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Top Tips on Using Our Service > ivy.gs/toptips

Ivy Grove Surgery : Top Tips

Top Tips on using our service

Make the Most of your GP

Did you know...? snippets


GENERAL PRACTICE IS IN CRISIS - PLEASE USE RESPONSIBLY!

It will not have escaped your notice that appointment waiting times are increasing. There are simply not enough GPs as existing GPs retire, resign and emigrate and those who leave are not being replaced. This is due to a variety of reasons, not least of which is deliberate and chronic underfunding by successive governments. The crisis is affecting the whole GP service throughout the UK.

We want to provide you with a quality service, however, we do need your help to do this. These pages are here to help you make the most effective use of our services.

Getting the best from our service

Some of this information may have been provided previously in the form of our regular newsletter, Ivy Grove News, which is available to download or read online.

Find out how to get the best help for your condition (not always your GP!)

Check your symptoms so that you know who to turn to first for help

Find out how to make the best out of your GP when you do see them

How to tell if your child is poorly and what to do about it

Request home visits appropriately (only for the most severely ill and bedbound)

Please present only one problem at a time to reduce the risk of mistakes being made

Go to the Minor Injuries Unit if your condition is better dealt with by them

Do more online, like request prescriptions and book appointments

Read more about the national crisis in General Practice

We will update this page regularly with more top tips.

'Day in the Life' newsletter articles

Day in the Life of a GP - part 1 of a series

Contrary to what you read in some tabloids, an everyday GP does not work 9 to 5 with a good dose of golf in the middle of the day! Here we start a new series having a brief look at the working lives of some of the practice staff. For this first episode, we look at a typical day for a GP at Ivy Grove.

Arrive at 8.00am. Deal with half a dozen urgent prescription queries and look at about a dozen hospital discharge letters requiring action. Start morning surgery at 8.30am with face to face appointments followed by ringing patients on a telephone list. Sign prescriptions and a short break at 10.30am. Continue seeing patients face to face till 12.00pm.

Meet with colleagues again at around 12.30pm and discuss clinical cases, significant events and chat about the morning. Perhaps eat a packed lunch if didn't forget to bring it! Discuss and share out the visiting workload.

Visit anything from 2 to 4 patients from about 1.00pm. Get back to surgery at around 2.00 to 2.30pm. Deal with 30 to 40 clinic letters, ensuring information is added correctly to the system, respond to about a dozen electronic notes for action, review about 30 to 40 blood results. Ring GP and hospital colleagues for advice on a few patients. Dictate letters. Catch up on reading of clinical journals and reply to emails.

Start evening surgery at 3.30pm by ringing more patients then face to face appointments after that. Finish surgery at 6.00pm if running right on time.

Dictate a couple of letters and finish off the day's work. If all goes well, leave surgery at 6.30pm. If a last minute emergency comes in, home time could well be 9.00pm.

The above does not include running late because of having to admit a poorly patient to hospital, emergencies cropping up throughout the day, abnormal blood results being rung through and needing action, fitting in required clinical meetings at lunchtime, preparing for an annual appraisal, keeping up to date and any of the other 1,001 things that a GP must do. As you can see, no time for golf at any point!

Day in the Life of a Practice Nurse - part 2 of a series

No two days are the same; but the variety of patient's conditions, ages and personalities make our job interesting. Some days can be more hectic than others, but we are never short of things to keep us busy.

A typical day starts when we arrive at around 8.15am to log onto the patient system, check the immunisation fridge temperatures, clean the ear irrigation machine and check equipment stock. Morning surgery starts at 8.30am with patients being able to see us for wound care/suture removal, ear irrigation, travel immunisations and advice, smear tests, blood pressure checks, health checks, family planning, warfarin management, vitamin and other injections. In between seeing patients we may be attending to requests from GPs for chaperones, taking a heart tracing or attending to wound care. From reception, we also have requests for queries and advice, urine samples to dip, travel forms to assess and results to deal with.

Lunch at 12noon (if morning surgery not overrun) will be spent with colleagues giving the opportunity to discuss any issues that have arisen during the morning. We also hold nurse/clinical meetings in our lunch break. In order to maintain our nursing registration, we have to provide evidence of our continuing professional development, which usually means keeping up to date with current policies and guidelines, reading relevant journals all of which is time consuming, so we use any spare time for this.

Afternoon surgery restarts at 1.00pm. As well as general nurse appointments as in the mornings, afternoons also tend to be when we have appointments for patients to be seen with chronic diseases such as diabetes and COPD/spirometry (we do of course accommodate for patients who cannot get to set clinic appointments due to work or other commitments). We will usually have finished seeing patients by 6.00pm, the last half an hour or so being used to tidy up our rooms, finish any paperwork and deal with any questions/queries before logging off the computer for the day….. all ready to start afresh the next day!!

Day in the Life of a Practice Manager - part 3 of a series

My day normally starts at 7.30am when I leave home for my one hour commute to work. On my way to work I stop to collect milk for the practice so everybody can have a cuppa at work.

8.15 – I arrive a little earlier today as the school children are off school on their summer holidays and the traffic is lighter – hooray! I check in on reception first to ensure that all is well and there are no immediate problems which need my attention.

I start off my morning by checking my emails, only 29 to deal with this morning – I work through them, respond to a couple of easy ones and flag those I need to action so that I don't lose them later in the raft of others than come in throughout the day. I also review the list of tasks I need to do today.

9.00 – I receive a telephone call from a locum agency to say that the doctor we had booked for next week is no longer available – they made a mistake with their annual leave dates. So it is back to the drawing board and I spend the next half an hour emailing around the various locums and calling the locum agencies to see if we can find a replacement at such short notice – it's not looking good!

9.30 – I make a cup of coffee and start going through my post and the 20 new emails which have arrived in my inbox since this morning.

10.00 – Reception call to say the patient booking in system is not working properly – I am on the phone to the clinical system providers for the next 40 minutes while they try everything they can think of to get it working again including getting me to sit in the waiting room and watch the screen for any signs of life – nothing happens and they decide they need to send an engineer out.

The receptionist on the front desk is overjoyed at having 8 GPs and 4 nurses buzzing her by telephone every couple of minutes to send down their next patient, whilst also trying to book appointments; print out repeat prescription request forms; take in, stamp and check repeat prescriptions and hospital discharge summaries and hand out prescriptions to the patients presenting at the desk. The receptionists in the back office are all busy on the telephones so I stay at the front desk to help out.

11.00 - the accountant calls to go over the queries he sent to me last week. We manage to resolve most of them but as the accountant has all the paperwork for last year's accounts at their office in Sheffield, I ask them to fax over some documents so I have a clearer picture on which to make a decision.

So far I have not managed to complete any of the tasks on my list.

12.00 – I email back responses to most of the accountant's queries but there are some Janette needs to look through when she gets a minute and I leave these to meet with the electrician who has come to give me a quote for the work we need to carry out in the admin office. The work will need to be scheduled on a weekend so staff and patients are not disrupted. I give him a date for the work to be done so I can tie it in with the work the heating engineers have to carry out. Hopefully this will mean I will only need to spend 1 weekend at the surgery rather than 2.

12.30 – I receive a telephone call from our Flu vaccine supplier to say that our vaccine delivery will be delayed due to a manufacturing problem. At the moment they think it will only be a one week delay – now due to arrive at the beginning of October. Luckily we have not planned our first flu clinic until 19th October but it does mean that our home visit plans will need to be changed. I review the nurses working schedules to see when this can be pulled in.

12.45 – I start to deal with some of my emails – one is from NHS England requesting data on the enhanced services they commission from us. I run a search on the clinical system to gather the data on what procedures we have completed in the last month, log in on line to the new reporting system and enter our details. Because of the changes to the local organisations since April, we now have to do this for three separate organisations every month instead of the previous one.

The doctors come up to the staff room to have a coffee at the end of morning surgery and sign the 200+ prescriptions produced that morning by the prescription clerk. I take the opportunity to ask them to sign a few documents and chat with them about any last minute items they might have for the business meeting planned for the following Wednesday evening.

13.30 – I make another cup of coffee, grab my sandwich and head into the Safeguarding Families/Clinical Meeting. There is a lot on the agenda today. The Health Visitors give an update of the families on their safeguarding register; one of the practice nurses gives an update on the recent changes within Family Planning and a presents the latest guidance on Infection Control. Two of the GPs present significant events, and the group agrees on the changes we need to make in practice to ensure non recurrence of these events. Changes to the way the practices confirms consent from patients for release of information to third parties is also agreed and I add the production of the form to my new tasks list.

15.00 – We leave the meeting and the GPs head off to see the patients requesting home visits, the nurses return to start their afternoon clinics and I go back to my office and the 11 new emails which have come in since lunchtime. I start to work through the emails I flagged this morning as needing action and prioritise those which need to be actioned today.

I start reading through the agenda and papers for the Amber Valley & South Dales Practice Managers Meeting planned for tomorrow, which Ivy Grove Surgery hosts each month, and the agenda and papers for the Primary Care Development Meeting I am due to attend the day after that.

15.15 – A receptionist calls to say the light in one of the patient toilets is not working. I go down stairs to check. I get the stepladder and a new bulb from the store room and change the bulb. This does not resolve the problem, so the receptionist logs a call to the estates department, gets a job number and puts an "out of order" sign on the door.

15.30 - I start on my list of tasks. The premises insurance is due for renewal within the next few weeks so I email the companies I contacted last year and request updated quotes.

Reception inform me that the Duty Doctor has just been called out on an urgent visit and will not be back in time to start her afternoon surgery at 4pm. The receptionist at the front desk informs her patients as they arrive and give them the option of waiting for her to return or rebooking for another day.

16.00 – one of the nurses comes to see me about the training course she is due to attend in a few weeks time. She has just completed the degree module in Family Planning and we have asked her to undertake training to insert coils and implants so we can offer an advanced Family Planning service to our female patients. All of the nurses have recently undertaken specialist training in a variety of chronic disease areas, including Asthma, COPD and Diabetes.

16.30 – I have a staff appraisal scheduled for tomorrow morning so I go over the pre-appraisal questionnaire the staff member has completed and make a few more notes of the things I want to discuss with her. I review the online training she has completed so far this year and consider the areas for development she has highlighted for the coming year.

17.00 – I go back to the emails I highlighted for 'action' this morning and work through a few more. I have already received responses from some to the insurance companies and I have a quick look through the quotes. I set up a new task for myself to produce a spreadsheet so I can clearly compare the quotes as I receive them.

17.30 - My computer alarm goes off reminding me to put the boiler on for the Patient Group meeting taking place in an hour. I set up the boiler and the drinks station for the meeting and go back to my office to finish off my emails and any tasks I can manage before the meeting starts. Unfortunately, to complete some to the tasks I need speak to a number of people by telephone but it is too late to catch them now. I will try again tomorrow.

18.30 – I go downstairs to join the patient group meeting in the health promotion room. Dr Wong has not finished surgery yet – he still has 1 patient left to see so he will be late joining the meeting.

The meeting goes really well. The group has found a dynamic trio to lead them. They seem committed to developing the patient group into a useful tool for the patients to have input into the development of services within the practice. I am looking forward to working with them.

The meeting finishes at 19.30 and I set off for home – but first I amend the date of the next patient group meeting on the patient messaging and the patient booking in system. If I leave it until tomorrow I will undoubtedly forget to do it!

Day in the Life of a Health Visitor - part 4 of a series

Health Visitors are all qualified nurses with additional training in public health and child development. Many Health Visitors have also previously worked as midwives or in other areas of the NHS and have a wide variety of skills and experience.

In Ripley, the Health Visitors work in teams covering a defined area and are supported by a Community Nursery Nurse and an administrator. The Health Visitors work closely with the doctor's surgery and all other professionals that support families.

Every child is allocated a Health Visitor from birth until they start full time education when the School Nurse takes over. This is often referred to as the 'Universal Health Visiting Service'.

Universal Health Visiting Service offered to all families

The Health Visiting team also offers additional support to families, for example, advice about minor ailments, immunisations, healthy eating, sleep, behaviour, routines, toileting, child development, breastfeeding and postnatal depression. The Health Visiting team are also able to signpost or refer families to specific services as identified, for example, the local Children Centre, Welfare Rights, support groups, smoking cessation and housing etc.

A Health Visitors day is extremely varied and no two days are alike. Most Health Visitors arrive early for work in order to plan their day, check emails, to catch up on telephone calls and paper work and to complete their electronic records.

Once a week the whole team meet up to allocate the teams work, review caseloads and to undertake team reflection regarding current research, training and workload planning.

The day is then taken up by a variety of home visits, meetings with both families and professionals, Child Health Clinics, development reviews, liaison with GPs, midwives, Children Centres, social workers, hospitals, nurseries etc alongside supporting students, attending training and drop in sessions. Health Visitors are actively involved in policy and service development and may represent the organisation at a variety of meetings across a wide area. When we do finally return to the office there are usually calls from families to return, record keeping and paperwork to complete. Despite this busy pace Health Visitors are committed to improving services and outcomes for children and families. It is now widely recognised that providing support in the antenatal period and into the early years of a child's life can have a significant impact on the long term health and wellbeing of that individual.

If you would like to discuss any aspect of your child's health or development or have any further questions in relation to this article please do not hesitate to contact one of the Ripley Health Visiting team on:

Church Farm Primary Care Centre
01773 514129 / 01773 514148
Gill Jablonski, Caz Mattocks, Elaine Offler, Angela Litchfield,
Emma Waterhouse, Stephanie Watson-Clay

Ripley Hospital
01773 571425
Jan Rayner & Amanda Donnelly

Day in the Life of the Admin Department - part 5 of a series

We are the secretaries and administrative staff for the surgery and are based in a busy department hidden away at the top of the building, in an office just down the corridor from the management team. Our day starts at around 8.30am, the first job of the day in the summer is to throw all of the windows open as we have the warmest room in the building. The surgery receives correspondence which comes in a variety of mediums from traditional paper to high tech electronic versions of letters from consultants which are received via an electronic link with the Derby Hospitals. This all has to be sorted and processed and directed to the relevant GP or Nurse.

When patients see the GP at the surgery the GP might refer patients to specialist departments at the hospital or write to consultants to seek advice as to how to manage or treat a patient's condition. This involves the Doctor dictating a letter which the secretaries in the team type up and either create the paperwork needed to arrange a hospital appointment via the Choose and Book system or send letters direct to the consultants. The consultants then provide advice back to the surgery or write to patients to offer appointments.

The GPs receive numerous requests for information from individual patient's medical records which can be anything from filling out a holiday cancellation medical certificate, to producing a report based on the patient's entire record usually requested by insurance companies. All of this information can only be shared with the patient's consent. The admin department deals with the chasing of consent, agreement of fees and typing up the completed reports.

Throughout the day we also deal with internal messages from anyone who works in the practice asking us to chase queries. These queries can sometimes be answered by one simple telephone call or can become quite time consuming and very often we have to use your detective skills as we usually have very little information to go on. The majority of these are medication or prescribing queries which are raised from hospital discharge paperwork or letters received from the hospital. Other queries involve chasing up clinic letters or outpatient appointments. We do not have any hotline to the hospital or special method to do this and we have often found that patients will have as much success in calling the hospital themselves.

When a patient registers with the practice we receive a copy of their records via the Health Authority, this comes in a paper wallet. After the notes have been checked and all of the relevant information about past or current conditions extracted, this information is added to the patient's computer record by the admin staff. We call this coding or adding a problem title. We do a lot of coding! When the GP's have read all of the many hundreds of letters they receive every week, we attach a problem code to the letter which we will have already scanned into the computer records. This highlights in the records all the information relating to specific problems, so that searches can be carried out on the computer system to invite patients who may require certain annual blood tests, flu vaccinations or condition monitoring. We deal with all of these vital invitations.

We also have many, many other tasks which take place in our office but the ones mentioned are the ones which keep us busy for most of our time. Our day should end at around 4.30pm when one of us has to go round and close all of the windows again ready for tomorrow!

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