CONTENTS:

Introduction
How can YOU help?
General Practitioner (GP)
Taking Medications
Accident and Emergency
Going into hospital
When in hospital
Before you leave hospital
Social workers
Out-of-hours services
Feedback/complaints
Freedom of Information
Data Protection Act
Useful Contacts

Introduction

Each one of us has a responsibility to improve the quality and safety of health and social care. You, as a user, patient or family carer can play a vital role by becoming an active and informed member of your care team.

From talking to people Health and Social Services Councils have learned that people's health and social care experiences could have been improved if they had been better prepared. This booklet suggests how you can work in partnership with those looking after you to get the best possible care and treatment.

This booklet also aims to provide you with:

	Information about what to expect from your care team.
	An explanation on how to discuss concerns about your health and social care needs.
	Tips for improving your health and social care management.
	Suggested questions to ask your care team.

No matter which member of the health care team (doctor, nurse, pharmacist, occupational therapist, physiotherapist, social worker, health visitor, dentist and others) that you are seeing, this booklet will be of help to you when you want to ask questions about the care you are getting.

So ... why should you get actively involved?

When you or a member of your family visits a health or social care professional you expect to:

	Get enough information about your care.
	Be able to make choices about the care that is available to you.
	Be given care that is based on your needs.
	Receive the best and safest care available.
	Understand what you are sigining if asked to give your written consent for treatment or care.

Health and social care is becoming more complex every day and money is limited. There is increasing demand to do more with less. While most receive excellent care, there is an increasing awareness that sometimes things can go wrong, or services are not received when they are most needed.

Errors occur mostly because of the way things are done, not as a result of who is doing them.

Everyone has a part to play - from the Government, which makes decisions about the health and social care system, to your own active involvement in your health and social care needs, which can lead to better overall experiences and outcomes.

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How can YOU help?

	Speak up if you have questions or concerns. If you don't understand, ask again. You have a right to ask questions and to expect answers you can understand.
	Don't be afraid to tell any member of the health or social care team if you think he or she has confused you with someone else.
	If you feel insecure or intimidated teell a senior member of staff.
	Pay attention to the care you are receiving. Make sure that you are getting the right treatments and medicine by the right health or social care professionals.

The following pages can assist you in becoming more actively involved and informed in managing your own health and social care when you attend or receive care or treatment from:

	A General Practitioner (Family Doctor)
	The Accident and Emergency Department.
	Hospital.
	The Social Worker.

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GENERAL PRACTITIONER (GP)

When you see your GP

	Write down what you want to know about your condition or treatment before your appointment. That way you won't forget to ask any questions.
	Take notes or have a family member or carer with you to do that.
	Tell your GP about all your symptoms no matter how trivial you think they are.
	You should be kept informed and agree on what treatment will be done during each step of your care.
	Ask how long any treatment will last and how you should feel.
	Ask what will happen if you don't have this operation or treatment.
	Remember that more tests or medicines may not always be better.
	Tell your GP about any complementary or over-the-counter medicines that you might be taking.
	If you are unsure about the nature of your illness or condition keep asking questions.
	Ask are there alternative ways to treat your condition.
	Keep a record of your own and your family medical history; talk this over with your GP.
	Ask for the name of any support groups for your illness or condition.
	Call your doctor to find out the results of tests or procedures and ask what this means for your care. Don't simply think 'no news is good news'.
	Go back to your GP if you remain unwell.
	If you cannot keep an appointment, let your GP know in time.
	Find out who to contact if you need a doctor after your surgery closes, at the weekends and public holidays.
	In general, find out who to contact if you have any enquiries or concerns.

Don't forget to ask:

	Can you please tell me more about my condition?
	How sure are you that I have this condition?
	Do you have any information that I can take home with me?
	Can you tell me where I can find out more?
	Why do I need this particular test?
	What are the different treatments for this condition?
	How will this treatment help me?
	What does the treatment involve?
	What are the risks of this treatment?
	What is likely to happen if I don't have this treatment?
	What signs/symptoms should I look out for?
	What can I do to help myself?
	When should I come back to see you?

Remember:

You have the right to be respected; your health or social care professional also has the right to be respected.

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TAKING MEDICATIONS

Know what medicines you take and why you take them. Errors with medicines are one of the most common forms of healthcare mistakes.

	When you get your medicine read the label, including the warnings. Make sure it is what was ordered for you - if not, tell your doctor/pharmacist.
	You should make a list of all medicines you are taking and any drug allergies you may have. Remember to include prescriptions, over-the-counter medicines and complementary medicines (such as vitamins and herbs) on your list.
	Keep the list of all of your medicines safe and tell a friend/relative where it is. Take it with you if or when you have to go into hospital.
	Ask your doctor/pharmacist why you are taking the medication and ask for written information about it. Also enquire about the side effects of the medication.

Remember to ask:

	Do you have any written information about this medicine?
	What do the directions on the label mean?
	How much should I take and when should I take it?
	What are the common side effects?
	What should I look out for?
	How long before it starts to work?
	Will this medicine work together with the other medicines that I am taking?
	Are there any foods or other things that I should avoid while I'm on this medicine?
	How long do I need to take this medicine?

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ACCIDENT AND EMERGENCY DEPARTMENTS

If you need to attend an Accident and Emergency Department (Casualty/A&E Department).

	Ask who will be in charge of your care.
	Ask how long you will have to wait to be seen by a nurse or doctor.
	If you don't understand what is being said to you, as for it to be explained again.
	Tell the staff about allergies you have, or unexpected reactions you have had to medicines in the past.
	Staff working in casualty should introduce themselves when they meet you. If they don't, ask their name or check their name badge.
	If you would like a trusted family member or friend to speak on your behalf, tell staff.
	Your friend can ask questions that you may not think of while you are ill.
	He/she can help remember answers to questions you have asked and speak up for you if you cannot.
	Make sure this person understands your preferences and wishes concerning your care and treatment.

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GOING INTO HOSPITAL

You may attend an outpatient clinic or become an inpatient for any of a variety of procedures or treatments.

	If you cannot keep an appointment let the hospital know.
	Ask what treatment is planned for you.
	Ask how this treatment will help you.
	Ask are there any possible risks attached to the treatment.
	Ask how soon you will get the treatment for your condition.

WHEN IN HOSPITAL

	Ask for a copy of the hospital leaflet.
	Ask who will be in charge of your care.
	Ask who will be doing the operation or procedure, what it will involve and how long it will take.
	Tell those in charge of your care if you have allergies or if you have ever had an unexpected reaction to an anaesthetic or any other drug. Discuss this before any operation or procedure.
	Make sure any member of the healthcare team confirms your identity, checks your wristband or asks your name before giving any medicine or treatment.
	Ask your doctor or surgeon exactly what treatment/operation is planned.
	Ask how having this treatment/operation will help you.
	Ask about the possible risks attached to this treatment/operation.
	Ask how you should expect to feel after your treatment/operation.
	Ask what will happen after your treatment/operation.
	Ask how long you are likely to be in hospital.
	Ask when your visitors can or cannot visit.
	If you are worried about healthcare associated infections, you should speak to a member of your healthcare team who will be able to give you information about the measures in place to prevent and control infection.
	Remember that patients and their visitors have an important role to play in preventing infection. Information on this will be available from staff or in the hospital booklet.
	Make sure you and your consultant agree on what will be done during any operation.

You should confirm with your surgeon the operation to be performed as close as possible to it happening. Do not be afraid to ask for the site to be marked.

Know what medicines you take and why you take them. Errors with medicines are one of the most common forms of healthcare mistakes.

	If you do not recognise a medicine, check that it is for you. You can also ask about the contents of intravenous fluids (drip). If you are given a drip, ask the nurse how long it should take for the liquid to "run out".
	Tell the nurse if you feel it diesn't seem to be dripping properly (that it is too fast or too slow).

Take part in all decisions about your treatment. The health and social care team is working for you.

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BEFORE YOU LEAVE HOSPITAL

Ask those in charge of your treatment and care to explain the treatment plan you will use at home.

It is important that you fully understand your treatment plan upon discharge from hospital including any follow-up care. Don't forget to ask for some written information about your treatment/operation.

If you have any medicines to take, know what medicines you should be taking and for how long.

If you are taking a lot of medicines, ask your doctor or local pharmacist if it is safe to take them all together.

This is also true for vitamins, herbal supplements and over-the-counter medicines that have been bought for you.

Remember to ask:

	Who will be following up on my care and when do I need to see them?
	How can I contact them?
	When can I go back to work?
	When can I drive?
	Will I be given a writen summary of my care to pass on to my GP or will this be sent directly to my GP?

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SOCIAL WORKERS AND SOCIAL CARE WORKERS

Social workers and social care workers have a role to help individuals, families and communities meet their specific personal care and support needs.

They work with:

	Elderly people.
	People with physical or learning disabilities.
	People with mental health problems.
	People with addictions.
	Fostering and adoption.
	Children being cared for in children's homes or by foster parents.
	Young people in the criminal justice system.
	Homeless people.
	Disadvantaged groups and/or communities.

Social workers have the responsibility for the assessment of service users' care and the planning and management of care services. Social care workers provide personal care and support services to individuals and families.

Don't be afraid to ask questions if you require social care help at home.

	Who are these people coming into my home?
	How many will be coming in?
	What will they be doing?
	How often should I expect them?
	How will I know them?
	How will they ensure that my specific needs are met?

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OUT OF HOURS SERVICES

To ensure that there is 24 hour care available to those who need it, out-of-hour medical and social care services are in place. These services should be used in the case of an emergency situation outside the normal operating hours of GP surgeries, social work offices etc. If you need an out-of-hours service, you should telephone first. Your call will be taken by specially trained staff who will be able to offer advice and help. If you don't have the out-of-hours number, dial your usual contact number and a message will tell you how to contact the out-of-hours service for your area.

FEEDBACK/SUGGESTIONS/COMPLAINTS

Health and social services can be improved by listening to and learning from your experience. If you are not happy with your treatment, tell those providing the service. If you wish to make a complaint,m then your hospital, social services, GP or other service you wish to complain about should have a trained person who can assist you and provide information about the complaints process. Printed information can be provided for you to take away and consider.

Some people require support in making a complaint and help and advice can be provided by your local Health and Social Services Council.

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Freedom of Information 2000

The Freedom of Information Act gives anyone the right to ask public authorities for any information they hold. This includes health and social services. Any person who makes a request for information to a public authority must be informed whether the public authority holds that information. Subject to exemptions they should supply the information that has been requested. There may be a fee attached to this.

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Data Protection Act 1998

The Data Protection Act 1998 gives you the right to obtain information about yourself. This includes access to health records held by hospitals, GPs, dentists, social workers and other health care professionals. The records tell you about your health and any care or treatment you've received. First ask the person who holds the records if you can see them. If your request is refused you have a legal right to ask again. Health and Social Care Organisations have an obligation to protect an individual's personal information from inappropriate use.

If you have a query about Data Protection or access to records you can contact your local Health and Social Services Council for advice.

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USEFUL CONTACT POINTS

Health and Social Services Councils were set up by Government to represent the views and opinions of the public. There are four Councils in Northern Ireland:

	Northern Health and Social Services Council 8 Broadway Avenue, Ballymena, BT43 7AA Tel 028 2565 5777 Fax 028 2565 5112 Minicom 028 2565 5777 E-Mail info@nhssc.n-i.nhs.uk Website www.nhssc.org
	Southern Health and Social Services Council Quaker Buildings, High Street, Lurgan, BT66 8BB Tel 028 3834 9900 Fax 028 3834 9858 Minicom 028 3834 6488 E-Mail reception@shssc.n-i.nhs.uk Website www.shsscouncil.net
	Eastern Health and Social Services Council 1st Floor, Lesley House, 25-27 Wellington Street, Belfast, BT! 6GQ Tel 028 9032 1230 Fax 028 9032 1750 Minicom 028 9032 1285 E-Mail info.ehssc@hscni.net Website www.ehssc.org
	Western Health and Social Services Council Hilltop, Tyrone and Fermanagh Hospital, Omagh, Co Tyrone BT79 0NS Tel 028 8225 2555 Fax 028 8225 2544 Minicom 028 8224 8389 E-Mail kloughran@hilltop.n-i.nhs.uk Website www.whssc.org Other useful contacts:
	The Northern Ireland Commissioner for Children and Young People Millennium House, 17-25 Great Victoria Street, Belfast, BT2 7BN Tel 028 9031 1616 Fax 028 9031 4545 E-Mail info@niccy.org Website www.niccy.org For advice on Human Rights issues contact:
	Northern Ireland Human Rights Commission Temple Court, 39 North Street, Belfast, BT1 1NA Tel 028 9024 3987 Fax 028 9024 7844 E-Mail info@nihrc.org Website www.nihrc.org For advice regarding discrimination on grounds of disability, gender, race, religious belief and political opinion:
	Equality Commission Equality House, 7-9 Shaftesbury Square, Belfast, BT2 7DP Tel 028 9050 0600 Fax 028 9024 8687 Textphone 028 9050 0589 E-Mail information@equalityni.org Website www.equalityni.org
	Information Commission's Office Room 101, Regus House, 33 Clarendon Dock, Laganside, Belfast, BT1 3BG Tel 028 9051 1200 Fax 028 9051 1584 E-Mail ni@ico.gsi.gov.uk Website www.informationcommissioner.gov.uk
	Data Protection Office 37 Castle Avenue, Moira, Co Armagh, BT67 0NH Tel 028 9261 3064 Website www.dataprotectionuk.co.uk

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Remember:

	Be actively involved in your health and wellbeing
	Take part in decisions about your treatment
	See yourself and your health or social care worker as a team
	You have the right to be respected
	Your health or social care worker has the right to be respected ... now we're talking.

This leaflet was adapted for Northern Ireland in agreement between NI Clinical and Social Care Governance Support Team and Irish Society for Quality and Safety in Healthcare, and in partnership with the four Health and Social Services Councils.

Units 2 & 3, St John's Court, Upper Newtownards Road, Belfast, BT16 1RJ

If this booklet is required in other languages or formats, please contact one of the Health Councils.

August 2005

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