Ambient transcription

We are committed to providing you with the highest quality of care. To enhance our service, we are starting to use IT tools which assist us by transcribing verbal conversations, either on the telephone, or in a face to face consultation. Each tool is described below.

Heidi Health: What is it?

Heidi Health is an AI-powered medical scribe, that assists in documenting our consultations. Below, we explain what Heidi Health is, how your data will be managed, and the benefits it brings to your care and our practice. You can click here to visit their website and know more about them. Heidi Health is an advanced AI medical scribe designed to transcribe patient visits, generate clinical notes, fill out documents, and dictate letters. This tool allows our clinical team to focus more on you, the patient, rather than on typing and administrative tasks.

Benefits of Using Heidi Health

  • Enhanced Focus on Patient Care: By automating the documentation process, Heidi Health allows us to spend more time interacting with you, improving the quality of care and communication during consultations.
  • Efficiency and Accuracy: The AI scribe ensures that all details of your visit are accurately recorded, reducing the risk of errors and omissions in your medical records.
  • Streamlined Workflow: Heidi Health helps in managing various administrative tasks such as generating patient summaries, filling out forms, and creating letters, making our workflow more efficient.

How Your Data is Managed

  • Data Security and Privacy: Heidi Health adheres to stringent UK compliance frameworks, including the Data Protection Act, GDPR, and NHS standards. This ensures that your personal information is handled securely and confidentially.
  • Local Data Hosting: All data is hosted within the UK, enhancing security and compliance with local data protection regulations.
  • Temporary Data Storage: Audio recordings used for generating notes are not stored permanently. They are processed and then deleted, ensuring your data remains private and secure.

Is it safe?

Fear of flying

People often request diazepam for fear of flying or to assist with sleep during flights.

Diazepam in the UK is a Class C/Schedule IV controlled drug. The following policy outlines the issues surrounding its use with regards to flying and why after careful consideration the surgery no longer prescribes such medications for this purpose.

Diazepam is a sedative, so it often does make you sleepy and more relaxed. However, there are several reasons why prescribing this drug is not recommended:
– According to the British National Formulary, diazepam is contraindicated (not allowed) for treating phobias such as fear of flying, and it is an inappropriate treatment for short-term ‘mild’ anxiety. Prescribing against these guidelines poses a significant legal risk.
– Diazepam reduces awareness and reaction times, which could be dangerous in the unlikely event of a flight-related emergency.
– Sedative drugs can cause unnatural non-REM sleep, increasing the risk of developing a blood clot (DVT) during long flights.
– While most people do find diazepam sedating, some people experience paradoxical agitation, aggression and disinhibition, causing you to behave in a way that is very different to your normal state, which can be problematic on a plane, potentially impacting on your safety or others.
– Diazepam and similar controlled drugs are illegal to posess in some countries, risking confiscation or legal trouble.
– It is important to declare all medical conditions and medications you take to your travel insurer, not doing so can nullify your insurance policy.

Given these reasons, we no longer provide diazepam or similar drugs for flight anxiety. Instead, we suggest a longer-term approach as recommended by the National Institute of Clinical Excellence (NICE), focussing on overcoming your phobia, take a look at these aviation industry-recommended flight anxiety courses:

– Flying Without Fear (https://www.flyingwithoutfear.com/)
– Fly and Be Calm (https://thefearofflying.com/programs/fly-and-be-calm/)
– Fearless Flyer(https://www.fearlessflyer.easyjet.com/)
– Flying with Confidence (https://www.britishairways.com/en-gb/information/travel-assistance/flying-with-confidence)

Flight anxiety does not fall within NHS General Medical Services as defined in the NHS GP contract, so we are not obliged to prescribe for this.

Prescribed drugs for sedation for hospital scans and procedures (e.g., MRI scans)

After careful consideration, we have decided no longer to prescribe diazepam for patients having MRI scans or other investigative procedures. This is not a decision we took lightly; we have a duty of care to provide safe, consistent, and appropriate care for our patients.  We hope the reasons outlined below help to explain our main concerns:

  • Small doses of benzodiazepines such at 2mg diazepam are likely to be sub-therapeutic for most adults for any effective sedation. Conversely in a small number of people an opposite response is seen in patients, with even very small doses causing greatly increased agitation.
  • A patient may take a sedative ‘an hour’ before their assumed procedure, to then attend the hospital to find their procedure has been delayed, therefore the timing of the drug effect would be suboptimal.
  • GPs are not regularly involved, skilled, trained or appraised in sedation skills (and are not present when the patient has the procedure)
  • All hospital consultants, both those requesting imaging and those providing it, have access to the same prescribing abilities as GPs. If a patient needs a certain medication to enable an investigation to go ahead, hospital doctors can provide a prescription, either through the hospital pharmacy or a hospital FP10.
  • Sedated patients should be regularly monitored, and we have been made aware of a case where a GP provided sedative was given, the patient not monitored, and subsequently had a respiratory arrest in an MRI machine.
  • The Royal College of Radiologists‘ own guidelines on sedation for imaging makes no mention of GP involvement or provision of low dose anxiolytics and stresses the importance of experienced well-trained staff involved and the monitoring of sedated patients:

(https://www.rcr.ac.uk/our-services/all-our-publications/clinical-radiology-publications/sedation-analgesia-and-anaesthesia-in-radiology-third-edition/#:~:text=Safe%20and%20effective%20analgesia%20and,resuscitation%20equipment%20and%20reversal%20agents)

NHS consultations whilst overseas

For reasons of clinical safety and information security we are not allowed to carry out consultations with you if you are not physically present in the UK. This includes answering written or digital requests for medical advice, and we are also not able to issue repeat prescriptions.

If you travel abroad often, or will be taking a trip outside the UK which will last for more than a couple of weeks, please plan ahead and order prescriptions at least a week before you travel.

If you become ill whilst abroad please seek local medical advice or contact the local British Embassy for assistance. If you receive treatment, please keep any written documentation and bring it home with you so that we can review it and put it in your medical record.

NHS care following a private consultation/prescription

Where possible, we will continue issuing repeat prescriptions for drugs/other items which were initially prescribed to you by a private practitioner. We can do this as long as the issuing practitioner is UK registered and has relevant expertise, they provide a written copy of their consultation which we can put in your medical record, they will communicate with us if we have any queries, and they can provide ongoing support to you should you need it. Also, the drug must be approved by the NHS for the specific usage and dosage (or there is an alternative that we can switch you to), and NHS guidance recommends it, there are no contraindications we are aware of, and you are willing to attend the surgery for any routine care and monitoring that we need to do whilst the treatment is active.

When you request continuation of private treatment via NHS prescription, we will tell you within 7 days if we are able to do it. Sometimes we can response more quickly, but these things often require us to review guidance, seek advice, and liaise with your private practitioner.

If we are not able to prescribe the treatment, or an alternative, we will let you know and you can seek a private prescription from the original practitioner.

GP Earnings

All GP practices are required to declare the mean earnings (e.g. average pay) for GPs working to deliver NHS services to patients at each practice.

The average pay for GPs working in H&F Group partnership in the last financial year was £64,939 before tax and National Insurance.

This is for 16 full time GP’s and 49 part time GPs who worked in the practice for more than six months.

It should be noted that the prescribed method for calculating this is potentially misleading as it does not take into account the amount of time doctors spent working and therefore it should not be used to form judgements about GP earnings

Patients Registering for Care who Live Out of Area

We are happy to look after patients who don’t live locally subject to a few considerations laid out below.

If you live or move outside our catchment area (shown in Catchment Area on this page) and want to register as an “out-of-area” patient, please take note of the following conditions:

If your medical concern requires attention, you must be able to visit the surgery during our opening hours. Phone consultations may not be appropriate for certain issues.

Your own health should not pose any personal factors or concerns that could prevent you from attending the surgery.

At present, you should not require access to any community health or social care services, as these are organized geographically.

It is your responsibility to visit the surgery to collect items like prescriptions and make suitable arrangements.

Home visits cannot be provided under any circumstances.

In the event that you need a GP but are too unwell to come to the surgery, please contact us initially. If we determine that you require services in your local area, we will direct you to the appropriate local service established by NHS England. This service could be a GP practice near your home, a local walk-in or urgent care centre, or a minor injuries unit.

You must reside within North West London.

Please understand that if your health needs change and you require access to other services, such as home visiting doctors, we may review your registration and ask you to register with a GP closer to your home.

Registration with our practice is subject to our discretion. If we find that your care needs become more complex after registration, we reserve the right to review your registration and ask you to register with a GP closer to your home.

In the event that we become aware of your out-of-area residence, we will notify you and ask for your agreement to the above conditions. If we don’t receive a response, we will send reminders. Failure to comply may result in deregistration. However, please note that we will still provide care on an “immediate and necessary” basis if an urgent need arises.

Recording Of Telephone Conversations

  1. We may record telephone calls to:
  • Review and improve services
  • Monitor and review quality of care
  • Train, develop and manage staff and medical trainees
  • Prevent, detect, investigate and prosecute allegations, complaints, claims and / or fraud relating to patients, other organisations or our staff
  • Protect staff and patients

We do this in the interests of offering a good service to our service users, patient safety, being a good employer and to protect public funds.

  1. How will call recordings be used:
  • Quality monitoring: Written records only provide partial information. A call recording provides a more rounded view and allows us to better understand patient and staff experience and assess the processes applied. This can help us identify any improvement areas.
  • Training and development: Listening to a sample number of calls allows managers to identify training needs. Call recordings may also be used as part of training for medical students, GP registrars and other clinical staff in training at the practice. This is part of their clinical skills development.
  • Gaining a better understanding of our patients: Many calls are verbally resolved without the need to complete records. Listening to sample calls will help us better understand our patient and staff needs and gain a more informed view of organisations we signpost to.
  • Complaints and disputes: Some calls are verbally resolved. Where information is entered onto an electronic system this becomes the established record. In the event of a complaint or dispute, a call recording (if possible), may provide additional information to help us investigate and resolve
  • Employee safety and wellbeing: A recording may become a vital piece of evidence in the event of any threats being made to the organisation or an individual or in dealing with employment-related matters.
  1. How your information is shared

Generally, call recordings are not shared. In certain circumstances, for example to comply with a court order or carry out a legislative requirement, we may share call recordings.

  1. How long we keep your call recording

General call recordings will be retained for up to 1 month from the date of creation. Where there is a complain or dispute we may keep the call recording longer until the issue is resolved.

  1. Can I request a copy of my call record?

If the recording is still available, you can request a copy of your conversation by contacting the surgery. This information will be provided to you in accordance with the terms of the Data Protection Act 1998.

  1. What we use your data for (including call recordings). Your data is processed to:
  • Provide care to you
  • Audit clinical quality and service experience
  • Resolve complaints or confusion

Violence Policy

The Practice staff shall always show due respect and courtesy when dealing with patients and their representatives. We respectfully request that patients and their representatives do the same when dealing with members of the practice team.

The NHS operate a zero tolerance policy with regard 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.

No form of aggression (whether verbal or physical in nature) will be tolerated – any instances of such behaviour on the practice premises may result in the perpetrator being reported to the Police and removed from the practice’s List of Registered Patients.

Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation 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.

Training

Medical Students

Here at the practice we help to teach medical students who are training to become doctors. You may be asked if a student is able to sit in on your consultation and it would be helpful if you allow this although it will only ever be with your consent.

Medical students are bound by the same rules of confidentiality as all staff so you can be assured that anything you discuss while they are present will remain private.