Patient Rights and Responsibilities-Duty of Candour report 2020-2021

Introduction

The Patient Charter sets out the responsibilities of the Practice as a provider of primary care and the responsibilities of the patient as the recipient of that care.

Practice Leaflet

All new patients will receive a copy of our practice leaflet and copies will be displayed at the reception desk.

Surgery Premises

Our surgery premises will be welcoming, easy for patients to find their way around and appropriate to the needs of users, including the disabled.

Our responsibility to you

• You will be greeted courteously.
• You will have a right to confidentiality: we will respect our patients’ privacy and confidentiality at all times.
• You have the right to see your medical records, subject to the limitations of the law and in accordance with Practice procedure for access to health records.
• Appointments are 10 minutes long. Multiple problems or complicated issues can take longer and this is one reason why surgeries run late. If you need longer, please tell the receptionist when booking.
• You will be seen the same day if your problem is urgent.
• You will be informed if there will be a delay of more than 20 minutes when you arrive for your appointment.
• You will be referred to a consultant when your GP thinks it is necessary.
• You will be given the result of any test or investigation on request or at your next appointment.
• Your repeat prescription will be ready for collection 48 hours (two working days) after your request.
• Your suggestions and comments about the services offered will be considered sympathetically and any complaint dealt with in accordance with the Practice Complaints Procedure.

Changes to Procedure

When changes that affect patients are introduced to practice procedures, we will ensure that these are clearly explained by means of our practice leaflet, waiting room notice-board or via individual leaflets.

Repeat Prescriptions

The procedure for obtaining repeat prescriptions will be explained in our practice leaflet. Prescriptions will be available from the reception desk. 48 hours’ notice (two working days) is required for a repeat prescription.

Referrals

Urgent referrals to other health and social care agencies will be made within one working day of the patient consultation. We will normally process non-urgent referrals within five working days of the patient consultation or of the doctor’s decision to refer.

Transfer of Medical Records

The Practice will endeavour to dispatch any medical record required by the Health Board within seven working days and on the same day of the request is urgent.

Appointments

With a doctor – for routine consultations, we will endeavour to offer patients an appointment within two working days of the request. For medically urgent requests, we will offer an appointment on the same day.

With a practice nurse – for routine appointments, we will offer an appointment within five working days.

Home Visits

Home visits are available for patients who are too ill or disabled to attend the surgery. You may be asked to discuss with the doctor the most appropriate place for you to be seen.

Out of Hours Emergencies

We will do everything possible to ensure that our system for contacting the duty doctor is easy to follow, reliable and effective.

With these rights come responsibilities and for patients this means:

• Courtesy to staff at all times – remember they are working under doctor’s orders.
• Attending appointments on time or giving the Practice adequate notice that they wish to cancel. Someone else could use your appointment.
• An appointment is for one person only – where another member of the family needs to be seen or discussed, another appointment should be made and the Medical Record be made available.
• Patients should make every effort when consulting the surgery to make the best use of nursing and medical time. Home visits should be medically justifiable and not requested for social convenience.
• Out-of-hours calls (e.g. evenings, nights and weekends) should only be requested if they are truly felt to be necessary.

Do let us know when you feel we have not met our responsibility to you. We would, of course, be pleased to hear when you feel praise is due as well.

Kingussie Medical Practice Duty of Candour Annual Report 2020/21

1. Introduction

 All health and social care services in Scotland have a duty of candour. This is a legal requirement which means that when unintended or unexpected events happen that result in death or harm as defined in the Act, the people affected understand what has happened, receive an apology, and are informed by the organisation what has been learned and how improvements for the future will be made.

An important part of this duty is that we publish an annual report which describes how NHS Highland has operated the duty of candour procedures during the time between 1 April 2018 and 31 March 2019.

2. About NHS Highland

Kingussie Medical Practice serves a population of 2987 people across the valley of Strathspey and Badenoch

Our aim is to provide high-quality care for every person who uses our services.

3. How many incidents happened to which the duty of candour applies?

Between 1 April 2020 and 31 March 2021, there were no incidents where the duty of candour applied. These are unintended or unexpected incidents that result in death or harm as defined in the Act, and do not relate directly to the natural course of someone’s illness or underlying condition.

Kingussie Medical Practice identified these incidents through our Significant event management procedures. Over the time period for this report we carried out and concluded 12 significant event analyses.  These events include a wider range of outcomes than those defined in the duty of candour legislation as we also include adverse events that did not result in significant harm but had the potential to cause significant harm.   Significant event analyses are also undertaken where there is no harm to patients or service users, but there has been a significant impact to service or care delivery.

We identify through the significant event analysis process if there were factors that may have caused or contributed to the event, which helps to identify duty of candour incidents.

Table 1.

4. To what extent did Kingussie Medical Practice follow the duty of candour procedure?

When we realised the events listed above had happened, we followed the correct procedure in 0 occasions (100% of the time).  This means we informed the people affected; apologised to them; offered to meet with them; reviewed what happened and what could have been better and fed back the findings to the people affected if this was their wish.

As there were no instances there was no need to invoke our duty of candour process

5. Information about our policies and procedures

Every SEA event is reported through our local reporting system as set out in our SEA management procedures.   Through our SEA management procedures we can identify incidents that trigger the duty of candour procedure.

Each adverse event is reviewed to understand what happened and how we might improve the care we provide in the future. The level of review depends on the severity of the event as well as the potential for learning.

Recommendations are made as part of the adverse event review, and Dr Heather Druett and Christian Aitken, Practice Manager  take action to implement these recommendations.  These are followed up until conclusion.

Staff received training on adverse event management and incident reporting as part of their induction.  Duty of Candour awareness raising and training took place throughout 2018 to highlight the procedures for escalating cases which had the potential to meet duty of candour.  Partners and Practice Team meet through various monthly meeting e.g Palliative care to oversee the investigation of SAEs.

We know that adverse events can be distressing for staff as well as people who receive care. We have support available for all staff through our occupational health support teams.

6. What has changed as a result?

We have made a number of changes following review of adverse events which have been identified as meeting the criteria of duty of candour.   Please see the following cases as examples:

7. Other information

This is the first year of the duty of candour being in operation and it has been a year of learning and refining our existing adverse event management processes to include the organisational duty of candour requirements. Duty of candour is now part of our regular training, with firm processes in place for dealing and reporting any incidents that may arise.

As required, we have submitted this report to Scottish Ministers and we have also placed it on our website.

If you would like more information about this report, please contact us using these details: Christian Aitken, Practice Manager, Kingussie Medical Practice.