Latest News Update 18.6
September 23, 2020
Dear Patients
This is an update from our last news update of August. This is a long update this month, so please bear with us.
Socially distanced waiting room
PANDEMIC REMAINS A SERIOUS THREAT
As the UK's covid alert level is raised to 4, the coronavirus pandemic remains a significant threat, with cases in the UK rising sharply, along with those in other countries all around the world.
It appears that the country has relaxed too much, and allowed the virus to resurge in all age groups but especially in the young, according to the latest figures. Whilst this cohort is less likely to become seriously ill or need admission, it has been shown (as in Spain and Italy) that such an increase in cases is then followed by higher numbers of infections in other groups of the population, such as the elderly and more vulnerable, with consequent increases in hospital admissions and deaths.
Given that the last global pandemic lasted over two years, we must remain vigilant and try not to trivialise the situation we are all being faced with at this time.
We all have a responsibility to those around us, especially those more vulnerable than ourselves, and therefore we urge all our patients to continue to follow the guidance in preventing spread of coronavirus:
- Strict hand hygiene
- Face coverings
- Social distancing
- Follow rules on gatherings
- Get tested if symptoms
- Self-isolation if poorly
We would like to extend the above by politely asking patients that if they cannot get through on the phone, that they do not turn up unannounced at the surgery as you might be putting yourself and others at risk.
For the latest information on coronavirus and answers to any questions you may have about it, please visit:
DOORS LOCKED BUT DEFINITELY OPEN!
The phones are horrendously busy
We respond to increasingly hostile media regarding GPs being shut and doing nothing much, when ironically, we have never been busier!
THE 'PATIENT' PATIENT
On 23rd March 2020 the Covid-19 situation affecting the UK forced the government to act and the country went into lockdown. Shops, restaurants and most offices and industry stopped. However, the keyworkers, which includes staff working in general practice, did not stop; they have been there day in day out, dealing with patient enquiries, booking appointments, talking to, advising, seeing and referring patients when necessary.
At the start, people across the country showed their appreciation to the NHS for their continued commitment to keeping patients safe and providing treatment to those who needed it, by clapping on Thursday evenings and drawing and displaying rainbows. But oh! how things change in a few short months!
Instead we now witness the media and the general population on social media condemning surgeries for being closed, that they can’t get though on the phone, that they cannot see their GP, that people who need it are not being referred, and that the GPs are doing very little.
So on behalf on Ivy Grove Surgery, I would like to put the record straight. WE ARE OPEN AND WE HAVE ALWAYS BEEN OPEN!
Our doors may be locked for the health and safety of our staff and other patients, but we continue to provide health care to our patients as and when appropriate, just in a different way.
Yes, the way we manage appointments is different. This crisis (which is still at large by the way – it has not gone away) has proven a number of things:
- The majority of issues people want an appointment for can be managed by telephone. However where they cannot, the GP will arrange to see you face to face if they feel your condition requires it. This is a clinical decision, made by the GP, after a discussion with you via a telephone or a video consultation
- Many requests for appointments could be managed with self-care, or by a pharmacist. For example, GPs cannot do anything more than direct patients with a verruca to the chemist to buy something over the counter, this condition does not require a GP appointment; most sore throats and runny noses will get better on their own, given a bit of time; hayfever medication can be bought very cheaply in supermarkets.
All these minor, self-limiting illnesses do not need a GP appointment. Booking appointments for conditions like these can, for instance, prevent the patient with an exacerbation of their asthma from getting an appointment and the help they need. We have developed SO MUCH information on our website to assist patients to self-treat, please take the time to have a look ivy.gs/selfcare ivy.gs/symptoms ivy.gs/team ivy.gs/winter - Despite what you may think, many telephone consultations can take twice as long as a face to face consultation used to take. This results in fewer appointments being available in general. Its simple maths really. If pre-Covid, an appointment took 10 minutes, then a GP could see 6 patients per hour. It now takes 15 – 20 minutes so in one hour the GP can only deal with 3-4 patients. They are still working 11-12 hour days, it is just that the capacity is reduced
- To see a face-to-face patient takes even longer. For each patient the GP sees they have to put on and take off PPE (personal protective equipment); clean the seat the patient used; the desk where the patient might have touched; the door handle; the couch if an examination was required, etc. This all takes a considerable amount of time, and for each face-to-face patient they need to see, this again reduces the amount of time they have to deal with the telephone calls
- The receptionist is not just being nosey when they ask you all those questions. The reception ‘script’ is very important and is devised by the GPs. It allows the receptionist to ensure that emergency calls are dealt with immediately. You would be amazed how many patients call the practice saying they think they are having a heart attack or think their partner/family member may have just had a stroke. These patients are immediately told to call 999 for an ambulance. There is very little a GP can do to help these patients, they need appropriate emergency help without delay ivy.gs/team
- The reception script allows for information given by the patient to be recorded on the appointment request, so the GPs can determine who has the greatest/most urgent need. For example a patient might call at 9am requesting an appointment for back pain, then at 9.20am a mother calls for an appointment for her small child who is lethargic. The GPs will give higher priority to the poorly child over the patient with back pain despite the other call being placed earlier
- Because more things are being managed over the phone the phone lines are even busier than before. Ivy Grove has 16 lines in and out of the practice. These are used by the GPs for their telephone consultations, receptions taking calls from patients, wanting to book an appointment; change their address; register as a new patient, the admin team calling patients to advise them the GP wants to arrange a repeat blood test, the medical secretaries calling hospitals chasing information on patients. So next time you hear the engaged tone or you are in a queue, just bear this in mind, it is not that we are not answering the telephones it is that all the lines are busy or all the staff is already dealing with other patients. If you are interested in the statistics, again there are loads to read on our website last news update
- Just turning up at the surgery is not appropriate, please DO NOT come to the surgery unless you have a booked appointment or have been told to come by a GP, Nurse or a member of Ivy Grove staff. Every time a receptionist has to go to the front door, they are not answering the telephone
So I would ask patients to bear all this in mind and be a little more patient and tolerant next time they try to get through to the surgery.
It is so demoralising for staff, who have been in work and working exceptionally hard throughout this entire period, to hear and see the hurtful and sometimes demeaning comments, made by some patients on the phones and on social media. Working in general practice is incredibly hard even without all the issues of dealing with Covid on top, and I feel the staff at ivy Grove Surgery have done and are still doing a sterling job.
So from now on, if you hear somebody saying the GPs are closed and they not seeing anybody, you can put them right!
Thank you and look after yourself.
The Practice Manager
LONG COVID (POST-COVID SYMPTOMS)
Whilst the young are less likely to be seriously affected by coronavirus or need hospital admission, patients of all ages who have had coronavirus infection are at risk of an emerging condition which has been called 'Long Covid' (or post-acute covid-19).
This condition, which has already affected hundreds of thousands of people in the UK, is characterised by symptoms of severe fatigue, along with a wide range of other symptoms including cough, breathlessness, general aches, chest tightness, skin rashes, palpitations, fever, headache, diarrhoea, and pins and needles. These symptoms can come and go for weeks or months.
Again, this is another reason why we should not be complacent about coronavirus, and we need to treat it as the serious condition that it is and do all we can to avoid getting it in the first place and avoid spreading it to others if we do get it.
We have set up a collection of links and documents on our General Practice 2.0 page to help support patients who might have contracted coronavirus and be in this situation:
"IT'S NOT COVID" - "OH, YES IT IS"
Quite frequently we hear the phrase: "it's not covid, doctor, I just know", when advising patients who have a temperature, plus possibly respiratory symptoms such as a cough or shortness of breath.
Whilst in some cases, there might be an obvious unrelated cause for a high temperature (such as a skin infection), the situation remains that any high temperature, any new persistent cough (and any loss of sense of smell or taste) remain definite criteria for suspected coronavirus, and therefore will require testing and self-isolation, regardless of the cause.
We know that getting a test is challenging at the current time, but testing remains necessary as part of the system of controlling the virus in the country. Everyone has a duty to protect others and be responsible.
until proven otherwise through testing
TESTING TIMES FOR EVERYONE
Talking about testing, we do realise many patients are having difficulties in arranging a test when they have symptoms.
Unfortunately, we have absolutely no influence to exert on the testing system, we have no access to testing, and we cannot request tests for patients.
Therefore, we kindly ask that patients do not ring us up or turn up at the desk asking for covid tests.
All we can say is to urge patients to keep trying to book a test using the online service.
THANK YOU FOR THE POSITIVE FEEDBACK
Many thanks for all those of you who very kindly took the time to comment on our news updates. As you know these are currently replacing our newsletter Ivy Grove News, given that during this very difficult time period, we have been dedicating most of our efforts towards maintaining essential services for patients. We are very grateful for the positive feedback and would like to share some of the comments we have received about the news updates below:
Please keep this service going. I do need to understand and work with the "new normal". Communication is so important. Thank you to you all for everything that you are doing. - J.B.
Thank you for the updated information about the Surgery. - R.E.
Please continue the updates, we find them very helpful indeed and are thankful for all the time and effort the doctors are putting in to keep us updated. - M.B.
Thank you all for the update emails and would be grateful if you could continue,I find them very useful and am very happy with the new way you’re working.Keep safe and thanks again - M.B. [a different one!]
I have found the news update very informative and helpful. Please continue to send these. I want to add that i have received excellent service from Ivy Grove throughout the current pandemic, albeit in a different way via phone consultations. I can't fault you all - your hardwork is appreciated very much at this difficult time. Thank you. - K.D.
I would appreciate receiving further updates thank you - E.B.
Just to confirm that I do wish to continue to receive the newsletter. It is pitched about right and contains essential information. Thank you for taking the time to produce this. It is read thoroughly and its messages noted. Please don't stop compiling this. - K.A.
We will be continuing with these updates for as long as necessary to keep our patients informed about what is happening at the surgery and around.
PATIENTS EMBRACING ONLINE INITIATIVES
It is now our turn to give thanks - we have been mightily impressed with the significant numbers of patients, especially those in the, shall we say, more mature age range, who are readily embracing technology, with messaging us, sending through photos using their smartphones, setting up brand new email addresses and completing online forms, all with relative ease.
With coronavirus, remote consulting is widespread amongst many NHS organisations and we do not see it disappearing any time soon, even after the pandemic is over. There will be increased use of IT and technological based solutions in health care systems with time, so it is now a good opportunity to start to be involved with it.
We appreciate there will always be some patients who have difficulties with IT, or some that refuse to engage with it, but by and large, the vast majority of the patients we have had interactions with have taken to remote consulting without complaint.
We remind all patients that first and foremost, remote consulting is here to keep everyone safe, and not as a barrier to accessing our services.
ECONSULT SOFT LAUNCH SEPTEMBER 23, 2020
ECONSULT FULL LAUNCH OCTOBER 7, 2020
From September 23, 2020, we will switch on eConsult and encourage our patients to start using it when requesting an appointment with the GP. After this short introductory period, from October 7, 2020, all requests for a GP appointment will need to be made using eConsult.
We strongly encourage all patients to start familiarising themselves with this service:
We realise this is a huge change for everyone, therefore Janette, our admin lead on eConsult, writes more about the service:
A NEW WAY OF ACCESSING OUR SERVICES
To enable us to manage the care of our patients safely, we need your help. From September 23, 2020, we will be using online consultations (known as eConsult) as the main way of accessing our services. We experience a high volume of phone calls on a daily basis and we appreciate that this can make it difficult for many of you to get through. eConsult will help to improve accessibility to the practice as well as bringing many other benefits.
eConsult enables you to contact a GP over the internet via computer, tablet or from a smartphone. It is accessed via our website or via the NHS app.
This service is available 24 hours a day Monday and Friday so you can submit your request at a day or time that suits you rather than waiting for our phone lines to open. eConsult improves our efficiency by asking you questions that we would ask about your condition so that we have as much information as possible in advance.
It has safety mechanisms built in so that if your answers suggest a more serious or life-threatening problem you will be advised on how to seek urgent help. It may also direct you to services outside the practice like a pharmacy, physiotherapy or talking therapies and also make self-help suggestions. You will even have the option to add up to four photos on most online requests. ivy.gs/selfcare ivy.gs/covid-selfcare ivy.gs/team
At the practice, the eConsult will be reviewed by a GP and we will then provide you with advice, arrange a telephone or video consultation or arrange a face-to-face appointment, as we feel clinically necessary. We will respond to you the same day for eConsults submitted by 2pm, and as soon as we can, but by the end of the next working day at the very latest for those submitted after 2pm. eConsult can also be used for follow-ups of a pre-existing problem. All administrative queries, like requests for a sick note or letter, should be submitted via eConsult too.
We recognise that some people will not be able to use this system and we will provide assistance to these patients; for these instances our reception staff will go through the online consultation with that person instead over the telephone. This will take more time than in the past, but ensures a consistent and fair approach for all our patients. These telephone contacts will be dealt with in exactly the same way as eConsults and will not be given priority. It is important that everyone who is able to use eConsult does so.
Repeat Prescriptions
eConsult is NOT to be used for ordering routine prescriptions, as we have other online ways of ordering a prescription that will continue. Please visit our website for further information on online prescriptions or try the NHS app. ivy.gs/online
Thank you for your help with this new initiative.
The Deputy Practice Manager
FLU VACCINATION
We can safely say that there has been absolutely HUGE interest in flu vaccination this year!
Please visit our flu page for information on flu clinic dates, step-by-step procedure for flu clinic day, additional session available and eligibility criteria.
We now have all our flu vaccinations in stock (over 65s jab, under 65s jab, nasal flu). Therefore please now actively book for your flu vaccination, or if you are attending a planned face-to-face appointment, ask your clinician for your jab there and then when you see them.
Some of you will know that we have been actively taking bookings the last few weeks.
We do realise that our phone lines are extremely busy and are aware that some people have had to ring back multiple times to get through to us. As well as having to deal with the ongoing clinical work that clearly still exists, we have been working flat out to accommodate you all in our various flu clinics and sessions, so we thank everyone for their patience in bearing with us.
Mindful of the coronavirus pandemic and the need to maintain safety, we would like to remind patients: do not attend surgery just because you cannot get through on the phone to book your flu jab.
To help avoid clogging the phone lines, we have also set up a new online method of requesting a flu jab appointment. By entering ID details and confirming which clinics/times we should book, we will get back to you with an appointment. Please try it if you cannot get through to us, although we might need to close the form regularly due to high demand. We will get back to you as soon as we can with an allocated appointment slot:
In order to get through everyone, we are also running ad-hoc flu vaccination sessions by the surgery back door in the car park. You will be advised by staff regarding the clinic arrangements.
We urge all patients attending our main flu clinic to familiarise themselves with the procedure for Saturday flu clinic days:
We are grateful to patients for choosing us to provide their flu jab - every flu jab we give means that resources for General Practice stay with General Practice and can be used for investing in staff and services.
TAKING GOOD CLINICAL PHOTOS
As many of you have discovered, with remote working, we have been asking you to take photos of skin rashes, lesions and other visible conditions where it is appropriate to do so and asking you to send these through to us, either using a specific email address we have set up or by responding to a text sent to your mobile phone.
We appreciate the efforts patients have gone through to get these photos through to us, however we do still receive a number of poor-quality photos, for instance, blurred and not in focus, not showing the correct part, or too small or too close-up.
We are sure that there are not many of us who are experts in good clinical photography, therefore we have linked to a patient guide for taking the best photos. You will find this link in any message we send you asking for photos. We hope you find the guide useful.
Keeping with this topic, all patients should be aware that we file the photos sent to us into the patient clinical record. We therefore advise all patients sending us photos to read our privacy policy on digital photos, which is available at:
WEBSITE UPDATES
We continue to update the website with the latest information.
New government guidance link on returning to school this Autumn term, information on when your child has a cold virus (rather than coronavirus), and requests for letters from GPs regarding non-prescribed medication:
We have now set up a search facility on our General Practice 2.0 page. This page has been set up to help patients understand how we are working, and to get the help and support that they need for their condition during these difficult times. To aid patients in finding the right help, you can now search for anything on the page:
An ongoing reminder for any patient with anxiety, depression or mental health issues during this coronavirus pandemic to visit the extensive section of links to support and help at this difficult time:
FINALLY...
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
Previous updates
For your information only, older update(s) appear below:
Written by Dr M. Wong
© Dr Michael Wong 2022