Practice Fact Sheet – updated January 2015
Dear Patients,
Thank you so much for your entirely positive feedback on my write-up and requests to continue. Many
of you came to me with the words ‘well, I never knew that!’ and this is precisely the point. Patients
sometimes rely on media-fed information that is often incomplete and primarily serves the purposes
of the originator. I wish to address the balance, at least a little. I plan to continue to add paragraphs
and any current information will remain in place for you to refer to should you wish. The date in the
file name will indicate the last update. The patient participation group is aware and supports this
initiative.
You, the patient, can help me with this! Tell me what interests you? What puzzles you in primary care?
If it puzzles you there will be other people out there thinking exactly the same. I will do my best to
provide you with clarifications where I can and where I cannot, I will advise accordingly.
Many thanks for your interest,
H. Burnett
Practice Manager
 One third of the world population is overweight or obese. In 1980 globally around 857 million
people had weight problems; by 2013 this had increased to 2.1 billion (source: Lancet, 2014)
 More people die of alcohol-induced illnesses than in road traffic accidents
 In September 101 patients did not attend their appointments and did not cancel!
As patients we are all frustrated when appointments are not available when needed. At the
practice we are equally frustrated to see dozens of appointments go to waste every
month because patients did not advise us that these are no longer required. The NHS
Constitution advises patients of their responsibility to cancel appointments no longer needed.
At Moatfield, we are monitoring appointment use daily. As a practice, we do have the right to
remove patients who repeatedly do not attend appointments without justifiable reasons and
who will then have to register elsewhere.
You are at risk of being removed from the practice list if you fail to respond to letters
regarding your registration!
NHS England is conducting a review of all registered patients. The reason for this is to remove what are
known as “Ghost” patients and to free up capacity in the NHS system. If you receive any
communication it is vital that you respond to show that you are an active patient and should therefore
remain on the practice list.
Thank you for your help with this matter.
Zero Tolerance Policy
We all have bad days, and when we feel ill we may feel 'down' and a little more irritable than normal.
Our experience over the last 12 months shows that a small number of patients think it acceptable to
approach practice staff in a verbally aggressive manner. All our staff are here to help you within the
framework provided by the NHS. Patient expectation is at an all time high, often fuelled by the NHS’
own rhetoric without appropriate funding for implementation, and GP practices are left with
disappointed patients when requests cannot be met. Our reception staff follow procedures designed
to care for as many patients as possible in a safe environment.
Fellow patients have a right to attend, and our staff have the right to work, in a safe and secure
environment and the practice has the legal responsibility to provide that safe and secure environment.
The practice will not tolerate:
Verbal abuse to staff which prevents them from doing their job or makes them feel unsafe.
Threats of violence or actual violence to a GP or a member of his or her staff.
Patients should understand that GPs have the right to remove from their list with immediate effect
any patient who behaves in the above manner.
Pharmacist or GP?
Pharmacists spend 5 years at university and are experts on advising patients on medication issues –
this does not necessarily require a phone call from a GP or even an appointment (unless the GP asks
you to do so). Please make use of one of the many pharmacy services available locally.
As covered under sad facts 101 appointments were not attended and not cancelled. The question
arises, were these appointments needed in the first place or might a pharmacist have been the better
option from the beginning?
University students and their health care
When students attend university they are often required to register with a GP at the university. This
triggers a re-registration process in the background whereby the patient notes will leave Moatfield to
go to the new registered practice and the student ceases to be a patient at Moatfield.
Many students wait to see a GP until they are back home assuming their registration to be active. The
GPs at Moatfield are only able to provide immediate & necessary treatment. Any medication requests,
referrals, chronic disease management eg asthma, need to be directed to the registered practice at
university and students are asked to obtain a sufficient amount of medication or a spare prescription
before coming home. The reason is simple: Your safety is paramount and without access to your
complete medical record this safety may be compromised. Please consult your registered doctor.
Self Care
It has widely been publicised that resources in the health service are scarce and ever depleting. The
NHS is therefore keen to raise awareness amongst patients how to self care. Some examples:
 On only one morning, 3 appointments were taken up for nappy rash! This is not appropriate
use of NHS time. Please consult a pharmacist, family members/friends or ask your health
visitor.
 Sore throat wanting to see a GP? Unless the sore throat has been present for 3 days there is
little your GP can do for you. Please gurgle with hot lemon tea or/and consult a pharmacist.
 Stomach upsets are often easily relieved by over-the-counter remedies or calming herbal teas.
 Patient infection control – germs are easily spread through shaking hands, touching door
handles, hand rails or trolleys in public places, particularly in winter time. Wash your hands
thoroughly and frequently after every outing before touching food or mouth.
 Further self care options can easily be obtained from the internet and our website and we are
currently compiling a folder with information for the most commonly experienced ailments for
patients to peruse in the waiting area. All we ask is that patients do not remove any
information but leave the folder intact for fellow patients to use.
Why do I only get 10 minutes and patients attending with a list of ailments?
The practice currently offers 10 minute appointments. This is to enable as many patients as possible to
access GP services. Health needs are becoming ever more complex and often patients attend with a
list of ailments delaying fellow patients in the process. The longer the appointment the fewer patients
can be seen. GPs also need to make home visits, deal with an avalanche of paperwork and enquiries,
as well as looking at clinic letters, discharge summaries from hospitals get your referrals done in good
time, interpret your ever increasing test results received from various hospital labs and deal with
phone enquiries from patients and other health professions. All this takes time and, again, your safety
is paramount.
It would help everyone concerned if patients were to attend for the most pressing medical problem
initially and ask the GP whether a further appointment for outstanding issues is required or whether
the services of a more appropriate service would be advisable.
If you do have a list, before asking to see your GP, please check whether some things could be dealt
with more appropriately by a pharmacist eg. medication queries, dosages, medicine interactions,
minor ailments as pharmacists are experts in their field.
Any social issues (money, drugs, alcohol, smoking, exercise, healthy home) may be best directed to the
Mid Sussex Wellbeing Hub on 01444 477191, a new service available to patients in Mid Sussex or visit
their website for further information. Some may be best discussed with that friend you trust over a
coffee or tea.
Repeat prescription time
The practice processes approximately 83000 prescriptions a year or 1596 prescriptions every week or
approximately 320 every day. We stipulate 48 hours to allow for a member of the non-clinical team to
work through the requests received during the day every day. Sometimes requests are not as straight
forward as they may seem to patients and a note needs to be sent to the doctor first. Once the
doctor’s response has been received, the prescription is dealt with appropriately and may await the
doctor’s signature. With all medications, safety is paramount and these protocols are in place to
protect you and your health.
Reception desk – why is there only one Receptionist?
In an ideal world we would like to have increased staffing levels in all areas of primary care. It is well
documented and publicised that resources in the health service are not infinite and we have to work
within the resources provided. If a second Receptionist is moved to the desk, this will reduce the
number of telephone calls being answered. Patients are encouraged to use the check-in screen to
register their arrival thus reducing theirs and fellow patients’ wait to be seen.
Currently we have 2 Receptionists every day during our busiest times. During our less busy times our
monitoring showed that the situation did not warrant two Receptionists at the desk. We therefore
have one Receptionist with a further Receptionist on stand-by.
Practice closure for training
This is an area wide arrangement and not unique to Moatfield. The majority of practices participate in
this as it provides GPs with latest updates of services and how to access these services. This helps GPs
to keep up their skills and knowledge and is vital in ensuring they provide a high quality service. Event
timings are not down to the surgery and participation is encouraged to allow clinical and service
provision development.
Books/toys for children
Infection control recommendations are such that most of the books and toys have now been removed.
Children are always more than welcome to bring their own toys/books to the surgery.
Car park, pavement and footpath in Moat Road
Car park: We are aware that sometimes space in our car park is limited. However, so are our options
on how to improve the situation. The practice has taken steps over the years and increased the
number of spaces available to patients including provision of a staff car park. Patients, just as our staff
do, can do their part by considering options available on how they access services eg does the need
require a trip to the surgery and is a car necessary.
The road: Road, pavement and footpath are not practice responsibility and any suggestions should be
directed to the appropriate authorities.
Priority for certain patient groups
We had several requests to give priority to certain age groups: some requested babies/small children,
some elderly patients, some patients with certain conditions, or the working population. The practice
is a general practice and as such has to find a happy medium to cater for all patients irrespective of
background but our overriding concern is prioritising our work to help those in crisis or needing urgent
care with a significant problem.
Receptionists asking questions
In order for our appointment system to work smoothly and enable GPs to prioritise their work,
Receptionists have been instructed by the doctors to obtain certain information. Patients should rest
assured that all staff have received training in confidentiality regulations and signed respective
agreements. Having a certain amount of information ensures that the practice identifies people with
urgent problems and manages those in a timely way. For example people with sudden tight central
chest pain and shortness of breath are directed immediately by the staff to 999 services due to the
presenting symptoms suggesting a heart attack.
More out-of-hours appointments
The practice already offers a number of appointments before 8 in the morning, after 6.30 in the
evening and certain Saturday mornings. Often, patients book these appointments but do not attend
without cancellation; these appointments would be available to other patients had we known that the
booked patient is unable to attend.
Registration with the practice
Patients have been registered with the practice rather than a particular GP since 2004 when the NHS
presented GPs with a new contract for service provision. Reason for this was to provide patients with a
greater choice and flexibility on who they were seeing. The practice does allocate a ‘usual’ GP to every
patient. All patient records are computerised enabling all clinicians to ascertain your medical history.
The NHS has recently announced that for certain patient groups it wishes to return to a ‘nominated’
GP and we are currently looking into how best to implement this change.
GPs presenting unusual cases to colleagues to enable correct identification and diagnosis
Our GPs meet on a regular basis, at least weekly, to discuss any medical cases that may present in a
more unusual manner. This has been the case for many years. This is recognised as good practice and
helps clinicians to keep up their skills and knowledge.
Appointment availability & Receptionists asking questions
The practice has a registered population of approx. 13,700; we currently have 10 GPs, 5 nurses who
are assisted by 3.5 healthcare assistants/phlebotomists and 23 non-clinical staff.
Appointment access changed recently to a system which has been highlighted nationally as a better
way of providing convenient access in the face of increasing, often inappropriate, demand and within
finite resources. This is not unique to Moatfield. For long-term and ongoing or follow up problems
such as diabetes, patients are still able to make appointments in advance although waiting times will
vary dependent on who patients need or wish to see. In our new system anyone with a problem
requesting help on the day will be called back by a GP for a telephone assessment usually within the
hour. Following this assessment, the GP will agree and arrange the right treatment or further
assessment as is needed. This is more convenient for our patients and means we make best use of our
resources for the largest number of people. Patients are still able to book appointments ahead with
GPs of their choice depending on availability.
We are aware that appointments are an issue and patients have asked why there are not more
doctors and nurses at the practice. Reasons for this are:
 The practice receives approx. £70 per patient per year from the NHS to provide services; there
is no more room for manoeuvre to increase its staff base
 Patient demand has increased immensely over the last 5 years and we have taken steps to try
and keep pace with developments
 The practice receives many calls that
- do not require a GP and can easily and conveniently be dealt with by a nurse, pharmacist,
optician, health visitor or the Mid Sussex Wellbeing hub (Tel 01444 477191).
- do not require an appointment but can be dealt with over the phone such as simple
advice, certificates and treatment changes.
- attach unnecessary patient expectation as to the immediacy of a matter needing to speak
to a GP. Patients can do their bit in simply leaving a message for a GP to return the call, not
always on the same day as this depends on daily workload. Our receptionists have been
instructed to obtain certain information and will need to ask questions as to the nature of
your call.
 Appointments no longer needed by patients but not cancelled. We are very grateful to those
patients who take the time to advise the practice when an appointment is no longer needed;
there are still approx. 20 appointments each week that are left unattended despite text
reminders from the practice. The NHS does outline patients’ rights but also patients’
responsibilities.
Waiting times in surgery
Appointment duration is 10 minutes to enable GPs to see a reasonable number of patients during
morning and afternoon surgery. The remainder of the day is spent on home visits, telephone calls,
liaising with other professionals and the ever increasing paperwork GPs are now asked to complete.
Emergencies do happen and a GP may have to spend a little more time with a patient, organise an
ambulance or contact community services to put arrangements in place for patients.
We find more and more that patients bring additional family members or long lists to appointments.
Whilst the doctors will attempt to help with a number of problems within a ten minute appointment,
patients may be asked to book a further appointment to cover all their needs. It helps the situation if
patients prioritise their concerns and deal with the most important ones. Patients can book double
appointments if they believe that more time is needed to address complicated or several problems.