Practice Policies

Appointments

Appointment systems are often a source of frustration for both practice staff and patients alike. The purpose of this guide is to provide patients a guide on our appointment system, how to book and why we operate this way.

On the Day System

We have appointments available for patients to call on the day. We offer a telephone appointment in the first instance. The GP will call the patient and if they feel necessary, will invite the patient in for a Face to Face (F2F) appointment.

The GP will call either in the morning or afternoon as arranged on the phone. If you have a specific timeframe you would like the GP to call you, please advise the reception staff who will let the GP know.

How to book?

Please call us on 01506 432 621 Option 2.

Why have this system?

We previously operated with a pre-bookable system which unfortunately resulted in many patients who Did Not Attend (DNA) their appointments. This previously resulted in 83 days of clinical time lost in one year. An on the day system limits DNAs considerably and means more patients are treated by the clinical staff.

Studies have found that an on the day system is safer for patients with poor mental health.

Signposting

We trained our reception staff to signpost. They ask for your symptoms which they pass onto the GP. This is really helpful for the GP to know your symptoms prior to contacting you. If you have a symptoms that can be treated by the Pharmacy or Optician for example, the reception staff can signpost you appropriately. This saves you time, and allows you to be seen by the right person.

Nursing Appointments

All Nursing and Phlebotomy appointments can be booked up to one week in advance. The only exceptions are INR Bloods.

Pre-bookable Appointments

We understand the telephone lines are extremely busy first thing in the morning. This can be very frustrating and also makes things tricky for those who work.

We have a limited number of pre-bookable appointments each day. They are released one week in advance and come in two different formats:

Extended Hours – available from 0730 – 0815 (typically telephone appointments)

When available:
Tuesday to Fridays 0730 – 0815
One week in advance

Pre-bookable F2F appointments – from 08:30 – 09:00 (patients can choose to have a telephone appointment in this slot should they wish).

When available:
Monday to Friday 08:30 – 09:00
Released a week ahead every Monday

Emergency Triage

Patients who call and have an urgent medical condition that cannot wait can be added to the Emergency Triage team. This is made up of the Duty Doctor and Advanced Nurse Practitioners who will call back in the first instance.

When available:
Monday to Friday
Urgent, on the day service

Practice Mental Health Nurse

We have a PMHN in all day on Tuesdays and Fridays. Appointments are a mix of F2F and Telephone Consultations.

When available:
Mondays and Fridays
One week in advance

GP Physio

We have a Physio in all day on Thursdays. If you have an MSK issue (problems with muscles and bones) you can arrange a F2F appointment. The Physio is the expert in all MSK issues and can also arrange medications and Fit to Work Notes when necessary.

When available:
Wednesday afternoons and Thursdays, one week in advance

Complaints

What is a Complaint?

We regard a complaint as:

  • Any expression of dissatisfaction about our action or lack of action, or about the standard of service provided by us or on our behalf.

If you need to complain about something, we encourage you to do so. We also understand that your complaint may involve more than one NHS body or service, or relate to both health and social care services, or it may be about someone working on our behalf. Our complaints procedure covers all of these possibilities.  Please click on the link to view our Complaints Leaflet.

You can also submit your complaint online by clicking here.

Data Protection / GDPR

Text Message Reminders

The Practice will send you appointment reminders using the mobile telephone number that patients provided. Patients can opt out of this service by contacting the practice or by responding to a text reminder with the phrase ‘NO TEXT’.

Data Protection Notice

Craigshill Health Centre is compliant with GDPR and Data Protection Legislation.

Subject Access Request

To make a Subject Access Request, please complete this attached form.

Consent to SMS / Text / Emails from the practice

You can submit a form to consent to texts and/or emails from the practice here.

Further Information

Please ask to speak to the Practice Manager.

GP Data Protection Notice

The following notice applies from 25/10/2024.

1. About Craigshill Health Centre
This practice is an independent contractor providing primary medical services by way of a
contract with NHS Lothian, made under the National Health Service (Scotland) Act 1978 (the
1978 Act). It is one of the organisations which form part of NHS Scotland (NHSS).

2. About the personal information we use
We use personal information on different groups of individuals including:
• Patients
• Staff
• Contractors
• Suppliers
• Complainants, enquirers
• Survey respondents
• Professional experts and consultants
• Individuals captured by CCTV
The personal information we use includes information that identifies you like your name, address,
date of birth and postcode.

We also use more sensitive types of personal information, including information about racial or ethnic origin; political opinions; religious or philosophical beliefs; trade union membership; genetic and biometric data, health; sex life or sexual orientation.

The information we use can relate to personal and family details; education, training and employment details; financial details; lifestyle and social circumstances; goods and services; visual images; details held in the patient record; responses to surveys.

3. Our purposes for using personal information
Under the 1978 Act Craigshill Health Centre has the statutory responsibility to provide or arrange for the provision of a range of healthcare, health improvement and health protection services.  We are given these tasks so that we can help to promote the improvement of the physical and mental health of the people of NHS Lothian and assist in operating a comprehensive and integrated national health service in Scotland.

We use personal information to enable us to provide healthcare services for patients (including reminding you of appointments), data matching under the national fraud initiative; research; supporting and managing our employees; maintaining our accounts and records and the use of CCTV systems for crime prevention.

4. Our legal basis for using personal information
Craigshill Health Centre, as data controller, is required to have a legal basis when using personal information. Craigshill Health Centre considers that performance of our tasks and functions are in the public interest. So, when using personal information our legal basis is usually that its use is necessary for the performance of a task carried out in the public interest, or in the exercise of official authority vested in us. In some situations, we may rely on a different legal basis; for example, when we are using personal information to pay a supplier, our legal basis is that its use is necessary for the purposes of our legitimate interests as a buyer of goods and services. Another example would be for compliance with a legal obligation to which Craigshill Health Centre is subject to, for example under the Public Health etc (Scotland) Act 2008 we are required to notify Health Protection Scotland when someone contracts a specific disease.

When we are using more sensitive types of personal information, including health information, our legal basis is usually that the use is necessary:
• for the provision of health or social care or treatment or the management of health or social care systems and services; or
• for reasons of public interest in the area of public health; or
• for reasons of substantial public interest for aims that are proportionate and respect people’s rights; or
• for archiving purposes, scientific or historical research purposes or statistical purposes, subject to appropriate safeguards; or
• in order to protect the vital interests of an individual; or
• for the establishment, exercise, or defence of legal claims or in the case of a court order.

On rare occasions we may rely on your explicit consent as our legal basis for using your personal information. When we do this, we will explain what it means, and the rights that are available, to you. You should be aware that we will continue to ask for your consent for other things like taking part in a drug trial, or when you are having an operation.

5. Who provides the personal information
When you do not provide information directly to us, we receive it from other individuals and organisations involved in the delivery of health and care services in Scotland. These include other NHS Boards and primary care contractors such as GPs, dentists, pharmacists and opticians, other public bodies e.g. Local Authorities and suppliers of goods and services.

6. Sharing personal information with others
Depending on the situation, where necessary we will share appropriate, relevant and proportionate personal information in compliance with the law, with the following:
• Our patients and their chosen representatives or carers
• Staff
• Current, past and potential employers
• Healthcare social and welfare organisations
• Suppliers, service providers, legal representatives
• Auditors and audit bodies
• Educators and examining bodies
• Research organisations
• People making an enquiry or complaint
• Financial organisations
• Professional bodies
• Trade Unions
• Business associates
• Police forces.
• Security organisations.
• Central and local government.
• Voluntary and charitable organisations.

7. Transferring personal information abroad
It is sometimes necessary to transfer personal health information overseas for example if you require urgent medical treatment abroad. When this is needed information may be transferred to countries or territories around the world. Any transfers made will be in full compliance with NHSScotland Information Security Policy.

8. Retention periods of the information we hold
Within Craigshill Health Centre we keep personal information as set out in the Scottish Government Records Management Code of Practice for Health and Social Care. The Code of Practice sets out minimum retention periods for information, including personal information, held in different types of records including personal health records and administrative records. As directed by the Scottish Government in the Records Management Code of Practice, we maintain a retention schedule as part of our Records Management policy detailing the minimum retention period for the information and
procedures for the safe disposal of personal information.

9. How we protect personal information
We take care to ensure your personal information is only accessible to authorised people. Our staff have a legal and contractual duty to keep personal health information secure, and confidential. The following security measures are in place to protect personal information:
• All staff undertake mandatory training in Data Protection and IT Security
• Compliance with NHS Scotland Information Security Policy
• Organisational policy and procedures on the safe handling of personal information
• Access controls and audits of electronic systems

10. Your rights
This section contains a description of your data protection rights within Craigshill Health Centre.

The right to be informed
Craigshill Health Centre must explain how we use your personal information. We use a number of ways to communicate how personal information is used, including:
• This Data Protection Notice
• Information leaflets
• Discussions with staff providing your care

The right of access
You have the right to access your own personal information.

This right includes making you aware of what information we hold along with the opportunity to satisfy you that we are using your information fairly and legally.

You have the right to obtain:
• Confirmation that your personal information is being held or used by us
• Access to your personal information
• Additional information about how we use your personal information

Although we must provide this information free of charge, if your request is considered unfounded or excessive, or if you request the same information more than once, we may charge a reasonable fee.

If you would like to access your personal information, you can do this by submitting a written request to the Practice Manager at the following address:

Craigshill Health Centre, The Mall, Craigshill, Livingston, EH54 5DY
Telephone: 01506 432621

Once we have received your request and you have provided us with enough information for us to locate your personal information, we will respond to your request without delay, within one month (30 days). However, if your request is complex we may take longer, by up to two months, to respond. If this is the case, we will tell you and explain the reason for the delay.

The right to rectification
If the personal information we hold about you is inaccurate or incomplete you have the right to have this corrected.

If it is agreed that your personal information is inaccurate or incomplete, we will aim to amend your records accordingly, normally within one month, or within two months where the request is complex. However, we will contact you as quickly as possible to explain this further if the need to extend our timescales applies to your request. Unless there is a risk to patient safety, we can restrict access to your records to ensure that the inaccurate or incomplete information is not used until
amended.

If for any reason we have shared your information with anyone else, perhaps during a referral to another service for example, we will notify them of the changes required so that we can ensure their records are accurate.

If on consideration of your request Craigshill Health Centre does not consider the personal
information to be inaccurate then we may add a comment to your record stating your concerns
about the information. If this is case we will contact you within one month to explain our reasons for
this.

If you are unhappy about how Craigshill Health Centre has responded to your request for rectification we will provide you with information on how you can complain to the Information Commissioner’s Office, or how to take legal action.

The right to object

When Craigshill Health Centre is processing your personal information for the purpose of the performance of a task carried out in the public interest or in the exercise of official authority you have the right to object to the processing and also seek that further processing of your personal information is restricted. Provided Craigshill Health Centre can demonstrate compelling legitimate grounds for processing your personal information, for instance; patient safety or for evidence to
support legal claims, your right will not be upheld.

Other rights
There are other rights under current Data Protection Law however these rights only apply in certain circumstances. For further information on these rights please visit ico.org.uk/for-the-public.

The right to complain
Craigshill Health Centre employ a Data Protection Officer to check that we handle personal information in a way that meets data protection law. If you are unhappy with the way in which we use your personal information, please tell our Data Protection Officer using the contact details below.

Data Protection Officer
Information Governance
Woodlands House
74 Canaan Lane
Edinburgh
EH9 2TB
Phone – 0131 465 5444
Email: Loth.DPO@nhs.scot 

Please note emails from your private email address may not be secure.
You also have the right to complain about how we use your personal information to the Information Commissioner’s Office (ICO). Details about this are on their website at www.ico.org.uk
Please note emails from your private email address may not be secure.
You also have the right to complain about how we use your personal information to the Information Commissioner’s Office (ICO). Details about this are on their website at https://ico.org.uk/your-datamatters/how-to-make-a-data-protection-complaint/

Our ICO registration number is Z5950117

11. Translation Service/ Accessibility
If you require a translation service, please find details to enquire below.

Interpretation and Translation Service
NHS Lothian Staff Bank
Comely Bank Centre
13 Crewe Road South
Edinburgh,
EH4 2LD
Telephone: 0131 536 2020 option 5 option 5
Email: loth.staffbankits@nhs.scot

12. DataLoch
For further information regarding NHS Lothian DataLoch Programme please go to https://dataloch.org/

13. Invitation to take part in research
Research is essential for progress within the NHS. Craigshill Health Centre may invite you to take part in a research study. Craigshill Health Centre do this with the support of specialist NHS staff who identify eligible patients from their medical record.

No data is provided to researchers without specific consent from patients.

Patients have the right to opt out of being contacted about research studies. Please let the reception staff, practice manager or your GP know if you wish to opt out

17/04/2024

There is an important update to Public Health Scotland’s General Practice data collection following the retirement of the SPIRE system in August 2023. Public Health Scotland (PHS) have been working with our NSS digital partners to confirm a new technical solution that will provide aggregate data extracts. This solution has been developed in tandem with our new national GP data extraction and analytical service, named the Primary Care Intelligence Service for Scotland (PCIS).

Data extracts previously captured via SPIRE are now scheduled to be undertaken by the new PHS Primary Care Intelligence Service (PCIS).

The permissions associated with the new service are the same as those previously agreed for SPIRE, so no changes are made to the practice’s privacy notice at this stage.

11/07/2022

This GP practice has agreed to take part in the DataLoch research programme. Both your GP practice and NHS Lothian are the data controller for the DataLoch programme (Data is only hosted within NHS Lothian), and are working in partnership with the University of Edinburgh. The aims of the DataLoch programme are to support research for the benefit of local residents in the South-East Scotland region. A Data Sharing Agreement is in place that covers the sharing of patient data with DataLoch, and all approved research is anonymous.


In line with data protection legislation, the legal basis that permits processing of patient data is:
• 6(1)(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.
• 9(2)(j) – Processing is necessary for archiving purposes in the public interest, or scientific and historical research purposes or statistical purposes in accordance with Article 89(1)

The DataLoch website covers the researcher data, public enquiries, and newsletter subscriptions for which the University of Edinburgh is the Data Controller:

Diazepam for Flying

Why We Don’t Give Diazepam for Flying Nerves

Some people ask the doctor or nurse for diazepam to help them feel calm or sleep during a flight. Diazepam is a strong calming medicine that can make you feel sleepy or relaxed.

But we don’t give this medicine for flying anymore. Here’s why:

It’s Not Meant for Fear of Flying

  • Doctors have rules to follow when they give out medicines.
  • Diazepam is not allowed to be used for things like fear of flying.
  • It is only used for people with serious, long-term anxiety, and even then, only in emergencies.
  • If your anxiety is really bad, it’s better to get proper support before flying.

It Doesn’t Help Your Anxiety Get Better

  • Research shows that using medicines like diazepam can stop your brain from learning to cope with flying.
  • That means it could make your fear worse in the long run.

It Can Be Dangerous on a Plane

  • If something goes wrong on the flight, diazepam might slow you down so you can’t react quickly.
  • It could stop you from moving fast if there’s an emergency.

You Could Get a Blood Clot

  • Diazepam makes you sleep unnaturally. You don’t move around as much.
  • Not moving for a long time can cause blood clots, which are very dangerous and can even be deadly.
  • This risk is worse on flights longer than 4 hours.

It Can Change Your Behaviour

  • Most people feel sleepy with diazepam, but a few can feel angry or act in strange ways.
  • This could get you into trouble on the flight or even with the police.

It’s Illegal in Some Countries

  • Some places don’t allow diazepam at all.
  • You could have it taken away or even be arrested.
  • You might not be able to get it for the return journey either.

It Stays in Your Body

  • Diazepam can stay in your system for days.

It Can Affect Your Travel Insurance

  • If you don’t tell your travel insurance about your medicine, your insurance might not work if you need help abroad.

What You Can Do Instead

We recommend special courses that help with fear of flying. These are run by airlines and the travel industry and teach you how to manage anxiety without medicine.

Final Note

Helping with flying anxiety is not part of the GP’s normal job (according to NHS rules), so we won’t prescribe diazepam for this anymore.

If you still want this medicine, you’ll need to see a private doctor or travel clinic.
Further information:
https://thefearofflying.com/programs/fly-and-be-calm/
https://www.fearlessflyer.easyjet.com/
https://www.britishairways.com/en-gb/information/travel-assistance/flying-with-confidence

[i] British National Formulary; Diazepam
[ii] British National Formulary; Hypnotics and anxiolytics
[iii] Generalised anxiety disorder and panic disorder in adults: management. NICE Clinical guideline [CG113] Published date: January 2011 Last updated: July 2019
[iv] Acute and delayed effects of Alprazolam on flight phobics during exposure. Behav Res Ther. 1997 Sep;35(9):831-41
[v] Travel Health Pro; Medicines and Travel; Carrying medication abroad and advice regarding falsified medication

Duty of Candour

The Duty of Candour is a rule that health and care services in Scotland must follow. It means being honest, open, and kind when something goes wrong with a person’s care.

Since April 2018, if a patient is hurt or dies by accident while getting care, the health centre must tell them (or their family) what happened and say sorry.

When does this happen?

It happens if:

  1. Someone dies because of an accident during their care.
  2. Someone is badly hurt, like losing a body part or having brain damage.
  3. Someone is hurt in other ways, like:
    • needing extra treatment
    • a part of their body being changed
    • living a shorter life
    • being in pain or upset for a long time (at least 28 days)

What does the health centre do?

  • They talk about what happened at their weekly team meeting.
  • They tell the patient or family within 10 working days.
  • They say sorry and explain what went wrong.
  • They offer a meeting to talk more and answer questions.
  • They try to do all this within 28 days.

What happens after?

  • The centre writes a report explaining what happened and what they learned.
  • They use the report to make care better in the future.
  • They put a summary report online every year (but don’t share any names).
  • If the patient or family wants, they can get a copy of the report and details of help or support.

Fit to Work Notes (Med3)

When to request for a Fit to Work Note

Employees might need a fit note when they’re off sick.  A fit note is an official statement from a registered healthcare professional giving their medical opinion on a person’s fitness for work. Fit notes were previously called sick notes.

Self-Certify

You can self-certify for 7 days (including weekends).

You do not need to provide a Fit to Work Note to your employer during this period.

How can I request a Fit to Work Note?

You can request a Fit to Work Note by calling us on 01506 432 621 Option 2. Please call after 10am.  You can also book an appointment with the GP if you feel that you need to discuss your symptoms further.

You can also request a Fit Note via our website.

How long does a Fit Note take to be ready?

It takes 48 hours (over the working week) to produce.  I.e. you request on Friday afternoon, the Fit Note will be ready for Tuesday afternoon.

Can you extend the Fit to Work Note in advance?

No. If your line runs out on the 10th, we cannot physically produce another line until the 11th. Our computer system doesn’t allow it.

Phased Return

The GP can recommend a phased return on your Fit Note. However this is an agreement between you and your employer. The GP is unable to contribute further to this.

If you cannot agree a phased return with your employer, you can be signed off sick for a further period which will require you to request a Fit to Work Note.

Do I need a note to say I can come back to work?

If your employer wishes for more information on your health, they can contact us directly and request a letter (subject to a charge) or refer you privately to Occupational Therapy. Both of which require your consent.

Does my employee need a fit note saying they are fit for work?

No. People do not need to be signed back to work and there is no option on the fit note to do so.  An employee’s healthcare professional assesses that they are fit for work, they will not be issued with a fit note.

An employee should return to work once their note expires (if they have not already done so) or will need a new fit note.

For a limited number of jobs, there are separate procedures to ensure someone is fit to carry out their role. Your HR, occupational health or legal department should know if this applies to your organisation.

If your organisation has a separate policy which requires someone to obtain medical evidence that they are fit for work, this should be arranged through a private arrangement with a healthcare professional or occupational health specialist.

Once your employee’s healthcare professional has assessed them as fit for work, they cannot issue any further fit notes to cover a period while they are waiting for additional health checks required by your organisation.

References
https://www.gov.uk/government/collections/fit-note

Training Practice

Training Practice

Craigshill Health Centre is a training practice. Every August and/or February, a new registrar joins us and receives 12 months GP training. We are also involved in the education and training of medical and nursing students. We would be grateful if you would accept them as part of the practice.

The doctor will inform you if a student is in attendance. They will ask if you are agreeable to them staying during the consultation. You have the right to say no. The students are the doctors and nurses of the future and practical experience is invaluable to them. Please help and encourage them as much as possible