Practice Policies & Patient Information

Child Safeguarding and Child Protection Policy

Policy statement
Basic principles
Responsibilities
Child protection: sources of advice and support
Immediate actions
What to do with allegations of abuse from a child
Confidentiality
Physical examination of a child or young person
Attitudes of parents or carers
Training – in house
Record keeping
Information on child abuse available at safe network: https://www.safenetwork.org.uk/Pages/default.aspx

Policy statement

Under the 1989 and the 2004 Children Acts a child or young person is anyone under the age of
18 years.
Safeguarding children is the action we take to promote the welfare of all children and protect them from harm.
Child Protection refers to the activity that is undertaken to protect specific children who are suffering or at risk of suffering significant harm.
The Practice recognises that all children have a right to protection from abuse and neglect and the
Practice accepts its responsibility to safeguard the welfare of all children with whom staff may come into contact.
We intend to:
- Respond quickly and appropriately where information requests relating to child protection are made, abuse is suspected or allegations are made.
- Provide children and parents with the chance to raise concerns over their own care or the care of others.
Have a system for dealing with, escalating and reviewing concerns.
Remain aware of child protection procedures and maintain links with other bodies, especially the commissioning body’s appointed contacts.
The Practice will ensure that all staff are trained to a level appropriate to their role, and that this is repeated on an annual refresher basis. New members of staff will receive induction training within 3 months of start date.

Basic principles

The welfare of the child is paramount.
It is the responsibility of all adults to safeguard and promote the welfare of children and young people. This responsibility extends to a duty of care for those adults employed, commissioned or contracted to work with children and young people.
The Practice must have safe recruitment practices including appropriate use of the disclosure and barring service https://www.gov.uk/government/organisations/disclosure-and-barringservice/ about and safe whistle blowing processes.
Staff who work with children are responsible for their own actions and behaviour and should avoid any conduct which would lead any reasonable person to question their motivation and intentions.
Staff should work and be seen to work, in an open and transparent way.
The same professional standards should always be applied regardless of culture, disability, gender, age, language, racial origin, religious belief and/or sexual identity.
Staff should continually monitor and review their practice and ensure they follow the guidance contained in this document and elsewhere.
The Practice will ensure regular meetings are held to discuss vulnerable children and families and that such meetings include other Agencies such as Midwives and Public Health Nurses to ensure early recognition of circumstances leading to abuse and neglect and early intervention to help prevent abuse and neglect.
The Practice will ensure children and their families are able to share concerns and complaints and that there are mechanisms in place to ensure these are heard and acted upon.

Responsibilities

Dr Ahmed Elsheikh is the appointed Clinical Safeguarding Lead within the practice.

Dr Omar Elsheikh is the appointed Clinical Safeguarding Deputy Lead within the practice.

Mrs Hala Zendah is the Administrative Safeguarding Lead.

The Clinical Safeguarding Lead and Clinical Safeguarding Deputy Lead are responsible for all aspects of the implementation and review of the children’s safeguarding procedure in this practice.

Child protection: sources of advice and support

Contact information

Practice Clinical Safeguarding Children Lead: Dr Ahmed Elsheikh.

Practice Clinical Safeguarding Children Deputy Lead: Dr Omar Elsheikh

Practice Administrative Lead: Mrs Hala Zendah

Named GP for Safeguarding Children: Dr Ahmed Elsheikh

Contact no.: 0121 440 3720

For further contacts

Designated Doctor: Dr. Dr. Ahmed Elsheikh
Social Care: https://www.birminghamchildrenstrust.co.uk/ and https://www.birmingham.gov.uk/info/20018/adult_social_care_and_health
Police Child Abuse Investigation Unit: 999
NSPCC Child Line 0800 1111
Useful websites RCGP/NSPCC Safeguarding Children Toolkit Local Safeguarding Children’s Board.

Common presentations and situations in which child abuse may be suspected include:

Disclosure by a child or young person.
Physical signs and symptoms giving rise to suspicion of any category of abuse and/or inconsistent with the history provided.
A history which is inconsistent or changes over time.
A delay in seeking medical help.
Extreme or worrying behaviour of a child, taking account of the developmental age of the child.
Self-harm.
Accumulation of minor incidents giving rise to a level of concern, including frequent A&E attendances.

Some other situations which need careful consideration are:

Repeated attendance of young baby under 12 months of age.
Any bruising or injury in child under 24 months of age.
Very young girls or girls with learning difficulties or disability requesting contraception, especially emergency contraception.
Girls under 16 presenting with pregnancy or sexually transmitted disease, especially those with learning difficulties, chronic long term illness, complex needs or disability.
Situations where parental factors such as mental health problems, alcohol, drug or substance misuse, learning difficulties, domestic abuse may impact on children and family life.
Unexplained or suspicious injuries such as bruising, bites or burns, particularly if situated unusually on the body.
The child says that she or he is being abused, or another person reports this.
The child has an injury for which the explanation seems inconsistent, delayed presentation, or which has not been adequately treated or followed up.
The child’s behaviour changes, either over time or quite suddenly, and he or she becomes quiet and withdrawn, or aggressive.
Refusal to remove clothing for normal activities or keeping covered up in warm weather.
The child appears not to trust particular adults, perhaps a parent or relative or other adult in regular contact.
An inability to make close friends.
Inappropriate sexual awareness or behaviour for the child’s age.
Fear of going home or parents being contacted.
Disclosure by an adult of abusive activities, including activities related to internet and social media use.
Reluctance to accept medical help.
Fear of changing for PE or school activities.

Immediate actions

Concerns should immediately be reported to the Lead clinician within the Practice or his / her deputy (above).
Concerns should be discussed internally and an action plan decided.
In the absence of one of the nominated persons, the matter should be brought to the attention of the local Safeguarding Team, or, if it is an emergency, and the designated persons cannot be contacted, then the most senior clinician will make a decision whether to report the matter directly to Social Services or the Police.
If the suspicions relate to a member of staff there should be internal discussion with the Practice Safeguarding Lead or deputy, and a plan of action decided, the local Safeguarding Children team and / or social services should be contacted directly. Consideration should be made to involving the LADO.
Suspicions should not be raised or discussed with third parties other than those named above.
Any individual staff member must know how to make direct referrals to the child protection agencies and should be encouraged to do so if they have directly witnessed an abuse action; however, staff are encouraged to use the route described here where possible. In the event that the reporting staff member feels that the action taken is inadequate, untimely or inappropriate they should report the matter directly. Staff members taking this action in good faith will not be penalised.
Where emergency medical attention is necessary it should be given. If necessary as ascertained by clinical judgement the child should be admitted to the care of the emergency Paediatric service and a social services referral made. Any suspicious circumstances or evidence of abuse should be reported to the designated clinical Lead.
If a Social Services referral is being made without the parent’s knowledge and urgent medical treatment is required, social services should be informed of this need. Otherwise, if it is decided that the child is not at risk, suggest to the parent or carer that medical attention be sought immediately for the child.
If appropriate the parent/carer should be encouraged to seek help from the Social Services Department prior to a referral being made. If parents do not consent to medical care or to a social care referral and they fail to do so in situations of real concern the safeguarding Lead will contact social services directly for advice.
Where sexual abuse is suspected the Practice Lead or Deputy will contact the Social Services or Police Child Protection Team directly. The Lead will not speak to the parents if to do so might place the child at increased risk.
Neither the Practice Safeguarding Lead or any other Practice team member should carry out any investigation into the allegations or suspicions of sexual abuse in any circumstances. The Practice Safeguarding Lead will collect exact details of the allegations or suspicion and provide this information to statutory child protection agencies: Social Care, the police or NSPCC, who have powers to investigate the matter under the Children Act 1989.

What to do with allegations of abuse from a child

Keep calm
Reassure the child that they were right to tell you, and that they are not to blame and take what the child says seriously.
Be careful not to lead the child or put words into the child’s mouth – ask questions sensitively.
Do not promise confidentiality.
Fully document the conversation on a word by word basis immediately following the conversation while the memory is fresh.
Fully record dates and times of the events and when the record was made, and ensure that all notes are kept securely.
Inform the child/ young person what you will do next.
Refer to the Practice Safeguarding Lead clinician or Deputy.
Decide if it is safe for a child to return home to a potentially abusive situation. It might be necessary to immediately refer the matter to social services and/or the police to ensure the child’s safety.

Confidentiality

Staff are required to have access to confidential information about children and young people in order to do their jobs, and this may be highly sensitive information. These details must be kept confidential at all times and only shared when it is in the interests of the child to do so, and this may also apply to restriction of the information within the clinical team. Care must be taken to ensure that the child is not humiliated or embarrassed in any way. If an adult who works with children is in any doubt about whether to share information or keep it confidential he or she should seek guidance from the practice clinical Safeguarding Children Lead.

Any actions should be in line with locally agreed information sharing protocols, and whilst the Data Protection Act applies it does not prevent sharing of safeguarding information.

Whilst adults need to be aware of the need to listen and support children and young people, they must also understand the importance of not promising to keep secrets. Neither should they request this of a child or young person under any circumstances.

Additionally, concerns and allegations about adults should be treated as confidential and passed to the practice safeguarding lead or appointed person or agency without delay.

Responding to requests for safeguarding/child protection information

All requests for information relating to a child protection investigation or report for Case

Conference will be passed to the Child Safeguarding Lead or Deputy on the day received.

A response will be made in a timely manner, preferably within 48 hours, and if this is not possible the Agency requesting information will be informed and a reason given.

Physical examination of a child or young person

A parent or carer should be present at all times, or a chaperone offered. Children should only be touched under supervision and in ways which are appropriate to, and essential for clinical care.

Permission should always be sought from a child or young person before physical contact is made and an explanation of the reason should be given, clearly explaining the procedure in advance.

Where the child is very young, there should be a discussion with the parent or carer about what physical contact is required. Routine physical examination of an individual child or young person is normally part of an agreed treatment procedure and/or plan and should be understood and agreed by all concerned, justified in terms of the child’s needs, consistently applied and open to scrutiny.

Physical contact should never be secretive or hidden. Where an action could be misinterpreted a chaperone should be used or a parent fully briefed beforehand, and present at the time. Where a child seeks or initiates inappropriate physical contact with an adult, the situation should be handled sensitively and a colleague alerted.

Attitude of parents or carers

Parental attitude may indicate cause for concern:
Unexpected delay in seeking treatment.
Reluctance to have child immunised.
Failure to take child for dental care.
Failure to attend scheduled appointment with GP or other healthcare providers.
Denial of injury, pain or ill-health.
Incompatible explanations, different explanations or the child is said to have acted in a way that is inappropriate to his/her age and development.
Reluctance to give information or failure to mention other known relevant injuries.
Unrealistic expectations or constant complaints about the child.
Alcohol misuse or drug/substance misuse.
Domestic Abuse or Violence between adults in the household.
Appearance or symptoms displayed by siblings or other household members.

Training – in house

Safeguarding Children Updates are given regularly by Lead Safeguarding GP at Team meetings.

The Practice Safeguarding Children Lead is responsible for ensuring training records are kept and maintained and will liaise with the Practice Appraisal Lead to ensure training is aligned with identified staff development needs. An annual Update and Refresher is given by a member of the Local Safeguarding Children Team, such as the Named GP.

Record keeping

All information received regarding children from the Safeguarding Children Team and any other associated Services should be regarded as strictly confidential.

This information should be handled by the designated member of staff who will deal with such paperwork in the following way.

Designated member of staff for record keeping: Mrs Hala Zendah.

Child Protection Reports are as important as records of serious physical illness and should be recorded in the same way and with the same degree of permanence.

Case Conference Reports should be ideally be scanned into that individual child’s electronic General Practice records. If necessary third party references must be blanked out or anonymized before scanning or sharing with appropriate agencies.

Appropriate coding and templates should be used in Active and Past Problem Lists and priority lists Child’s records should be linked in some way to parents even if not living at the same address, siblings and others in household by use of appropriate templates and codes.

Read codes expressing that a child is on a Child Protection Plan should be entered into notes of all individuals living at same address. It is vital that when a child who is or has been on a Child Protection Plan moves to another area that the full clinical record including Case Conference Reports be sent to the next GP. Therefore they must NOT be kept separate or isolated from the child’s written or computer records.

Tragedies have resulted from Case Conference Records not being passed on to the child’s current GP. (Pass on welfare concerns even if the child is not subject to a protection plan.)

Therefore:

All reports will be scanned onto the relevant child’s records.
These reports will be vetted to remove any 3rd party information especially if external agencies request these medical records.
All reports/correspondence will be seen and summarized by a GP.
All contacts with any parties regarding any safeguarding children issues should be recorded on the patient’s medical records and any necessary action taken immediately.

Data Protection Privacy Notice for Candidates applying for work

Data Protection Privacy Notice for Candidates applying for work

Introduction:

This privacy notice lets you know what happens to any personal data that you give to us, or any that we may collect from or about you.

This privacy notice applies to personal information processed by or on behalf of the practice.

This Notice explains

Who we are, how we use your information and our Data Protection Officer
What kinds of personal information about you do we process?
What are the legal grounds for our processing of your personal information (including when we share it with others)?
What should you do if your personal information changes?
For how long your personal information is retained by us?
What are your rights under data protection laws?

The UK General Data Protection Regulation (UK GDPR) became law on 24th May 2016. This is a regulation on the protection of confidential and sensitive information. It entered into force in the UK on the 25th May 2018, repealing the Data Protection Act (1998), being supplemented by the Data Protection Act 2018.

For the purpose of applicable data protection legislation (including but not limited to the UK General Data Protection Regulation (Regulation (UK) 2016/679) (the “UKGDPR”), and the Data Protection Act 2018 the practice responsible for your personal data is Strensham Road Surgery.

This Notice describes how we collect, use and process your personal data, and how, in doing so, we comply with our legal obligations to you. Your privacy is important to us, and we are committed to protecting and safeguarding your data privacy rights

This Privacy Policy applies to the personal data collected from Candidates applying for roles within the practice.

How we use your information and the law.

Strensham Road Surgery will be what’s known as the ‘Controller’ of the personal data you provide to us.

Upon commencement of employment with the company you will be asked to supply the following personal information:

Name, address, telephone numbers, email address, date of birth, national insurance number, bank details, emergency contact information and health information.

The information that we ask you to provide to the company is required by the business for the following reasons:

In order for us review your application
In order for us to contact you for interview details
Comply with appropriate Employment law
To ensure that we can provide any reasonable adjustments as necessary

We ask that you provide ID for copying to comply with our responsibilities as an employer under section 8 of the Asylum and Immigration Act 1996.

Throughout the application process we will collect data and add to your file i.e. interview scores etc

How do we lawfully use your data?

We need to know your personal, sensitive and confidential data in order to Employ you, under the General Data Protection Regulation we will be lawfully using your information in accordance with: –

Article 6, (b) Necessary for performance of/entering into contract with you

Article 9(2) (b) Necessary for controller to fulfil employment rights or obligations in employment.

This Privacy Notice applies to the personal data of our Candidates.

How do we maintain the confidentiality of your records?

We are committed to protecting your privacy and will only use information collected lawfully in accordance with:

Data Protection Act 2018
The UK General Data Protection Regulation 2016
Human Rights Act 1998
Common Law Duty of Confidentiality
NHS Codes of Confidentiality, Information Security and Records Management

We will only ever use or pass on information about you if others who 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), where the law requires information to be passed on.

Our practice policy is to respect the privacy of our candidates and to maintain compliance with the UK General Data Protection Regulation (UK GDPR) and all UK specific Data Protection Requirements. Our policy is to ensure all personal data related to our candidates will be protected.

All employees and sub-contractors engaged by our practice are asked to sign a confidentiality agreement. The practice will, if required, sign a separate confidentiality agreement if the client deems it necessary. If a sub-contractor acts as a data processor for Strensham Road Surgery an appropriate contract (art 24-28) will be established for the processing of your information.

In Certain circumstances you may have the right to withdraw your consent to the processing of data. Please contact the Data Protection Officer in writing if you wish to withdraw your consent. If some circumstances we may need to store your data after your consent has been withdrawn to comply with a legislative requirement.

Where do we store your information Electronically?

All the personal data we process is processed by our candidates in the UK however for the purposes of IT hosting and maintenance this information may be located on servers within the European Union.

No 3rd parties have access to your personal data unless the law allows them to do so and appropriate safeguards have been put in place. We have a Data Protection regime in place to oversee the effective and secure processing of your personal and or special category (sensitive, confidential) data.

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;

NHS Commissioning Support Units
Clinical Commissioning Groups
NHS England (NHSE) and NHS Digital (NHSD)
Local Authorities
CQC
Private Sector Providers providing employment services
Other ‘data processors’ which you will be informed of

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

We may also use external companies to process personal information, such as for archiving purposes. These companies are bound by contractual agreements to ensure information is kept confidential and secure. All employees and sub-contractors engaged by our practice are asked to sign a confidentiality agreement. If a sub-contractor acts as a data processor for Strensham Road Surgery an appropriate contract (art 24-28) will be established for the processing of your information.

How long will we store your information?

We are required under UK tax law to keep your information and data for the full retention periods as specified by the UK Employment legislation as below

Business Function	Examples of documents	Retention Period
	Training records	Current year plus 2 years
	Candidate application forms/CVs and archiving documentation (of applicants who aren’t successful)	6 months post-date of recruitment decision
	DBS data	6 months post-date of check

How can you access, amend move the personal data that you have given to us?

Even if we already hold your personal data, you still have various rights in relation to it. To get in touch about these, please contact us. We will seek to deal with your request without undue delay, and in any event in accordance with the requirements of any applicable laws. Please note that we may keep a record of your communications to help us resolve any issues which you raise.

Right to object: If we are using your data because we deem it necessary for our legitimate interests to do so, and you do not agree, you have the right to object. We will respond to your request within 30 days (although we may be allowed to extend this period in certain cases). Generally, we will only disagree with you if certain limited conditions apply.

Right to withdraw consent: Where we have obtained your consent to process your personal data for certain activities (for example for a research project), or consent to market to you, you may withdraw your consent at any time.

Right to erasure: In certain situations (for example, where we have processed your data unlawfully), you have the right to request us to “erase” your personal data. We will respond to your request within 30 days (although we may be allowed to extend this period in certain cases) and will only disagree with you if certain limited conditions apply. If we do agree to your request, we will Delete your data but will generally assume that you would prefer us to keep a note of your name on our register of individuals who would prefer not to be contacted. That way, we will minimise the chances of you being contacted in the future where your data are collected in unconnected circumstances. If you would prefer us not to do this, you are free to say so.

Right of data portability: If you wish, you have the right to transfer your data from us to another data controller.

Access to your personal information

Data Subject Access Requests (DSAR): You have a right under the Data Protection legislation to request access to view or to obtain copies of what information the surgery holds about you and to have it amended should it be inaccurate. To request this, you need to do the following:

Your request should be made in writing to the Practice
There is no charge to have a copy of the information held about you
We are required to respond to you within one month

What should you do if your personal information changes?

You should tell us so that we can update our records please contact the Practice Manager as soon as any of your details change, this is especially important for changes of address or contact details (such as your mobile phone number), the practice will from time to time ask you to confirm that the information we currently hold is accurate and up-to-date.

Objections / Complaints

Should you have any concerns about how your information is managed at the Surgeryt, please contact the GP Practice Manager or the Data Protection Officer as above. If you are still unhappy following a review by the GP practice, you have a right to lodge a complaint with a supervisory authority: You have a right to complain to the UK supervisory Authority as below.

Information Commissioner:

Wycliffe house

Water Lane

Wilmslow

Cheshire

SK9 5AF

Tel: 01625 545745

https://ico.org.uk/

If you are happy for your data to be extracted and used for the purposes described in this privacy notice, then you do not need to do anything. If you have any concerns about how your data is shared, then please contact the Practice Data Protection Officer.

If you would like to know more about your rights in respect of the personal data we hold about you, please contact the Data Protection Officer as below.

Data Protection Officer:

The Practice Data Protection Officer is Paul Couldrey of PCIG Consulting Limited. Any queries in regard to Data Protection issues should be addressed to him at: –

Email: Couldrey@me.com

Postal: PCIG Consulting Limited

7 Westacre Drive

Quarry Bank

Dudley

West Midlands

DY5 2EE

Changes:

It is important to point out that we may amend this Privacy Notice from time to time. If you are dissatisfied with any aspect of our Privacy Notice, please contact the Practice Data Protection Officer.

Equality and Diversity Policy

Confidentiality Notice

This document and the information contained therein is the property of Strensham Road Surgery.

This document contains information that is privileged, confidential or otherwise protected from disclosure. It must not be used by, or its contents reproduced or otherwise copied or disclosed without the prior consent in writing from Strensham Road Surgery.

Statement on Policies of Strensham Road Surgery

Staff and Patients

The Practice is committed to ensuring that, as far as is reasonably practicable, the way in which we provide services to the public and the way in which we treat our staff reflects their individual needs and does not discriminate against individuals or groups on any grounds.

Equality and Diversity

The Practice aims to promote equality and diversity and value the benefits this brings. It is our aim to ensure that all staff feel valued and have a fair and equitable quality of working life.

Human Rights

The Practice is committed to the principles contained in the Human Rights Act. We aim to ensure that our employment policies protect the rights and interests of our staff and ensure that they are treated in a fair, dignified and equitable way when employed at the Practice.

Information Governance

Any Practice policy which impacts on or involves the use and disclosure of personal information (patient or employee) must make reference to and ensure that the content of the policy is comparable with the relevant statutory or legal requirement and ethical standards.

Data Protection Act 1998 and the NHS Confidentiality Code of Practice

The Data Protection Act (DPA) provides a framework which governs the processing of information that identifies living individuals.

Processing includes holding, obtaining, recording, using and disclosing of information and the Act applies to all forms of media, including paper and images.

It applies to confidential patient information but is far wider in its scope, e.g. it also covers personnel records.

The DPA provides a legal gateway and timetable for the disclosure of personal information to the data subject (e.g. Health Record to a patient, personal file to an employee).

Whilst the DPA applies to both patient and employee information, the Confidentiality Code of Practice (COP) applies only to patient information.

The COP incorporates the requirements of the DPA and other relevant legislation together with the recommendations of the Caldicott report and medical ethical considerations, in some cases extending statutory requirements and provides detailed specific guidance.

This Equal Opportunities and Diversity Policy contains the following sections:

Introduction
Practice Statement
Recruitment and Selection
Employee relations
Zero Tolerance

Introduction

The Practice is committed to equal opportunities and to building a valued workforce whose diversity reflects our community.

Our Equality and Diversity Policy takes into account all current UK and EU legislation and guidelines, including codes of practice from the Equality and Human Rights Commission.

This Equality and Diversity Policy has been written in accordance with current best practice and has been updated in line with the Equality Act 2010.

Practice Statement

Under the Equality Act 2010, it is against the law for a company to discriminate against anyone on the grounds of colour, age, sex, race / nationality – including citizenship – ethnic or national origins, marital status, civil partnership, disability, sexual orientation, any religion, or religious or philosophical belief.

It is also possible for employees to claim for discrimination on a combination of two of these grounds. Similarly if employees discriminate against a colleague or patient, the Practice could be held vicariously liable for their acts, and be responsible for paying the compensation or damages to the victim of the discrimination.

If the Practice can prove that it has done all that was reasonable to prevent the discriminatory acts from occurring then its liability can be reduced or entirely eliminated. Having an equal opportunities policy, and apprising all staff of its existence is one of the things that a reasonable employer should do.

The Practice has the following policies in place which need to be read along with this Equality and Diversity policy:

Equality Act: Operational Procedures & Policy
Culture & Religious policy
Grievance Procedures
Bullying and Harassment
Age Discrimination
Equal Opportunities policy
Recruitment and Selection Policy
Training and Development policy
Dignity at work
Being Open Policy
Information Governance Policy i.e. confidentiality / consent

Recruitment and Selection

The Practice has implemented a Recruitment & Selection policy. The objective of this policy is to recruit the best person for a role and outlines the responsibilities of the recruiting managers in complying with legal and locally agreed requirements.

At every stage of the recruitment process, Managers will treat all applicants equally, showing no discrimination on the grounds of their ethnic origin or nationality, disability, gender, gender reassignment, marital status, age, sexual orientation, race, trade union activity or political or religious beliefs.

Applicants will be selected against criteria based solely on objective, job related criteria and their ability to do the job applied for. The Practice will consider providing appropriate assistance to ensure equality for all.

Relevant educational, training and development opportunities are open to all staff and all staff have a personal development plan in place, which must be reviewed annually. Information on education, training and development opportunities is widely publicised, and attendance monitored for.

Monitoring information is gathered periodically to ensure there are no inequalities in opportunities for promotion.

Employee Relations

The Practice has developed a number of ‘Employee Friendly’ Policies and also has in place Disciplinary, Dignity at Work and Grievance Policies to process employee relations issues.

As with any Practice Policy these are fair and consistent in their manner. Practice policies do not discriminate against anyone on the grounds of colour, age, sex, race / nationality – including citizenship – ethnic or national origins, marital status, civil partnership, disability, sexual orientation, any religion, or religious or philosophical belief.

Instances of harassment under any of the above are treated very seriously and are addressed under the Dignity at Work and Disciplinary Policies.

Zero Tolerance

The Practice is committed to developing and maintaining a safe and secure environment, for its patients, staff and visitors and has a duty to take all reasonable steps to protect and support its staff.

Violent and abusive behaviour includes bullying and / or harassment of any description. Violent or abusive behaviour by patients, visitors or staff is not tolerated and decisive action will be taken to protect staff, patients and visitors, including combating behaviour contrary to the principles outlined in this Policy on the grounds outlined in the Policy Statement.

All violent adverse incidents are reported, investigated and appropriate remedial action is taken. When a clinical risk/incident is reported, a risk assessment may be appropriate to identify the need for change. On-going follow up and review of progress may also be appropriate.

GDPR privacy notice

Strensham Road Surgery has a legal duty to explain how we use any personal information we collect about you, as a registered patient at the practice. Staff at this practice maintain records about your health and the treatment you receive in electronic and paper format.

You can read our GDPR Data Protection Privacy Notice below or you can download a copy.

Data Protection Privacy Notice for Patients

Introduction:

This privacy notice lets you know what happens to any personal data that you give to us, or any information that we may collect from you or about you from other organisations.

This privacy notice applies to personal information processed by or on behalf of the practice.

This Notice explains

Who we are and how we use your information
Information about our Data Protection Officer
What kinds of personal information about you we hold and use (process)
The legal grounds for our processing of your personal information (including when we share it with others)
What should you do if your personal information changes?
For how long your personal information is retained / stored by us?
What are your rights under Data Protection laws

The UK General Data Protection Regulation (UKGDPR) and the Data Protection Act 2018 (DPA 2018) became law on 25th May 2018, and 1^st January 2021 when the UK exited the EU.

For the purpose of applicable data protection legislation (including but not limited to the General Data Protection Regulation (Regulation (UK) 2016/679) (the “UKGDPR”), and the Data Protection Act 2018 the practice responsible for your personal data is Strensham Road Surgery.

This Notice describes how we collect, use and process your personal data, and how in doing so, we comply with our legal obligations to you. Your privacy is important to us, and we are committed to protecting and safeguarding your data privacy rights.

How we use your information and the law.

Strensham Road Surgery will be what’s known as the ‘Controller’ of your personal data.

We collect basic personal data about you and location-based information. This does include name, address and contact details such as email and mobile number etc.

We will also collect sensitive confidential data known as “special category personal data”, in the form of health information, religious belief (if required in a healthcare setting) ethnicity and sex life information that are linked to your healthcare, we may also receive this information about you from other health providers or third parties.

Why do we need your information?

The health care professionals who provide you with care maintain records about your health and any treatment or care you have received previously. These records help to provide you with the best possible healthcare and treatment.

NHS health records may be electronic, paper-based or a mixture of both. We use a combination of working practices and technology to ensure that your information is kept confidential and secure.

Records about you may include the following information;

Details about you, such as your address, your carer or legal representative and emergency contact details.
Any contact the surgery has had with you, such as appointments, clinic visits, emergency appointments.
Notes and reports about your health.
Details about your treatment and care.
Results of investigations such as laboratory tests, x-rays etc.
Relevant information from other health professionals, relatives or those who care for you.
Contact details (including email address, mobile telephone number and home telephone number)

To ensure you receive the best possible care, your records are used to facilitate the care you receive, including contacting you. Information held about you may be used to help protect the health of the public and to help us manage the NHS and the services we provide. Limited information may be used within the GP practice for clinical audit to monitor the quality of the service we provided.

How do we lawfully use your data?

We need your personal, sensitive and confidential data in order to provide you with healthcare services as a General Practice, under the General Data Protection Regulation we will be lawfully using your information in accordance with: –

Article 6, 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;”

Article 9, (h) processing is necessary for the purposes of preventive 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

This Privacy Notice applies to the personal data of our patients and the data you have given us about your carers/family members.

We use your personal and healthcare information in the following ways:

when we need to speak to, or contact other doctors, consultants, nurses or any other medical/healthcare professional or organisation during the course of your diagnosis or treatment or on going healthcare;
when we are required by law to hand over your information to any other organisation, such as the police, by court order, solicitors, or immigration enforcement.
In a de-identified form to support planning of health services and to improve health outcomes for our population

We will never pass on your personal information to anyone else who does not need it, or has no right to it, unless you give us consent to do so.

Legal justification for collecting and using your information

The law says we need a legal basis to handle your personal and healthcare information.

Contract: We have a contract with NHS England to deliver healthcare services to you. This contract provides that we are under a legal obligation to ensure that we deliver medical and healthcare services to the public.

Consent: Sometimes we also rely on the fact that you give us consent to use your personal and healthcare information so that we can take care of your healthcare needs.

Please note that you have the right to withdraw consent at any time if you no longer wish to receive services from us.

Necessary care: Providing you with the appropriate healthcare, where necessary. The Law refers to this as ‘protecting your vital interests’ where you may be in a position not to be able to consent.

Law: Sometimes the law obliges us to provide your information to an organisation (see above).

Special categories

The law states that personal information about your health falls into a special category of information because it is very sensitive. Reasons that may entitle us to use and process your information may be as follows:

Public Interest: Where we may need to handle your personal information when it is considered to be in the public interest. For example, when there is an outbreak of a specific disease and we need to contact you for treatment, or we need to pass your information to relevant organisations to ensure you receive advice and/or treatment

Consent: When you have given us consent

Vital Interest: If you are incapable of giving consent, and we have to use your information to protect your vital interests (eg if you have had an accident and you need emergency treatment)

Defending a claim: If we need your information to defend a legal claim against us by you, or by another party

Providing you with medical care: Where we need your information to provide you with medical and healthcare services

GP Connect System and Data Sharing

Strensham Road Surgery has signed the National Data Sharing Arrangement (NDSA) for GP connect. GP Connect helps clinicians gain access to GP patient records during interactions away from a patient’s registered practice and makes their medical information available to appropriate health and social care professionals when and where they need it, to support the patient’s direct care.

From a privacy, confidentiality and data protection perspective, GP Connect provides a method of secure information transfer and reduces the need to use less secure or less efficient methods of transferring information, such as email or telephone.

GP Connect – key points.

GP Connect can only be used for direct care purposes.
Individuals can opt out of their GP patient record being shared via GP Connect by contacting their GP practice.
Access to GP Connect is governed by role-based access control (RBAC) and organisational controls; only people who need to see the GP patient record for a patient’s direct care should be able to see it
All systems that allow the use of GP Connect must undergo a robust compliance process and the organisations involved must sign a connection agreement holding them to high standards of information security.

GP Connect products can help health and social care professionals share, view or act on information that could be required for a patient’s direct care, but they would otherwise have difficulty accessing easily (for example if they are using different IT systems).

Organisations can have access to relevant information in GP patient records to provide direct care to patients only.

Type of organisations that use GP Connect

Examples of organisations that may wish to use GP connect to view GP patient records include:

GP surgeries that patients are not registered at – for example, if they need to see a doctor when they are away from home
secondary care (hospitals) if they need to attend A&E or are having an operation
GP hubs/primary care networks (PCNs)/integrated care systems (ICSs), partnerships between healthcare providers and local authorities
local ‘shared care‘ record systems
ambulance trusts, so paramedics can view GP patient records in an emergency
healthcare professionals such as community services
acute and emergency care service providers
NHS 111
pharmacies
optometrists
dentistry
mental health trusts
hospices
adult and children’s social care
care and nursing homes

All access to your GP patient record is stored within an audit trail at your GP practice and within the organisation that information has been shared with.

Confidentiality

Confidentiality and trust are essential to the relationship between GPs and their patients.

The information a patient provides to their GP is confidential, and they can expect that any information that is shared for their direct care will remain confidential.

GP Connect relies on ‘implied consent’.

Explicit consent is not required when information is shared for a direct care purpose. If a patient does not want their information to be shared using GP Connect, they can opt out.

The NDSA and its terms and conditions stipulate that any information received or accessed about a patient for direct care purposes must remain confidential.

In addition to the NDSA, health and social care professionals are also subject to their own professional codes of confidentiality and are aware that any information received via GP Connect is provided in confidence, which must be respected.

Organisations using GP Connect are notified of their duty as ‘controllers’ to be fair and transparent about their processing of their patients’ information and to ensure that their transparency notices are fully updated with how they may be using GP Connect functionality.

NHS England helps support the mitigation of information sharing risks by ensuring that:

NHS England audit data access is subject to two-factor authentication and role-based access controls – only certain assured users can have access to the full audit logs
a completed Supplier Conformance Assessment List (SCAL) which covers service and capability specific compliance requirements and controls of the consumer system is in place

It is the responsibility of organisations using GP Connect to ensure that they comply with the NDSA, and their statutory and legal obligations regarding data protection and confidentiality.

Opting out of GP Connect

If patients do not wish their information to be shared using GP Connect, they can opt out by contacting their GP practice.

National Data Opt-Out

The National Data Opt-out is a service that allows patients to opt out of their confidential patient information being used for research and planning.

The National Data Opt-out only applies to any disclosure of data for purposes beyond direct care, so having National Data Opt-out will not prevent your GP patient record being shared via GP Connect.

Risk Stratification

Risk stratification data tools are increasingly being used in the NHS to help determine a person’s risk of suffering a condition, preventing an unplanned or (re)admission and identifying a need for preventive intervention. Information about you is collected from several sources including NHS Trusts and from this GP Practice. The identifying parts of your data are removed, analysis of your data is undertaken, and a risk score is then determined. This is then provided back to your GP as data controller in an identifiable form. Risk stratification enables your GP to focus on preventing ill health and not just the treatment of sickness. If necessary, your GP may be able to offer you additional services. Please note that you have the right to opt out of your data being used in this way in most circumstances, please contact the practice for further information about opt out.

Individual Risk Management at a GP practice level however is deemed to be part of your individual healthcare and is covered by our legal powers above.

Medicines Management

The Practice may conduct Medicines Management Reviews of medications prescribed to its patients. This service performs a review of prescribed medications to ensure patients receive the most appropriate, up to date and cost-effective treatments. The reviews are carried out by the ICBs Medicines Management Team under a Data Processing contract with the Practice.

Transferring the current paper medical records into patients’ electronic medical records.

The following provisions of the General Data Protection Regulation permit us to digitise existing paper medical records:

Article 6(1)(e) – ‘processing is necessary…in the exercise of official authority vested in the controller…’’

Article 9(2)(h) – ‘processing is necessary for the purpose of preventative…medicine…the provision of health or social care or treatment or the management of health or social care systems and services…’

The paper patient records will be shared with [Scanning provider], who will scan and digitise the current paper medical records before destroying them. The paper patient records will be shared with the scanning provider above, who will scan and digitise the current paper medical records before destroying them.

Anonymised information

Sometimes we may provide information about you in an anonymised form. Such information is used analyse population- level heath issues and helps the NHS to plan better services. If we share information for these purposes, then none of the information will identify you as an individual and cannot be traced back to you.

Research – National Institute for Health & Social Care Research (NIHR) – Clinical Research Network

Clinical Research Network West Midlands (CRN WM) provides a research delivery service to GP practices across the West Midlands. All CRN WM Delivery Support staff are employed by The Royal Wolverhampton NHS Trust. All NHS Staff members who have been allocated to work within the Practice will be issued with a Letter of access or assurance to confirm individual study placements and pre-employment checks.

The legal bases for processing this information

CRN WM processes data under the instruction of the individual research protocol, as delegated by the practice (data controller). You can opt out of being invited to participate in research at any time, please inform a member of the practice team and we will add the appropriate opt out code to your record.

Prior to informed consent:
The legal basis which allows us to process your personal data for research is GDPR article 6 (1)(f) …legitimate interests…except where such interests are overridden by the interests or fundamental rights and freedoms of the data subject…’

Once informed consent has been given:
The legal basis which allows us to process your personal data is informed consent – Article 6 1(a) the data subject has given consent to the processing of his or her personal data for one or more specific purposes; and Article 9 (2) (a) the data subject has given explicit consent to the processing those personal data for one or more specified purposes.

Individual study consent forms will detail how to withdraw consent and who to contact, this will usually be via the study sponsor.

Categories of personal data
The data processed by CRN WM delivery staff, in addition to demographic and contact details, is likely to be special category information (such as health information) to determine eligibility for individual research studies.

Recipients of data
The data processed by CRN WM delivery staff will be used to invite potentially eligible patients into research studies. Once patients have consented to participate, data processed by the CRN WM delivery staff will be used to answer the research questions as outlined in individual research protocols.

For further information, please refer to the Clinical Research Network West Midlands Privacy Notice: https://local.nihr.ac.uk/documents/crn-wm-privacy-notice-march-2021/27187

Summary Care Records

All patients registered with a GP have a Summary Care Record, unless they have chosen not to have one. The information held in your Summary Care Record gives registered and regulated healthcare professionals, away from your usual GP practice, access to information to provide you with safer care, reduce the risk of prescribing errors and improve your patient experience.

Your Summary Care Record contains basic (Core) information about allergies and medications and any reactions that you have had to medication in the past.

Some patients, including many with long term health conditions, previously have agreed to have Additional Information shared as part of their Summary Care Record. This Additional Information includes information about significant medical history (past and present), reasons for medications, care plan information and immunisations.

Change to information held in your Summary Care Record

In light of the current emergency, the Department of Health and Social Care has removed the requirement for a patient’s prior explicit consent to share Additional Information as part of the Summary Care Record.

This is because the Secretary of State for Health and Social Care has issued a legal notice to healthcare bodies requiring them to share confidential patient information with other healthcare bodies where this is required to diagnose, control and prevent the spread of the virus and manage the pandemic. This includes sharing Additional Information through Summary Care Records, unless a patient objects to this.

If you have already expressed a preference to only have Core information shared in your Summary Care Record, or to opt-out completely of having a Summary Care Record, these preferences will continue to be respected and this change will not apply to you. For everyone else, the Summary Care Record will be updated to include the Additional Information. This change of requirement will be reviewed after the current coronavirus (COVID-19) pandemic.

Why we have made this change

In order to look after your health and care needs, health and social care bodies may share your confidential patient information contained in your Summary Care Record with clinical and non-clinical staff in other health and care organisations, for example hospitals, NHS 111 and out of hours organisations. These changes will improve the healthcare that you receive away from your usual GP practice.

Your rights in relation to your Summary Care Record

Regardless of your past decisions about your Summary Care Record preferences, you will still have the same options that you currently have in place to opt out of having a Summary Care Record, including the opportunity to opt-back in to having a Summary Care Record or opt back in to allow sharing of Additional Information.

You can exercise these rights by doing the following:

Choose to have a Summary Care Record with all information shared. This means that any authorised, registered and regulated health and care professionals will be able to see a detailed Summary Care Record, including Core and Additional Information, if they need to provide you with direct care.
Choose to have a Summary Care Record with Core information only. This means that any authorised, registered and regulated health and care professionals will be able to see limited information about allergies and medications in your Summary Care Record if they need to provide you with direct care.
Choose to opt-out of having a Summary Care Record altogether. This means that you do not want any information shared with other authorised, registered and regulated health and care professionals involved in your direct care. You will not be able to change this preference at the time if you require direct care away from your GP practice. This means that no authorised, registered and regulated health and care professionals will be able to see information held in your GP records if they need to provide you with direct care, including in an emergency.

To make these changes, you should inform your GP practice or complete this form and return it to your GP practice.

Patient Communication

Because we are obliged to protect any confidential information, we hold about you and we take this very seriously, it is imperative that you let us know immediately if you change any of your contact details.

We may contact you using SMS texting to your mobile phone if we need to notify you about appointments and other services that we provide to you involving your direct care, therefore you must ensure that we have your up-to-date details. This is to ensure we are sure we are contacting you and not another person. As this is operated on an ‘opt out’ basis we will assume that you give us permission to contact you via SMS if you have provided us with your mobile telephone number. Please let us know if you wish to opt out of this SMS service. We may also contact you using the email address you have provided to us. Please ensure that we have your up-to-date details.

There may be occasions where authorised research facilities would like you to take part in research. Your contact details may be used to invite you to receive further information about such research opportunities.

The NHS App

We use the NHS Account Messaging Service provided by NHS England to send you messages relating to your health and care. You need to be an NHS App user to receive these messages. Further information about the service can be found at the privacy notice for the NHS App managed by NHS England.

Safeguarding

The Practice is dedicated to ensuring that the principles and duties of safeguarding adults and children are holistically, consistently, and conscientiously applied with the wellbeing of all, at the heart of what we do.

Our legal basis for processing For the General Data Protection Regulation (GDPR) purposes is: –

Article 6(1)(e) ‘…exercise of official authority…’.

For the processing of special categories data, the basis is: –

Article 9(2)(b) – ‘processing is necessary for the purposes of carrying out the obligations and exercising specific rights of the controller or of the data subject in the field of employment and social security and social protection law…’

Research

Clinical Practice Research Datalink (CPRD) collects de-identified patient data from a network of GP practices across the UK. Primary care data are linked to a range of other health related data to provide a longitudinal, representative UK population health dataset. You can opt out of your information being used for research purposes at any time (see below), full details can be found here: –

https://cprd.com/transparency-information

The legal bases for processing this information

CPRD do not hold or process personal data on patients; however, NHS Digital (formally the Health and Social Care Centre) may process ‘personal data’ for us as an accredited ‘safe haven’ or ‘trusted third-party’ within the NHS when linking GP data with data from other sources. The legal bases for processing this data are:

Medicines and medical device monitoring: Article 6(e) and Article 9(2)(i) – public interest in the area of public health
Medical research and statistics: Article 6(e) and Article 9(2)(j) – public interest and scientific research purposes

Any data CPRD hold or pass on to bona fide researchers, except for clinical research studies, will have been anonymised in accordance with the Information Commissioner’s Office Anonymisation Code of Practice. We will hold data indefinitely for the benefit of future research, but studies will normally only hold the data we release to them for twelve months.

Categories of personal data

The data collected by Practice staff in the event of a safeguarding situation will be as much personal information as is possible that is necessary to obtain in order to handle the situation. In addition to some basic demographic and contact details, we will also process details of what the safeguarding concern is. This is likely to be special category information (such as health information).

Sources of the data

The Practice will either receive or collect information when someone contacts the organisation with safeguarding concerns, or we believe there may be safeguarding concerns and make enquiries to relevant providers.

Recipients of personal data

The information is used by the Practice when handling a safeguarding incident or concern. We may share information accordingly to ensure duty of care and investigation as required with other partners such as local authorities, the police or healthcare professionals (i.e. their GP or mental health team).

Third party processors

To deliver the best possible service, the practice will share data (where required) with other NHS bodies such as other GP practices and hospitals. In addition, the practice will use carefully selected third party service providers. 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 include:

Companies that provide IT services & 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 to the Data Protection Officer as below.

How do we maintain the confidentiality of your records?

We are committed to protecting your privacy and will only use information collected lawfully in accordance with:

Data Protection Act 2018
The General Data Protection Regulations 2016
Human Rights Act 1998
Common Law Duty of Confidentiality
Health and Social Care Act 2012
NHS Codes of Confidentiality, Information Security and Records Management
Information: To Share or Not to Share Review

Every member of staff who works for an NHS organisation has a legal obligation to keep information about you confidential.

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), where the law requires information to be passed on and / or in accordance with the information sharing principle following Dame Fiona Caldicott’s information sharing review (Information to share or not to share) where “The duty to share information can be as important as the duty to protect patient confidentiality.” This means that health and social care professionals should have the confidence to share information in the best interests of their patients within the framework set out by the Caldicott principles.

Our practice policy is to respect the privacy of our patients, their families and our staff and to maintain compliance with the General Data Protection Regulation (GDPR) and all UK specific Data Protection Requirements. Our policy is to ensure all personal data related to our patients will be protected.

All employees and sub-contractors engaged by our practice are asked to sign a confidentiality agreement. The practice will, if required, sign a separate confidentiality agreement if the client deems it necessary. If a sub-contractor acts as a data processor for Strensham Road Surgery, an appropriate contract (art 24-28) will be established for the processing of your information.

In certain circumstances you may have the right to withdraw your consent to the processing of data. Please contact the Data Protection Officer in writing if you wish to withdraw your consent. If some circumstances, we may need to store your data after your consent has been withdrawn to comply with a legislative requirement.

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. Sometimes your information may be requested to be used for research purposes – the surgery will always gain your consent before releasing the information for this purpose in an identifiable format. In some circumstances you can Opt-out of the surgery sharing any of your information for research purposes.

With your consent we would also like to use your information

There are times that we may want to use your information to contact you or offer you services, not directly about your healthcare, in these instances we will always gain your consent to contact you. We would however like to use your name, contact details, and email address to inform you of other services that may benefit you. We will only do this with your consent. There may be occasions where authorised research facilities would like you to take part on innovations, research, improving services or identifying trends, you will be asked to opt into such programmes if you are happy to do so.

At any stage where we would like to use your data for anything other than the specified purposes and where there is no lawful requirement for us to share or process your data, we will ensure that you have the ability to consent and opt out prior to any data processing taking place.
This information is not shared with third parties or used for any marketing and you can unsubscribe at any time via phone, email or by informing the practice DPO as below.

National Opt-Out Facility

You can choose whether your confidential patient information is used for research and planning.

Who can use your confidential patient information for research and planning?

It is used by the NHS, local authorities, university and hospital researchers, medical colleges and pharmaceutical companies researching new treatments.

Making your data opt-out choice

You can choose to opt out of sharing your confidential patient information for research and planning. There may still be times when your confidential patient information is used: for example, during an epidemic where there might be a risk to you or to other people’s health. You can also still consent to take part in a specific research project.

Will choosing this opt-out affect your care and treatment?

No, your confidential patient information will still be used for your individual care. Choosing to opt out will not affect your care and treatment. You will still be invited for screening services, such as screenings for bowel cancer.

What should you do next?

You do not need to do anything if you are happy about how your confidential patient information is used.

If you do not want your confidential patient information to be used for research and planning, you can choose to opt out securely online or through a telephone service.

You can change your choice at any time. To find out more or to make your choice visit nhs.uk/your-nhs-data-matters or call 0300 303 5678

NHS Digital Data Collection from the Practice

The NHS needs data about the patients it treats to plan and deliver its services and to ensure that care and treatment provided is safe and effective. The General Practice Data for Planning and Research data collection will help the NHS to improve health and care services for everyone by collecting patient data that can be used to do this. For example, patient data can help the NHS to:

monitor the long-term safety and effectiveness of care
plan how to deliver better health and care services
prevent the spread of infectious diseases
identify new treatments and medicines through health research

GP practices already share patient data for these purposes, but this new data collection will be more efficient and effective.

This means that GPs can get on with looking after their patients, and NHS Digital can provide controlled access to patient data to the NHS and other organisations who need to use it, to improve health and care for everyone.

Contributing to research projects will benefit us all as better and safer treatments are introduced more quickly and effectively without compromising your privacy and confidentiality.

NHS Digital has engaged with the British Medical Association (BMA), Royal College of GPs (RCGP) and the National Data Guardian (NDG) to ensure relevant safeguards are in place for patients and GP practices.

NHS Digital purposes for processing patient data

Patient data from GP medical records kept by GP practices in England is used every day to improve health, care and services through planning and research, helping to find better treatments and improve patient care. The NHS is introducing an improved way to share this information – called the General Practice Data for Planning and Research data collection.

NHS Digital will collect, analyse, publish, and share this patient data to improve health and care services for everyone. This includes:

informing and developing health and social care policy
planning and commissioning health and care services
taking steps to protect public health (including managing and monitoring the coronavirus pandemic)
in exceptional circumstances, providing you with individual care
enabling healthcare and scientific research

Any data that NHS Digital collects will only be used for health and care purposes. It is never shared with marketing or insurance companies.

What patient data NHS Digital collect

Patient data will be collected from GP medical records about:

any living patient registered at a GP practice in England when the collection started – this includes children and adults
any patient who died after the data collection started, and was previously registered at a GP practice in England when the data collection started

While 1 September has been seen by some as a cut-off date for opt-out, after which data extraction would begin, Government has stated this will not be the case and data extraction will not commence until NHS Digital have met the tests.

The NHS is introducing three changes to the opt-out system which mean that patients will be able to change their opt-out status at any time:

Patients do not need to register a Type 1 opt-out by 1 September to ensure their GP data will not be uploaded
NHS Digital will create the technical means to allow GP data that has previously been uploaded to the system via the GPDPR collection to be deleted when someone registers a Type 1 opt-out
The plan to retire Type 1 opt-outs will be deferred for at least 12 months while we get the new arrangements up and running, and will not be implemented without consultation with the RCGP, the BMA and the National Data Guardian

We will not collect your name or where you live. Any other data that could directly identify you, for example NHS number, General Practice Local Patient Number, full postcode and date of birth, is replaced with unique codes which are produced by de-identification software before the data is shared with NHS Digital.

This process is called pseudonymisation and means that no one will be able to directly identify you in the data. The diagram below helps to explain what this means. Using the terms in the diagram, the data we collect would be described as de-personalised.

Image provided by Understanding Patient Data under licence.

NHS Digital will be able to use the same software to convert the unique codes back to data that could directly identify you in certain circumstances, and where there is a valid legal reason. Only NHS Digital has the ability to do this. This would mean that the data became personally identifiable data in the diagram above. An example would be where you consent to your identifiable data being shared with a research project or clinical trial in which you are participating, as they need to know the data is about you.

More information about when we may be able to re-identify the data is in the who we share your patient data with section below.

The NHS Digital programme will be providing further information as the programme progresses. In the meantime, if you have any questions, you can contact the programme at enquiries@nhsdigital.nhs.uk.

The NHS Digital web pages also provide further information at https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/general-practice-data-for-planning-and-research#additional-information-for-gp-practices.

The Data NHD Digital collect

We will only collect structured and coded data from patient medical records that is needed for specific health and social care purposes explained above.

Data that directly identifies you as an individual patient, including your NHS number, General Practice Local Patient Number, full postcode, date of birth and if relevant date of death, is replaced with unique codes produced by de-identification software before it is sent to NHS Digital. This means that no one will be able to directly identify you in the data.

NHS Digital will be able to use the software to convert the unique codes back to data that could directly identify you in certain circumstances, and where there is a valid legal reason. This would mean that the data became personally identifiable in the diagram above. It will still be held securely and protected, including when it is shared by NHS Digital.

NHS Digital will collect

data on your sex, ethnicity and sexual orientation
clinical codes and data about diagnoses, symptoms, observations, test results, medications, allergies, immunisations, referrals and recalls, and appointments, including information about your physical, mental and sexual health
data about staff who have treated you

More detailed information about the patient data we collect is contained in the Data Provision Notice issued to GP practices.

NHS Digital Does not collect.

your name and address (except for your postcode in unique coded form)
written notes (free text), such as the details of conversations with doctors and nurses
images, letters and documents
coded data that is not needed due to its age – for example medication, referral and appointment data that is over 10 years old
coded data that GPs are not permitted to share by law – for example certain codes about IVF treatment, and certain information about gender re-assignment

Opting out of NHS Digital collecting your data (Type 1 Opt-out)

If you do not want your identifiable patient data (personally identifiable data in the diagram above) to be shared outside of your GP practice for purposes except for your own care, you can register an opt-out with your GP practice. This is known as a Type 1 Opt-out.

Type 1 Opt-outs were introduced in 2013 for data sharing from GP practices but may be discontinued in the future as a new opt-out has since been introduced to cover the broader health and care system, called the National Data Opt-out. If this happens people who have registered a Type 1 Opt-out will be informed. More about National Data Opt-outs is in the section Who we share patient data with.

NHS Digital will not collect any patient data for patients who have already registered a Type 1 Opt-out in line with current policy. If this changes patients who have registered a Type 1 Opt-out will be informed.

If you do not want your patient data shared with NHS Digital, you can register a Type 1 Opt-out with your GP practice. You can register a Type 1 Opt-out at any time. You can also change your mind at any time and withdraw a Type 1 Opt-out.

Data sharing with NHS Digital will start on 1 September 2021.

If you have already registered a Type 1 Opt-out with your GP practice your data will not be shared with NHS Digital.

If you wish to register a Type 1 Opt-out with your GP practice before data sharing starts with NHS Digital, this should be done by returning this form to your GP practice. If you have previously registered a Type 1 Opt-out and you would like to withdraw this, you can also use the form to do this. You can send the form by post or email to your GP practice or call 0300 3035678 for a form to be sent out to you.

If you register a Type 1 Opt-out after your patient data has already been shared with NHS Digital, no more of your data will be shared with NHS Digital. NHS Digital will however still hold the patient data which was shared with us before you registered the Type 1 Opt-out.

If you do not want NHS Digital to share your identifiable patient data (personally identifiable data in the diagram above) with anyone else for purposes beyond your own care, then you can also register a National Data Opt-out. There is more about National Data Opt-outs and when they apply in the National Data Opt-out section below.

NHS Digital legal basis for collecting, analysing, and sharing patient data.

When we collect, analyse, publish, and share patient data, there are strict laws in place that we must follow. Under the UK General Data Protection Regulation (GDPR), this includes explaining to you what legal provisions apply under GDPR that allows us to process patient data. The GDPR protects everyone’s data.

NHS Digital has been directed by the Secretary of State for Health and Social Care under the General Practice Data for Planning and Research Directions 2021 to collect and analyse data from GP practices for health and social care purposes including policy, planning, commissioning, public health and research purposes.

NHS Digital is the controller of the patient data collected and analysed under the GDPR jointly with the Secretary of State for Health and Social Care.

All GP practices in England are legally required to share data with NHS Digital for this purpose under the Health and Social Care Act 2012 (2012 Act). More information about this requirement is contained in the Data Provision Notice issued by NHS Digital to GP practices.

NHS Digital has various powers to publish anonymous statistical data and to share patient data under sections 260 and 261 of the 2012 Act. It also has powers to share data under other Acts, for example the Statistics and Registration Service Act 2007.

Regulation 3 of the Health Service (Control of Patient Information) Regulations 2002 (COPI) also allow confidential patient information to be used and shared appropriately and lawfully in a public health emergency. The Secretary of State has issued legal notices under COPI (COPI Notices) requiring NHS Digital, NHS England and Improvement, arm’s-length bodies (such as Public Health England), local authorities, NHS trusts, Integrated Care Boards and GP practices to share confidential patient information to respond to the COVID-19 outbreak. Any information used or shared during the COVID-19 outbreak will be limited to the period of the outbreak unless there is another legal basis to use confidential patient information.

The legal basis under UKGDPR for General Practice Data for Planning and Research

How NHS Digital use patient data

NHS Digital will analyse and link the patient data we collect with other patient data we hold to create national data sets and for data quality purposes.

NHS Digital will be able to use the de-identification software to convert the unique codes back to data that could directly identify you in certain circumstances for these purposes, where this is necessary and where there is a valid legal reason. There are strict internal approvals which need to be in place before we can do this and this will be subject to independent scrutiny and oversight by the Independent Group Advising on the Release of Data (IGARD).

These national data sets are analysed and used by NHS Digital to produce national statistics and management information, including public dashboards about health and social care which are published. We never publish any patient data that could identify you. All data we publish is anonymous statistical data.

For more information about data, we publish see Data and Information and Data Dashboards.

We may also carry out analysis on national data sets for data quality purposes and to support the work of others for the purposes set out in Our purposes for processing patient data section above.

Who NHS Digital share patient data with

All data which is shared by NHS Digital is subject to robust rules relating to privacy, security, and confidentiality and only the minimum amount of data necessary to achieve the relevant health and social care purpose will be shared.

All requests to access patient data from this collection, other than anonymous aggregate statistical data, will be assessed by NHS Digital’s Data Access Request Service, to make sure that organisations have a legal basis to use the data and that it will be used safely, securely and appropriately.

These requests for access to patient data will also be subject to independent scrutiny and oversight by the Independent Group Advising on the Release of Data (IGARD). Organisations approved to use this data will be required to enter into a data sharing agreement with NHS Digital regulating the use of the data.

There are several organisations who are likely to need access to different elements of patient data from the General Practice Data for Planning and Research collection. These include but may not be limited to:

the Department of Health and Social Care and its executive agencies, including Public Health England and other government departments
NHS England and NHS Improvement
primary care networks (PCNs), Integrated Care Boards (ICBs) and integrated care organisations (ICOs)
local authorities
research organisations, including universities, charities, clinical research organisations that run clinical trials and pharmaceutical companies

If the request is approved, the data will either be made available within a secure data access environment within NHS Digital infrastructure, or where the needs of the recipient cannot be met this way, as a direct dissemination of data. We plan to reduce the amount of data being processed outside central, secure data environments and increase the data we make available to be accessed via our secure data access environment. For more information read about improved data access in improving our data processing services.

Data will always be shared in the uniquely coded form (de-personalised data in the diagram above) unless in the circumstances of any specific request it is necessary for it to be provided in an identifiable form (personally identifiable data in the diagram above). For example, when express patient consent has been given to a researcher to link patient data from the General Practice for Planning and Research collection to data the researcher has already obtained from the patient.

It is therefore possible for NHS Digital to convert the unique codes back to data that could directly identify you in certain circumstances, and where there is a valid legal reason which permits this without breaching the common law duty of confidentiality. This would include:

where the data was needed by a health professional for your own care and treatment
where you have expressly consented to this, for example to participate in a clinical trial
where there is a legal obligation, for example where the COPI Notices apply – see Our legal basis for collecting, analysing and sharing patient data above for more information on this
where approval has been provided by the Health Research Authority or the Secretary of State with support from the Confidentiality Advisory Group (CAG) under Regulation 5 of the Health Service (Control of Patient Information) Regulations 2002 (COPI) – this is sometimes known as a ‘section 251 approval’

This would mean that the data was personally identifiable in the diagram above. Re-identification of the data would only take place following approval of the specific request through the Data Access Request Service, and subject to independent assurance by IGARD and consultation with the Professional Advisory Group, which is made up of representatives from the BMA and the RCGP. If you have registered a National Data Opt-out, this would be applied in accordance with the National Data Opt-out policy before any identifiable patient data (personally identifiable data in the diagram above) about you was shared. More about the National Data Opt-out is in the section below.

Details of who we have shared data with, in what form and for what purposes are published on our data release register.

The practice one of many organisations working in the health and care system to improve care for patients and the public)[1].

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:

https://www.hra.nhs.uk/information-about-patients/ (which covers health and care research); and

https://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 / is not currently’ compliant with the national data opt-out policy[2]

Where do we store your information electronically?

All the personal data we process is processed by our staff in the UK however for the purposes of IT hosting and maintenance this information may be located on servers within the European Union.

No 3rd parties have access to your personal data unless the law allows them to do so and appropriate safeguards have been put in place such as a Data Processor as above). We have a Data Protection regime in place to oversee the effective and secure processing of your personal and or special category (sensitive, confidential) data.

EMIS Web

The Practice uses a clinical system provided by a Data Processor called EMIS, from 10^th June 2019, EMIS started storing your practice’s EMIS Web data in a highly secure, third-party cloud hosted environment, namely Amazon Web Services (“AWS”).

The data will remain in the UK at all times and will be fully encrypted both in transit and at rest. In doing this, there will be no change to the control of access to your data and the hosted service provider will not have any access to the decryption keys. AWS is one of the world’s largest cloud companies, already supporting numerous public sector clients (including the NHS), and it offers the very highest levels of security and support.

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.

NHS Trusts / Foundation Trusts
GP’s
Primary Care Network
NHS Commissioning Support Units
Independent Contractors such as dentists, opticians, pharmacists
Private Sector Providers
Voluntary Sector Providers
Ambulance Trusts
Integrated Care Boards
Social Care Services
NHS England (NHSE) and NHS Digital (NHSD)
Multi Agency Safeguarding Hub (MASH)
Local Authorities
Education Services
Fire and Rescue Services
Police & Judicial Services
Voluntary Sector Providers
Private Sector Providers
Other ‘data processors’ which you will be informed of

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

Computer System

This practice operates a Clinical Computer System on which NHS Staff record information securely. This information can then be shared with other clinicians so that everyone caring for you is fully informed about your medical history, including allergies and medication.

To provide around the clock safe care, unless you have asked us not to, we will make information available to our Partner Organisation (above). Wherever possible, their staff will ask your consent before your information is viewed.

Shared Care Records

To support your care and improve the sharing of relevant information to our partner organisations (as above) when they are involved in looking after you, we will share information to other systems. You can opt out of this sharing of your records with our partners at anytime if this sharing is based on your consent.

Sharing your information without consent

We will normally ask you for your consent, but there are times when we may be required by law to share your information without your consent, for example:

where there is a serious risk of harm or abuse to you or other people;
Safeguarding matters and investigations
where a serious crime, such as assault, is being investigated or where it could be prevented;
notification of new births;
where we encounter infectious diseases that may endanger the safety of others, such as meningitis or measles (but not HIV/AIDS);
where a formal court order has been issued;
where there is a legal requirement, for example if you had committed a Road Traffic Offence.

How long will we store your information?

We are required under UK law to keep your information and data for the full retention periods as specified by the NHS Records management code of practice for health and social care and national archives requirements.

More information on records retention can be found online at (https://digital.nhs.uk/article/1202/Records-Management-Code-of-Practice-for-Health-and-Social-Care-2016).

How can you access, amend move the personal data that you have given to us?

Right to object: If we are using your data and you do not agree, you have the right to object. We will respond to your request within one month (although we may be allowed to extend this period in certain cases). This is NOT an absolute right sometimes we will need to process your data even if you object.

Right to withdraw consent: Where we have obtained your consent to process your personal data for certain activities (for example for a research project, or consent to send you information about us or matters you may be interested in), you may withdraw your consent at any time.

Right to erasure: In certain situations (for example, where we have processed your data unlawfully), you have the right to request us to “erase” your personal data. We will respond to your request within one month (although we may be allowed to extend this period in certain cases) and will only disagree with you if certain limited conditions apply. If we do agree to your request, we will delete your data but will need to keep a note of your name/ other basic details on our register of individuals who would prefer not to be contacted. This enables us to avoid contacting you in the future where your data are collected in unconnected circumstances. If you would prefer us not to do this, you are free to say so.

Right of data portability: If you wish, you have the right to transfer your data from us to another data controller. We will help with this with a GP to GP data transfer and transfer of your hard copy notes.

Primary Care Network

The objective of primary care networks (PCNs) is for group practices together to create more collaborative workforces which ease the pressure of GP’s, leaving them better able to focus on patient care.

This practice is a member of Smartcare Central PCN. Other members of the network are:

Acocks Green Medical Centre

Cranes Park Road Surgery

Druids Heath Surgery

Greet Medical Practice

Homeless Health Exchange

Maypole Health Surgery (Y)

Oakwood Surgery

Springfield Surgery

The Balaji Surgery Sparkbrook CHC

Weather Oak Medical C entre

Primary Care Networks form a key building block of the NHS long-term plan. Bringing general practices together to work at scale has been a policy priority for some years for a range of reasons, including improving the ability of practices to recruit and retain staff; to manage financial and estates pressures; to provide a wider range of services to patients and to more easily integrate with the wider health and care system.

This means the practice may share your information with other practices within the PCN to provide you with your care and treatment.

Service Evaluation

The PCN carries out service evaluations in order to improve the quality and accessibility of primary care services. This may be carried out in a number of ways including telephone surveys, online surveys and interviews.

The legal basis for contacting you to take part –

Article 6, 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;”

To process the survey information, we collect from you we will only do so with your consent.

Article 6(1)(a) – Consent of the data subject (you)

Article 9(2)(a) – Explicit consent of the data subject. (you)’

Population Health Management

Population Health Management (or PHM for short) is aimed at improving the health of an entire population. It is being implemented across the NHS and this Practice is taking part in a project as a time limited pilot across named practices in Derby and Derbyshire.

The PHM approach requires health care organisations to work together with communities and partner agencies, for example, GP practices, community service providers, hospitals and other health and social care providers. These organisations will share and combine information with each other in order to get a view of health and services for the population in a particular area. This information sharing is subject to robust security arrangements.

As part of this programme, personal data about your health care will have all identifiers removed (like your name or NHS Number) and replaced with a code which will be linked to information about care received in different health care settings. If we see that an individual might benefit from some additional care or support, we will send the information back to your GP or hospital provider and they will use the code to identify you and offer you relevant services.

As part of this programme your GP and other care providers will send the information they hold on their systems to the North Of England Commissioning Support Unit (NECS). NECS are part of NHS England. More information can be found here https://www.necsu.nhs.uk

NECS will link all the information together. Your GP and other care providers will then review this information and make decisions about the whole population or particular patients that might need additional support. NECS work in partnership with a company called Optum to help them with this work. Both NECS and Optum are legally obliged to protect your information and maintain confidentiality in the same way that your GP or hospital provider is. More information about Optum can be found here www.optum.co.uk.

Health and Social Care Providers are permitted by data protection law to use personal information where it is ‘necessary for medical purposes’. This includes caring for you directly as well as management of health services more generally.

The PHM project is time-limited to 22 weeks. Once the project has completed all de-identified , information processed by NECS / Optum will be securely destroyed. This will not affect any personal information held by your GP or other health or social care providers.

Access to your personal information

Your request should be made to the Practice. (For information from a hospital or other Trust/ NHS organisation you should write direct to them.
There is no charge to have a copy of the information held about you
We are required to provide you with information within one month
You will need to give adequate information (for example full name, address, date of birth, NHS number and details of your request) so that your identity can be verified, and your records located information we hold about you at any time.

What should you do if your personal information changes?

Online Access

You may ask us if you wish to have online access to your medical record. However, there will be certain protocols that we have to follow to give you online access, including written consent and the production of documents that prove your identity.

Please note that when we give you online access, the responsibility is yours to make sure that you keep your information safe and secure if you do not wish any third party to gain access.

Third parties mentioned on your medical record

Sometimes we record information about third parties mentioned by you to us during any consultation, or contained in letters we receive from other organisations. We are under an obligation to make sure we also protect that third party’s rights as an individual and to ensure that references to them which may breach their rights to confidentiality, are removed before we send any information to any other party including yourself.

The NHS wants to give people better ways to see their personal health information online. We know that people want to be able to access their health records. It can help you see test results faster. It also lets you read and review notes from your appointments in your own time.

From 01/112022 we’re now letting you see all the information within your health record automatically. If you are over 16 and have an online account, such as through the NHS App, NHS website, or another online primary care service, you will now be able to see all future notes and health records from your doctor (GP). Some people can already access this feature, this won’t change for you.

This means that you will be able to see notes from your appointments, as well as test results and any letters that are saved on your records. This only applies to records from your doctor (GP), not from hospitals or other specialists. You will only be able to see information from [insert date that your practice will make the change]. For most people, access will be automatic, and you won’t need to do anything.

Your doctor (GP) may talk to you to discuss test results before you are able to see some of your information on the app. Your doctor (GP) may also talk to you before your full records access is given to make sure that having access is of benefit to you. There might be some sensitive information on your record, so you should talk to your doctor if you have any concerns.

These changes only apply to people with online accounts. If you do not want an online account, you can still access your health records by requesting this information through reception. The changes also only apply to personal information about you. If you are a carer and would like to see information about someone you care for, speak to reception staff.

The NHS App, website and other online services are all very secure, so no one is able to access your information except you. You’ll need to make sure you protect your login details. Don’t share your password with anyone as they will then have access to your personal information.

If you do not want to see your health record, or if you would like more information about these changes, please speak to your GP or reception staff.

Our website

The only website this Privacy Notice applies to is the Surgery’s website. If you use a link to any other website from the Surgery’s website then you will need to read their respective Privacy Notice. We take no responsibility (legal or otherwise) for the content of other websites.

The Surgery’s website uses cookies. For more information on which cookies we use and how we use them, please see our Cookies Policy.

CCTV recording

CCTV is installed on our practice premises covering both the external area of the building and the internal area excluding consulting rooms. Images are held to improve the personal security of patients and staff whilst on the premises, and for the prevention and detection of crime. The images are recorded onto an integral hard drive of the equipment and are overwritten on a rolling basis. Viewing of these digital images is password protected and controlled by the Practice Manager.

Telephone system

Our telephone system records all telephone calls. Recordings are retained for up to three years, and are used periodically for the purposes of seeking clarification where there is a dispute as to what was said and for staff training Access to these recordings is restricted to named senior staff.

Medical Examiner Service

Following the death of any patients of Strensham Road Surgery, we are now obliged to inform [Provider Trust] NHS Trust, Medical Examiner Service.

Medical examiner offices at acute trusts now provide independent scrutiny of non-coronial deaths occurring in acute hospitals. The role of these offices is now being extended to also cover deaths occurring in the community.

Medical examiner offices are led by medical examiners, senior doctors from a range of specialties including general practice, who provide independent scrutiny of deaths not taken at the outset for coroner investigation. They put the bereaved at the centre of processes after the death of a patient, by giving families and next of kin an opportunity to ask questions and raise concerns. Medical examiners carry out a proportionate review of medical records, and liaise with doctors completing the Medical Certificate of Cause of Death (MCCD).

The Practice will share any patient with the service upon request.

Objections / Complaints

Should you have any concerns about how your information is managed at the GP, please contact the GP Practice Manager or the Data Protection Officer as above. If you are still unhappy following a review by the GP practice, you have a right to lodge a complaint with a supervisory authority: You have a right to complain to the UK supervisory Authority as below.

Information Commissioner:

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

Tel: 01625 545745

https://ico.org.uk/

If you are happy for your data to be used for the purposes described in this privacy notice, then you do not need to do anything. If you have any concerns about how your data is shared, then please contact the Practice Data Protection Officer.

If you would like to know more about your rights in respect of the personal data we hold about you, please contact the Data Protection Officer as below.

Data Protection Officer:

The Practice Data Protection Officer is Paul Couldrey of PCIG Consulting Limited. Any queries regarding Data Protection issues should be addressed to him at: –

Email: Couldrey@me.com

Postal: PCIG Consulting Limited, 7 Westacre Drive, Quarry Bank, Dudley, West Midlands, DY5 2EE

Changes:

GP net earnings

All GP practices are required to declare the mean earnings (e.g. average pay) for GP’s working to deliver NHS services to patients at each practice.

Disclaimer: NHS England require that the net earnings of doctors engaged in the practice is publicised, and the required disclosure is shown below.

The average pay for GP’s working in the surgery for the last financial year was £54,628.

This figure is before tax, national insurance and pension contributions. This is made up of one full time GP and 3 part time GP’s.

Named GP

All patients at Strensham Road Surgery have a named, accountable doctor who is responsible for coordinating their care.

Your named doctor will be allocated to you by the practice. You can still talk to or make appointments to see any of our doctors or nurses, not just your named GP.

If you have a preference and would like to request a particular doctor at the practice to be your named GP please talk to one of our receptionists.

Patient confidentiality

We respect your right to privacy and keep all your health information confidential and secure. It is important that the NHS keeps accurate and up-to-date records about your health and treatment so that those treating you can give you the best possible care.

This information may be used for management and audit purposes. However, it is usually only available to, and used by, those involved in your care. You have the right to know what information we hold about you. If you would like to see your records please contact the Practice Manager.

Privacy notice

As data controllers, GPs have fair processing responsibilities under the Data Protection Act and GDPR law 2018. This means ensuring that your personal confidential data (PCD) is handled in ways that are safe, transparent and what you would reasonably expect. Please find links below.

Read our GDPR Patient Privacy notice or download a copy.

GP Patient Participation Group Privacy Notice 1 July 2023

COVID-19 Privacy Notice

Our Data Protection Officer: Paul Couldrey – Info@pcdc.org.uk

Safeguarding Adults at Risk of Harm

1	Introduction
2	Safeguarding Adults in General Practice
3	Impact Analyses
4	Scope
5	Policy Aim
6	Adult Safeguarding
7	Safeguarding Adult Principles
8	Categories of abuse
9	Adults with capacity
10	Adults who lack of mental capacity to make a specific decision, IMCA and DoLS
11	CONTEST and PREVENT
12	Roles and Responsibilities
13	Practice Arrangements
14	What to do if you have concerns about a vulnerable Adults welfare
15	Information Sharing
16	Recording Information
17	Implementation
18	Training and Awareness
19	Safer Employment
20	Managing Allegations against Staff
21	Whistle Blowing
22	Professional Challenge
23	Monitoring and audit
24	References

1. Introduction

1.1 Safeguarding is everyone’s responsibility and aims to protect people’s health, wellbeing and human rights, and enable them to live free from harm, abuse and neglect.

1.2 The aims of adult safeguarding are to:

stop abuse or neglect wherever possible;
prevent harm and reduce the risk of abuse or neglect to adults with care and support needs;
safeguard adults in a way that supports them in making choices and having control about how they want to live;
promote an approach that concentrates on improving life for the adults concerned;
raise public awareness so that communities as a whole, alongside professionals, play their part in preventing, identifying and responding to abuse and neglect;
provide information and support in accessible ways to help people understand the different types of abuse, how to stay safe and what to do to raise a concern about the safety or well-being of an adult; and
address what has caused the abuse or neglect.

1.3 The Care Act 2014 sets out the first ever statutory framework for adult safeguarding, stating that Local Authorities are required to make enquiries into allegations of abuse or neglect. Safeguarding is mainly aimed at people with care and support needs who may be in vulnerable circumstances and at risk of abuse or neglect by others. In these cases, local services must work together to identify those at risk and take steps to protect them.

1.4 Local authority statutory adult safeguarding duties apply equally to those adults with care and support needs regardless of whether those needs are being met, regardless of whether the adult lacks mental capacity or not, and regardless of setting.

1.5 The support and protection of vulnerable adults cannot be achieved by a single agency, every service has a responsibility. The Practice staff are not responsible for making a diagnosis of adult abuse and neglect, however they are responsible to share concerns appropriately and refer onto the relevant agency responsible for carrying out an assessment of need based on the safeguarding allegations.

1.6 This policy outlines how Strensham Road Surgery will fulfil their legal duties and statutory responsibilities effectively in accordance with safeguarding adult procedures of Birmingham Safeguarding Adults Board and/or Solihull Safeguarding Adults Board

2. Safeguarding Adults in General Practice

2.1 GPs are the first point of contact for most people with health problems, this sometimes includes individuals who are not registered but seek medical attention. Safeguarding adults is a complex area of practice. The client group is extremely wide, ranging from adults who are incapable of looking after any aspect of their lives, to individuals experiencing a short period of illness or disability. Individuals may have a wide range of services and service providers involved in their lives, making it difficult to identify those with responsibility.

2.2 GPs may be the first to recognise an individual’s health problems, carer related stress issues, or someone whose behaviour may pose a risk to vulnerable adults. The primary health care team may be the only professionals to have contact with vulnerable adults and it is important that any response taken is appropriate and timely, thereby preventing the potential long term effects of abuse and neglect.

2.3 It is essential that safeguarding adults is considered in line with the Mental Capacity Act 2005 which provides a statutory framework for people who lack capacity to make decisions for themselves. It sets out who can take decisions, in which situations, and how they should go about this. A person who lacks capacity may not always recognise that they are at risk of or are being abused or neglected.

3. Impact Analyses

3.1. Equality

3.1.1. In line with the Strensham Road Surgery Equality and Diversity Policies and Sustainability impact assessment, this policy aims to safeguard all adults who may be at risk of abuse, irrespective of disability, race, religion/belief, colour, language, birth, nationality, ethnic or national origin, gender or sexual orientation. Practice Equality and Diversity Policy.

3.1.2. All Practice Staff must respect the adult at risk’s (and their family’s/ carers) culture, religious beliefs, gender and sexuality. However this must not prevent action to safeguard adults who are at risk of, or experiencing, abuse.

3.1.3. All reasonable endeavours should be used to establish the adult at risk and their family/carer’s preferred method of communication, and to communicate in a way they can understand.

3.2. Bribery Act 2010

Due consideration has been given to the Bribery Act 2010 in the development of this policy and no specific risks were identified.

4. Scope

4.1. This policy applies to GP Partners and all staff employed by the Strensham Road Surgery including; all employees (including those on fixed-term contracts), temporary staff, bank staff, locums, agency staff, contractors, volunteers (including celebrities), students and any other learners undertaking any type of work experience or work related activity.

4.2. All Practice staff have an individual responsibility to safeguard and promote the welfare of individuals and must know what to do if concerned that an adult is at risk of being abused or neglected.

5. Policy Aim

5.1. The Practice adopts a zero tolerance approach to abuse and neglect and in doing so ensures that safeguarding the rights of adults at risk of abuse is integral to all we do.

5.2. This policy outlines how the Practice will fulfil its statutory responsibilities and ensure that there are in place robust structures, systems and quality standards for safeguarding adults, which are in line with Birmingham and Solihull Safeguarding Adult Boards procedures.

6. Adult Safeguarding

6.1. All adults (those over 18 years of age) have the right to live a life free from abuse and neglect. Abuse is a violation of an individual’s human and civil rights by any other person or persons.

6.2. Where someone is 18 or over but is still receiving children’s services and a safeguarding issue is raised, the matter should be dealt with through adult safeguarding arrangements. For example, this could occur when a young person with substantial and complex needs continues to be supported in a residential educational setting until the age of 25. Where appropriate, adult safeguarding services should involve the local authority’s children’s safeguarding colleagues as well as any relevant partners.

6.3. The safeguarding duties apply to an adult who:

has needs for care and support (whether or not the local authority is meeting any of those needs) and;
is experiencing, or at risk of, abuse or neglect;
and as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect

6.4. Consideration needs to be given to a number of factors; abuse may consist of a single act or repeated acts. It may be physical, verbal or psychological, it may be an act of neglect or an omission to act or it may occur when a vulnerable person is persuaded to enter into a financial or sexual transaction to which he or she has not consented to, or cannot consent. Abuse can occur in any relationship and may result in significant harm to, or exploitation of, the person subjected to it.

7. Principles of adult safeguarding

7.1. The Practice acknowledges the six principles of adult safeguarding and ensures these principles underpin Practice Staff safeguarding work

Empowerment; People being supported and encouraged to make their own decisions and informed consent.

“I am asked what I want as the outcomes from the safeguarding process and these directly inform what happens.”

Prevention; It is better to take action before harm occurs.

“I receive clear and simple information about what abuse is, how to recognise the signs and what I can do to seek help.”

Proportionality; The least intrusive response appropriate to the risk presented.

“I am sure that the professionals will work in my interest, as I see them and they will only get involved as much as needed.”

Protection; Support and representation for those in greatest need.

“I get help and support to report abuse and neglect. I get help so that I am able to take part in the safeguarding process to the extent to which I want.”

Partnership; Local solutions through services working with their communities. Communities have a part to play in preventing, detecting and reporting neglect and abuse.

“I know that staff treat any personal and sensitive information in confidence, only sharing what is helpful and necessary. I am confident that professionals will work together and with me to get the best result for me.”

Accountability; Accountability and transparency in delivering

“I understand the role of everyone involved in my life”

7.2 Making Safeguarding Personal

The adult should always be involved from the beginning of the enquiry unless there are exceptional circumstances that would increase the risk of abuse. If the adult has substantial difficulty in being involved, and there is no one appropriate to support them for the purpose of facilitating their involvement, then the practice must arrange for an independent advocate to represent them for the purpose of facilitating their involvement.

‘Making Safeguarding Personal’ involves

giving people the opportunity to discuss the outcomes they want at the start of the safeguarding process,
engaging them in discussions and planning throughout the process
following up discussions with people at the end of the process to see to what extent their desired outcomes have been met. This may be done in conjunction with Adult Social Care.

8. Categories of abuse

Physical abuse; including assault, hitting, slapping, pushing, misuse of medication, restraint or inappropriate physical sanctions including female genital mutilation.
Domestic violence; including psychological, physical, sexual, financial, emotional abuse. So called ‘honour’ based violence and forced marriage.
Sexual abuse; including rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting.
Psychological abuse; including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.
Financial or material abuse; including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
Modern slavery; encompasses slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.
Discriminatory abuse; including forms of harassment, slurs or similar treatment because of race, gender and gender identity, age, disability, sexual orientation or religion.
Organisational abuse; including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.
Neglect and acts of omission; including ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating
Self-neglect; this covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding.

9. Adults with capacity

9.1. A person’s ability to make a particular decision may at a particular time be affected by:

Duress and undue influence;
Lack of mental capacity.

9.2. There may be a fine distinction between a person who lacks the mental capacity to make a particular decision and a person whose ability to make a decision is impaired, e.g. by duress or undue influence or the perceived lack of any alternative choice. Nonetheless, it is an important distinction to make.

9.3. Safeguarding interventions must ensure that when an adult with mental capacity takes a decision to remain in an abusive situation, they do so without duress or undue influence, with an understanding of the risks involved, and with access to appropriate services should they change their mind. The exception to this principle would occur in situations where the decision may have been influenced by threat or coercion and consequently lack validity and need to be over-ridden.

10. Adults who lack mental capacity to make a specific decision.

10.1. The Mental Capacity Act (MCA) 2005 provides a statutory framework that underpins issues relating to capacity and protects the rights of individuals where capacity may be in question. MCA implementation is integral to safeguarding vulnerable adults.

10.2. The 5 principles of the MCA must be followed and are directly applicable to safeguarding:

A person must be assumed to have capacity unless it is established that they lacks capacity. Assumptions should not be made that a person lacks capacity merely because they appear to be vulnerable;
A person is not to be treated as unable to make a decision unless all practicable steps to help them do so have been taken without success. Empower individuals to make decisions about managing risks e.g. use communication aides to assist someone to make decisions; for example, choose the optimum time of day where a person with dementia may best be able to evaluate risks;
A person is not to be treated as unable to make a decision because they make an unwise decision. Individuals may wish to balance their safety with other qualities of life such as independence and family life. This may lead them to make choices about their safety that others may deem to be unwise but they have the right to make those choices;
An act or decision made under this Act for or on behalf of a person who lacks capacity must be done, or made, in their best interests. Best interest decisions in safeguarding take account of all relevant factors including the views of the individual, their values, lifestyle and beliefs and the views of others involved in their care;
Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s right and freedom of action. Any use of restriction and restraint must be necessary and proportionate to prevent harm to that individual. Safeguarding interventions need to balance the wish to protect the individual from harm with protecting other rights such as right to family life.

10.3. Deprivation of Liberty Safeguards

The practice will also consider whether a person is deprived or their liberty as defined by the MCA in its Deprivation of Liberty Safeguards. If this deprivation is thought to be unlawful, this will be reported to the Local Authority within a reasonable time frame of usually no longer than 48 hours. The Local Authority holds the legal power to process an application and make a Deprivation of Liberty Safeguard (DoLS) order where it is decided that a person’s freedom needs to be restricted in their best interests.

10.4. Independent Mental Capacity Advocate (IMCA)

An Independent Mental Capacity Advocate (IMCA) will be sought by the practice if the person lacking capacity has no one to represent them. Birmingham City Council has awarded the contract for IMCA services for patients to POhWER and for Solihull there is Solihull Action through Advocacy (see Appendix 1 for details).

An IMCA must be engaged if major treatment decisions are being made or if a change of residence is being considered. If a patient has no one to represent them during the course of a safeguarding investigation an IMCA should be used.

11. CONTEST and PREVENT (Radicalisation of vulnerable people)

11.1. Contest is the Government’s Counter Terrorism Strategy, which aims to reduce the risk from terrorism, so that people can go about their lives freely and with confidence.

11.2. Contest has four strands which encompass;

PREVENT; to stop people becoming terrorists or supporting violent extremism.
PURSUE; to stop terrorist attacks through disruption, investigation and detection.
PREPARE; where an attack cannot be stopped, to mitigate its impact.
PROTECT; to strengthen against terrorist attack, including borders, utilities, transport infrastructure and crowded places.

11.3. Prevent focuses on preventing people becoming involved in terrorism, supporting extreme violence or becoming susceptible to radicalisation. Alongside other agencies, such as education services, local authorities and the police, healthcare services have been identified as a key strategic partner in supporting this strategy.

11.4. Channel is a programme which focuses on providing support at an early stage to people who are identified as being vulnerable to being drawn into terrorism. The programme uses a multi-agency approach to protect vulnerable people by:

Identifying individuals at risk
Assessing the nature and extent of that risk
Developing the most appropriate support plan for the individuals concerned

11.5. Healthcare professionals may meet and treat people who are vulnerable to radicalisation, such as people with mental health issues or learning disabilities, who may have a heightened susceptibility to being influenced by others.

11.6. The key challenge for the health sector is to be vigilant for signs that someone has been or is being drawn into terrorism. GPs and their staff are the first point of contact for most people and are in a prime position to safeguard those people they feel may be at risk of radicalisation.

11.7. Practice staff who have concerns about that someone may be becoming radicalised must seek advice and support from the Safeguarding Lead and dedicated PREVENT Lead.

11.8. The GP Safeguarding Lead for Adult Safeguarding acts as the PREVENT lead for General Practice and will advise on concerns following the referral pathway in line with the policy and procedure.

The Practice PREVENT Lead is:

Dr. Ahmed Elsheikh

The PREVENT Lead for General Practice is:

Rosie Luce, Head of Safeguarding for BSolCCG 07899 065594

11.9. It is important to note that PREVENT operates within the pre-criminal space and is aligned to the multi-agency safeguarding agenda.

Notice: if you have a cause for concern about someone, perhaps their altered attitude or change in behaviour
Check: discuss concern with appropriate other (safeguarding lead)
Share: appropriate, proportionate information (safeguarding lead/PREVENT lead)

12. Roles and Responsibilities

12.1. The Safeguarding Adults Boards (SAB) are responsible for ensuring that;

partner agencies including the local authority, the NHS and the police, meet regularly to discuss and act upon local safeguarding issues;
- develop shared plans for safeguarding, working with local people to decide how best to protect adults in vulnerable situations;
- publish a safeguarding plan and report to the public annually on its progress, so that different organisations can make sure they are working together in the best way.
Undertake Safeguarding Adult Reviews in order to learn lessons where an adult has died or suffered significant harm as a result of abuse or neglect and multi-agency failure is indicated as playing a part

12.2. The Local Authority is responsible for making enquires, or asking others to make enquiries, when they think an adult with care and support needs may be at risk of abuse or neglect and to find out what, if any, action may be needed. This applies whether or not the authority is actually providing any care and support services to that adult.

12.3. The Practice team have a responsibility for recognising the potential signs and indicators of abuse, sharing information appropriately, and acting on concerns in a timely manner. The Practice recognises that safeguarding adults is a shared responsibility with the need for effective joint working between professionals and agencies. In order to achieve effective joint working there must be constructive relationships at all levels, promoted and supported by:

the commitment of all staff within the practice to safeguarding and promoting the welfare of adults;
clear lines of accountability within the practice for work on safeguarding;
practice developments that take account of the need to safeguard and promote the welfare of adults and is informed, where appropriate, by the views of the adult at risk and their families;
staff training and continuing professional development enabling staff to fulfil their roles and responsibilities, and have an understanding of other professionals and organisations in relation to safeguarding adults;
Safe working practices including recruitment and vetting procedures;
Effective interagency working, including effective information sharing

12.4. When an Adult Safeguarding Referral is not accepted by the Local Authority

There may be times when the Local Authority may not accept a safeguarding referral for a variety of reasons, so other measures may need to be taken to protect adults at risk of harm.

These may include:

Reviewing your Adult Safeguarding Referral to see if you can make your concerns clearer or add additional information and resend it
Assessment of either the adult’s service need or review of how the service is being delivered
Complaints investigation
Referral to CQC
Significant incident investigation within the practice
Disciplinary procedures
Referral to the local authority business management unit where there are concerns about the quality of a care provider
Police/criminal investigation
Whistleblowing

13. Practice Arrangements

13.1 Strensham Road Surgery has clearly identified lines of accountability within the practice to promote the work of safeguarding vulnerable adults within the practice. Safeguarding responsibilities will be clearly defined in all job descriptions and there are nominated leads for safeguarding adults.

13.2. The Practice Lead for Safeguarding Adults is:

Dr. Ahmed Elsheikh

The Deputy Practice Lead for Safeguarding Adults is:

Dr. Omar Elsheikh

The Administration Lead for managing Safeguarding data is:

Mrs. Hala Zendah – Practice Manager

0121 440 3720

13.3. The Practice Lead for Safeguarding Adults is responsible for;

Ensuring that they are fully conversant with the practice safeguarding adult policy, the policies and procedures of Safeguarding Adults Board; and the integrated processes that support safeguarding;
Facilitating training opportunities for staff groups (see Primary Care Training strategy) ;
Acting as a focus for external contacts on safeguarding adult and Mental Capacity Act matters; this may include requests to contribute to sharing information required for safeguarding adult reviews, domestic homicide reviews, multi-agency/ individual agency reviews and contribution to safeguarding investigations where appropriate;
Disseminating information in relation to safeguarding adults/Mental Capacity Act to all practice members;
Act as a point of contact for practice members to bring any concerns that they have, to document those concerns and to take any necessary action to address concerns raised;
Assess information received on safeguarding concerns promptly and carefully, clarifying or obtaining more information about the matter as appropriate;
Facilitate access to support and supervision for staff working with vulnerable adults and families;
Ensure that the practice team completes the practice’s agreed incident forms and analysis of significant events forms which are available on surgery computers under Z:\CQC Policies Makes recommendations for change or improvements in practice

13.4. The Practice Manager is responsible for ensuring that safeguarding responsibilities are clearly defined in all job descriptions. For employees of the practice, failure to adhere to this policy and procedures could lead to dismissal and/or constitute gross misconduct. The Practice Manager has a responsibility to ensure that Practice has a clear safer recruitment policy and that this is adhered to.

13.5. Partners are responsible for ensuring that;

safeguarding vulnerable adults is integral to clinical governance and audit arrangements within the practice;
the practice meets the contractual and clinical governance arrangements on safeguarding adults;
all practice staff are alert to the potential indicators of abuse or neglect, and know how to act on those concerns in line with local guidance;

13.6. GPs have an important role to play in safeguarding and promoting the welfare of adults. Identification of abuse has been likened to putting together a complex multi-dimensional jigsaw. GPs hold knowledge of family circumstances and can interpret multiple observations accurately recorded over time, and may be the only professionals holding vital pieces necessary to complete the picture.

The GMCs ‘Good medical practice code’ (2013) stresses the need for doctors to

protect patients and take prompt action if “patient safety, dignity or comfort is or may be seriously compromised”.

GPs contribution to multi-agency safeguarding adults meetings and other such meetings including Multi Agency Risk Assessment Conferences (MARAC) for cases of high risk domestic violence is important and supports guidance from the Royal College of General Practitioners.

Priority should be given to the attendance and a written report should be made available for meetings where the GP will not be in attendance
Consideration needs to be given when sharing information for these meeting with regard to appropriate information sharing i.e. with consent of adult at risk; or overriding consent if life-threatening situation or in wider public interest (See section 15 Information Sharing)

13.7. Practice nurses must ensure that Safeguarding is part of everyday nursing practice. The Nursing and Midwifery Council’s Code of Conduct states that Nurses should raise concerns immediately if they believe a person is vulnerable or at risk and needs extra support and protection’

The Code states that Nurses must:

take all reasonable steps to protect people who are vulnerable or at risk from harm, neglect or abuse
share information if you believe someone may be at risk of harm, in line with the laws relating to the disclosure of information, and
have knowledge of and keep to the relevant laws and policies about protecting and caring for vulnerable people

13.8. All Individual staff members, including partners, employed staff and volunteers have an individual responsibility to;

Be alert to the potential indicators of adult abuse or neglect and know how to act on those concerns in line with national guidance and the safeguarding adult procedures;
Be aware of and know how to access their local Safeguarding Adult Board’s policies and procedures for safeguarding adults;
Take part in training, including attending regular updates so that they maintain their skills and are familiar with procedures aimed at safeguarding adults and implementation of the Mental Capacity Act;
Understand the principles of confidentiality and information sharing in line with local and government guidance;
Contribute, when requested to do so, to the multi-agency meetings established to safeguard and protect vulnerable adults;

14. What to do if you have concerns about an Adult’s welfare or an adult tells you about abuse

14.1. Concerns about the wellbeing and safety of an Adult at Risk must always be taken seriously. Any Practice member of staff who first becomes aware of concerns of abuse must report those concerns as soon as possible and if possible within the same working day to the relevant senior manager/ safeguarding lead within the practice.

14.1.1. When an adult makes a disclosure it is important to reassure the adult at risk and that the information will be taken seriously. It is good practice to ensure that the adult is given information about what steps will be taken, including any emergency action to address their immediate safety or well-being.

14.1.2. When suspecting or having abuse reported to them by a patient or member of the public, practice staff will initially:

Remain calm and non-judgemental
Take immediate action to ensure the safety or medical welfare of the adult
Not discourage the adult from further disclosure
Use active listening skill, clarify the main facts and summarise what has been said to you
Remain supportive, sensitive and attentive
Give reassurance but do not press for more detail or make promises
Retain, record and report information
Ensure all potential evidence has been preserved
Inform the Practice Safeguarding Lead

14.1.2. The human rights and views of the adult at risk should be considered as a priority, with opportunities for their involvement in the safeguarding process to be sought in ensuring that the safeguarding process is person centred.

14.1.3. If an adult in need of protection or any other person makes an allegation to you asking that you keep it confidential, you should inform the person that you will respect their right to confidentiality as far as you are able to, but that you are not able to keep the matter secret and that you must inform your manager/safeguarding lead within the practice and the Local Authority safeguarding team.

14.1.4. If it is suspected that a crime could have been committed, it is important that you do not contact the person alleged to have caused harm or anyone that might be in touch with them. Contact the police 999 in an emergency or 101 for non-emergencies.

14.1.5. The disclosed information must be recorded in the health records in the way that the adult at risk describes the events.

14.1.6. Ability to consent to the safeguarding process should be determined by the person’s mental capacity at that specific time and their understanding of risk and consequences of their situation. In determining validity of consent to making a safeguarding adult alert, the possibility of threat or coercion from others should also be explored and considered.

14.1.7. There may be instances where a safeguarding alert can be made without an adult at risk’s consent, this could include circumstances where others could be at risk if the alert is not made or instances where a crime may have been committed. This is known as a public interest disclosure to share information. In circumstances where information is shared using public interest disclosure the ‘alerter’ must be able to justify their decision to raise an alert in that information is accurate, shared in a timely manner and necessary and proportionate to the identified risk.

14.1.8 If any member of the Practice team is unsure how to proceed or is in doubt about making an alert, the case can be discussed with a senior colleague/ line manager, Safeguarding Practice lead or a member of the Adult Safeguarding team.

14.2. Risk Assessment

14.2.1. It is best practice to raise an alert at the earliest opportunity of the allegation from when the abuse or neglect was witnessed or suspected. A preliminary risk assessment should be undertaken with the main objective to act in the adult at risks best interest and to prevent the further risk of potential harm. It is important to consider the following:

Is the adult at risk, still in the place where the abuse was alleged or suspected or is the adult about to return to the place where the abuse was alleged or suspected.
Will the person alleged to have caused harm have access to the adult at risk or others who might be at risk?
What degree of harm is likely to be suffered if the person alleged to have caused harm is able to come into contact with the adult at risk or others again?

14.2.2. Once the alert has been raised and if appropriate to be managed by the safeguarding process, the safeguarding plan sets out an individual risk assessment plan to ascertain what steps can be taken to safeguard the adult at risk, review their health or social care needs to ensure appropriate accessibility to relevant services and how best to support them through any action to seek justice or reduce the risk of further harm.

14.2.3 An adult who has capacity may choose to stay in an abusive situation or choose to not take part in the safeguarding process. In such a case the plan may therefore be centred around managing the risk of the situation with the person ensuring that they are aware of options to support their safety. Such cases will require careful monitoring and recording so it is recommended to seek advice if this occurs.

To seek further advice contact :

BSolCCG Safeguarding Team on 07730 318 300 Mon to Fri 9am to 5pm

14.2.5. Local Safeguarding Adult Board:

Birmingham https://www.bsab.org/

Solihull https://www.ssab.org.uk/

15. Information Sharing

15.1. Sharing of information is vital for early intervention and is essential to protect adults at risk from suffering harm from abuse or neglect. It is important that all practitioners understand when, why and how they should share information.

15.2. Always consider the safety and welfare of the adult at risk when making decisions on whether to share information about them. Where there is concern that the adult may be suffering or is at risk of suffering significant harm then their safety and welfare must be the overriding consideration.

15.3. Information may also be shared where an adult is at risk of serious harm, or if it would undermine the prevention, detection, or prosecution of a serious crime including where consent might lead to interference with any potential investigation.

15.4. Sharing the right information, at the right time, with the right people, is fundamental to good practice in safeguarding adults but has been highlighted as a difficult area of practice. It is important to keep a balance between the need to maintain confidentiality and the need to share information to protect others. Decisions to share information must always be based on professional judgement about the safety and wellbeing of the individual and in accordance with legal, ethical and professional obligations.

15.5. Ideally consent should be provided along with the request for adult health information however there are times when the concerns/risks to the adult are such that it is not appropriate to seek consent, principally as this may increase the risk of further abuse. A lack of consent should not prevent a GP or other practitioner within the Practice from sharing information if there is sufficient need in the public interest to override the lack of consent. Where the practitioner is uncertain advice about consent is available from the Safeguarding Practice Lead, Named GP, Nurse Consultant for Safeguarding in Primary Care, Designated Professional for Adult Safeguarding, the GMC, LMC or medical defence organisation

15.5. The ‘Seven Golden Rules’ of information sharing are set out in the Information Sharing Advice for practitioners providing safeguarding services to children, young people, parents and carers (2018) https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/721581/Information_sharing_advice_practitioners_safeguarding_services.pdf

This guidance is applicable to all professionals charged with the responsibility of sharing information, including in safeguarding adults scenarios.

Key points about information sharing:

The Data Protection Act is not a barrier to sharing information but provides a framework to ensure personal information about living persons is shared appropriately.
Be open and honest with the person/family from the outset about why, what, how and with whom information will be shared and seek their agreement, unless it is unsafe or inappropriate to do so.
Seek advice if you have any doubt, without disclosing the identity of the person if possible.
Share with consent where appropriate and where possible, respect the wishes of those who do not consent to share confidential information. You may still share information without consent, if, in your judgment, that lack of consent can be overridden by the public interest. You will need to base your judgment on the facts of the case, on considerations of the safety and well-being of the person and others who may be affected by their actions.
Necessary, proportionate, relevant, accurate, timely and secure, ensure that the information you share is necessary for the purpose for which you are sharing it, is shared only with those people who need to have it, is accurate and up to date, is shared in a timely fashion and is shared securely.
Keep a record of your concerns, the reasons for them and decisions. Whether it is to share information or not. If you decide to share, then record what you have shared, with whom and for what purpose

16. Recording Information

16.1. Where there are concerns about an adult’s welfare, all concerns, discussions and decisions made and the reasons for those decisions must be recorded in writing in the person’s medical records.

16.2. This Practice ensures that computer systems are used to identify those patients and families with risk factors or concerns using locally agreed Read Codes.

16.3. It is recognised that it is as important to be alert to the children and other members of the household as the adult there are direct concerns about.

16.4. The Practice has a dedicated Administration Team who are responsible for managing alerts and Safeguarding Adult information/ correspondence which is all held together within one health record.

17. Implementation

17.1. Practice staff will be advised of this policy through Practice meetings. The Safeguarding Adult Policy will be available via the Z:\CQC Policies

17.2. Breaches of this policy may be investigated and may result in the matter being treated as a disciplinary offence under the Practice disciplinary procedure.

18. Training and Awareness

18.1. The Practice’s induction for partners and employees will include a briefing on the Safeguarding Adult Policy by the Practice Manager or Practice Lead for Safeguarding. At induction new employees will be given information about who to inform if they have concerns about an Adult’s safety or welfare and how to access the Local Safeguarding Adult procedures.

18.2. All Practice staff must be trained and competent to be alert to potential indicators of abuse and neglect in Adults, know how to act on their concerns and fulfil their responsibilities in line with LSAB policy and procedures.

18.3. The Practice will enable staff to participate in training on adult safeguarding and promoting their welfare provided on both a single and interagency basis. The training will be proportionate and relevant to the roles and responsibilities of each staff member.

18.4. The Practice will keep a training database detailing the uptake of all staff training so that the Practice Manager and Safeguarding Leads can be alerted to unmet training needs.

18.5. All GPs and Practice staff should keep a learning log for their appraisals and or personal development plans

19. Safer Employment

19.1. The Criminal Records Bureau (CRB) and Independent Safeguarding Authority (ISA) functions have now merged to create the Disclosure and Barring Service (DBS).

19.2. The Practice recruitment process recognises that it has a responsibility to ensure that it undertakes appropriate criminal record checks on applicants for any position within the practice that qualifies for either an enhanced or standard level check. Any requirement for a check and eligibility for the level of check is dependent on the roles and responsibilities of the job.

19.3. The Practice recognises that it has a legal duty to refer information to the DBS if an employee has harmed, or poses a risk of harm, to vulnerable groups and where they have dismissed them or are considering dismissal. This includes situations where an employee has resigned before a decision to dismiss them has been made.

19.4. For further information see

https://www.homeoffice.gov.uk/agencies-public-bodies/dbs

https://www.nhsemployers.org/case-studies-and-resources/2014/08/an-employers-guide-to-using-the-dbs-update-service

19.5. Safer employment extends beyond criminal record checks to other aspects of the recruitment process including:

making clear statement in adverts and job descriptions regarding commitment to safeguarding
seeking proof of identity and qualifications
providing two references, one of which should be the most recent employer
evidence of the person’s right to work in the UK is obtained

20. Managing Allegations against Staff who have contact with Vulnerable Adults

20.1. Vulnerable adults can be subjected to abuse by those who work with them in any and every setting. All allegations of abuse or maltreatment of vulnerable adults by an employee, agency worker, independent contractor or volunteer will be taken seriously and treated in accordance with Safeguarding Adult Board policy and procedures (SAB).

20.2. The Practice safeguarding lead should, following consultation with the Designated Adult Safeguarding Manager, Local Authority Safeguarding Adults Enquiry Team and where appropriate the Police, inform the subject that allegations have been made against them without disclosing the nature of those allegations until further enquiry has taken place. If it is deemed appropriate to conduct an investigation prior to informing those who are implicated, clear record needs to be made of who took the decision and why.

20.3. Suspension of the employee concerned from their employment should not be automatic. Depending on the person’s role within the practice and the nature of the allegation it may be possible to step the person aside from their regular duties to allow them to remain at work whilst ensuring that they are supervised or have no patient/public contact. This is known as suspension without prejudice Suspension offers protection for them as well as the alleged victim and other service users, and enables a full and fair investigation/safeguarding risk assessment to take place. The manager will need to balance supporting the alleged victim, the wider staff team, the investigation and being fair to the person alleged to have caused harm.

20.4. All allegations should be followed up regardless of whether the person involved resigns from their post, responsibilities or a position of trust, even if the person refuses to co-operate with the process. Compromise agreements, where a person agrees to resign without any disciplinary action and agreed future reference must not be used in these cases.

20.5. If it is concluded that there is insufficient evidence to determine whether the allegation is substantiated, the chair of the safeguarding strategy meeting will ensure that relevant information is passed to the Practice Safeguarding lead. The senior manager of the practice will consider what further action, if any, should be taken in consultation with the Local Authority safeguarding lead for Managing Allegations and in line with the Practice HR procedures.

20.6. When an allegation of abuse or neglect has been substantiated, the Practice Safeguarding lead should consult with the Local Authority safeguarding team for advice and whether it is appropriate to make a referral to the professional or regulatory body and to the Disclosure and Barring Service (DBS), because the person concerned is considered unsuitable to work with Adults at Risk.

21. Whistle blowing

21.1. The Practice recognises that it is important to build a culture that allows practice staff to feel comfortable about sharing information, in confidence and with a lead person, regarding concerns about quality of care or a colleague’s behaviour. Direct to or insert link to the Practice Whistle Blowing Procedure.

22. Professional Challenge

22.1. This Practice enables and encourages any practice member that disagrees with an action taken and still has concerns regarding an adult at risk of abuse to either contact the Safeguarding Practice Lead, Nurse Consultant Safeguarding Primary Care, or the Designated Professional for Safeguarding Adults for independent reflection and support.

23. Monitoring and Audit

23.1. Audit of awareness of this safeguarding adult policy and processes will be undertaken the Practice Manager and Practice Safeguarding lead.

24. References

In developing this Policy account has been taken of the following statutory and non-statutory guidance:

Health and Social Care Act 2008 ( Regulated Activities ) regulations 2014 https://www.legislation.gov.uk/uksi/2014/2936/pdfs/uksi_20142936_en.pdf

HM Government (2015) Information Sharing Advice for practitioners providing safeguarding services to children, young people, parents and carers https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/419628/Information_sharing_advice_safeguarding_practitioners.pdf

HM Government (2015) Revised PREVENT Duty Guidance for England and Wales

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/445977/3799_Revised_Prevent_Duty_Guidance__England_Wales_V2-Interactive.pdf

HM Government (2014) The Care Act https://www.legislation.gov.uk/ukpga/2014/23/contents/enacted

Local Government Association 2014 Making Safeguarding Personal: Guide.

https://www.local.gov.uk/documents/10180/5854661/Making+Safeguarding+Personal+-+Guide+2014/4213d016-2732-40d4-bbc0-d0d8639ef0df

NHS England (2016) Safeguarding Adults: Roles and competences for health care staff Intercollegiate Document

https://www.england.nhs.uk/wp-content/uploads/2016/03/safeguarding-adults-intercollegiate.pdf

Mental Capacity Act 2005 https://www.legislation.gov.uk/ukpga/2005/9/contents

24. Appendix 1 INDEPENDENT MENTAL CAPACITY ADVOCACY (IMCA) details

For Residents of Birmingham

Birmingham IMCA provided by POhWER Birmingham

POhWER is a local user-led charity and will provide high quality advocacy services to vulnerable adults who meet the IMCA criteria. This includes people with learning disabilities, dementia, mental health needs and acquired brain injury. This is a free, confidential and independent service.

POhWER is open: Monday to Friday – 8am and 6pm. Outside these hours leave a message by phone or email.

You can contact POhWER by:

Telephone: 0300 456 2370 (charged at local rate)

Minicom: 0300 456 2364

Text: send the word “pohwer” with your name and number to 81025

Email: pohwer@pohwer.net

Skype: pohwer.advocacy

Fax: 0300 456 2365

Post: PO Box 14043, Birmingham, B6 9BL

For more information or to download a referral form visit the website at https://www.pohwer.net/in-your-area/where-you-live/birmingham

What happens next?

POhWER can deal with enquiries about IMCA eligibility and processes and can accept initial third-party referrals e.g. from nurses or care home managers, ensuring these are followed up with formal authorised instruction from the Decision Maker.

Referrals are allocated within 2 working days, or sooner. The allocated IMCA will arrange to meet with the service-user and discuss the case with the Decision Maker including agreeing appropriate timescales for completion of each individual case.

Feedback

POhWER takes feedback about their services seriously. You can feedback by contacting them as above or via the feedback section on their website:

https://www.pohwer.net/about-us/form/tell-us-what-you-think-about-our-services

Decision Makers can complete their required feedback for each IMCA case here:

https://www.pohwer.net/about-us/form/tell-us-what-you-think-about-our-services/record-of-decision-makers-feedback.htm

For Residents of Solihull

https://solihulladvocacy.org.uk/about-sata

Violent or abusive behaviour

Whistleblowing policy

This document and the information contained therein is the property of Strensham Road Surgery.

Introduction

Strensham Road Surgery helps protect the rights of its patients by providing a means for its employees to report any suspected malpractice, failure or malfunction at the Practice that could potentially endanger, or put at-risk, patients who use its services.

The means for the above procedure is provided through The Public Disclosure Act 1998; often referred to as the ‘Whistleblowing Act’. This Act provides protection for workers from being subjected to any detriment by their employer, and protection against victimisation and dismissal.

The Practice is committed to effectively and promptly dealing with any malpractice, failure or malfunction that occurs and has numerous policies, procedures and systems in-place to help prevent such occurrences.

The Practice follows the guidelines suggested in the revised version of the GMC document “Raising and acting on concerns about patient safety”, effective 12 March 2012, a copy of which can be downloaded here:

https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/raising-and-acting-on-concerns

The Practice will not tolerate victimisation, harassment or detriment to any worker who has exercised their right and raised a concern under the Act.

The Practice will ensure that all concerns raised are taken seriously and are fully investigated.

Detriment

The Practice recognises a detriment as any one of the following:

A restriction or a denial of promotion;
Facilities;
Training opportunities, or;
Opportunities which may have been offered if a disclosure had not been made.

Concerns

A malpractice, failure or malfunction which is believed to be currently occurring, has previously happened, or is likely to happen in the future will not be tolerated by this Practice, and includes such events as:

Any criminal offence;
Any breach of a legal obligation;
A miscarriage of justice;
Endangering the health or safety of any worker or patient;
Damage to the environment, or;
Any deliberate cover-up of information in relation to any of the above.

Confidentiality

The Practice will maintain complete confidentiality when any concerns are raised using the internal ‘Whistleblowing’ procedure.

Applicability

The ‘Whistleblowing’ policy and procedure applies to the following groups of workers:

Employees under regular contracts of employment;
Locums and other NHS contracted workers;
Contractors providing services;
Temporary or dayworkers;
Trainees on vocational and work experience schemes.

Procedure

The following procedure must be adopted when raising a concern:

If you wish to raise a malpractice, failure or malfunction which you believe to be currently occurring, has previously happened, or is likely to happen in the future, you must inform Ms. Hala Zendah – Practice Manager (in writing) of your concern;
If the above person is the subject of the concern you should inform their immediate superior (in writing) of your concern;
You should fully explain the nature and extent of your concern;
Your concern will be investigated fully and promptly and you will be advised of the progress by Ms. Hala Zendah.
On conclusion you will receive a written response to your concern detailing the outcome of the investigation;
If you are not satisfied with the investigation or the outcome of the investigation then you have the right to notify the appropriate prescribed person. Ms. Hala Zendah – Practice Manager holds a list of prescribed persons;
If you believe you have been subjected to victimisation, harassment or suffered a detriment (at any time) due to you raising a concern, then this is regarded as a serious disciplinary offence and will be dealt with in-line with normal Practice disciplinary procedure;
In the first instance you must inform Ms. Hala Zendah – Practice Manager (in writing) of your detriment;
If the above person is the subject of the detrimental behaviour, you should inform their immediate superior (in writing) of your detriment;
A full investigation into the suspected victimisation, harassment or detriment will then be conducted.

If we conclude that you have made false allegations, whether in relation to raising a concern maliciously, in bad faith or with a view to personal gain, then you will be subject to disciplinary action.

We have put this policy in place to allow you to raise concerns internally with the assurance that this will be dealt with adequately. We feel that this should mean that you will not need to make a disclosure externally.

The law recognises that in some instances external disclosures, to a regulator for example, will be required. We strongly encourage you to seek advice before reporting a concern to anyone external. The independent whistleblowing charity, public concern at work, operates a confidential helpline (0207 404 6609). They also have a list of prescribed regulators for reporting certain types of concern.

Practice Policies & Patient Information

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