Our Policy is designed to ensure and promote equality and inclusion, supporting the ethos and requirements of the Equality Act 2010 for all visitors to our Practice.

We are committed to:

• ensuring that all visitors are treated with dignity and respect
• promoting equality of opportunity between men and women
• not tolerating any discrimination or perceived discrimination against, or harassment of, any visitor for reason of age, sex, gender, marital status, pregnancy, race, ethnicity, disability, sexual orientation, religion or belief
• providing the same treatment and services (including the ability to register with the Practice) to any visitor irrespective of age, sex, marital status, pregnancy, race, ethnicity, disability, sexual orientation, medical condition, religion or belief
• This Policy applies to the general public, including all patients and their families, visitors and contractors

Procedure

Discrimination by the Practice or Visitors / patients against you

If you feel discriminated against:

• You should bring the matter to the attention of the Practice Manager
• The Practice Manager will investigate the matter thoroughly and confidentially within 14 working days
• The Practice Manager will establish the facts and decide whether or not discrimination has taken place, and advise you of the outcome of the investigation within 14 working days
• If you are not satisfied with the outcome, you should raise a formal complaint through our Complaints Procedure

Discrimination against our Practice staff

The Practice will not tolerate any form of discrimination or harassment of our staff by any visitor. Any visitor who expresses any form of discrimination against or harassment of any member of our staff will be required to leave the Practice premises immediately. If the visitor is a patient they may also, at the discretion of the Practice Management, be removed from the Practice list if any such behaviour occurs.

The NHS is the UK’s state health service which provides treatment for UK residents. Some services are free, other have to be paid for. The regulations that govern who can and can’t receive treatment are complex and may change.

If you have any questions relating to entitlement to treatment under the NHS please contact the Practice.

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Free Services

GP and Nurse consultations in primary care, treatment provided by a GP and other primary care services are free of charge to all, whether registering as an NHS patient, or as a temporary patient (which is when the patient is in the area for more than 24 hours and less than 3 months).

For secondary care services, the UK’s healthcare system is a residence based one, which means entitlement to free healthcare is based on living lawfully in the UK on an approved and settled basis. The measure of residence that the UK uses to determine entitlement to free NHS healthcare is known as ‘ordinary residence’. This requires non-EEA nationals subject to immigration control, to also have the immigration status of ‘indefinite leave to remain’. Individuals who are not ordinarily resident in the UK may be required to pay for their care when they are in England. However, some services and some individuals are exempt from payment.

The following NHS treatment is available to anyone:

• Treatment in an emergency (but not follow up treatment)
• Treatment of certain communicable diseases
• Compulsory psychiatric treatment

GPs are the first point of contact for virtually all NHS patients:

• They can direct you to other NHS services and are experts in family medicine, preventative care, health education, and treating people with multiple and long-term conditions
• If you’re planning to live and work in England, you need to register with a local GP
• Being registered with a GP Practice does not in itself mean you’ll be entitled to free NHS hospital treatment
• You’ll need to fill out a GMS1 form (PDF, 156kb) using exactly the same details you used when you filled out your visa
• If you’re in England for a short visit but need to see a GP, you can register as a temporary patient with a local Doctor – to do this, you need to be in the area for more than 24 hours but less than 3 months
• Treatment will be free of charge, but make sure you present your European Health Insurance Card (EHIC) if you have one

Medical emergencies

If you need immediate medical assistance (e.g. because of an accident) telephone 999. The call is free. An Operator will ask you which emergency service you require (Fire, Police or Ambulance). You will need to tell the emergency services what has happened and where you are. If someone is injured and needs to go to Hospital, an ambulance will be sent out to pick the patient up and take them to the nearest Hospital that has an Accident & Emergency Department.

If you need urgent treatment but are well enough to travel please make your own way to the nearest Accident & Emergency Department.

We share a common purpose with our partners in health and social care – and that is to provide high quality care and ensure the best possible outcomes for the people who use our services. Promoting improvement is at the heart of what we do.

We endeavour to provide a first class service at all times but sometimes things go wrong and our service may fall below our expected levels.

In order to comply with Regulation 20 of the Health and Social Care Act 2008 (Regulations 2014) we pledge to:

• Have a culture of openness and honesty at all levels
• Inform patients in a timely manner when safety incidents have occurred which may affect them
• Provide a written and truthful account of the incident, explaining any investigations and enquiries made
• Provide a written apology
• Provide support if you are affected directly by an incident

If you have any special needs please let our staff know so that we can help you, and also ensure you get the same support in the future. The surgery at Park Road has ramp access. Ground & 1^stfloor consulting and treatment rooms are available. Please let staff know if you’re unable to manage the stairs and they’ll’ arrange for you to be seen in a ground floor room. Battle Hill access is all on one level with good car parking facilities.

Wheelchair access

The Practice has been specially designed to make it easier for disabled patients to visit; patients also have access to a disabled toilet.

Disabled parking – Blue badge scheme

The Blue Badge Scheme is for people with severe mobility problems. It allows Blue Badge holders to park close to where they need to go. For more information and an Application Form visit your local council office.

Loop system

We have a loop induction system at Reception to assist the hearing impaired. For more information on the loop hearing system visit Hearing Link website.

• British Deaf Association
• British Sign Language Healthy Mind
• Action Hearing Loss
• Royal Association for Deaf People
• National Deaf Children’s Society

Blind/partially sighted

If you or your family members are blind or partially sighted we can give you a CD or large print of our Practice leaflet upon request. Please ask our staff for further information.

For more advice and support for blind people please visit the following websites:

• Royal National Institute of Blind People (RIND)
• Action for Blind People
• blind.org.uk
• Blind in Business
• British Blind Sport

Guide Dogs

Guide dogs are welcome at the Practice but we ask that you be aware of other patients and staff who may have an allergy or fear of dogs. Please visit the guide dog website for further information.

Consent to treatment is the principle that a person must give permission before they receive any type of medical treatment, test or examination and is generally requested on the basis that an explanation of the required treatment, test or procedure has been received from a Clinician.

Consent from a patient is needed regardless of the procedure, whether it’s a physical examination, organ donation or something else.

The principle of consent is an important part of medical ethics and international human rights law.

Defining consent

For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision.

These terms are explained below:

• voluntary– the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family
• informed– the person must be given all of the information in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment doesn’t go ahead
• capacity– the person must be capable of giving consent, which means they understand the information given to them and they can use it to make an informed decision

If an adult has the capacity to make a voluntary and informed decision to consent to or refuse a particular treatment, their decision must be respected.This is still the case even if refusing treatment would result in their death, or the death of their unborn child.

If a person doesn’t have the capacity to make a decision about their treatment, the Healthcare Professionals treating them can go ahead and give treatment if they believe it’s in the person’s best interests.

Clinicians must however take reasonable steps to seek advice from the patient’s friends or relatives before making these decisions.

Read more about assessing the capacity to consent.

How consent is given

Consent can be given:

• verbally– for example, by saying you are happy to have an X-ray
• in writing– for example, by signing a Consent Form for surgery to be performed

Someone could also give non-verbal consent, as long as they understand the treatment or examination about to take place – for example, holding out an arm for a blood test.

Consent should be given to the Healthcare Professional directly responsible for the person’s current treatment, such as:

• a Nurse arranging a blood test
• a GP prescribing new medication
• a Surgeon planning an operation

If someone is going to have a major medical procedure such as an operation, their consent should ideally be secured plenty of time in advance, so that they have time to obtain information about the procedure and ask questions.

If a patient changes their mind at any point before the procedure, they are entitled to withdraw their previous consent.

Consent from children and young people

If they’re able to, consent is usually given by patients themselves. However, someone with parental responsibility may need to give consent for a child up to the age of 16 to have treatment.

Read more about the rules of consent applying to children and young people.

When consent isn’t needed

There are a few exceptions when treatment may be able to go ahead without the person’s consent, even if they’re capable of giving their permission.

It may not be necessary to obtain consent if a person:

• requires emergency treatment to save their life, but they’re incapacitated (for example, they’re unconscious) – the reasons why treatment was necessary should be fully explained once they’ve recovered
• immediately requires an additional emergency procedure during an operation – there has to be a clear medical reason why it would be unsafe to wait to obtain consent, and it can’t be simply for convenience
• with a severe mental health condition such as schizophrenia, bipolar disorder or dementia, lacks the capacity to consent to the treatment of their mental health (under the Mental Health Act 1983) – in these cases, treatment for unrelated physical conditions still requires consent, which the patient may be able to provide, despite their mental illness
• requires Hospital treatment for a severe mental health condition, but self-harmed or attempted suicide while competent and is refusing treatment (under the Mental Health Act 1983) – the person’s nearest relative or an approved Social Worker must make an application for the person to be forcibly kept in Hospital, and two Doctors must assess the person’s condition
• is a risk to public health as a result of rabies, cholera or tuberculosis (TB)
• is severely ill and living in unhygienic conditions (under the National Assistance Act 1948) – a person who is severely ill or infirm and is living in unsanitary conditions can be taken to a place of care without their consent

Consent and life-sustaining treatments

A person may be being kept alive with supportive treatments – such as lung ventilation – without having made an advance decision based on information which outlined the care that they may have refused to receive.

In these cases, a decision about continuing or stopping treatment needs to be made based on what that person’s best interests are believed to be.

To help reach a decision, the Healthcare Professionals responsible for the person’s care should discuss the issue with the relatives and friends of the person receiving the treatment.

They should consider, among other things:

• what the person’s quality of life will be if treatment is continued
• how long the person may live if treatment is continued
• whether there’s any chance of the person recovering

Treatment can be withdrawn if there’s an agreement that continuing treatment isn’t in the person’s best interests.

The case will be referred to the Courts before further action is taken if:

• an agreement can’t be reached
• a decision has to be made on whether to withdraw treatment from someone who has been in a state of impaired consciousness for a long time (usually at least 12 months)

It’s important to note the difference between withdrawing a person’s life support and taking a deliberate action to make them die. For example, injecting a lethal drug would illegal.

Complaints

If you believe you’ve received treatment you didn’t consent to, you can make an official complaint, please write to the Practice Manager, who will assist you with this process.

You have a right to know who holds personal information about you. This person or organisation is called the Data Controller. In the NHS, the Data Controller is usually your local NHS Board and your GP Surgery. The NHS must keep your personal health information confidential. It is your right.

Please be aware that our staff are bound to the NHS code of confidentiality; they are therefore not permitted to discuss any of our patient’s medical history, including their registration status, without their written consent to do so.

Once written consent has been received and verified with the patient we can provide you with information as required; this includes communicating with you on behalf of the patient with regards to any complaints, but excludes patients who are unable to act on their own behalf and already have a designated person or carer responsible for their medical care.

We therefore respectfully ask parents, relatives and guardians not to request information regarding their relatives/friends or to complain on their behalf unless we have their written consent that you may do so. If consent is required we advise that the person concerned attends the Practice to complete the required form.

Clinical Trials help Doctors understand how to treat a particular disease or condition. It may benefit you, or others like you, in the future.

If you take part in a Clinical Trial, you may be one of the first people to benefit from a new treatment.

However, if you do take part you should also be aware that there is a chance that the new treatment turns out to be no better, or worse, than the existing standard treatment.

Clinical governance is the system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care, by creating an environment in which clinical excellence will flourish.

Clinical governance encompasses quality assurance, quality improvement and risk & incident management.

Our 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; the safety of everyone is of paramount importance.

All medical consultations, examinations and investigations are potentially distressing. Patients can find examinations, investigations or photography involving the breasts, genitalia or rectum particularly intrusive (these examinations are collectively referred to as ‘intimate examinations’). Consultations involving dimmed lights, the need for patients to undress or intensive periods of being touched may also make a patient feel vulnerable.

Chaperoning is the process of having a third person present during such consultations to provide support, both emotional and sometimes physical, to the patient, to provide practical support to the Doctor as required, and also to protect the Doctor against allegations of improper behaviour during such consultations.

NHS England is currently involved in developing a modern information system, to help improve health services.

To discover how information about you helps us to provide better care you can visit nhs.uk/caredata