Practice Policies

We make every effort to give the best service possible to everyone who attends our Practice.

However, we are aware that things can go wrong, resulting in a patient feeling that they have a genuine cause for complaint. If this is so, we would like the matter to be settled as quickly, and as amicably, as possible.

To have your complaint investigated, you need to complain within 12 months of the event happening, or as soon as you first become aware of the issue you want to complain about.

This time limit may be extended in special circumstances.

How do I raise a concern / informal complaint?

You can speak to any member of staff initially with your complaint. This gives you the opportunity to resolve any concern you may have without it going through a formal process.

Most complaints are best resolved within the practice, and these should be made via the Practice Management Team. These can either be made in writing or can be submitted using the form below.

What happens next?

What we will do

We will acknowledge your complaint within three working days, investigate the concerns you raised and will respond as soon as possible.

We will:

• • Find out what happened and what went wrong

• • Invite you to discuss the problem with those involved, if you would like this

• • Apologise where this is appropriate

• • Identify what we can do to make sure that the problem does not happen again.

If you feel you do not want to contact the surgery directly, or are unhappy with the outcome of your complaint, you can contact The NHS complaints team

Complain to the Ombudsman

If, after receiving our final decision, you remain dissatisfied you may take your complaint to the relevant Ombudsman.

The Ombudsman is independent of the NHS and free to use. It can help resolve your complaint and tell the NHS how to put things right if it has got them wrong.

The Ombudsman only has legal powers to investigate certain complaints. You must have received a final response from the Practice before the Ombudsman can look at your complaint and it will generally not investigate your complaint if it happened more than 12 months ago, unless there are exceptional circumstances.

Making a complaint | Parliamentary and Health Service Ombudsman (PHSO)

Phone: 0345 015 4033

Independent Complaints Advocacy Service (ICAS)

ICAS helps people who want to make a complaint about the NHS through the NHS Complaints Procedure. Our service is free and independent whatever level of support you require from us.

Complaints resolution staff at your Practice should give you further information about making a complaint and assist you in contacting ICAS, should you require help with your complaint from outside the NHS.

Please refer to the NHS England website for more information.

Overview – Icas (Independent Complaints Advocacy Service) Io Hertfordshire And Bedfordshire – NHS (www.nhs.uk)

Telephone: 0300 330 5454

Confidentiality

All complaints will be treated in the strictest confidence.

Where the investigation of the complaint requires consideration of the patient’s medical records, we will inform the patient or person acting on his/her behalf if the investigation will involve disclosure of information contained in those records to a person other than the Practice or an employee of the Practice.

We keep a record of all complaints and copies of all correspondence relating to complaints, but such records will be kept separate from patients’ medical records.

Statistics and reporting

The Practice must submit to the local primary care organisation periodically/at agreed intervals details of the number of complaints received and actioned.

Patient Advice and Liaison Service

The Patient Advice and Liaison Service (PALS) within the hospital setting offers confidential advice, support and information on health-related matters. They provide a point of contact for patients, their families and their carers.

Further information on raising a complaint with PALS or other NHS services can be found on the NHS website.

How to complain to the NHS – NHS (www.nhs.uk)

• • The website Schopwick Surgery is www.schopwicksurgery.co.uk

• • I understand that I choose to make use of the electronic communication service with Schopwick Surgery.

• • I understand that any electronic communications from me will only be seen by staff at Schopwick Surgery and that any communication will be added to my clinical notes in the same way that any written communication would be.

• • I understand it is my responsibility to inform the surgery of any changes to my email address or mobile phone number and that Schopwick Surgery is not responsible for onwards use or transmission of email or text messages once it has been received by me.

• • I give permission for my email and mobile phone number to be used by Schopwick Surgery to communicate with me about relevant issues regarding my health. Schopwick Surgery may wish to contact me in the future regarding any forthcoming appointments, reminders about my treatments including medications and health promotion.

• • I understand that there is a possibility (however small) that my emails and the responses could be intercepted and read by someone else. I will bear this in mind in deciding how much information to seek and how much information to disclose by email.

• • Schopwick Surgery advises me to use a private email address (rather than a shared business or family address) to contact the surgery.

• • I understand that if I require urgent clinical advice or attention I should contact the surgery using the Online Services platform PATCHS, by telephone or in person.

• • I understand that under no circumstances will Schopwick Surgery pass on my personal contact details to any other third party without my express permission.

Giving us consent to use your Mobile number and email for correspondence – Guidance for patients and service users.

The practice may use email and text messaging to contact you with:

• • Appointment reminders

• • Appointment letters

• • Individual invites to screening, medication reviews, vaccination appointments and long term condition reviews

• • Test result notifications/advice to call the practice where action is needed

• • Clinical advice

• • Friends and family test surveys

• • Interactive messages with the ability to confirm/cancel appointments.

You can choose not to receive emails and text messages from us. If you make this decision, it will be noted on your record so other members of staff know how you wish to be contacted. You can change your mind at any time by informing us.

Please see our Privacy Policy for details about how we store, process and share this with other care organisations.

There are benefits to using email and text messages to communicate with your health and care provider as it:

• • Provides an easy, low-cost way for you to contact your health and care provider

• • Saves you time waiting on the phone to get through

• • Supports people with hearing difficulties and other sensory impairments.

Things to consider

You should consider the following before agreeing to use emails and text messages for communications with your health and care provider.

• • Does anyone else have access to your phone or email and if so, would you be happy for them to see any messages you may receive?

• • Health and care providers use encrypted emails which means that no one can see or tamper with the data while it is being transferred across the network or internet. Your own emails to us may not be encrypted.

• • You are responsible for ensuring that you provide the correct email address and mobile number. Please inform us of any changes. This will ensure you don’t miss any information and it avoids information going astray should it be sent to the wrong email or phone number.

Be careful of spam texts or emails that might come from people posing as a health or care organisation. We will always make it clear that the email or text message is from us and will provide information in advance about what you may be texted or emailed about.

If you are unable to receive email/text messages or choose not to, then you can continue to use other communication methods such as telephone calls & PATCHS

Our Practice aims to provide quality, consistent primary care for all patients. We strive to meet the high standards expected in any clinical setting and we expect all members of our Team to work to these standards to help us achieve our aim.

The policies, systems and processes in place in our Practice reflect our professional and legal responsibilities and follow recognised standards of good practice. We evaluate our Practice on a regular basis, through audit, peer review and patient feedback and monitor the effectiveness of our quality assurance procedures.

Quality standards and procedures

To assist our Team in providing our patients with care of a consistent quality we will:

• • Provide a safe and welcoming environment

• • Ensuring all staff training is up to date

• • Give our patients information about our Practice and the care available, and making sure the patient understands the terms under which care is offered

• • Explain all treatment options and agree clinical decisions with the patient(s), explaining the possible risks involved with each option

• • Obtain valid consent for all treatment

• • Refer to Specialists for investigation or treatment as appropriate and without undue delay

• • Maintain clinical records with an up-to-date medical history for all patients

• • Provide secure storage of patients records to main confidentiality

• • Explain the procedure to follow for raising a complaint about the service, identifying the Practice contact

To provide our patients with a Team that provides care of a consistent quality we will:

• • Provide a safe working environment through hazard identification and risk assessment

• • Provide relevant training for all new Team members

• • Provide Job Descriptions and Contracts of Employment

• • Agree terms for all non-employed contractors working at the Practice

• • Keep staff records up to date

• • Ensure staff know where all Practice policies and procedures are stored and how they can access them

Under the Health and Social Care Act 2008 (The Care Quality Commission Registration Regulations 2009 Part 4), the registering body Abbey Medical Practice is required to provide to the Care Quality Commission a statement of purpose.

The name of the registered provider is Schopwick Surgery, and the address is:

Tel: 0203 667 1850

Practice Web Site – www.schopwicksurgery.co.uk

CQC Provider ID : 1-540710007

Registered GP Manager: Dr Joanna Szafaryn, GP Partner

Practice Manager: Sheetal Shah

About Us

Schopwick Surgery is a Partnership.  There are 7 GP partners:

We also have GP registrars, Advanced Nurse Practitioners,  Clinical Pharmacists, Practice Nurses,  Nursing Associates and  Health Care Assistants to provide clinical care to our patients.

We are part of the Herts Five Primary Care Network, closely working with other Practices in Hertsmere. As a collaboration we share the services of Clinical Pharmacists, Physios and Advanced Nurse Practitioners.

The main surgery is in Elstree, this currently has 9 clinical rooms available across 3 floors but has limited parking available. Our branch practice in Bushey has more dedicated patient parking and the 9 clinical rooms are all fully accessible at ground level.  Patients are able to attend either premises for care and treatment.

The Practice has a contract with the local health organisation and offers directly and locally enhanced services to its patients.

Our Aims and Objectives

The Practice is committed to delivering a service, which is easily accessible to all patients, combining the personal care of the traditional family doctor with the best that modern general practice can provide.

We aim to:

• • Ensure high quality, safe and effective personal medical services and environment

• • Be a patient centred organisation, delivering outstanding customer service

• • Provide monitored, audited and continually improved healthcare services

• • Provide healthcare which is available to the whole of our registered population and create a partnership between patient and health professionals which ensures mutual respect, holistic care and continuous learning and training

• • To ensure that our patients are treated with dignity and respect, in complete confidence and with the utmost discretion

• • Ensuring the patient sees or speaks to the most appropriate clinicians suitable to meet the patient clinical need.

• • To provide our patients and staff with an environment which is safe, friendly and clean

• • Improve Clinical Governance and Evidence Based Practice

• • Improve Clinical and Non-clinical risk management

• • Reduce risk in specific clinical risk areas and facilities

• • Improve vigilance for unforeseen emergencies

• • Continually review and improve services offered to patients

• • Encourage the development of an active and effective patient participation group

• • Recruit, retain and develop a highly motivated and appropriately skilled workforce

• • To enhance performance of the workforce

• • Guide the employees in accordance with the Equalities Scheme

• • Ensure effective management and governance systems

• • Participate effectively in the Locality Group of GP Practices

• • Work with local Practices providing enhanced care to our patients

• • Meet key targets set by NHS England and Herts and West Essex Integrated Care Board.

• • To optimise performance against key targets and core standards

• • The provision of accessible healthcare which is proactive to healthcare changes, efficiency and innovation and development.

• • To meet Annual Health Check targets

• • To improve communication between the surgery and the patients

• • The registered activities and service types have been agreed by the medical practice Surgery’s Practice Manager and Partners in accordance with CQC guidance. Services are described under registered activity and Service Type.

The regulated services provided by the Practice:

• • Medical care and treatment in accordance with our core GMS contracts: Monday to Friday 08:00 – 18:30

• • Extended Hours before 8:00 and after 18:30 on some weekdays and adhoc Saturdays.

• • Enhanced Access weekday evenings 18:30 – 20:00 and weekends/Bank Holidays 08:00 – 12:00 at one of the practices within our PCN

• • NHS relevant prescriptions and medications or a private prescription can be issued.

• • Immunisations, e.g. childhood immunisations, flu, COVID, travel (NHS only)

• • Weight loss and Dietician clinic lifestyle management

• • Long Term Condition clinics

• • Asthma/Respiratory review clinics

• • Diabetic Clinic – The practice operates diabetes clinics each week to provide ongoing care for our diabetic patients, this is run by trained nurses and supervised by GP partners

• • Well Women Clinics – including smears, coil and implant clinics, HRT

• • Baby checks at age 6-10 weeks and post-natal review

• • Health Checks – the practice offers health checks to patients aged 40 and over

• • Dressings

• • Phlebotomy – the practice offers patients to have their blood tests at both sites, these can also be booked via Swiftqueue at West Herts or Royal Free trust hospitals

• • Minor Surgery and joint injections – The minor operations are held by Dr Raj Badiani and joint injections are offered by Dr Vyas and Dr Badiani at the surgery

• • Dedicated Healthy Minds Practitioner for patients with mental health problems

• • Clinical Pharmacist appointments for long term condition review, medication reviews and medication related queries

• • Social Prescribers which allows GPs to refer patients to non-clinical services, which are often run by charities, with the aim of helping then to take greater control of their own health

• • Home Visiting service provided by the Practice

• • Adult and child safeguarding MDT reviews – the practice holds regular team meetings with other service providers reviewing palliative care and safeguarding issues/concerns

• • Executive & employee medicals – Our GP’s are able to carry out medical report and review.

• • Assessment of employees returning to work after illness

• • Cervical Screening – at the practice our nurses are qualified to carry out cervical screening and test in the form of cervical smears

We use Patchs for our internet-based appointment request system.  They are fully accredited by NHS England and compliant with data security standards set by NHS Digital.  They are DCB0129 compliant and work closely with NHS England.

Our practice ethos is to strive towards a partnership between patients and health professionals based on the following key facets:

Mutual Respect

We endeavour to treat all our patients with dignity, respect and honesty. Everyone at the surgery is committed to deliver an excellent service.  We ask all patients to highlight any discrepancies and to offer the same commitment in return. We provide safe, effective and compassion to all individuals.

‘Holistic’ Care

We treat ‘patients’ and not illnesses. This means that we are equally interested in the physical, psychological and social aspects of your individual care.

Continuity of Care and the ‘Therapeutic relationship’

Building and maintaining a strong relationship between doctors, health professionals, and patients is essential to the way we work. This is especially so in the management of ongoing problems or long-term illness. Although we would encourage you to continue seeing the same health professional, sometimes it is more appropriate or necessary for you to see an alternative clinician, for example an Advanced Nurse Practitioner or an alternative G.P. Wherever possible we will try to accommodate your requests to see the same G.P, however, if you have a new problem and the doctor or nurse that you normally see is not available, or you would like to see someone else then we would encourage you to see any of the doctors or nurses at the practice.

Learning and Training

As a training practice, we contribute to the education and development of future generations of General Practitioners, medical students, nurses, apprentices and other professionals.

We believe in “life-long learning” and all the health professionals here, and administrative staff, undergo an annual appraisal where learning and development needs are identified. We also recognise the benefit of supported learning for our patients and families in enhancing your ability to manage and deal with both ‘self-limiting’ and long-term illnesses.

Open List

The Practice has an open list policy and accepts patients who are resident and newly resident in the defined practice area.

Signed by

Dr Joanna Szafaryn

GP Partner

Revision 1 – June 2024

All employees and professionals at the practice have a legal duty to keep all information held confidential. Only those NHS staff that need to, can access your information. NHS staff is bound by the NHS Confidentiality Code of Conduct – Professional Codes of Conduct and the Common Law Duty of Confidentiality. All staff has requirements in their contracts of employment that require them to maintain confidentiality.

It’s important to us that you feel safe and that your privacy is respected, ask at reception if you need to speak privately or want to know more about confidentiality. All information is completely confidential and secure and the Practice is registered under the Data Protection Act.

Information will only be shared with those who are involved in your medical care, this could include other healthcare professionals, district nurses, health visitors and midwives. Information to family members, carers and other parties such as insurance companies, solicitors or employers will only be given on receipt of written consent. Please note we are not being obstructive when we say that we cannot provide any information, results or tests etc to anyone other than the patient in question without the appropriate authority- signed consent.

The NHS operate a Zero Tolerance Policy regarding violence and abuse. The Practice has the right to remove violent patients from the list with immediate effect to safeguard practice staff and patients. Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.

We aim to always treat our patients courteously and expect our patients to treat our staff in a similarly respectful way.

In England, please refer to NHS Constitution your rights and responsibilities for further information.

We collect Personal information about you at the organisation. We collect records about your health and the treatment you receive in both electronic and paper format.

Why do we have to provide this privacy notice?

We are required to provide you with this privacy notice by law. It provides information about how we use the personal and healthcare information we collect, store and hold about you. If you have any questions about this privacy notice or are unclear about how we process or use your personal information, or have any other issue regarding your personal and healthcare information, then please contact our Data Protection Officer; [email protected].

The main things the law says we must tell you about what we do with your personal data are:

• • We must let you know why we collect personal and healthcare information about you

• • We must let you know how we use any personal and/or healthcare information we hold about you

• • We need to inform you in respect of what we do with it

• • We need to tell you about who we share it with or pass it on to and why

• • We need to let you know how long we can keep it for

What is a privacy notice?

A privacy notice (or ‘fair processing notice’) explains the information we collect about our patients and how it is used. Being open and providing clear information to patients about how an organisation uses their personal data is an essential requirement of the new UK General Data Protection Regulations (UK GDPR).

Under the UK GDPR, we must process personal data in a fair and lawful manner. This applies to everything that is done with patient’s personal information. This means that the organisation must:

• • Have lawful and appropriate reasons for the use or collection of personal data

• • Not use the data in a way that may cause harm to the individuals (e.g., improper sharing of their information with third parties)

• • Be open about how the data will be used and provide appropriate privacy notices when collecting personal data

• • Handle personal data in line with the appropriate legislation and guidance

• • Not use the collected data inappropriately or unlawfully

What is fair processing?

Personal data must be processed in a fair manner – the UK GDPR says that information should be treated as being obtained fairly if it is provided by a person who is legally authorised or required to provide it. Fair processing means that the organisation has to be clear and open with people about how their information is used.

Pinhoe and Broadclyst Medical Practice manages patient information in accordance with existing laws and with guidance from organisations that govern the provision of healthcare in England such as the Department of Health and the General Medical Council.

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

• • UK General Data Protection Regulations 2016

• • Data Protection Act 2018

• • Human Rights Act 1998

• • Common Law Duty of Confidentiality

• • Health and Social Care Act 2012

• • NHS Codes of Confidentiality and Information Security

• • Information: To Share or Not to Share Review

This means ensuring that your personal confidential data (PCD) is handled clearly and transparently and in a reasonably expected way.

The Health and Social Care Act 2012 changed the way that personal confidential data is processed so it is important that our patients are aware of and understand these changes and that you have an opportunity to object and know how to do so.

The healthcare professionals who provide you with care maintain records about your health and any NHS treatment or care you have received (e.g., NHS Hospital Trust, GP surgery, walk-in clinic, etc.). These records help to provide you with the best possible healthcare.

NHS health records may be processed electronically, on paper or a mixture of both and we use a combination of working practices and technology to ensure that your information is kept confidential and secure.

The Data Protection Officer

The Data Protection Officers for our Surgery are : Ms Tania Palmariellodviney and Mr Barry Moult, (Hertfordshire & West Essex ICB). The DPO Team can be contacted via Schopwick Surgery as [email protected] as a first point of contact,  if:

• • You have any questions about how your information is being held

• • If you require access to your information or if you wish to make a change to your information

• • If you wish to make a complaint about anything to do with the personal and healthcare information we hold about you

• • Or any other query relating to this Policy and your rights as a patient

What type of information do we collect about you?

Information held by this organisation may include the following:

• • Your contact details (such as your name, address and email address)

• • Details and contact numbers of your next of kin

• • Your age range, gender, ethnicity

• • Details in relation to your medical history

• • The reason for your visit to the organisation

• • Any contact the organisation and/or your practice has had with you including appointments (emergency or scheduled), clinic visits, etc.

• • Notes and reports about your health, details of diagnosis and consultations with our GPs and other health professionals within the healthcare environment involved in your direct healthcare

• • Details about the treatment and care received

• • Results of investigations such as laboratory tests, x-rays, etc.

• • Relevant information from other health professionals, relatives or those who care for you

• • Recordings of telephone conversations between yourself and the organisation

Information collected about you from others

We collect and hold data for the purpose of providing healthcare services to our patients and we will ensure that the information is kept confidential. However, we can disclose personal information if:

• • It is required by law

• • You provide your consent – either implicitly for the sake of your own care or explicitly for other purposes

• • It is justified to be in the public interest

To ensure you receive the best possible care, your records are used to enable the care you receive. Information held about you may be used to help protect the health of the public and to help us to manage the NHS.

Information may be used for clinical audit purposes to monitor the quality of services provided, may be held centrally and may used for statistical purposes. Where we do this, we ensure that patient records cannot be identified.

Sometimes your information may be requested to be used for clinical research purposes – the organisation will always endeavour to gain your consent before releasing the information.

Improvements in information technology are also making it possible for us to share data with other healthcare providers with the objective of providing you with better care. You can choose to withdraw your consent to your data being used in this way. When the organisation is about to participate in any new data-sharing scheme, we will make patients aware by displaying prominent notices and on our website at least four weeks before the scheme is due to start. We will also explain clearly what you have to do to ‘opt-out’ of each new scheme.

A patient can object to their personal information being shared with other healthcare providers but if this limits the treatment that you can receive then the doctor will explain this to you at the time.

What is special category data?

The law states that personal information about your health falls into a special category of information because it is extremely 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 (e.g., 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

The 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 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

How do we use your information?

Your data is collected for the purpose of providing direct patient care; however, we are able to disclose this information if it is required by law, if you give consent or if it is justified in the public interest.

In order to comply with its legal obligations, this organisation may have to send data to NHS Digital when directed by the Secretary of State for Health under the Health and Social Care Act 2012. Additionally, we may have to contribute to national clinical audits and will send the data that is required by NHS Digital as the law allows. This may include demographic data, such as date of birth, and information about your health which is recorded in coded form; for example, the clinical code for diabetes or high blood pressure.

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

Who can we provide your personal information to and why?

Whenever you use a health or care service, such as attending the local hospital or using the district nursing service, clinical information about you is collected to help ensure you get the best possible care and treatment. This information may be passed to other approved organisations where there is a legal basis to do so, to help with planning services, improving care, researching to develop new treatments and preventing illness. All of this helps in providing better care to you and your family and future generations.

However, as explained in this privacy notice, confidential information about your health and care is only used in this way as allowed by law and would never be used for any other purpose without your clear and explicit consent.

We may pass your personal information on to the following people or organisations because these organisations may require your information to assist them in the provision of your direct healthcare needs. It therefore may be important for them to be able to access your information in order to ensure they may deliver their services to you:

• • Hospital professionals (such as doctors, consultants, nurses etc.)

• • Other GPs/doctors

• • Primary Care Networks

• • NHS Trusts/Foundation Trusts/Specialist Trusts

• • NHS Commissioning Support Units

• • NHS England (NHSE) and NHS Digital (NHSD)

• • Multi-agency Safeguarding Hub (MASH)

• • Independent contractors such as dentists, opticians, pharmacists

• • Any other person who is involved in providing services related to your general healthcare including mental health professionals

• • Private sector providers including pharmaceutical companies to allow for the provision of medical equipment, dressings, hosiery etc.

• • Voluntary sector providers

• • Ambulance Trusts

• • Integrated Care Systems

• • Clinical Commissioning Groups

• • Local authority

• • Social care services

• • Education services

• • Other ‘data processors’, e.g., Diabetes UK

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

Who may we provide your information to:

• • For the purposes of complying with the law, e.g., the police

• • Anyone you have given your consent to, to view or receive your record, or part of your record. If you give another person or organisation consent to access your record, we will need to contact you to verify your consent before we release that record. It is important that you are clear and understand how much and what aspects of your record you give consent to be disclosed

• • Computer systems – we operate 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. We will make information available to our partner organisations (above) unless you have declined data sharing to ensure you receive appropriate and safe care. Wherever possible, staff will ask your consent before your information is viewed.

• • Extended access – we provide extended access services to our patients so that you can access medical services outside of our normal working hours. To provide you with this service, we have formal arrangements in place with the Clinical Commissioning Group whereby certain key ‘hubs’ offer this service for you as a patient to access outside of our opening hours.

• • This means those key ‘hubs’ will have to have access to your medical record to be able to offer you the service. Please note to ensure that those hubs comply with the law and to protect the use of your information, we have very robust data sharing agreements and other clear arrangements in place to ensure your data is always protected and used for those purposes only.

• • Data extraction by the Clinical Commissioning Group – the Clinical Commissioning Group at times extracts medical information about you but the information we pass to them via our computer systems cannot identify you to them

• • This information only refers to you by way of a code that only your own practice can identify (it is pseudo-anonymised). This therefore protects you from anyone who may have access to this information at the Clinical Commissioning Group from ever identifying you as a result of seeing the medical information and we will never give them the information that would enable them to do this.

Your rights as a patient

Access and Subject Access Requests

You have a right under the Data Protection legislation to request access to view or to obtain copies of what information the organisation 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 to the Practice Manager of Pinhoe and Broadclyst Medical Practice

• • For information from a hospital or other Trust/NHS organisation you should write directly to them

• • There is no charge to have a copy of the information held about you. However, we may, in some limited and exceptional circumstances, have to make an administrative charge for any extra copies if the information requested is excessive, complex or repetitive

• • We are required to provide you with information within one month. We would ask therefore that any requests you make are in writing and it is made clear to us what and how much information you require

• • 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

Correction

We want to make sure that your personal information is accurate and up to date. You may ask us to correct any information you think is inaccurate. It is especially important that you make sure you tell us if your contact details including your mobile phone number have changed

Removal

You have the right to ask for your information to be removed. However, if we require this information to assist us in providing you with appropriate medical services and diagnosis for your healthcare, then removal may not be possible

Objection

We cannot share your information with anyone else for a purpose that is not directly related to your health, e.g., medical research, educational purposes etc.

Transfer

You have the right to request that your personal and/or healthcare information is transferred, in an electronic form (or other form), to another organisation but we will require your clear consent to be able to do this.

How long do we keep your personal 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: NHSX – Records Management Code of Practice 2020.

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 third 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 data protection processes in place to oversee the effective and secure processing of your personal and/or special category data.

Schopwick Surgery uses a clinical system provided by a data processor called EMIS. With effect from 10 June 2019, EMIS started storing the organisation’s EMIS web data in a highly secure, third party cloud hosted environment, namely Amazon Web Services (‘AWS’).

Data does remain in the UK 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 highest levels of security and support.

Maintaining your confidentiality and accessing your records

We are committed to protecting your privacy and will only use information collected lawfully in accordance with the UK General Data Protection Regulations (which is overseen by the Information Commissioner’s Office), Human Rights Act, the Common Law Duty of Confidentiality and the NHS Codes of Confidentiality and Security. Every staff member who works for an NHS organisation has a legal obligation to maintain the confidentiality of patient information.

All of our staff, contractors and locums receive appropriate and regular training to ensure they are aware of their personal responsibilities and have legal and contractual obligations to uphold confidentiality, enforceable through disciplinary procedures. Only a limited number of authorised staff have access to personal information where it is appropriate to their role and this is strictly on a need-to-know basis. If a sub-contractor acts as a data processor for Schopwick Surgery, an appropriate contract (Article 24-28) will be established for the processing of your information.

We maintain our duty of confidentiality to you at all times. We will only ever use or pass on information about you if others involved in your care have a genuine need for it. We will not disclose your information to any third party without your permission unless there are exceptional circumstances (i.e., life or death situations) or where the law requires information to be passed on 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 organisational policy is to respect the privacy of our patients, their families and our staff 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 patients will be protected.

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

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.

Third party processors

To enable us to deliver the best possible services, we will share data (where required) with other NHS bodies such as hospitals. In addition, the organisation 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 and support, including our core clinical systems, systems that manage patient facing services (such as our website and service accessible through the same), data hosting service providers, systems that facilitate appointment bookings or electronic prescription services and document management services etc.

• • Further details regarding specific third-party processors can be supplied on request to the data protection officer as below.

Third parties mentioned on your medical record

Sometimes we record information about third parties mentioned by you to us during any consultation. 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 that may breach their rights to confidentiality are removed before we send any information to any other party including yourself. Third parties can include spouses, partners and other family members.

Anonymised information

Sometimes we may provide information about you in an anonymised form. If we do so, then none of the information we provide to any other party will identify you as an individual and cannot be traced back to you.

Audit

Auditing of clinical notes is done by Schopwick Surgery as part of their commitment to the effective management of healthcare whilst acting as a data processor.

Article 9.2.h is applicable to the management of healthcare services and “permits processing necessary for the purposes of medical diagnosis, provision of healthcare and treatment, provision of social care and the management of healthcare systems or services or social care systems or services.’” No consent is required to audit clinical notes for this purpose.

Furthermore, compliance with Article 9(2)(h) requires that certain safeguards are met. The processing must be undertaken by or under the responsibility of a professional subject to the obligation of professional secrecy or by another person who is subject to an obligation of secrecy.

Auditing clinical management is no different to a multi-disciplinary team meeting discussion whereby management is reviewed and agreed. It would be realistically impossible to require consent for every patient reviewed that is unnecessary.

It is also prudent to audit under Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 17: Good Governance.

GP connect service

The GP connect service allows authorised clinical staff at NHS 111 to seamlessly access our clinical system and book directly on behalf of a patient. This means that, should you call NHS 111 and the clinician believes you need an appointment, the clinician will access available appointment slots only (through GP Connect) and book you in. This will save you time as you will not need to contact the organisation directly for an appointment.

We will not be sharing any of your data and we will only allow NHS 111 to see available appointment slots. They will not even have access to your record. However, NHS 111 will share any relevant data with us but you will be made aware of this. This will help in knowing what treatment/service/help you may require.

CFH Docmail

We use a system called AccuRx for the sending of batch invitations/messages. However, where we do not hold a mobile number or email address for a patient or have recorded dissent for SMS messaging/email for a patient, we will default to sending a letter.

Invoice validation

Your information may be shared if you have received treatment to determine which Clinical Commissioning Group (CCG) is responsible for paying for your treatment. This information may include your name, address and treatment date. All of this information is held securely and confidentially; it will not be used for any other purpose or shared with any third parties.

Patient communication

As we are obliged to protect any confidential information we hold about you, 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 should we need to notify you about appointments and other services that we provide to you involving your direct care. 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 have given us permission to contact you via SMS if you have provided your mobile telephone number. Please let the organisation 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.

Primary care networks

The objective of primary care networks (PCNs) is for group practices together to create more collaborative workforces that ease the pressure of GPs, leaving them better able to focus on patient care. All areas within England are covered by a PCN.

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 integrate with the wider health and care system more easily.

All GP practices have come together in geographical networks covering populations of approximately 30–50,000 patients to take advantage of additional funding attached to the GP contract. This size is consistent with the size of the primary care homes that exist in many places in the country but are much smaller than most GP federations.

This means that Schopwick Surgery may share your information with other practices within the Primary Care Network to provide you with your care and treatment.

Risk stratification

Risk stratification is a mechanism used to identify and subsequently manage those patients deemed as being at high risk of requiring urgent or emergency care. Usually this includes patients with long-term conditions, e.g., cancer. Your information is collected by a number of sources including Schopwick Surgery. This information is processed electronically and given a risk score which is relayed to your GP who can then decide on any necessary actions to ensure that you receive the most appropriate care.

Safeguarding

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

Our legal basis for processing for UK General Data Protection Regulation (UK 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…’

Safeguarding information such as referrals to safeguarding teams is retained by Schopwick Surgery when handling a safeguarding concern or incident. We may share information accordingly to ensure a duty of care and investigation as required with other partners such as local authorities, the police or healthcare professionals (i.e., the mental health team).

Shared care

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 any time if this sharing is based on your consent.

Telephone system

Our telephone system records both incoming and outgoing telephone calls by default. 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 the Practice Management Team.

Opt-outs

National opt-out facility

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

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.

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 screening for bowel cancer.

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 by using one of the following:

• • Online service – patients registering need to know their NHS number or their postcode as registered at their GP practice

• • Telephone service – 0300 303 5678 which is open Monday to Friday between 0900 and 1700

• • NHS App – for use by patients aged 13 and over (95% of surgeries are now connected to the NHS App). The app can be downloaded from the App Store or Google play

• • “Print and post” registration form: Manage Your Choice

Getting a healthcare professional to assist patients in prison or other secure settings to register an opt-out choice. For patients detained in such settings, guidance is available on NHS Digital and a proxy form is available to assist in registration.

Photocopies of proof of applicant’s name (e.g., passport, UK driving licence etc.) and address (e.g., utility bill, payslip etc.) need to be sent with the application.  It can take up to 14 days to process the form once it arrives at NHS, PO Box 884, Leeds, LS1 9TZ.

Getting a healthcare professional to assist patients in prison or other secure settings to register an opt-out choice. For patients detained in such settings, guidance is available on NHS Digital and a proxy form is available to assist in registration.

Note: Unfortunately, the national data opt-out cannot be applied by this organisation.

General Practice Data for Planning and Research opt out (GPDPR)

The NHS needs data about the patients it treats to plan and deliver its services and to ensure that the 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.

What patient data is shared about you with NHS Digital?

The collection date is still to be confirmed, although when it has been, 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

They 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, postcode and date of birth, is replaced with unique codes that 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 from the data.

The data collected by NHS Digital

We will share structured and coded data from GP medical records that is needed for specific health and social care purposes as explained above.

Data that directly identifies you as an individual patient, including your NHS number, General Practice Local Patient Number, 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 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 the staff who have treated you

More detailed information about the patient data collected is contained within the Data Provision Noticed issued to GP practices.

NHS Digital will 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

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

When NHS Digital collects, analyses, publishes and shares patient data, there are strict laws in place that it must follow. Under the UK General Data Protection Regulation (UK GDPR), this includes explaining to patients what legal provisions apply under UK GDPR that allows it to process patient data. The UK 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 allows 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, clinical commissioning groups 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.

How NHS Digital uses 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 patients 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 NHS Digital 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. NHS Digital never publish any patient data that could identify any individual. All data they publish is anonymous statistical data.

For more information about data NHS Digital publish see Data and Information and Data Dashboards.

Who does NHS Digital share patient data with?

All data that 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 that 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), clinical commissioning groups (CCGs) 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 the NHS Digital infrastructure or, where the needs of the recipient cannot be met this way, as a direct dissemination of data. NHS Digital plan to reduce the amount of data being processed outside central, secure data environments and increase the data it makes available to be accessed via its secure data access environment.

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 patients 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 is needed by a health professional for the patient’s own care and treatment

• • Where the patient has expressly consented to this, for example to participate in a clinical trial

• • Where there is a legal obligation, for example where there are COPI Notices

• • 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 patients 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 the patient was shared.

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

Where does NHS digital store patient data?

NHS Digital only stores and processes patient data for this data collection within the United Kingdom (UK). Fully anonymous data (that does not allow patients to be directly or indirectly identified), for example statistical data that is published, may be stored and processed outside of the UK.

Some of the NHS Digital processors may process patient data outside of the UK. If they do, they will always ensure that the transfer outside of the UK complies with data protection laws.

What to do if you have any questions

Should you have any questions about our privacy policy or the information we hold about you, you can:

1. Contact the surgery using a PATCHS Admin request; GP practices are data controllers for the data they hold about their patients
2. Write to the data protection officer at [email protected].
3. Ask to speak to the Practice Manager

The data protection officers (DPO) for Schopwick Surgery are Barry Moult and Tania Palmariellodiviney

Objections or complaints

In the unlikely event that you are unhappy with any element of our data-processing methods, do please contact the Practice Manager, in the first instance. If you feel that we have not addressed your concern appropriately, you have the right to lodge a complaint with the ICO. For further details, visit ico.gov.uk and select “Raising a concern” or telephone: 0303 123 1113.

The Information Commissioner’s Office is the regulator for the General Data Processing Regulations and offers independent advice and guidance on the law and personal data including your rights and how to access your personal information.

Changes to our privacy policy

We regularly review our privacy policy and any updates will be published on our website. This policy is to be reviewed annually.

Organisation name;	Schopwick Surgery
Location;	Bushey & Elstree
Registered Manager;	Sheetal Shah
Infection control Leads;	Michelle Orecchio (lead Nurse) & Alex Byrne (GP Partner)
Date infection control statement produced;	7/3/24
Date of next review;	March 2025
Introduction
As a requirement of the Health and Social Care act 2008 Code of practice, on prevention and control of infections and related guidance, it is required that an annual statement is produced regarding compliance with good practice on infection prevention and control. The annual statement will be made available for anyone who wishes to see it (patients, representatives/staff/regulatory authorities). It has been produced by Michelle Orecchio and will be updated annually or when current advice and guidelines change.
Outbreaks of infection
We have had no significant events reported regarding infection control issues in the time covered by this report. Due to following on from the covid pandemic we are still using face masks and PPE after risk assessment by clinicians for face to face appointments if they have respiratory symptoms.
Audit Summary
We have recently under gone an ICat audit from an external source. We are currently working through this action plan. We are moving the minor ops clinic to a more suitable room. The past year there have been ongoing audits regarding PPE, sharps and hand hygiene. There have been some good improvements to the sharps audits- the temporary closures are usually in place at every audit check, much improved from the previous year. We need to ensure we have safety needles in place for when the need arises. Hand hygiene audit is ongoing. No issues raised. PPE audit shows clinicians are using PPE appropriately, we need to make improvements to where the items are kept and this will be looked at once we re-organise Bushey site. Risk assessments regrading IPC have been completed. The introduction of a log to record water flushing if a room is out of use for more than one week or the shower is not used-as although this was carried out by the manager (for reducing risk of legionella) it was not recorded anywhere. The largest change will be to replace our chairs with wipeable compliant ones and curtains/blind to be removed and replaced with window film. This will take some time so we will aim to replace these items gradually due to cost. Actions- Action plan for replacing chairs Action plan for replacing curtains/blinds with window film. Action plan for replacing sinks (hand washing sinks) Action plan for introducing a sluice room at Bushey site (Elstree will be moved to new purpose built building) Clearing clutter and re-organising Bushey site (Elstree site can be done but due to be moving so Bushey is priority), need to book date with colleagues Establish Minor ops room and set up ie window net.
Training
All staff will now be trained in Cold chain as mandatory. All staff have infection control training, cold chain overview and emergency equipment as part of induction from a nurse as well as the usual e-learning which is now mandatory (ie cold chain).
Review and update of policies, procedures and guidance
All policies, procedures and guidance are updated on an annual basis or when changes occur. They have been updated and not due for review until the end of this year. The review dates can be found on the policies themselves on teamnet. All changes to IPC are discussed at regular meetings with staff.
Additional information
Michelle Orecchio is the lead IPC nurse and decontamination lead,  Alex Byrne is the lead GP partner
Annual statement created by;	Michelle Orecchio
Signed by;	M.Orecchio
Date;	7/3/24