Missed Appointment and Late Attendance Policy (Updated April 2022)

 

This policy is to manage missed appointments, which can impact on other patients wanting to book in  along with the practitioner's time.

 

If an appointment is missed the full price of the treatment booked will be charged unless:

 

• 24 hours notice is given

 

• The patient/client of the missed appointment has an acceptable reason for not attending their appointment*

If three missed appointments, the patient/client will be requested to pay for the appointment at time of booking.
 

*acceptable reasons for not attending the appointment may include:

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• Illness, appointment can be rescheduled with no additional charge

 

• Medical emergency (patient, close relative or close friend), appointment can be rescheduled with no additional charge

 

• Patient/client’s family member or dependent is ill and requires their care, appointment can be rescheduled with no additional charge

 

• Death/serious injury to family member or close friend, appointment can be rescheduled with no additional charge

 

• Mater out of control of the client/patient, appointment can be rescheduled with no additional charge

 

• At the discretion of the practitioner, appointment can be rescheduled with no additional charge

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Late Attendance

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Late attendance to an appointment can impact on the subsequent patients booked afterwards.  Please note that late attendance will result in less treatment time which will be charged at the full price of the booked treatment.  If it is more than 25% of the treatment time the appointment will be cancelled as a missed appointment and the patient is liable for the full cost of the booked treatment.

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PRIVACY NOTICE (updated December 2020)

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(Why we collect your personal data and what we do with it) 

When you supply your personal details to this clinic they are stored and processed for 4 reasons (the bits in bold are the relevant terms used in the General Data Protection Regulation – i.e. the law):-

 

1. We need to collect personal information about your health in order to provide you with the best possible treatment. Your requesting treatment and our agreement to provide that care constitutes a contract. You can, of course, refuse to provide the information, but if you were to do that we would not be able to provide treatment. 

 

2. We have a “Legitimate Interest” in collecting that information, because without it we couldn’t do our job effectively and safely. 

 

3. We also think that it is important that we can contact you in order to confirm your appointments with us or to update you on matters related to your medical care. This again constitutes “Legitimate Interest”, but this time it is your legitimate interest. 

 

4. Provided we have your consent, we may occasionally send you general health information in the form of articles, advice or newsletters. You may withdraw this consent at any time – just let us know by any convenient method. 

 

We have a legal obligation to retain your records for 8 years after your most recent appointment (or age 25, if this is longer), but after this period you can ask us to delete your records if you wish. Otherwise, we will retain your records indefinitely in order that we can provide you with the best possible care should you need to see us at some future date. 

 

Your records are stored on a secure cloud platform which complies with GDPR (https://www.writeupp.com/)

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We will never share your data with anyone who does not need access without your written consent. Only the following people/agencies will have routine access to your data:-

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•  Your practitioner(s) in order that they can provide you with treatment

•  Reception staff (if engaged), because they organise our practitioners’ diaries, and coordinate appointments and reminders (but they do not have access to your medical history or sensitive personal information) 

•  Other administrative staff, such as our bookkeeper. Again, administrative staff will not have access to your medical notes, just your essential contact details. We also use Mailchimp to coordinate our messages, so your name and email address may be saved on their server. 

 

From time to time, we may have to employ consultants to perform tasks which might give them access to your personal data (but not your medical notes). We will ensure that they are fully aware that they must treat that information as confidential, and we will ensure that they sign a non-disclosure agreement. 

You have the right to see what personal data of yours we hold, and you can also ask us to correct any factual errors. Provided the legal minimum period has elapsed, you can also ask us to erase your records. 

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We want you to be absolutely confident that we are treating your personal data responsibly, and that we are doing everything we can to make sure that the only people who can access that data have a genuine need to do so. 

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Of course, if you feel that we are mishandling your personal data in some way, you have the right to complain. Complaints need to be sent to what is referred to in the jargon as the “Data Controller”. Here are the details you need for that: 

 

Trevor England  

info@TrevorEngland.com

 07851241782

Flat 15 Marine Tower, Abinger Grove, Deptford, London, SE8 5UY

 

If you are not satisfied with our response, then you have the right to raise the matter with the Information Commissioner’s Office

ICO
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF

Telephone:- 0303 123 1113.

https://ico.org.uk/global/contact-us/email/

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Valid Consent Policy (updated December 2020)

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1. Introduction
 

Patients have a legal and ethical right to determine what happens to their own bodies. This right is enshrined in the Mental Capacity Act 2005, the Human Rights Act 1998 and in common law. Valid consent to treatment is therefore absolutely central in all forms of healthcare.

 

Gaining valid consent protects staff from charges of assault and is also a matter of common courtesy between health professionals and patients. 

 

This policy addresses the procedures and responsibilities for obtaining consent to                      examination or treatment.
 

2. Purpose

 

The aim of this document is to ensure that all staff are aware of the need to obtain valid consent for treatment, and that they obtain that valid consent in an appropriate way. 

 

3. Definitions
 

Valid Consent:  The patient’s agreement for a health professional to provide care or treatment. For consent to be valid, the patient must:

 

• Have capacity to make the particular decision; 

• Have received sufficient information to make it; and 

• Not be acting under duress.

 

The giving of consent by a patient is not the same as the consent process. The consent process encompasses the whole process of information provision, discussion and decision-making.
 

Capacity:  The patient’s ability make decisions.  To do so they must:   

 

• understand the information about the decision to be made 

• be able to retain that information in their mind;

• evaluate the information

 

Gillick Capacity:  A child under the age of 16 is considered to be “Gillick” competent if they have sufficient understanding and intelligence to understand fully what is involved in the proposed intervention. In these circumstances, consent is valid and it is not necessary to obtain additional consent from a person with parental responsibility.

 

Intimate Treatment:  treatment in close proximity to the genitals, anus or breasts.

 

Invasive Treatment:  any treatment involving puncture of the skin (eg acupuncture or dry-needling), or any per rectum or per vaginal treatment.
 

Notes:  the official record of treatment (otherwise known as the Case History)

 

4. Documentation

 

4.1  In general, oral consent to examination and/or treatment is sufficient, but must be given at the time of each intervention and must be documented in the patient’s case history.  It is acceptable to use the  abbreviation “VCO” (valid consent obtained) for this purpose.  This abbreviation need only be applied once, in which case it will be deemed that consent has been obtained for each aspect of treatment written consent

 

4.2   It is not sufficient to obtain written consent at the commencement of an appointment.  Consent must be given contemporaneously with the procedures concerned.

 

4.3   Written consent is required for invasive procedures unless a patient is physically unable to sign.  For PR and PV procedures, patients should be given 24 hours to consider the treatment before proceeding.  

 

4.4    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.
 

5. Waiver of Consent

 

5.1 A patient may opt not to be warned of the risks and benefits, or to receive other information about their treatment.  If so, this must be clearly and explicitly documented in their notes at the appointment when the decision is first made. 
 

5.2    It must be confirmed at the outset of each subsequent appointment that this continues to be their choice, and the abbreviation “WOC” (Waiver of Consent) must be used to record this.
 

5.3    A waiver of consent can be withdrawn at any time, including within an appointment.

 

  

6. Capacity

 

6.1   There is a presumption that patients who are 16 or over have the mental capacity to make decisions for themselves unless this is assessed to be otherwise at the time.

 

6.2 Children under the age of 13 might have capacity to give valid consent (“Gillick Capacity”), but this will be the exception, not the rule.  Practitioners  should exercise great care in making this decision; normally parental consent will be required.
 

 

6.3   Staff must never assume that a patient lacks capacity simply because they are suffering from a mental disorder.
 

 

6.4   Capacity might vary according to the patient's mental condition, their medication or other factors, and must be assessed in every case in relation to the particular decision being made.
 

 

6.5   Where an adult patient lacks the mental capacity (either temporarily or permanently) to give or withhold consent for themselves, only an attorney appointed under a Lasting Power of Attorney by the patient or a court appointed Deputy may give consent or refuse treatment on their behalf if authorised to do so. However, treatment may be provided by clinicians in the patient’s best interests provided the patient has not made a valid and applicable Advance Decision refusing the specified treatment. 

 

7. Consent
 

7.1  Valid consent applies only to the treatments discussed with the patient, and only at the time of that discussion.
 

7.2   While patients between the ages of 16 and 18 are likely to be able to give consent to treatment, if they refuse then a person with parental responsibility may override that decision.  However, if the young person agrees to treatment, the parent may not refuse it.
 

7.3   Consent can be withdrawn at any time.
 

7.4   A patient with capacity may refuse treatment even if the practitioner deems it would be in their best interest to proceed. 
 

7.5   Refusal to consent should be documented in the patient’s notes.
 

7.6   Patients are not required to justify their refusal to accept examination or treatment.
 

8. Confidentiality

 

8.1. Practitioners have a duty of confidentiality to patients who have “Gillick capacity” and to patients between the ages of 16 and 18.
 

8.2. It is good practice to involve the child's family in the decision making process provided the Gillick competent child consents to their involvement. Where a child is seen alone, efforts should be made to persuade the child that his or her parents should be informed except in circumstances where it is clearly not in the child’s best interest to do so.
 

8.3. Healthcare professionals must however respect the views of the Gillick competent child in the event that they do not wish for their parents to be involved.
 

8.4. When a patient under 18 attends treatment alone, their case may not be discussed with anyone, including parents, without the patient’s consent.  This consent can be oral or written, but must be documented in the notes.
 

9. Responsibilities

 

All practitioners carrying out examination or treatment are responsible for ensuring that valid consent is obtained; it is they who will be held responsible in law if this is challenged later.

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10. Consent Process

 

10.1  In most cases the practitioner may initiate a procedure immediately after discussing it with the patient. For example, during an ongoing episode of care a practitioner might suggest a manipulative technique and explain how it might help the patient’s condition and whether there are any significant risks.   If the patient is willing for the technique to be used, they will then give their consent and the procedure can go ahead immediately. In most such cases, consent will be given orally.
 

10.2   If a proposed procedure is invasive written consent will be required, and the patient must be given sufficient time to absorb the necessary information.

 

11. Provision of Sufficient Information 

 

Before patients can come to a decision about treatment, they need sufficient information about their condition and about possible treatments, including risks and benefits (including the risks/benefits of doing nothing). Practitioners must ensure that they provide patients with sufficient information to enable them to make an informed judgment on whether to give or withhold consent. They must inform the patient of any significant, unavoidable or frequently occurring risks.  Risks and benefits can be expressed in whichever way is felt best to facilitate patient understanding, but should not be expressed in a way designed to unreasonably influence their decision.

 

12. Emergencies

 

12.1. In emergency situations patients may not be able to consent to treatment. At such times clinicians can act in the patient’s best interests.
 

12.2. Some patients might have completed a Do Not Attempt Resuscitation (DNAR) form. Provided the practitioner has seen a copy of this form, with an original signature (not a photocopy or image) it is acceptable not to attempt CPR.
 

12.3. Any treatment (emergency or otherwise) made without consent but in the patient’s best interests must be clearly documented in their notes.

 

13   Parental Responsibility

 

13.1 Only the biological parents of a child under 18, adoptive parents, foster parents or a guardian appointed by the court are deemed to have parental responsibility and can give consent to treatment.  This responsibility may NOT be delegated to other family members, and is NOT assumed by step-parents.

 

13.2 Parental responsibility gives the right to give or refuse consent for a child under 16, and to override a decision to refuse treatment by a child between the ages of 16 and 18.

 

13.3 Only one person with parental responsibility is required to give or refuse consent for the consent to be valid.

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Practitioner Complaints Procedure

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If you have a complaint or concern about any aspect of your treatment, please let me know

as soon as possible.

Please give me full details of your complaint and I will undertake to treat it seriously, deal

with it promptly and learn from it by reviewing or, if appropriate, improving my standards.

Make your complaint to me either in person, by phone, by letter or in an email to [email address].

I will investigate your complaint during the following few days and will aim to:-

1. Find out what happened and what went wrong

2. Make sure you receive an explanation and an apology if this is appropriate

3. Identify what I can do to ensure that this problem does not arise again

 

Raising concerns with my professional register

I am professionally registered with the General Osteopathic Council, my registration number is 10220

If you feel uncomfortable complaining directly to me or do not feel that your complaint has been resolved to your satisfaction, you can find information on raising concerns with the General Osteopathic Council here: https://www.osteopathy.org.uk/home/. 

The General Osteopathic Council can also be contacted on 020 7357 6655 and by regulation@osteopathy.org.uk