The Care Quality Commission (CQC) makes sure hospitals, care homes, dental and GP surgeries, and all other care services in England provide people with safe, effective, compassionate and high-quality care, and encourages them to make improvements where possible.

They do this by inspecting services and publishing the results on their website: www.cqc.org.uk

You can use the results to help you make better decisions about the care you, or someone you care for, receives.

Our CQC Inspection

Our practice is inspected by the Care Quality Commission (CQC) to ensure we are meeting essential standards of quality and safety.

More information

NHS Salford Clinical Commissioning Group (CCG) is the organisation that decides how to spend the NHS budget on the majority of health services for 270,000 people registered with a GP in Salford. This includes the care and treatment you receive in hospital, maternity services, community and mental health services.

This document contains information that is privileged, confidential or otherwise protected from disclosure. It must not be used by, or its contents reproduced or otherwise copied or disclosed without the prior consent in writing from The Sides Medical Centre

Read more about our Complaints Policy and Procedure

General Consent

When Do Health Professionals Need Consent From Patients?

Before you examine, treat or care for competent adult patients you must obtain their consent.
Adults are always assumed to be competent unless demonstrated otherwise. If you have doubts about their competence, the question to ask is: “Can this patient understand and weigh up the information needed to make this decision?” Unexpected decisions do not prove the patient is incompetent, but may indicate a need for further information or explanation.
Patients may be competent to make some health care decisions, even if they are not competent to make others.
Giving and obtaining consent is usually a process, not a one-off event.
Patients can change their minds and withdraw consent at any time. If there is any doubt, you should always check that the patient still consents to your caring for or treating them.

Can Children Give Consent For Themselves?

Before examining, treating or caring for a child, you must also seek consent.
Young people aged 16 and 17 are presumed to have the competence to give consent for themselves.
Younger children who understand fully what is involved in the proposed procedure can also give consent (although their parents will ideally be involved). In other cases, some-one with parental responsibility must give consent on the child’s behalf, unless they cannot be reached in an emergency. If a competent child consents to treatment, a parent cannot over-ride that consent. Legally, a parent can consent if a competent child refuses, but it is likely that taking such a serious step will be rare.
Who is the right person to seek consent?

It is always best for the person actually treating the patient to seek the patient’s consent. However, you may seek consent on behalf of colleagues if you are capable of performing the procedure in question, or if you have been specially trained to seek consent for that procedure.
What information should be provided?

Patients need sufficient information before they can decide whether to give their consent: for example information about the benefits and risks of the proposed treatment, and alternative treatments. If the patient is not offered as much information as they reasonably need to make their decision, and in a form they can understand, their consent may not be valid.
Consent must be given voluntarily: not under any form of duress or undue influence from health professionals, family or friends.

Does It Matter How The Patient Gives Consent?

• No: consent can be written, oral or non-verbal. A signature on a consent form does not itself prove the consent is valid – the point of the form is to record the patient’s decision, and also increasingly the discussions that have taken place.

Refusal of Treatment

• Competent adult patients are entitled to refuse treatment, even when it would clearly benefit their health. The only exception to this rule is where the treatment is for a mental disorder and the patient is detained under the Mental Health Act 2007 in which case the patient can receive care or treatment relating to his mental health disorder/illness without giving consent. However, in this situation the patient still retains the right to give or refuse consent for any other care or treatment should he/she be deemed competent to do so. A competent pregnant woman may refuse any treatment, even if this would be detrimental to the foetus.

Adults Who Are Not Competent To Give Consent

• No-one can give consent on behalf of an incompetent adult. However, you may still treat such a patient if the treatment would be in their best interests ‘Best interests’ go wider than best medical interests, to include factors such as the wishes and beliefs of the patient when competent, their current wishes, their general well-being and their spiritual and religious welfare. People close to the patient may be able to give you information on some of these factors. Where the patient has never been competent, relatives, carers and friends may be best placed to advise on the patient’s needs and preferences.
• If an incompetent patient has clearly indicated in the past, while competent, that they would refuse treatment in certain circumstances (an ‘advance refusal’), and those circumstances arise, you must abide by that refusal. Any ‘advance refusal’ regarding life sustaining treatment in a life threatening situation must be witnessed and signed by the patient and the witness.

Types of Consent

Consent is often wrongly equated with a patient’s signature on a consent form. A signature on a form is evidence that the patient has given consent, but is not proof of valid consent. If a patient is rushed into signing a form, on the basis of too little information, the consent may not be valid, despite the signature. Patients may, if they wish, withdraw consent after they have signed a form: the signature is evidence of the process of consent-giving, not a binding contract.
If a patient has given valid verbal consent, the fact that they are physically unable to sign the form is no bar to treatment.

Implied Consent

The majority of examinations provided by health professionals are carried out under implied consent This is no longer considered best practice as staff should not rely on a patient’s apparent compliance with a procedure as a form of consent i.e. the fact that a patient lies down on an examination couch does not in itself indicate that the patient has understood what is proposed and why. For consent to be legal, the professional must demonstrate through documentation that the patient understands the process, procedure, problems and outcome. If there is an alternative to this procedure, this must also be fully discussed.

Verbal Consent

Verbal consent should be sought before any procedure takes place. A clear explanation of what is to be done, any risks to consider and any alternative should be discussed with the patient. The discussion which takes place should be recorded in the case notes. Written evidence of consent should include how you tested that the patient understood what was going to be done to them; this will demonstrate that informed consent was given. As with all entries to case notes, the date and time must be recorded and the entry signed

Written Consent

There are no legal requirements in terms of specific procedures that require written consent. However, as a matter of good practice, the General Medical Council guidance states that written consent should be obtained in cases where the treatment is complex, or involves significant risks and /or side effects (the term ‘risk’ is used throughout to refer to any adverse outcome, including those which some health professionals would describe as ‘side-effects’ or complications’)

The guidance on best practice applies especially to:

• Minor surgery performed under local anaesthesia.
• the provision of clinical care is not the primary purpose of the investigation or examination eg videoing of consultation for education and training
• there may be significant consequences for the patient’s employment, social or personal life.
• the treatment is part of research programme

Mental Capacity Act 2006 

The Mental Capacity Act 2005 (the Act) provides the legal framework for acting and making decisions on behalf of individuals who lack the mental capacity to make particular decisions for them. Everyone working with and/or caring for an adult who may lack capacity to make specific decisions must comply with this Act when making decisions or acting for that person, when the person lacks the capacity to make a particular decision for themselves. The same rules apply whether the decisions are life-changing events or everyday matters.

For mental capacity principles, assessments, best interests, restraint & deprivation of liberty information please refer to Policy for Mental Capacity Procedures to follow when patients lack capacity to give or withhold consent

Where an adult patient does not have the capacity to give or withhold consent to a significant intervention, this fact should be documented in form 4 (form for adults who are unable to consent to investigation or treatment), along with the assessment of the patient’s capacity, why the health professional believes the treatment to be in the patient’s best interests, and the involvement of people close to the patient. The standard consent forms should never be used for adult patients unable to consent for themselves. For more minor interventions, this information should be entered in the patient’s notes.

The Mental Capacity Act introduced a duty on NHS bodies to instruct an independent mental capacity advocate (IMCA) in serious medical treatment decisions when a person who lacks the capacity to make a decision has no one who can speak for them, other than paid staff. The Act allows people to plan ahead for a time when they may not have the capacity to make their own decisions: it allows them to appoint a personal welfare attorney to make health and social care decisions, including medical treatment, on their behalf or to make an advance decision to refuse medical treatment. Further guidance is available in the Mental Capacity Act (2005) Code of Practice.

An apparent lack of capacity to give or withhold consent may in fact be the result of communication difficulties rather than genuine incapacity. You should involve appropriate colleagues in making such assessments of incapacity, such as specialist learning disability teams and speech and language therapists, unless the urgency of the patient’s situation prevents this. If at all possible, the patient should be assisted to make and communicate their own decision, for example by providing information in non-verbal ways where appropriate.

Occasionally, there will not be a consensus on whether a particular treatment is in an incapacitated adult’s best interests. Where the consequences of having, or not having, the treatments are potentially serious, a court declaration may be sought.

Is The Consent Given Voluntarily?

To be valid, consent must be given voluntarily and freely, without pressure or undue influence being exerted on the person either to accept or refuse treatment. Such pressure can come from partners or family members, as well as health or care practitioners. Practitioners should be alert to this possibility and where appropriate should arrange to see the person on their own in order to establish that the decision is truly their own.
When people are seen and treated in environments where involuntary detention may be an issue, such as prisons and mental hospitals, there is a potential for treatment offers to be perceived coercively, whether or not this is the case. Coercion invalidates consent, and care must be taken to ensure that the person makes decisions freely. Coercion should be distinguished from providing the person with appropriate reassurance concerning their treatment, or pointing out the potential benefits of treatment for the person’s health. However, threats such as withdrawal of any privileges, loss of remission of sentence for refusing consent or using such matters to induce consent may well invalidate the consent given, and are not acceptable.

Written Consent

Consent is often wrongly equated with a patient’s signature on a consent form. A signature on a form is evidence that the patient has given consent, but is not proof of valid consent. If a patient is rushed into signing a form, on the basis of too little information, the consent may not be valid, despite the signature. Similarly, if a patient has given valid verbal consent, the fact that they are physically unable to sign the form is no bar to treatment. Patients may, if they wish, withdraw consent after they have signed a form: the signature is evidence of the process of consent-giving, not a binding contract.

It is good practice to get written consent if any of the following circumstances apply:

the treatment or procedure is complex, or involves significant risks (the term ‘risk’ is used throughout to refer to any adverse outcome, including those which some health professionals would describe as ‘side-effects’ or ‘complications’)
the procedure involves general/regional anaesthesia or sedation
providing clinical care is not the primary purpose of the procedure
there may be significant consequences for the patient’s employment, social or personal life
the treatment is part of a project or programme of research
Completed consent forms should be scanned onto the patient’s EMIS notes. Any changes to a consent form, made after the form has been signed by the patient, should be clearly documented.

It will not usually be necessary to document a patient’s consent to routine and low risk procedures, such as providing personal care or taking a blood sample.
However, if you have any reason to believe that the consent may be disputed later or if the procedure is of particular concern to the patient (for example if they have declined, or become very distressed about, similar care in the past) it would be helpful to do so.

Treatment of Young Children

Parental responsibility: The mother of a child, and the child’s father (if he is married to the mother) automatically have parental responsibility. If the parents are not married, the father will have parental responsibility if he acted with the mother to have his name recorded in the registration of the child’s birth and the child’s birth was registered after 1 December 2003.

An unmarried father can also obtain parental responsibility by later marrying the mother, by making a parental responsibility agreement with her, or by getting a court order. Parental responsibility can also be granted to other people by the courts, such as a legally appointed guardian. Members of Staff are advised to check carefully and record details of parental responsibility in the child’s records. Parents and those with parental responsibility can only provide or refuse consent if they are thought to be capable and can communicate their decision. Children who are under 16 years of age can also consent or refuse treatment if it is thought that they have sufficient intelligence, competence, and understanding to fully appreciate what is involved in their treatment. This was recognised in the House of Lords in the Fraser case of 1986 which resulted in the concept of ‘Fraser Competent’ :-Refer to Fraser Guidelines (1986)

Teenagers and Consent & Confidentiality 

Teenagers who are 16 or 17 years of age are entitled to consent to their own treatment.

Who Is Responsible For Seeking Consent?

The health professional carrying out the procedure is ultimately responsible for ensuring that the patient is genuinely consenting to what is being done: it is they who will be held responsible in law if this is challenged later.
Where oral or non-verbal consent is being sought at the point the procedure will be carried out, this must be done by the health professional responsible.

IMCA Service In Salford

Independent Mental Capacity Advocacy (IMCA) is a new type of advocacy service introduced by the Mental Capacity Act 2005. They can be accessed through Mind in Salford

Fair processing notice 2022

Requests for completion of firearms certificates for patients of the sides medical centre

The GPs Partners at The Sides Medical Centre have taken the decision to refuse to engage in the firearms certification process on grounds of conscientious objection because of ethical beliefs. A GP practice does not need to arrange for alternative provision of a report.

Greater Manchester Police have been informed of this decision.

If access to a firearm is a professional requirement – such as for gamekeepers and farmers – our doctors will assist applicants in finding a colleague to help.

Requests for completion of firearms certificates for patients of the sides medical centre

The GPs Partners at The Sides Medical Centre have taken the decision to refuse to engage in the firearms certification process on grounds of conscientious objection because of ethical beliefs; a GP practice does not need to arrange for alternative provision of a report.

Greater Manchester Police have been informed of this decision.

If access to a firearm is a professional requirement – such as for gamekeepers and farmers – our doctors will assist applicants in finding a colleague to help.

View the Government Guidance at GOV.UK

The Freedom of Information Act creates a right of access to recorded information and obliges a public authority to:

• Have a publication scheme in place
• Allow public access to information held by public authorities.

The Act covers any recorded organisational information such as reports, policies or strategies, that is held by a public authority in England, Wales and Northern Ireland, and by UK-wide public authorities based in Scotland. However, it does not cover personal information such as patient records, which are covered by the Data Protection Act.

Public authorities include government departments, local authorities, the NHS, state schools and police forces.

The Act is enforced by the Information Commissioner who regulates both the Freedom of Information Act and the Data Protection Act.

The surgery publication scheme

A publication scheme requires an authority to make information available to the public as part of its normal business activities. The scheme lists information under seven broad classes, which are:

• who we are and what we do
• what we spend and how we spend it
• what our priorities are and how we are doing it
• how we make decisions
• our policies and procedures
• lists and registers
• the services we offer

You can request our publication scheme leaflet at the surgery.

Who can request information?

Under the Act, any individual, anywhere in the world, is able to make a request to a practice for information. An applicant is entitled to be informed in writing, by the practice, whether the practice holds information of the description specified in the request and if that is the case, have the information communicated to him/her. An individual can request information, regardless of whether he/she is the subject of the information or affected by its use. 

How should requests be made?

Requests must:

• be made in writing (this can be electronically e.g. email/fax)
• state the name of the applicant and an address for correspondence
• describe the information requested.

What cannot be requested?

Personal data about staff and patients covered under Data Protection Act.

For more information see these websites:

• Legislation GOV.UK
• Information Commissioners Office

The NHS needs data about the patients it treats in order to plan and deliver its services and to ensure that care and treatment provided is safe and effective. The General Practice Data for Planning and Research data collection will help the NHS to improve health and care services for everyone by collecting patient data that can be used to do this. For example, patient data can help the NHS to:

• monitor the long-term safety and effectiveness of care
• plan how to deliver better health and care services
• prevent the spread of infectious diseases
• identify new treatments and medicines through health research

GP practices already share patient data for these purposes, but this new data collection will be more efficient and effective.

This means that GPs can get on with looking after their patients, and NHS Digital can provide controlled access to patient data to the NHS and other organisations who need to use it, to improve health and care for everyone.

Opting out of NHS Digital collecting your data (Type 1 Opt-out)

If you do not want your identifiable patient data (personally identifiable data in the diagram above) to be shared outside of your GP practice for purposes except for your own care, you can register an opt-out with your GP practice. This is known as a Type 1 Opt-out.

Type 1 Opt-outs were introduced in 2013 for data sharing from GP practices, but may be discontinued in the future as a new opt-out has since been introduced to cover the broader health and care system, called the National Data Opt-out. If this happens people who have registered a Type 1 Opt-out will be informed. More about National Data Opt-outs is in the section Who the NHS shares patient data with.

Here is a brief video to explain –

NHS Digital will not collect any patient data for patients who have already registered a Type 1 Opt-out in line with current policy. If this changes patients who have registered a Type 1 Opt-out will be informed.

If you do not want your patient data shared with NHS Digital, you can register a Type 1 Opt-out with your GP practice. You can register a Type 1 Opt-out at any time. You can also change your mind at any time and withdraw a Type 1 Opt-out.

Data sharing with NHS Digital will start on 1 July 2021.

If you have already registered a Type 1 Opt-out with your GP practice your data will not be shared with NHS Digital.

To register a Type 1 Opt-out with your GP practice before data sharing starts with NHS Digital, the quickest way is by opting out directly via the NHS Digital website. The link to this is – https://www.nhs.uk/your-nhs-data-matters/manage-your-choice/

Alternatively, you return this form to your GP practice by 23 June 2021 to allow time for processing it. If you have previously registered a Type 1 Opt-out and you would like to withdraw this, you can also use the form to do this. You can send the form by post or email to your GP practice or call 0300 3035678 for a form to be sent out to you.

For more information please see the NHS Digital website.

We aim to keep our surgery clean and tidy and offer a safe environment to our patients and staff. We are proud of our modern, purpose built practice and endeavour to keep it clean and well maintained at all times.

If you have any concerns about cleanliness or infection control, please report these to our reception staff.

Our GPs and nursing staff follow our Infection Control Policy to ensure the care we deliver and the equipment we use is safe.

We take additional measures to ensure we maintain the highest standards:

• Encourage staff and patients to raise any issues or report any incidents relating to cleanliness and infection control. We can discuss these and identify improvements we can make to avoid any future problems
• Carry out an annual infection control audit to make sure our infection control procedures are working
• Provide annual staff updates and training on cleanliness and infection control
• Review our policies and procedures to make sure they are adequate and meet national guidance
• Maintain the premises and equipment to a high standard within the available financial resources and ensure that all reasonable steps are taken to reduce or remove all infection risk
• Use washable or disposable materials for items such as couch rolls, modesty curtains, floor coverings, towels etc., and ensure that these are laundered, cleaned or changed frequently to minimise risk of infection
• Make alcohol hand rub gel available throughout the building

Privacy Notice 2022

We welcome all comments on the services provided by the practice.

We are continually looking to turn our patients’ feedback into real improvements in the services we provide. We use it to focus on the things that matter most to our patients, carers and their families.

We’ll let the staff involved know and share the good practice across our teams.

You may write to us or contact us by phone.

There is a new Central NHS Computer System called the Summary Care Record (SCR). It is an electronic record which contains information about the medicines you take, allergies you suffer from and any bad reactions to medicines you have had.

Why do I need a Summary Care Record?

Storing information in one place makes it easier for healthcare staff to treat you in an emergency, or when your GP practice is closed.

This information could make a difference to how a doctor decides to care for you, for example which medicines they choose to prescribe for you.

Who can see it?

Only healthcare staff involved in your care can see your Summary Care Record.

How do I know if I have one?

Over half of the population of England now have a Summary Care Record. You can find out whether Summary Care Records have come to your area by contacting the practice.

Do I have to have one?

No, it is not compulsory. If you choose to opt out of the scheme, then you will need to complete a form and bring it along to the surgery. You can opt-out by completing our Summary Care Record Opt Out form.

More Information

For further information visit the NHS Care records website.

Help us to help you

We aim to provide the best possible service to our patients and hope you will feel that we achieve that aim.

The care of your health is a partnership between yourself and the primary health care team. The success of that partnership depends on an understanding of each other’s needs and co-operation between us.

Doctor’s Responsibilities

• You will be greeted courteously
• You have a right to confidentiality
• You have the right to see your medical records subject to the limitations of the law
• You will be seen the same day, if your problem is urgent
• You will be seen by your doctor whenever possible
• You will be informed if there will be a delay of more than 20 minutes for your appointment
• You will be referred to a consultant when your GP thinks it 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 after your request
• Your suggestions and comments about the services offered will be considered sympathetically and any complaint dealt with quickly

Patient’s Responsibilities

• Please treat all surgery staff with the same respect – we are all just doing our job
• Do not ask for information about anyone other than yourself
• Tell us of any change of name or address, so that our records are accurate
• Only request an urgent appointment if appropriate. Home visits should only be requested if you are too ill to attend the surgery and night visits should be for emergencies only – the doctor on-call will be at work as usual the next day
• Please cancel your appointment if you are unable to attend
• Please be punctual but be prepared to wait if your own consultation is delayed by an unexpected emergency
• Please allow sufficient time for your consultant’s letter of the results of any tests to reach us
• You will be advised of the usual length of time to wait
• Use the tear-off slip to request your repeat prescription whenever possible. Please attend for review when asked, before your next prescription is due
• Do let us know whenever you feel we have not met our responsibility to you
• We would, of course, be pleased to hear when you feel praise is due

The practice fully supports the NHS Zero Tolerance Policy. The aim of this policy is to tackle the increasing problem of violence against staff working in the NHS and ensures that doctors and their staff have a right to care for others without fear of being attacked or abused.

We understand that ill patients do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint. We ask you to treat your doctors and their staff courteously and act reasonably.

All incidents will be followed up and you will be sent a formal warning after a second incident or removed from the practice list after a third incident if your behaviour has been unreasonable.

However, aggressive behaviour, be it violent or verbal abuse, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police will be contacted if an incident is taking place and the patient is posing a threat to staff or other patients.