The information on this page establishes the procedures that the Practice has in place for identifying Carers to ensure they are appropriately referred for a Carers Assessment to Adult Care Services.

Definition of a Carer

Carers are people who, without payment, provide help and support to a family member, friend or neighbour who cannot manage on their own due to physical or mental illness, disability, substance misuse or frailty brought on by old age.

Caring roles can include administering medication, lifting and handling and personal or emotional care. Carers should not be confused with paid care workers, care assistants or with volunteer care workers.

A “Young Carer” is defined as a person under 18 who carries out significant caring tasks and by doing so, shoulders a level of responsibility for another person which is inappropriate for their age.

This situation often arises when parents who have long term conditions are not offered appropriate help and support, although it is a fact that most children of disabled or sick parents do not have to take on such responsible caring roles.

The person receiving care may not be registered at the Carer’s Practice. When this situation arises, because the Practice will not be always be able to ascertain that the Carer/Patient relationship has ceased, the Carer may be asked to re-confirm their Carer status.

Where the person receiving care is a registered patient at the Carer’s Practice, the Carer/Patient relationship can be verified more frequently, resulting in practice-held information being able to be modified when significant events such as death or de-registration occur.

It is important to estimate the total number of Carers within the Practice Catchment Area.

Monkseaton Medical Centre is likely to have 900 carers with over 300 of them caring for over 20 hours/week.

The objective of this Protocol is to ensure that all Carers registered with the Practice are identified and referred to Adult Care Services.

The Practice will do its utmost to facilitate this process by actively identifying, supporting and referring known Carers who are patients of the Practice or where the person receiving care is a registered patient of the Practice.

The Practice will support Carers by:

• Identifying a “Carer’s Champion” to ensure that the support to Carers by the Practice is being undertaken and to be available to Carers as the first line of liaison
• Providing relevant information, Local Authority resources and contact points
• Providing suitable appointment flexibility and understanding
• Providing care, health checks and advice to enable them to maximise their own health and needs
• Routinely direct identified Carers (with consent) to local support services and, where appropriate, refer for Carers Assessment via Social Services

Identifying Carers

There are two proven methods of identification:

1. Self-Identification
2. Pro-active Practice Identification

The Practice undertakes the following activities as part of each method:

Self-Identification

Notice Boards

The Practice displays a poster on existing notice boards requesting Carers to contact the Practice to provide details of their caring responsibilities. However, during appropriate seasonal times (e.g. flu clinics) a notice board is dedicated to Carer information, for enhanced visibility.

Carer Referral Forms

Carer referral forms are displayed in reception to encourage Carers to complete and hand in to the Practice.

New Patient Registration Forms

The Practice’s new patient registration form incorporates the following two questions:

1. Do you look after someone?
2. Does someone look after you?

This information is used in the new patient screening appointment, tagging the patient’s notes and arranging referral to Care Services.

Pro-active Practice Identification

Letter and Questionnaire to Patients

When the Practice writes to a patient, (e.g. during the flu vaccination campaign), the communication incorporates a section on Carers, where if they are a carer but have not yet completed a Carer referral form, they are requested to contact the Practice and complete one. This may be part of the procedure for Disability Allowance forms.

Health Professional Identification

All Health Professionals in the surgery ask Carers to complete a Carer referral form when they ascertain a patient is a Carer. Many Carers may be identified as a result of Learning Disability Health Checks, Dementia Annual Reviews or Dementia Screening.

This is regularly discussed at multi-disciplinary team meetings to exploit personal knowledge. This will be of particular value at the High Risk Patient meeting.

Upon identification of a Carer the Practice will take the following steps:

• The Medical Record of the Carer should be edited to insert the ‘Carer’ Read Code and entered as an alert
• The Role of Carer should be marked as an ‘Active Problem’ so that it can be easily visible to the Clinician when accessing the Medical Record of the Carer
• An ‘Alert Message’ should be added to the Carer’s Record on the front desk to alert Receptionists in order for them to prioritise booking appointments where necessary
• The medical record of the person receiving care will be allocated a read code of  “has a carer” and cross reference the carers details in the text box
• Chronic Disease Templates used by Nurses and Doctors when consulting Patients include data entry spaces for inserting a Carer’s name and contact details

Competency

All Carer registrations will, in the first instance, be reviewed by the patient’s usual doctor who will confirm that the patient is competent to give a valid informed consent.

Process for Subsequent Referral

The following read codes are used to tag Carers notes where applicable:

• Carer Ua0VL
• Has a Carer 918F
• No able Carer in household ZV604
• Carer unable to cope ZV608
• Referral for social services assessment 8HkB

Supporting Information

The following documents are available on the practice Intranet and on the practice Website support this policy:

• Carer’s Support Policy
• Carer’s Identification and Referral Form
• Poster
• Agreement by a Patient to allow a Carer to have access to their Personal Details and/or Copies of Correspondence
• Contact Points

Useful Contacts

North Tyneside Council

North Tyneside Carers Centre

NHS Choices

Call Carers Direct on 0300 123 1053

The RCGP also has some useful resources.

Young Carers

Young carers are children and young people aged 5-18 who help to look after somebody in their family because they have a disability, illness, mental health difficulty or misuse drugs or alcohol. There are many young carers in North Tyneside and GPs and primary care staff are well placed to identify them.  If you identify a young carer, you are encouraged to signpost them to North Tyneside Carers’ Centre where they can access support and advice.  The contact details are:

North Tyneside Young Carers

[email protected]

0191 643 2298

North Tyneside Carers’ Centre, 3rd Floor, YMCA Building, Church Way, North Shields, NE29 0AB

Confidential patient information is when 2 types of information from your health records are joined together.

The 2 types of information are:

• something that can identify you
• something about your health care or treatment

For example, your name joined with what medicine you take.

Identifiable information on its own is used by health and care services to contact patients and this is not confidential patient information.

How the NHS uses your confidential patient information

Your individual care

Health and care staff may use your confidential patient information to help with your treatment and care. For example, when you visit your GP they may look at your records for important information about your health.

Research and planning

Confidential patient information might also be used to:

• plan and improve health and care services
• research and develop cures for serious illnesses

Your choice

You can stop your confidential patient information being used for research and planning. Find out how to make your choice.

If you’re happy with your confidential patient information being used for research and planning you do not need to do anything.

Any choice you make will not impact your individual care.

To view our Privacy Notice click here 

To view our Privacy Notice for Children click here 

To view our GDPR Privacy Notice for Job Applicants click here

Fair Processing Policy

Your Information, Your Rights – How we use your personal information

Being transparent and providing accessible information to patients about how we will use your personal information is a key element of the GDPR Regulations.

The following notice reminds you of your rights in respect of the above legislation and how your GP Practice 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;
• The management and clinical planning of services to ensure that appropriate care is in place.

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 it is received directly from you or from a third party in relation to your care and we are committed to protecting your privacy.

‘Personal data’ means 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 personal data’ includes things 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.

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:

• Details about you, such as your address, legal representative, emergency contact details
• Any contact the surgery has had with you, such as appointments, clinic visits, emergency appointments, etc.
• Notes and reports about your health
• Details about your treatment and care
• Results of investigations such as laboratory tests, x-rays etc.
• Relevant information from other health professionals, relatives or those who care for you
• Your records will be retained in accordance with the NHS Code of Practice for Records Management

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 maybe 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 do we use this information?

To ensure that you receive the best possible care, your records will be used to facilitate the care you receive.  Information held about you may be used to protect the health of the public and to help us manage the NHS.  Information may also be used for clinical audit to monitor the quality of the service provided.  In addition, your information will be used to identify whether you are at risk of a future unplanned hospital admission and/or require support to effectively manage a long term condition.

How is the information collected?

Your information will be collected either electronically using secure NHS Mail or a secure electronic transferred 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:

• NHS Trusts/Foundation Trusts
• Local GP practices in order to deliver extended primary care services
• NHS Commissioning Support Units
• 111 and Out of Hours Services
• Independent Contractors such as dentists, opticians, pharmacists
• Private Sector Providers
• Voluntary Sector Providers
• Ambulance Trusts
• Clinical Commissioning Groups
• Social Care Services
• NHS Digital
• Local Authorities
• Education Services
• Fire and Rescue Services
• Police & Judicial Services

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.

Who do we receive information from?

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 received data from NHS Digital (as directed by the Department of Health) such as the uptake of flu vaccinations and disease prevalence in order to assist us to improve “out of hospital care”.

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 your 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 at any time for any particular instance of processing, provided consent is the legal basis for the processing.  Please contact your GP Practice 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 may use computer based algorithms or calculations to identify their registered patients who are at most risk, with support from the local Commissioning Support Unit and/or a third party accredited Risk Stratification provider.

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.

A Section 251 Agreement 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. 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.

The National Data opt-out service is available from May 25^th 2018. Patients can decide if they want to share their personally identifiable data to be used for planning and research purposes. If you wish to apply a Type 1 Opt Out to your record then please fill in the Opt Out Form and hand it to your GP surgery, click here for more information. For further information on Type 2 Opt Outs please visit www.digital.nhs.uk.

Sharing of Electronic Patient Records within the NHS

Electronic patient records are kept in most places where you receive healthcare.  Our local electronic systems (SystmOne) 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 about medication you are taking, allergies you suffer from and any bad reactions to medication that you have had in the past.

Your electronic health record contains lots of information about you.  In most cases, particularly for patients with complex conditions and care arrangements, the shared 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.

Change of Details

It is important that you tell the person treating you if any of your details such as your name or address have changed or if any of your details such as date of birth is incorrect in order for this to be amended. You have a responsibility to inform us of any changes so our records are accurate and up to date for you. 

Your Right of Access to Your Records

The 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 well being or to protect the identity of a third party.  If you would like access to your GP record please submit a 2024 Patient Subject Access Request Form to the practice.

Complaints

In the event that you 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 at the address 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 by clicking here

Travel Vaccinations Policy

We can only provide vaccinations to patients registered at the surgery.

In order for us to arrange any travel vaccinations available on the NHS for you, you can either:

1. Attend a private travel clinic, they will tell you which vaccinations are needed for the area you are travelling to. You will need to take a printed list of your vaccination history, which we can provide you with. Please bring the written copy of the travel advice recommendations to the surgery.
2. Ask for a printed list of your vaccination history, then visit this website which will advise you on the recommended vaccines for your travel area. Once you have done this, fill in our NHS Travel Vaccine Request form and return it to the surgery.

If possible, provide us with documentation at least eight weeks before you are due to travel, because some vaccinations need to be given well in advance to allow your body to develop immunity and some involve multiple doses spread over several weeks.

The Practice Nurses will check the information provided  and ensure that the vaccines are in stock or arrange a prescription for you, you will then be invited to make an appointment.

Free travel vaccinations (available at the GP surgery)

The following travel vaccinations are available free on the NHS:

• Diphtheria, polio and tetanus (combined booster)
• Typhoid
• Hepatitis A (including when combined with typhoid or hepatitis B)
• Cholera

These vaccines are free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.

The practice will be able to provide these vaccines for you given enough notice.

Private travel vaccinations (available at a private travel clinic)

You will have to pay for travel vaccinations against:

• Hepatitis B (when not combined with hepatitis A)
• Japanese encephalitis and tick-borne encephalitis
• Meningococcal meningitis
• Rabies
• Tuberculosis (TB)
• Yellow fever

Yellow fever vaccines are only available from designated centres.

The NaTHNaC website can help you find where to get a yellow fever vaccination.

The cost of travel vaccines at private clinics will vary but could be around £50 for each dose of a vaccine. Therefore, if a vaccine requires three doses, the total cost could be around £150.  It’s worth considering this when budgeting for your trip.

Malaria prophylaxis

Drugs for malaria prophylaxis are not prescribable on the NHS. You will have to buy them or pay for a private prescription.

Our Practice adopts a ZERO TOLERANCE approach to violence and aggression. Aggressive and violent behaviour is considered to be any personal, threatening or abusive language (cursing or swearing), gestures (including sexual), physical contact, derogatory sexual or racial remarks, shouting at any persons or applying force to any Practice property.

This approach applies to any patients, visitors and any persons working within the Practice demonstrating any of the mentioned behaviour towards patients, visitors or staff. The Partners are committed to doing everything possible to protect staff, patients and visitors from unacceptable behaviour and to support Zero Tolerance to any incident that causes hurt, alarm, damage or distress.

Patients who are violent or aggressive towards any person on Surgery premises will be removed from the Practice list.