Integrated care boards (ICBs) replaced clinical commissioning groups (CCGs) in the NHS in England from 1 July 2022. ICB’s commission most of the Hospital and community NHS services in the local areas for which they are responsible.

Commissioning involves deciding what services are needed for diverse local populations, and ensuring that they are provided.

ICBs are assured by NHS England, which retains responsibility for commissioning primary care services such as GP and Dental services, as well as some specialised Hospital services. Many GP services are now co-commissioned with ICBs.

All GP practices now belong to a ICB, but ICBs also include other Health Professionals, such as nurses.

Services ICBs commission include:

• most planned Hospital care
• rehabilitative care
• urgent and emergency care (including out-of-hours)
• most community health services
• mental health and learning disability services

All GP practices are required to declare the mean earnings for GPs working to deliver NHS services to patients at each practice.

The mean earnings for GPs working in Tarleton Group Practice in the financial year ended 31st March 2023 was £117,697 before deduction of employee’s superannuation contributions, tax and National Insurance. This is the average pay for the 2 full-time GPs and 4 part-time GPs who worked in the practice for more than 6 months during that year.

Disclaimer
NHS England require that the net earnings of Doctors engaged in the Practice is publicised, and the required disclosure is shown above. However it should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time Doctors spend working in the Practice, and should not be used to form any judgement about GP earnings, nor to make any comparison with any other Practice.

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.

The time limit can be extended in special circumstances.

Interpreting Service

We can arrange for a meeting with the Practice Manager and an Interpreter for any patient whose first language is not English and needs help with their complaint.

How to make a compliment or complaint

Whether you are happy or unhappy with the care and treatment that you have received, please get in touch and let us know your views.

Receiving compliments and complaints is important to ensuring good quality local healthcare in our Practice – helping us to find out more about what we’re getting right and what we can improve.

We hope this will help you to make your feelings and experiences known to the appropriate people. Should you have a complaint we hope this page will give you more information about what to do, who to contact and what happens next.

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.

Alternatively you can complete the form located here and return to the surgery this will not be viewed as a formal complaint however it will be investigated with the relevant parties and any learning outcomes identified.

Most complaints are best resolved within the practice and these should be made via the Practice Manager.

Formal Complaint

What we will do

We have a escalation process so the first point of contact would try to find a resolve, then it’s passed to the reception manager, if patients are still not satisfied the complaint would be escalated to the practice manager.

We ask for up to 30 days to send a formal response and if it is any longer than this we would contact the patient to explain the delay and advise them when we hope to send a full response. We will aim to offer you an explanation within that time frame. Or a meeting with the people involved.

• 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, then you can contact the NHS Complaints team on:

NHS England
PO Box 16738
Redditch
B97 9PT

If you are making a complaint please state: ‘For the attention of the complaints team’ in the subject line.

In General

If you have a complaint to make, you can either contact the Practice Manager or ask the Receptionist for a copy of our Complaints Procedure. We will endeavour to:

1. acknowledge any letter or Complaints Form within 3 working days of receiving it.
2. deal with the matter as promptly as possible – usually within 20 working days – dependent on the nature of the complaint.

Who can complain

• Complainants may be current or former patients, or their nominated or elected representatives (who have been given consent to act on the patients behalf).
• Patients over the age of 16 whose mental capacity is unimpaired should normally complain themselves or authorise someone to bring a complaint on their behalf.
• Children under the age of 16 can also make their own complaint, if they’re able to do so.

If a patient lacks capacity to make decisions, their representative must be able to demonstrate sufficient interest in the patient’s welfare and be an appropriate person to act on their behalf. This could be a partner, relative or someone appointed under the Mental Capacity Act 2005 with lasting power of attorney.

Appropriate person

In certain circumstances, we need to check that a representative is the appropriate person to make a complaint.

• For example, if the complaint involves a child, we must satisfy ourselves that there are reasonable grounds for the representative to complain, rather than the child concerned.
• If the patient is a child or a patient who lacks capacity, we must also be satisfied that the representative is acting in the patient’s best interests.

If we are not satisfied that the representative is an appropriate person we will not consider the complaint, and will give the representative the reasons for our decision in writing.

Time limits

A complaint must be made within 12 months, either from the date of the incident or from when the complainant first knew about it.

The regulations state that a responsible body should only consider a complaint after this time limit if:

• the complainant has good reason for doing so, and
• it’s still possible to investigate the complaint fairly and effectively, despite the delay.

Procedure

We have a two stage complaints procedure. We will always try to deal with your complaint quickly however if it is clear that the matter will need a detailed investigation, we will notify you and then keep you updated on our progress.

Stage one – Early, local resolution

• We will try to resolve your complaint within five working days if possible.
• If you are dissatisfied with our response, you can ask us to escalate your complaint to Stage Two.

Stage Two – Investigation

• We will look at your complaint at this stage if you are dissatisfied with our response at Stage One.
• We also escalate some complaints straight to this stage, if it is clear that they are complex or need detailed investigation.
• We will acknowledge your complaint within 3 working days and we will give you our decision as soon as possible. This will be no more that 20 working days unless there is clearly a good reason for needing more time to respond.

Complain to the Ombudsman

If, after receiving our final decision, you remain dissatisfied you may take your complaint to the 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 look into your complaint if it happened more than 12 months ago, unless there are exceptional circumstances.

Address:

Parliamentary & Health Service Ombudsman
Tower 30
Millbank
London SW1P 4QP

Phone: 0345 015 4033

E: email the Ombudsman 

Other organisations that can help you make a complaint about health services

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.

Complaints regarding commissioning decisions/issues e.g. individual patient funding requests

Customer Care Team
Lancashire Commissioning Support Unit
Lancashire Business Park
Jubilee House
Centurion Way
Leyland
PR26 6TR

Give feedback or make a complaint

You can complain to a member of staff at the NHS service you went to, such as a GP surgery or hospital, or you can complain to the organisation in charge.

Attending a busy GP Practice as a patient can be an anxious and worrying time for you. We aim to make your time here as short and as simple as possible and the following should help to explain what you, as a patient, can expect from our staff and what we, the staff, can expect from you.

Your Doctor’s Responsibilities

• To treat you with respect and courtesy at all times
• To treat you as an individual, and to discuss with you the care and treatment we can provide
• To give you full information on the services we offer
• To give you the most appropriate care by suitably qualified staff
• To provide you with emergency care when you need it
• To refer you to a suitable Consultant when necessary
• To give you access to your health records, subject to any limitations in the law

Your Responsibilities as a Patient

• To treat all staff with respect and courtesy at all times
• To tell us if you are unsure about the treatment we are offering you
• To ask for a home visit only when you are unable to attend the Practice through illness or infirmity
• To request such a visit before 10.00 am, if possible
• To ask for an out-of- hours visit only when necessary
• Please ensure that you order your repeat medication in plenty of time allowing 48 working hours for your request to be processed
• To keep to your appointment time (note: if you are more than 10 minutes late for your appointment you may not be seen)
• To notify us at least 24 hours prior to an appointment if you cannot attend
• To notify us of any changes to your personal details (e.g. name, address, telephone number, mobile numbers etc).

ZERO TOLERANCE

It is our policy to be helpful and polite to all our patients regardless of age, ethnic origin, disability, gender or sexual orientation. We expect the same courtesy from our patients. Discriminatory, unsocial, threatening, violent or abusive behaviour towards staff, other patients or the premises will not be tolerated. The Practice will take action in these circumstances, which may involve the Police and result in the removal of the patient from our Practice list.

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

Confidentiality

The practice complies with the Data Protection Act.  All information about patients is confidential: from the most sensitive diagnosis, to the fact of having visited the surgery or being registered at the Practice. All patients can expect that their personal information will not be disclosed without their permission except in the most exceptional of circumstances, when somebody is at grave risk of serious harm.

All members of the primary health care team (from reception to doctors) in the course of their duties will have access to your medical records. They all adhere to the highest standards of maintaining confidentiality.

You have a right to know who holds personal information about you. This person or organisation is called the Data Controller. In the NHS, the Data Controller is usually your local NHS Health Authority and/or your GP Surgery. The NHS must keep your personal health information confidential. It is your right.

Please be aware that our staff are bound to the NHS code of confidentiality; they are therefore not permitted to discuss any of our patient’s medical history, including their registration status, without their written consent to do so.

Once written consent has been received and verified with the patient we can provide you with information as required; this includes communicating with you on behalf of the patient with regards to any complaints, but excludes patients who are unable to act on their own behalf and already have a designated person or carer responsible for their medical care.

Under 16s:

The duty of confidentiality owed to a person under 16 is as great as the duty owed to any other person. Young people aged under 16 years can choose to see health professionals, without informing their parents or carers. If a GP considers that the young person is competent to make decisions about their health, then the GP can give advice, prescribe and treat the young person without seeking further consent.

However, in terms of good practice, health professionals will encourage young people to discuss issues with a parent or carer. As with older people, sometimes the law requires us to report information to appropriate authorities in order to protect young people or members of the public.

Useful Websites:

• Confidentiality and Mental Health
• Confidentiality Guidance

We therefore respectfully ask parents, relatives and guardians not to request information regarding their relatives/friends or to complain on their behalf unless we have their written consent that you may do so. If consent is required we advise that the person concerned attends the Practice to complete the required form.

Collecting and sharing information is essential to provide safe and effective healthcare.

Appropriate information sharing is an essential part of the provision of safe and effective care. Patients may be put at risk if those who provide their care do not have access to relevant, accurate and up-to-date information about them.

All staff have an ethical and legal duty to keep patient information confidential.

If you do not wish your health information to be shared please notify the Practice in writing, in order that we may update your record.

Subject Access Requests

A request by a patient, or a request by a third party who has been authorised by the patient, for access under the GDPR (and DPA 2018) is called a Subject Access Request (SAR). If you want to see your health records, or wish a copy, please complete a Practice Subject Access Request Form which you can complete online or please contact the Practice and we will provide you with our paper format. Contact will, subsequently, be made by the Practice to arrange a time for you to come in and collect or read them. You don’t have to give a reason for wanting to see your records and there is no charge for this service. You willl however be required to produce proof of identity before being allowed to read them.

The Practice has up to 28 days to respond to your request. If additional information is needed before copies can be supplied, the 28-day time limit will begin as soon as the additional information has been received.

The 28 day time limit can be extended for two months for complex or numerous requests where the data controller (usually your Practice) needs more time to collate and supply the data. You will be informed about this within 28 days and provided with an explanation of why the extension is necessary.

When writing/calling, you should say if you:

• want a copy of your healthcare records as well as to see them (if you wish to see them your Doctor or member of staff will be present to assist you and explain any medical terms to you)
• want all or just part of them
• would like your records to be given to you in a specific format that meets your needs, and we will endeavour to accommodate your request
• If you request your records to be emailed, then we will secure you or your representative’s agreement (in writing or by email) that they accept the risk of sending unencrypted information to a non-NHS email address

You may also need to fill in an Application Form and give proof of your identity. The Practice has an obligation under the GDPR and DPA2018 to ensure that any information provided for the patient can be verified.

Please note we never send original medical records because of the potential detriment to patient care should these be lost

Who may apply for access?

1(1) Patients with capacity

Subject to the exemptions listed in paragraph 1(6) (below) patients with capacity have a right to access their own health records via a SAR. You may also authorise a third party such as a Solicitor to do so on your behalf. Competent young people may also seek access to their own records. It is not necessary for them to give reasons as to why they wish to access their records.

1(2) Children and young people under 18

Where a child is competent, they are entitled to make or consent to a SAR to access their record.

Children aged over 16 years are presumed to be competent. Children under 16 in England, Wales and Northern Ireland must demonstrate that they have sufficient understanding of what is proposed in order to be entitled to make or consent to an SAR.However, children who are aged 12 or over are generally expected to have the competence to give or withhold their consent to the release of information from their health records. In Scotland, anyone aged 12 or over is legally presumed to have such competence. Where, in the view of the appropriate health professional, a child lacks competency to understand the nature of his or her SAR application, the holder of the record is entitled to refuse to comply with the SAR. Where a child is considered capable of making decisions about access to his or her medical record, the consent of the child must be sought before a parent or other third party can be given access via a SAR (see paragraph 1 (3) below)

1(3) Next of kin

Despite the widespread use of the phrase ‘next of kin’, this is not defined, nor does it have formal legal status. A next of kin cannot give or withhold their consent to the sharing of information on a patient’s behalf. As next of kin they have no rights of access to medical records. For parental rights of access, see the information above.

1(4) Solicitors

You can authorise a Solicitor acting on your behalf to make a SAR. We must have your written consent before releasing your medical records to your acting Solicitors. The consent must cover the nature and extent of the information to be disclosed under the SAR (for example, past medical history), and who might have access to it as part of the legal proceedings. Where there is any doubt, we may contact you before disclosing the information. (England and Wales only – should you refuse, your Solicitor may apply for a court order requiring disclosure of the information. A standard consent form has been issued by the BMA and the Law Society of England and Wales. While it is not compulsory for Solicitors to use the form, it is hoped it will improve the process of seeking consent).

The Practice may also contact you to let you know when your medical records are ready. If your Solicitor is based within our area, then we may ask you to uplift them and deliver them to your Solicitor. This is because we can no longer charge for copying and postage, so we would appreciate your help if you can do this, or alternatively ask your Solicitor if they can uplift your medical records.

1(5) Supplementary Information under SAR requests

The purposes for processing data

The purpose for which data is processed is for the delivery of healthcare to individual patients. In addition, the data is also processed for other non-direct healthcare purposes such as medical research, public health or health planning purposes when the law allows.

The categories of personal data

The category of your personal data is healthcare data.

The organisations with which the data has been shared

Your health records are shared with the appropriate organisations which are involved in the provision of healthcare and treatment to the individual. Other organisations will receive your confidential health information, for example Digital or the Scottish Primary Care Information Resource (SPIRE) or research bodies such as the Secure Anonymised Linkage Databank (SAIL). (This information is already available to patients in our Practice privacy notices).

The existence of rights to have inaccurate data corrected and any rights of objection

For example, a national ‘opt-out’ model such as SPIRE etc.

Any automated decision including the significance and envisaged consequences for the data subject

For example, risk stratification.

The right to make a complaint to the Information Commissioner’s Office (ICO)

1(6) Information that should not be disclosed

The GDPR and Data Protection Act 2018 provides for a number of exemptions in respect of information falling within the scope of a SAR. If we are unable to disclose information to you, we will inform you and discuss this with you.

1(7) Individuals on behalf of adults who lack capacity

Both the Mental Capacity Act in England and Wales and the Adults with Incapacity (Scotland) Act contain powers to nominate individuals to make health and welfare decisions on behalf of incapacitated adults. The Court of Protection in England and Wales, and the Sheriff’s Court in Scotland, can also appoint Deputies to do so. This may entail giving access to relevant parts of the incapacitated person’s medical record, unless health professionals can demonstrate that it would not be in the patient’s best interests. These individuals can also be asked to consent to requests for access to records from third parties.

Where there are no nominated individuals, requests for access to information relating to incapacitated adults should be granted if it is in the best interests of the patient. In all cases, only information relevant to the purposes for which it is requested should be provided.

1(8) Deceased records

The law allows you to see records of a patient that has died as long as they were made after 1st November 1991.

Records are usually only kept for three years after death (in England and Wales GP records are generally retained for 10 years after the patient’s death before they are destroyed).

Who can access deceased records?

You can only see that person’s records if you are their personal representative, administrator or executor.

You won’t be able to see the records of someone who made it clear that they didn’t want other people to see their records after their death.

Accessing deceased records

Before you get access to these records, you may be asked for:

• proof of your identity
• proof of your relationship to the person who has died

Viewing deceased records

You won’t be able to see information that could:

• cause serious harm to your or someone else’s physical or mental health
• identify another person (except members of NHS staff who have treated the patient), unless that person gives their permission
• If you have a claim as a result of that person’s death, you can only see information that is relevant to the claim.

1(9) Hospital Records

To see your Hospital records, you will have to contact your local Hospital.

1(10) Power of attorney

Your health records are confidential, and members of your family are not allowed to see them, unless you give them written permission, or they have power of attorney.

A lasting power of attorney is a legal document that allows you to appoint someone to make decisions for you, should you become incapable of making decisions yourself.

The person you appoint is known as your attorney. An attorney can make decisions about your finances, property, and welfare. It is very important that you trust the person you appoint so that they do not abuse their responsibility. A legal power of attorney must be registered with the Office of the Public Guardian before it can be used.

If you wish to see the health records of someone who has died, you will have to apply under the Access to Medical Records Act 1990. You can only apply if you:

• are that person’s next of kin, are their legal executor (the person named in a will who is in charge of dealing with the property and finances of the deceased person),
• have the permission of the next of kin or have obtained written permission from the deceased person before they died.
• To access the records of a deceased person, you must go through the same process as a living patient. This means either contacting the Practice or the Hospital where the records are stored.

If you think that information in your health records is incorrect, or you need to update your personal details (name, address, phone number), approach the relevant health professional informally and ask to have the record amended. Some Hospitals and GP Surgeries have online forms for updating your details. If this doesn’t work, you can formally request that the information be amended under the NHS complaints procedure.

All NHS trusts, NHS England, CCGs, GPs, Dentists, Opticians and Pharmacists have a complaints procedure. If you want to make a complaint, go to the organisation concerned and ask for a copy of their complaints procedure.

Alternatively, you can complain to the Information Commissioner (the person responsible for regulating and enforcing the Data Protection Act), at:

The Information Commissioner’s Office (ICO)
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
Telephone: 01625 545745

If your request to have your records amended is refused, the record holder must attach a statement of your views to the record.

Consent to Share Information

Giving someone power of attorney

A note about Medical Records

Sometimes when people view their medical records they see things recorded in ways that they don’t understand or in which don’t fully record the medical problems that they have or have had.

There are a number of reasons that may account for this:

1. It may have been incorrectly recorded or dated. If you are viewing your medical records and something is clearly wrong, please let us know so we can investigate and correct it. If possible, let us know of problems in writing rather than by telephone. Please do not book an appointment just to raise concerns about details in your medical record.
2. It may not be able to be exactly recorded due to the limitations of the system used to “code” medical information. Much of the information in medical records is recorded using medical terms that the computer system recognises. Unfortunately the number of computer recognised terms is not as extensive as enormous variety of medical conditions that people have. Rare, very detailed and newly described conditions or procedures are often not available on the coding system so we have to use approximations. We have to accept and work with this.
3. Remember that medical terminology does not always have exactly the same meaning as when the words are used in day to day conversation.

Your Data Matters to the NHS

Information about your health and care helps us to improve your individual care, speed up diagnosis, plan your local services and research new treatments. The NHS is committed to keeping patient information safe, and will always be clear about how it is used.

How your data is used

Information about your individual care such as treatment and diagnoses is collected about you whenever you use health and care services. It is also used to help both the Practice and other organisations for research and planning, for example research into new treatments, deciding where to put GP clinics and planning for the number of Doctors and Nurses in your local Hospital.  It is only used in this way when there is a clear legal basis to use the information to help improve health and care for you, your family and future generations.

Wherever possible we try to use data that does not identify you, but sometimes it is necessary to use your confidential patient information.

You have a choice

You do not need to do anything if you are happy about how your information is used. However, if you do not want your confidential patient information to be used for research and planning, you can choose to opt out securely, either online or through a telephone service. You can change your mind about your choice at any time.

Will choosing this opt-out affect your care and treatment?

No, choosing to opt out will not affect how information is used to support your care and treatment. You will still be invited for screening services, such as screenings for bowel cancer.

What do you need to do?

If you are happy for your confidential patient information to be used for research and planning, you do not need to do anything.

To find out more about the benefits of data sharing, how data is protected, or to make/change your opt-out choice visit Your NHS data matters.

You can also view/download the leaflet below for your information.