Earlsfield Practice is committed to providing equal access and care for all patients.

Our premises are fully wheelchair accessible. We also provide accessible toilets and an induction loop for patients who use hearing aids. If you need any additional support to access our services, please let our team know and we will do our best to help.

We do not discriminate against anyone on the basis of race, gender, age, social background, religion or belief, sexual orientation, disability, or medical condition. Every patient will be treated with dignity, fairness, and respect.

This website has been developed by EMIS Health and is run by the specified organisation. We want as many people as possible to be able to use this website. For example, that means you should be able to:

• change colours, contrast levels and fonts
• zoom in up to 300% without the text spilling off the screen
• navigate most of the website using just a keyboard
• navigate most of the website using speech recognition software
• listen to most of the website using a screen reader (including the most recent versions of JAWS, NVDA and VoiceOver)

We’ve also looked to use ‘Plain English’ where possible in order to make the website text simple to understand.

AbilityNet has advice on making your device easier to use if you have a disability.

Keyboard navigation in Mac OS

For keyboard navigation to work in Mac OS an option has to be turned on:

System Preferences Keyboard  Shortcuts

In that panel is a check box labelled “Use keyboard navigation to move focus between controls”. Check that box and Restart your browser for the change to take effect.

How accessible this website is

Although we have used our reasonable efforts to make the website accessible to all we appreciate that some parts of this website are not currently fully accessible, in particular:

• some of our downloadable documents may not fully accessible to screen reader software
• there are a limited number of keyboard navigation issues including; menu navigation and notification acknowledgement
• the site tagline styling may not be deemed to meet accessibility standards
• table layout for opening times does not use the correct grid format to be deemed fully accessible

As part of our ongoing continuous improvement exercises we are working to further improve on the accessibility aspects of the site.

What to do if you cannot access parts of this website

If you need information on this website in a different format like accessible PDF, large print, easy read, audio recording or braille then please:

• email: mysupport@emishealth.com
• Call: 0845 124 5245

We will consider all requests and aim to get back to you within 5 working days.

Reporting accessibility problems with this website

We are always looking to improve the accessibility of this website. If you find any problems not listed on this page or identify ways that we can improve accessibility then please do call or email us to report the issue:

• email mysupport@emishealth.com
• call 0845 124 5245

Enforcement procedure

The Equality and Human Rights Commission (EHRC) is responsible for enforcing the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018 (the ”Accessibility Regulations”). If you have any concerns or issues with our site and are not happy with how we have responded to your concerns, then you may wish to contact the Equality Advisory and Support Service (EASS).

Alternatively, if you are based in Northern Ireland, please contact the Equalities Commission for Northern Ireland (ECNI).

Technical information about this website’s accessibility

EMIS Health are committed to making its websites accessible, in accordance with the Accessibility Regulations.

This website is partially compliant with the Web Content Accessibility Guidelines version 2.1 AA standard, due to the non-compliances listed below.

Non-accessible content

The content listed below is non-accessible for the following reasons.

Content that is not within the scope of the Accessibility Regulations

PDFs and other documents

This site may contain older PDFs and Word documents that do not meet accessibility standards – for example, they may not be structured so that they are accessible to a screen reader. This does not meet WCAG 2.1 success criterion 4.1.2 (name, role value).

The Accessibility Regulations do not require us to fix PDFs or other documents published before 23 September 2018 if they are not essential to providing our services.

Navigation Issues

This site may contain elements that cannot be navigated through using a keyboard. This does not meet WCAG 2.1 success criterion 2.1.1 (keyboard).

Plans are in place to rectify these issues as soon as practicable.

Styling Issues

This site may contain elements of styling that are not deemed to be accessible. This does not meet WCAG 2.1 success criterion 1.4 (distinguishable).

Plans are in place to rectify these issues as soon as practicable.

Disproportionate burden

Google Maps – There is a limit as to how far you can magnify the embedded Google Maps on our ‘contact us’ page. The code for this map is supplied by Google and we are unable to make amendments to it.

Introduction

1.1 Policy statement
The Earlsfield Practice is committed to ensuring safe, evidence-based, and consistent prescribing. To safeguard patients and maintain clinical governance, we will not assume prescribing responsibility for ADHD medications initiated privately, even where a shared care agreement is provided. Patients will be directed to appropriate NHS pathways for assessment, diagnosis, titration, and prescribing. Shared care prescribing will only be considered once patients have been stabilised by an NHS service and meet the required monitoring standards.

1. Policy

   2.1 General principles
   • We do not accept shared care prescribing requests from private providers for ADHD medications.
   • This applies even where a shared care agreement is provided by the private psychiatrist.
   • All patients must access ADHD diagnosis and prescribing via NHS pathways.

   2.2 New patient registration
   • Staff All new patients will be informed at registration that the practice does not take over ADHD prescribing from private providers.
   • Information will be provided in written form and made available on the practice website.
   • Where appropriate, patients will be directed to NHS Right to Choose pathways.

   2.3 Existing patients/Ongoing ADHD requests
   • Patients requesting ADHD assessment or treatment are directed to the NHS Right to Choose pathway or local NHS ADHD services.
   • If a patient is diagnosed and titrated via an NHS provider, the practice will consider shared care prescribing once the patient is stable.
   • Shared care will only continue if patients attend:
   – Annual reviews with the diagnosing psychiatrist, and
   – Six-monthly physical health checks at the practice (BP, weight, pulse).
   • Failure to attend these checks will result in cessation of shared care prescribing.

   2.4 Process for handling requests
   • All ADHD-related requests are funnelled through the nominated admin lead.
   • The admin lead will:
   – Explain the practice policy to patients.
   – Provide standard information letters and links to NHS Right to Choose.
   – Process referrals to NHS ADHD services as needed.
   • Clinical staff will only be involved where direct clinical input is required (e.g., questionnaires, physical health checks).

   2.5 Clinical governance
   • All ADHD-related requests are funnelled through the nominated admin lead.
   • The admin lead will:
   – Explain the practice policy to patients.
   – Provide standard information letters and links to NHS Right to Choose.
   – Process referrals to NHS ADHD services as needed.
   • Clinical staff will only be involved where direct clinical input is required (e.g., questionnaires, physical health checks).

   2.6 Communication to clinicians
   • All clinicians must follow this policy.
   • Prescriptions should not be issued outside of this pathway, even if patients present letters from private providers.
   • Any exceptions or uncertainties must be escalated to the prescribing lead/partners before action is taken

1 Introduction
1.1 Policy statement
The purpose of this policy is to outline the administration processes to be followed when a
patient or their carer advises the practice of a change of address or personal details. Under
Article 5 of the UK General Data Protection Regulation (GDPR), it is essential that the
organisation demonstrates that data is:
Accurate and, where necessary, kept up to date; every reasonable step must be taken to
ensure that personal data that is inaccurate, having regard to the purposes for which it is
processed, is erased or rectified without delay.
1.2 Status
In accordance with the Equality Act 2010, we have considered how provisions within this
policy might impact on different groups and individuals. This document and any procedures
contained within it are non-contractual, which means they may be modified or withdrawn at
any time. They apply to all employees and contractors working for the organisation.
2 Record management
2.1 Change of address or personal details
Should a registered patient inform the organisation that they are going to change, or have
changed, their address, they are to be instructed to complete the Change of Patient Address
or Details form, available on the organisation’s website or at Annex A.
Hard copy completed forms are to be handed in at reception and a member of the
reception/administration team will update the clinical system to ensure the correct details are
held.
Forms completed online will be processed by a member of the administration team and the
details on the clinical system updated accordingly.

Please click here to open this form.

Please note that if you are collecting a prescription, letter, form or anything for another person, the one you are picking up for will need to inform us before you arrive. We will also need to see a form of I.D upon arrival.

Privacy and Confidentiality of your Medical Records:
Your medical record is a lifelong history of your consultations, illnesses, investigations, prescriptions and other treatments. Your GP is responsible for the accuracy and safekeeping of your medical record whether it is a paper or computer held record. You can help to keep this information accurate by informing your GP of any change in your name, address, telephone number or marital status, and by ensuring your GP is informed about any changes in your health, or treatment that you receive.

If you move to another area or change GP, we will send your medical records to Primary Care Support England (Preston), to be passed on to your new practice. However, a copy of all computer entries made onto your record during the time you were registered will be retained by the practice. If you are under 16 years of age, you have rights to confidentiality where it is appropriate for your needs. For further information, please ask at your surgery.

How can I find out what is in my Medical Record?

We are required by law to allow you access to your medical record. If you wish to see your records, please contact the surgery for further advice. All requests to view your records should be made in writing to the practice.

Your GP has a duty to keep your medical record accurate and up to date. Please inform us of any errors of fact that have been made over the years.

What GPs will not do: To protect your privacy and confidentiality, GPs will not normally disclose any of your medical information over the telephone or fax, unless we are sure that we are talking to you. GPs will not normally disclose any information to your family, friends or colleagues about any medical matters at all, unless they know that they have your consent to do so.

To protect your privacy: practice staff have been instructed not to disclose any patient information over the phone. Please do not ask them to do so. If you have any queries, comments or complaints about privacy, confidentiality or your medical records, please contact your practice manager, or talk to your GP.

Disclosure of your details to a third party: As a patient you have rights to be seen in confidence. It is our duty to ensure that we protect these rights. If you would like us to disclose information to a third party, then you must inform us in advance and this information will be recorded. If you have not informed us then we will not share with any other family member or friend. This includes details of whether you are on the premises.

Who can see my medical records?

Anyone authorised to see your medical records has a legal, ethical and contractual duty to protect your privacy and confidentiality.

Doctors, practice nurses, health visitors, district nurses and midwives who are providing health care and treatment: It is our policy to have a single medical and nursing record for each patient. We firmly believe that this offers the best opportunity for delivering the highest quality of care from a modern primary care team. Access to records will only be given to professionals directly involved in the treatment or investigation of your health needs.

Therapists and technicians: Access to records will only be given to professionals directly involved in the treatment or investigation of your health needs.

Notes summarising project: We are slowly summarising everyone medical notes so that past medical details are available on our computer. The doctor doing the summary has signed a legal contract to protect your privacy and confidentiality. Your computerised medical records are held to the same level of confidentiality as your paper ones, are only accessible to practice staff and fully comply with the data protection act.

Medical students, GP trainees: From time to time we are involved in the teaching and training of medical students and doctors. We will always ask for your permission before allowing a medical student or trainee to be present. They may be given supervised access to your health records at that consultation.

Practice staff: Staff have access only to information that they need to perform their role within the practice, informing the Health Authority of registration and claim details, and performing various administrative tasks.

Government: We are required by law to notify the Government of certain infectious diseases for public health reasons.

Law courts: The law courts can insist that doctors disclose medical records. When we are asked for medical reports from solicitors, we will only provide them if we can obtain signed consent to disclose information from the patient.

The primary care agency (Previously the health authority): We provide them with limited information so that they can organise national health care programmes such as childhood immunisations, cervical smear tests and breast screening. GP’s also inform the primary care agency of registration changes and certain procedures that they carry out on patients.

Social services, benefits agencies and local authorities: We would not normally release any information without your signed consent. This is sometimes needed in order for benefits or other support to be provided.

Life assurance companies: We provide information only when we have received your signed consent to do so.

The National Health Service: Anonymised statistical information on the quantity and quality of health care provision and need is collected from our medical records to help plan and manage the NHS. It also helps us to review the standard of care provided, and helps us to train and educate staff and undertake research approved by the Local Research Ethics Committee.

Our Service to You

Our Charter and Your Rights

As a patient of this practice you can expect:

-To register with us, if you live within our catchment area (SW17 and SW18).

-To be seen the same day for conditions you and the doctor agree are urgent.

-For routine or non urgent problems to be seen by a doctor of your choice within the next 7 working days when that doctor is conducting surgery.

-To have your records treated confidentially.

-To be seen at home at your doctors discretion.

-To have your long term medication and treatment reviewed at agreed intervals.

-To be informed (through leaflets, posters etc) of the practices services and how best to use them.

-To receive health care in clean, comfortable and appropriate surroundings.

-To be treated with courtesy.

-To be told to whom you are speaking with when you make a call to the surgery.

Help Us to Help You

As a patient of this practice we expect you:

-To treat the doctors and practice staff with courtesy.

-To be punctual for your appointment time.

-To give the practice as much notice as possible if you are unable to keep a booked appointment

-To make more than 1 appointment if more than 1 person needs to be seen.

-To be prepared to make further appointments if you have numerous or complicated problems.

-To be patient if appointment times are running late. It may be you who needs extra time on another occasion.

-To ask for a home visit only if the illness prevents you from attending the surgery – Children can usually be brought to the surgery.

-Only to contact the doctor out of surgery hours in the case of an emergency which cannot wait until the next working day.

National Rights

As a patient you have the right to:

-Be registered with a GP and to change your doctor easily and quickly. .

-Be offered a health check on joining a doctor’s list for the first time.

-Ask for a health check if you are between 16 & 74 years old and have not seen a GP in the last three years.

-Receive emergency care at any time through a GP.

-Receive health care on the basis of clinical need, regardless of ability to pay.

-Be given a clear explanation of any treatment proposed, including any visits and any alternatives, before you decide whether you will agree to the treatment.

-Have appropriate drugs and medicine prescribed.

-Be referred for a second opinion if you and GP agree this to be desirable.

-Have access to your health records, subject to any limitations in the law, and know that those working for the NHS are under legal duty to keep the contents confidential.

-Choose whether or not to take part in medical research or medical student training.

-Be given detailed information about local family doctor services through Wandsworth PCT local directory.

-Receive a copy of your doctors practice leaflet, setting out the services he or she provides.

-Receive a full and prompt reply to any complaints you make about NHS services.

The Practice takes our responsibilities associated with Data Protection seriously please find below a copy our Privacy Notice which tells you how we handle and use your personal information.

• Privacy Notice

DATA OPT-OUT

The Practice is required to comply with the Health and Social Care Act 2012. NHS Digital have the power under the Health and Social Care Act 2012 Section 259 (1) to issue a Data Provision Notice. This mandates us to share information about you unless you tell us not to.

• National Data Opt-Out
• Type 1 Opt-Out

To opt out please complete the opt out form before 23rd June 2021 and return it to the Practice by email to theearlsfield.practice@nhs.net or hard copy.

List of the Data Provision Notices

Feedback

1 Introduction

1.1 Policy statement
The Earlsfield Practice is committed to providing safe, consistent, and evidence-based care
for patients seeking hormone treatment for gender dysphoria/gender identity services.
The practice will not take over prescribing initiated by private providers. NHS referral
pathways are available to ensure safe access to appropriate care. Shared care requests
from NHS specialist services will be considered on a case-by-case basis, taking into account
the medication involved, safety considerations, and GP partner experience.

2 Policy

2.1 General principles
• We do not accept shared care prescribing requests from private providers for gender
identity hormone treatment
• Patients will be offered referral via NHS gender identity clinics (GICs) or other NHSapproved routes
• Shared care prescribing will only be considered if:
• The request comes from an NHS specialist service, and
• The medication is appropriate, safe, and within the GP partners’ competence
and experience
GPs are not mandated to accept shared care prescribing and may decline where this falls
outside professional competence or safety standards.

2.2 Referrals and Access to Care
• Patients requesting assessment for gender dysphoria or hormone therapy will be
referred to an NHS Gender Identity Clinic (GIC) via the standard NHS referral
process
• Patients will be informed that NHS pathways may involve waiting times, but this
ensures safe, multidisciplinary care and appropriate follow-up
Information about NHS GICs and referral processes will be made available via practice staff
and on the practice website.

2.3 Shared Care prescribing principles
• Private provider requests: Declined automatically, in line with practice policy. Patients
may continue privately or transfer to NHS care.
• NHS provider requests: Considered on a case-by-case basis by GP partners.
Factors considered include:
• The specific hormone or medication requested
• Monitoring and follow-up requirements
• The GP partner’s competence and ability to safely prescribe and monitor
• Local SWL ICB prescribing guidance and formulary positions
If declined, the patient and specialist provider will be informed promptly with a clear
explanation.

2.4 Clinical governance and GMC guidance
• This policy is underpinned by the GMC’s Good practice in prescribing and managing
medicines and devices guidance on shared care
• GPs may decline prescribing where:
• The treatment is outside their competence
• Monitoring arrangements are unclear or unsafe
• Specialist oversight is inadequate
An audit of gender identity prescribing requests and decisions will be carried out annually to
ensure consistent application of this policy.

2.5 Communication with patients
• Patients will be informed in a supportive, respectful, and clear manner about:
• The practice’s prescribing boundaries
• Available NHS referral options
• Reasons for declining private shared care requests
Standard information letters will be provided, and updates will be added to the practice
website for transparency.

2.6 Responsibilities
• Partners: Accountable for final decisions on shared care requests and overall
governance
• Practice Manager/Admin Staff: Ensures requests are triaged, policies applied
consistently and communication is sent to patients/specialists
• Prescribing Clinicians: Follow this policy when approached with hormone
prescribing requests and escalate uncertain cases to the partner

Less than 10 minutes late-

The patient will be checked in if they arrive within their 10 minute pre-booked slot. The doctor or nurse will call them in at the first available opportunity, as the following patient may have arrived in good time.

More than 10 minutes, less than 20 minutes late-

It is at the Doctor’s/Nurse’s discretion whether the patient will be seen on the day. The patient should be encouraged to re-book. In all cases, the Doctor will be sent a message advising them that the patient has reported late, and what the outcome regarding the future appointment is.

Please click here to view.

General Practice Privacy Notice 

The information we hold on you

Our practice keeps data on you relating to who you are, where you live, contact details, what you do, your family, possibly your friends, your employers, your habits, your problems and diagnoses, the reasons you seek help, your appointments, if you have a carer, where you are seen and when you are seen, who by, referrals to specialists and other healthcare providers, tests carried out here and in other places, investigations and scans, treatments and outcomes of treatments, your treatment history, the observations and opinions of other healthcare workers, within and without the NHS as well as comments and aide memoires reasonably made by healthcare professionals in this practice who are appropriately involved in your health care.

When registering for NHS care, all patients who receive NHS care are registered on a national database, the database is held by NHS Digital, a national organisation which has legal responsibilities to collect NHS data.

Identifying patients who might be at risk of certain diseases

-Your medical records will be searched by a computer programme so that we can identify patients who might be at high risk from certain diseases such as heart disease or unplanned admissions to hospital.

-This means we can offer patients additional care or support as early as possible.

-This process will involve linking information from your GP record with information from other health or social care services you have used.

-Information which identifies you will only be seen by this practice.

-The surgery will use the contact details that were provided from the data you have given to the surgery; to send care related text or emails (via Accurx or iPlato)

If you would like more information, please speak with the practice manager.

Who we share information with.

As GPs, we cannot handle all your information ourselves, so we need to delegate this responsibility to others within the practice and sometimes with other organisations.

If your care requires treatment outside the practice, we will exchange with those providing such care and treatment whatever information may be necessary to provide safe, high-quality care.

Once you have seen the care provider, they will normally send us details of the care they have provided you with, so that we can understand your health better.

Your consent to this sharing of data, within the practice and with those others outside the practice is assumed and is allowed by the Law, however, we will gladly discuss this with you in more detail if you would like to know more.

The Practice team (clinicians, administration and reception staff) only access the information they need to allow them to perform their function and fulfil their roles.

You have the right to object to our sharing your data in these circumstances but we have an overriding responsibility to do what is in your best interests.

We are required by Articles in the General Data Protection Regulations to provide you with the information in the following 9 subsections:

Privacy Policy

Click here to view our Policy on informing you of test results.

The Earlsfield Practice operates a zero tolerance policy with regards to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons.

We will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.

-Using bad language or swearing at practice staff

-Any physical violence towards any member of staff or other patients, such as pushing or shoving

-Verbal abuse towards the staff in any form including verbally insulting the staff

-Racial abuse and sexual harassment will not be tolerated

-Persistent or unrealistic demands that cause stress to staff will not be accepted

-Requests will be met wherever possible and explanations given when they cannot.