Administration Flashcards
Medical records:
-Can patients see what is in their medical record?
-what about children/parents?
-when should medical records not be released
-is there a charge?
Key principles
patients have a right to see what is written in their medical record competent children may seek access to their records parents may request access to their children's (< 16 years) records doctors should not release information they feel may damage a patients emotional or physical health following the Data Protection Act access to medical records should be given within 28 days following the General Data Protection Regulations and the Data Protection Act 2018 a fee can no longer be charged for a simple copy of the medical notes.
What is a caldicott guardian?
The 1997 Caldicott Report identified weaknesses in the way parts of NHS handled confidential patient data. The report recommended the appointment of Caldicott Guardians, a member of staff with responsibility to ensure patient data is kept secure
It is now a requirement for every NHS organisation to have a Caldicott Guardian
What are the 8 principles of the data protection act?
he Data Protection Act is the main piece of legislation that governs the protection of personal data in the UK. The Act covers both manual and computerised records.
There are 8 main principles of the Data Protection Act:
-data must be used for the specific purpose it was collected
-data must not be disclosed to other parties without the consent of the individual whom it is about
-individuals have a right of access to the information held about them
-personal information may be kept for no longer than is necessary and must be kept up-to-date
-personal information may not be transmitted outside the European Union unless consent has been given
-all entities (e.g. a GP surgery) that process personal information must register with the Information Commissioner’s Office
-adequate security measures must be in place. Those include technical measures (e.g. passwords, firewalls) and organisational measures (e.g. staff training)
-subjects (i.e. patients) have the right to have factually incorrect information about them corrected
The original Data Protection Act was in 1998. The following key additions were made in the 2018 document:
the right to erasure inclusions of exemptions of the Data Protection Act being regulated in tandem with the GDPR
Give 3 examples whereby removal of a patient from the practice list is justified?
Examples of situations that may justify removal:
unacceptable behaviour: for example violence, sexual harassment, stalking, racial abuse crime and deception: for example fraudulently obtaining drugs, stealing from the practice distance: a patient moves outside the catchment area. Please note from January 2015 practices are now able to register patients outside of their catchment areas. This is however voluntary and practices are able to decline to register patients if they feel the distance is impractical
what is advised if there is an irretrievable breakdown of the doctor-patient relationship? How should patients be removed from a practice list?
Further guidance is given on exceptional situations where there is an ‘irretrievable breakdown’ in the doctor-patient relationship. It is important that a formal process is agreed to try and rectify this problem rather than unilaterally declaring an irretrievable breakdown without giving any reasons to the patient.
Removing a patient from the practice list involves the following steps:
give warning to the patient inform the clinical commissioning group in writing write to the patient
The patient’s family should not be automatically removed although in practice this may be necessary.
HOw can a ‘frequent flyer’ patient be managed?
This question looks at the management of a ‘frequent-flyer’.
From the scenario it appears that the patient has developed an element of doctor dependence. The best option is to be honest with the patient about your observations and suggest a way of resolving the issue. One of the best approaches to this problem is to arrange regular appointments, the time between which can be gradually increased.
When is universal credit recieved and give 4 requirements of recieving
t is usually received monthly (or twice a month in Scotland). You can no longer apply for the old benefits system and people on the old system are slowly being moved over to universal credit. People can apply for universal credit online.
The requirements to receive this are that the person and their partner
Live in the UK Are aged 18 or over and earn a low income or are out of work Have less than £16,000 collectively in savings Are below the age of receiving the state pension. In rare cases 16 and 17-year-olds can claim universal credit if, for example, they are a carer, are estranged from their parents, have a child or are unable to work.
How is universal credit calculated? who gets extra payments?
Universal credit is composed of a standard allowance, plus extra payments depending on circumstances. There is a benefit cap which limits the total amount one can receive:
The monthly standard allowance is determined by age and relationship status: single vs a couple Extra payments are awarded for up to 2 children, either having a disability or caring for a severely disabled person and to help with housing costs.
The universal credit payment reduces as people earn money. People have work allowance of how much they can earn before their payment is decreased. This allowance is higher for people responsible for children/young people, people with disability limiting work. It is lower if people have help with housing costs.
Give 5 issues that make universal credit controversial
1) People have to wait 5 weeks to receive their first payment, and then struggle due to only receiving payments every month.
2) Childcare must be paid by parents upfront and is then refunded by universal credit.
3) Many disabled people and households receive less than they did with the old benefits system
4) The old benefits paid benefits for each child per year, however universal credit will only pay for the first 2 children for children born after April 2017.
5) Private tenants find it harder to rent.
What is PIP?
Personal Independence Payment: for patients under the age of 65 years
Attendance Allowance: for patients over aged 65 years and over
This replaced the Disability Living Allowance (DLA) for adults in 2013. It is a tax-free benefit for adults aged 16-64 years who need help with personal care or have walking difficulties because they are physically or mentally disabled. For children there is still the ‘DLA for children’
Statutpry sick pay - who is this given to? what is the maximum this can be paid for?
For employees unable to work due to illness. Unable to work for > 4 days in a row. Paid up to a maximum of 28 weeks
What is Incapacity Benefit & Employment and Support Allowance
Employment and Support Allowance replaced Incapacity Benefit for new claimants from October 2008. Claimable by those not entitled to Statutory Sick Pay (SSP), for example self-employed, or when SSP has ended
Retirement pension - when is this paid?
State pension may be claimed from 60 years for women* and 65 years for men. State pensions are taxable and paid even if the claimant is still working
What is bereavement support payment? How long is this paid for?
Replaced ‘Bereavement payment’ and ‘Bereavement allowance’
Lump sum followed by 18 monthly payments
Spouse must be under state pension age when their partner died
Depends on national insurance contributions
Must claim within 3 months of your partner’s death to get the full amount.
You can claim up to 21 months after their death but you’ll get fewer monthly payments.
Who gets a funeral payment?
One-off payment to the partner or parent of the deceased if they are on benefits to help pay for a funeral
Widowed parent’s payment:
-what is this?
-Who is eligible?
Payable to a parent whose husband or wife has died.
Eligibility
surviving partner is bringing up a child < 19 years of age and receiving child benefit deceased partner had made adequate national insurance contributions also if the woman was expecting her late husband's baby divorcees and those who remarry are not eligible to claim
what is attendance allowance?
Attendance Allowance (AA) is a tax-free allowance for people aged 65 or over when they claim who need help with their personal care. To claim AA patients should normally have needed help with care for 6 months. Like DLA it is not means tested.
Personal Independence Payment: for patients under the age of 65 years Attendance Allowance: for patients over aged 65 years and over
How can patients who have a terminal illness apply for benefits? can this be fast tracked?
Patients who have a terminal illness (where there is an expectation that the patient will not live for more than 12 months) are eligible to be fast-tracked through the system for claiming Personal Independence Payment (PIP), Universal Credit (UC), employment support allowance (ESA), DLA or AA. The SR1 (‘Special Rules’) form is a medical report form that is used to provide evidence of a terminal illness for people who are applying for benefits under the Special Rules. It replaced the previous DS1500 form. The Special Rules are a set of criteria that allow people with a terminal illness to claim benefits sooner than they would otherwise be able to.
Who completes the SR1 form? and give the time frames
The SR1 form must be completed by a healthcare professional who is registered with the General Medical Council (GMC) or the Nursing and Midwifery Council (NMC). The form asks for information about the patient’s diagnosis, prognosis, and clinical features. It also asks for information about the treatment that the patient has received, is receiving, or is planned to receive.
The following are the time frames for completing and submitting the SR1 form:
The form must be completed within 28 days of the date that the healthcare professional first believes that the patient meets the criteria for the Special Rules. The form must be sent to the Department for Work and Pensions (DWP) within 28 days of being completed. If the healthcare professional is unable to complete the form within 28 days, they must provide a written explanation to the DWP.
The DWP will use the information on the SR1 form to decide whether the patient meets the criteria for the Special Rules. If the patient is found to meet the criteria, they will be able to claim benefits sooner than they would otherwise be able to.
What is carer’s credit?
Carer’s credit provides credits to help fill gaps in the national insurance record of the carer, that they may have lost due to caring for their loved one. This therefore will not affect their ability to claim the state pension later in life.
Who is eligible for the carers credit?
Eligibility for the carer’s credit:
Aged 16 or over Under State Pension age Looking after one or more people for at least 20 hours a week
The person you are looking after must get one of the following:
Disability Living Allowance care component at the middle or highest rate Attendance Allowance Constant Attendance Allowance Personal Independence Payment - daily living component, at the standard or enhanced rate Armed Forces Independence Payment
Who is eligible for child tax credits?
Child tax credits are a method of helping families with the cost of bringing up children.
The following guidelines are from the UK Government website.
Eligibility depends on:
The child's age If you're responsible for the child
The child’s age - To qualify the child must be:
Under 16 - you can claim up until the 31st August after their 16th birthday Under 20 - if they're in approved education or training
Responsibility for a child - You’re usually responsible for a child if:
They live with you all the time They normally live with you and you're the main carer They keep their toys and clothes at your home You pay for their meals and give them pocket money They live in an EEA country or Switzerland but are financially dependent on you
How many children can a foster family look after? do the children require a medical check?
Key points
limit of 3 foster children per family (Schedule 7 of the Children Act 1989) all children in long-term foster care require a 6-monthly medical examination
How long can a statement of fitness to work be issued for?
he Statement of Fitness for Work replaces the Med3 and Med5 in one form
the Med4, Med6 and RM 7 forms have been withdrawn due to the replacement of Incapacity Benefit with the Employment and Support Allowance
telephone consultations are now an acceptable form of assessment
there is no longer a box to say a patient is fit for work. There is however an option to state if you need to assess your patient’s fitness for work again at the end of the statement period
there is increased space for comments on the functional effects of the condition, including tick boxes for simple things that may help a patient back to work
during the first 6 months of an illness the new statement can be issued for no longer than 3 months.. After this time it may be issued for an indefinite period
Statement of fitness to work:
-who issues?
-when can you issue?
Things that stay the same
can only be completed by a doctor you can still advise a patient that they are not fit for work (of any type) the advice on the statement is not binding on employers
The statement may be issued:
on the day that you assessed the patient on a date after you assessed your patient if you consider that it would have been reasonable to issue a statement on the day of the assessment after consideration of a written report from another doctor or registered health care professional
What are the 4 boxes on a statement of fitness to work?
There are 4 ‘tick boxes’ included on the form which represent common approaches to aid a return to work. One or more may be ticked. Other approaches can be suggested in the comments box. The options are:
a phased return to work altered hours amended duties workplace adaptations
How long may patients self certify for an illness?
Patients may self-certify for the first 7 calendar days:
Form Details
SC1 Self-certification, for patients not eligible to claim statutory sick pay (e.g. Unemployed or self-employed). For the first 7 calendar days of an illness
SC2 The ‘standard’ self-certification form, for patients eligible to claim statutory sick pay. For the first 7 calendar days of an illness
Evidence based recovery time for:
Abdominal/groin hernia
Laparoscopic
1 - 2 weeks
Open
2 - 3 weeks
Evidence based recovery time for:
Appendicectomy
Laparoscopic
1 - 2 weeks
Open
2 - 3 weeks
Evidence based recovery time for:
Cholecystectomy
Laparoscopic
2-3 weeks
Open
3-5 weeks
