Healthwatch North East Lincolnshire
Enter and View Report
GP Centre Visit
Ashwood Surgery – Weelsby View Medical Centre, Ladysmith Road, Grimsby
Dr Reeta Singh
Dee Gillie – Practice Manager
Visited unannounced Tuesday 17th June 2014
Authorised Representatives
April Baker, Marie Fitzgerald and Elaine Flower
Background
Healthwatch North East Lincolnshire (HWNEL) is the new consumer champion
created to gather and represent the views of the public. It plays a role at local and
national level to make sure the views of the public and people who use health and
social care services are taken into account. As part of our work we have powers that
allow us to use an ‘Authorised’ team of representatives to give an independent,
transparent and honest view of services provided in local GP centres across the area
including Grimsby, Immingham and Cleethorpes.
Introduction
As a result of the ongoing dispute with the other medical practices at Weelsby View
Medical Centre – Ashwood Surgery had its electricity supply cut on Wednesday 14 th
May 2014. As Healthwatch NEL we were concerned with the impact this would have
on the patients and the service they received and discussions were held with both
the Clinical Commissioning Group and NHS England prior to this visit. The
Healthwatch Team devised a questionnaire to take into the surgery and complete
with patients about their experiences.
The Visit
We were welcomed by Dee Gillie, the Practice Manager, who explained the
difficulties they had encountered since the 14 May until 12 June when the electricity
was restored. The power had been off for four weeks and they had done all they
could to stop it affecting their patients.
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They had obtained battery controlled lap tops, printers, ECG machine, and lamps
and had succeeded in running the practice. Dr Reeta Singh joined us and explained
the health and safety of their patients was their main concern and they had closed
for two days until battery controlled equipment was in use. NHS England and the
Care Quality Commission had visited them and agreed the practice was running
safely. We were provided a copy of Ashwood Risk Register Report attached. It has
two sections firstly around working with no electricity and secondly communication
with patients.
Both Dee and Dr Singh said that patients had been very supportive even to the
extent of hugging them and squeezing their hands in sympathy. The staff had
worked very hard and pulled together to form a great team and are now clearing up
the backlog of paper entries which have to be transferred to computer records. Dee
did admit that 205 patients had left them but that still left 4,800 who were happy with
the practice.
The patients we spoke to in the afternoon walk in clinic agreed with this and only one
wanted to move. The others spoke highly of the doctors and the service they
received.
Ashwood Risk Register
Ashwood completed their own Risk Assessment regarding working with no
electricity and communication with patients.
Working with no electricity
They looked at a range of issues including having no computers – Clinicians and
admin working on laptops to ensure patients are seen, treated and prescriptions and
referrals are issued. Clinicians are handwriting acute prescriptions as necessary.
Laptops are taken off site every lunch and evening to charge up for next day
sessions.
No printers – Two battery powered printers were purchased and set up by IT
services to ensure smooth operations for prescriptions etc…
No lights – Battery powered lights were purchased to use in admin room as
necessary – clinicians rooms quite light but mobile lights used as necessary.
No outgoing phone lines – 4 mobile phones were purchased so that patients could
be contacted – note put JX board and website to inform patients of us contacting
them by mobile phone and not surgery phone lines.
ECG Machine – Has battery power so charged regularly for use.
Nebuliser – Not able to use as not battery powered – purchased spacers and
inhalers in case of an emergency.
Defribulator – Has battery power so charged overnight as necessary.
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Vaccine Fridge – Was moved to another area of Weelsby View and Vaccines were
purchased to replace lost stock. Kept in secure area with two members of staff
having keys. Temperature checked and recorded regularly in line with Surgery
protocols. Note on fridge door and on socket to ensure not switched off by mistake.
Ear syringing machine – has battery power charged overnight.
Incoming correspondence (unable to scan onto system) – post checked daily –
anything needing urgent attention is put onto the system as a Clinical task and put in
Doctors day tray to be processed. All other correspondence is put into file for
reference if needed by Dr. during surgery. Admin going through correspondence to
take out letters re patients who have been deducted and sent back to relevant
departments or hospitals.
No fax machine – unable to send referrals by fax so sending by email or through
internal post to hospital departments.
Digital door lock – is kept on now for security/ safety reasons
Working from home – only the practice manager and Dr Singh have used their
laptops for working from home. Minimal risk for security purposes.
Backlog of work – work will commence to ensure the backlog of work is undertaken
as quickly as possible once power is resumed.
OOH Reports – Are being checked daily by practice manager and anything urgent is
reported to the duty dr.
Communication with patients
Communicating situation to patients – keeping them informed
Initially there was press coverage in the Grimsby Telegraph and the Cleethorpes
Chronicle re Ashwood Surgery. Practice put out a statement stating that they were
not closed or closing and that a situation had arisen between themselves and the
other surgeries within Weelsby View. The other surgeries then put out flyers and
posters about Ashwood, stating they had not paid some bills and that the whole of
the Health Centre was at risk of closing, causing a lot of concern to practice staff and
patients.
Practice decided to contact patients to explain that they were still in business and the
situation they were in. They looked at various ways of contacting their patients either
by SMS Text message, email or letter/leaflet.
As they did not hold very many email addresses and with patients changing their
mobile numbers frequently, they decided on the latter and produced a leaflet to put
on Reception and attach to prescriptions to keep them updated of the situation. They
also put this onto their website and informed the press to make another statement.
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Information Governance
Passwords – Staff have been using each others passwords due to different people
taking laptops home to charge and different start times the next day. IT were asked
about a generic login to Windows but apparently they do not do this any more. Once
this situation over disconnection has been concluded, all staff will change their
current passwords so nobody else will have access to their laptop or log in.
Copying Patient notes off site – practice sought confirmation of guidance.
Solicitors requesting copies of patient’s notes, unfortunately unable to copy on site –
Possibility of taking off site to the head office by Assistant/ Practice Manager
securely transported and copied as necessary.
Survey Questions
Enter and View team asked questions to a few patients at the time as it was not
busy. We asked the following:
1. Have you contacted or visited the surgery since 14 May 2014?
Yes/No
2. If yes, please supply brief details:
3. Did you find that your contact or visit was affected by the cut of electricity supply?
Yes/No
4. If yes, please supply details:
5. Did you have any problems getting your prescriptions and medications? Yes/No
6. If yes, please supply details:
7. Do you consider that the surgery has delivered a full and safe service since 14
May 2014?
Yes/No
8. Give reasons for your answer at 7 above:
9. Are there any other comments you would like to make about the current situation
at Ashwood Surgery?
10. Are you happy with the service and have enough confidence in your GP to stay
with the practice?
Case Studies 1- 4
Case Study 1 - A lady spoke to us that had been in touch with the surgery regarding
her repeat prescription. She did not feel the service she received was affected by the
cut off of the electricity. She did not have any problems getting her repeat
prescription. She felt the surgery had delivered a full and safe service since 14 May
2014. However she did point out she only wanted the prescription and did not use
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any other service. She commented “Glad it was still open and would not want to go
anywhere else. The Doctors were lovely and treat us well.” When asked if she was
happy with the service and have enough confidence in their GP to stay with the
practice she said “Yes could not hear the thought of going elsewhere.”
Case Study 2 – A lady spoke with us and told us she had used the surgery after 14
May 2014. She had been treated as normal and had no problems. She did not find
her visit had been affected by the cut in electricity supply. The service delivered was
full and safe. She commented that “All care was given as normal.” She was happy
with the service and had enough confidence in her GP to stay.
Case Study 3 – A lady came in for a consultation since 14 May 2014. She was
treated as normal with no problems due to the cut in the electricity supply. There
were no problems with getting prescriptions or medications. She considered the
service provided was delivered in full and safe way. She commented that “Always
treated well at this surgery.” She was not moving to another GP as she was
confident about her own.
Case Study 4 – A lady told us she had visited the surgery since 14 May 2014. She
told us there were only emergency available for appointments. She commented that
“Dr moaned at patients water infection when it is an emergency as doctor thought
not.” When asked whether her contact/ visit was affected by the cut to the electricity
she told us “Letters for cancer smear arrived, no treatment available.” “Only
medications for emergency and nothing else.” When asked if the service was
delivered in full and safe way she commented “No, because of the above. Why send
out letters when they cannot deliver service?” Other comments included “Will change
GP if this continues. Why turn up and arrange appointments when clearly: difference
of opinion re GP and Hospital wasting time re lumps.” When asked if she had
enough confidence in her GP to stay she said “No.”
Due to NHS England involvement and CCQ involvement no recommendations were
made at the time of the visit. It was felt there was not enough patients to get a true
picture of issues faced by patients.
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