August 17, 2020

Dear Patients

This is an update from our last news update of July.

NOT BACK TO 'NORMAL' ANY TIME SOON

The country, along with many others in Europe and beyond, remains in a precarious state with ongoing and significant levels of infection as restrictions are being eased or tightened accordingly in various areas (mostly tightened).

The global pandemic is continuing and will not be over for a significant length of time yet.

We ourselves are in the process of making the surgery more 'covid-secure', however, along with many other practices, we are now having to bid for monies in order to fund the necessary changes that need to be put in place.

For the latest information on coronavirus and answers to any questions you may have about it, please visit:

WORKING UNDER DIFFICULT CIRCUMSTANCES

We do know many of you do appreciate everything we are trying to do for you during these difficult times, and this is witnessed by some of the comments we have received regarding our service:

I've just spoken to Mrs A and she wanted to pass on her thanks to everyone at the surgery for doing a great job. She feels we are all doing a great job and thanked everyone including clinicians, reception and admin staff

I have just spoken to Mrs B, who says she wants to thank everyone at the surgery for doing a marvellous job, she says 'the whole set up is just wonderful.'

Patient phoned to thank you for yesterday. It wasn't a heart attack. He was in hospital until very late at night. They did various checks which they will send through

Just to say thank you for all the information sent to all Ivy Grove patients. I firstly received the text, then went to the website to read the information. Very informative and a lot of hard work has been put in to achieve all this. Being 70, I like many others are being very diligent during these awful times. Have been with the surgery for a long time but do not have to visit too frequently but I have always been treated well. I now visit QMC more than the surgery and this was due to one of the GP's picking up a problem which could have been easily missed. I do have a lot to say thank you for to all staff

Hi all, patient wanted to say 'Thank you for the wonderful service'

However, we are also aware that a small but significant minority of patients have questioned our response to coronavirus, have been rude and abusive to our staff, and reported that we have not been open, and that we have not made any efforts to keep them informed. Keeping our patients up to date with everything that is happening is one of the things that we at Ivy Grove have always taken great pride in and to hear this is very disheartening.

We therefore thought it would be interesting to try and quantify some of the clinical work that we have been doing, as to us, it feels like we have never been busier, with scarcely time to have a drink or a loo break. Our findings are below, which should be taken into context of all the other work that we have also been doing, which we highlighted in the last news update:

WHAT WE'VE ACTUALLY DONE DURING LOCKDOWN

These figures relate to March 12, 2020 (the first day we changed our appointment system over) through to August 11, 2020, representing a total of five months' work.

Cancer cases referred	167
Entries made into computer system (e.g., records upkeep, consultations, filing	19,289
High risk patients for coronavirus identified	421
Home visits made by doctors (e.g., end-of-life care)	49
Home visits made by nurses (e.g., INR)	55
Medications issued	80,605 (7,591 acute and 73,014 repeats)
Medication requests dealt with	25,741 (4,824 via online, 20,917 direct)
Pathology results actioned and filed	3,972
Coronavirus symptom screenings performed	9,819 (353 suspected cases, 43 confirmed, some deaths)
Coronavirus tests done	446
Patients signposted to other appropriate services	186
Face-to-face appointments with doctor	518
Face-to-face appointments with nurse (e.g., injections, smears)	1,212
Telephone appointments with doctor	9,301
Telephone appointments with nurse	1,164
Telephone calls received into building	33,022
Telephone calls made out of building	22,627
Wasted encounters (e.g., missed calls or appointments)	623
Total appointments made of all types	11,436

It should be noted that each appointment now takes significantly longer than appointments before coronavirus because of time taken to put on or take off PPE, time spent cleaning between patients, time taken to set up photos or video chat with patients, relatives or their carers, time taken to email documents and paperwork through to patients, time spent dealing with complex cases remotely. Because of all this, and the numbers we are now having to deal with, the workload is relentless.

We are facing continued pressure from authorities to resume face-to-face working on top of what we are already doing with remote working, and like many GP surgeries, we do not feel that this is either appropriate, necessary or safe to do so. We feel that it is like asking all the shops, restaurants and attractions to start packing people in back to 100% capacity, plus carry on with all the new remote/takeaway/online initiatives they started for coronavirus, whilst asking them to still keep everyone safe. We feel it simply is not possible.

ECONSULT ONLINE CONSULTATION SERVICE

The current model of providing service with escalating numbers of calls and longer waits for patients is not going to be viable in the long-term. Therefore, in order to try and maintain a safe, sustainable and secure service that will not grind our staff and doctors into the ground, we will soon be launching the eConsult service. This is a service that is already being used in over 3,000 practices and its use has been fully endorsed by NHS England and the Health Minister. In fact, using an online consultation service is actually a new contractual requirement for all GP surgeries.

The benefits of the system will hopefully include: improved timely access to our services, improved patient experience, avoidance of full (and potentially unsafe) waiting rooms, enhanced patient convenience, maintained quality of care, empowered patients who know how to self-care, more efficient working, and happier staff who can manage workload levels.

We have set up a new page providing more information on the service which you can access below, along with a demo of the service and a useful information video.

HELP IS ALWAYS AVAILABLE

In preparation for this new way of working, which will result in patients starting to take more responsibility for their own health and conditions, and which will increase patients' confidence levels in seeking the most appropriate source of help, we strongly encourage all patients to start using our existing resources so that they can familiarise themselves with what help is available out there:

FACE COVERINGS MANDATORY IN GP SURGERIES

Government guidance was recently updated on August 7, 2020 to include GP surgeries as places where face coverings must be worn:

Face coverings are needed in NHS settings, including hospitals and primary or community care settings, such as GP surgeries.

We have a responsibility to protect our staff and other patients, therefore, if a patient refuses to wear a face covering whilst inside the practice, without good reason, the practice reserves the right to choose to provide services to that patient by means other than a face-to-face consultation. This position is fully supported by Derbyshire LMC and the BMA.

If you have been specifically invited to come to the surgery, the procedure for attending a face-to-face appointment (with a face covering, of course) is outlined here:

Just a reminder that we will not issue GP letters to exempt any patient from wearing a face covering. Self-declarations are sufficient if wished and details and download links can be found here:

BOOTS CHEMIST, CHURCH FARM

Boots Chemist, Church Farm branch has now closed. If you had this chemist as your nominated chemist, then you will need to let us know which new chemist you now wish your repeat prescriptions to be sent to. We have been advised not to automatically transfer nominations for you, as it must remain your own choice.

Please look out for our patient survey on provision of chemist services in due course.

FLU CLINIC - SAVE THE DATES!

We have now set dates for our flu clinics, so please save the dates in your diaries. These are:

• Saturday September 26, 2020 - clinic for over 65s
• Saturday October 10, 2020 - for under 65s/catch-up
• Monday October 5 to Friday October 9, 2020 - flu awareness week for jabs in nurse clinics

Please visit our flu page for more information on eligibility. It would also be a good time to mention our winter self-care page given that the season will soon be with us.

BLOOD PRESSURE MONITORS

We are actively encouraging all patients with heart disease, previous stroke, long-term kidney disease, and of course, those with high blood pressure, to invest in their future health and buy a blood pressure (BP) monitor. These are now very accurate, and relatively inexpensive and we feel a small price to pay for enabling you all to keep safe in the current situation by allowing you to measure your own BP in the comfort of your own home and reporting the readings back to us.

Please see this page for details of recommended BP monitors:

MONITORING RECALL

We are starting to invite more patients who are overdue for monitoring for their medications and/or conditions. Where possible, we will email the required request forms to you to print out yourself and for you to then book your own appointment for your blood test. It is therefore important that we have up to date email addresses for yourself, or a relative/friend who can accept and print forms and book online on your behalf.

Blood tests for monitoring are being carried out at local community hospitals, but appointments need to be booked before attending. As with all health settings, you must wear a face covering and you must bring your paper form with you. Please see the link below to find out how to book your blood test.

You may also receive texts about your condition which require a response back to us. We should be grateful for your co-operation in this, as it will help us to monitor your condition and determine if you need any help or support from us.

WEBSITE UPDATES

We continue to update the website with the latest information and videos.

Please watch the latest videos we have posted:

Everyone's mental health and wellbeing remains at risk during this whole crisis. Our mental health section has been updated with new information and we urge all patients who may need support to check the resources available:

FINALLY...

Do you want to keep receiving these updates? If so, please let us know. It can be quite difficult to know how well things are being received, when we are all working in our own little silos, in a bigger socially-distanced world, so some feedback would be gratefully appreciated.

Please keep safe, and think about and protect others. And do try and look after yourselves in these trying times.

Kind regards

Ivy Grove Surgery

Written by Dr M. Wong