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Home >>Practice >>Practice Policy >>Health and Disability Code of Rights Policy

Health & Disability Code of Rights

Policy

  • The practice is committed to the implementation of the Health and Disability Code of Rights in daily delivery of health services as set out in detail below.
  • The practice will display a copy of the Health and Disability Code of Rights poster in the waiting room
  • The practice will make available pamphlets related to the Code of Rights and the Advocacy Service.
  • The practice staff will have appropriate ongoing training in relation to the Health and Disability Code and Advocacy Service.

The ten Rights of Patients in the Health and Disability Code.

  1. To be treated with respect including respect for personal privacy
  2. Freedom from discrimination, coercion, harassment and exploitation
  3. To be treated with dignity and independence
  4. Services of appropriate standards
  5. Effective communication
  6. To be fully informed
  7. To make your decision (informed choice & informed consent)
  8. To be supported by another if wished
  9. To participate or decline participation in teaching and research
  10. To 'complain’ / give feedback in order to help improve services

Practice policy for achieving these rights.

A non-judgemental approach is required in all cases. Examining one’s own feelings and possible prejudices and recognising them is the first step to treating everyone in a non-judgemental fashion. However care also needs to be taken that we are not victims of deceit or unreasonable requests in an attempt to be ‘neutral’. Personal privacy will be achieved through the practice’s privacy policies and procedures.

Patients will be treated based on clinical grounds regardless of race, gender, age, socioeconomic status or sexual orientation. If there are reasonable grounds to assume that the practice or its staff are being exploited by any particular patient then the appropriate response is not based on any particular characteristic of that individual but rather on the actual circumstances of the problem that has arisen. The Practice has a complaints officer who has the responsibility of monitoring, educating staff and dealing with any issue where discrimination in provision of service has taken place. All reasonable efforts to provide facilities for those with disabilities will be made by the practice. Such disabilities may include: impaired literacy, intellectual impairment, dementia, impaired hearing or vision or a physical handicap.

All patients need to be given the benefit of the doubt about their sincerity and genuineness unless there is good reason to believe that they are not acting in good faith. If that is suspected then the evidence for that conclusion needs to be strong and consideration should be given for documenting that. A way to test whether any patient is not being treated with the appropriate dignity and state of independence is to consider

  • How your colleagues would treat this patient or
  • Whether your treatment is of a standard that you would wish for yourself or your family if you were that individual.
Through following these principles it is thought that all patients will be afforded the dignity and independence they are entitled to.

Appropriate standards are maintained through ongoing professional development and benchmarking against any minimum standards set by professional bodies such as the Medical Council and the Nursing Council, colleagues as well as setting one’s own standards high. All legal and professional and ethical standards will be adhered to. The practice will operate on a CQI (continuous quality improvement) philosophy in order to be always ready to correct errors if they occur and improve service where possible. Services will be provided tailored to the individual’s needs in a patient centred approach. Patients will be involved as much as possible in their care and decisions regarding their care. The practice will foster a team approach working together to achieve the best outcomes possible. Continuity of care is an important principle to strive for. There will a staff training record which all staff training within and outside the practice will be recorded. New staff will have adequate training to ensure they comply with the Code of Rights. Training will take place annually either by in house discussion or using external trainers.

Effective honest communication is strived for by all staff for always and mechanisms for dealing with poor communication as evidenced by complaints or poor outcomes or significant adverse events are addressed in other policies (complaints management and significant events management). Details of translation services for as many languages as possible will be kept at the surgery. The patient may be required to cover the reasonable cost of any such services. Disabled patients e.g. with hearing difficulties or sight problems will need special consideration about how best to effectively communicate with them. E.g. written information or engaging a signer. Fax machines provide a possible solution to some communication problems.

This is part of effective communication and staff will be required to give as full an explanation to patients regarding their health problems and possible treatment options as the context requires. There is a practice policy for informing patients of their test results. Patients may allow a nominated representative to receive health information about them-see Privacy Policy. Patients will be routinely given a copy of the practice information leaflet. Where able staff will direct patients to sources of information or provide written material such as leaflets that are relevant to their health problem or disability. Patients must be given all the information that a reasonable patient would expect to receive to enable them to make an informed decision, including (but not limited to):

  • an explanation of their condition and the treatment options available to them including information about the expected risks, side effects, benefits, and costs of each option;
  • advice on the estimated time within which they will be treated;
  • details of any proposed participation in teaching or research; and
  • the results of tests and procedures.

It is the health professional who is to provide services to the patient who must obtain the patient’s consent. The practice has a form for obtaining consent. This form should be tailored to the particular case. Details of specific and significant risks discussed must be recorded on the form.

Patients have the right to ask questions and to receive honest and accurate answers to their questions, including questions about:

  • the identity and qualifications of the person who will be treating them;
  • how to obtain a second opinion; and
  • the results of research.

Patients also have the right to receive a written summary of any information that has been provided to them if such a request is made.

Staff are trained to be aware of the concept of the need to be as patient centred as possible appropriate to each set of circumstances that arises, and the medical staff attempt to act as examples of this. Patients are assumed to be competent to make an informed choice and give informed consent unless there is good reason to think otherwise. If this is the case then information. Hence decisions will hopefully be made with patients in an informed way and consent given freely. The practice has a consent form for more non routine treatment or more significant and invasive procedures for patients to sign. When a patient has diminished competence, the patient still has the right to make informed choices and give informed consent to the extent that the level of competence allows.

When a patient is not competent to make an informed choice or give informed consent, and there is no-one available to consent on the patient’s behalf, staff can treat the patient if the treatment is in the patient’s best interests, staff have taken steps to ascertain the patient’s views, and either:

  • staff believe that the patient would have consented to the treatment if he/she was competent given the views that the patient has expressed; or
  • staff have not been able to ascertain the patient’s views, but have taken into account the views of other suitable persons who are interested in the patient’s welfare.

At all times patients are free to have any support person they wish to have as long as it does not detract from the effectiveness of the consultation and clinical outcomes, or compromise the rights of another patient. Where this may be the case the patient will be advised of this and given the choice as to whether to have the support present still. Furthermore there will be freely available material and posters displayed about the advocacy services available. The patient may need to be asked in private whether they wish to have a support person present with them or not.

Participation research is a patient’s prerogative and will never be forced. Explicit informed consent will always be obtained Where students are taught in the practice patients will be offered the choice of whether they wish the student to be present.

Complaints procedures are covered under Complaints Management Policy and Procedures. All staff will be aware of this policy. Under this policy all complaints will be documented in the practice minutes (a regular item on the agenda) and the process of the complaint documented and the outcomes and any actions required for the staff member or practice as a whole. Complaints will not compromise the care the patient is given.

Further Policy statement:

All patients with the following disabilities (this list is not exhaustive and discretion to add to this list is encouraged) will have their records set up with appropriate READ codes (Classifications) and an Alert set up in the PMS system. This will be done on an opportunistic basis and based on prior staff knowledge. The goal is to ensure all patients in the practice population will have the appropriate and accurate disability information and consideration of their needs can be given so they can participate in their care according to their needs.

  • Hearing impaired
  • Vision impaired
  • Mobility problem
  • Intellectual impairment including dementia
  • Literacy difficulties
  • Language difficulties
A list of organisations and resources will be kept in the practise and added to as required that provide assistance to people with disabilities. Such organisations and resources relevant to the listed disabilities will be identified and easily accessible on the computer system for use by the practice staff.

Review Date: Health & Disability Code, March 2011