8. Patients

Abstract

Introduction 8-03 Access to the GP 8-03 Improving access in the practice 8-04 Demand management 8-04 Making changes to the system 8-06 Triage 8-06a The pitfalls 8-06b Rotas 8-06b Other rotas 8-06c Patients who do not keep appointments 8-06c Summary 8-06d Telephone, the Internet and access 8-06e Telephones, voicemail and confidentiality 8-06e Telephone consulting 8-06f Telephone messaging 8-06f E-health 8-06f Time 8-06f Practice set-up 8-06f Security and confidentiality 8-06g E-administration and e-ordering of repeat prescriptions 8-06g Practice websites 8-06g Online health information 8-06h Telemedicine 8-06i E-consulting 8-06i Staff and Internet access 8-06j Information governance 8-06j SMS communication with patients 8-06k Choose and Book 8-06l What is Choose and Book? 8-06l Directory of Services (Dos) 8-06l Registration to use Choose and Book 8-06l Getting the practice connected 8-06l How does Choose and Book work? 8-06m What does the patient have to do? 8-06m How can patients choose their NHS provider? 8-06m Problems with Choose and Book 8-06n The future: referral management services 8-06n Minor ailment schemes: an alternative form of access 8-06o Running a minor ailment scheme 8-06o Referral mechanism 8-06p Formulary 8-06p Documentation and record keeping 8-06p Organising to meet the needs of all patients 8-06t Difficult patients or difficult practice? 8-06t The socially excluded 8-07 Registration 8-07 Continuity of care 8-07 Special health needs 8-07 Special services or mainstream management? 8-07 Homeless patients 8-08 Practice in a multi-ethnic area 8-09 Ethnic monitoring 8-10 Names and filing systems 8-11 Language and interpreters 8-12 Written material 8-12 Cultural issues 8-13 Asylum seekers and refugees 8-13 Who is an ‘asylum seeker’ or a ‘refugee’? 8-13 Registration issues 8-14 Rights to medical care 8-14 Financial issues for practices 8-15 Health issues 8-15 Problem areas 8-15 Refugee doctors 8-16 Violent and abusive patients 8-17 Reducing the risk of violence 8-17 When a critical incident occurs 8-17 Removal of violent patients from the list 8-18 If a violent patient is assigned to your list 8-18 Secure facilities 8-18 Drug users 8-18 Patients with debt problems 8-19 Free debt counselling agency contacts 8-20 Travellers 8-20 Who are they? 8-20 Attitudes 8-20 Potential problems 8-20a Health needs 8-20a Traveller children 8-20a Improving services for travellers 8-20b References 8-20b Students 8-21 Meningitis 8-21 Homesickness 8-21 Sexual health 8-22 Travel medicine 8-22 Exams 8-23 Managing students as patients during vacations 8-23 Disabled patients 8-24 Deaf patients 8-24 Telephone use 8-25 Patient call systems 8-25 The consultation 8-25 Informing the patient 8-25 Other methods of communication 8-25 Blind patients 8-26 Accessibility to the building 8-26 Information 8-26 Staff as patients 8-27 Children and young people 8-28 Registering children and young people 8-28 Parental responsibility 8-28 Competency and capacity to consent 8-29 Confidentiality and young people 8-30a Child protection 8-30b Medical records of adopted children 8-30i Child death review 8-30i Patient involvement 8-30i Further information and help 8-32 Patient participation groups 8-32 Letter sharing 8-33b Patient records access and the National Data Spine 8-33c Patients surveys 8-33d Consent 8-34a Consent and children 8-34c Post-payment verification – confidentiality and consent 8-34c Mental Capacity 8-34c Lasting Power of Attorney 8-34d The Role of GPs 8-34d Advance decisions (advance directives/living wills) 8-34d Organ and body donation 8-34di Living donors 8-34dii Transplants overseas 8-34dii Donating a body to medical science 8-34dii Confidentiality 8-34diii Practice confidentiality policy 8-34diii