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

Where it is clinically appropriate and practical to register, we now accept new registration from patients who work in the local area but reside outside of our registration area. Patients registered this way would not be entitled to home visit from the practice, however they will be able to contact NHS 111 in order to be seen by a practice closer to where they live.

For further information about this type of registration, please contact us on 020 3326 9301 or feel free to come into the practice.

What is non-NHS work and why is there a fee?

The National Health Service provides most health care to most people free of charge, but there are exceptions: prescription charges have existed since 1951 and there are a number of other services for which fees are charged.

Sometimes the charge is because the service is not covered by the NHS, for example, providing copies of health records or producing medical reports for insurance companies, solicitors or employers.

The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. It is important to understand that many GPs are not employed by the NHS; they are self-employed and they have to cover their costs – staff, buildings, heating, lighting, etc. – in the same way as any small business.

In recent years, however, more and more organisations have been involving doctors in a whole range of non-medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to ensure that information provided to them is true and accurate.

Examples of non-NHS services for which GPs can charge their own NHS patients are:

• • accident/sickness certificates for insurance purposes
  • school fee and holiday insurance certificates
  • reports for health clubs to certify that patients are fit to exercise
  • private prescriptions for travel purposes

Examples of non-NHS services for which GPs can charge other institutions are:

• • life assurance and income protection reports for insurance companies
  • reports for the Department for Work and Pensions (DWP) in connection with
  • disability living allowance and attendance allowance
  • medical reports for local authorities in connection with adoption and fostering
  • copies of records for solicitors

Do GPs have to do non-NHS work for their patients?

With certain limited exceptions, for example a GP confirming that one of their patients is not fit for jury service, GPs do not have to carry out non-NHS work on behalf of their patients. Whilst GPs will always attempt to assist their patients with the completion of forms, they are not required to do such non-NHS work.

Is it true that the BMA sets fees for non-NHS work?

The British Medical Association (BMA) suggest fees that GPs may charge their patients for non-NHS work (i.e. work not covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested by them are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates they suggest.

Why does it sometimes take my GP a long time to complete my form?

Time spent completing forms and preparing reports takes the GP away from the medical care of his or her patients. Most GPs have a very heavy workload and paperwork takes up an increasing amount of their time. Our GPs do non-NHS work out of NHS time at evenings or weekends so that NHS patient care does suffer.

I only need the doctor’s signature – what is the problem?

When a doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. In order to complete even the simplest of forms, therefore, the doctor might have to check the patient’s ENTIRE medical record. Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council (the doctors’ regulatory body) or even the Police.

If you are a new patient we may not have your medical records so the doctor must wait for these before completing the form.

What will I be charged?

It is recommended that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual doctors to decide how much they will charge. The surgery has a list of fees based on these suggested fees which is available on request.

What can I do to help?

• • Not all documents need a signature by a doctor, for example passport applications. You can ask another person in a position of trust to sign such documents free of charge. Read the information that comes with these types of forms carefully before requesting your GP to complete them.

• • If you have several forms requiring completion, present them all at once and ask your GP if he or she is prepared to complete them at the same time to speed up the process.

• • Do not expect your GP to process forms overnight: urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this may cost more. Usually non-NHS work will take 2 weeks.

Patient’s Rights

We are committed to giving you the best possible service. This will be achieved by working together. Help us to help you. You have a right to, and the practice will try to ensure that:

• • You will be treated with courtesy and respect
  • You will be treated as a partner in the care and attention that you receive
  • All aspects of your visit will be dealt with in privacy and confidence
  • You will be seen by a doctor of your choice subject to availability
  • In an emergency, out of normal opening hours, if you telephone the practice you will be given the number to receive assistance, which will require no more than one further call
  • You can bring someone with you, however you may be asked to be seen on your own during the consultation
  • Repeat prescriptions will normally be available for collection within two working days of your request
  • Information about our services on offer will be made available to you by way of posters, notice boards and newsletters
  • You have the right to see your medical records or have a copy subject to certain laws.

Patient’s Responsibilities

With these rights come responsibilities and for patients we would respectfully request that you:

• • Treat practice staff and doctors with the same consideration and courtesy that you would like yourself. Remember that they are trying to help you
  • Please ensure that you order your repeat medication in plenty of time allowing 48 working hours.
  • Please ensure that you have a basic first aid kit at home and initiate minor illness and self-care for you and your family.
  • Please attend any specialist appointments that have been arranged for you or cancel them if your condition has resolved or you no longer wish to attend
  • Please follow up any test or investigations done for you with the person who has requested the investigation
  • Attend appointments on time and check in with Reception
  • Patients who are more than 20 minutes late for their appointment may not be seen.
  • If you are unable to make your appointment or no longer need it, please give the practice adequate notice that you wish to cancel. Appointments are heavily in demand and missed appointments waste time and delay more urgent patients receiving the treatment they need
  • An appointment is for one person only. Where another family member needs to be seen or discussed, another appointment should be made
  • Patients should make every effort to present at the surgery to ensure the best use of nursing and medical time. Home visits should be medically justifiable and not requested for social convenience
  • Please inform us when you move home, change your name or telephone number, so that we can keep our records correct and up to date
  • Read the practice leaflets and other information that we give you. They are there to help you use our services. If you do not understand their content please tell us
  • Let us have your views. Your ideas and suggestions whether complimentary or critical are important in helping us to provide a first class, safe, friendly service in pleasant surroundings.

NHS Constitution

The NHS Constitution establishes the principles and values of the NHS in England. For more information see these websites:

• • GOV.UK – The NHS Constitution for England
  • NHS Choices – NHS Constitution

1. Purpose of the Policy

This policy sets out Little Venice Medical Centre’s position on housing support letters and ensures a consistent, fair, and transparent approach for all patients, in line with NHS contractual requirements and Care Quality Commission (CQC) expectations. 

2. Scope of Services

Little Venice Medical Centre is commissioned to provide primary medical services. The practice does not provide non-clinical advocacy services, which includes housing assessments or housing priority determinations. 

Housing need, suitability, and prioritisation fall outside the scope of General Practice and are the responsibility of local authorities and housing organisations. 

3. Policy Statement

Little Venice Medical Centre does not issue housing support letters, specifically (but not limited to): 

• Housing priority or rehousing letters 

• Letters supporting homelessness or overcrowding applications 

• Letters requesting emergency, temporary, or alternative accommodation 

• Letters recommending relocation or property adaptations for housing purposes 

This applies to all patients without exception. ( See Section 5 of this policy statement for more information) 

4. Clinical Governance and NHS Guidance

In line with NHS guidance: 

• GPs are not contractually required to provide letters for housing purposes 

• Housing providers must use their own assessment processes, which may include independent medical advisors or occupational health services 

• Requests for GP letters for housing reasons do not constitute a clinical need 

This approach ensures: 

• Appropriate use of NHS time and resources 

• Clear boundaries between clinical care and non-clinical decision-making 

• Safe and effective service delivery for all patients 

5. Medical Information Requests

Where appropriate and lawful, the practice will: 

• Provide copies of medical records or medical summaries upon request 

• Comply with GDPR and NHS information governance requirements 

• Respond to formal medical information requests made directly by authorised organisations with patient consent 

• We can provide you with access to your full medical record, allowing you to download any information you feel may support your application and share this directly with the relevant housing authority or organisation, as appropriate. You can also access this information yourself via the NHS App or SystmOnline. 

The practice will not interpret medical information for housing decision-making purposes. 

6. Equality, Consistency, and Fair Access

This policy is applied consistently to all patients, ensuring: 

• Fair treatment 

• Non-discrimination 

• Transparency in service provision 

No patient will be advantaged or disadvantaged by requesting housing support letters. 

7. Signposting and Patient Support

Patients requiring housing assistance will be signposted appropriately to: 

• Local council housing departments 

• Housing advice services 

• Citizens Advice or relevant charities 

These organisations are best placed to assess housing needs and provide support. 

8. Review and Monitoring

This policy is reviewed periodically as part of the practice’s clinical governance framework to ensure continued compliance with NHS and CQC requirements. 

 Reviewed and updated by Dr Nicholas E Collinson and Mr Yakup Seyer on 1/10/2025. 

1. Policy Statement

Little Venice Medical Centre is committed to providing high-quality, safe, and effective primary medical care in line with NHS guidance, General Medical Council (GMC) standards, and Care Quality Commission (CQC) requirements. 

As part of this commitment, the practice does not provide non-clinical support letters or statements for the purposes of: 

• School or college finance 

• University finance or funding applications 

• Absence from school, college, or university 

• Extenuating circumstances or academic appeals 

This policy ensures that GP time is used appropriately for clinical care and that medical evidence is provided only where clinically indicated and contractually required. 

3. Scope of the Policy

This policy applies to: 

• All registered patients of Little Venice Medical Centre 

• All clinical and non-clinical staff 

• All requests for letters or written statements related to education or finance that are non-medical or non-contractual 

4. NHS and Regulatory Context

4.1 NHS Guidance 

Under NHS guidance: 

• GPs are not contractually obliged to provide letters that are not directly related to clinical care or statutory medical certification. 

• Many education providers and finance bodies are expected to rely on their own policies, attendance records, or self-certification systems rather than GP letters. 

4.2 Care Quality Commission (CQC) Alignment 

This policy supports the CQC’s key lines of enquiry by ensuring: 

• Safe: Avoids inappropriate use of medical opinion outside clinical competence. 

• Effective: Ensures GP appointments are available for patients with medical needs. 

• Responsive: Provides clear, consistent, and transparent information to patients. 

• Well-led: Demonstrates governance, fairness, and appropriate use of NHS resources. 

4.3 GMC Guidance 

In line with GMC guidance on medical reports: 

• Doctors must only provide information that is factually accurate, clinically relevant, and within their professional role. 

• Doctors should not provide letters that serve primarily administrative, financial, or academic purposes without a clear medical necessity. 

5. What the Practice Does Not Provide

Little Venice Medical Centre does not provide: 

• Letters to confirm absence from school, college, or university 

• Letters to support applications for student finance, hardship funds, or bursaries 

• Letters for exam mitigation, extensions, or academic appeals 

• Letters requested solely for administrative or non-medical reasons 

This includes both NHS and private (paid) requests. 

6. What the Practice May Provide

Where clinically appropriate and contractually required, the practice may provide: 

• Fit notes (Med3) for patients who meet eligibility criteria ( Please see our Sick Certification Policy ) 

• Copies of existing medical records (subject to data protection regulations) 

• Medical reports requested by statutory bodies using the appropriate formal process 

• Comply with GDPR and NHS information governance requirements 

• Respond to formal medical information requests made directly by authorised organisations with patient consent 

• We can provide you with access to your full medical record, allowing you to download any information you feel may support your application and share this directly with the relevant housing authority or organisation, as appropriate. You can also access this information yourself via the NHS App or SystmOnline. 

These are provided strictly in line with NHS regulations and data protection law. 

7. Patient Responsibilities

Patients are encouraged to: 

• Use self-certification systems offered by schools, universities, or employers 

• Refer to attendance records, university wellbeing services, or student support teams 

• Check institutional policies, which often confirm that GP letters are not required 

8. Equality and Fairness

This policy is applied consistently and fairly to all patients regardless of age, background, or circumstances. Exceptions are not made to ensure equity and avoid disadvantage to other patients. 

9. Communication of the Policy

This policy will be: 

• Displayed on the practice website 

• Available at reception 

• Communicated verbally by staff when requests are made 

Staff are trained to explain the policy clearly and respectfully. 

10. Review and Governance

• Policy owner: Practice Manager (Mr Yakup Seyer) 

• Approval: GP Partners (Dr Nicholas E Collinson)  

• Review cycle: Every 1 year or earlier if NHS/CQC guidance changes 

• Date Reviewed and Approved :  30/12/2025 

11. Summary

Little Venice Medical Centre prioritises clinical care and patient safety. In line with NHS, GMC, and CQC guidance, the practice does not provide support letters for education- or finance-related matters that fall outside medical care. This ensures responsible use of NHS resources and timely access to medical appointments for all patients. 

A “Did Not Attend” (DNA) occurs when a patient: 

• Fails to attend a scheduled appointment without giving prior notice. 

• Cancels with insufficient notice, usually less than 24 hours (unless stated otherwise). 

Policy Guidelines 

1. Appointment Reminders

• You will receive a reminder (via SMS/email/phone) 24 hours before your booked appointment. 

• It remains your responsibility to remember and attend your appointment. 

• Should you fail to attend your scheduled appointment, you will receive an SMS DNA message and an email 10 minutes after the appointment was due to begin. 

2. Missed Appointments

• First DNA: A reminder will be sent, emphasizing the importance of attending or cancelling in advance. 

• Second DNA: A warning letter/email will be issued, and further non-attendance may affect future bookings. 

• Third DNA: You may be temporarily restricted from booking further appointments and as a last resort following repeated missed appointments we may request that you register at another surgery.( We reserve the right to exclude you from our practice list on this basis.) 

Allowances 

• Missed appointments due to genuine emergencies or circumstances (e.g., illness, accident, bereavement) will be considered on a case-by-case basis. 

Responsibilities 

• All Patients: It is your responsibility to attend your appointment on time (Late Patient Policy) or cancel with appropriate notice (ideally 24+ hours). 

• Staff: Our staff will log all DNAs and apply the policy consistently. Documentation of contacts and actions will be maintained. 

Appeals 

You may contact the Practice manager to appeal decisions related to any missed appointments. 

Reviewed and updated by Dr Nicholas E Collinson and Mr Yakup Seyer on 30/05/2025. 

Why have I been referred? 

Our GP will discuss with you and, if appropriate, your carer, about why a referral is being recommended. It is usually because your GP wants a specialist 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 may 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 across to you usually by text.(if requested by you) 

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 cannot 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 for which you have been referred. 

Please note that the management of these waiting lists are not within the remit of the  GP Surgery. Whilst we can confirm that you are indeed on a waiting list, there is nothing we can do to expedite hospital waiting times.Should you have any queries please contact the department which you were referred and not our surgery! 

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 through this pathway to contact the surgery if they have not heard anything about their appointment within 1 week of the referral being made. Please note 2 week wait referrals are used for conditions such as suspected cancers. 

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

Where an investigation has been requested by a specialist doctor from the hospital, they are responsible for following this up themselves and will usually offer you a follow up appointment. As our doctors have not ordered such tests, it would not be appropriate for our doctors to offer an explanation or management of an investigation arranged by a specialist doctor. Therefore, we kindly request that you await your follow up with yourspecialist doctor who requested any investigation as part of an outpatient visit.( Eg scans, X-Rays , Blood tests , other specialist investigations )  

Reviewed and Updated by Dr Nicholas E Collinson and Mr Yakup Seyer on 30/05/2025. 

1. Purpose

The purpose of our policy is to ensure the safe, effective, and consistent prescribing and management of acute medications within the practice. It aims to support clinicians in making appropriate decisions and to ensure patients receive timely and safe care. 

2. Definition of Acute Medication

Acute medication refers to a short course of treatment for a new or temporary condition. These are not intended for long-term or repeat use, and typically include: 

• Antibiotics 

• Analgesics (pain killers given short-term for specific ailments) 

• Short courses of anti-inflammatories 

• Medication for infections or minor illnesses 

3. 3. Prescribing Principles

• All acute prescriptions are based on clinical assessment, which may be, or have been, face-to-face, by telephone, or via online consultation (PATCHS system). 

• Acute medications are recorded accurately in the patient’s clinical record, including the reason why the acute medication was initially prescribed. 

• Antibiotics are prescribed in line with local antimicrobial stewardship guidelines. 

• Medication is only prescribed if necessary; self-care advice is offered when appropriate. 

• If an acute prescription is requested by a patient for a medication that has previously been prescribed some time ago for a specific condition, our doctors will: 

• Review the patient’s record 

• Assess if the condition is recurrent or now chronic 

• Consider if the medication can be safely reissued to treat the condition or consider if further investigation or discussion is needed. (Conditions and symptoms do change, and the doctor may feel that the reason for your request needs further clarification.)  

4. 4. Patient Requests for Acute Medication

• Requests will be assessed for clinical appropriateness. 

• Our Reception/administration staff will not promise prescriptions without clinician approval. 

• If you are repeatedly requesting acute medication, a medication review or face-to-face consultation will be arranged. 

5. 5. Safety and Monitoring

• All prescribing is checked for drug interactions and contraindications. 

• We ensure that any allergies you may have to medications are recorded and checked before prescribing. 

• We always report and manage any adverse drug reactions following national guidelines. 

6. 6. Timeframe

Requests for Medication previously prescribed as acute require longer to process because our GPs will review your medical records to determine the appropriateness of the medication you have requested and it may take up to 5 working days should a prescription be prepared. This may be because the medication you are requesting was prescribed in the past to treat and control an acute (one off or occasional) rather than chronic (regular and continuing) event. 

To summarise, if a condition that was treated in the past acutely returns at some point in the future, the doctor will need to assess whether the condition needs to be reviewed in a consultation. This is for patient and prescriber safety. We do hope you understand. 

 Reviewed and updated by Dr Nicholas E Collinson and Mr Yakup Seyer on 30/05/2025 

At Little Venice Medical Centre, we are committed to providing a safe, respectful, and comfortable environment for all our patients and staff. We ensure that best practices are upheld at all times, with the safety, dignity, and privacy of every individual being of paramount importance. 

Patient Rights 

• All patients have the right to request the presence of a chaperone during any consultation, examination, or procedure.  A chaperone for the purposes of an examination will be one of our staff members appropriately trained in medical chaperoning. 

• If a chaperone is not immediately available, the appointment may need to be rescheduled, depending on the clinical urgency. 

• Our healthcare professionals may also request the presence of a chaperone during certain consultations in line with clinical guidelines and the centre’s risk management protocols. 

Requesting a Chaperone 

• If you would like a formal chaperone (a trained member of the Practice staff) to be present during your consultation, please inform our Reception Staff at the time of booking or speak to the clinician at the beginning of your appointment. 

• We will make every effort to accommodate your request and ensure minimal disruption to your care. 

Training and Confidentiality 

• All formal chaperones are trained to understand their role and responsibilities, including issues of patient dignity, confidentiality, and safeguarding. 

• Chaperones are bound by the same standards of patient confidentiality as all healthcare professionals. 

Reviewed and updated by Dr Nicholas E Collinson and Mr Yakup Seyer on 30/05/2025 

Introduction/Background 

Nowadays it is recognised that home visits are not an effective use of a GP’s time and therefore are restricted to those patients who really need them.  

As GP workload escalates, making best use of valuable GP and clinical time is a priority. 

From both the patient and clinician perspective care is best delivered in an environment where there is access to full medical records, an optimum environment in which to examine a patient and the additional resources of the whole primary care team immediately to hand. 

This in most situations is the GP surgery, so a good reason should be apparent for a home visit to be deemed appropriate. With the exception of elderly and housebound patients with long-standing conditions which impact on mobility etc. please consider the appropriateness of requesting a home visit by one of our GPs what can be provided by a GP on home visit for an acute condition is limited and it may be more appropriate for your condition to assessed in a safer environment ( Eg Hospital ) Our doctors may advise you of this during a triage call. 

Who is eligible for a Home Visit? 

• Patients whom we have assessed as genuinely housebound. 

• Terminally ill patients. 

• The GP/ Nurse Practitioner MAY visit those patients who are not usually bed-bound but have a clinical condition that prevents them from being ambulatory. Alternatively, the GP may request a visit from the Rapid Response Team or from our Paramedic Service. 

Home visit requests for an acutely ill patient 

This refers to home visit requests for patients with life threatening conditions. 

Our surgery follows these guidelines: 

Any patient calling our surgery may be advised to dial 999 immediately if deemed necessary by one of our team, as requesting a visit from a GP/Nurse for patients experiencing certain symptoms may delay life- saving treatment. 

Examples of such situations are: 

• Myocardial infarction/ Heart attack 

• Severe shortness of breath 

• Severe haemorrhage 

• Suspected stroke 

• Severe Infection  

Patients will therefore be advised to ring the emergency services directly. 

Conditions not classed as being eligible for a Home Visit 

A GP/ Nurse Practitioner will NOT visit for these conditions and circumstances, and it is expected that the patient will attend the surgery to be seen. 

• Common symptoms of childhood fevers, cold, cough, earache, headache, diarrhoea /vomiting and most cases of abdominal pain. These patients are usually well enough to travel by car. It is not harmful to take a child with a fever outside. These children may not be fit to travel by bus or walk, but car transport is available from friends, relatives or taxi firms. 

• Adults with common problems, such as a cough, sore throat, influenza, back pain and abdominal pain, are also readily transportable by car to the surgery premises. 

• Common problems in the elderly, such as poor mobility, joint pain and general malaise, would also best be treated by consultation at the surgery premises where the facilities are available for full examination and investigations.  

Please note the following: 

• Our practice is not responsible for arranging transport to the surgery. 

• We will not visit for convenience.  

• Age is not a criterion for a home visit.  

• Wherever possible patients requiring a consultation with a GP/ Nurse Practitioner will be asked to attend the surgery. The surgery has the correct facilities for undertaking examinations.  

• In the surgery the GP/ Nurse Practitioner undertaking the consultation has access to the full clinical record and access to support services such as Practice Nurses and therefore a consultation at the practice is better quality with regard to patient safety. 

• If you request a home visit, you may initially receive a telephone consultation from the Doctor or Nurse Practitioner, who will discuss your symptoms with you. You may be asked to attend the surgery as a result of this consultation if clinically appropriate. You may also be referred to the Rapid Response Team , our Paramedic Service.  The Doctor/ Nurse Practitioner will decide on the most suitable place and time for your condition to be assessed.  

• We cannot provide an emergency service for accidents, acute injury, or for the treatment of the sudden acute onset of significant, potentially life-threatening symptoms. 

Reviewed and Updated by Dr Nicholas E Collinson and Mr Yakup Seyer on 30/05/2025. 

If you have a complaint or concern about the service you have received from the practice, please let us know. We operate a practice complaints procedure as part of the wider NHS complaints system. Mr Yakup Seyer , our Practice Manager, is responsible for ensuring that complaints are dealt with in line with appropriately.  

How To Complain 

We hope that most problems can be resolved easily and quickly, often at the time they arise and with the person concerned. If your problem cannot be sorted out in this way and you wish to make a complaint, we would like you to let us know as soon as possible – ideally, within a matter of days or at most a few weeks – because this will enable us to establish what happened more easily. If it is not possible to do that, please let us have details of your complaint: 

• within 12 months of the incident which caused the problem; or 

• Within 12 months of discovering that you have a problem or of the incident. 

Of course we will still investigate a complaint if you have good reasons for not being able to do so and if it is still possible to investigate effectively and fairly despite the delay. 

Complaints should be addressed to Mr Yakup Seyer, Practice Manager, or Dr Nicholas E Collinson if you would prefer. Alternatively, you may ask for an appointment with Mr Yakup Seyer in order to discuss your concerns. He will explain the complaints procedure to you and will make sure that your concerns are dealt with promptly. It will be a great help if you are as specific as possible about your complaint. 

What We Shall Do 

We shall acknowledge your complaint in writing within three working days and we will offer you a meeting with Jeanette to discuss the matter. At this meeting we will agree together how the complaint should be managed, the length of time it may take to investigate the issues and when you can expect to receive a final written response. When we look into your complaint, we shall aim to: 

• find out what happened and what went wrong; 

• make it possible for you to discuss the problem with those concerned, if you would like this; 

• Keep you informed of the progress of the investigation 

• make sure you receive an apology, where this is appropriate; 

• Identify what we can do to make sure the problem doesn’t happen again. 

Complaining On Behalf Of Someone Else- Please note that we keep strictly to the rules of medical confidentiality. If you are complaining on behalf of someone else, we have to know that you have their permission to do so. A note signed by the person concerned will be needed, unless they are incapable (because of illness) of providing this. If your complaint is on behalf of a child please ensure that this is communicated clearly in your complaint. 

For information about the NHS complaints procedure please visit: 

NHS England » Feedback and complaints about NHS services 

You can contact an independent complaints advocacy service 

Called HealthWatch,as they are experienced in supporting people with complaints about the NHS.  Further information about HealthWatch can be found: 

Find your local Healthwatch | Healthwatch 

If you are unhappy with the response you have been given, and want 

an independent review of the complaint please write to 

 the Health Service Ombudsman for England, Millbank Tower, Millbank, London 

SW1P 4QP. Alternatively you can contact NHS England, PO Box 16738, Redditch, B97 9PT,  T0300 311 22 33  email England.contactus@nhs.net 

Reviewed and Updated by Dr Nicholas E Collinson and Mr Yakup Seyer on 30/05/2025 

A ‘fit note’ is a legal medical statement that is provided by a clinician following a medical assessment, at the clinician’s discretion.  It considers your illness and its impact on your ability to work. The clinician treating you is best placed to assess your condition. If appropriate, a suitable form of fit note may be issued as part of your treatment plan. 

This clinician can be a doctor (specialist or GP), nurse, occupational therapist, pharmacist, or physiotherapist delivering NHS services 

Fit notes after hospital care 

If you are likely to need a fit note (otherwise known as a sick note or MED 3) when you come out of hospital or following outpatient attendance, please ask the doctor treating you in the hospital at the time of your discharge to provide you with one before you leave. 

Mythbusters 

• “Consultants and junior doctors do not write fit notes. Fit notes are a GP’s job” – FALSE 

• “The hospital just don’t have any fit note pads” – FALSE 

• “The hospital can only issue notes for one or two weeks at the very most” – FALSE 

• “The hospital can’t issue you with a fit note if you’ve only been to outpatients” – FALSE 

• “The hospital won’t be able to message me with my fit note or send it to me in the post” – FALSE 

• “The doctor who is treating you at the time has a statutory obligation to provide you with a fit note if you need one. This includes all hospital doctors” – TRUE 

• “The doctor who is treating you should sign you off for the appropriate time period according to the condition you have been treated for” – TRUE 

• “Both private and NHS doctors can issue fit notes” – TRUE 

• “It is part of the hospital’s contractual duty to issue a fit note when one is required. Failure to do so is breach of the hospital’s contract with the NHS” – TRUE 

• “Fit notes can be forward dated” – FALSE. If you have a planned operation or procedure that requires time to recover, on the day of the procedure, the fit note can be issued. This should ideally be done by the specialist’s team, who are better able to advise you on the timelines, precautions as well as the recovery period.  They will have standard advice regarding recovery times for specific procedures or conditions. 

Please help us to keep our appointments free for patients who have genuine clinical need, rather than for administrative paperwork that could have easily been dealt with by others at the end of your hospital visit. If you have trouble obtaining a fit note from the hospital, please contact the PALS (Patient Advice Liaison Service) team at the hospital. 

For illnesses lasting less up to 7 days 

As per national guidance and regulations, GPs do not issue fit notes during the first 7 calendar days of sickness absence. Employees can self-certify for this time, visit Employee’s statement of sickness to claim Statutory Sick Pay for a template form.  Your employer must accept your word that you are ill and unable to attend your place of employment for any absence up to and including the 7th day of any illness.  Should the illness continue or you expect to be absent for more than 7 days, you will need to contact us by the 8th day of illness, from which time, and following an assessment, we can then issue a MED3 to you. 

If your employer does require medical evidence for the first 7 days of sickness absence, it is the responsibility of your employer to arrange and to pay for this. Getting the most out of the fit note: guidance for employers and line managers. 

For illnesses lasting more than 7 days 

If you are off work for more than seven days due to illness, your employer can ask you to give them some form of medical evidence to support payment of SSP (statutory sick pay) or other sickness benefit. 

If you are not currently under the care of a Clinician, you will typically need an in-person assessment. If appropriate, a suitable fit note may be issued as part of your treatment plan. 

This Clinician can be a doctor (specialist or GP), nurse, occupational therapist, pharmacist, or physiotherapist delivering NHS services. In some cases, a fit note may be issued based on a written report from another Clinician such as a specialist, at the GP’s discretion. However, it is better to obtain the fit note directly from the team treating you, as they are better equipped to assess and issue it with the necessary details and advice regardingyour recovery. 

The fit note assessment will consider which daily activities you are able to do, including work (paid or unpaid), studies, caring for others, commuting including travel. If you are unable to perform any form of work, a ‘complete’ or ‘total’  fit note  may be issued for an appropriate period, then reviewed if required.  

It remains the responsibility of and discretion of the clinician treating you if a fit note is issued and any associated stipulations. 

A total fit not implies that unable to undertake any forms of work whatsoever. The fit note: guidance for patients and employees. 

Illnesses where you are deemed able to do some work 

Alternatively, under certain circumstances a doctor may issue a ‘may be fit note’. This has four iterations: 

• A phased return to work: a gradual increase in work duties or hours 

• Altered hours: changing their work times or total hours 

• Amended duties: changing their work duties 

• Workplace adaptations: changing aspects of the workplace 

A Clinician may also use the comments box to give you more detailed advice about what your type work you can do. This advice will be about their general fitness for work, not just related to your current role. If there are certain parts of your role that may be affecting their health, these will be mentioned in the comments box. 

In most cases, people do not need to be 100% fit to return to work. This may not mean doing their normal job. People with health conditions may have limits on what they can do at work, but these will not always mean they cannot do any work. If your employer is unable to accommodate the amendments suggested, the amended duties fit note becomes a total (IE cannot work) fit note. The fit note: guidance for patients and employees. 

Please note once a ‘fit note’ or ‘amended sick note’ expires, if the employer feels that the employee requires further assessment to consider them fit to go back to work, this is up to the employer to make the necessary assessments i.e. by instructing an occupational health assessment or conducting a human resources return to work interview. 

Optional Occupational Sick Pay Schemes 

A number of employers operate occupational sick pay schemes which, while offering employees more benefits than those prescribed under SSP (Statutory Sick Pay) legislation, require more in the way of certification.  Specifically, they require a Doctor’s certificate for illnesses of less than 7 days’ duration. Since the advent of self-certification for statutory sick pay purposes in 1983, as has been mentioned GPs are not required to issue certificates for periods of sickness of less than 7 days duration. It is clearly not a GP’s role to supervise an employer’s enhanced occupational sick pay scheme. If employers require additional certification, it is up to them to make their own arrangements, on a private basis, with a Doctor to examine and verify the genuineness of the patient’s illness. For this reason, when  

Please note that our members of staff including reception and clinical staff have a right to work in a safe environment, without fear of bullying, aggression, intimidation or harassment. The national NHS Zero Tolerance Policy applies at all times and such any behaviour deemed by us to be in breach of this will not be tolerated. Please refer to our Zero Tolerance page for further information. 

Renewal or continuation of Sick Notes (Med3s) 

Our surgery generally issues Med3s for a maximum period of 2 months for chronic or on-going medical conditions.  Requests for renewal of a sick note can be made via the PATHCS system.  This system allows you to give further information about your request.  An enquiry received through this system will be forwarded to your doctor, who will aim to respond within 48 hours of receipt.  Please note that all PATCH request are processed by a third party and forwarded on to us. 

Purpose 

Our policy outlines the procedure for requesting, issuing, and reviewing repeat prescriptions to ensure patient safety, compliance with NHS regulations, and efficient practice operations. 

1. Eligibility for Repeat Prescriptions

• Only patients registered with the practice are eligible for repeat prescriptions. 

• Our GPs must have previously approved the medication as suitable for repeat prescribing. 

• Repeat medications are reviewed at least annually or more frequently as needed. 

• We generally provide medication as a two-month supply (according to Local and National Guidance) . We allow patients to order 3 prescriptions (6 months of medication) before our system alerts us to the need for review. Patients may receive notification from your nominated pharmacy that a review is required. Please note that this is an alert to ensure that your medications are reviewed by our team as some of these medications may need monitoring for example yearly blood test , Blood pressure check etc. and does not mean you will not receive your medication. 

2. How to Request Repeat Medications

Repeat prescriptions must be requested at least 3 full working days (72 hours) before the medication is needed. Accepted methods: 

• Online: Via the NHS App , the practice’s online services ( Systmonline ) or via the PATCHS system.  

• Repeat Slip: Hand in the right-hand side of your last prescription, ticking the items you require 

• Written Request: A written note listing the medication(s) ( Medication Request Forms at reception area)  

• Telephone Requests: Not accepted, except for elderly or vulnerable patients by prior arrangement 

🚫 We do not accept requests via email or during GP consultations. 

3. Prescription Processing

• All requests are reviewed by a GP or prescribing clinician. 

• Any discrepancies, overuse, or overdue reviews may delay issuance. 

• All prescriptions are sent electronically to the nominated pharmacy. There are very small number of medications which can only be issued on a paper prescription ( FP10). We will inform you if it is the case for your medication and this is your responsibility to order and collect the prescription for such medications.  

4. Medication Reviews

• Patients on repeat prescriptions will be invited for a medication review at least every 12 months.( This may be a face-to-face appointment or Telephone Consultation ) 

• Reviews may include blood tests, blood pressure checks, or in-person consultations. 

• Repeat prescriptions may be withheld if a review is overdue.This is to ensure safety in prescribing.  

5. Emergency Supply Requests

• Emergency prescriptions will only be issued at a GP’s discretion. 

• Frequent last-minute requests may be monitored and addressed. 

• Patients are expected to manage medication supplies responsibly. 

6. Controlled Drugs and Special Medications

• Controlled drugs (e.g., morphine, diazepam , Zopiclone ,ADHD/ADD medications) are not routinely issued on repeat and may require more frequent review. 

• These prescriptions are usually limited to 7–28 days and may require in-person collection. 

7. Third-Party Requests

• Pharmacies or carers may request repeats on the patient’s behalf with written consent.( Eg. Electronic Requests)  

• The practice reserves the right to require direct confirmation from the patient in certain cases. 

8. Collection and Dispensing

• Prescriptions are sent via Electronic Prescription Service (EPS) to your chosen pharmacy. 

• Paper prescriptions are available by arrangement or where EPS is not suitable.(see above) 

• Please check with your pharmacy before collection. 

9. Patient Responsibility

Patients must: 

• Request medication on time (at least 3 working days in advance) 

• Attend medication reviews when invited 

• Keep track of medication supply  

• Inform the practice of any changes in medication or pharmacy nomination 

 Reviewed and Updated by Dr Nicholas E Collinson and Yakup Seyer on 30.05.2025