Frequently Asked Questions

COVID MEASURES

Last updated 30th October 2020

We have put several measures in place in response to the pandemic for the protection of our patients, staff and clinicians. However in spite of any measures a risk exists, and we ask that you consider every possible way of reducing this risk to you and your family, for example by wearing a mask, respecting social distancing and avoiding crowded places and public transport whenever possible.

You will notice some changes within the centre:

Masks are at your disposal upon arrival at reception, we ask that you wear them at all times in the clinic.

Please sanitise your hands upon arrival. Regular handwashing is encouraged for all (alcohol hand sanitizer is available throughout the centre for patients and staff, and soap is available in all bathrooms and consultation rooms/dispensers in workstations/communal areas/offices).

Temperature is monitored in all patients via a contactless forehead thermometer upon arrival at Medicare Francais, for your safety and that of our staff.

We practice social distancing within the centre, and we ask that you keep at least 2m between yourself and any other patient or member of staff whenever possible. The following measures have also been introduced to aid social distancing:

  • Appointments are staggered to avoid crowding
  • We ask that you come alone or, in the case of minors, accompanied by one adult only
  • Any accompanying adults are requested to kindly wait outside the centre until the end of their child’s session
  • For any family groups, you may be shown to an empty room and asked to wait separately
  • Floor markings have been installed to indicate where patients should stand when queuing for the reception, pharmacy or for payment
  • If the centre is particularly busy, we may need to use secondary waiting areas to ensure social distancing is maintained at all times
  • A one-way system is in operation within the centre to facilitate patient flow

All patients are triaged prior to attending a physical appointment to ensure they are not currently exhibiting signs and symptoms of COVID-19 – if you or a member of your household have fever and/or a cough, or are experiencing loss of taste or smell, you will be offered a video consultation. Please let us know if you are currently isolating or completing a compulsory period of quarantine and you will also be offered a virtual appointment.

All practitioners wear a mask within the centre and appropriate PPE (personal protective equipment) during consultations.

All hygiene protocols have been enhanced within Medicare Francais and communal areas are disinfected throughout the day. Every clinic room is cleaned between each patient.

Patients are encouraged to avoid cash payments and the card terminal is disinfected after each use with appropriate agent. Online payment facilities are available, please let us know, should you prefer to pay safely online.

As you will appreciate, we are all doing our best to lower the risks and evolve with the situation, changing government guidelines etc. Please feel free to contact us if you have any queries or suggestions, we are available by email (info@medicarefrancais.com) at any time and will get back to you as soon as possible.

DATA PROTECTION & COVID-19

In order to look after your healthcare needs and in accordance with legal requirements in place due to COVID-19, we may urgently need to share your personal information including medical records, with clinical and non-clinical staff who belong to organisations that are legally permitted to use your information and need to use it to help deal with the pandemic. This enables public health organisations to monitor the disease, assess risk and manage its spread. Please be assured that we will only share information and health data that is absolutely necessary to meet yours and public healthcare needs.

 

We take the security of your personal information extremely seriously at Medicare Francais. Our Privacy Policy is available here.

 

Click here for clarification about confidential information and public health and here for the ICO summary.

Dealing with Violent or Aggressive Patients

  1. Introduction

Medicare Francais has zero tolerance policy of all violence and aggression. This policy is for the protection of all staff, but also for the protection of other patients, their families, visitors, etc. In order to ensure that this zero tolerance approach is adhered to, it is essential to have robust policies and procedures in place. In General Practice, this will need to cover a variety of situations in which incidents could occur. Generally speaking, the majority of patients behave in acceptable or manageable ways, however the incidence of excessively aggressive or violent attacks may occur.

Medicare Francais recognises that there can be contributory reasons for patients behaving in difficult, challenging or an overly friendly ways, however, where this tips over into aggression or violence, the practice will adopt a zero-tolerance approach.

Medicare Francais aims to provide high quality healthcare and we will treat all patients with respect and dignity. In return we expect all our staff to be treated with respect. We will not tolerate abusive language, threatening behaviour, discrimination explicit or implied against any member of staff. Such behaviour may result in the offender being denied access to the doctor and/or further measures as appropriate.

1.1 Communication

The practice will communicate this policy by a variety of communication mediums e.g. a clear policy on the web site, the practice newsletter, the policy (sign) clearly displayed in the waiting area near to the reception desk etc

2.0 Aims and Objectives

The aims and objectives of this policy are as follows:

• To ensure adequate processes are in place for the protection of staff and patients

• To ensure staff are fully aware of their responsibilities when dealing with violent or aggressive patients

• To ensure that staff are fully aware of their rights when they have to deal with such incidents

3.0 Aggressive Patient

What is an aggressive patient?

The Health & Safety Executive1 defines work-related violence as: ‘Any incident in which a person is abused, threatened or assaulted in circumstances relating to their work.

This could be from a patient (carer/ relative/ friend) who exhibits one or more of the following patterns of behaviour:

• Verbally abusive, offensive or intimidating in their behaviour towards staff

• Threatening physical violence

• Making excessive demands and/or maintaining certain expectations and failing to accept that these are unreasonable (e.g. wanting an immediate appointment and becoming aggressive when this is not possible)

• insisting that a member of staff is dismissed

• insisting that treatment is carried out on demand

3.1 Risk assessment

The HSE2 recommends a proactive approach to the assessment of risk from aggressive or violent patients. This could involve the practice team “walking through” the logistics of the reception area, identifying an escape plan(s), panic button protocol, security personnel support etc. The practice may wish to undertake a generic risk assessment which should consider the overall needs of the organisation, for example:

• general risks to staff from patients, service users and their relatives or visitors

• risks associated with the design of the work environment, ie layout of rooms, lockable doors, escape routes, alarm systems, access to car parks at night

• risks associated with lone working, whether working in the community or alone in work premises

• identification and testing of appropriate instructions, information and training

• identification, agreement and testing of security support arrangements.

4.0 Dealing with an Aggressive Patient

Patients can become aggressive for a variety of reasons, and it is always advisable to try to calm down the situation as early as possible, as this may prevent an incident. Being observant of patients/relatives is often the first sign that a difficult/tense situation is imminent.

4.1 Recognising the signs of an impending aggressive incident

The use of appropriate inter-personal skills in potentially difficult situations is essential.

Observation of the patient/client can help in predicting when aggression may occur. The following are some of the signs to look for:

• Staring, unblinking, uncomfortable gaze.

• Muscles tensed; jawline tensed.

• Facial expression

• Person balanced to move quickly

• Fingers or eyelids twitching

• Pacing about, uncomfortable stance, alternate sitting/standing

• Withdrawn on approach

• Voice-change of pitch or tone, use of insults, obscenities or threats

• Sweating

• Increase in rate of breathing

• Tears (crying)

• Offensive weapon carried or visible

4.2 Proactively diffusing a recognised condition

Having recognised such signs and assessed the potential of violence occurring, staff may feel they are able to diffuse the situation by using some of the following behaviours:

• Adopt an empathic, understanding approach, and attempt to show some affinity with the other person’s position – “I can see why you are upset about that”

• Use active NLP (neuro linguistic programming) – saying a small portion of a sentence back to the patient in the patient’s own words

Avoid confrontation, do not argue but do not agree to reward their bad behaviour

• Speak and stand calmly with an open posture, but always remain balanced and ready to move away

Do not move closer to the patient, even if they are speaking in whispers

• Try to distract the person from the immediate cause of concern by changing the course of the conversation – buy time to think, to plan, to obtain assistance – if possible, ask the patient to have a seat “while I go to see what I can do to help you” – this buys time and allows you to think of your options.

Speak clearly, evenly and slowly and do not necessarily stop talking because the other person does not answer

• Even if the other person is very loud, do not raise your voice

• Try to identify the source (nub of their problem) of concern, acknowledge this and offer to help if possible

Do not disagree where it is not necessary

• Do not give orders or use status or authority as a threat, remember your body language

Never make promises which cannot be kept

Never reward aggressive behaviour

Do not make threats

Be alert and send for assistance where necessary

• Be prepared to leave the situation if necessary to avoid injury

4.3 If the incident escalates further

If the aggressor continues or becomes more verbally aggressive, then the following process should be followed:

• If they continue with their aggressive behaviour, the receptionist should be clear in telling them that they will not be dealt with until they calm down.

“I am sorry (use aggressor’s name here if it is known), we do not deal with people who are being aggressive or abusive. I will try to help you but must *stop shouting/ *stop swearing/*stop being aggressive, or I will not be able to deal with you.

• Remain calm and clear and keep repeating that the behaviour is unacceptable. Insist that you are trying to help but cannot do so until they calm down. For example, immediately giving the aggressor what they have asked for just to end the situation, or the Practitioner agreeing to see the patient just “to keep them quiet”. This just sets a precedent which will repeat in the future and sets a poor example to on-lookers. If the patient continues/ does not desist, in the interests of safety, it is best to have another member of staff come to you at the desk. Staff should never isolate themselves with a potentially violent patient. The second member of staff may ask other patients (in queue) to step back while the current patient is being dealt with.

• If it is deemed appropriate, get a more senior member of staff to speak to the patient, again keeping calm and stressing that you are trying to help. If possible, move the patient to a side of the desk whilst being mindful about not isolating the member of staff or allowing the patient access to the receptionist/ reception area.

• If the aggressor refuses to calm down or refuses to leave when requested to do so, the risk assessment at 3.1 should have identified the additional security arrangements which will come into place at this point.

4.4 Repeated Incidents

If there are repeated incidents from a particular patient, then the practice should write to the patient warning them that no other incidents will be tolerated, and the patient will be removed from the list if this happens again.

Note that it is important to carry out this action once it has been written down. If the patient continues with this behaviour, even after the written warning, then they should be removed from the list for the sake of staff and other patients.

5.0 Violent Patients

Dealing with a violent patient requires a much more immediate response. It is good practice to test these procedures on a regular basis. As soon as a patient turns violent, then immediate action must be taken, as follows:

• Step back from the desk.

• Lock the reception door (may consider this door is locked as a matter or course)

• If the aggressive behaviour continues employ the additional security measures as described in 3.1

• If the patient is in the consulting room with a clinician, then the correct procedure should implemented (see app 2)

• Phone the police. Once violence occurs, it becomes a crime.

• If there are other patients in the vicinity, then there is a duty to protect them. If possible remove/instruct other patients in the vicinity to move to another part of the waiting area or another room away from the situation. The logistics of this action should be tested in a “dummy” run and the policy updated.

5.1 Staff support following a violent incident

• Staff directly involved in the incident should talk through the incident on a one-to one basis with the manager/partners/nurse

• Staff not involved in the incident should be briefed about the incident

• If the person affected is not employed by the practice then inform their line manager immediately after the incident

• The policy should be reviewed in light of the incident to update it with any additional learning points/changes necessary

• Following an incident of violence, the practice should hold a significant event meeting to decide if the patient should be removed from the list.

• If the patient is to be removed from the list, then the practice should now follow the procedure for the removal of patients.

6. Following an Incident

Every incident of violence or aggression should be recorded in the patient’s notes and additionally in a log specifically used for this purpose. This log should contain the following information:

• Patient ID

• Time and date of incident

• Nature of incident – particularly the trigger point (eg not able to get appointment)

• Perspective of staff member dealing with the incident,

• Names and statement of any witnesses

• Record of any actions taken

7.0 Removal of Patient from Practice List

In Good Medical Practice, the GMC states that: “In rare circumstances, the trust between you and a patient may break down, and you may find it necessary to end the professional relationship. For example, this may occur if a patient has been violent to you or a colleague, has stolen from the premises, or has persistently acted inconsiderately or unreasonably.”

If patients have been violent to any members of the practice staff or have threatened staff safety, the incident must be reported to the police straightaway

Even in these circumstances, the practice should inform the patient of the reasons leading to removal from the practice list, unless one or more of the following apply:

• it would be harmful to the mental or physical health of the patient

• it would put practice staff or patients at risk

• it would not be reasonably practicable to do so.

The practice is required to record this in the patient’s records and set out the circumstances leading to removal. Family members should not be struck off  our lists, unless there is a threat to the practice from the ex-patient as a result of keeping these patients on.

The RCGP states that: “Where violence has been an issue, the PCO has responsibility for ensuring that all patients can receive primary care services, if necessary within a more secure setting.” These are often known as violent patient services (VPS). Unfortunately, VPS  service is not offered at the Medical Francais.

When it becomes necessary to remove the patient from the practice list, for reasons of violent or aggressive behaviour, then a specific process should be followed.

8.  Discrimination to include Prejudice

Discrimination exists in all aspects of life, including in Health and Social Care. Everywhere we look, we see differences and these differences can lead to prejudice; a pre-formed negative judgement or attitude towards someone who is different to ourselves.

Prejudice may lead people to view certain individuals or groups as inferior, or to treat people different to themselves unfairly or to be patronising or to not consider the feelings, the opinions or the needs of people different to themselves at all. This results in discrimination, which is defined as the unjust or prejudicial treatment of different categories of people.

Discrimination can be based on many different characteristics, however, it is only unlawful discrimination under the Equality Act 2010 if you are treated or treat someone unfairly because of any one or more of the so-called protected characteristics.

These characteristics are:

  • Age.
  • Disability.
  • Gender reassignment.
  • Pregnancy and maternity.
  • Race/ Ethnicity
  • Religion or belief.
  • Sex.
  • Sexual orientation.

This does not mean that discrimination is not also happening based on other categories, such as:

  • Socio-economic.
  • Education level.
  • Nationality (which is different to Race).
  • Regional or national accent.
  • Appearance.

Although these are not protected characteristics under the Equality Act 2010, public authorities* have responsibilities not to discriminate under the Human Rights Act 1998. The Human Rights Act also protects people from discrimination, but only in connection with their human rights under the Act.

This means people must not be discriminated against in their enjoyment of their human rights; therefore, the protection against discrimination under the Human Rights Act is wider than under the Equality Act. Whilst the Human Rights Act includes the Equality Act’s protected characteristics, it also protects people from discrimination because of other characteristics.

These are:

  • Language.
  • Political opinion.
  • National or social origin.
  • Property.
  • Birth.
  • Association with a national minority.
  • Other status.

An example of where the Human Rights Act 1998 has been applied successfully to combat discrimination in Health and Social Care, and where the Equality Act 2010 could not be applied, is when a council had a policy to pay lower allowances to foster carers who were family members, compared to carers who looked after children who were unrelated to them.

The hearing found there had been a disproportionate difference in treatment on grounds of ‘family status’, which the council had failed to justify. This meant that the policy fell foul of Article 8 and Article 14 of the Human Rights Act 1998.

A public authority is an organisation which provides public services. This can be a public sector organisation, for example the NHS or social services. Private organisations or charities which carry out public services or functions are also called public authorities and this includes private care homes funded by a local authority.

9 Governance Arrangements

This policy will be approved by the Practice Manager. The Practice Manager will be responsible for notifying all staff of the process, ensuring all staff has up to date copies of the document and that the staff are following the processes documented within.

This policy will be reviewed 2 years from the date of publication

Medicare Francais 19/10/21                               

Review date : 18/10/22

 

Please note that whilst every effort is made to remain up to date on current travel guidelines and recommendations, Medicare Francais cannot accept liability for delayed results beyond our control and missed or altered travel arrangements. It is the patient’s responsibility to ensure they are aware of entry requirements for the country they are travelling to, and that they have checked with their travel company to ensure no additional checks or documents are required when travelling.

WHAT TESTS ARE AVAILABLE?

Three types of tests are currently available: the PCR COVID-19 test, the RAPID ANTIGEN/Lateral Flow TEST test and the ANTIBODY tests.

The PCR COVID-19 and the rapid ANTIGEN tests detect the presence of the virus (SARS-CoV-2) in the nasopharyngeal secretions of a given individual and therefore allow to diagnose the presence of an acute COVID infection. The ANTIBODY tests check for evidence of past infection in a sample of blood.

DO I HAVE COVID-19?

The PCR (polymerase chain reaction) test is the gold standard for diagnosing COVID-19. If you have any symptoms, this is the only test you should be offered. The Rapid ANTIGEN tests also look for the presence of the virus but it should only be used in the absence of any symptoms.

WHAT IS THE PCR COVID-19 TEST?

The PCR COVID-19 test is a swab taken from the nose and back of the throat by the health professional during your consultation. Once collected, it is processed by the laboratory and results are available the next day. This test is approved by Public Health England who leads the COVID response in the UK.

WHAT IS THE RAPID ANTIGEN/LATERAL FLOW TEST?

The RAPID ANTIGEN test is a swab taken from the nose and/or from the back of the throat. It is widely available, and you can do this yourself, in a pharmacy or in a centre holding appropriate accreditation for this. Its results are available within 30 minutes.

HAVE I HAD COVID? WHAT IS THE ANTIBODY TEST?

An antibody or “serological” test can detect if a person has mounted an immune response as a result of a past Covid-19 infection by detecting the presence of antibodies to SARS-CoV-2 in a blood sample. This test is done by a medical professional and is most reliable from 21 days following the first symptoms.

There are two types of antibody tests; the RAPID test, results of which are available within 10 mins during the consultation, and the ABBOTT or AUTOMATED test which, once a blood sample is taken during your appointment, is then sent to the lab for processing. The results of the automated tests are available within 24 hrs.

There are many different brands of antibody tests which have different efficacies depending on their sensitivity (true positive rate) and specificity (true negative rate). It is important to look at those values before deciding to get tested.

 

WHICH TESTS ARE AVAILABLE AT MEDICARE FRANCAIS?

Medicare Francais is currently accredited by UKAS to offer PCR tests for General Population testing (UKAS registration number 22252). For Lateral Flow Tests tests, we recommend our partner The Regenerative Clinic. Which test you decide to use will depend on what information you require and on your individual circumstances. Do not hesitate to book into the COVID clinic or contact us on info@medicarefrancais.com if you have any questions.

**Please note that if you, or a member of your household, currently have any symptoms of COVID (a new persistent cough, fever or loss of smell and taste) it is essential that you remain in isolation and that you have a PCR test as soon as possible. If you wish to see one of our doctors, please book a video-consultation or contact us**

Pricing

If you have any further questions or if you would like more information on our testing services or prices, please email us on linda@medicarefrancais.com

You can also book an appointment online.

Our pharmacy is an internal pharmacy. This means that we are only able to dispense medicines that have been prescribed by one of Medicare Francais’ prescribing doctors on our premises.

We apologise that external prescriptions will not be able to be processed.

The level of cover you have will depend on your insurer and your policy.

Medicare Francais has an agreement with certain providers such as Welcare/Humanis, GMC and Allianz for third-party billing. For other insurance companies please refer to your provider.

Do not hesitate to contact us on info@medicarefrancais if you have any questions or if we can be of any further assistance.

If you need to change or cancel your appointment, please give us at least 24 hours’ notice. You may be charged for any appointment that you fail to attend without notice.

It is your right to have a chaperone present during any consultation or treatment. Please let our reception team or your practitioner know, and we will provide a trained chaperone. You are always welcome to bring a friend or family member along.

We aim to ensure that your experience at Medicare Francais is helpful and professional. However, if you are unhappy about any aspect of your care, please contact us on 0207 370 4999 or by email on info@medicarefrancais.com as soon as possible so that we can try to rectify the problem.

We aim to deal with all concerns as quickly and efficiently as possible. If you are not satisfied with our response, you may wish to consult our Complaints Policy.

We welcome feedback at Medicare Francais. Your views are important to us and help us to provide you with the best possible healthcare service.

Please feel free to email us on info@medicarefrancais.com, alternatively you can leave feedback on Findoc, Google or our Contact page

A comprehensive list of fees is available on our Price List page.

This website is not intended to be a substitute for professional medical guidance. Always consult a medical professional if you have any concerns about your health.

In order to comply with the General Data Protection Regulation (GDPR) enforced in May 2018, we have reviewed our Privacy Procedure. If you wish to see why we collect your personal data and what we do with it, please read our Privacy Notice.

DATA PROTECTION & COVID-19

In order to look after your healthcare needs and in accordance with legal requirements in place due to COVID-19, we may urgently need to share your personal information, including medical records, with clinical and non-clinical staff who belong to organisations that are legally permitted to use your information and need to use it to help deal with the pandemic. This enables public health organisations to monitor the disease, assess risk and manage its spread. Please be assured that we will only share information and health data that is absolutely necessary to meet yours and public healthcare needs.

We take the security of your personal information extremely seriously at Medicare Francais. Our Privacy Policy is available here.

Click here for clarification about confidential information and public health and here for the ICO summary.

Please note that we are not responsible for the content of external websites/links. They are used as a reference or recommendation only.

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