Patient Rights and Responsibilites, Terms of Care and Practice Policies - Winelands Wellness Practice

Last Updated: 1 April 2026

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1. Introduction
 

Winelands Wellness is committed to providing respectful, ethical, evidence-based, and professionally appropriate psychiatric care in a safe and structured practice environment. Effective psychiatric treatment depends on a collaborative relationship between the patient, the treating psychiatrist, and, where relevant, family members or other healthcare providers.
 

This document sets out:

• the rights of patients receiving care at Winelands Wellness;

• the responsibilities of patients engaging in treatment;

• the practice policies that govern appointments, communication, fees, prescriptions, records, emergencies, and professional boundaries; and

• the terms under which care is provided.
   

The purpose of this document is to promote clarity, consistency, accountability, and mutual respect. Psychiatric treatment works best when expectations are explicit rather than guessed, assumed, or discovered only once something has already gone wrong.
 

By attending the practice and continuing treatment, the patient acknowledges that they have read, understood, and accepted these terms and policies.

 

2. Nature of the Practice
 

Winelands Wellness is a private psychiatric practice providing outpatient mental health assessment, diagnosis, treatment, and follow-up care.
 

Where clinically necessary, the practice may also assist with:

• coordination of psychiatric hospital admission;

• inpatient treatment and follow-up where the psychiatrist is involved in hospital-based care;

• collaboration with hospital teams and other healthcare professionals;

• coordination of care during periods of acute mental illness.
   

Although the practice may assist patients during crises where feasible, it is not a 24-hour emergency service. Patients experiencing urgent psychiatric emergencies should still seek immediate assistance through emergency medical services or the nearest emergency department.
 

For patients already known to the practice, reasonable efforts may be made to assist with urgent situations or facilitate appropriate care where circumstances allow. However, availability cannot always be guaranteed outside scheduled consultations.

 

3. Core Principles of Care
 

Winelands Wellness is guided by the following principles:

• dignity and respect;

• patient autonomy;

• professional integrity;

• confidentiality within legal and ethical limits;

• evidence-based practice;

• beneficence and non-maleficence;

• clear therapeutic boundaries;

• collaborative and realistic treatment planning;

• responsible use of healthcare resources.
   

Treatment is offered in the patient’s best interests, but not every patient preference can or should be accommodated if it is clinically unsafe, ethically inappropriate, outside scope, or inconsistent with sound professional practice.

 

4. Patient Rights
 

4.1 Right to Respect and Dignity

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Every patient has the right to be treated with courtesy, compassion, fairness, and dignity, regardless of age, gender, sex, sexual orientation, disability, religion, culture, language, social status, ethnicity, personal history, diagnosis, or presenting difficulties.
 

No patient will be humiliated, demeaned, or treated in a discriminatory manner.

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4.2 Right to Safe and Professional Care

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Patients have the right to receive care in an environment that is clinically appropriate, professionally managed, and as physically and emotionally safe as reasonably possible.

This includes the right to expect that staff will act professionally and that the practice environment will support privacy, order, and therapeutic work.
 

4.3 Right to Privacy and Confidentiality
 

Patients have the right to privacy regarding their consultations, personal information, mental health information, and medical records.
 

Information shared in treatment will be kept confidential except where disclosure is:

• authorised by the patient;

• clinically necessary for coordinated care;

• required by law;

• required by court order or lawful process;

• necessary to reduce a serious risk of harm to the patient or others;

• required for billing, claims administration, or practice operations within lawful and ethical limits.
   

Confidentiality is a cornerstone of psychiatric treatment, but it is not absolute.
 

4.4 Right to Information
 

Patients have the right to receive clear and understandable information about:

• the reason for assessment or treatment;

• diagnostic impressions or areas of concern;

• recommended treatment options;

• expected benefits and limitations of treatment;

• likely risks and side effects of medication or other interventions;

• alternatives to proposed treatment where relevant;

• likely consequences of declining or delaying treatment;

• fees and major practice policies that affect care.
   

Information will be explained in a manner appropriate to the patient’s level of understanding and clinical state.
 

4.5 Right to Participate in Decisions About Care
 

Patients have the right to be involved in decisions affecting their treatment. Their values, concerns, preferences, and goals will be considered in treatment planning.

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Shared decision-making is encouraged where the patient has capacity to participate meaningfully.

 

4.6 Right to Informed Consent

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Patients have the right to give or withhold informed consent before treatment is initiated, except where treatment without consent is permitted by applicable law.
 

Informed consent includes discussion of:

• the nature and purpose of the proposed intervention;

• material risks and possible adverse effects;

• benefits and expected outcomes;

• reasonable alternatives;

• the likely consequences of refusing treatment.
   

4.7 Right to Refuse or Withdraw From Treatment
 

A patient may refuse treatment or choose to discontinue treatment, provided they have the capacity to do so and understand the possible consequences.
 

The psychiatrist may discuss risks, limitations, and alternatives, but treatment cannot be forced outside lawful exceptions.
 

4.8 Right to a Second Opinion
 

Patients may seek a second opinion from another qualified healthcare professional at any time.

Seeking another opinion will not in itself prejudice ongoing care, although practical arrangements may be needed.
 

4.9 Right to Continuity of Care
 

Patients have the right to appropriate follow-up arrangements, continuity of care where feasible, and referral when treatment needs fall outside the scope of the practice or cannot be safely managed on an outpatient basis.
 

Continuity does not mean unlimited availability or indefinite treatment regardless of circumstances.
 

4.10 Right to Access Records
 

Patients may request access to their records, subject to applicable legal, ethical, and professional requirements.
 

Access may occur through copies, summaries, or formal release procedures, and certain limitations may apply where permitted by law or professional guidance.
 

4.11 Right to Raise Concerns or Complaints
 

Patients have the right to raise concerns, ask questions, or lodge complaints regarding their treatment, billing, communication, or experience of care.
 

Complaints will be considered seriously and addressed respectfully, fairly, and within a reasonable time frame.

4.12 Right to Appropriate Professional Boundaries
 

Patients have the right to receive care within a professional therapeutic relationship. Treatment will not be exploited for personal, financial, social, political, or other improper purposes.
 

4.13 Right to Reasonable Accommodation
 

Where reasonably possible and clinically appropriate, the practice will attempt to accommodate language, accessibility, cultural, and communication needs.
 

4.14 Right to Honest Clinical Opinion
 

Patients have the right to a professional opinion that reflects the psychiatrist’s genuine clinical judgment. This includes the right to hear opinions that may be uncomfortable, unwelcome, or different from what the patient expected.

Psychiatric care is not customer service in a nicer jacket. Clinical honesty matters.

 

5. Patient Responsibilities
 

5.1 Responsibility to Provide Accurate Information
 

Patients are responsible for providing complete, accurate, and honest information about:

• current symptoms;

• psychiatric history;

• medical history;

• substance use;

• prior diagnoses and treatments;

• allergies and medication side effects;

• current medication and supplements;

• past hospitalisations;

• relevant personal, family, occupational, and legal history where clinically relevant.
   

Treatment quality is limited by the quality of information provided.
 

5.2 Responsibility to Disclose Risk
 

Patients are responsible for informing the psychiatrist, as soon as reasonably possible, of:

• suicidal thoughts, plans, or intent;

• thoughts of harming others;

• self-harm behaviour;

• severe deterioration in mental state;

• psychotic symptoms;

• significant substance misuse;

• major medication reactions;

• pregnancy or breastfeeding where medication is relevant;

• hospital admissions or emergency visits.
   

5.3 Responsibility to Participate in Care
 

Patients are expected to engage in treatment in good faith, which includes:

• attending appointments;

• discussing concerns openly;

• asking questions when uncertain;

• giving feedback about treatment response;

• informing the psychiatrist if the plan is not working or not being followed.
   

5.4 Responsibility to Follow the Agreed Treatment Plan
 

Patients are expected to make reasonable efforts to follow agreed recommendations or discuss barriers to doing so.
 

Patients remain free to decline treatment, but they are responsible for discussing difficulties honestly rather than silently abandoning care and then expecting psychiatry to perform necromancy on the chart afterward.

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5.5 Responsibility to Attend Appointments Reliably
 

Patients are responsible for:

• attending appointments on time;

• notifying the practice if running late;

• cancelling or rescheduling within the required notice period;

• arranging follow-up appointments when advised.
   

5.6 Responsibility to Treat Staff and Others Respectfully
 

Patients must behave respectfully toward clinicians, administrative staff, and other patients.

The following are not acceptable:

• threatening behaviour;

• intimidation;

• harassment;

• verbal abuse;

• discriminatory remarks;

• repeated hostile or manipulative communication;

• physical aggression;

• damage to property.
   

Such behaviour may result in the appointment being ended, refusal of non-emergency services, or termination of the treatment relationship.
 

5.7 Responsibility Regarding Medication Use

Patients are responsible for taking medication only as prescribed and for informing the psychiatrist about:

• non-adherence;

• side effects;

• overuse or misuse;

• concurrent treatment by other practitioners;

• use of alcohol, illicit substances, or non-prescribed medication.
   

Medication requests that are clinically inappropriate, unsafe, or unlawful will not be accommodated.
 

5.8 Responsibility to Understand Fees and Payment Policies
 

Patients are responsible for understanding the practice’s fees, payment expectations, cancellation charges, and the distinction between direct payment to the practice and reimbursement by medical schemes where applicable.
 

5.9 Responsibility to Respect Boundaries of Communication
 

Patients must use the correct channels for routine, urgent, and emergency matters, and must understand that electronic communication has limits.
 

5.10 Responsibility to Respect the Privacy of Others
 

Patients may not record staff, other patients, or private interactions in the practice without consent. They must respect the confidentiality and privacy of others in waiting areas and shared spaces.

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5.11 Responsibility for Minors or Dependent Patients

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Where a parent, guardian, or legally authorised representative is responsible for a patient, that person is responsible for ensuring attendance, consent where applicable, payment, and communication with the practice.

 

6. Appointments and Attendance Policy
 

6.1 Booking of Appointments
 

Appointments are scheduled in advance and are reserved specifically for the patient.

Appointment duration may vary depending on whether the consultation is:

• an initial assessment;

• a standard follow-up;

• a psychotherapy session;

• a report-related consultation;

• a medico-legal or special assessment.
   

6.2 Arrival Time
 

Patients are expected to arrive on time. Late arrival may reduce the time available for the consultation.

If a patient arrives significantly late, the appointment may need to be shortened or rescheduled, and the full fee may still apply.
 

6.3 Cancellation and Rescheduling
 

At least 24 business hours’ notice is required for cancellation or rescheduling of appointments unless otherwise specified by the practice.
 

Appointments cancelled late, forgotten, or missed without adequate notice may be charged in full.

This policy exists because the appointment time has been reserved and usually cannot be filled at short notice.
 

6.4 Repeated Non-Attendance
 

Repeated missed appointments, late cancellations, or poor attendance may result in:

• requirement for advance payment;

• limitation of booking privileges;

• review of suitability for ongoing outpatient treatment;

• discharge from the practice where appropriate.
   

6.5 Follow-Up Responsibility
 

It remains the patient’s responsibility to book and attend follow-up appointments. The practice may remind patients of appointments, but reminder systems are a courtesy and not a substitute for patient responsibility.

 

7. Fees, Accounts, and Payment Policy

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7.1 Private Practice Fees

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Winelands Wellness operates as a private practice. Patients are responsible for the payment of consultation fees and any additional services provided.

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7.2 Payment Expectations

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Payment is not necessarily required on the day of the appointment, but accounts should be settled within a reasonable time frame after the consultation.

Timely payment helps ensure the smooth operation of the practice and continued availability of services.

 

7.3 Medical Scheme Claims

 

Patients are responsible for understanding their medical scheme benefits and claim processes. Depending on practice arrangements:

• claims may be submitted directly to the medical scheme; or

• patients may pay the consultation fee and claim reimbursement from their medical scheme.

Reimbursement from medical schemes cannot be guaranteed by the practice.

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7.4 Outstanding Accounts
 

If accounts remain unpaid for an extended period, the practice may:

• request settlement before further appointments are scheduled;

• pause non-urgent administrative requests such as reports or forms; or

• make reasonable arrangements for payment where appropriate.

The practice will always attempt to manage billing concerns respectfully and collaboratively.

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7.5 Fees for Additional Services
 

Additional charges may apply for services outside standard consultations, including:

• completion of forms or reports

• medical motivation letters

• insurance or disability documentation

• extensive administrative work

• medico-legal reports

Patients will be informed where such fees apply.

 

8. Communication Policy
 

8.1 Administrative Communication
 

Administrative communication may occur via telephone, messaging platform, email, or other approved channels for matters such as:

• appointment scheduling;

• cancellations;

• invoice requests;

• logistical questions.
   

8.2 Clinical Communication Outside Sessions
 

Clinical decision-making generally requires a scheduled consultation. Brief communication between sessions may sometimes occur, but this is at the discretion of the psychiatrist and depends on clinical appropriateness, complexity, and availability.

Extensive assessment, treatment changes, or ongoing therapy should not be conducted by ad hoc messaging.
 

8.3 Email and Messaging Limitations
 

Email and messaging are not ideal for urgent, complex, or sensitive clinical matters. They may be delayed, misread, incomplete, or insecure despite reasonable safeguards.

The practice cannot guarantee immediate review or response to electronic communication.
 

8.4 No Emergency Response by Email or Text
 

Patients must not use email, text, or routine messaging for emergencies, suicidal crises, severe deterioration, medication overdose, violent risk, or other urgent situations.

In an emergency, patients must contact emergency services, proceed to the nearest emergency department, or use designated crisis resources.
 

8.5 Telephone Availability
 

Telephone access outside appointments is limited. Calls may be returned when possible, but immediate availability cannot be guaranteed.

 

9. Emergency and Crisis Policy
 

9.1 Crisis Situations
 

Psychiatric emergencies may include situations such as:

• suicidal intent or behaviour

• severe self-harm risk

• violent or aggressive behaviour

• acute psychosis or severe agitation

• severe intoxication or substance-related crises

• sudden and severe deterioration in mental state
   

9.2 Assistance During Emergencies
 

For patients known to the practice, reasonable efforts may be made to assist in urgent situations, including:

• providing guidance to patients or families where possible

• facilitating urgent assessment

• assisting with arrangements for hospital admission when clinically appropriate

However, the practice cannot guarantee immediate availability at all times.
 

9.3 When Immediate Emergency Care Is Needed
 

If an urgent or life-threatening situation arises, patients or family members should contact:

• emergency medical services

• the nearest hospital emergency department

• appropriate crisis services

These services are equipped to provide immediate assessment and intervention.
 

Following emergency care, the practice may assist with ongoing treatment and follow-up where appropriate.

9.4 Hospital Admission

Where outpatient care is no longer safe or sufficient, hospital admission may be recommended. Refusal of recommended admission may affect the practice’s ability to continue treating the patient safely on an outpatient basis.

 

10. Prescriptions and Medication Policy
 

10.1 Prescriptions Are Issued as Part of Ongoing Clinical Care
 

Prescriptions are issued within the context of appropriate clinical assessment and follow-up.

The practice does not guarantee indefinite renewal of medication without review.
 

10.2 Repeat Prescriptions
 

Repeat prescriptions may require an appointment, particularly where:

• significant time has passed since review;

• the medication requires monitoring;

• the patient’s condition has changed;

• there are concerns about side effects, misuse, safety, or adherence.
   

10.3 Controlled or High-Risk Medication
 

Certain medications may require stricter monitoring, shorter prescribing intervals, or more frequent review.

The psychiatrist may decline to prescribe, continue, or replace medication where there are concerns about misuse, dependency, diversion, doctor-shopping, intoxication, or unsafe combined use.
 

10.4 Lost, Stolen, or Early Medication Requests
 

Requests for early replacement, lost prescriptions, stolen medication, or repeated “I accidentally finished it” situations will be considered individually and may be declined.
 

Psychiatry is many things, but it is not a magical re-spawn point for controlled substances.
 

10.5 Medication Responsibility
 

Patients are responsible for:

• taking medication as prescribed;

• reading instructions;

• reporting side effects;

• attending follow-up review;

• disclosing pregnancy, breastfeeding, substance use, and medical changes relevant to medication safety.

 

11. Confidentiality, Information Sharing, and Limits of Privacy

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11.1 General Confidentiality
 

All reasonable steps will be taken to protect patient confidentiality.

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11.2 Circumstances in Which Information May Be Shared
 

Information may be shared without consent where legally or ethically required, including where there is concern regarding:

• serious risk of harm to self;

• serious risk of harm to others;

• abuse or neglect where reporting duties arise;

• court order or lawful subpoena;

• statutory obligations;

• emergency treatment needs;

• hospital admission processes;

• valid professional communication required for patient care.
   

11.3 Communication With Family or Third Parties
 

Information will not ordinarily be shared with family members, partners, employers, schools, or other third parties without patient consent unless an exception applies.

Patients may choose to authorise communication with specific individuals.
 

11.4 Minors and Dependent Patients
 

Where the patient is a minor or lacks decision-making capacity, confidentiality and information-sharing will be managed in accordance with applicable legal and ethical requirements, taking into account the patient’s best interests, developmental level, and rights.
 

11.5 Electronic Records and Communication
 

The practice may use electronic record systems, email, and digital communication tools as part of routine care and administration. While reasonable steps are taken to protect privacy, no digital system can be guaranteed risk-free.

 

12. Records, Reports, Letters, and Documentation
 

12.1 Clinical Records
 

The practice keeps records of assessment, diagnosis, treatment, medication, correspondence, and other clinically relevant material.
 

Records are created primarily for clinical care and legal/ethical documentation, not for narrative entertainment or to prove to future readers that psychiatry once happened.
 

12.2 Access Requests

Requests for records must be made through the appropriate process and may require identity verification, written consent, fees for copying, or controlled release procedures.
 

12.3 Reports and Letters
 

Requests for reports, letters, forms, sick notes, medical motivations, disability documentation, insurance forms, or legal documents must be made in advance.

Such documents:

• may attract additional fees;

• require adequate clinical basis;

• may take time to prepare;

• will reflect the psychiatrist’s honest clinical opinion;

• may be declined if clinically unsupported, ethically problematic, outside scope, or too urgent to complete safely.
   

12.4 Fitness Notes, Motivation Letters, and Medico-Legal Requests
 

The practice will not backdate documentation inaccurately or provide misleading statements for employers, schools, insurers, attorneys, or family members.

A patient’s wish for a certain document outcome does not determine the clinical opinion expressed.
 

12.5 Court and Legal Involvement

If the psychiatrist is requested to provide court testimony, affidavits, extensive legal reports, or formal forensic opinions, this may fall outside routine clinical care and may require separate written agreement, dedicated fees, and consideration of scope and role conflict.

 

13. Professional Boundaries
 

13.1 Therapeutic Relationship
 

The psychiatrist-patient relationship is a professional one. Its purpose is assessment and treatment, not friendship, business partnership, informal advising, or social connection.
 

13.2 Contact Outside the Clinical Role
 

The practice does not engage in dual relationships that may impair professional judgment or exploit the therapeutic relationship.
 

13.3 Social Media and Public Platforms
 

To preserve privacy and professional boundaries:

• the psychiatrist may not accept social media friend or follower requests from patients on personal accounts;

• public commentary on treatment interactions is discouraged;

• online contact is not a substitute for clinical care.
   

13.4 Gifts and Personal Favour Requests
 

Large, inappropriate, or boundary-blurring gifts may be declined. Requests that fall outside the therapeutic role may also be declined.

 

14. Telehealth / Remote Consultations
 

14.1 Suitability
 

Remote consultations may be offered where clinically appropriate and practically feasible.
 

14.2 Limitations
 

Telehealth has limitations, including:

• technology failure;

• reduced ability to observe certain clinical signs;

• privacy concerns in the patient’s environment;

• emergency management limitations.
   

14.3 Patient Responsibilities During Telehealth
 

Patients must ensure, as far as possible, that they are:

• in a private setting;

• reachable at the agreed time;

• not driving or engaged in unsafe activity during the consultation;

• able to provide their physical location at the start of the session for safety purposes where relevant.
   

14.4 Emergency Risk in Telehealth
 

If a patient presents with acute risk during a remote consultation, emergency procedures may need to be activated based on the information available.

 

15. Consent and Capacity

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15.1 Capacity to Consent
 

Treatment decisions require the patient to have sufficient capacity to understand the relevant information, appreciate consequences, and make a voluntary choice.
 

15.2 Fluctuating Capacity
 

Mental state may affect capacity. Where capacity is impaired, treatment decisions may need to follow applicable legal and ethical processes.
 

15.3 Involvement of Representatives
 

Where lawful and clinically appropriate, a parent, guardian, caregiver, or authorised representative may be involved in treatment planning.

 

16. Involvement of Family, Partners, and Other Professionals

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16.1 Collaborative Care

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Where clinically useful and with appropriate consent, the psychiatrist may communicate with:

• psychologists;

• general practitioners;

• physicians;

• occupational therapists;

• family members;

• schools;

• employers;

• hospitals or rehabilitation services.
   

16.2 Limits of Family Involvement
 

Family involvement may be helpful, but the treatment relationship remains grounded in the patient’s welfare, confidentiality rights, and clinical needs.
 

16.3 Information From Third Parties
 

The practice may receive information from family or others. Receipt of information does not automatically mean reciprocal disclosure can occur.

 

17. Safety, Conduct, and Practice Environment

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17.1 Safe Premises

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Patients and accompanying persons are expected to maintain a safe, calm, and respectful environment.

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17.2 Weapons, Intoxication, and Unsafe Conduct

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The practice may refuse or terminate an appointment where a person presents:

• intoxicated;

• violent or threatening;

• carrying a weapon;

• grossly disruptive;

• unable to participate safely.
   

Emergency assistance or referral may be arranged where necessary.
 

17.3 Recording of Sessions
 

Audio or video recording of consultations is not permitted without prior explicit consent from the psychiatrist.
 

17.4 Accompanying Persons
 

A patient may request the presence of a support person, but the psychiatrist may limit this where clinically inappropriate, disruptive, or inconsistent with confidentiality and treatment goals.

 

18. Children, Adolescents, and Dependent Adults

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18.1 Consent and Responsibility

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Where treatment involves a minor or dependent adult, the relevant legal framework regarding consent, guardianship, confidentiality, and decision-making will apply.

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18.2 Balance Between Confidentiality and Caregiver Involvement

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The practice will aim to balance the patient’s privacy with the legitimate involvement of caregivers where appropriate and lawful.

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18.3 Attendance and Payment

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The responsible adult remains accountable for attendance, transport, consent processes where required, and payment.

 

19. Complaints and Feedback Procedure

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19.1 Raising Concerns
 

Patients are encouraged to raise concerns early and directly where possible.

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19.2 How Complaints Will Be Managed

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Complaints may be submitted verbally or in writing. The practice will aim to:

• acknowledge the complaint;

• review the concern fairly;

• provide a response within a reasonable time;

• seek clarification if needed;

• attempt resolution where appropriate.
   

19.3 Serious Complaints

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If the patient remains dissatisfied, they may pursue the matter through appropriate regulatory or legal channels.
 

Raising a complaint will not in itself result in retaliation, although abusive conduct in the course of complaining is still abusive conduct.

 

20. Grounds for Declining, Limiting, or Ending Treatment

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20.1 Circumstances in Which the Practice May Decline or End Care
 

The practice may refuse to initiate or continue treatment where:

• the patient’s needs fall outside the practice scope;

• outpatient treatment is no longer safe or adequate;

• the therapeutic relationship has irretrievably broken down;

• there is repeated non-attendance;

• there is persistent non-payment;

• there is abusive, manipulative, threatening, or unsafe behaviour;

• there is repeated misuse of prescriptions or dishonesty that compromises care;

• there is persistent refusal to engage in essential elements of treatment such that safe care is no longer possible;

• there is a conflict of interest or boundary issue;

• the psychiatrist becomes unavailable due to illness, relocation, leave, retirement, or other legitimate reason.
   

20.2 Process for Ending Care
 

Where clinically appropriate, the practice will attempt to provide:

• reasonable notice;

• interim prescriptions where safe and appropriate;

• referral options or advice on alternative care;

• guidance regarding emergencies.
   

The practice will not abandon patients, but neither is it obliged to continue care under conditions that are unsafe, abusive, or professionally untenable.

 

21. Patient Acknowledgements
 

By engaging with Winelands Wellness, the patient acknowledges that:

1. psychiatric care is a collaborative process and cannot guarantee a specific outcome;

2. diagnosis and treatment may evolve over time as new information emerges;

3. no service can eliminate all risk;

4. medication may have side effects and requires monitoring;

5. confidentiality has lawful and ethical limits;

6. the practice is not an emergency or 24-hour response service;

7. fees, cancellation rules, and prescription policies apply;

8. reports and letters are based on clinical judgment, not patient preference alone;

9. respectful conduct is required at all times;

10. continuation of care depends on mutual cooperation and safe professional boundaries.

11. they have read and accepted the boundaries of this contract.