Nhs doctor problem, also failure to comply with s10 data protection request

[Hadituptohere]

Hi,

 

Firstly sorry for the long winded post but just trying to summarise our problem and will get to the point eventually lol, hopefully someone can help with my fiances problem,

 

My Fiance moved in with me in July 2014 and she has some serious medical conditions that have been going on for 9 years and aren't going to get any better, She moved from the south to join me up north and we both new it was important to become registered with a local GP as soon as possible with her requiring constant repeat prescriptions for controlled drugs.

 

She approached the local GP surgery and requested registration, was given a form to complete and thought that was that, from there its been nothing but a nightmare.

 

On our first visit to the GP we were informed that the secretary had registered her on a temporary basis and not permanent meaning her files wouldn't be requested and the GP would have no info on her conditions and problems, the secretary said it was done in error but it was ok as after the 2 month period she could register again on a permanent basis, creating major problems as the level of her medication which had been established over the last years with her old GP was under question by the local GP and trying to explain all the medical problems (there are many) seemed to be falling on deaf ears and literally taken with a pinch of salt and disbelief by the GP.

 

As my fiance is on such high levels of meds she frequently had to request repeat perscriptions due to the GP not allowing the levels her previous GP and pain clinic had perscribed as they had no medical notes infront of the explaining her medical history.

 

On one occasion my fiance (who struggles to get out of bed some days and has great difficulty getting about) walked up to the surgery as per practise rules to order a repeat prescription and allowed the 48 hours for processing, as my fiance was unwell and had ran out of her med's for a day I went to collect the script that had been ordered to be told that there wasn't one there and the secretary then looked at her computer screen and said there was no script, and went on to work out how much medication my partner should have left for the time period from the last script (thought this was a clinical decision and not one a secretary should be making or discussing openly on reception infront of waiting patients), despite my fiance being on a sliding amount relevant to her pain, this calculation made by the secretary was wrong leaving my fiance with no med's and told that it would take a further 48 hours to rectify (the med's are controlled drugs and cannot just be stopped), despite this there was no offer to rectify the secretary's error straight away and refused to be able to see a doctor urgently. Obviously we were disgusted and frustrated.

 

On another occasion my fiance had an appointment to see a GP, as she is unsteady on her feet I escorted her to the surgery, her appointment lasted 25 mins to my surprise and on her exit she had a urgent referral letter to hand to the secretary, she informed me that the GP had found a lump in her arm, one in her armpit and one in her breast, the reason for the lengthy consultation was that the GP had to call a second senior GP for a second opinion, the urgent request was handed in and we awaited an appointment. Several weeks passed and we received a Book and Choose appointment to the local Skin Tag clinics, my fiance rang and enquired with the skin tag clinic if this was the correct referral for lumps in flesh i.e lumps in breast tissue and in armpits, she was told it was a skin tag clinic for removal of lumps ontop of skin and to contact her GP surgery and notify them there has been an error as she had been referred to the wrong clinic.

upon doing this my fiance managed to speak to the secretary that had made the referral and she apologised for the error but was told that she couldn't rectify the problem and that she would have to go back and see the GP for it to be rectified, an appointment was made for two days later for 11.30am despite my fiance having an hospital appointment the same day for 3.00pm for an endoscopy but due to the worry of an urgent referral that hadn't turned out that urgent in their eyes my fiance accepted the appointment.

On the day of the GP appointment and the endoscopy appointment my fiance hadn't slept all night with worry, she fell asleep at 7am. I tried to wake her (which is difficult enough on normal days due to the medication she is on) for her GP appointment but was unable to do so right upto half an hour before the GP appointment, so i rang the surgery 25 mins before she was due there to notify that she wouldn't be able to attend and informed them the reason why, I was told in a not so nice way that I should have called Half an hour before the appointment and that this would go down as an Did Not Attend, despite the secretary being very off in her manner I asked if we could reappoint as the appointment was regarding an Urgent referral that had been made with the wrong clinic and that the referral was supposed to Urgent despite 3 weeks passing and hadn't been rectified.

With that the receptionist checked the appointment and informed myself that my fiance had been made the GP appointment but that she had Dropped of the system due to her only being temporally registered and the 2 months had expired so she wouldn't have been able to have see the doctor anyway! Obviously this created great confusion and frustration, my fiance had an appointment booked but had she have arrived at the surgery she wouldn't have been able to see the GP?? and was told before my fiance could have an appointment she would have to go to the surgery and register as a permanent patient, I was then asked if my fiance was available to talk (due to patient confidentiality) I told the receptionist that my fiance had just stirred from her sleep due to her bad night of worry and that she was'nt really in a state to talk but she said its fine if a can just talk to her plz so i passed the phone over to my fiance, i was by her side and could hear the receptionist being very abrupt and talking down to my fiance, to that my fiance asked the receptionist said 'excuse me iv'e only just opened my eyes, would you mind not speaking down to me like something you've just stepped in and talk to me a little more civilly), my fiance was explained why she would'nt have seen a doctor today if she had attended and told to visit the surgery and register as a permanent patient, my fiance hung up, this was a friday so she could'nt get to the surgery until monday as she had her endoscopy to attend that afternoon.

 

Monday came and my fiance realised that her meds were very low and that she needed to register as a permanent patient to avoid complications as in the past, she rang the Surgery and asked what the procedure was to register permanently and that she needed an appointment due to her med's running low.

She was told by the receptionist that the surgery would'nt accept her as a patient due to being Verbally Abusive to staff and she had to find another GP surgery, she was also informed a letter was out in the post notifying her as to the reason why.

 

We never received any letter so we rang and asked the Practise Managers name to address our complaint to and was informed Dr X by the receptionist, so we wrote to Dr X asking for a meeting regarding the accusations and what had happened in the past, Dr X replied refusing a meeting/appointment stating that on several occasions my fiance had been verbally abusive to staff and due to the NHS zero tolerance procedure the practise wouldn't accept her as a patient.

 

So we sent a section 10 Data Protection Act Request for my fiances notes and copies of any documentation including notes of the alleged verbal and abusive behaviour including dates and copies of any referrals made urgent or non urgent and to which clinic, along with the stat £10.00 postal order.

 

we have since been sent a reply from Dr X returning our postal order stating that they no longer hold any records and enclosed a list of dates and circumstances that my fiance was supposed to have been verbally abusive to staff but these are written in his letter not copies and to be honest none of the dates tally with appointments she had and the seems all fictional there's double appointments she has missed apparently after the date her notes so called dropped of the system??? the GP clearly refers to evidence he holds in his hands and on a recent telephone call to the surgery with an enquiry about my fiances sicknotes the typed her name in their system and they informed us of dates that they stared and finished in the past, so obviously something is on their system.

 

We sent a letter notifying DRx that he had failed a s10 Request and returned the postal order and that the days are still counting down, and just had a reply stating that ' we do hold statements from staff regarding your communication and conduct during your contact with the surgery, however as it has been abusive both in the surgery and over the telephone I'am refusing to release those statements to you on the grounds that should I do so, I feel there is a real risk of my staff having further abuse which is not acceptable' and that he has taken advise from his local NHS information Governance Support Officer.

 

We have since found out that Dr X isn't the practise manager as informed although Dr X has taken it upon himself to reply and that Dr Y is the Official Practise manager. (again informed by receptionist that Dr X was Practise Manager???)

 

Can anyone please advise if this is correct??? if we can continue persuing any documentation they hold on my fiance?? the pure incompetence of the receptionists is unbelievable and beyond belief the claims being made are so far from the truth, my fiance has been with her old GP for 13 years and not one complaint made against her but yet she moves here and within 2 months there's two or three and I have been with her in the surgery at the alleged times and also within earshot on the phone.. and none of these alligations are true.

 

Since this farce with the Local Gp and only a week after the refusal to re register there my fiance ended up in hospital for two weeks prior to christmas and this could have been avoided had she her GP to call on...

 

Again sorry for the lenthy post just hope we can get some help/advise

 

 

Hadituptohere

[nolegion]

There's a lot of information in that post, "hiuth", and others may come along to pick up more general points.

 

Perhaps, apart from commiserating on the all-too-often- encountered difficulties on changing medical service provider, I could just address the question of getting details the GPs hold about your intended under the Data Protection Act.

 

The section of the Act principally concerned is Section 7. (Section 10 is about trying to force changes to data, rather than extracting it in the first place.)

 

The reason you carefully report the GPs as having provided to you, for not complying with your written 'subject access request', is NOT an adequate reason for refusing to send you the copy information you have requested.

 

The law allows a 'let-out' where there is a risk of the release of information causing 'serious harm' to someone. Even if it were the case that it might prompt, say, an 'expressive outburst', in words or in print - which I am sure is not relevant in your case anyway – , that wouldn't mean 'serious harm' entitling them to withhold what you have asked for.

 

When the 40 day time-limit expires, if it hasn't already, I would suggest that you raise a formal complaint with the Information Commissioner's Office without further ado.

 

As you may know you can, complain to the ICO 'online' and it doesn't cost anything - although it will take several weeks. I see no useful future in being deflected towards some purported NHS 'governance officer'. Just more delay.

 

Best of luck.

[Hadituptohere]

There's a lot of information in that post, "hiuth", and others may come along to pick up more general points.

 

Perhaps, apart from commiserating on the all-too-often- encountered difficulties on changing medical service provider, I could just address the question of getting details the GPs hold about your intended under the Data Protection Act.

 

The section of the Act principally concerned is Section 7. (Section 10 is about trying to force changes to data, rather than extracting it in the first place.)

 

The reason you carefully report the GPs as having provided to you, for not complying with your written 'subject access request', is NOT an adequate reason for refusing to send you the copy information you have requested.

 

The law allows a 'let-out' where there is a risk of the release of information causing 'serious harm' to someone. Even if it were the case that it might prompt, say, an 'expressive outburst', in words or in print - which I am sure is not relevant in your case anyway – , that wouldn't mean 'serious harm' entitling them to withhold what you have asked for.

 

When the 40 day time-limit expires, if it hasn't already, I would suggest that you raise a formal complaint with the Information Commissioner's Office without further ado.

 

As you may know you can, complain to the ICO 'online' and it doesn't cost anything - although it will take several weeks. I see no useful future in being deflected towards some purported NHS 'governance officer'. Just more delay.

 

Best of luck.

 

My mistake in print sorry it was a s7 request made not 10, im aware that you can take this to court to ask a DJ to demand the information required, thankyou for your reply and glad to hear that their reason for not disclosing is inadequate

 

hadituptohere

[think about it]

Okay, wow - lots of info to try and get into order.

 

I'll try to cover registrations initially, now I can only speak accurately for the procedure here in our practice and we're more West than North so local health board procedures might also be different. But, I can change someone's registration status from temp to regular in less time than it's taken to type this sentence. It's a matter of about 6 clicks. What is correct is that we too register someone as temporary until we've recieved their files from their old surgery (now, these come via the health board and we don't normally have any direct contact with the old surgery unless there are queries that pop up). Filling out the GMS1 registration form takes a few minutes and then it gets sent off to the health board who process the 'subtraction' from one practice list to an 'addition' in ours.

Medical records follow a few weeks later and then get summarised by one of our admin team.

 

I can't help but wonder what's gone on here, almost invariably new patients bring with them a copy of their most recent repeat prescription slip from their old surgery, or in the absence of that their medication. It means that the GP can see clearly what's being taken and at what frequency.

 

Receptionists do look at medication usage, we have an absolute responsibility to check that medication is being used responsibly at all times, this happens at every level of the organisation as it has safety implications. There are posts lower down the forum where people are astonished at the level of waste and/or abuse of prescription medication and we do what we can to minimise that, in doing so we don't discriminate and we check everyone. Ideally, the GP will have set the dosages to meet the highest level of demand so that there is suffient medication for the month. If they attempt to override that then the safety systems within the clinical records system then it refers the decision elsewhere, or potentially, goes with the directive already set by the GP.

 

If I'm being brutally honest, I can't imagine (other than for reasons relating to perhaps distance to another surgery) any good reason for wanting to extend your relationship with a surgery that seems to have fallen so short of your expectations. I think the suggestion to register elsewhere potentially is a very good one.

 

For some reason the GP/PM doesn't wish to engage with you on any level. This seems very unusual and as I don't have everything sat here in front of me I can't really draw conclusion as to why, but what is clear is that any meaningful therapeutic relationship with the surgery would be impossible. To lend a bit of scale to that we have over 3000 patients, and in all of the time I've been PM here I've had to remove one patient due to an absolute breakdown in Dr / Pt relationship that became abusive.

 

As a temporary patient, all notes of treatment there may have been sent to your fiance's old surgery. I won't get into the legalities of requesting copies of info, someone's already covered that.

 

However, in pulling this all together I do recommend speaking with your local health board's concerns team. You can find details easily by going onto their website. Let them handle the complaints for you and do all of the liason with the GP/PM as it seems, as I said earlier, that the GP won't engage (still puzzles me).

 

Good luck in getting things sorted out.

 

TAI

[think about it]

Just a quick addition, it's unusual but not unknown for GP's to also act as PM, they may well share the duties.

[Hadituptohere]

Okay, wow - lots of info to try and get into order.

 

I'll try to cover registrations initially, now I can only speak accurately for the procedure here in our practice and we're more West than North so local health board procedures might also be different. But, I can change someone's registration status from temp to regular in less time than it's taken to type this sentence. It's a matter of about 6 clicks. What is correct is that we too register someone as temporary until we've recieved their files from their old surgery (now, these come via the health board and we don't normally have any direct contact with the old surgery unless there are queries that pop up). Filling out the GMS1 registration form takes a few minutes and then it gets sent off to the health board who process the 'subtraction' from one practice list to an 'addition' in ours.

Medical records follow a few weeks later and then get summarised by one of our admin team.

 

I can't help but wonder what's gone on here, almost invariably new patients bring with them a copy of their most recent repeat prescription slip from their old surgery, or in the absence of that their medication. It means that the GP can see clearly what's being taken and at what frequency.

 

Receptionists do look at medication usage, we have an absolute responsibility to check that medication is being used responsibly at all times, this happens at every level of the organisation as it has safety implications. There are posts lower down the forum where people are astonished at the level of waste and/or abuse of prescription medication and we do what we can to minimise that, in doing so we don't discriminate and we check everyone. Ideally, the GP will have set the dosages to meet the highest level of demand so that there is suffient medication for the month. If they attempt to override that then the safety systems within the clinical records system then it refers the decision elsewhere, or potentially, goes with the directive already set by the GP.

 

If I'm being brutally honest, I can't imagine (other than for reasons relating to perhaps distance to another surgery) any good reason for wanting to extend your relationship with a surgery that seems to have fallen so short of your expectations. I think the suggestion to register elsewhere potentially is a very good one.

 

For some reason the GP/PM doesn't wish to engage with you on any level. This seems very unusual and as I don't have everything sat here in front of me I can't really draw conclusion as to why, but what is clear is that any meaningful therapeutic relationship with the surgery would be impossible. To lend a bit of scale to that we have over 3000 patients, and in all of the time I've been PM here I've had to remove one patient due to an absolute breakdown in Dr / Pt relationship that became abusive.

 

As a temporary patient, all notes of treatment there may have been sent to your fiance's old surgery. I won't get into the legalities of requesting copies of info, someone's already covered that.

 

However, in pulling this all together I do recommend speaking with your local health board's concerns team. You can find details easily by going onto their website. Let them handle the complaints for you and do all of the liason with the GP/PM as it seems, as I said earlier, that the GP won't engage (still puzzles me).

 

Good luck in getting things sorted out.

 

TAI

Thanks for your response TAI, my fiancé did have repeat prescriptions and had her health/care plan drawn up for the new gp to see, the fact was that the receptionist didn't do her maths correctly leaving my fiancé with no medication due to not getting her prescription done, there is nothing from any of the doctors about being abusive just the receptionist say so and I am also my fiances carer and was with her at every occasion that she went to the surgery, the highlight to our circumstances is that the receptionist has been incompetent and been to busy looking down her nose and judging people leading to having my fiancé refused permanent registration and the duty of care that everyone is entitled to.

We have registered permanently elsewhere to to these matters and caused considerable stress and Trauma which you could say has led to further health related problems that could have been avoided had she have been under the care of her gp..

The fact that the PM doesn't want to interact is wrong and we should be entitled to see evidence of the alleged abusive behaviour. The complaints procedure has led us to the ombudsman which I don't have great faith in at all..

What we do want is to clear this image of my fiancé being violent and abusive, it clearly seems to me that the PM thinks they don't have to answer or respond to legal requests sent.

 

Thanks again

 

Hadituptohere

[think about it]

HIUTH,

 

Just a thought with regards to the mysterious PM, do they have a practice website? I know I'm certainly named on ours (although I can't think why then patients think it's okay to try to add me on Facebook... Cue the world's most locked-down profile)

 

Have you engaged with the Health Board at all?

[Hadituptohere]

HIUTH,

 

Just a thought with regards to the mysterious PM, do they have a practice website? I know I'm certainly named on ours (although I can't think why then patients think it's okay to try to add me on Facebook... Cue the world's most locked-down profile)

 

Have you engaged with the Health Board at all?

 

Hi, we have been in contact with NHS England and they have helped in finding the alternative GP surgery and they have spoken to the GP/PM they themselves are astonished by the reasons the PM has given for refusal to permenant registration, they have done all they can and pointed us to the Obudsman. The PM has used the NHS zero tolerance policy but I've been employed as a security officer employed by the NHS and worked this policy myself and there has been no incidents whatsoever that could be classed as abusive or aggressive which is one of the frustrating factors

 

hadituptohere

[think about it]

HIUTH,

 

It might be worth penning (well, typing anyway ) an official complaint first to the Health Board, I see you've got Lancashire as your location so here's the link. They'll go directly to the practice concerned and give them very little truck if they're not playing ball.

 

http://www.lancashirecare.nhs.uk/contact-us/Complaints.php

 

Going to the PHSO as we know can take months, so the 25 day limit cited on the linked page won't really affect things too much. Keep the complaint factual, you want reasons for all of the errors listed above (I'd bullet point them), and also details of the alleged 'offences'.

 

Let's continue to be honest here, something that has been said or done has seriously offended or concerned a member of the team at this practice. We're a really tolerant bunch here, we know people only really come to us when they're unwell, so we rarely get to see people at their best. That said, there are limits and I can't help but wonder what has tripped someone's tolerance level to the point where you've found yourselves in the situation you are now.

[Hadituptohere]

HIUTH,

 

It might be worth penning (well, typing anyway ) an official complaint first to the Health Board, I see you've got Lancashire as your location so here's the link. They'll go directly to the practice concerned and give them very little truck if they're not playing ball.

 

http://www.lancashirecare.nhs.uk/contact-us/Complaints.php

 

Going to the PHSO as we know can take months, so the 25 day limit cited on the linked page won't really affect things too much. Keep the complaint factual, you want reasons for all of the errors listed above (I'd bullet point them), and also details of the alleged 'offences'.

 

Let's continue to be honest here, something that has been said or done has seriously offended or concerned a member of the team at this practice. We're a really tolerant bunch here, we know people only really come to us when they're unwell, so we rarely get to see people at their best. That said, there are limits and I can't help but wonder what has tripped someone's tolerance level to the point where you've found yourselves in the situation you are now.

 

I have been totally honest and and would never stand up for anything but the truth hence my post here seeking others opinion and thoughts on the matter.. My children have been registered at this practise since birth and my eldest is now 13, im not registered at this practise and felt the service was slightly better than my own hence advising my fiancé to register there, but it does seem there has been something trigger their actions and I can assure you it wasn't aggressive or abusive actions on my fiances behalf, as I've said in my main post being previously registered with her previous GP for 13 years without any complaint and being on first name terms with all contact with them and now two have three complaints within less than 2 months and accused of these allegations seems beyond belief, as I've said in my main post the listed accusations don't tally with appointments my fiancé has had at the surgery.. Thankyou for the advise and the link I will go through that when I return get home from the hospital at my fiances bedside

 

Hadituptohere

[think about it]

HIUTH,

 

Good luck with getting this all sorted out, please do keep us updated. I hope your good lady makes a speedy recovery.

 

Tai

[Hadituptohere]

Thankyou Tai,

 

just got my hands full with my Good Lady in hospital due to loosing the use of her left leg...

 

Hadituptohere

[Hadituptohere]

nolegion, can you point me in the direction of this law/let out please,

 

The law allows a 'let-out' where there is a risk of the release of information causing 'serious harm' to someone. Even if it were the case that it might prompt, say, an 'expressive outburst', in words or in print - which I am sure is not relevant in your case anyway – , that wouldn't mean 'serious harm' entitling them to withhold what you have asked for.

 

Many thanks

 

Hadituptohere

[nolegion]

The applicable law is buried in a statutory instrument made under the DPA 1998, HIUTH.

 

I give a link to the actual "Order" at the foot of this post, but the ICO's code of practice covers the point fairly clearly:-

 

"……special rules apply where providing subject access to information about an individual’s physical or mental health or condition would be likely to cause serious harm to them or to another person’s physical or mental health or condition. These rules are set out in the Data Protection (Subject Access Modification) (Health) Order 2000 (SI 2000/413), and their effect is to exempt personal data of this type from subject access to the extent that its disclosure would be likely to cause such harm."

 

From (page 50 of):-

 

https://ico.org.uk/media/for-organisations/documents/1065/subject-access-code-of-practice.pdf

 

It is a very narrow exemption, and if they are still relying on it, I would send the issue to the ICO to look at, without delay. As the code indicates, there must be a real likelihood of actual harm - and, from what you have reported, I just don't see that holding up as an excuse.

 

http://www.legislation.gov.uk/uksi/2000/413/contents/made

[Hadituptohere]

Thankyou so much for your time and effort very useful info..

 

Hadituptohere