Practice staff should use the new GP e-form to report all patient safety incidents and near misses whether they result in harm or not.
These reports are used to spot any emerging patterns of similar incidents or anything of particular concern.
This will help protect patients by raising awareness of the risks through shared learning with general practices and other health providers across the country.
The Freedom of Information Act creates a right of access to recorded information and obliges a public authority to:
• Have a publication scheme in place
• Allow public access to information held by public authorities.
The Act covers any recorded organisational information such as reports, policies or strategies, that is held by a public authority in England, Wales and Northern Ireland, and by UK-wide public authorities based in Scotland, however it does not cover personal information such as patient records which are covered by the Data Protection Act.
Public authorities include government departments, local authorities, the NHS, state schools and police forces.
The Act is enforced by the Information Commissioner who regulates both the Freedom of Information Act and the Data Protection Act.
A publication scheme requires an authority to make information available to the public as part of its normal business activities.
The scheme lists information under seven broad classes, which are:
• who we are and what we do
• what we spend and how we spend it
• what our priorities are and how we are doing it
• how we make decisions
• our policies and procedures
• lists and registers
• the services we offer
You can request our publication scheme leaflet at the surgery.
Under the Act, any individual, anywhere in the world, is able to make a request to a practice for information. An applicant is entitled to be informed in writing, by the practice, whether the practice holds information of the description specified in the request and if that is the case, have the information communicated to him. An individual can request information, regardless of whether he/she is the subject of the information or affected by its use.
Requests must:
• be made in writing (this can be electronically e.g. email/fax)
• state the name of the applicant and an address for correspondence
• describe the information requested.
Personal data about staff and patients covered under Data Protection Act.
For more information see these websites:
The Surgery prides itself in maintaining professional standards. For certain examinations during consultations an impartial observer (a “Chaperone”) will be required.
This impartial observer will be a practice Nurse, Health Care Assistant or a member of our reception team who is familiar with the procedure and be available to reassure and raise any concerns on your behalf. If a nurse in unavailable at the time of your consultation then your examination may be re-scheduled for another time.
You are free to decline any examination or chose an alternative examiner or chaperone. You may also request a chaperone for any examination or consultation if one is not offered to you. The GP may not undertake an examination if a chaperone is declined.
The role of a Chaperone:
• Maintains professional boundaries during intimate examinations.
• Acknowledges a patient’s vulnerability.
• Provides emotional comfort and reassurance.
• Assists in the examination.
• Assists with undressing patients, if required.
The average pay for GPs working in the Links Medical Practice in the last financial year was £39,943 before tax and National Insurance. This is for 4 full time GPs and 5 part time GPs who worked in the practice for more than six months.
The Links Medical Practice
*Unless the health & safety of others is at risk, the law requires it or it is required to carry out a statutory function
Your information, what you need to know
This privacy notice explains why we collect information about you, how that information may be used and how we keep it safe and confidential.
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 within any NHS organisation. These records help to provide you with the best possible healthcare. We collect and hold data for the sole purpose of providing healthcare services to our patients. 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. The records may include basic details about you, such as your name and address. They may also contain more sensitive information about your health and also information such as outcomes of needs assessments.
Details we collect about you
The health care professionals who provide you with care maintain records about your health and any treatment or care you have received previously (eg. NHS Trust, GP Surgery, Walk-in clinic, etc.). These records help to provide you with the best possible healthcare.
Records which this GP Practice may hold about you may include the following:
How we keep your information confidential and safe
Everyone working for the NHS is subject to the Common Law Duty of Confidence. Information provided in confidence will only be used for the purposes advised with consent given by the patient, unless there are other circumstances covered by the law. The NHS Digital Code of Practice on Confidential Information applies to all our 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 our staff are expected to make sure information is kept confidential and receive annual training on how to do this.
NHS health records may be electronic, on paper or a mixture of both, and we use a combination of working practices and technology to ensure that your information is kept confidential and secure. Your records are backed up securely in line with NHS standard procedures. We ensure that the information we hold is kept in secure locations, is protected by appropriate security and access is restricted to authorised personnel.
We also make sure external data processors that support us are legally and contractually bound to operate and prove security arrangements are in place where data that could or does identify a person are processed.
We are committed to protecting your privacy and will only use information collected lawfully in accordance with:
We maintain our duty of confidentiality to you at all times. We will only ever use or pass on information about you if others involved in your care have a genuine need for it. We will not disclose your information to any third party without your permission unless there are exceptional circumstances (i.e. life or death situations), or where the law requires information to be passed on.
Under the powers of the Health and Social Care Act 2015, NHS Digital can request personal confidential data from GP Practices without seeking patient consent. Improvements in information technology are also making it possible for us to share data with other healthcare providers with the objective of providing you with better care.
You may choose to withdraw your consent to personal data being used in this way. When we are about to participate in a new data-sharing project we will make patients aware by displaying prominent notices in the Practice and on our website at least four weeks before the scheme is due to start. Instructions will be provided to explain what you have to do to ‘opt-out’ of each new scheme.
You can object to your personal information being shared with other health care providers but if this limits the treatment that you can receive then the doctor will explain this to you at the time.
To ensure you receive the best possible care, your records are used to facilitate the care you receive. Information held about you may be used to help protect the health of the public and to help us manage the NHS.
Information may be used for clinical audit to monitor the quality of the service provided. Some of this information may be held centrally and used for statistical purposes. Where we do this we take strict measures to ensure that individual patients cannot be identified e.g. the National Diabetes Audit.
Occasionally your information may be requested to be used for research purposes. The surgery will always gain your consent before releasing any information for this purpose.
National Registries (such as the Learning Disabilities Register) have statutory permission under Section 251 of the NHS Act 2006, to collect and hold service user identifiable information without the need to seek informed consent from each individual service user.
The use of data by the Cabinet Office for data matching is carried out with statutory authority under Part 6 of the Local Audit and Accountability Act 2014. It does not require the consent of the individuals concerned under the Data Protection Act 1998.
Data matching by the Cabinet Office is subject to a Code of Practice.
Information on the Cabinet Office’s legal powers and reasons why it matches particular information. https://www.gov.uk/government/publications/code-of-data-matching-practice-for-nationalfraud-initiative
Risk Stratification is a process for identifying and managing patients who are most likely to need hospital or other healthcare services. Risk stratification tools used in the NHS help determine a person’s risk of suffering a particular condition and enable us to focus on preventing ill health and not just the treatment of sickness. Information about you is collected from a number of sources including NHS Trusts and from this GP Practice.
Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for risk stratification purposes.
Further information is available from the following link:
https://www.england.nhs.uk/ourwork/tsd/ig/risk-stratification/
If you do not wish information about you to be included in the risk stratification programme, please let us know. We can add a code to your records that will stop your information from being used for this purpose.
An ‘Individual Funding Request’ is a request made on your behalf, with your consent, by a clinician, for funding of specialised healthcare which falls outside the range of services and treatments that CCG has agreed to commission for the local population. An Individual Funding Request is taken under consideration when a case can be set out by a patient’s clinician that there are exceptional clinical circumstances which make the patient’s case different from other patients with the same condition who are at the same stage of their disease, or when the request is for a treatment that is regarded as new or experimental and where there are no other similar patients who would benefit from this treatment.
A detailed response, including the criteria considered in arriving at the decision, will be provided to the patient’s clinician.
Invoice validation is an important process. It involves using your NHS number to check the CCG that is responsible for paying for your treatment. Section 251 of the NHS Act 2006 provides a statutory legal basis to process data for invoice validation purposes. We can also use your NHS number to check whether your care has been funded through specialist commissioning, which NHS England will pay for. The process makes sure that the organisations providing your care are paid correctly.
CCGs support local GP practices with prescribing queries which generally don’t require identifiable information. CCG pharmacists work with your practice to provide advice on medicines and prescribing queries, and review prescribing of medicines to ensure that it is safe and cost-effective. Where specialist support is required e.g. to order a drug that comes in solid form, in gas or liquid, the CCG medicines management team will order this on behalf of the practice to support your care.
To ensure that adult and children’s safeguarding matters are managed appropriately, access to identifiable information will be shared in some limited circumstances where it’s legally required for the safety of the individuals concerned.
NHS England uses a national electronic record called the Summary Care Record (SCR) to support patient care. It contains key information from your GP record. Your SCR provides authorised healthcare staff with faster, secure access to essential information about you in an emergency or when you need unplanned care, where such information would otherwise be unavailable.
Summary Care Records are there to improve the safety and quality of your care. SCR core information comprises your allergies, adverse reactions and medications. An SCR with additional information can also include reason for medication, vaccinations, significant diagnoses / problems, significant procedures, anticipatory care information and end of life care information. Additional information can only be added to your SCR with your agreement.
Please be aware that if you choose to opt-out of SCR, NHS healthcare staff caring for you outside of this surgery may not be aware of your current medications, allergies you suffer from and any bad reactions to medicines you have had, in order to treat you safely in an emergency.
Your records will stay as they are now with information being shared by letter, email, fax or phone. If you wish to opt-out of having an SCR please return a completed opt-out form to the practice.
Your patient record is held securely and confidentially on our electronic system. If you require attention from a health professional such as an Emergency Department, Minor Injury Unit or Out Of Hours location, those treating you are better able to give appropriate care if some of the information from your GP patient record is available to them. This information can be locally shared electronically via the portal
In all cases, information is only used by authorised health and social care professionals in East London organisations, involved in your direct care. Your permission will be asked before the information is accessed, unless the health and social care user is unable to ask you and there is a clinical reason for access, which will then be logged.
We will approach the management of patient records in line with the Records Management NHS Code of Practice for Health and Social Care which sets the required standards of practice in the management of records for those who work within or under contract to NHS organisations in England, based on current legal requirements and professional best practice.
Who are our partner organisations?
We may also have to share your information, subject to strict agreements on how it will be used, with the following organisations:
We will never share your information outside of health partner organisations without your explicit consent unless there are exceptional circumstances such as when the health or safety of others is at risk, where the law requires it or to carry out a statutory function.
Within the health partner organisations (NHS and Specialist Trusts) and in relation to the above mentioned themes – Risk Stratification, Invoice Validation, Supporting Medicines Management, Summary Care Record – we will assume you are happy to for your information to be shared unless you choose to opt-out (see below).
This means you will need to express an explicit wish not to have your information shared with the other NHS organisations; otherwise they will be automatically shared. We are required by law to report certain information to the appropriate authorities. This is only provided after formal permission has been given by a qualified health professional. There are occasions when we must pass on information, such as notification of new births, where we encounter infectious diseases which may endanger the safety of others, such as meningitis or measles (but not HIV/AIDS), and where a formal court order has been issued. Our guiding principle is that we are holding your records in strictest confidence.
Your right to withdraw consent for us to share your personal information (Opt-Out)
If you are happy for your data to be extracted and used for the purposes described in this fair processing notice then you do not need to do anything. If you do not want your information to be used for any purpose beyond providing your care you can choose to opt-out. If you wish to do so, please let us know so we can code your record appropriately. We will respect your decision if you do not wish your information to be used for any purpose other than your care but in some circumstances we may still be legally required to disclose your data.
There are two main types of opt-out.
Type 1 Opt-Out
If you do not want information that identifies you to be shared outside the practice, for purposes beyond your direct care, you can register a ‘Type 1 Opt-Out’. This prevents your personal confidential information from being used other than in particular circumstances required by law, such as a public health emergency like an outbreak of a pandemic disease.
Type 2 Opt-Out
NHS Digital collects information from a range of places where people receive care, such as hospitals and community services. If you do not want your personal confidential information to be shared outside of NHS Digital, for purposes other than for your direct care, you can register a ‘Type 2 Opt-Out’. For further information about Type 2 Opt-Outs, please contact NHS Digital contact centre at enquiries@hscic.gov.uk referencing ‘Type 2 Opt-Outs – Data Requests’ in the subject line; or call NHS Digital on (0300) 303 5678; or visit the website http://content.digital.nhs.uk/article/7092/Information-on-type-2-opt-outs .
If you wish to discuss or change your opt-out preferences at any time please contact the Senior Administrator.
Access to your information
Under the new General Data Protection Regulation (GDPR) 2018 everybody has the right to see, or have a copy, of data we hold that can identify you, with some exceptions. You do not need to give a reason to see your data.
Subject access requests can be made verbally or in writing and the practice has one month to respond to the request. Under GDPR, organisations are not permitted to charge the data subject in most circumstances.
If you want to access your data you must make the request in writing. Under special circumstances, some information may be withheld. If you wish to have a copy of the information we hold about you, please contact the Senior Administrator.
It is important that you tell the person treating you if any of your details such as your name or address have changed or if any of your details are incorrect in order for this to be amended. Please inform us of any changes so our records for you are accurate and up to date.
If you provide us with your mobile phone number, we may use this to send you reminders about your appointments or other health screening information. Please let us know if you do not wish to receive reminders on your mobile. If you provide us with your email address, we may use this to send you reminders to make an appointment for a review. Please let us know if you do not wish to receive correspondence by email.
The Links Medical Practice is registered with the Information Commissioner’s Office (ICO) to describe the purposes for which they process personal and sensitive information.
We are a registered 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 .
We can be contacted at:
The links Medical Practice, 27 Brook Lane, BR1 4PX 0208 461 3333
If you have concerns or are unhappy about any of our services, please contact:
The links Medical Practice, 27 Brook Lane, BR1 4PX 0208 461 3333.
For independent advice about data protection, privacy and data-sharing issues, you can contact: The Information Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF – Phone: 0303 123 1113 Website: www.ico.gov.uk.
Further information about the way in which the NHS uses personal information and your rights in that respect can be found here: https://www.england.nhs.uk/contact-us/privacy/privacy-notice/your-information/.
The NHS Care Record Guarantee for England sets out the rules that govern how patient information is used in the NHS, what control the patient can have over this, the rights individuals have to request copies of their data and how data is protected under the Data Protection Act 1998. http://systems.digital.nhs.uk/infogov/links/nhscrg.pdf
NHS Digital collects health information from the records health and social care providers keep about the care and treatment they give, to promote health or support improvements in the delivery of care services in England.
http://content.digital.nhs.uk/article/4963/What-we-collect
We will keep our Fair Processing & Privacy Notice under regular review. This notice was last reviewed following GDPR implementation in May 2018.
The Links Medical Practice
Legal Grounds for Processing PERSONAL DATA under THE GENERAL DATA PROTECTION REGULATION (GDPR)
The General Data Protection Regulation (GDPR) came into force on 25 May 2018. Under the GDPR, organisations need to ensure activities involving the processing of personal information are undertaken under one of the six legal grounds for processing.
Article 6(1) of the GDPR sets out the conditions the must be met for the processing of personal data to be lawful.
They are:
(a) the data subject has given consent to the processing of their personal data for one or more specific purposes;
(b) processing is necessary for the performance of a contract to which the data subject is party or in order to take steps at the request of the data subject prior to entering into a contract;
(c) processing is necessary for compliance with a legal obligation to which the controller is subject;
(d) processing is necessary in order to protect the vital interests of the data subject;
(e) processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller;
(f) processing is necessary for the purposes of the legitimate interests pursued by a controller, except where such interests are overridden by the interests or fundamental rights and freedoms of the data subject which require protection of personal data, in particular where the data subject is a child. This shall not apply to processing carried out by public authorities in the performance of their tasks.
These conditions are all equally valid and organisations should assess which of these grounds are most appropriate for different processing activities and then fulfil any further requirements the GDPR sets out for these conditions (GDPR Article 5).
Processing activities that fall under performance of a contract, legal obligation, vital interests and public task may be fairly straight-forward to identify. The key for many is in assessing whether Consent or Legitimate Interests will be most appropriate for specific processing of personal information.
The GDPR defines Consent in Article 4(11) as:
‘consent’ of the data subject means any freely given, specific, informed and unambiguous indication of the data subject’s wishes by which he or she, by a statement or by a clear affirmative action, signifies agreement to the processing of personal data relating to him or her;
Recital 32 states:
Consent should be given by a clear affirmative act establishing a freely given, specific, informed and unambiguous indication of the data subject’s agreement to the processing of personal data relating to him or her, such as by a written statement, including by electronic means, or an oral statement. This could include ticking a box when visiting an internet website, choosing technical settings for information society services or another statement or conduct which clearly indicates in this context the data subject’s acceptance of the proposed processing of his or her personal data. Silence, pre-ticked boxes or inactivity should not therefore constitute consent.
Consent should cover all processing activities carried out for the same purpose or purposes. When the processing has multiple purposes, consent should be given for all of them. If the data subject’s consent is to be given following a request by electronic means, the request must be clear, concise and not unnecessarily disruptive to the use of the service for which it is provided.
The UK’s Data Protection Regulator’s (ICO) draft guidance on Consent clearly states:
Consent requires a positive opt-in. Don’t use pre-ticked boxes or any other method of consent by default.
The ICO has stressed the following:
The final text of the proposed Regulation on Privacy and Electronic Communications is anticipated later this year. ePrivacy Regulation – what can we expect?
To offer support to the ICO and in the spirit of Industry and Regulator partnership, the Data Protection Network (DPN) has published guidance for commercial and not-for-profit organisations on the use of Legitimate Interests under the General Data Protection Regulation (GDPR). View DPN’s Legitimate Interests Guidance
The ICO’s draft guidance on Consent states:
consent is one lawful basis for processing, but there are five others. Consent won’t always be the easiest or most appropriate.
When considering whether you can rely on Legitimate Interests, organisations should be aware of four key factors:
1) It is necessary to demonstrate that you have balanced your interests with the interests and rights of the individuals affected by your proposed processing activity
2) This assessment (which may be a simple process or very detailed in more complex scenarios) should be documented and may be challenged by individuals or the Regulator
3) You need to inform individuals that you are processing their personal information under this condition (i.e. via your Privacy Policy)
4) You need to be able to uphold the individual’s right to object to such processing
Recital 47 of the GDPR broadly describes areas where Legitimate Interest might be relied upon, for example when the processing is strictly necessary for the purposes of preventing fraud or ensuring network security, where there is a ‘reasonable expectation’ or a ‘relevant and appropriate relationship’. Recital 47 also specifically mentions; “the processing of personal data for direct marketing purposes may be regarded as carried out for a legitimate interest.”
GP surgeries in Bromley work hard to provide the public and patients with clear and accurate information relating to how their personal information is used. Privacy Notices are put in place on the Bromley Clinical Commissioning Group website to inform service users of these uses of data by your GP surgery.
Please find further information regarding privacy notices here.
Information about you, your medical treatment, and family background may be recorded, either on paper or in computer files, as part of providing you with health services. This information is vital to the proper operation of the NHS, and is needed to give you and others the best possible healthcare.
Please read the rest of this notice in order to better understand how we use medical information about you. For further details please see information leaflet entitled “Your Information” displayed in the Practice or ask receptionist for details.
The NHS is not the only government service to provide you with care, and it will be necessary for us to provide other agencies with appropriate information, but only with your consent (or that of your relatives if you are too ill).
The sensitivity of patient information is well understood within the NHS. All staff and contractors are trained to respect their duty of confidentiality to you. We keep paper and electronic records securely to prevent unauthorised access or misuse. Wherever practicable, we also remove references to personal details such as your name and address, and often restrict it further to reduce the chances of anyone identifying a record as relating to you.
You can have a say in how the NHS uses information about you. If you want to find out more or have any concerns you can phone NHS Direct on 0845 4647 and request a booklet giving more details; go online at www.nhs.uk\confidentiality; or you can contact the Patient Liaison Team at the following address: Bromley PCT, Bassetts House, Broadwater Gardens, Orpington, Kent BR6 7UA. Tel. No. 01689 853339
The ICO has published a new Model Publication Scheme that all public authorities are required to adopt by 1st January 2009.
How information about you helps us to provide better care.
Confidential information from your medical records can be used by the NHS to improve the services offered so we can provide the best possible care for everyone. This information along with your postcode and NHS number but not your name, are sent to a secure system where it can be linked with other health information.
This allows those planning NHS services or carrying out medical research to use information from different parts of the NHS in a way which does not identify you. You have a choice. If you are happy for your information to be used in this way you do not have to do anything. If you have any concerns or wish to prevent this from happening, please see the leaflet “How information about you helps us to provide better care” in the waiting Room.
Doctors need to make notes about any diagnosis, test results, treatments including drugs prescriptions, and other information that you may provide, that seems relevant to the treatment of your condition. We need to keep this information in order to provide proper care for you (for later treatment, or if you should be seen by another doctor) and to allow others to check the treatment that you have received.
Nurses and other health professionals also need access to these records, and will add their own notes, as part of the overall healthcare provision. Secretaries, receptionists, and other clerical staff need access to some of your records in order to do administrative tasks, such as: booking appointments and communicating with you and other parts of the NHS.
Your doctor may also need to provide information under certain Acts of Parliament (e.g. the Communicable Diseases Act 1978, which is necessary to prevent the outbreak of certain highly contagious diseases) to protect you and others.
In order to manage the NHS, some restricted information concerning treatments, drugs prescribed, numbers of patients seen etc. is needed, and hospitals and general practices must provide this information in returns to various central bodies. This information has personal details such as your name and address removed wherever possible. It is necessary from time to time to check these returns to prevent fraud as part of the NHS’s statutory obligations. This may result in your being contacted by an NHS Fraud Office to see if you will consent to your records being checked. Only if you provide your consent will the auditors be allowed to access your records.
Some medical files are needed to teach student clinicians. Without such materials, new doctors and nurses would be not be properly prepared to treat you.
We need to be able to plan ahead about treatments, patient numbers, etc., but this uses summary information, not personal information.
Some medical research will require your direct involvement (especially if taking part in clinical trials) in which case the circumstances will be fully explained to you, and your express consent required. If you do not consent, then you will not be included in the trial.
Other researchers only require access to medical statistics, and can greatly improve our understanding of health, and how to treat patients more effectively. Generally, researchers only need information about groups of people, so that no individual information is apparent. In some cases, they need individual records, but wherever we can we will provide these in an anonymous form (so individuals cannot be identified).
Sometimes, researchers need access to individual medical files. We will contact you first for your consent (and before this the researchers must present their case before an Ethics Committee to check that their research is appropriate and worthwhile). Rarely, it may not be practicable (or even possible) to contact individuals for their consent, in which case the researchers must make their case before a Confidentiality Committee to show that there is enough benefit to the public at large to justify this.
We need to be able to move electronic information from system to system, extracting the data and modifying it for the next system. Occasionally, tests will need to be made on the data to check that it has been transferred correctly. This will only be done under carefully controlled conditions and all employees and contractors will be under strict contractual obligations to protect your confidentiality.
Information for patients explaining how your data is being processed to support vital coronavirus (COVID-19) planning and research.