Practice Policies

Chaperone Policy

Definition of a Chaperone: A person who accompanies and looks after another person or group of people.

This policy is designed to protect both patients and staff from abuse or allegations of abuse and to assist patients to make an informed choice about their examinations and consultations.

GUIDELINES

The doctor must be satisfied that the chaperone will:

1. be sensitive and respect the patient’s dignity and confidentiality
2. reassure the patient if they show signs of distress or discomfort
3. be familiar with the procedures involved in a routine intimate examination
4. stay for the whole examination and be able to see what the doctor is doing, if practical
5. be prepared to raise concerns if they are concerned about the doctor’s behaviour or actions.

Clinicians (male and female) should consider whether an intimate or personal examination of the patient (either male or female) is justified, or whether the nature of the consultation poses a risk of misunderstanding.

• The clinician should give the patient and the chaperone a clear explanation of what the examination will involve.
• The chaperone will always adopt a professional and considerate manner – be careful with humour as a way of relaxing a nervous situation as it can easily be misinterpreted.
• Always ensure that the patient is provided with adequate privacy to undress and dress.
• Ensure that a suitable sign is clearly on display in each consulting or treatment room offering the chaperone service if required.To remove any misunderstanding and either clinician or patient feeling uncomfortable it is normal policy to use or consider using a chaperone. Patients will always be offered the services of a chaperone for any intimate examination.Patients who request a chaperone should never be examined without a chaperone being present. If necessary, where a chaperone is not available, the consultation / examination should be rearranged for a mutually convenient time when a chaperone can be present.

WHO CAN ACT AS A CHAPERONE?

A variety of people can act as a chaperone in the practice, both clinical and non-clinical.

Where the practice determines that non-clinical staff will act in this capacity the patient must agree to the presence of a non-clinician in the examination, and be at ease with this. If the patient is not happy to have a non clinician present, and there are no nurses available, an alternative appointment should be made when a nurse or HCA can be available.

The staff member should be comfortable in acting in the role of chaperone, and be confident in the scope and extent of their role. Members of staff undertaking this role will have received training/instruction on the role of a chaperone.

All staff eligible to chaperone have been DBS checked.

CONFIDENTIALITY

• The chaperone should only be present for the examination itself, and most discussion with the patient should take place while the chaperone is not present.
• Patients should be reassured that all practice staff understand their responsibility not to divulge confidential information.

Click here to link to the latest GMC guidelines for intimate examinations: http://www.gmc-uk.org/guidance/current/library/maintaining_boundaries.asp#10

PROCEDURE

• The clinician will ask the patient if they would like a chaperone as appropriate and record the offer in the patient’s record using code XaEiq Chaperone offered.
• If the patient declines the offer this should be recorded in the patient’s record using the code XaEis Chaperone refused.

Where no chaperone is available the examination will not take place if a chaperone has been identified as being necessary. The patient should not normally be permitted to dispense with the chaperone once a desire to have one present has been expressed.

• The chaperone will enter the room discreetly and remain in room until the clinician has finished the examination.
• The chaperone will always attend inside the curtain at the head of the examination couch and watch the procedure.
• To prevent embarrassment, the chaperone should not enter into conversation with the patient or GP unless requested to do so, or make any mention of the consultation afterwards.
• Following the examination the chaperone will remain in the room, outside the curtain, until the patient has dressed.
• Following the examination the chaperone will make a record in the patient’s notes by entering the code XaEir Chaperone present followed by text for example: examination by RM. JB present. No concerns.The record should state the name of the doctor carrying out the procedure and the initials of the chaperone. The record should confirm that there were no problems, or give clear details of any concerns or incidents that occurred.
• The patient can refuse a chaperone, and if so this must be recorded in the patient’s medical record. Concerns:   If a chaperone has concerns following an examination these should be made known to the Practice Manager immediately. In the absence of the Practice Manager a detailed report outlining concerns should be written immediately after the consultation and discussed with the Practice Manager or Senior Partner as soon as possible. 

Duty of Candour

The Duty of Candour has been introduced as a direct result of the Francis Inquiry Report into the Mid Staffordshire NHS Foundation Trust, which recommended that a statutory “duty of candour” be imposed on all healthcare providers, which defined “Openness”, “Transparency” and “Candour”.

To this end, we at The Wellbridge Practice will:

• Acknowledge, apologise and explain when things go wrong;
• Carry out investigations into incidents affecting Patient Safety;
• Provide support for those involved in the incident (patients & staff) to cope with the physical & emotional impact.
• Reassure patients, families & carers that lessons learned will prevent patient safety incidents happening in the future.

Equality Policy

We operate an Equality and Diversity Policy as follows:

The term ‘visitor’ used below refers to anyone (including patients and their family members, other visitors and contractors) making use of the Practice’s premises and services.

The Practice:

• will ensure that all visitors are treated with dignity and respect
• will promote equality of opportunity between men and women
•  will not tolerate any discrimination against, or harassment of, any visitor for reason of age, sex, marital status, pregnancy, race, ethnicity, disability, sexual orientation, religion or belief
• will provide the same treatment and services (including the ability to register with the Practice) to any visitor irrespective of age, sex, marital status, pregnancy, race, ethnicity, disability, sexual orientation, religion or belief

Applicability

This Policy applies to the general public, including all patients and their families, visitors and contractors.

Procedure

Discrimination by the Practice against you.
If you feel discriminated against:

• You should bring the matter to the attention of the Practice Manager.
• The Practice Manager will investigate the matter thoroughly and confidentially within 5 working days.
• The Practice Manager will establish the facts, and decide whether discrimination has taken place  and advise you of the outcome of the investigation within 10 working days.

If you are not satisfied with the outcome, you should raise a formal complaint through the Practice’s Complaints Procedure (please ask for a copy of our leaflet “If things go wrong” from reception.

Discrimination against the Practice’s staff
The Practice will not tolerate any form of discrimination or harassment of our staff by any visitor. Any visitor who expresses any form of discrimination against, or harassment of, any member of our staff, will be required to leave the Practice’s premises forthwith. If the visitor is a patient, he/she may be removed from the Practice’s list if any such behaviour occurs on more than one occasion.

In addition to the above provision Dorset PCT provide PALS (Patient Advice & Liaison Service)

Practice Charter

Practice Responsibilities	Patient Responsibilities
Names People involved in your care will give you their names & ensure you know how to contact them. The surgery should be well signposted & the Doctors’ or Nurses’ names should be on their room doors or name badges.	Please let us know if you change your name, address or landline or mobile telephone number.
Waiting Times We run an appointment service. You will be given a time at which the doctor or nurse hopes to be able to see you.   If you have been waiting more than 30 minutes please ask at reception for an explanation.	Please try to keep appointments, and tell us as soon as possible if you cannot. Otherwise, other patients may have to wait longer.   Try not to save up lots of different problems for a single appointment.
Home Visits We will arrange a home visit for patients who are too ill to be brought to the surgery.	Please only ask for home visits only when the patient is too ill to visit the surgery.
Telephone We will try to answer the phone promptly and ensure we have sufficient staff available to do this. You should be able to speak to a doctor by telephone.	Please keep your telephone call brief and avoid calling during peak morning times for non-urgent matters.
Test Results If you have undergone tests or X-rays ordered by the practice, we will inform you of the results at your next appointment. If no further appointment needs to be arranged we will tell you how to obtain the results.	Test results take time to reach us, so please do not ring before you have been advised to. Enquiries about tests ordered by the hospital should be direct to the hospital, not the practice.
Respect Patients will be treated as individuals & partners in their health care irrespective of their ethnic origins, religious or cultural beliefs.	We ask that you treat the doctors and practice staff with the same courtesy and respect.
Information      We will give you full information about the services we offer. Every effort will be made to ensure you receive the information that directly affects your health and the care being offered.	Please read our Practice Leaflet. It will help you get the best out of the services we offer. It is important you understand the information given to you.   Please ask us questions if you are unsure of anything.
Health Promotion The practice will offer patients advice & information on steps they can take to promote good health and avoid illness.	Remember, you are responsible for your own health and the health of your children. We will give you our professional help and advice.   Please act upon it.
Health Records You have the right to see your health records, subject to any limitations in the law.   They will be kept confidential at all times. On line access is now available for certain parts of your health record.	Please ask if you would like to see your records or to register for on line access to your records. You can also use on line access to re order prescriptions and make appointments.
Complaints We will provide you with information about how to make suggestions or complaint about the care we offer. We want to improve services, so we welcome any comments you have.	Please read our Practice Leaflet or access our website www.wellbridge.co.uk which will tell you about the arrangements we have made to receive your suggestions, complaints or even compliments!

Zero Tolerance

As a healthcare organisation we are very aware that visiting the surgery or contacting us can, at times, be stressful and concerning for patients. Delays in obtaining appointments and delays sometimes due to unforeseen emergency appointments, can also add to these concerns.

We always strive to meet patient expectation and deliver the highest standards of healthcare. For the vast majority of our patients, we achieve this, despite the finite resources and steadily increasing demand for services that exists today within the NHS.

Our staff come to work to care for others, and it is important for all members of the public and our staff to be treated with respect.

In line with the rest of the NHS and to ensure this is fully observed we have instigated a Dignity at Work and Zero Tolerance policy, whereby aggressive or violent behaviour towards our staff will not be tolerated under any circumstances.

Anyone who verbally abuses a member of practice staff will be sent a letter from the Practice Manager confirming that this behaviour will not be tolerated. Any future violation of this policy may result in removal from the Practice patient list. The Police will be called in all cases of violence.

We are sure you will understand that appropriate behaviour is absolutely necessary for our staff and patients and that non observance will not be accepted.