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

All patients are entitled to have a chaperone present for any consultation, examination or procedure where they feel one is required. This chaperone may be a family member or friend. On occasions the patient or Clinician may require a formal chaperone to be present, i.e. a trained member of staff.

The practice requests that, wherever possible a patient makes a request for a formal chaperone when booking the appointment so that arrangements can be made and the appointment is not delayed. The practice will endeavour to provide a formal chaperone at the time of the request but it may occasionally be necessary to reschedule the appointment.

Your healthcare professional may require a chaperone to be present for certain consultations. This may include video consultations in some circumstances. Your healthcare professional will discuss this with you if it is needed.

A chaperone at this practice may be another doctor, a practice nurse, a health care assistant or a member of staff who has had chaperone training.

We have always welcomed constructive suggestions for improvement of our service. If you have a complaint about a specific episode we would like to hear about it, via our Patient Experience Champion. If you are pleased with the service, we would also like to know!

Gold Street Surgery aims to give a friendly and professional service to all our patients. However, if you have any concerns about any aspect of our service, please let us know. Speak to whoever you feel most comfortable with – your GP, our Patient Experience Champion or our reception staff will all be happy to help.

If you want to complain on behalf of someone else, a friend or a relative for example, we are likely to need their written consent to discuss their care with you.

In the majority of cases, concerns can be resolved quite easily. However, if you feel we have not dealt with the issues you have raised as you would wish, you can ask for a copy of our complaints procedure and complaints form, pick one up in reception, or download it below:

Complaint Form

It helps us if you can put your concerns in writing as it helps us clearly understand the problem and we can more easily discuss it with all those concerned. However, if this is not something you are happy to do, please don’t let it stop you raising a concern!

Please be assured that raising a complaint will not affect your future care. We take complaints very seriously, but see them as an opportunity to learn. Sometimes we may not be able to change things because they are dependent on factors outside our control, such as resources within healthcare or third-party services, but all formal complaints are discussed and reviewed by the surgery’s senior management.

For more general comments and suggestions, please use the suggestions box in Reception.

Alternatively, you can complain to NHS England on 0300 311 22 33 (Monday to Friday 8.00am to 6.00pm, excluding English Bank Holidays) or email: england.contactus@nhs.net or write to:

NHS England
PO Box 16738
Redditch
B97 9PT.

For further details about how to make a complaint to NHS England please visit the NHS England website.

www.england.nhs.uk/contact-us/complaint

If you remain dissatisfied with the outcome, you may refer the matter to:

Parliamentary and Health Service Ombudsman
Citygate
47-51 Mosley Street
Manchester
M2 3HQ

Tel: 0345 0154033

www.ombudsman.org.uk

We ask you for personal information so that you can receive appropriate care and treatment. This information is recorded securely on computer and we are registered under the Data Protection Act with the Information Commissioner’s Office. The practice will ensure that patient confidentiality is maintained at all times by all members of the practice team. However, for the effective functioning of a multi-disciplinary team, it is sometimes necessary that medical information about you is shared between members of the team. Please see also our “Fair Processing and Privacy Notice” on this website.

1. Gold Street Surgery recognises the right of every patient to have information about them kept secure and private.
2. Any information given to any member of staff will remain confidential.
3. In exceptional circumstances, permission from the patient will be sought before any information is disclosed.
4. The practice has a confidentially policy which is signed and adhered to by every member of staff. Patients have a right to the standards of confidentiality maintained by those providing their care and these standards should be made known at their first point of contact.

All patient information is considered to be confidential and we comply fully with the Data Protection Act 1998 and Caldicott principles. All employees in the practice have access to this information in relation to their role, have confidentiality clauses in their contracts of employment and have signed a confidentiality agreement. All staff members adhere to the Confidentiality: NHS Code of Practice 2003.

Where appropriate, patient information may be shared with other parties within the care team. However, they must be involved in the direct care of patients, based on implied consent. This will be on a “need to know” basis only and in order to ensure the safe, effective care of patients. Where a patient wishes information not to be shared within the team providing direct care, then they must discuss this with their GP.

Patient information will not be shared outside of the direct care team without consent being sought. An individual has the right to refuse to have their information disclosed, although this may have an impact on their care, and their wishes will be complied with.

It is imperative that when it is right to release details to 3rd parties that the information only includes what has been asked for and not necessarily the full record.

Medical information may be divulged to parents or guardians of children under 16 years, but this must not override the young person’s right to privacy. The patient’s best interests come first.

If you need to speak to someone in private then please tell the reception staff who will arrange this for you.

You do not have to say what it is about, we respect your privacy and right to confidentiality.

“Virtual” Consultations

A virtual consultation is a video or telephone appointment, which allows patients to speak to their clinicians without the need to travel to the surgery. Virtual consultations have played a particularly significant role during the coronavirus pandemic, and many patients appreciate their convenience.

Virtual consultations have often enabled continuity of services, for those with longer term conditions, and patients who are unable to travel (eg those in high risk groups), and has also allowed shielded staff and those in quarantine to work remotely. This has demonstrated that there are several benefits of using virtual consultations.

However, virtual consulting presents particular challenges for young people aged 10 to 25 and carries potential risks, such as safeguarding, confidentiality, and digital exclusion due to socio-economic status and access to technology.

If a virtual consultation is likely to involve either photographs or video that the patient is likely to perceive as intimate, or involving an intimate area, Gold Street Surgery clinicians will follow the principles laid out in the GMC guidance “Intimate Examinations and Chaperones“, and will ensure the consent of the patient, protection of their privacy (both in the patient’s surroundings and the clinician’s) to ensure that no-one can view or overhear the call without the patient’s explicit consent. In some circumstances either the Clinician or the patient may wish for an appropriate chaperone for a virtual consultation.

Your Information, Your Rights

Being transparent and providing accessible information to patients about how we will use your personal information is a key element of the Data Protection Act 2018 and the EU General Data Protection Regulations (GDPR).

The following notice reminds you of your rights in respect of the above legislation and how Gold Street Surgery will use your information for lawful purposes in order to deliver your care and the effective management of the local NHS system.

This notice reflects how we use information for:

• The management of patient records;
• Communication concerning your clinical, social and supported care;
• Ensuring the quality of your care and the best clinical outcomes are achieved through clinical Audit and retrospective review;
• Participation in health and social care research; and
• The management and clinical planning of services to ensure that appropriate care is in place for our patients today and in the future.

See the note at the bottom of this page for information specific to the current Coronavirus / COVID-19 pandemic and your data.

Data Controller

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

What information do we collect and use?

All personal data must be processed fairly and lawfully, whether is it received directly from you or from a third party in relation to the your care.

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

• ‘Personal data’ meaning any information relating to an identifiable person who can be directly or indirectly identified from the data. This includes, but is not limited to name, date of birth, full postcode, address, next of kin and NHS number

And

• ‘Special category / sensitive data’ such as medical history including details of appointments and contact with you, medication, emergency appointments and admissions, clinical notes, treatments, results of investigations, supportive care arrangements, social care status, race, ethnic origin, genetics and sexual orientation.

Your healthcare records contain information about your health and any treatment or care you have received previously (e.g. from an acute hospital, GP surgery, Community Care provider, mental health care provider, walk-in centre, social services). These records may be electronic, a paper record or a mixture of both. We use a combination of technologies and working practices to ensure that we keep your information secure and confidential.

Why do we collect this information?

The NHS Act 2006 and the Health and Social Care Act 2012 invests statutory functions on GP Practices to promote and provide the health service in England, improve quality of services, reduce inequalities, conduct research, review performance of services and deliver education and training. To do this we will need to process your information in accordance with current data protection legislation to:

• Protect your vital interests;
• Pursue our legitimate interests as a provider of medical care, particularly where the individual is a child or a vulnerable adult;
• Perform tasks in the public’s interest;
• Deliver preventative medicine, medical diagnosis, medical research; and
• Manage the health and social care system and services.

How is the information collected?

Your information will be collected electronically using secure NHS Mail or a secure electronic transfer over an NHS encrypted network connection. In addition physical information will be sent to your practice. This information will be retained within your GP’s electronic patient record or within your physical medical records.

Who will we share your information with?

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

• Local GP Practices in order to deliver extended primary care services
• NHS Trusts including Cambridge University Hospitals NHS Foundation Trust, Mid Essex Hospital Services NHS Trust, Princess Alexandra Hospital NHS Trust and Essex Partnership University NHS Foundation Trust
• 111 and Out of Hours Service
• Local Social Services and Community Care services
• Voluntary Support Organisations commissioned to provide services by West Essex Clinical Commissioning Group or Essex County Council

Your information will only be shared if it is appropriate for the provision of your care or required to satisfy our statutory function and legal obligations.

Your information will not be transferred outside of the European Union.

Whilst we might share your information with the above organisations, we may also receive information from them to ensure that your medical records are kept up to date and so that your GP can provide the appropriate care. In addition, we receive data from NHS Digital (as directed by the Department of Health) such as information on the uptake of flu vaccinations and disease prevalence in order to assist us to improve “out of hospital care” and health screening.

Third party processors

In order 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 includes:

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

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

How do we maintain the confidentiality of your records?

We are committed to protecting your privacy and will only use information that has been collected lawfully. Every member of staff who works for an NHS organisation has a legal obligation to keep information about you confidential. We maintain our duty of confidentiality by conducting annual training and awareness, ensuring access to personal data is limited to the appropriate staff and information is only shared with organisations and individuals that have a legitimate and legal basis for access.

Information is not held for longer than is necessary. We will hold your information in accordance with the Records Management Code of Practice for Health and Social Care 2016.

Consent and Objections

Do I need to give my consent?

The GDPR sets a high standard for consent. Consent means offering people genuine choice and control over how their data is used. When consent is used properly, it helps you build trust and enhance reputation. However consent is only one potential lawful basis for processing information. Therefore your GP practice may not need to seek your explicit consent for every instance of processing and sharing your information, on the condition that the processing is carried out in accordance with this notice. Your GP Practice will contact you if they are required to share your information for any other purpose which is not mentioned within this notice. Your consent will be documented within your electronic patient record.

What will happen if I withhold my consent or raise an objection?

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

Health Risk Screening / Risk Stratification

Health Risk Screening or Risk Stratification is a process that helps your GP to determine whether you are at risk of an unplanned Admission or deterioration in health. By using selected information such as age, gender, NHS number, diagnosis, existing long term condition(s), medication history, patterns of hospital attendances, admissions and periods of access to Community Care your GP will be able to judge if you are likely to need more support and care from time to time, or if the right services are in place to support the local population’s needs.

To summarise Risk Stratification is used in the NHS to:

• Help decide if a patient is at a greater risk of suffering from a particular condition;
• Prevent an emergency admission;
• Identify if a patient needs medical help to prevent a health condition from getting worse; and/or
• Review and amend provision of current health and social care services.

Your GP will use computer based algorithms or calculations to identify their registered patients who are at most risk, with support from the local Commissioning Support Unit (CSU) and/or a third party accredited Risk Stratification provider. The risk stratification contracts are arranged by West Essex Clinical Commissioning Group in accordance with current legal agreements. Neither the CSU nor your local CCG will at any time have access to your personal or confidential data. They will only act on behalf of your GP to organise the risk stratification service with appropriate contractual technical and security measures in place.

Your GP will routinely conduct the risk stratification process outside of your GP appointment. This process is conducted electronically and without human intervention. The resulting report is then reviewed by a multidisciplinary team of staff within the Practice. This may result in contact being made with you if alterations to the provision of your care are identified.

“Legal Agreements” above is where the Secretary of State for Health and Social Care has granted permission for personal data to be used for the purposes of risk stratification, in acknowledgement that it would overburden the NHS to conduct manual reviews of all patient registers held by individual providers.

As mentioned above, you have the right to object to your information being used in this way. However you should be aware that your objection may have a negative impact on the timely and proactive provision of your direct care. Please contact the Practice Manager to discuss how disclosure of your personal data can be limited.

Sharing of Electronic Patient Records within the NHS

Electronic patient records are kept in most places where you receive healthcare. Our local electronic systems (such as SystmOne, EMIS and Eclipse) enables your record to be shared with organisations involved in your direct care, such as:

• GP practices
• Community services such as district nurses, rehabilitation services, telehealth and out of hospital services.
• Child health services that undertake routine treatment or health screening
• Urgent care organisations, minor injury units or out of hours services
• Community hospitals
• Palliative care hospitals
• Care Homes
• Mental Health Trusts
• Hospitals
• Social Care organisations
• Pharmacies

In addition, NHS England have implemented the Summary Care Record which contains information including medication you are taking and any bad reactions to medication that you have had in the past.

In most cases, particularly for patients with complex conditions and care arrangements, the shared electronic health record plays a vital role in delivering the best care and a coordinated response, taking into account all aspects of a person’s physical and mental health. Many patients are understandably not able to provide a full account of their care, or may not be in a position to do so. The shared record means patients do not have to repeat their medical history at every care setting.

Your record will be automatically setup to be shared with the organisations listed above, however you have the right to ask your GP to disable this function or restrict access to specific elements of your record. This will mean that the information recorded by your GP will not be visible at any other care setting. You can also reinstate your consent at any time by giving your permission to override your previous dissent.

Invoice Validation

If you have received treatment within the NHS, the local Commissioning Support Unit (CSU) may require access to your personal information to determine which Clinical Commissioning Group is responsible for payment for the treatment or procedures you have received. Information such as your name, address, date of treatment and associated treatment code may be passed onto the CSU to enable them to process the bill. These details are held in a secure environment and kept confidential. This information is only used to validate invoices in accordance with the current Section 251 Agreement, and will not be shared for any further Commissioning purposes.

Your Right of Access to Your Records

The Data Protection Act and General Data Protection Regulations allows you to find out what information is held about you including information held within your medical records, either in electronic or physical format. This is known as the “right of subject access”. If you would like to have access to all or part of your records, you can make a request in writing to the organisation that you believe holds your information. This can be your GP, or a provider that is or has delivered your treatment and care. You should however be aware that some details within your health records may be exempt from disclosure, however this will in the interests of your wellbeing or to protect the identity of a third party. If you would like access to your GP record please submit your request in writing to:

Hugh Weller-Lewis
Practice Manager
Gold Street Surgery
Gold Street
Saffron Walden
CB10 1EJ

Complaints

In the event that your feel your GP Practice has not complied with the current data protection legislation, either in responding to your request or in our general processing of your personal information, you should raise your concerns in the first instance in writing to the Practice Manager as above.

If you remain dissatisfied with our response you can contact the Information Commissioner’s Office at Wycliffe House, Water Lane, Wimslow, Cheshire SK9 5AF – Enquiry Line: 01625 545700 or online at www.ico.org.uk

How the NHS and care services use your information

Gold Street Surgery is one of many organisations working in the health and care system to improve care for patients and the public.

Whenever you use a health or care service, such as attending Accident and Emergency or using Community Care services, important information about you is collected in a patient record for that service. Collecting this information helps to ensure you get the best possible care and treatment.

The information collected about you when you use these services can also be used and provided to other organisations for purposes beyond your individual care, for instance to help with:

• improving the quality and standards of care provided
• research into the development of new treatments
• preventing illness and diseases
• monitoring safety
• planning services

This may only take place when there is a clear legal basis to use this information. All these uses help to provide better health and care for you, your family and future generations. Confidential patient information about your health and care is only used like this where allowed by law.

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

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

To find out more or to register your choice to opt out, please visit www.nhs.uk/your-nhs-data-matters. On this web page you will:

• See what is meant by confidential patient information
• Find examples of when confidential patient information is used for individual care and examples of when it is used for purposes beyond individual care
• Find out more about the benefits of sharing data
• Understand more about who uses the data
• Find out how your data is protected
• Be able to access the system to view, set or change your opt-out setting
• Find the contact telephone number if you want to know any more or to set/change your opt-out by phone
• See the situations where the opt-out will not apply

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

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

understandingpatientdata.org.uk/what-you-need-know (which covers how and why patient information is used, the safeguards and how decisions are made)

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

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

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

Coronavirus / COVID-19

Gold Street Surgery is supporting vital coronavirus (COVID-19) planning and research by sharing your data with NHS Digital. For more information about this see: digital.nhs.uk/coronavirus/gpes-data-for-pandemic-planning-and-research/general-practice-transparency-notice

The Freedom of Information Act 2000 obliges the practice to produce a Publication Scheme. A Publication Scheme is a guide to the ‘classes’ of information the practice intends to routinely make available.

Gold Street Surgery publication of GP earnings 2022/23

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

The average pay for GPs working at the Gold Street Surgery in the last financial year before tax and national insurance is £94,568.

This is for 7 part time GPs who worked in the practice for more than 6 months.
It should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice, and should not be used to form any judgement about GP earnings, nor to make any comparison with any other practice.

My Care Record allows health and care professionals working directly with you to access your medical and social care information. This is to improve the care you receive.

Patient information and care records are usually made available through traditional methods such as secure post, fax or email. This can be slow and, at times, unreliable, and possibly prolong diagnosis and treatment.

My Care Record is accessed via secure but different health and care computer systems from different partner organisations. The information is requested from the original system and relayed to the health or care professional treating you.

By making your information available across the health and care system the direct care team including your GP practice, hospital team or community nurse will be able to see the most up-to-date, accurate information about you.

For example, if you were receiving care at one of the hospitals involved, the doctor treating you would be able to see your GP record on their own computer.

This will lead to:

• Better co-ordinated and seamless care
• Quicker diagnosis and treatment
• More time to spend on clinical care
• Less paperwork and less repetition
• Fewer unnecessary clinical tests
• More accurate prescriptions
• Safe and secure decision-making

My Care Record will only be used by professionals involved in your care. Full details on how My Care Record manage your information is available on their website: www.mycarerecord.org.uk as well as more information about where My Care Record is in operation, the organisations taking part and answers to frequently asked questions.

Fair Processing Notice

How we use your information

What is My Care Record?

In west Essex and Hertfordshire, providers of health and social care services are working more closely together to better co-ordinate the delivery of care to people supported by local commissioners.

My Care Record is a programme which allows people to give health and care professionals their permission to access their medical records during their treatment.

The people caring for you need to access about your health and care record in order to make the best decisions about your diagnosis and treatment. This could include GPs, hospital-based clinicians, nurses, health visitors and social workers.

To enable this to happen more quickly and to improve the care you receive, a new process has been put in place. This will allow your information to be accessed by different health and care organisations, using existing computer systems.

Your record will only be accessed by health and care professionals involved in your care.

Information will only be accessed with your permission – where applicable – and while you are receiving direct treatment by a health and care professional.

Information accessed through My Care Record is treated to the same security standards as all confidential information.

What information will be made available?

The record accessed is your health and care record. Examples of information that will be available include:

Name, address, NHS Number and phone number

• Medications
• Test results and investigations
• Correspondence
• Clinical history
• Emergency department treatment
• Future and past appointments
• Health plans and alerts
• Mental health alerts and diagnoses
• Social care lead co-ordinator and your care plan.

How is this information used?

The information available in the record from your care provider is in a chronological order so that your care provider can see a relevant history of your care. They will always update their own care record with any new information. This helps them to make better decisions about your care. Access is only with your explicit permission.

The organisations that could be involved in the service are:

• GP practices in west Essex and Hertfordshire
• Princess Alexandra Hospital Trust
• Essex Partnership University NHS Trust (EPUT)
• Hertfordshire Community NHS Trust
• Hertfordshire Partnership University NHS Foundation Trust
• East of England Ambulance
• IC24 (111 provider)
• Out of hours providers (such as PELC, HUC)
• Essex County Council and their care providers (such as Essex Cares)
• Hertfordshire County Council
• Other local hospitals (such as Addenbrooke’s, Whipps Cross, Broomfield, East and North Hertfordshire and West Hertfordshire Trusts)

You can tell your care provider if you don’t want them to make your information available by completing a form available on www.mycarerecord.org.uk or by asking your care provider for one. Your record will be edited and no information will be available to access.

Access to your information

My Care Record is simply a reflection of your individual records held by the organisations above and therefore you should contact them directly if you wish to have a copy of the information held about you. The contact details for each organisation’s Data Protection Officer or Team is below.

Contact details for data protection officers:

West Essex CCG on behalf of My Care Record

Building 3, Spencer Close, St Margaret’s Hospital, The Plain, Epping, CM16 6TN

Tel 01992566140

Email: weccg.comms@nhs.net

Princess Alexandra Hospital

Medical Records Manager, The Princess Alexandra Hospital NHS Trust, Hamstel Road, Harlow, Essex, CM20 1QX

Tel No: 01279 827341

Email: health.records@pah.nhs.uk

Essex Partnership University NHS Trust (EPUT)

Access to Records team, Mental Health Unit, Basildon Hospital, Nethermayne, Basildon, Essex, SS15 6NL

Tel No: 01268 246873 / 246889

Essex Social Care

Transparency Team, Essex County Council, PO Box 11, County Hall, Chelmsford, CM1 1QH

Hertfordshire Community NHS Trust

Access to records, Hertfordshire community NHS Trust, Unit 1a, Howard Court, 14 Tewin Road, Welwyn Garden City, AL7 1BW

Hertfordshire Social Care

Data Protection Team, Hertfordshire County Council, CHO150, County Hall, Pegs Lane, Hertford, SG13 8DF

Hertfordshire Partnership University NHS Foundation Trust

Records and Access to Information Team, Hertfordshire Partnership NHS Foundation Trust, 99 Waverley Road, St Albans, AL3 5TL

Tel No: 01727 804707 / 804228

Please contact your own General Practice directly for a copy of your GP record.

For further information on My Care Record please visit www.mycarerecord.org.uk.

All our patients are registered with one of our GPs as their named “Usual Doctor” when they join the surgery. This ensures that the same Clinician sees any clinic letters from hospital consultants etc, and can keep an overview of your care.

Blood test, ultrasound and X-Ray results are normally sent to the Clinician requesting them, but they are visible to any Clinician at either Gold Street or Great Chesterford.

From time to time, we may have to change the allocation of Doctors to ensure fairness of workload. We have over 10,000 patients and so are unable to write to everyone individually to advise them who their “Usual Doctor” is. Please ask any of our staff when contacting us should you wish to know. Having a named GP does not prevent you from seeing any other GP in the practice at any time, and all have access to your medical notes. You do not need to take any further action. If you want a particular GP to be your Usual Doctor, we’ll do our best to accommodate you, although we will have to consider their overall workload.

If you would like to see a specific GP please ask about their availability when booking an appointment. However, as most GPs work only part-time, there may be a delay before an appointment with your preferred GP is available.

These are the local standards set within this practice for the benefit of our patients. It is our job to give you treatment and advice. Following discussion with you, you will receive the most appropriate care, given by suitably qualified people. No care or treatment will be given without your informed consent. In the interest of your health, it is important for you to understand all the information given to you. Please ask us questions if you are unsure of anything.

The practice is committed to protecting children and vulnerable adults, and makes their welfare a priority. This will include working with other agencies where additional support is necessary. If you have any concerns about a child or vulnerable adult please speak to a GP or Practice Nurse. All information will of course be treated confidentially.

Our Responsibility To You

We are committed to giving you the best possible service.

• Names: People involved in your care will give you their names and ensure that you know how to contact them. The surgery is well signposted and the doctors’ names are indicated on their surgery doors.
• Waiting time: We run an appointment system in this practice. You will be given a time at which the doctor or nurse hopes to be able to see you. You should not wait more than 30 minutes in the waiting room without receiving an explanation for the delay.
• Access: You will have access to a doctor rapidly in case of emergency; 24 hours in cases of urgency; and otherwise within two working days if required. We will arrange a home visit as appropriate for those who are too ill or infirm to be brought to the surgery.
• Telephone: We will try to answer the phone promptly and to ensure that there are sufficient staff available to do this. You should be able to speak to a doctor by telephone, by arrangement.
• Test results: If you have undergone tests or x-rays ordered by the practice, we will inform you of the results at your next appointment. If no further appointment needs to be arranged, we will advise you when and how to obtain the results.
• Respect: Patients will be treated as individuals and partners in their healthcare, irrespective of their ethnic origin or religious and cultural beliefs.
• Information: We will give you full information about the services we offer. Every effort will be made to ensure that you receive that information which directly affects your health and the care being offered.
• Health promotion: The practice will offer patients advice and information on steps they can take to promote good health and avoid illness, and self-help which can be undertaken without reference to a doctor in the case of minor ailments.
• Health records: You have the right to see your health records, subject to limitations in the law. Records will be kept confidential at all times. Requests from other parties for such information will only be released with your written consent.

Help Us To Help You

• Please let us know if you change your name, address or telephone number.
• Please do everything you can to keep appointments. Tell us as soon as possible if you are unable to attend. Otherwise, other patients may have to wait longer.
• Remember that clinicians can usually only discuss one problem per 10 minute consultation.
• Please keep your phone call brief and avoid calling during the peak morning time for non-urgent matters.
• Test results take time to reach us, so please do not ring before you have been asked to do so. Enquiries about tests ordered by the hospital should be directed to the hospital, not the practice.
• We ask that you treat the doctors and practice staff with courtesy and respect.
• Please read our practice booklet along with this website. It will help you to get the best out of the services we offer. It is important that you understand the information given to you. Please ask us questions if you are unsure of anything.

PALS/CQC

The NHS Patient Advice and Liaison Service (PALS) provides an independent Advocacy service for advice and support. They can be contacted on 0800 783 3396.

Patients may make complaints or comments verbally or in writing, or through a representative.

The Care Quality Commission (CQC) can be contacted by phone: 0300616161
Or by e-mail: enquiries@cqc.org.uk. Website address www.cqc.org.uk

Patient Information

What Happens to information held about you?

This page explains how Gold Street Surgery uses and safeguards your personal information.

Gold Street Surgery keeps information about you and your care in various formats including both paper and computerised records. This includes your:

• Name
• Address
• Date of birth
• Contact details
• Next of kin

Your records are also identified by an NHS number, which can be used across the NHS.

Sharing your information with those looking after you, both inside and outside the Practice is a vital part of safe and effective care, but we also place the highest importance on maintaining its confidentiality.

How your information is stored and who has access to it is strictly regulated by the Data Protection Act 1998, NHS protocols and a code of confidentiality that is binding on all NHS staff. This includes procedures on storing your information securely, how long we keep it and when it is destroyed. Information about your care is also used to support local and national clinical audits, service improvements, education, contracting and research. However, the following conditions and exceptions may apply:

• For clinical audit, medical notes and computer files may be seen by members of the audit/clinical team when the information is first collected. It is then analysed for presentation to clinicians, who use it to improve patient care. Audit staff, like all others with access to your information, are legally bound to ensure confidentiality.
• If your personal information is to be used in research you will be asked for your consent. However, a specially appointed national body, the National Information Governance Board (NIGB), may allow personal details to be used without consent in specific circumstances when the research is seen to be in the public interest.
• Some details must be provided in relation to police investigations into a specific incident or crime, or in accordance with legal requirements.

In all these instances there are strict rules to ensure that the minimum information is used by as few individuals as possible. In emergency situations, or where consent is not possible, permission is only given after careful review by a senior staff member, known as the Caldicott Guardian, and his/her advisors ensure that any information is carefully considered, clearly justified and safely carried out.

If you supply us with a landline or mobile telephone number, we will, unless you advise us not to, use it to contact you. This could also include via a text message or voice message to you reminding you about appointments.

You may register an objection to uses of your information, and the Practice will use all practical measures to follow your wishes.

You also have the right to see your health records (a fee is chargeable), and to make corrections if necessary.

Please contact the Practice Manager on 01799 582620.

If you suffer harm through misuse of your information you may seek compensation.

Safeguarding Policy

The Gold Street Surgery is committed to protecting Children and Vulnerable Adults and we make their welfare our highest priority. Where additional support is necessary this will include working with other agencies. If you have any concerns about a child or vulnerable adult please speak to your GP or Practice Nurse.

Gold Street Surgery – Vulnerable Adult Statement

What is a vulnerable adult?

The definition is wide, however this may be regarded as anyone over the age of 18 years who may be unable to protect themselves from abuse, harm or exploitation, which may be by reason of illness, age, mental illness, disability or other types of physical or mental impairment.

Those at risk may live alone, be dependent on others (care homes etc.), elderly, or socially isolated.

Forms of abuse

• Neglect – ignoring mental or physical needs, care, education, or basic life necessities or rights
• Bullying – family, carers, friends
• Financial – theft or use of money or possessions
• Sexual – assault, rape, non-consensual acts (including acts where unable to give consent), touching, indecent exposure
• Physical – hitting, assault, man-handling, restraint, pain or forcing medication
• Psychological – threats, fear, being controlled, taunts, isolation
• Discrimination – abuse based on perceived differences and vulnerabilities
• Institutional abuse – in hospitals, care homes, support services or individuals within them, including inappropriate behaviours, discrimination, prejudice, and lack of essential safeguards

Abuse may be deliberate or as a result of lack of attention or thought, and may involve combinations of all or any of the above forms. It may be regular or on an occasional or single event basis, however it will result in some degree of suffering to the individual concerned. Abuse may also take place between one vulnerable adult and another, for example between residents of care homes or other institutions.

Indications

• Bruising
• Burns
• Falls
• Apparent lack of personal care
• Nervousness or withdrawn
• Avoidance of topics of discussion
• Inadequate living conditions or confinement to one room in their own home
• Inappropriate controlling by carers or family members
• Obstacles preventing personal visitors or one-to-one personal discussion
• Sudden changes in personality
• Lack of freedom to move outside the home, or to be on their own
• Refusal by carers to allow the patient into further care or to change environs
• Lack of access to own money
• Lack of mobility aids when needed

Where abuse of a vulnerable adult is suspected the welfare of the patient takes priority. In deciding whether to disclose concerns to a third party or other agency the GP will assess the risk to the patient. Ideally the matter should be discussed with the patient involved first, and attempt made to obtain consent to refer the matter to the appropriate agency. Where this is not possible, or in the case of emergency where serious harm is to be prevented, the patient’s doctor will balance the need to protect the patient with the duty of confidentiality before deciding whether to refer. The patient should usually be informed that the doctor intends to disclose information, and advice and support should be offered. Where time permits, the medical defence organisation will be telephoned before any action is taken.

Due regard will be taken of the patient’s capacity to provide a valid consent. (See also Consent Protocol)

In assessing the risk to the individual, the following factors will be considered:

• Nature of abuse, and severity
• Chance of recurrence, and when
• Frequency
• Vulnerability of the adult (frailty, age, physical condition etc.)
• Those involved – family, carers, strangers, visitors etc.
• Whether other third parties are also at risk (other members of the same household may being abused at the same time)

If any Patient suspects that an adult may be vulnerable and “at risk” please advise one of the Practice Partners, or a member of management – in strictest confidence.

Alternatively, you can report concerns via Social Care Direct 0345 6037630, email socialcaredirect@essex.gov.uk or see www.essexsab.org.uk

Practice Safeguarding Children and Young People Statement

Gold Street Surgery has a statutory duty of care towards children (Section 11 Children Act 2004) and young people at risk. We are committed to a best practice which safeguards children and young people irrespective of their background, and which recognises that a child may be abused regardless of their age, gender, religious beliefs, racial origin or ethnic identity, culture class, disability or sexual orientation.

Having safeguards in place within any organisation not only protects and promotes the welfare of children and young people at risk, but also enhances the confidence of staff, volunteers, parents/carers and the general public. Protecting children and young people from abuse and neglect, and exploitation, preventing impairment of health and development, and ensuring children grow up in circumstances consistent with the provision of safe and effective care enables them to have optimum life chances and enter adulthood successfully.

Gold Street Surgery is committed to safeguarding children and young people at risk and has a responsibility to ensure that practice staff know what to do if they encounter child or adult abuse or have concerns that they may be at risk of harm.

The practice is committed to working within agreed policies and procedures and in partnership with other agencies to ensure that the risk of harm to a child or young person is minimised. This work may include direct and indirect contact with children, (access to patient’s details, communication via email, text message/phone). This partnership also includes sharing information with partner agencies and services to ensure the best interests of the child are protected. While we would wish to do this with the consent of parents and/or carers wherever possible, there may be circumstances where information may need to be shared without consent.

Safeguarding – keeping children and vulnerable adults safe

Safeguarding is everyone’s responsibility – not just professionals. You can learn about Gold Street Surgery’s policies elsewhere on this website (see sidebar). but here some resources that may be helpful if you have concerns.

Safeguarding Resource Hub

Online Safety for children – what parents need to know (NSPCC article)

www.escb.co.uk (Essex Safeguarding Children Board)

www.nspcc.org.uk

NHS Pocket Guide to Adult Safeguarding (EXTERNAL PDF LINK)

www.essexsab.org.uk (Essex Safeguarding Adults Board)

www.essex.police.uk

www.essexcompass.org.uk (A partnership of domestic abuse services providing a response in Essex)

www.thenextchapter.org.uk (help for adults and children affected by domestic abuse)

If you have concerns about a child or an adult, please feel free to talk to a Clinician in confidence.

Sharing your records: your personal information

Information about you is used in a number of ways by the NHS and social care services to support your personal care and to improve health and social care services for everyone.

You can choose not to have anything that could identify you shared beyond your GP practice. You can also choose for the NHS not to share information it collects from all health providers any further.

If you have previously told your GP practice that you don’t want the NHS to share your personal confidential information for purposes other than your own care and treatment, your opt-out will have been implemented by the HSCIC or NHS Digital and will remain in place unless you change it.

Simply contact your GP either to register an opt-out or end an opt-out you have already registered and they will update your medical record. Your GP practice will also be able to confirm whether or not you have registered an opt-out in the past.

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. You can find out more and follow the links to opt out via the NHS Website:

digital.nhs.uk/services/national-data-opt-out

The national data opt-out allows a patient to choose that they do not want their confidential patient informationto be used for purposes beyond their individual care and treatment. Use of patient data for purposes beyond individual care is always subject to data protection legislation and the common law duty of confidentiality (CLDC) considerations, which are not changed by the national data opt-out. Further information can be found in Factsheet 1B – “Types of data used and legal protection in place”.

The national data opt-out policy and rules must be considered every time data is disclosed by health and care organisations for purposes beyond the individual’s care and treatment. The policy must be assessed against the lawful basis underpinning the use of the data, rather than the type of organisation the data is being provided to. The national data opt-out policy must also be considered when using confidential patient information within the same organisation where there is a change in purpose for the use of that information. When a national data opt-out has been set, there are circumstances when it must be applied, and the patient’s data cannot be used, and circumstances when the national data opt-out will not apply. The information below provides more information on those different circumstances. The national data opt-out will apply when:

• Confidential patient information is used for purposes beyond an individual’s care and treatment, AND
• The legal basis to use the data is approval under regulation 2 or 5 of the Control of Patient Information Regulations 2002, section 251 of the NHS Act 2006

Definition of individual care

Individual care was defined by the National Data Guardian (NDG) in her 2016 ‘Review of Data Security, Consent and Opt-Outs’ as:

“A clinical, social or public health activity concerned with the prevention, investigation and treatment of illness and the alleviation of suffering of individuals. It includes supporting individuals’ ability to function and improve their participation in life and society. It includes the assurance of safe and high-quality care and treatment through local audit, the management of untoward or adverse incidents, person satisfaction including measurement of outcomes undertaken by one or more registered and regulated health or social care professionals and their team with whom the individual has a legitimate relationship for their care” (www.gov.uk/government/publications/review-of-data-security-consent-and-opt-outs)

Section 251 approval

The Confidentiality Advisory Group (CAG) considers applications for the use of confidential patient information without patient consent under the following regulations of the Control of Patient Information Regulations 2002, section 251 of the NHS Act 2006:

• regulation 2 (processing for medical purposes related to the diagnosis or treatment of cancer); or
• regulation 5 (processing for general medical and research purposes) Both regulations are also subject to regulation 7, which sets out that the data must not be processed further than for the permitted purpose.

The national data opt-out will apply to approvals made by CAG under the NHS Act 2006 s251, which is in line with the standard conditions for the approval of applications under section 251 to allow opt-outs. In very limited and exceptional circumstances CAG can determine that no opt-out will apply to an approved use of data, where such a decision is made the national data opt-out will not apply.

For further information about section 251 approvals and CAG, see also Factsheet 1B – “Types of data used and legal protection in place”

The national data opt-out will not apply to uses beyond individual care and treatment in the following circumstances:

• When the data being used is anonymised such that it is considered to meet the requirements of the Information Commissioner’s Office (ICO) anonymisation code of practice. See: www.ico.org.uk/for-organisations/guide-to-data-protection/anonymisation.

The intent of anonymisation is to turn data into a form which does not directly identify individuals and where re-identification through its combination with other data is not likely to take place. The ICO’s anonymisation code of practice explains the issues surrounding the anonymisation of personal data, and the disclosure of data once it has been anonymised. The code provides good practice advice that will be relevant to all organisations that need to convert personal data into a form in which individuals are no longer identifiable. It is clear from the code that anonymisation does not need to be risk free but that data controllers need to mitigate the risk of re-identification until it is remote. It covers a range of types of anonymised data from aggregate data through to de-identified individual-level data and sets out how this can meet the legal tests required under the DPA when considering the risk of identification of an individual

This anonymisation code of practice will be reviewed by the ICO after the General Data Protection Regulations have come into force on 25 May 2018.

• When data is provided under a mandatory legal requirement.Such as when there is a court order, when the Care Quality Commission (CQC) use their statutory powers to request information in support of their inspection role, NHS Digital’s powers to collect information when directed (Health and Social Care Act 2012) or sharing for safeguarding cases (The Children Act 1989). For further examples of mandatory legal requirements when a national data opt-out would not apply, see the Operational Policy Guidance document published at: digital.nhs.uk/national-data-opt-out.
• When there is an overriding public interest.There are a small number of exceptional circumstances when clinicians, Caldicott Guardians and managers can decide to share information based on public interest. Such decisions about disclosures of information are made on a case-by-case basis and carefully consider the specific circumstances involved. Data controllers are expected to have existing arrangements in place to apply the public interest test where necessary, and the national data opt-out will not apply.

This also includes approvals made under regulation 3 of section 251, The Control of Patient Information Regulations 2002, which relate to the notification and use of identifiable data for monitoring and managing communicable diseases and risks to public health.

• When the patient has given explicit consent (to meet CLDC requirements) to the use of their data for the specific purpose e.g. they have consented to participate in a medical research study. This rule applies even if the consent may have been given before the patient had set a national data opt-out. It is important to recognise consent required to satisfy the CLDC is different to consent being used as the legal basis for processing data under the Data Protection Act. Further information about consent can be found in Factsheet 1B – “Types of data used and legal protection in place”.
• When data is provided to the services below, which operate a separate opt-out mechanism:The National Cancer Registration Service If a patient does not want their information to be provided to the National Cancer Registration Service and if they have not already done so, they will need to opt out of this data use separately. For more information about this service see www.gov.uk/guidance/national-cancer-registration-and-analysis-service-ncras

The National Congenital Anomalies and Rare Diseases Registration Service.If a patient does not want their information to be provided to the National Congenital Anomalies andRare Diseases Registration Service and if they have not already done so, they will need to opt out of this data use separately. For more details about this service and how to opt out see: www.gov.uk/guidance/the-national-congenital-anomaly-and-rare-disease-registration-service-ncardrs

• When the data is not confidential patient information See Factsheet 3 – “What data and organisations it applies to” for further explanation of confidential patient information. National data opt-out policy considerations for specific purposesThe NDG review made it clear that there are some elements of individual care which rely on the wider processing of data, for example screening and immunisation programmes, and risk stratification for case-finding. These purposes should be treated as for individual care and are therefore not subject to the national data opt-out.

National data opt-outs will not be applied when, for example:

• Data is provided for the oversight and provision of population health screening programmes. This refers to screening programmes that an independent expert group, the UK National Screening Committee (UK NSC), have advised that the NHS should offer.See Annex A for NHS screening programmes offered in 2018 in England.
• Data is provided for the purposes of risk stratification for case-finding, when carried out by a provider involved in an individual’s care. Further detail about considerations for risk stratification can be found in the National Data Opt-out Operational Policy Guidance document published at: digital.nhs.uk/national-data-opt-out.

Information to support payments and invoice validation

Wherever possible, anonymised data should be used for payment and invoice validation purposes. However, the NDG review set out the importance of accurately allocating NHS resources, and recommended that national data opt-outs will not apply when:

• Data is provided for non-contracted invoice validation. This refers to confidential patient information relating to health and care services provided by an organisation when there is no agreed contract in place with the patient’s responsible commissioner for those health and care services.

Further detail about considerations for payments and invoice validation can be found in the National Data Opt-out Operational Policy Guidance document published at: digital.nhs.uk/national-data-opt-out.

New contractual arrangements came into force on 1st April 2014 requiring GP practices to make available a statement of intent in relation to the following IT developments:

1. Summary Care Record (SCR)
2. GP to GP Record Transfers (GP2GP)
3. Patient Online Access to their GP Record
4. Data for Commissioning and other secondary care purposes

The same contractual obligations require that we have a statement of intent regarding these developments in place and publicised by 30th September 2014.

Please find below details of the arrangements Gold Street Surgery has in place for these developments.

Summary Care Record (SCR)

NHS England requires practices to enable successful automated uploads of any changes to patient summary information, at least on a daily basis, to the SCR or to have published plans to achieve this by 31st March 2015.

Having your SCR available to other service providers, such as hospitals, will help those treating you by allowing them to see a small part of your GP medical record. They will have access to information about any medication you may be taking and any allergies you may have.

Of course if you do not want your medical records to be available in this way then you will need to let us know so that we can update your record. If you have already advised us that you do not want a SCR available outside of the practice, you do not need to do so again, your records will have already been excluded from this. More details about the SCR can be found at www.nhscarerecords.nhs.uk

Gold Street Surgery confirms that your SCR is already automatically updated on at least a daily basis to ensure that your information is as up to date as it can possibly be.

GP to GP Record Transfers (GP2GP)

NHS England requires practices to use the GP2GP facility for the transfer of patient records between practices, when a patient registers or de-registers. This does not apply to temporary patient registrations.

It is very important that you are registered with a doctor at all times. If you leave your GP and register with a new GP, your medical records will be removed from your previous doctor and forwarded to your new GP via NHS England. It can take your paper records several weeks to reach your new practice.

With GP2GP transfers, your electronic record is transferred to your new practice much sooner.

Gold Street Surgery confirms that GP2GP transfers are already active and that we send and receive patient records via this system.

Patient Online Access to their GP Record

NHS England requires practices to promote and offer the facility to enable patient online access to appointments, prescriptions, allergies and adverse reactions or have published plans in place to achieve this by 31st March 2015.
Gold Street Surgery confirms that the facility to book and cancel appointments and to order repeat prescriptions is already active. If you do not already have a user name and password for this system, you can find more information on Patient Access on the practice website under “Online Services” or by asking at reception.

Gold Street Surgery will also be offering patients the facility to access their own summary information from their records relating to medication, allergies, adverse reactions and any other items that may have previously been agreed between the practice and the patient.

Data for Commissioning and other secondary care purposes

It is already a requirement of the Health & Social Care Act that practices must meet the reasonable data requirements of commissioners and other health and social care organisations through appropriate and safe data sharing for secondary usage, as specified in the technical specification for care data.

Gold Street Surgery has specific arrangements in place to allow patients to “opt out” of care.data if they wish to. Care.data allows patient data to be used outside of the practice. For further information about care.data please visit: www.nhs.uk/caredata. If you wish to opt out of this data sharing please contact reception.

Gold Street Surgery confirms these arrangements are already in place and that we undertake annual training and audits to ensure that all our data is handled correctly and safely via the Information Governance Toolkit.

March 2015

Summary Care Record – your emergency care summary

The NHS in England is introducing the Summary Care Record (SCR), which will be used in emergency care.

To ensure those caring for you have enough information to treat you safely, the record will contain information about any medicines you are taking, allergies you suffer from and any bad reactions to medicines you have had.

Your Summary Care Record will be available to authorised healthcare staff providing your care anywhere in England, but they will ask your permission before they look at it. This means that if you have an Accident or become ill, the doctors treating you will have immediate access to important information about your health.

As a patient you have a choice:

• Yes I would like a Summary Care Record – you do not need to do anything and a Summary Care Record will be created for you.
• No I do not want a Summary Care Record – get the opt out form. Please complete the form and hand it to a member of the GP practice staff.

If you need more time to make your choice you should let your GP Practice know.

Additional copies of the opt out form can be collected from the GP practice, printed from the website www.nhscarerecords.nhs.uk or requested from the dedicated NHS Summary Care Record Information Line on 0300 123 3020.

You can choose not to have a Summary Care Record and you can change your mind at any time by informing your GP practice.

If you do nothing we will assume that you are happy with these changes and create a Summary Care Record for you. Children under 16 will automatically have a Summary Care Record created for them unless their parent or guardian chooses to opt them out. If you are the parent or guardian of a child under 16 and feel that they are old enough to understand, then you should make this information available to them.

You can find out more by contacting www.nhscarerecords.nhs.uk or telephone the dedicated NHS Summary Care Record Information Line on 0300 123 3020.

If you’re particularly at risk of needing emergency medical care, for example, if you are getting older and have a history of falls or serious breathing problems, you can choose to have other useful information added to your SCR, including:

• Your illnesses and any health problems
• Operations and vaccinations you have had in the past
• How you would like to be treated – such as where you would prefer to receive care
• What support you might need
• Who should be contacted for more information about you.

All of these will help emergency or hospital doctors treat you, especially if you’re too unwell to tell them everything yourself or if you’re on your own.

What to do next

If you think you want to add other useful information to your SCR, talk to your GP practice. They will add it to your SCR and keep it up to date for you.

If there is information you don’t want adding, let your GP practice know.

For more information

• Talk to staff at your GP practice
• Call 0300 303 5678

Free Wi-Fi now available

Look up health information, download health apps and browse the internet.

Gold Street Surgery provides free publicly accessible WiFi at both its Gold Street and School Street sites. The service has been kindly provided by West Essex Clinical Commissioning Group. Use of the WiFi service is conditional, and by making use of the WiFi provided, you are indicating your agreement to the terms of the following contract:-

Patient WiFi Disclaimer

These are the terms and conditions on which your GP practice’s wireless internet access services (the “WiFi Service”) will be provided to you (the “Contract”). Please read the Contract carefully, so that you fully understand the WiFi Service that you are planning to use. By continuing to use the WiFi Service in your GP practice (the “Practice”) you agree to the terms and conditions of the Contract.

You will be able to access the WiFi Service using compatible portable devices.

References below to “we” or “us” are to your Practice.

Agreed Terms

1. Access to the Wifi Service

1.1 You may access the WiFi Service at no cost to you while you are attending our Practice but restrictions may apply including but not limited to the length of connection time. The WiFi Service is a service which we have chosen to make available to our patients, but we are under no obligation to do so and we may terminate this access at any time without notice to you.

1.2 The WiFi Service is a wireless data service which allows you to access data services when attending the Practice and within an appropriate distance of one of our hotspots.

1.3 You acknowledge that the WiFi Service is not a private network and that there is an inherent risk when using any publically accessible network that other people may be able to intercept or access your data.

1.4 You are responsible for all charges incurred when accessing any subscription based websites or other chargeable services and for all your other activities when using the WiFi Service.

1.5 You agree that we may modify, restrict, suspend or temporarily cease your access to the WiFi Service at any time in order to test the operation of the WiFi Service, carry out maintenance, technical repair, enhancement or emergency work or for any other reason.

2. Devices and Hotspots

2.1 In order to access the WiFi Service, device(s) must meet any minimum hardware, systems and software requirements and be in proper working condition (each a “Device”).

2.2 Although you should be able to access the WiFi Service when attending the Practice, the WiFi Service may not be available or fully operational at all times and its speed, quality and availability may vary.

2.3 The WiFi Service is intended for e-mail, instant messaging, browsing the internet and using apps. It is not intended for use with any service that requires a high speed or dedicated connection such as streaming media files or downloading large files. It should not be used for any use where a stable or reliable connection is required.

3. Use of the WiFi Service

3.1 The WiFi Service must not be used for any commercial or business purpose and you do not have the right to resell or enable access to any third party.

3.2 You must comply with our acceptable use terms as set out below in clause 6.

3.3 To protect the WiFi Service and maintain quality we may temporarily or permanently control or restrict your online activities where we consider that such activities may have a detrimental effect on others (e.g. sending “spam” messages or hosting a website).

3.4 You agree to indemnify us against all losses, liabilities, costs (including legal costs) and expenses which we may incur as a result of third party claims against us arising from, or in connection with, your misuse of the WiFi Service or breach of this Contract.

3.5 We may require you to reimburse us for any reasonable and foreseeable losses, costs and expenses which we incur as a direct result of the misuse of the WiFi Service by you.

4. Landing Pages

4.1 When you start using the WiFi Service you will access a bespoke landing page chosen by the Practice (the “Landing Page”).

4.2 The content of Landing Pages may be protected by intellectual property laws such as copyright and trade mark. The re-distribution, re-publication, or otherwise making available of such material to third parties is prohibited. Unauthorised use of the Landing Page may give rise to a claim against you for damages and/or be a criminal offence.

5. Changes to the WiFi Service

The WiFi Service is provided (subject to the terms of this Contract) without charge. We may change, replace or withdraw it at any time.

6. Acceptable Use Policy

6.1 We may block access to general categories of sites that may be deemed inappropriate for public environments or specific URLs for legal or contractual reasons. The type of site categories that we may block include, but is not limited to, those relating to drug use, pornography, offensive or illegal speech, network malfeasance and material intended for those aged over 18 years.

6.2 We may amend the list of categories in clause 6.1 from time to time.

6.3 You must ensure that you have in place at all times, on any Devices used to access the WiFi Service, adequate and appropriate protections against any computer software that contains any “time-bombs”, “worms”, “viruses”, “Trojan horses”, “protect codes”, “data destruct keys” or other programming devices that might, or might be used to, improperly access, modify, delete, damage, deactivate or disable any third party’s computer software, hardware or data.

6.4 You undertake to comply with generally accepted principles of online service usage (including when sending, receiving, storing, distributing, transmitting, posting, uploading or downloading any materials or data), whether governed by the laws of any jurisdiction or not, including never:

6.4.1 sending “spam” mail (i.e. unsolicited mass communications);

6.4.2 sending mail bombs, trojan horses, viruses, malware or other disruptive programs or devices;

6.4.3 pirating or otherwise illegally copying software or other proprietary material or infringing any intellectual property rights or any other proprietary right of any third party;

6.4.4 uploading or transmitting any material which constitutes harassment, is unlawful, hateful, obscene, libellous, threatening, offensive or defamatory;

6.4.5 engaging in activities which may be harmful to minors or which promote or encourage illegal or socially unacceptable or irresponsible behaviour;

6.4.6 violating the security of any website or network or engaging in unauthorised decryption of protected material;

6.4.7 engaging in activities with a fraudulent purpose or effect or which involve a user impersonating another person or otherwise misrepresenting himself as the source of any communication; or

6.4.8 damaging or risking damaging our name and/or reputation.

7. How Long Your Contract Lasts

7.1 This Contract commences when you indicate your acceptance of the terms and conditions of the Contract by continuing to use the WiFi Service. This Contract shall continue until terminated in a way set out in this Contract.

7.2 You can discontinue using the WiFi Service at any time which will also terminate this Contract.

7.3 Notwithstanding any other clause in this Contract, we may end your access to the WiFi Service at any time.

7.4 We may, at our discretion, immediately suspend or terminate the provision of the WiFi Service and/or this Contract if:

7.4.1 you breach any term or condition of this Contract;

7.4.2 we consider that you have committed or may be committing any fraudulent activity against us or against any other person or organisation through your use of the WiFi Service;

7.4.3 we are told to do so by the Government or other lawful regulatory authority or the emergency services; or

7.4.4 you act in a way towards our staff or agents which we consider to be inappropriate.

7.5 On termination of the Contract for any reason:

7.5.1 the accrued rights and liabilities of you and us as at termination and the continuation of any provision expressly stated to survive or implicitly surviving termination shall not be affected; and

7.5.2 the following clauses shall survive and continue in full force and effect: clauses 1, 3, 7, 8 and 10.

8. What we are not Liable for

8.1 Subject to clause 8.2, we will not be liable under this Contract to you for:

8.1.1 any defect in use of any Device used to access the WiFi Service;

8.1.2 any use made of the WiFi Service nor for any content accessed, sent or received using the WiFi Service, nor for any charges incurred with any third party or for any transactions entered into when using the WiFi Service, unless caused by us;

8.1.3 the act of suspending or terminating access to the WiFi Service in accordance with the terms of this Contract;

8.1.4 any delay or failure by us to provide any element of the WiFi Service;

8.1.5 any loss or damage caused by your use of the WiFi Service, us, or any of our respective officers, employees, sub-contractors or agents in circumstances where there is no breach of a contractual obligation or legal duty of care by us or any of our respective officers, employees, sub-contractors or agents; or such loss or damage is not a reasonably foreseeable result of any such breach;

8.1.6 any loss or damage caused by us, or any of our respective officers, employees, sub-contractors or agents to the extent that such loss or damage results from any breach by you of these terms and conditions;

8.1.7 the security of any data you transmit using the WiFi Service;

8.1.8 the accuracy, completeness, availability or timeliness of any information obtained via the internet (including, without limitation, information or links to other such information on the Landing Page) when using the WiFi Service;

8.1.9 any loss or damage caused by viruses or unauthorised use of, or attempts to access, the WiFi Service or by your Devices;

8.1.10 any loss or corruption of data, indirect or consequential loss, loss of business, contracts, profits, anticipated savings, reputation, or revenue or any other form of economic loss; or

8.1.11 any loss or damages if anyone else, other than you, gains access to your Devices.

8.2 Nothing in this Contract shall limit or exclude in any way any liability we may have to you for (a) death or personal injury as a result of our negligence, (b) fraudulent misrepresentation or (c) any other matter for which it would be illegal or unlawful for us to exclude or attempt to exclude our liability.

8.3 Subject to clauses 8.1 and 8.2, our total aggregate liability in contract, tort (including negligence or breach of statutory duty), misrepresentation, restitution or otherwise arising out of or in connection with this Contract will be limited to £1,000.00.

8.4 You shall at all times be under a duty to mitigate any losses you suffer.

9. How this contract can be transferred and Third Parties

9.1 We may assign the Contract or the WiFi Service we provide to you on the same terms to any third party.

9.2 You may not assign this contract or the benefit of the WiFi Service we provide to you unless we agree in writing.

10. Law and Geographical Limits

Please note that this Contract is governed by and construed in accordance with English law. You and we both agree to submit to the exclusive jurisdiction of the courts of England and Wales (save that if you are a resident of Northern Ireland you may also bring proceedings in Northern Ireland, and if you are resident of Scotland, you may also bring proceedings in Scotland).

LCC128EG-Practice Wifi Service Schedule Version 5: 25 April 2017.

The practice operates a zero-tolerance policy. Therefore aggression, violence and threatening behaviour will not be tolerated and may result in the offending patient’s removal from the practice list.

If that is the case a letter giving a full explanation for their removal from the list (containing details of the procedure for re-registering with an alternative practice) will be sent to the patient and a copy kept in their computer/medical record.

NHS staff should be able to come to work without fear of violence, abuse or harassment from patients or their relatives. In most cases, patients and their relatives are appreciative towards those who treat them but a minority of people are still abusive or violent towards staff. The NHS is committed to dealing with this problem and has a ‘zero tolerance’ attitude towards violence or aggressive behaviour. Gold Street Surgery unequivocally supports this policy. Offenders will usually be warned not to repeat their behaviour, but the surgery reserves the right to remove from its list without further warning repeat offenders or those who are physically or verbally violent towards staff, or who behave in a discriminatory manner.