INTRODUCTION

There may be circumstances when it would be considered reasonable, or in the best interests of the patient, to remove patients from the list.

The purpose of this policy, therefore, is to define the practice guidelines for removal of a patient from the practice list and to ensure that any concerns about removing patients from the list are dealt with fairly.

SITUATIONS WHICH JUSTIFY REMOVAL

Violence

When a patient:-

• Is physically violent or threatening towards a doctor, practice staff or other patients on the practice premises.
• Causes physical damage to practice premises or other patient’s property.
• Gives verbal abuse or makes threats towards the doctor, practice staff or other patients.
• Gives racist abuse, orally or physically.
• Is violent or uses or condones threatening behaviour to doctors (or some other members of the primary health care team) while visiting the patient’s home. Such behaviour may involve the patient, a relative, a household member, or pets (such as unchained dogs).

Crime & Deception

Where a patient:-

• Fraudulently obtains drugs for non-medical reasons.
• Deliberately lies to the doctor or other member of the primary health care team (e.g. by giving a false name or false medical history) in order to obtain a service or benefit by deception.
• Attempts to use the doctor to conceal or aid any criminal activity.
• Steals from practice premises.

Distance

• Where a patient has moved out of the designated practice area and has failed to re-register with another GP.

Embarkation

• Where a patient has moved abroad for a period of 3 months or more.
• Failure to attend pre-booked appointments.
• Where a patient fails to attend pre-booked appointments on a number of occasions during a given period.
• Irretrievable breakdown of the Doctor/Nurse-Patient relationship.
• Where a patients behaviour falls outside of that which is normally considered reasonable and leads to an irretrievable breakdown of the doctor-patient relationship.

PROCEDURE FOR REMOVAL

Violence / Crime and Deception

Any incident involving violence, crime or deception will be immediately reported to the Management Team, who will complete an incident report and bring to the attention of the practice partners. Staff involved should also make a written statement at the time as further evidence.  It may be so serious that the police may need to be contacted.

If it is that serious then the patient can be removed immediately by contacting the Commissioning Group / Registration Department advising them of the incident and giving them a log number that the police have given.

For less serious matters.

Each case will be discussed with all involved in the surgery and a partner. A majority agreement will be reached.  If it is to remove the patient it can be done under the 8 day rule.

The Commissioning Group and Registration Department will need to be contacted and a brief outline given.

Following that agreement, the Management Team will write to the patient and explain the reasons for removal.

The Registration Department should then deduct the patient in the normal way.

Distance

On notification that the patient is no longer living within the practice boundary, a letter will be sent to the patient advising of the need to re-register within 28 days elsewhere.

Notification will be sent to the Registration Department after 28 days if the patient has not been deducted by the Registration Department as they have not registered elsewhere.

Embarkation

On notification that the patient has moved abroad the patient will be removed from the Practice list within 3 months of that notification.

Failure to attend pre-booked appointments

If a patient continually fails to attend pre-booked appointments, they will be reviewed and if deemed necessary a warning letter will be sent to the patient, advising them that a further occurrence could risk removal from the practice.

Warning letters are valid for a period of 12 months. Removal based on warnings greater than 12 months old will be invalid – in this case a further formal warning and period of grace will be required.

If the patient fails to attend another appointment, the matter will be discussed at a practice meeting and a majority agreement will be reached as to whether the patient will be removed from the practice list.

Following agreement the Management Team will write to the patient and explain the reasons for removal.

Guidance on removing patients due to irretrievable breakdown of the doctor – patient relationship.

Occasionally patients persistently act inconsiderately and their behaviour falls outside that which is normally considered to be reasonable. In such circumstances there may be a complete breakdown in the doctor-patient relationship.

Steps to be taken within the Practice

• Inform all appropriate members of the practice about the problem.
• The patient and possible reasons for the patient’s behaviour (e.g. disagreeableness, cultural differences, mental illness, and personality disorder) will be discussed at a practice meeting.

Steps to be taken with the patient

• Inform the patient, either personally or in writing, that there is a problem.
• Explain the nature of the problem to the patient.
• Obtain the patient’s perspective and interpretation of the situation.
• Obtain advice of a Medical Defence Organisation.

Steps to be taken if discussion fails to resolve the problem

• Suggest that another GP within the practice might better fit with the patient’s needs and expectations.
• Steps to be taken in actually removing the patient.
• Inform the appropriate Registration Department in writing of your decision.
• Inform the patient in writing of the decision and the reason for removal from the list.
• Explain to the patient that he or she will not be left without a GP.
• Give the patient information on how to begin the process of registering with another GP.

Family Members

When a decision is made to remove a patient from the practice list, the removal may well be extended to other members of the family or household.

Removing other members of the household

If the behaviour of one member of a household or family has led to their removal, this does not mean that the removal of other family members should automatically follow. An explicit discussion, whilst protecting the confidentially of the removed patient, with other family members about the problem and the doctor’s concerns will often obviate the need for any further action.

In rare cases, however, because of the possible need to visit patients at home it may be necessary to terminate responsibility for other members of the family or the entire household. The prospect of visiting patients where a relative who is no longer a patient of the practice by virtue of their unacceptable behaviour resides, or being regularly confronted by the removed patient, may make it too difficult for the practice to continue to look after the whole family.

This is particularly likely where the patient has been removed because of violence or threatening behaviour and keeping the other family members could put doctors or their staff at risk.

The practice should always consider how it would look to outside observers if a family were to be summarily removed from the list, in haste, without explanation for a single misdemeanour or disagreement with one family member.

The Management Team will write to the family / household offering an explanation for the removal. They will be allowed 4 weeks to re-register rather than being removed from the practice list immediately.

Responsibility

Responsibility for implementing and monitoring the policy rests with the Practice Partners / Management Team.

The practice re-affirm its commitment to do everything possible to protect staff, patients and visitors from unacceptable behaviour and their zero tolerance of any incident that causes hurt, alarm damage or distress.

At Redlands we have a Facebook page which provides a range of useful information for our patient population.
Redlands has a duty to maintain patient confidentiality and to safeguard vulnerable patients. You can help us to achieve this by adhering to the code of conduct outlined in this policy.

Patients of Redlands Primary Care are expected to adhere to the following code of conduct at all times:

• The organisation requires all users of portable devices to use them in a courteous and considerate manner, respecting their fellow patients. Portable devices are not to be used during consultations, except when agreed with your clinician.
• Patients are not permitted to disclose any patient-identifiable information about other patients, unless they have the express consent of that patient.
• Whilst not encouraged, patients may record their consultation, but this should be agreed with your clinician. This recording will solely be for your own purpose.
• Patients must not post any material that is inaccurate, fraudulent, harassing, embarrassing, obscene, defamatory, or unlawful. Any such posts on the organisation Facebook page will be deleted and the post reported.
• Patients are not permitted to take photographs in the waiting room or areas where other patients are present, nor are photographs of staff permitted to be taken.
• Patents must not post comments on social media that identify any staff.
• Defamatory comments about our team are not to be shared on any social media platform. Legal advice will be sought, and the appropriate action taken against any patient who posts defamatory comments
• We ask if you have a complaint to please contact the Complaints Manager in the first instance. We would be grateful if patients could be pro-active in reporting any incidents of this nature to the Complaints Manager.

For a number of years, work has been ongoing to improve the way that medical records are made available to treating clinicians. Our main computer system is called SystmOne which has the advantage of enabling information to be shared between certain health professionals, and where necessary their support staff.

Enhanced data sharing model (EDSM) enables us, with your consent, to share your medical records with those in the NHS who are involved in your care. NHS staff can only access shared information if they are involved in your care and records are kept showing who has accessed your medical records.

As the scheme has been designed to enhance patient care, you have been automatically opted in.

For some time we have shared information for children for child protection reasons and also for patients under the care of the district nursing team. This has helped clinicians to make decisions based upon a wider knowledge of the patient and also helps to reduce the number of times that patients or family members are asked the same question. In short it assists clinicians to provide more ‘joined up care’.

If I agree, who can see my records?

EDSM allows clinicians treating you, who have access to SystmOne to view and in some cases update your medical records. Locally this includes the walk-in centre, many departments at local hospitals (including A&E) and community services, such as the district nursing team. It is anticipated that over time more health services will be able to benefit from EDSM.

Clinicians outside of the surgery who wish to access your medical records will ask for your consent to do so and will need to have been issued with a NHS smartcard. This is a chip and pin card – similar to a bank card.

Can I opt out or pick and choose who sees my record?

Yes, you can. Under EDSM there are two levels of consent. The first is to agree to sharing your medical records out. This is your agreement that records maintained by your GP can be seen, subject to your authority at the time, by clinicians working outside of the surgery. The second is agreeing to share your records in. This means that your GP can see the records made by other health professionals who have access to EDSM.

However, as the treating clinician needs to ask your permission to see your records at the beginning of each period of care you are in control of who can see your medical information.

I can see the benefits of the other people treating me seeing my notes, but what if there is a matter that I want to stay just between me and my doctor?

You can ask for any consultation to be marked as private, this means that viewing is restricted to the surgery, but allows the rest of the record to be viewed by whoever else is treating you. It is your responsibility to ask for a consultation to be marked as private.

Haven’t I agreed/disagreed to do this before?

EDSM may seem very similar to patients as the summary care record which went live some years ago. The summary care record contains only a very small part of your record that is available to be seen by clinicians who might be treating you in A&E departments, walk in centres or if you register temporarily somewhere else within the UK.

Can I change my mind?

Yes, you can always change your mind and amend who you consent to see your records. For instance you can decline to share your records out from the surgery, but if you build up a relationship with the physiotherapist who is treating you and they asked you if they could look at an x-ray report, you could give your consent at that point for them to view your records. You will be referred back to us to change your preference, so the physio treating won’t be able to see your records instantly, but should be able to by, the next time of your next appointment.

If I decline what happens in an emergency?

In the event of a medical emergency, for instance if you were taken unconscious to A&E, and the clinician treating you feels it is important to be able to see your medical records he is able to override any consents set.

However, the doctor has to give a written reason for doing so. Where this happens an audit is undertaken by the local Caldicott Guardian (the person with overall responsibility for Data Protection compliance).

Can anyone else see my medical records?

On a daily basis, we get requests from insurance companies to either have copies of medical records or excerpts from patients’ medical records. This requires your signed consent.

Occasionally we are asked for information from the medical records for legal reasons and we will only provide information when legally required to do so.

Any questions?

If you have any questions or wish to opt out, please contact reception.

You are free to change your mind at any time. Information about you and the care you receive is shared, in a secure system, by healthcare staff to support your treatment and care.

We share a common purpose with our partners in health and social care – and that is to provide high quality care and ensure the best possible outcomes for the people who use our services. Promoting improvement is at the heart of what we do.

We endeavour to provide a first class service at all times but sometimes things go wrong and our service may fall below our expected levels.

In order to comply with Regulation 20 of the Health and Social Care Act 2008 (Regulations 2014) we pledge to:

• Have a culture of openness and honesty at all levels
• Inform patients in a timely manner when safety incidents have occurred which may affect them
• Provide a written and truthful account of the incident, explaining any investigations and enquiries made
• Provide a written apology
• Provide support if you are affected directly by an incident.

Consent to treatment is the principle that a person must give permission before they receive any type of medical treatment, test or examination and is generally requested on the basis that an explanation of the required treatment, test or procedure has been received from a Clinician.

Consent from a patient is needed regardless of the procedure, whether it’s a physical examination, organ donation or something else.

The principle of consent is an important part of medical ethics and international human rights law.

Defining consent

For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision.

These terms are explained below:

• voluntary– the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family
• informed– the person must be given all of the information in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment doesn’t go ahead
• capacity– the person must be capable of giving consent, which means they understand the information given to them and they can use it to make an informed decision

If an adult has the capacity to make a voluntary and informed decision to consent to or refuse a particular treatment, their decision must be respected. This is still the case even if refusing treatment would result in their death, or the death of their unborn child.

If a person doesn’t have the capacity to make a decision about their treatment, the Healthcare Professionals treating them can go ahead and give treatment if they believe it’s in the person’s best interests.

Clinicians must however take reasonable steps to seek advice from the patient’s friends or relatives before making these decisions.

Read more about assessing the capacity to consent.

How consent is given

Consent can be given:

• verbally– for example, by saying you are happy to have an X-ray
• in writing– for example, by signing a Consent Form for surgery to be performed

Someone could also give non-verbal consent, as long as they understand the treatment or examination about to take place – for example, holding out an arm for a blood test.

Consent should be given to the Healthcare Professional directly responsible for the person’s current treatment, such as:

• a Nurse arranging a blood test
• a GP prescribing new medication
• a Surgeon planning an operation

If someone is going to have a major medical procedure such as an operation, their consent should ideally be secured plenty of time in advance, so that they have time to obtain information about the procedure and ask questions.

If a patient changes their mind at any point before the procedure, they are entitled to withdraw their previous consent.

Consent from children and young people

If they’re able to, consent is usually given by patients themselves. However, someone with parental responsibility may need to give consent for a child up to the age of 16 to have treatment.

Read more about the rules of consent applying to children and young people.

When consent isn’t needed

There are a few exceptions when treatment may be able to go ahead without the person’s consent, even if they’re capable of giving their permission.

It may not be necessary to obtain consent if a person:

• requires emergency treatment to save their life, but they’re incapacitated (for example, they’re unconscious) – the reasons why treatment was necessary should be fully explained once they’ve recovered
• immediately requires an additional emergency procedure during an operation – there has to be a clear medical reason why it would be unsafe to wait to obtain consent, and it can’t be simply for convenience
• with a severe mental health condition such as schizophrenia, bipolar disorder or dementia, lacks the capacity to consent to the treatment of their mental health (under the Mental Health Act 1983) – in these cases, treatment for unrelated physical conditions still requires consent, which the patient may be able to provide, despite their mental illness
• requires Hospital treatment for a severe mental health condition, but self-harmed or attempted suicide while competent and is refusing treatment (under the Mental Health Act 1983) – the person’s nearest relative or an approved Social Worker must make an application for the person to be forcibly kept in Hospital, and two Doctors must assess the person’s condition
• is a risk to public health as a result of rabies, cholera or tuberculosis (TB)
• is severely ill and living in unhygienic conditions (under the National Assistance Act 1948) – a person who is severely ill or infirm and is living in unsanitary conditions can be taken to a place of care without their consent

You can always talk to the clinician providing you with care if you have any concerns in relation to consent.

Consent and life-sustaining treatments

A person may be being kept alive with supportive treatments – such as lung ventilation – without having made an advance decision based on information which outlined the care that they may have refused to receive.

In these cases, a decision about continuing or stopping treatment needs to be made based on what that person’s best interests are believed to be.

To help reach a decision, the Healthcare Professionals responsible for the person’s care should discuss the issue with the relatives and friends of the person receiving the treatment.

They should consider, among other things:

• what the person’s quality of life will be if treatment is continued
• how long the person may live if treatment is continued
• whether there’s any chance of the person recovering

Treatment can be withdrawn if there’s an agreement that continuing treatment isn’t in the person’s best interests.

The case will be referred to the Courts before further action is taken if:

• an agreement can’t be reached
• a decision has to be made on whether to withdraw treatment from someone who has been in a state of impaired consciousness for a long time (usually at least 12 months)

It’s important to note the difference between withdrawing a person’s life support and taking a deliberate action to make them die. For example, injecting a lethal drug would illegal.

Complaints

If you believe you’ve received treatment you didn’t consent to, you can make an official complaint, please write to the Complaints Manager, who will assist you with this process.

We make every effort to give the best service possible to everyone who attends our Practice.

However, we are aware that things can go wrong, resulting in a patient feeling that they have a genuine cause for complaint. If this is so, we would like the matter to be settled as quickly, and as amicably, as possible.

To have your complaint investigated, you need to complain within 12 months of the event happening, or as soon as you first become aware of the issue you want to complain about.

The time limit can be extended in special circumstances.

Interpreting Service

We can arrange for a meeting with the Complaints Manager and an interpreter for any patient whose first language is not English and needs help with their complaint.

How to make a compliment or complaint

Whether you are happy or unhappy with the care and treatment that you have received, please get in touch and let us know your views.

Receiving compliments and complaints is important to ensuring good quality local healthcare in our Practice – helping us to find out more about what we’re getting right and what we can improve.

We hope this will help you to make your feelings and experiences known to the appropriate people. Should you have a complaint we hope this page will give you more information about what to do, who to contact and what happens next.

How do I raise a concern / informal complaint?

You can speak to any member of staff initially with your complaint. This gives you the opportunity to resolve any concern you may have without it going through a formal process.

Most complaints are best resolved within the practice and these should be made via the Complaints Manager.

Formal Complaint

What we will do

We will contact you about your complaint within three working days and offer to discuss with you the best way to investigate it, including the time scales for a reply. We will aim to offer you an explanation within that time frame or a meeting with the people involved.

• Find out what happened and what went wrong
• Invite you to discuss the problem with those involved, if you would like this
• Apologise where this is appropriate
• Identify what we can do to make sure that the problem does not happen again.

If you feel you do not want to contact the surgery directly, then you can contact the NHS Complaints team on:

NHS England,
PO Box 16738,
Redditch,
B97 9PT

If you are making a complaint please state: ‘For the attention of the complaints team’ in the subject line.

Contact Information

In General

If you have a complaint to make, you can either contact the Complaints Manager or ask a receptionist for a copy of our Complaints Procedure. We will endeavour to:

1. acknowledge any letter or Complaints Form within 3 working days of receiving it.
2. deal with the matter as promptly as possible – usually within 20 working days – dependent on the nature of the complaint.

Who can complain

• Complainants may be current or former patients, or their nominated or elected representatives (who have been given consent to act on the patients behalf).
• Patients over the age of 16 whose mental capacity is unimpaired should normally complain themselves or authorise someone to bring a complaint on their behalf.
• Children under the age of 16 can also make their own complaint, if they’re able to do so.

If a patient lacks capacity to make decisions, their representative must be able to demonstrate sufficient interest in the patient’s welfare and be an appropriate person to act on their behalf. This could be a partner, relative or someone appointed under the Mental Capacity Act 2005 with lasting power of attorney.

Appropriate person

In certain circumstances, we need to check that a representative is the appropriate person to make a complaint.

• For example, if the complaint involves a child, we must satisfy ourselves that there are reasonable grounds for the representative to complain, rather than the child concerned.
• If the patient is a child or a patient who lacks capacity, we must also be satisfied that the representative is acting in the patient’s best interests.

If we are not satisfied that the representative is an appropriate person we will not consider the complaint, and will give the representative the reasons for our decision in writing.

Time limits

A complaint must be made within 12 months, either from the date of the incident or from when the complainant first knew about it.

The regulations state that a responsible body should only consider a complaint after this time limit if:

• the complainant has good reason for doing so, and
• it’s still possible to investigate the complaint fairly and effectively, despite the delay.

Procedure

We have a two stage complaints procedure. We will always try to deal with your complaint quickly however if it is clear that the matter will need a detailed investigation, we will notify you and then keep you updated on our progress.

Stage one – Early, local resolution

• We will try to resolve your complaint within five working days if possible.
• If you are dissatisfied with our response, you can ask us to escalate your complaint to Stage Two.

Stage Two – Investigation

• We will look at your complaint at this stage if you are dissatisfied with our response at Stage One.
• We also escalate some complaints straight to this stage, if it is clear that they are complex or need detailed investigation.
• We will acknowledge your complaint within 3 working days and we will give you our decision as soon as possible. This will be no more that 20 working days unless there is clearly a good reason for needing more time to respond.

Complain to the Ombudsman

If, after receiving our final decision, you remain dissatisfied you may take your complaint to the Ombudsman.

The Ombudsman is independent of the NHS and free to use. It can help resolve your complaint, and tell the NHS how to put things right if it has got them wrong.

The Ombudsman only has legal powers to investigate certain complaints. You must have received a final response from the Practice before the Ombudsman can look at your complaint and it will generally not look into your complaint if it happened more than 12 months ago, unless there are exceptional circumstances.

Address:
Parliamentary & Health Service Ombudsman,
Tower 30,
Millbank,
London,
SW1P 4QP

Phone: 0345 015 4033

Email the Ombudsman

Other organisations that can help you make a complaint about health services

Confidentiality

All complaints will be treated in the strictest confidence.

Where the investigation of the complaint requires consideration of the patient’s medical records, we will inform the patient or person acting on his/her behalf if the investigation will involve disclosure of information contained in those records to a person other than the Practice or an employee of the Practice.

We keep a record of all complaints and copies of all correspondence relating to complaints, but such records will be kept separate from patients’ medical records.

Statistics and reporting

The Practice must submit to the local primary care organisation periodically/at agreed intervals details of the number of complaints received and actioned.

Give feedback or make a complaint

You can complain to a member of staff at the NHS service you went to, such as a GP surgery or hospital, or you can complain to the organisation in charge.

GPs are often asked to make Mental Capacity Assessments for patients.

These assessments can be requested for a variety of different reasons.

As GPs it is an essential part of our role that we are able to perform capacity assessments which relate to decisions regarding medical investigations, treatment and care. However capacity assessments relating to overall welfare, finances and property are often more complex and sit outside our expertise.

The level of risk and responsibility linked to capacity assessments can be extremely high. Decisions such as whether someone’s house is sold or how their life savings are spent can depend on capacity assessments.

It is therefore essential that adequate time and attention is dedicated to these assessments. It is also essential that those carrying out these assessments for legal purposes are highly trained and experienced in this area.

Legal capacity assessments do not fall within the NHS duties of GPs. Some GPs do agree to perform these assessments privately at a fee, but many others feel the risks of doing so are too high or that the time needed to perform an adequate assessment is not available to them. There are other professionals who can perform mental capacity assessments including solicitors and psychiatrist.

As a surgery we do not feel we have the capacity to offer Mental Capacity Assessments for legal purposes for our patients. To do so would require significant resources being diverted from our core duties as a health care provider. It would also pose a significant legal and financial risk to our GPs. We feel there are other professionals available with more appropriate training, legal protection and expertise who can perform these assessments.

We realise that this practice policy may cause some inconvenience to our patients but hope you can understand that our priority must be to our core NHS duties as a health care provider. If, in the future, the funding crisis in General Practice is adequately addressed by government we may find ourselves able to reconsider our position.

Mid Devon Primary Care Network

Since the NHS was created in 1948, the population has grown, and people are living longer. Many people are living with long term conditions such as diabetes and heart disease or suffer with mental health issues and may need to access their local health services more often.

To meet these needs, practices have begun working together and with community, mental health, social care, pharmacy, hospital and voluntary services in their local areas in primary care networks.

Primary care networks (PCNs) build on the core of current primary care services and enable greater provision of proactive, personalised, coordinated and more integrated health and social care. Clinicians describe this as a change from reactively providing appointments to proactively care for the people and communities they serve. Where emerging PCNs are in place in parts of the country, there are clear benefits for patients and clinicians.

Primary care networks are based on GP registered lists, typically serving natural communities of around 30,000 to 50,000. They should be small enough to provide the personal care valued by both patients and GPs, but large enough to have impact and economies of scale through better collaboration between practices and others in the local health and social care system.

PCNs form a key building block of the NHS long-term plan. Bringing general practices together to work at scale has been a policy priority for some years for a range of reasons, including improving the ability of practices to recruit and retain staff; to manage financial and estates pressures; to provide a wider range of services to patients and to more easily integrate with the wider health and care system. In addition, PCN funding provides the opportunity to recruit a more diverse skill mix into general practice, through recruitment of roles such as first contact physiotherapists, social prescribers and physician assistants.

Prescribing Policy For Patients Travelling Abroad

This policy outlines the procedure for patients travelling abroad for short and long periods of time.

NHS Policy

By law, the NHS ceases to have responsibility for the medical care of patients when they leave the UK. In addition GPs are not required by their terms of service to provide prescriptions for the treatment of a condition that is not present and may arise while the patient is abroad.

The NHS does accept responsibility for supplying ongoing medication for temporary periods abroad of up to 3 months. However, if a person is going to be abroad for more than 3 months, then they are only entitled (at NHS expense) to a sufficient supply of regular medication in order to get to their destination, where they should the find an alternative supply of that medication.

Patients residing abroad for a period of more than 3 months will be removed from the registered patient list.

Redlands Primary Care Policy

Travelling out of the country for less than 3 months
For patients who inform us they will be out of the country for less than 3 months, we will provide sufficient medicines for an existing condition (e.g. asthma, diabetes…) for the period while the patient is away where it is safe to do so. Drugs that require frequent monitoring may not be prescribed where there are safety concerns. 1 months supply only will be issued for drugs normally available over the counter, such as paracetamol.

Travelling out of the country for more than 3 months
Patients who inform us they will be leaving the country for more than 3 months will be prescribed sufficient medication to enable them to make alternative arrangements at their destination (up to 3 months supply where safe to do so).

They will also be removed from our patient list. We will be pleased to re-register patients on their return to residence in the UK and can reassure patient that their electronic notes are kept with NHS England.

Patients and relatives should not seek medication for themselves while they are abroad as this constitutes NHS fraud.

Prescriptions for medicines in case of illness while abroad

GPs will only prescribe NHS prescriptions in this case for exacerbations of pre-existing illnesses, e.g., antibiotics for patients who have frequent infections secondary to an underlying lung condition.

GPs may provide private prescriptions if it is clinically appropriate and they can be self-administered safely without medical assessment while abroad. These prescriptions are not free.

Patients should be aware that some drugs commonly prescribed in the UK may be illegal in certain countries and you should check with that countries embassy before you travel.