Fitness to Travel Policy

Read / Download our Prescribing Policy.

We are unable to prescribe sedatives, such as diazepam, for any procedure or scan being undertaken outside the practice, this includes MRI scans and dental procedures.

If you feel you need sedation in such circumstances, please speak to the team undertaking the procedure or scan, as they are responsible for providing this if needed. All our local NHS hospitals have formal procedures in place for sedation during procedures, so you shouldn’t be directed to your GP for this.

Sedatives are medicines which make patients sleepy and relaxed. There are several reasons why GPs at The Thornton Practice do not prescribe these medicines for procedures outside of our practice:

• GPs are not regularly involved, skilled, trained or appraised in sedation skills. Providing too little sedation won’t help you, providing too much sedation can make you too sleepy, which could lead to the procedure being cancelled. Too much sedation can dangerously affect your breathing. After taking a sedative for a procedure or scan, you will need to be closely monitored to keep you safe.
• Although diazepam makes most people who take it sleepy, in some rare situations it can have an opposite effect and make people aggressive or agitated.
• Scans and hospital procedures are often delayed, therefore the team performing he procedure or scan should provide the sedation, to ensure you become sleepy and relaxed at the right time.
• Sedated patients should be regularly monitored and there has been a case where a GP prescribed sedative was used, the patient wasn’t monitored and subsequently had a respiratory arrest in an MRI machine.
• The Royal College of Radiologists own guidelines on sedation for imaging makes no mention of GP involvement or prescribing and stresses the importance of experienced well-trained staff being involved and the need for monitoring of sedated patients.

Feel free to show this policy to your hospital team or dentist.

We are occasionally asked by patients to prescribe sedating medication for flying.

We regret that henceforth we are not able to facilitate these requests on the grounds of patient safety and our need to prioritise the delivery of NHS care on the basis of patients’ clinical needs.

Sedating medication, e.g. benzodiazepines such as diazepam, can render someone either paradoxically aggressive, or less able to follow instructions in an emergency, thus putting crew and other passengers at risk.

Sleeping tablets similarly have no indication for flying, and again could make a passenger difficult to rouse or transfer if there was a genuine in-flight emergency. Often passengers mix these medications with alcohol, with deleterious consequences. We would not wish you to be barred from a flight or face prosecution, or find yourself incapacitated due to the unpredictable effects of said medication. The drug driving legislation which came into effect in recent years would also potentially prohibit onward driving from an airport.

Flight anxiety should be treated by Cognitive Behavioural Therapy – a form of counselling, which has long lasting benefits and is safe. Airline carriers offer excellent courses for free, so do speak with your flight provider to arrange to go on a course well in advance of when you know you will be flying.

It is not within the remit of the NHS to render someone fit to travel on a voluntary holiday or business trip, and due to the inexorable demands currently facing general practice, we make no apology for prioritising NHS care for patients on the basis of their clinical need.

We acknowledge there may be occasion when you have previously received a prescription for this purpose. We regret that we will be unable to agree to such requests henceforth. This is a joint decision, unanimously made by all senior clinical staff within the practice.

Patients are reminded that they are able to arrange a consultation at a private travel clinic should they wish to pursue the option of in-flight medication further, but we cannot accommodate their request and so would politely ask that they respect this universal practice policy from 01/04/2024.

We have been supported in the drafting of this policy by the Local Medical Committee.

Reviewed by: Practice Business Partner

Review Date: February 2024

Next Review Date: February 2026       

 

Introduction

This policy outlines The Thornton Practices’ call recording process. The purpose of call recording is to provide a record of incoming and outgoing calls which can:

• Identify practice staff training needs
• Protect practice staff from nuisance or abusive calls
• Establish facts relating to incoming/outgoing calls made (e.g. complaints)
• Identify any issues in practice processes with a view to improving them

Purpose

The purpose of this policy is to ensure that call recording is managed in line with DPA & Data Retention requirements.

This will generally involve the recording of telephone conversations which is subject to the Telecommunications Act 1984.

The practice will make every reasonable effort to advise callers that their call may be recorded and for what purpose the recording may be used. This will normally be via a pre-recorded message within the telephone system.

The voice file may be stored within the telephone system to which the same rules of confidentiality will apply.

Where a patient requests to listen to a recording then this should be allowed within the general provisional of data subject access under the Data Protection Act 2018.

 

Scope

This policy applies to all practice staff including any contracted or temporary workers.

All calls via the telephone systems used in the practice will be recorded, including:

• All external incoming calls
• All external outgoing calls made by practice staff
• All internal incoming and outgoing calls made by the practice staff
• Call transfers

Recording will automatically stop when the practice staff member terminates the call.

Callers must be advised that the call will be recorded for quality/training purposes – this can be in the form of an automated voice message or similar.

 

Playback/Monitoring of Recorded Calls

Monitoring of the call recordings will be undertaken by the Partners and the Practice Management.

Any playback of recordings will take place in a private setting and where applicable, individuals should be given the opportunity to listen to the relevant recordings to receive feedback and developmental support.

All recordings and call recording equipment will be stored securely for 45 days, and access to these will be controlled and managed by senior staff as above.

Access to the recordings will only be given to authorised staff by logging in to a dedicated password protected computer system.

 

Confidentiality

The Data Protection Act allows access to information that is held about them and their personal data. This includes recorded telephone calls. Recordings should be stored in such a way that will enable easy access to the information relating to one or more individuals.

Requests for copies of telephone conversations can be made under the Data Protection Act as a “Subject Access Request”. This can be done in writing or verbally and after assessing whether the information can be released and verifying the identity of the requestor, this can be in the form of ID documentation such as Driving License and/or Passport.  The requestor will be invited to the practice premises to present the identification and to listen to the recording. Whether or not the requestor listens to the recording within the Practice a copy of the recording will be provided by email. If there is a request from an external body relating to the detection or prevention of a crime (e.g. police), then requests for information should be directed to the Practice Manager to carry out the request for the recording.

Information for patients considering Private Medical Consultations

 

When you are seeing a private specialist, you should be aware what may happen about medication you may need after the consultation.

 

Guidance for NHS patients

In March 2009, the Department of Health (DH) published guidance (78) for NHS patients who wish to pay for additional private care. The guidance includes the key points below:

• your NHS care will continue to be free of charge
• you can’t be asked to pay towards your NHS care, except where legislation allows charges, such

as prescription charges

• the NHS cannot pay for or subsidise your privately funded care
• your privately funded care must be given separately, at a different time and place from your NHS care

 

Waiting times for NHS services

We are aware that NHS waiting times for some services are unacceptably long. However, for reasons of safety and professional accountability we cannot consider that a reason for our GPs to take on prescribing for issues that are beyond our expertise to diagnose and manage without specialist input.

 

Independent Private Referral:

If you choose to refer yourself to a consultant independently of your GP for additional privately funded care (i.e., outside the NHS), whether in the UK or abroad, you are expected to pay the full cost of any treatment (including medication) you receive in relation to the package of care provided privately (including non-emergency complications). Whilst you are undertaking private treatment, all prescriptions and associated care, monitoring of bloods, etc will also have to be undertaken privately. We are unable to ‘mix and match’ NHS and private care.

 

Private referral through your GP:

After a private referral made by your GP, your private specialist may give you a prescription. You may only need one prescription. The prescription provided by your private specialist will be a private prescription and you must pay for the medication.

If you need continued treatment, you may initially be given just one private prescription (which you will need to pay for) and advised to return to your GP to see if further NHS prescriptions can be provided.

There is no obligation, however, for your GP to accept clinical responsibility to prescribe the treatment recommended by a private specialist. To judge your clinical need for the treatment including the reasons for the proposed medication, your GP must have received a full clinical report from the private specialist.

 

If your GP does not feel able to accept clinical responsibility, then the GP may consider:

1. Offering a referral to an NHS consultant to consider whether the recommended medication should be prescribed as part of ongoing NHS funded treatment.
2. Asking the specialist to remain responsible for the treatment because of its specialist nature, and to provide further prescriptions, for which you will need to pay.

 

Shared Care

This is used in prescribing for complex conditions or with specialist medications, that often require specific monitoring and certainly require the GP to be able to access guaranteed urgent specialist advice or referral in case of problems. We can’t rely on this support from private providers.

 

If we start prescribing medication, we are taking complete clinical responsibility for the safety and appropriateness of that medication for an individual patient. Even under the NHS a GP can decline to take on shared care for a patient’s medication if they feel it is inappropriate or outside their competence.

 

Unfortunately, we are not able to enter shared care agreements with private providers. Over the past few years, huge numbers of private clinics have appeared offering diagnostic services for many conditions, some based overseas. Some of these clinics of course will provide thorough expert assessment and advice, but unfortunately others will not. We are not able to quality check all these clinics, and it is important for us to have a consistent approach

 

Local Policies

GPs have agreed to prescribe in line with local policies.

Only if your GP considers there is a clinical need and that an NHS patient would be treated in the same way would an NHS prescription to continue your treatment be considered.

If the recommendation from your private specialist is for treatment that is not in line with local policies, then your GP may change the medication in line with that used for NHS patients.

 

Your decision to see private care either independently or via your GP does not in any way impact your rights to access future NHS treatment for any condition. Patients seeking private treatment also have the choice of switching from private to NHS care at any time during their treatment, but you would be referred for NHS care in the same way as any other patient.

 

For these reasons, you may not be able to have an NHS prescription immediately, if at all.

The NHS is there for us from the moment we are born. It takes care of us and our family members when we need it most.

The NHS Constitution was created to protect the NHS and ensure it will always do the things it was set up to do when launched in 1948: provide high quality healthcare that is free and for everyone.

No government is able to change this constitution – essentially a promise that the NHS will always be there for you – without the full involvement of staff, patients and the public.

The NHS Constitution sets out what you can expect from the NHS, your rights as a patient, the quality of care you’ll receive, the treatments available to you and your right to comment and complain.

Download a copy Below.

NHS Constitution

Patient responsibilities

To help all healthcare services provide a prompt, courteous and efficient service to all, we ask you to:

• Use appointment and prescription systems appropriately and responsibly
• Supply information requested by staff
• Treat staff with courtesy and respect

Please do let us know if you have any comments, suggestions or complaints about the service you have received. We operate a practice complaints procedure that meets national criteria and ensures your views are recorded and, where appropriate, acted upon.

If you would like to make a complaint, please submit in writing by letter or by completing this form and send by email to lscicb-fw.thorntonpractice@nhs.net

All other comments, views or suggestions are always welcome and help us to continue providing a high-quality service to all our patients. Please contact the practice on 01253 204212 or via email at lscicb-fw.thorntonpractice@nhs.net with any comments you have to make.

If you feel you can’t do this, or would prefer not to, then please contact the Lancashire and South Cumbria Integrated Care Board on 0300 373 3550 or email lscicb-fw.patientexperience@nhs.net

Service Provider Complaints

For complaints about independent contractor services, such as GPs, dentists, pharmacies and opticians, please contact:

NHS England
PO Box 16738
Redditch
B97 9PT

Tel: 0300 311 22 33 (Monday to Friday 8am to 6pm, excluding bank holidays)

Email: england.contactus@nhs.net

Health Service Ombudsman

If you are unhappy with the way we have handled your complaint, we will undertake further investigation to resolve it to your satisfaction. However, if you are still not happy, you can report it to the health service ombudsman.

The parliamentary and health service ombudsman may investigate complaints on your behalf, but only if your complaint has already been investigated at a local resolution and independent review level. There is no charge for this service and the ombudsman is completely independent of the NHS.

Telephone: 0345 015 4033 (open 8.30am to 5.30pm, Monday to Friday)
Email: phso.enquiries@ombudsman.org.uk
www.ombudsman.org.uk

Independent Advice

If you require independent advice about the complaints process, there is a service called Advocacy Access for all advocacy-related issues/enquiries, aimed at both members of the public and professionals.

Tel: 0345 456 3210
Textphone: 07886 744 634
Fax: 0300 323 0966

Email: contact@advocacyaccess.org.uk

Confidentiality

You don’t ever need to worry about the service you receive in future being adversely affected because you have made a complaint. We take all comments seriously and only ever use the information to review our services and make improvements, where needed.

Everyone who is cared for by the NHS in England has formal rights to make choices about the service they receive.  These include the right to choose a GP surgery, to state which GP you’d like to see, to choose which hospital you’re treated at, and to receive information to support your choices.