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Ivy Grove News 16.1 March 2018 Patient Newsletter

Here you will find an online edition of our popular patient newsletter, Ivy Grove News. Click the images below, or scroll down to read the newsletter. You may wish to download a PDF This is a PDF download of this edition, or you can view or download older versions of the patient newsletter from our newsletter page.


Piloting Minor Illness Clinics – please bear with us

Demand on our services is increasing whilst the funding we are given to provide your care, and the numbers of front line NHS staff are reducing. Therefore we are trying some novel ways of working in order to meet demand as best as possible, within the constraints that we have. We know this will not fix the bigger picture, but it might help you to see us a bit more easily when you need to. We are therefore running a pilot of Minor Illness Clinics on Wednesday and Friday, with possibility of adding Mondays too.

If, on these days you have an urgent problem, and feel you need to see a GP on that same day, please contact us before 10.00am; you will get to see a GP that morning. The receptionist will give you a time when you should arrive. However, particularly at busy times, you might have to wait a little while for your turn to see the Doctor.

We know sitting in a waiting room when you feel unwell is not pleasant. We aim to work safely and as quickly as we can. We normally see patients in the order in which they arrive, however if someone is seriously unwell, and might, for example, need a hospital admission or urgent treatment, we will see them sooner. This is not queue jumping, but merely safe clinical practice.

This service will only work with your help. We continue to offer routine pre-bookable appointments, and if your problem is long-term, we ask that you book a routine appointment to avoid overwhelming the Minor Illness Clinic.


Check website and try self-care
For urgent problems only
Do not just turn up at desk
Always ring for an appointment

Please note, we are not an emergency walk-in service like a casualty department and we advise that you do not simply turn up on the day to sit and wait. Please always ring for an appointment first.

We still find that many people attending with minor illness have conditions that would get better on their own, with self-care or home treatment. We therefore urge all patients to consult our advice pages on our website before ringing. These are easily accessible at ivy.gs/help or ivy.gs/symptoms. You can also pick up our leaflet called ‘Get the right help for your condition’ to guide you to the most appropriate professional and also download this leaflet and other minor illness leaflets at ivy.gs/downloads.

If you feel you need to see a GP in our Minor Illness Clinic, please ring us and our receptionist will direct you. Please help us to continue in our efforts to provide excellent care when you need it for you and your family.

Make the Most of Your GP part 16

Your GP is not a substitute

Although we are generally more accessible by phone than your average hospital consultant, as your GPs, we are definitely not substitutes for when you need specialist advice or treatment from your regular hospital consultant. Some patients feel that they cannot ask their hospital doctors detailed questions about planned procedures or results, or request sick notes or prescriptions fearing that it is either not the hospital doctor’s job, or that it would be wasting their time, so they get in touch with us instead.

You may not know it, but the hospital is contractually obliged to deal with all your queries regarding your ongoing care at the hospital. Feel free to contact them via their secretaries.

Please respect hygiene

Your GP is not immune to coughs and colds and we kindly ask that patients do all they can to maintain hygiene and reduce the risk of spreading disease. This means keeping clean, washing hands regularly, using disposal tissues and also alcohol gel to clean hands and surfaces.

Accordingly, we also respectfully request that patients do not blow or cough in our faces when we are examining them, and at the very least, use a tissue and cover their mouths. The last thing patients or the practice needs is our medical staff going off sick after catching something from our patients. Many thanks.

The Job of a General Practitioner

And how times have changed

You may think, on reading our news, and viewing our information videos, that we are just trying to put you off from seeing the doctor. We can definitely say we are not deterring you from seeing us, but we are instead trying to encourage you to see us appropriately. Whilst we can keep telling you about NHS plans and future direction, it may still be difficult to understand why we are doing all this.

So here is some context. Our contract is to see people who are ill, or who perceive themselves to be ill. This was originally defined in a contract that is decades old.

One of the most important aspects of our job involves detecting serious disease early, so that patient outcomes can be improved. We also promote good health so that patients can use knowledge to prevent health problems from occurring in the first place.

A GP often stays in the same workplace over many years and develops a long-term relationship with a patient and their family. Their holistic role encompasses many aspects of patients’ health and wellbeing.

Since the contract was drawn up with that broadest of job descriptions, things are now very very different. 12 hour days are not unusual. We have to meet hundreds of targets from government and regulatory bodies. Each doctor deals with upwards of 200 pieces of correspondence every single day (tasks, results, paperwork). Due to compensation culture, we now have to document everything in great deal. This all takes time. More time than is feasible within 10 minutes.

As Doctors are put under more pressure,
patients are put more at risk

People now have very little tolerance for anything going wrong with them, and they expect instant fixes. We now see very many people who are in the very earliest stage of their conditions where self-care or any other treatments have not been tried and where they might get better anyway. Although people now live longer, they have more long-term diseases and lots of medications, and their cases are vastly more complex.

This is against a background of fewer GPs because many GPs are leaving the service due to intense work pressures and the chronic short staffing and underfunding that has become the norm for the NHS.

The modern NHS has seen an explosion of other workers, whose role is designed to take on additional responsibilities, provide specialist care and accept direct referral from patients. Examples include direct physio, practice pharmacists, counsellors, nurse practitioners and care co-ordinators to name a few.

Yet, due to decades-old tradition and political promise, people’s first thoughts are still to ring or attend the GP, often as soon as possible. Given all of this, something has got to give. It cannot go on.

Because if a doctor is swamped with lots of self-limiting, minor conditions then spotting the early cancer in amongst all of that is going to be even more difficult.

Because if a doctor is frazzled with hundreds of patients all demanding instant attention, then, because a doctor is only human, they are going to make a serious mistake eventually.

Because if a doctor is rushed, then they won’t have the time to detect and explore subtle but vital problems in a patient whom they have known since that patient was a child.

Because if everything is urgent and everyone wants to see the GP there and then, then in reality, nothing is urgent.

All of these stresses put our doctors under more pressure and ultimately, this puts their patients more at risk.

The NHS is a precious and limited resource. We therefore ask that it be used responsibly. This includes seeing the right person for the job. Check our website for more information to help you achieve this.

Easter Holidays

We will be closed on Friday March 30th (Good Friday) and Monday April 2nd (Easter Monday).

If you need medical attention or advice when we are closed, please ring NHS 111 on 111, or see our website at ivy.gs.

Check our website for latest news and updates or to order your prescription online (ivy.gs/online).

Minor Surgical Procedures

Dr Simon Francis

We are now operating a monthly clinic for minor surgical procedures.

This includes the removal of simple skin lesions that are causing pain or discomfort. Examples include skin tags, cysts, warts and some other lumps and bumps.

Dr Horton, Dr Axten, Dr Francis and Dr Greer are currently performing these procedures. Dr Wordley also performs removal of toenails for painful ingrowing toenails.

Whilst we appreciate that some people would like something removing as they feel it appears unsightly, unfortunately we are not able to offer this service for this reason, as it would be classed as a cosmetic procedure, which is not available under the NHS.

We can remove simple skin lesions that are causing pain or discomfort

If you have a problem which you feel could be dealt with by a minor surgical procedure then please make an appointment with the relevant GP.

They will be able to assess the problem to determine whether it is suitable and they will also be able to discuss the procedure in more detail including any risks involved.

Whilst all GPs can assess the suitability of a problem for a minor surgical procedure, it may not be the same doctor performing the procedure on the day. This will depend on which doctor has been allocated to be performing operations on the day the procedure is performed.

Please also be aware that the final decision to perform a minor surgical procedure will be made by the operating doctor on the day in question.

News Snippets

Jeremy Hunt’s performance

The Prime Minister’s decision to keep the Health Secretary in post just shows how happy she is with his performance so far:

We think the plan is ticking along quite nicely, and look forward to more great things for the NHS.

GP numbers continue to fall

In sharp contrast to the government’s 2015 pledge to bring 5,000 more GPs into the profession by 2020, official figures show that the number of GPs in England has actually fallen by 1,200 over the past year, putting the government’s somewhat fanciful target even more at risk of not being fulfilled.

Sad day for patient safety

The tragic case of the death of a six year old and the conviction of his doctor for gross negligence manslaughter and her later trial to remove her from the medical register has sent shockwaves through the medical profession. No-one can take away the awfulness of the death of a child, however, it is clear that there are very few doctors who start their day setting out to deliberately harm or even kill a patient, and as doctors, we try to do our very best for our patients, within a broken system that is chronically underfunded and understaffed. These pressures would contribute to anyone making a mistake, but sending hardworking caring doctors to prison won’t help to make patients safer.

Doctor, doctor, where are you? Australia probably…

The situation with the continuing national shortage of GPs is reflected in our own practice where we have been advertising for a new doctor for the last four months, but are still without a single suitable applicant. We have shared our advert with local medical committees, and with NHS jobs, and it is also on our website at ivy.gs/jobs.

The doctors and nurses here continue to work hard to provide a quality service, however, we again ask that all patients follow current NHS guidance, which is to seek the right help from the right professional in the first instance.

We therefore urge all patients to pause a moment before they pick up the phone and perhaps think about whether the GP surgery should be the first port of call and/or whether they can self-care. We have many resources available to help patients, from our leaflets, to download or pick up from reception, to our symptom checker at ivy.gs/symptoms and help page at ivy.gs/help.

Our help page shows you who does what within the NHS and most of these workers do accept referrals from patients without the need to see a GP. This should save you time on the phones and time waiting to see a GP.

As mentioned, we are always trying to improve our service within the above constraints, but we ask all our patients for their help and co-operation in what continue to be very difficult circumstances for the NHS. Your GP service and the NHS are precious commodities, please use them responsibly.

Derbyshire CCGs to introduce self-care policy

Encouraging patients to explore self-care is necessary in order to help everyone

Self-care is now widely acknowledged as an important solution to managing demand and keeping the NHS sustainable and promoting self-care is officially part of NHS plans. At Ivy Grove Surgery we have always tried to empower our patients to self-care through the use of patient education materials and directly from within the consultation itself, so we are pleased that the NHS has finally started to catch up.

Supporting people to self-manage common conditions such as coughs and colds could help bring down the 57 million GP consultations each year for minor ailments, a situation which costs the NHS approximately £2 billion and takes up to an hour a day on average for every GP, if not significantly more.

Promoting the concept of self-care and increasing the awareness that there are alternatives to making GP appointments, or attendance at OOHs or A&E departments with minor conditions, will encourage patients to explore self-care in the future, so changing the culture of dependency on the NHS.

Together, the four CCGs in Derbyshire (Erewash, Hardwick, North Derbyshire and Southern Derbyshire) spent over £3 million in 2015/2016 on some of the medicines that are available to purchase over-the-counter.

Whilst it is recognised that much of this cost is attributable to long-term or complex conditions, removing specific medications from routine prescription, for minor, short-term conditions and for conditions, such as a common cold, sore throat or minor cough, which would naturally get better themselves in the majority of patients if untreated - would release money to treat more serious conditions such as heart disease and diabetes and would help with the overall health economy.

The exactly policy wording is currently in the process of being finalised and we will be able to give details of this in due course. In the meantime, please refer to our website resources at bit.ly/ivyselfcare or check our ivy.gs/help and ivy.gs/symptoms pages.

Waiting Room Display Videos

A valuable resource for our patients

Regular visitors to the surgery will have noticed that we have radically updated our waiting room display and replaced many of the usual uninspiring scaremongering doctors’ surgery videos with something a bit more useful.

At Ivy Grove Surgery, we are always striving to provide a high quality and friendly family service. We feel, however, that we have a duty to inform our patients about what is happening in the wider political context of General Practice, as unfortunately, such external constraints do have a significant bearing on what we are able to reasonably achieve within practice. To this end, we display our State of and Politics of General Practice videos for your information.

It’s not all doom and gloom though, so we also have 200 slides showing top tips and pointers on using your GP service, as well as educational videos on self-care, recovery and home visiting, hospital contract, winter illness, self-referral amongst many others.

And finally just for fun, we have a new true false quiz series and for interest, we have a series of touching personal perspectives about Diabetes in Days Gone By from one of our receptionists. We hope you enjoy all these videos, and hope you can see we are trying our best for you and your family.

Gluten Free Foods

The four Derbyshire CCGs have made the decision to decommission the prescribing of gluten free foods. From May 31, 2018, the Amber Valley Community Pharmacy Gluten Free Food Scheme provided by community pharmacy services will end and gluten-free foods will no longer be available on NHS prescription. This decision affects all patients in Derbyshire.

Gluten-free foods are widely available in shops and supermarkets. Support can be obtained from Coeliac UK (0333 332 2033 or coeliac.org.uk) or if you have any questions, contact Patient Advice & Liaison Service PALS (0800 032 32 35).

Newsletter Future

Dr Wong writes the patient newsletter for the benefit of all patients, all in his own time. As the newsletter enters its 16th year, the job doesn’t get any easier. In fact, it would be safe to say it is becoming more difficult, given the pressures of work and the need to balance home life.

We send out hundreds by email and print out many more hundreds of copies, all of which are consumed, however, it would be good to hear some feedback or ideas about the newsletter, that may help to inform us on the its future or its content. Do you enjoy the newsletter? Does it just go in the bin? Do you keep the leaflets for reference? Should we continue publishing it? Please do let us know at ivy.gs/contact. We would love to hear from you.

Stroke Act FAST Poster

Information poster from the Stroke Association on the Stroke Act FAST campaign. See image marked 'page 5' at top of page or download as a PDF This is a PDF download.

Where to get help for your condition leaflet

Information leaflet on where to get help for your condition. See images marked 'page 7' to 'page 10' at top of page or download as a PDF This is a PDF download.

The included leaflets are © Dr M Wong 2016-18 and may not be reproduced without permission.