Penrhyn Surgery: How We Do Things

GP & Patient Responsibilities

To facilitate your navigation and in support of improving your patient experience at Penrhyn Surgery, please read this document.

It provides a short overview of how the surgery operates and the responsibilities of Practice Staff and Patients alike.

You may also want to familiarise yourself with other Penrhyn Surgery policies available on the website.

It is by no means an exhaustive list, but aims to cover the key areas.

GP Responsibilities

In undertaking our duties as your GP we will ensure the following:

You will be treated as an individual and will be given courtesy and respect at all times.
You have the right to be treated confidentially.
Respect for religious and cultural beliefs will be honoured.
We will answer the telephone promptly and courteously.
We will offer medical advice and information for promotion of good health. You have the right to information about your own health (illness and treatment, possible side effects, prevention or recurring illness, etc.). You have the right to see your own medical records subject to the limitations of the law. A charge may be made.

Patient Responsibilities

As a Patient of Penrhyn Surgery we are working towards ensuring the best healthcare outcomes for you, and you can also contribute towards this by ensuring the following

Take personal responsibility for your health, as this makes a significant contribution to your own, and your families, good health and well-being.
Provide accurate information about your (and or that of your children) health, condition and status. It is very helpful if you can provide us with as much information as you know about your medications, allergies, and any significant past illnesses, this is especially important if you are a newly registered patient at the practice. The more information you can give us, the better we are able to help you.
Please take the advice given to you at the Practice and follow the course of treatment and management (which may include regular blood tests) which the clinicians have recommended. Talk to your clinician if you find this difficult. Remember, you are allowed a second opinion if you are not wholly in agreement with the advice given, please request this respectfully.
If tests are ordered for you, kindly do them. They are an important part of ensuring you are in the best of health. Please ask your Doctor or a member of Staff about the process for receiving test results. More information about test results
We ask that you treat our Doctors and all Practice Staff with the same courtesy and respect you would also like to receive from us.
Treat all NHS staff and other patients with respect and recognise that causing a nuisance or disturbance on NHS premises could result in prosecution and removal from the surgery list. We ask that you familiarise yourself with all our policies including, Zero tolerance, Unacceptable behaviour, Social Media policy. More information on Practice Policies
Please let us know if you cannot attend an appointment as soon as possible. This appointment can be offered to another patient.
Let us know as soon as possible, if you change your address, name or any of your contact details. Remember to include your phone number (especially your mobile) and postcode.
Please speak to a member of staff if you wish to see your medical records. This can be arranged with your Doctor. All requests must be in writing.
Participate in important public health programmes.
Please ensure that those closest to you are aware of your wishes about organ donation.
Please provide feedback – both positive and negative – about the treatment and care you have received from the Surgery. Constructive feedback is an important resources in ensuring the Surgery works proactively to provide safe and effective services to our patients.

Expectations

Patients and doctors can often have different expectations of treatment outcomes, so it’s important to understand each other’s perspectives

Why might patients see things differently?

Too much information
Patients might attend their doctor with a preconception of how they will be treated, which could be for a variety of reasons.
Websites patients have viewed might be inaccurate, or aimed at patients from other countries where the medical care may be different.
Patients might expect investigations or treatment currently unavailable in the UK or on the NHS.
They might base their expectations of the experiences of friends or relatives whose clinical scenario may have been different (such as expecting antibiotics for a sore throat).
Lack of information
Patients may not have been appropriately informed about what to expect. They could have unrealistic expectations about things like waiting times, private-non NHS fees, or complications of treatment.
Please read our website for our Policies, especially our access processes and what to expect in terms of getting an appointment in Penrhyn Surgery. More information on Practice Policies.

Contradictory advice

A patient might be seen by different clinicians for the same problem. Without a proper understanding of medicine, they may view uncertainty about diagnosis or treatment, or inconsistent advice, as indicating that one or more of their doctors is wrong.
Patients come to see clinicians for their medical opinions on their diseases and also for their opinions on management.
Patients need to understand that it is perfectly normal for doctors to have separate opinions occasionally about how a particular case is managed.

Time pressures

GP appointments in the NHS are usually set at 10 minutes per consultation to ensure all patients get a chance at being consulted with. This time may be extended for certain patient group’s e.g. vulnerable patients, patients with communication challenges and patients who may need interpreters.
Patients may feel that they have not been given enough time to discuss their issue(s) with the doctor.
In view of this we have maintained a policy of one issue per consultation. If you would like to discuss more than one issue, kindly inform the reception staff so a double appointment can be offered where available.

Unmet Expectations

A clinician will tend to view successful care usually in terms of clinical outcomes, but we also understand that patients are much more likely to place importance on other factors. These can include the emotional impact of the experience, or whether or not they feel cared about and cared for by the clinician.

This may be due to a variety of reasons including

Patients unmet clinical outcome
Patients should understand that they have primarily come to seek the medical opinion of a clinician when they come for a consultation.
Please understand that a clinician will base their clinical opinions and decisions on a combination of factors which include experience, clinical judgement and evidence-based clinical guidelines which can either be locally determined or national guidance such as NICE.
In view of this, a clinician may not honour a request for medications such as antibiotics or a request for sick notes or investigations if s/he does not think it is clinically justified or in keeping with evidence-based guidelines.
We do appreciate, however, that you may not agree with the decision of the clinician. If you don’t agree with the outcome of your consultation, please make this known respectfully and calmly.
You can request for a second opinion from another clinician in the practice and we will endeavour to accommodate your request.
Furthermore, we may also refer you to a specialist for review if this is deemed appropriate in agreement with you.
Whilst it's appreciated that not all clinical decisions will be acceptable to the patient, the surgery will not accept behaviour that is considered unreasonable, violent, defamatory or racist, this is by no means an exhaustive list.
We would kindly ask that you familiarise yourself with our relevant policies (zero tolerance, unacceptable behaviour policy) on our surgery website. More information on Practice Policies.

Patient’s unmet expectation on the way Surgery does things/operates.

We recognise that sometimes our patient’s expectations regarding the way the Surgery operates does not meet their expectation.

This may be due to a variety of reasons including, patient’s expectations on how they think the Surgery operates or indeed a gap in the way the Surgery provides a service requested. While we strive to operate a service that takes into account our patient population, patients should also recognise that it is impossible that any organisation can meet the expectations of all their clients all the time.

Please see the section below for more information on what to expect from the Surgery

Appointments

Patients can request appointments at Penrhyn Surgery via:

Patients with urgent or significant clinical concerns should walk directly to the surgery or telephone the surgery. They will be placed on a triage list, and they will be managed accordingly by the on-call doctor.
Patients with non-urgent issues should book online with Klink They will also be triaged and managed appropriately.
We ask that patients should not use Klink for urgent requests as their request will be declined and they will be directed back to the right pathway. Depending on the non-urgent request, the surgery can take up to two weeks to respond to it.
Be aware that the first two hours of the morning can be extremely busy. Please keep telephone calls brief. If possible, leave routine calls until later in the day.
Please click on the link for more information about appointments
We recognise that our phone lines can be quite busy, unfortunately this problem is not peculiar to our surgery. The government and NHSEngland have recognised this problem and mandated all practices as part of NHS digital transformation strategy to change to Cloud Based Telephony (CBT) by the end of 2024/2025. We are also currently working on changing our current service from an analogue to Cloud Based Telephony (CBT) system which will offer patients a better experience overall.
Please note our telephone calls are recorded for training and dispute resolution purposes.
We provide home visits for certain categories of patients, please click on this link for more information about our Home Visit Policy

Consultations

You will be allocated to an appropriate member of the clinical team based on your health needs.

Our clinical team includes a variety of professionals including Doctors, Nurses, Nurse Practitioners, Physician Associates, Pharmacists, Physiotherapists, Social Prescribers, and Mental Health Practitioners

All members of our clinical team are qualified, trained and accredited by their respective regulatory bodies.

Be aware of our one problem per consultation policy. Kindly click on this link for more information.

Each clinician’s consultation is within an allocated time period. GPs (10 minutes), ANPs (15 minutes), Physician’s Associates, Clinical Pharmacists and Physiotherapist (15 minutes), and Practice nurses (20 minutes) as examples.

Sometimes, the doctors and nurses may be running late, please bear with us. If you have an issue with time, please calmly discuss this with our receptionists.

Prescriptions

The practice will endeavour to process and issue ‘routine and uncomplicated’ repeat prescription requests within 2 whole working days (excluding weekends and bank holidays) of their receipt.

Urgent prescription requests are dealt with during consultations and usually arise as a direct requests from hospitals e.g. antenatal requests, palliative teams or from A and E attendances. These will be dealt with on a case-by-case basis.

Private prescription scripts- certain (not all) can be converted to NHS Prescriptions but this is decided on a case-by-case basis.

Following a consultation with you, where we have requested a test (Blood test, X-ray, Scan etc.), please click on the link for more information about what to expect.

Referrals

Why have I been referred?

Your GP will discuss with you and, if appropriate, your carer, why a referral is being recommended. It is usually because your GP wants a specialist’s help in deciding on the best way to treat your condition.

This might involve referring you for tests or investigations that cannot be carried out in a GP surgery. Your GP will also discuss with you what choices there are for where you can be referred.

How will I hear about where and when the appointment is?

GP practices and hospitals use different ways of arranging appointments:
We may give you a reference number and a password you can use to book, change or cancel your appointment online or by phone. Our secretary will send this to you usually by text.
You may receive a letter from the hospital confirming your appointment. You need to reply as soon as possible and tell the hospital if you can attend on the date offered.
Alternatively, sometimes patients receive a letter asking them to phone the hospital to make an appointment with a specialist.
Unfortunately, there are instances where you may have to be placed on a waiting list for a service/investigation you have been referred to, and the management of these waiting lists is not within the remit of the GP Surgery. Whilst we can confirm that you are indeed on a waiting list, there is not much we can do to expedite these waiting lists.
The staff will make every effort to follow up on your requests for information from third parties (such as the hospitals) but can only relay back to you the information that third parties are prepared to release.

2-week wait referral

In the special circumstance, however, where we have referred you on the 2-week pathway, the aim is to ensure that you get your first appointment within the 2 weeks of the referral being made.
We kindly ask all patients who have been referred by this pathway to contact the surgery if they have not heard anything about their appointment within 1 week of the referral being made.

Advice and Guidance

Sometimes we may ask a specialist to give us further advice and guidance on how to manage your condition.

The specialists usually respond to this request within 2 weeks

The specialist may advice a number of things including

Continue with your current treatment and management.
Request that you have additional tests e.g. blood tests, X-rays or Scan
Request we make changes to your current medication and/or prescribe additional medication.
We will contact you to let you know what advice they have offered.
Sometimes they may request that we refer you directly to the hospital for further assessment and management. Don’t panic, this usually means they want to do more assessments and tests which can only be done by a hospital specialist.

Please note, if they ask us to refer you, we will usually notify you by text.

Futher information on referrals for specialist care

What happens during my appointment?

Please ensure that you prepare adequately to maximise your time with the specialist. You may want to write down all your concerns and questions regarding your ailment and possible treatment. We recommend that you take a notepad along with you to write down things so you don’t forget.

Unfortunately we cannot answer queries about the management plan your specialist has agreed with you, as we are not specialist in that field and can only reiterate whatever they have agreed with you at the appointment.

Investigations requested by hospital/specialist doctors (including scans, blood tests, X-rays etc.)

When an investigation has been requested by a specialist doctor from the hospital, they are responsible for following it up and will usually offer the patient a follow-up appointment. As we are not specialist doctors, it will not be appropriate for us to offer an explanation or management of an investigation requested by a specialist doctor, so please don’t ask us.

Therefore we kindly request you await your follow-up with the specialist doctor who requested the investigation or await any written correspondence they may sendto us regarding your management.

Training Practice

Penrhyn Surgery is an approved training practice and we can provide training for a variety of clinical roles including medical students, GP trainees and internationally trained Medical Graduates.

In view of this, from time to time, you may be assessed by a trainee (working under the direct supervision of a GP Trainer).

All trainees are bound by the same confidentiality rules of GPs and NHS Staff. You will always be informed prior to your appointment if students/trainees are present. They will not be present during your consultation if you so wish.

Recording of Consultations (as part of training)

As part of this training programme, we will regularly use telephone and video for patient consultations as this forms part of the educational training process for assessing consultations with trainees.

The telephone and video recording is only of you and the doctor talking together. Intimate examinations will not be recorded and video recording can be switched off on request. All recordings are carried out according to guidelines issued by the General Medical Council.

More information about recordings of patients

Only those persons who have legal access to your medical records will see the video or hear the recording, as also doctors and advisers involved in the assessment. Its use will be limited to the assessment of the doctor with whom you are consulting and possibly for research, learning and teaching purposes.

All telephone calls to the practice are recorded securely on our telephony provider's server and are fully GDPR compliant.

We will be using appropriate applications for the recording of video consultations, and uploading them to secure sites for assessment. They are both subject to the same degree of confidentiality and security as medical records. Recordings will be erased as soon as practicable and in any event within three years.

You do not have to agree with your consultation with the doctor being recorded. If you want the video recording turned off, or change your mind about the telephone recording being used, please tell the doctor. This is not a problem, and will not affect your consultation in any way. But if you do not mind your consultation being recorded, we are very grateful to you.

Please confirm your consent to having your video consultation recorded for training assessment purposes when requested. This agreement will be recorded in your medical record. Improving the assessment of GPs should lead to better service to patients. Thank you very much for your help.

We are open to constructive feedback

While we strive towards providing an excellent service we recognise that we will sometimes get things wrong.

We have found out that engaging with patients, who provide us with constructive feedback on how we can improve the system when things go wrong is a valuable resource for our practice.

We have an informal, non-confrontational way for patients to discuss concerns or provide feedback which can allow us to address any issues raised in full, and hopefully avoid escalation to a formal complaint.

We encourage patients to go through this route first for all complaints if possible. This will assist us in making changes and improving service provision to our patients, thereby enhancing your satisfaction with the service received from us.

These informal opportunities allow patients to discuss their care and also let us reassure them, manage their expectations, and build trust. Please ask for the Practice Manager who can help facilitate this process.

We also have a formal complaint policy, and we encourage patients to go through this also for complaints if they are unwilling to pursue the informal route.

As a practice, we do recognise a minority of patients whose expectations we cannot meet no matter what we do.

How to complain to the NHS

Breakdown in the relationship between the patient and the surgery

We are of the opinion that if a patient considers that the practice as a whole has failed him or her and there is a fundamental lack of trust in the practice team, then in order for them to ensure they continue to receive the desired health care they have not received from our surgery, it will be better for them to find an alternative practice that will serve their needs better.

This is considered a better outcome for both parties.

Please ask the practice manager for assistance on this matter.

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