792 / 0161 213 1790.

In the unlikely event that you are unhappy with any element of our data-processing methods, you should raise your concerns in the first instance in writing with the Practice Manager.

Compliants

If you remain dissatisfied with our response, you have the right to lodge a complaint with the Information Commissioner’s Office (ICO) at:

Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF

Telephone: 01625 545 700

Website: ico.org.uk

Page updated: 17/11/2023

We are happy to assist you with a range of services outside of the standard NHS requirements, however you will be asked to pay a fee.

Medical Reports, Forms and Letter Requests

Florence House receives numerous requests from patients and third parties (insurance companies, employers etc) to provide a range of documents such as medical reports, medical opinion letters or information from medical records.

Most health care provided by the NHS is free of charge but there are some exceptions to this i.e. private/non-NHS work. GPs can decide whether they will undertake private work or not.

Examples of chargeable services to patients include but are not limited to

• accident/sickness certificates for insurance claims
• school fee and holiday insurance certificates
• reports for health clubs/sports clubs to certify that patients are fit to exercise
• private prescriptions for travel
• fit to fly letters

Examples of chargeable services to third parties include but are not limited to

• life assurance and income protection reports for insurance companies
• medical reports for local authorities in connection with adoption and fostering
• DVLA requests

Do GPs have to do non-NHS work for their patients?

GPs do not have to carry out non-NHS work on behalf of their patients. At Florence House, we aim to support our patients as much as possible, however, we sometimes have no choice but to pause new requests for non-NHS work. In cases where non-NHS requests are accepted, the wait is usually quite significant. This is due to the high-demand for these services, pressure on NHS workloads and GP availability.

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 their patients. Please therefore do not expect your request to be undertaken quickly, even if you are under a short time frame. We aim to assist if we can, but we are not obliged to expediate a request, particularly if it means that patient requests that have already been waiting will take even longer.

I only need the GP’s signature – why the delay?

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.

If you are a new patient, we may not have your medical records so the doctor must wait for these before completing the form.

Finally, please be respectful as we try to assist you with your request. We have a zero-tolerance policy with regards to abuse towards staff.

Non-NHS Work Fees

These fees are payable in advance that a charge is made in all cases and the doctor does not have the discretion to waive the charge. Currently the time for processing private work is minimum 120 working days. We do not sign passport forms. 

Private Sick Note – £15.00

Duplicate Sick Note – £5.00

Simple Medical Letter – £25.00
i.e Employer, School, University,
Housing, TWIMC

Complex Medical Letter – £30.00 – £40.00

Fitness to Travel Letter – £35.00

Report (without examination)
Holiday Cancellation Form – £45.00

Report for Insurance or Accident
and Sickness Claim – £50.00

Insurance Mortgage/Life – £100
Depending on complexity

Extract from Medical Records Report – £75.00

Bus Pass – £30.00

Report and Opinion – £125.00

Firearms – £80.00

Report (with examination)
HGV/PCV/Taxi
Licence Medical Report – £115.00

Other Driving/Flying Medical Report – £115.00

Pre-Employment Medical Report – £115.00
(holiday reps, cruise ships)

Please ask for a receipt. Updated November 2023

Proxy access (also known as linked profiles on the NHS app) allow parents/guardians, family members and carers to access health services on behalf of others. Once profiles are linked, this will show on the NHS app.

Please submit an admin query to request proxy access.

Florence House follows the existing guidelines for proxy access and identity verification provided by the Royal College of General Practitioners.

We do not accept new or adjusted shared care prescribing in any circumstances

If we are currently prescribing on a shared care basis, please expect this to be reviewed for patient safety reasons.

In the interest of patient safety, many shared care drugs require a number of conditions to be met before transfer can be made to primary care

Shared care is usually declined based on the below points. Please note, this is not an exhaustive list

1. The prescriber does not feel clinically confident in managing the individual patient’s condition and there is a sound clinical basis for refusing to accept shared care

2. The medicine or condition does not fall within the criteria defining suitability for inclusion in a shared care arrangement

3. A minimum duration of supply by the initiating clinician has not been met

4. Initiation and optimisation by the initiating specialist has not been met

5. Shared Care Protocol not received

6. Other (Primary Care Prescriber to provide explanation if there are other reasons why shared care cannot be accepted)

A detailed letter providing reasons for decline will be sent to the requesting clinic

Thank you for your understanding

Feedback

Our priority is to ensure that all of our patients receive the best service that is possible. If you would like to provide feedback, please complete our online feedback form.

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.

To pursue a complaint, please contact the practice manager via gmicb-mh.florence@nhs.net,  who will deal with your concerns appropriately. Further written information is available here Complaint Handling Leaflet regarding the complaints procedure or via contacting our main email address and at reception.

Data Processing Complaints

In the unlikely event that you are unhappy with any element of our data-processing methods, you should raise your concerns in the first instance in writing with the practice manager.

If you remain dissatisfied with our response, you have the right to lodge a complaint with the Information Commissioner’s Office (ICO) at:

Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF

Telephone: 01625 545 700

As an approved training practice your appointment maybe with:

• Registrars – fully qualified doctors who spend six months per year with us prior to qualifying as a GP.
• Foundation doctors – doctors who have just completed their hospital training and spend up to six months while they receive GP training from our doctors.

Occasionally medical and nursing students sit in on consultations and visits to gain experience in primary care.

If you prefer to see the doctor alone, please inform reception.

Florence House Medical Practice aims to provide high quality healthcare and we will treat all patients with respect and dignity.

Unfortunately, there has been an increase in verbal and physical attacks on staff and this is unacceptable.

Florence House and Manchester Health and Care Commissioning support The NHS Zero Tolerance Policy. This policy recognises the increasing problem of violence against staff working in the NHS and ensures that doctors and healthcare staff have a right to care for others without fear of being attacked or abused.

Patients also have a right to access services without fear of violence at their practice.

In line with this policy, we have a zero tolerance approach to aggression, abuse, violence or anti-social behaviour.

What do we mean by zero tolerance?

We understand that when patients feel ill, they do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint. We ask you to treat healthcare professionals and practice staff courteously and act reasonably.

Whilst it is not possible to list all types of incidents, some examples of unacceptable behaviour are provided below:

• Offensive language, verbal abuse and swearing
• Racist and hate comments
• Loud and intrusive conversation
• Unwanted or abusive remarks
• Negative, malicious or stereotypical comments
• Carrying weapons or using objects as weapons
• Damage, defacing or vandalism of NHS property
• Threats or risk of injury to NHS staff
• Intimidation
• Stalking
• Unreasonable behaviour and non-cooperation
• Pressurising staff to request sign offs for pending prescriptions

This relates to any form of abuse from patients or staff which includes (but is not limited to) sexism, racism homophobia, biphobia, transphobia and ageism, or harassment or abuse on basis of disability, marriage or civil partnership, pregnancy or maternity, religion or belief.

Such behaviour or verbal abuse causing distress and or constituting harassment will not be tolerated and could lead to the person being removed from the practice list. In extreme cases the police will be contacted if the patient is posing a threat to staff or others.

If you wish to provide feedback or make a complaint, please complete our Feedback form

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 if there is a 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.