I omitted to say that she joined me on my regular visit to Minster Grange
Residential Care Home.
I visit every 6 weeks to assess the patients there who are registered with
our Practice and have been doing this for some years now. In fact I have
always had a close working relationship with Minster Grange ever since I
started here 22 years ago.
Minster Grange is a very pleasant care home to visit, with staff who are
extremely competent and caring and provide not only high quality care
for each person on a individual basis, but also a comfortable and
stimulating environment for the residents to enjoy.
For more information about Minster Grange please click here
We have the same arrangement for all our nursing and residential care
homes although obviously all GPs cover different homes.
The purpose of these visits is to monitor the ongoing health of the
residents and to try and optimise treatment in order to reduce the risk of
falls or medical problems that might otherwise arise.
Many patients in care homes suffer from dementia and thus need
managing in a way that takes account of their memory problems and the
confusion that they sometimes experience but we are trying very hard
not to use any kind of sedative medication, as this obviously has an
negative impact and can increase the risk of falls.
I guess the most important factor for us is to try and put in place
recommendations and measures that will reduce the likelihood of
residents having to be admitted to hospital, as in general their care needs
are provided by the staff at the home.
On Sunday last week I attended the dedication of a plaque to 2 patients
of mine who had unfortunately died over the last couple of years. This
plaque was set into stone that was taken from their garden and has been
placed in a church yard in Abberley, where
they were regular attendees.
It is situated just left of the main
entrance. They were a fascinating couple
and both lived well into their 90s.
Their home is the
most fantastic 16th
century timber
frame farmhouse
which is positioned
almost in the middle
of nowhere along a
mile long bumpy
track which
itself is off a
narrow
country lane
between
Dunley and
Abberley.
He was a
retired
radiologist
from Kidderminster and she was a former nurse and midwife. I learnt
that she in the early part of her career worked in the east end of London
very much in the way that the recent TV programme called The Midwife
portrayed.
They actually met in Africa and it was interesting to see some photos that
had been taken of a solar eclipse in 1959 which were regarded by the
Astrology Society to be the best taken of an eclipse. Click here to see
these photos
They were very much in to all matters of equestrian
and both Aldiniti (Grand National winner) and
Desert Orchid enjoyed bed and breakfast in their
stable in their travels around the country.
The gentleman actually spent his last days in
Minster Grange although his wife received 24 hour
nursing care via a care agency from Worcester. It is
a testament to the strength and fortitude that they
managed to stay in their home for as long as they did
but also a credit to the agency and Minster Grange for the
care that they provided to both, in their last few years.
To return to the journal click here.
On Monday last week the Partners of the Practice met with the Business
Manager (Richard Jarman) to discuss potential changes to the new
appointment system.
We have been under tremendous pressure trying to make this work and
at the same time listened to concerns, criticisms and observations offered
by patients and staff.
With that in mind we have modified the system so that it will be possible
to pre book appointments but also to arrange to speak to a GP of your
own choice for advice, if you feel that an appointment may not be
required.
In addition we will continue to run an urgent same day service with a
Nurse Practitioner and Duty Doctors who will see patients who require an
appointment and can’t wait for their own Doctor to become available.
These appointments will generally be allocated following telephone
assessment much in the same way as the current system works, but I
would like to stress that this is for patients who can’t wait. For those
patients that can wait, they will be offered the option of their preferred
Doctor when available.
On Tuesday afternoon I spent some time in the Long Term Conditions
clinic. Most people with an ongoing chronic illness will already have
experienced this.
It was a model that we introduced last year in an attempt to ensure that
all our patients with ongoing medical problems receive a full review at
least once every year.
We have set it up so that we can review all aspects of their health and
medication in order to try to reduce the need for repeated appointments
in relation to each medical condition.
Many patients suffer from heart disease, diabetes, and respiratory illness
and were finding it tiresome to have to attend on separate occasions for
each aspect of their health. The clinic is actually run mainly by the nurses
who go through a full assessment but each patient also sees a GP to
review the medical treatment plan and reauthorise medication
appropriately so that patients can receive repeat prescriptions without
any difficulty and with the knowledge that it is safe for them to do so.
On Thursday I met once again with Rachael Faulkener who I have spoken
about previously. We spent approximately an hour reviewing the notes of
patients whose team were providing input and care.
For more information about the Admission Prevention Team please click here
Again the purpose of this is to try to ensure that patients are receiving
the best quality of care possible and to try to overt the need for hospital
admissions.
On Friday I was the Visiting Doctor and so undertook the visits requested
by patients, in fact there were only a few but included a visit to the Wyre
Forest Community Unit to rewrite a drug chart.
I am not quite sure why it is that hospitals still require prescription charts
to be written out by hand when in General Practice we have been using
computers to issue prescriptions for at least 25 years.
I would also have thought that electronic systems would enable such
processes to be undertaken more safely and effectively using the patients
computerised records, which we have at the surgery rather than having
to drive to Kidderminster Hospital and use up 45 minutes of our time
which could be utilised better to deliver care to our patients.
It was interesting to note at the end of last week with regards to Out of
Hours Care. Secretary of State the Rgt Honourable Jeremy Hunt
challenged some GPs in another part of the country to take over the Out
of Hours care in General Practice. I am sure it is only a matter of time
before this does in fact begin to happen.