Practice Policies & Patient Information
Carers
Chaperones
This organisation 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.
All patients are entitled to have a chaperone present for any consultation, examination or procedure where they feel one is required. The chaperone may be a family member or friend. On occasions you may prefer a formal chaperone to be present i.e. a trained member of staff.
Wherever possible we would ask you to make this request at the time of booking your appointment so that arrangements can be made and your appointment is not delayed in any way. Where this is not possible, we will endeavour to provide a formal chaperone at the time of request. However, it may be necessary to re-schedule your appointment.
Your healthcare professional may also require a chaperone to be present for certain consultations in accordance with our Chaperone Policy.
If you would like to see a copy of our Chaperone Policy or have any questions or comments regarding this, please contact the Practice Manager.
Freedom of Information Act
Information available from Westbury Medical Centre under the Freedom of Information Act model publication scheme can be obtained from our Practice Manager.
The Freedom of Information Act 2000 obliges the practice to produce a Practice Booklet. A Practice Booklet is a guide to the services the practice intends to routinely make available. This booklet is available from reception.
Getting the Best from Us
- See your one usual doctor wherever possible to maximise continuity in your care
- Be aware that appointments are limited by time. For multiple problems, it may take more than one appointment to get to grips with them all.
- Emergency appointments are for medical problems that cannot wait until the next routine appointment – please do not be disappointed if routine matters are not dealt with in these appointments.
- Be aware of the pressure on the telephone lines at peak times and use them in accordance with the principles set out above.
- Let us know of any change of name, address or telephone number immediately
Some useful advice on how to get the most out of a consultation. Information is also available on the NHS Website and NHS 111.
Integrated Care Board
NHS North Central London Integrated Care Board (ICB) is responsible for deciding how the NHS budget for North Central London is spent. It is also responsible for developing a plan to improve people’s health, deliver higher quality care and better value for money. Find out how the ICB improves health services, manages performance, quality and safety by visiting the NHS North Central London website.
Key Performance Indicators
Westbury Medical Centre is required to agree a set of performance indicators. These are called Key Performance Indicators or KPIs. Agreed list of Key Performance Indicators for this year Please note that the agreed KPIs 2014 and 2015 have not altered for;
Missed Appointments
It is an Unacceptable Behaviour for patients to repeatedly miss booked appointments. Patients who repeatedly miss booked appointments risk being removed from the practice register. Once removed, patients will not be permitted to register again at the Surgery for 4 months and will need to seek registration at another local GP Surgery.
The Surgery is under a great deal of pressure to provide as many appointments to the practice population as it can. Patients receive an SMS text reminder for their appointments and have the opportunity to text back cancelling their appointment. Please note this facility cannot be used where there is less than three hours before the appointment.
Unfortunately patients frequently missing booked appointments is a wasted resource the Surgery cannot accept.
Patients who repeatedly miss booked appointments will be contacted by letter with a behaviour warning and reminded of this policy.
Where the patient who has missed appointments is a child (generally defined as under 8 years) and removal from the practice register is being considered, the Surgery will contact the Health Visitor team to visit the family and conduct a child protection/safeguarding assessment prior to removal.
NHS Summary Care Records
As part of a mandatory, national programme each GP Practice will have to make a summary care record for each patient (unless the patient has already opted out).
If you wish to opt out download and complete the opt out form and return to the Practice (see below).
Information Website
NHS Summary Care Record on the NHS Digital website.
Information Leaflets and Opt Out Form
NHS Zero Tolerance Policy
More information about how the Surgery deals with Unacceptable Behaviour is provided below:
Acceptable Behaviour in the Surgery Policy
It is important that our Surgery is always a safe place to visit. Patients and staff must not feel threatened.
In light of this the Surgery has clear procedures on non acceptable behaviour.
Such non acceptable behaviours include, but are not limited to:
- any display of a violent temper
- shouting, raised voices, sarcasm, pointing fingers.
- repeated or insistent points being made; not engaging with staff in a positive way; being pushy or trying to indimidate staff
- hostile or aggressive behaviours
- threats, swearing, spitting
- any mention or display of any object that could be used as a weapon
Patients will always be immediately warned their behaviour is unacceptable and asked to desist. Where patients do not comply they will receive a FIRST BEHAVIOUR WARNING letter. Where patients behaviour is unacceptable on a subsequent occasion, they will receive a FINAL BEHAVIOUR WARNING. Any further display of unacceptable behaviour will result in REMOVAL from the practice list.
At all times patients will be told exactly the nature of the unacceptable behaviour. Closed Circuit Television (CCTV) images or audio evidence will be retained by the practice and may be passed to the police. It is an offence under the Public Order Act 1986 to use threatening, abusive or insulting words or behaviour that cause fear of or provoke violence.
Although this procedure will be generally applied, there may be occasions where the practice team feel that an episode of unacceptable behaviour is so serious that a patient will receive either a FINAL behaviour warning or REMOVAL in response to the episode.
Where police have been called to attend the practice in response to one or more members of staff (or patients) being threatened and/or attacked (or narrowly avoided being attacked in the view of staff) the offending patient(s) will be immediately removed. Where staff feel particularly threatened, the perpetrator(s) will be removed from the practice list and registered to the Violent Patient Scheme using the crime reference number to access this service.
It is important to remember that it is not the intention of the perpetrator that is relevant, rather than the perception that is generated by the actions and behaviours of the perpetrator that will generate the practice response.
In 2014 a practice nurse working in an adjacent Surgery was stabbed to death by a patient. A risk assessment by our practice following this episode has made a close following of this protocol an important priority.
I have received a letter about my hostile behaviour, but I was frustrated with a problem!
The Surgery staff will always work with patients to resolve difficulties when they arise. This process is not helped by a hostile or angry attitude from the patient. This behaviour can make staff and other patients feel threatened. There are no situations where a forceful or belligerent approach by patients will help to sort out problems. Patients should stay calm at all times while any difficulties are resolved.
Patient Preference of Practitioner
All registered patients have the right to express a preference to receive services from a particular Doctor/Clinician, either generally or in relation to any particular condition; such preferences will be recorded by the Practice. This will mean there will be a longer wait for you to be seen.
The Practice will endeavour to comply with any reasonable preference, but need not do so if the preferred performer has reasonable grounds for refusing to provide services to the patient or if the performer does not routinely perform the services in question within the Practice.
Photographs Policy
From time to time, where it is useful in the treatment or management of a particular condition (most usually relating to skin disease), the treating GP may wish to take a photograph and append this to your medical record. This allows the medical team to monitor disease progression and response to treatment. The image may be passed as part of a secondary care (hospital) referral if the treatment the Surgery has given has not been successful or there is diagnostic uncertainty or concern. Video recordings are not used in this Surgery.
The use of photographs in the Surgery is subject to these safeguards:
- Consent will be obtained before any photograph is taken. This is not usually written/signed consent and may take the form of discussion and agreement, so called implied consent. Patients will never be put under pressure to have an image taken and can refuse consent without affecting treatment. The image should be regarded as an adjunct to the written clinical records
- Images will be uploaded directly to the clinical computer system Emis Web and then deleted or wiped from the camera.
- Emis Web is a secure and encrypted storage facility of all medical information and is backed up regularly to prevent data loss
- Smartphones are never used to take images.
- Other than as part of an agreed secondary care referral, images will never be taken off site. In particular, for the avoidance of doubt, images are never shared on any social media site, such as Facebook or YouTube.
- As with the rest of their medical records, patient are able to request to review the images held by the Surgery.
- The Surgery is involved in teaching medical students from the Royal Free and University College Hospital Medical Schools. From time to time, some images taken may form part of this teaching. In these cases, all images are fully anonymised with no patient identifiable information. Where a patient does not wish that an image taken as part of their treatment should be used in this way, they are asked to communicate this preference to the Surgery. We will then take care to follow this instruction carefully.
- Safeguarding. Where there are adults who lack capacity to give consent, the GP will obtain consent from someone who has legal authority to make the decision on the patient’s behalf before taking the image. Those under 16 who have the capacity and understanding to give consent for a photograph may do so. Where a child or young person is not able to understand the nature, purpose and possible consequences of the photograph, the GP will obtain consent from a person with parental responsibility.
Practice Privacy Notice
Our Practice Privacy Notices explain what information we collect about you, how we store this information, how long we retain it and with whom and for which legal purpose we may share it, the documents can be downloaded here:
Problems or Complaints
Compliments, Feedback and Complaints
Our complaints procedure gives you the opportunity to tell us about any concerns or complaints that you may have.
If you wish to make a complaint, please download and complete our Patient Complaint Form. Either return the form to the practice reception or by post (using a secure, tracked postal service) to 205 Westbury Avenue, Wood Green, London N22 6RX.
The form gives information on how the complaint will be processed and the timelines by which you will receive a response.
We welcome all feedback and compliments are especially welcome. You can do this by completing a Friends and Family Test.
Complaint Resolution Meetings
The Surgery does not routinely offer Complaint Resolution Meetings.
This is for several reasons:
- The best way of communicating a complaint to the Surgery is to write to us. This allows the Surgery an opportunity to investigate the complaint thoroughly, reflect on its causation and consider systemic changes that may need to be adopted in respect of the issues raised. This also allows the Surgery to use the complaint constructively for learning purposes to improve service delivery and patient experience. Meetings do not allow the Surgery time to address issues raised in an appropriate manner. Written complaints do however allow an objective record of the complaint as its process evolves.
- Some Complaint Resolution Meetings held in the past have been marred by hostile behaviour on the part of the complainant or their advocate or team. Although occurring in only a minority of encounters, it became necessary to undertake a risk assessment before meetings to ensure that staff were not at risk. The Surgery does not employ in house security staff.
- The Surgery is a resource limited organisation. There is a great deal of demand placed on clinical and management staff to run the Surgery safely and effectively. Whilst a comprehensive evaluation and detailed response to all issues raised in a complaint are best practice, Complaint Resolution Meetings are not felt to be an effective deployment of the available resources for the Surgery team in a manner that equitably benefits all patients registered at the Surgery.
Publication of GP Net Earnings
All GP Practices are required to declare mean earnings (i.e. average pay) for GPs working to deliver NHS services to patients at each practice. The average pay for GPs working in the practice of Westbury Medical Centre in the last financial year was £134,965 before tax and National Insurance. This is for 2 full time GPs and 2 part time GPs who worked in the practice for more than six months.
Recording Devices in the Surgery
Patients are welcome to record their own consultations with the healthcare practitioner they have an appointment with. They can either record audio or video. It is courteous, and it is practice policy, that patients doing so, discuss this and, where possible, gain the agreement of, the practitioner BEFORE commencing any recording. We ask that patients think very carefully before carrying out concealed recordings of practitioners. Such behaviour will inevitably damage trust between the patient and the Surgery and will not promote a positive therapeutic relationship. We ask that patients considering making a covert recording of a practitioner consider how they themselves would feel if a member of the Surgery made a concealed recording of them during a consultation. In such a situation, patients would feel rightly violated and the practitioner would face a serious disciplinary issue. Accordingly: It is practice policy that a covert recording of a practitioner is an Unacceptable Behaviour. Patients found to be doing so will be asked to stop the recording where possible and will receive a behaviour warning which may put at risk their registration at the Surgery. No one is permitted to use a recording device in the public areas of the Surgery. To do so is a serious Unacceptable Behaviour which may lead to removal from the practice. Patients have a reasonable expectation of privacy when they attend the Surgery. Recorded audio and or images made in the public areas of the Surgery, e.g. by the reception desk, may reveal personal and intimate information. Such images and audio (that may either be shared, uploaded or otherwise stored) would cause a serious breach in a patient’s expectation of privacy.
SMS Text Messaging Policy
Mobile phones have opened up a new avenue for communication between the Surgery and its patients. The immediate delivery of Small Message Service (SMS or Text) messages gives it an advantage over other forms of communication. Text messaging has wide accessibility. There are a number of scenarios in which an SMS message be very useful: The usefulness of text messaging depends on having reliable data. We will check mobile telephone numbers as often as we can but we ask that patients let the surgery know as soon as their mobile telephone number changes. Mobile telephone numbers can be updated by calling reception or talking to the receptionists in the Surgery; they will be updated immediately.Let us know as soon as a mobile telephone number has changed. Communicating with patients: the Surgery will send SMS texts to the mobile telephone number that has been provided. Written and posted letters are rarely used. Patients are responsible for ensuring that the mobile phone number given to the Surgery is correct, uptodate and appropriate to be used for all communications that the Surgery may need to make. We understand that some patients will not want to receive SMS text messages from the Surgery. We ask that patients carefully consider the advantages of receiving these messages before choosing to opt out. If patients are clear they wish to opt out, we ask them to write to the Practice Manager at the surgery indicating their name and mobile telephone number. When this letter has been processed, no more SMS messages will be sent to that mobile. Please note that the preference to opt-out of receiving SMS text messages from the Surgery will need to be renewed annually after 1 November. The Surgery will try its hardest to respond to all messages sent via SMS. Patients retain responsibility to check that an SMS message has been actioned in the absence of any confirmatory response. All SMS messages the Surgery receives should be written in polite and respectful language. Where langauge is offensive or foul, the SMS message will be deleted and a behaviour warning letter may be sent.
Opting Out
Sending SMS Messages to the Surgery
Transferring Your Electronic Health Record
Your GP practice holds copies of your patient health record electronically and in paper format. Both contain the healthcare information about you that your GP needs including your medical history, medications, allergies, immunisations and vaccinations.
If you have previously registered with a different GP in England, upon registering at this practice your electronic health record will, where possible, be transferred automatically from your previous practice through the use of an NHS system called GP2GP.
Transferring Your Electronic Health Record Information Leaflet
Written Correspondence Received by the Surgery
The Surgery welcomes correspondence (including complaints) from patients. These often allow the Surgery to further refine its procedures and improve its delivery of care. To enable the content of any correspondence to be investigated and actioned promptly we recommend that these letters are written in a polite tone and use respectful language.
Where correspondence from patients contains material that is insulting or rude, it will be returned to the sender for redrafting without being further actioned. This process will enable the Surgery to better understand, interpret and action any content. Correspondence containing insulting or rude or derogatory material may prompt a Behaviour Warning. This can put a patient’s registration at the Surgery at risk. Patients are responsible for any advocates acting on their behalf.
Where we feel the language in correspondence is unnecessarily intemperate or assertive, the Surgery will address any issues contained therein but will recommend that written language should adopt a more polite tone. Where advice to correspond in such tone is ignored and correspondence we receive repeatedly uses language that is felt to be unsuitable, the Surgery may respond with a Behaviour Warning. This can put a patient’s registration at the Surgery at risk. Patients are responsible for any advocates acting on their behalf.