EAST PARADE SURGERY
PRACTICE NEWSLETTER – OCTOBER 2015
Welcome to the second East Parade Surgery Newsletter.
East Parade Staff – Update
Since the last newsletter Deborah (Receptionist) has left us to semi-retire
and Andy (Health Care Assistant - HCA) has moved to work full time at
the SPA surgery. Susie Cook who is our new HCA has started with us.
She has a background in District nursing and has worked previously in a
GP practice in Boroughbridge.
Local NHS – Update
Harrogate is a Government Vanguard Site
Earlier this year the government agreed to invest £7-8 million over three
years in the Harrogate and Rural area. They want to develop new ways
of caring for patients that may become the blueprints for the rest of the
NHS and care system.
Harrogate and Rural District CCG, Harrogate District NHS Foundation
Trust, North Yorkshire County Council, Harrogate Borough Council, Tees
Esk and Wear Valley Foundation Trust, Yorkshire Health Network (all the
local GPs Practices) are all involved in this work.
What new care models are being developed?
Local GPs, community services, hospitals, mental health and social care
staff will work more closely together to support people to remain
independent, safe and well at home. Hospital beds will be used only when
they are truly needed and GPs will have a greater role in caring for their
patients.
Why is this happening?
It is believed that by bringing services together not only will patients
benefit but it will reduce hospital visits and help to improve waiting times
and sustain NHS services. It is a complex thing to do which is why there
are just 29 Vanguard sites in England.
How can I have my say about changes to services?
You can register with the CCG’s HaRD Net service via:
- Phone: 01423 799300
- http://www.harrogateandruraldistrictccg.nhs.uk/get-involved/hard-net/
Your Health:
What to do when you are not sure you need an appointment.
There is increasing pressure on the NHS and as the winter approaches
we want to make sure the right people are seen promptly at the practice.
Many things we see often don’t actually need a GP. Examples might
include minor rashes, coughs and colds, diarrhoea and vomiting,
problems that have actually gone away and ‘relationship problems’.
We want to encourage our patients to feel empowered to self-manage
conditions themselves.
What can you do?
 Speak to a pharmacist
 Browse www.patient.co.uk – this is an excellent website with lots of
good advice
 Google ‘When should I worry’ – there is a useful leaflet for parents
about common minor illnesses.
 NHS111 is able to help especially when the practice is closed
 GP triage – all urgent requests for help are assessed by our duty
doctor at the practice. We can often give timely advice.
Most minor illnesses are self-limiting and get better with time.
Patients with Winter Illnesses
We are starting to see more patients with common winter illnesses. Here
are some useful facts about them:
Illness
Middle Ear
Infection
Cough or
Bronchitis
Sore throat
Common Cold
Sinusitis
Usually
lasts
4-5 days
Other info
Antibiotics are rarely needed. Just use
pain relief.
21-28 days Most coughs even when producing
sputum don’t need antibiotics unless
you are breathless, have a high
temperature or feel very unwell with it.
7-10 days >90% of tonsillitis are viral and don’t
need antibiotics. Loss of voice is
common.
10 days
Antibiotics won’t work!
18-21 days Antibiotics rarely are needed. Steam,
menthol and pain killers help.
The common theme is that antibiotics are rarely needed for common
winter illnesses. We see very large numbers of patients with coughs and
colds and patients are always surprised when we inform that the average
cough lasts 3-4 weeks.
Winter’s coming! What’s a Chilblain?
Chilblains are small, itchy, uncomfortable swellings on the skin that occur
as a reaction to cold temperatures. They most often affect fingers and
toes. The affected skin may also swell and turn red or dark blue. In severe
cases, the surface of the skin may break and sores or blisters can
develop.
When to seek medical advice
Most people don't need to seek medical advice for chilblains as they
usually heal within a few weeks and don't cause any permanent
problems. You should see your GP or chiropodist for advice if you have
severe or recurring chilblains or if they don't improve within a few weeks.
Several creams are available that claim to treat chilblains but there is no
good evidence that they are effective. If your chilblains are severe and
they keep returning your GP may recommend medication.
Preventing chilblains
If you are susceptible to chilblains a number of self-help measures can
help, including:




wearing warm clothes and ensuring your home is well heated
keeping active
stopping smoking
avoiding tight-fitting shoes and boots. Wear warm socks and gloves
in cold weather.
If your skin gets cold, it's important to warm it up gradually. Heating the
skin too quickly, for example by placing your feet in hot water or near a
heater, is one of the main causes of chilblains.
Keep taking the tablets!
With increasing numbers of people living with conditions such as diabetes
and high blood pressure more and more of our patients are taking longterm repeat medications. The total cost to the NHS of prescriptions
issued by the practice each year is more than a million pounds. This
is more than the total cost of operating the surgery including all staff and
doctor costs and all the buildings and running costs.
With the financial pressure the NHS is under it is important that this
spending on medication is not wasted. If you find that you are receiving
medications that you no longer take or the quantities are larger than you
need please tell us or let your pharmacy know.
Some types of medicines are often used intermittently such as painkillers,
laxatives and some asthma inhalers. These can be particularly prone to
unintended stockpiling. With some asthma inhalers costing £40 each this
can quickly become very costly for the NHS.
Please help us keep wastage down so that we can ensure NHS
resources are wisely spent. Any savings can be redeployed by the local
health system to fund other essential services.
Patient Participation
Patient Meeting
Many thanks to the patients who attended our first open patient meeting
on Wednesday 30th September. We felt it was a useful exchange of
information and ideas. GP Partner Dr Dilley and our Practice Manager
Elaine Turner presented information about the practice and the local NHS
and answered questions about how the practice runs.
We spent time in the meeting discussing the continuing increase in
pressure on GP appointments at a time when practices are having
funding withdrawn from them. It is a national problem and we discussed
how the practice is responding as well as the local Vanguard Initiative.
 Since 2013 we have seen a 24% increase in Triage requests
 Since 2013 we have seen a 12% increase in Rapid Access
Appointments
 Since 2013 we have seen a 57% increase in Urgent Afternoon
Appointments
We explained that we have been concerned about the impact increased
demand has on waiting times for appointments. In 2013 the average wait
for the next routine appointment was approx. 2.5 days whereas often now
it is 5 days. The patients who attended did not feel this was an issue as
they felt they were able to access more urgent medical help before the
next routine appointment when they needed it. They fed back that they
were particularly impressed with the Triage system we have in place.
As part of the meeting we agreed to write to the council with regards to
the congestion where Myrtle Road meets Mowbray Square as there was
general agreement that this is an issue. We also said we would look at
publishing appropriate information about the formal complaints the
practice receives and the actions taken in a response to them. When we
do this we will need to ensure that any details given do not breach patient
confidentiality.
Patient Questions & Answers
Can patients email their GPs?
 The practice currently has the facility to receive information from
patients by email but patients should only do this only with the
agreement of their GP for two reasons:
- We are dealing with a huge increase in the volume of
communications we receive about patients and need to be able to
manage the information coming into the practice in a safe way. We
are doing this in part by limiting the ways information can come into
the practice so it can be dealt with promptly and safely.
- When we undertook a pilot to allow email communications for non
clinical matters last year patients sent inappropriate clinical
information to us which meant the system became clinically unsafe.
Is it possible to book a telephone appointment with a GP?
 Yes it is possible to book a telephone appointment with the GPs.
 If your request is routine you can book into a specific afternoon
telephone appointment. The receptionist will ask what the
appointment is regarding to ensure it is appropriate for a phone call.
 If you have a medically urgent problem this will be dealt with by the
duty doctor who will phone patients on the day. These calls are
categorised as Urgent, 4 hour or 24 hour requests depending on the
urgency of the medical need.
…And don’t forget
We are keen for patients to give us feedback on their experience of the
practice. You can feedback to us by:
 Using the NHS Choices or Friends and Family Test link on our
website: www.eastparadesurgery.co.uk
 By emailing us at: pt.b82016@nhs.net
 In writing, by phoning us or calling in and speaking to a member
of the reception team.
 Attending patient meetings. If you want to join our patient group,
please email us on pt.b82016@nhs.net.
What we do - A day in the life of a senior member of
the Reception Team.
This newsletter diary looks at a typical Wednesday with Jane Walker a
Receptionist & Medicine Manager.
7.40 a.m
 Logged onto the computer system in reception only to find Dr Dilley’s
morning clinic had disappeared from the system! This has only
happened once so an unusual start to the day.
 Checked the desk was prepared for the day. We need to ensure we
have a stock of things like urine bottles, registration packs, patient
leaflets and that items to collect like sick notes are at hand.
8a.m.- 8.30a.m
 Added Dr Dilley’s patients on to the system for his morning clinic, as
they arrived. Luckily everyone was clear of their own appointment time
and also arrived on time which made the problem much easier to
resolve.
 Read all my emails and took action as appropriate.
 Took calls from patients and dealt with their queries.
 Dealt with patients who needed assistance at the reception desk
including a prescription dosage query. I can resolve a lot of
prescription enquiries but I had to liaise with the duty doctor as to the
correct dose for the patient.
9.00 a.m.- 10.00a.m
 The mystery of the lost clinic has been resolved. For infection control
purposes we clean our keyboards daily. Someone had cleaned theirs
whilst logged into our clinical system and inadvertently deleted the
clinic. The learning for us is that cleaning needs to be done before we
log in!
 Checked the prescription collect box for any prescriptions more than 3
months old. I recorded on the patients’ records that they were not
collected and put 2 queries to the duty doctor, as prescriptions were
issued in relation to abnormal blood tests, so I needed to check if the
doctor wanted to take any further action.
 Dealt with 26 electronic out of hours GP letters and hospital discharge
letters. A lot of our letters come electronically and need adding to
patients records, coding and sending to GPs if necessary.
 Answered more phone calls and dealt with patient queries at reception
desk. It was a normal day so there was a constant stream of issues to
deal with.
10a.m.-11.00a.m
 Left front reception to work through tasks (electronic messages) sent
by the clinical staff for action by reception staff. These are always
varied and involve contacting patients and care providers to give
information, ask for information and often involve problem solving.
 Prepared about 30 prescriptions for signing and 12 blood forms for
patients to collect before going to have their blood taken.
11.30a.m-12.30p.m.
 Prepared the staffing rotas for the following month with the practice
reception manager Gail. They will be challenging weeks for us to
ensure cover because when a team member leaves it takes time to
recruit suitable new staff. The rota is critical to the smooth running of
the practice so two of us do it.
12.30p.m.-1.00 p.m. Lunch break
1.00 p.m-3p.m.
 Produced the gluten free prescriptions for patients. I checked patient
records to see what their monthly unit allowance is and what gluten
free items are available on the NHS.
 Spent an hour doing my weekly inventory of the practice storeroom
which holds all items from latex gloves to drugs. I checked everything
for expiry dates and placed an order with our suppliers. I recorded
information on our intranet system which notifies me when key items
are coming close to their expiry date.
 Checked if any GPs wanted a cup of tea and took it to them. Although
everyone is encouraged to get up and make their own tea as a break
from their screens, often when it is busy breaks get forgotten. It’s
important though to ensure the GPs feel supported and this is one way
the reception team help to do that.
 Dealt with further tasks that needed action and processed further
electronic documents that we received during the day. It is a constant
juggling process as we have to ensure we respond to urgent requests
first but meet our deadlines for routine matters.
Find us at East Parade Surgery.