Latest News Update 18.7 SHORTCUT

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November 23, 2020

Dear Patients

This is an update following on from our last news update of September. We apologise for the delay in publishing this issue, but as you might know, we have been rather busy...


On November 5, 2020 the country went into a new national lockdown. We encourage all patients to follow current guidance in order to keep themselves safe.

We have updated our coronavirus advice page with latest information. We really do urge everyone to follow the rules of lockdown and stick to ongoing guidance.


With nearly 60 million people now infected and nearly 1.5 million deaths worldwide, and over 1.5 million cases in the UK, the pandemic continues, with no immediate signs of ending yet. Those figures obviously only take into account officially logged cases and it is very likely the true numbers are far higher than those.

In the UK, cases continue to rise at an alarming rate. New figures from the Office of National Statistics (ONS) show that Covid-19 was the third leading cause of death in October, after dementia and heart disease.

We all know deaths happen all the time, and deaths increase over winter from all causes, but the number of deaths in the UK from just this one single cause is equivalent to a jumbo jet falling from the sky, day after day, every day. That might appear alarmist and overdramatic to say, but it appears, quite tragically for all those affected through this crisis, that we have normalised such 'old news' and carry on regardless, exactly at the time when an ongoing global pandemic should be taken in all seriousness.

Locally, and very worryingly, the rate of new cases in Amber Valley is now over 450 per 100,000 people in the week to November 12th, one of the highest in Derbyshire. This area includes Ripley, Heanor, Belper and Alfreton. Unless behaviour changes and infection levels reduce, it seems extremely likely that Amber Valley will be one of those areas entering a higher and more restrictive tier when lockdown ends.

We get copies of all results for covid tests that our patients have had performed, and over recent weeks, we have noticed a sharp increase in the number of positive results. It is clear that more and more of you are getting infected, and we therefore strongly urge that all our patients follow, as much as possible, the current guidance on keeping safe.


If you have coronavirus, please do not attend surgery even if you have an already booked appointment.

You must actively follow self-isolation rules and stay at home . If you get worse, seek advice .


In line with national guidance, we would like to remind patients that attendance at the surgery requires you to wear a face covering that covers both your nose and mouth. 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.

We remain in the midst of a global pandemic, and we have a responsibility to protect our staff and other patients.

This position is fully supported by Derbyshire LMC and the BMA.


A big well done to everyone for the flu clinic on Saturday, it was very well organised and everyone was very friendly - Anon.

Mrs Stephenson, our practice manager, writes about flu clinic this year:

The interest in receiving a flu vaccine this year has been higher than usual. Normally during a Saturday flu clinic we would be able to vaccinate about 1,100 patients in 4 hours (275 patients per hour). But in 2020, the Covid-19 pandemic changed everything.

With social distancing and limited numbers of patients permitted in the building at one time, we had to manage things a bit differently this year. Across the two Saturday clinics we held, we were able to vaccinate around 1,500 patient in 13 hours (115 per hour). That was a reduction of almost 60% on our normal volume of patients!

Our staff really enjoy working at flu clinics. Although it is busy, it is usually a rewarding day and staff get to see many patients they haven’t seen all year. The patients are usually happy too with our quick service so they are in and out in no time, off to do their shopping or back home for a cuppa.

Despite the restrictions this year, the patient feedback from the Saturday clinics was really good. We managed to keep patients flowing with a one-way system through the building. At our first Saturday clinic, a few patients with limited mobility struggled with the queuing system, so we changed it for the second clinic and this worked much better for everybody. However, with more than 4,800 patients to vaccinate, we had to come up with some more innovative ways to manage the volume of patients.

Over a period of 6 weeks throughout September and October, our lovely health care assistant, Carissa, manned the back door (and a small patch of the staff car park) offering a drive through flu clinic for our patients. This was a roaring success with over 1,200 patients being vaccinated at the back door or in their cars. The feedback from the ‘Drive Thru’ clinics has been great with patients finding them quick and easy. Patients have really appreciated not having to come into the surgery alongside other ill patients.

So far in total, around 3,400 patients had received their flu vaccination but there are nearly 1,500 patients who still need one. So if you have received a flu vaccination invite from us and you have not had flu vaccinations yet, please give us a call on 01773 514130 to book yours as soon as possible.

From the middle of December we will be able to offer flu vaccinations to all patients over the age of 50 years, which is another 1,500 patients. However, at the moment, and despite the information in the national press, we have not received our delivery of vaccine for this group, from government stocks.

Thank you.

The Practice Manager

We will post updates and news about the flu vaccination programme to our flu page.


The pneumonia jab (pneumovax) is usually a one-off injection that protects against serious and potentially fatal pneumococcal infections.

Most patients who are eligible for a flu jab will also be eligible for a pneumonia jab. If you have not yet had yours, please ask when you see your nurse, or call reception to book. Although we do get regular supplies, stocks are limited at any one time, and will be provided on a first-come first-served basis, so get yours now.


As we are now well into cold and flu season, it might be difficult to tell the difference between those two as well as coronavirus, which clearly is also circulating. Therefore we have compiled a table for you to refer to, along with links to for advice and help.

recognised symptom   
very typical symptom   
not usually a symptom

Fever (high temp)
Short of breath
Aches and pains
Sore throat
Runny/blocked nose
Find out more Cold Flu Covid
SYMPTOM Fever (high temp)
SYMPTOM Short of breath
SYMPTOM Tiredness
SYMPTOM Aches and pains
SYMPTOM Headache
SYMPTOM Sore throat
SYMPTOM Runny/blocked nose
SYMPTOM Sneezing
  Find out more


This is a very difficult article to write, and we hope that you will appreciate where we come from in trying to be open and honest about this.

We are having to deal with huge numbers of patients with mental health issues, anxiety, depression, deterioration of existing conditions and onset of new mental illness.

The population is deeply unhappy (for want of a better word) at the moment and in a heightened state of distress and unrest. We know this. We do understand it. In fact, we are suffering ourselves just like everyone else. Our staff and doctors are not immune to what is happening in the world and all around them at the moment, and we are also having to cope with the effects of stress and illness.

We have many calls about mental health every single day. This is in itself is not really the issue. But what we have noticed is that many people do not seem happy with the solutions we offer. We have people declining counselling. We have people declining self-help as if it is an inferior option. We have people wanting more and more medication as if it was the only answer.

We can honestly say we do not have all the answers, and we are genuinely trying to help the people who get in touch with us with what limited options we have available to us. We know studies show that medication alone with no other input is proven to be not as effective as medication plus other therapy, which includes talking therapy, i.e., counselling and also, as important, doing everything you can to be as healthy as possible.

We understand that when you are poorly, levels of motivation, levels of energy are at their lowest. We are fully aware that it is tremendously difficult to know what to do and then actually even get round to doing it. But we also know that everything we do and how we behave does come down to small choices we make this way and that, some which will be helpful, and some which we know will be not. Just as you can choose to contact the GP, we also ask that you choose to start making the right choices in getting better.

We know it is so difficult to know where to turn when your head is in a spin. Therefore, right at the start of this pandemic, knowing what was coming, we set up a section on our website specifically to help those suffering during this extraordinary crisis, collecting many of the available resources and avenues of support available to people in one easy to reference area of our website. Many of these services have been newly set up in response to the pandemic.

The list of options includes helplines, offers of support, apps to download to your smartphone, anxiety relieving measures, apps to help with relaxation, to record your reflections, exercises to help with thought processes, forums to gain support from experts or mutual sufferers, leaflets and booklets to provide robust written advice on what to do, lots of support numbers to agencies willing to help and to talk to. Setting this up especially for our patients has taken significant amounts of our time and energy.

We even set up a specific section on our coronavirus page to support pressured healthcare staff, including our own, to access help during these very difficult times. We have done all this in an effort to help all of you and also all of us who are suffering during this time.

But we are finding many patients are actively choosing to ignore such avenues of help, and immediately turning to us under the impression that we have the answer to their problems. Unfortunately, as we all know, life is not as easy as that. We all know it takes hard work to get from one point to another in our lives and much of that is off our own steam (with some help and support from others along the way of course). Mental health is no different.

We are in no way discouraging you from getting in touch with us when you need to, but we are asking you to consider helping yourself as well, as this is a vital and very much overlooked part of getting better. The key here is that no one single thing will solve your problems for you. This includes considering the doctor as the only answer. It will require a combination of help and support from lots of different directions.

We are more than happy to help those in need, in fact that's what we are here for and what we try and do all day, but all we ask is that you also start to help yourselves too.

Many thanks for your understanding at this hugely stressful time for all.


Carers Rights Day 2020 #UnitedForCarers is on November 26, 2020 and there are a number of events happening across Derbyshire and Derby City to mark this.

Derbyshire Carers Association is running various events via Zoom webinar.

Find out how partners from health, social care and the voluntary sector across Derby and Derbyshire are supporting Carers Rights Day .

Download the poster .


Just some of the feedback from patients using our new eConsult service.

Ease of use and convenient

Effective and useful

The service allowed me to access treatment without having to leave home and sit in the surgery waiting room where appointments are not always on time. It still felt personal as the GP had clearly read what I had described as my problem and related his advice to it

It was easy to use. The doctor contacted me same day. And everything was resolved in the telephone call

I have been with this practice for many years. They have always strived to find ways to continue for patients to be seen as numbers grow with more people wishing to join. Under these difficult times, I receive updates via text with advice for reassurance that the support is always there when needed. The staff are always friendly too when contacting the surgery. The eService seems a great idea and I like that even for those with no internet access, the staff are there at the end of a phone call to help put the eform through. I’d like to thank all at Ivy Grove for the service they give :) - SJF

Our eConsult lead writes about the service:

Our new eConsult system is now live and we ask that all requests for appointments with a GP are made through this system. We really appreciate the effort that patients have made to use this system and our doctors have found it really useful to have this information ready to review before a consultation.

All clinical queries sent before 2pm will receive a response on the same day - you will then receive a message with an offer of an appointment, or a text message advising that a prescription or fit note has been issued, advice for further tests required or advice on to contact a more appropriate service such as the minor injuries unit.

eConsult can be completed from our practice website or alternatively through the NHS app on a smartphone or iPad. For conditions such as rashes, we would encourage you to take photographs which can be sent to us as part of your eConsult message.

Further details can be found our website. Please also see our FAQs for information.


We are finding a number of patients are being kicked out of the eConsult system and then being directed to A&E or 999, or 111 for advice. Detective work has revealed that a fair proportion of these instances are related to using high pain scores in the questionnaires. Accordingly, here we reproduce an article from our eConsult information page.

Please note that this advice needs to be taken in the context that General Practice is not considered to be an emergency service, like 999, A&E, police, coastguard and so on - we have always run services based on an appointments system with response times measured in hours and days, not minutes.

eConsult questions are designed with safety in mind. If you present answers that could indicate a more serious condition, you will be automatically referred to emergency services. This is for your safety.

Many questions also ask for pain scores. So, if you report being in severe 10/10 pain, you will, quite rightly, be advised to ring for a 999 ambulance.

Whilst pain is always unpleasant, we also know that it is a very subjective phenomenon, varying in degree from person to person, but it may help patients if they have an idea what the scores 0 to 10 on the pain scale are recognised to represent.


If you have a pain level which is 7 or above (as on the chart below) you must attend A&E or ring for an ambulance.

The following table might help you to complete the pain severity questions safely.

0 (none) No pain No pain at all; perfectly normal
1 (mild) Very mild Very minor annoyance; mild twinges; barely noticeable (mosquito bite)
2 (mild) Discomforting Minor annoyance; strong twinges (pinch fold of skin)
3 (mild) Tolerable Annoying enough to be distracting; can get used to it and adapt (accidental cut, an injection)
4 (moderate) Distressing Can be ignored if really involved in activity, but still distracting (average toothache, pinching skin really hard with fingernails)
5 (moderate) Very distressing Can't be ignored for more than 30 minutes, but participating in most normal activities (badly sprained ankle)
6 (moderate) Intense Can't be ignored for any length of time; affecting normal daily activities (severe back pain spasms)
7 (severe) Very intense Makes it difficult to concentrate; dominates senses; interferes with sleep; can still function with great effort (average migraine)
8 (very severe) Utterly horrible All physical activity severely limited; can read and converse with great effort (childbirth)
9 (very severe) Excrutiatingly unbearable Unable to speak; crying out or moaning uncontrollably; near delirium (throat cancer; kidney stone)
10 (worst pain imaginable) Unimaginable; unspeakable Unconscious; bedridden; pain makes you pass out (multiple injuries from road accident; crushed limbs)
SCORE 0 (none)
DESCRIPTION No pain at all; perfectly normal
SCORE 1 (mild)
SEVERITY Very mild
DESCRIPTION Very minor annoyance; mild twinges; barely noticeable (mosquito bite)
SCORE 2 (mild)
SEVERITY Discomforting
DESCRIPTION Minor annoyance; strong twinges (pinch fold of skin)
SCORE 3 (mild)
SEVERITY Tolerable
DESCRIPTION Annoying enough to be distracting; can get used to it and adapt (accidental cut, an injection)
SCORE 4 (moderate)
SEVERITY Distressing
DESCRIPTION Can be ignored if really involved in activity, but still distracting (average toothache, pinching skin really hard with fingernails)
SCORE 5 (moderate)
SEVERITY Very distressing
DESCRIPTION Can't be ignored for more than 30 minutes, but participating in most normal activities (badly sprained ankle)
SCORE 6 (moderate)
DESCRIPTION Can't be ignored for any length of time; affecting normal daily activities (severe back pain spasms)
SCORE 7 (severe)
SEVERITY Very intense
DESCRIPTION Makes it difficult to concentrate; dominates senses; interferes with sleep; can still function with great effort (average migraine)
SCORE 8 (very severe)
SEVERITY Utterly horrible
DESCRIPTION All physical activity severely limited; can read and converse with great effort (childbirth)
SCORE 9 (very severe)
SEVERITY Excrutiatingly unbearable
DESCRIPTION Unable to speak; crying out or moaning uncontrollably; near delirium (throat cancer; kidney stone)
SCORE 10 (worst pain imaginable)
SEVERITY Unimaginable; unspeakable
DESCRIPTION Unconscious; bedridden; pain makes you pass out (multiple injuries from road accident; crushed limbs)

This table is compiled from multiple sources and is intended to be a guide only


The official NHS App is a simple and secure way to access a range of NHS services on your smartphone or tablet. Such services include ordering your repeat prescriptions, checking your symptoms and viewing your medical record.

Additionally you will be able to submit eConsults directly through the NHS App.

Registration is required, but is quick and easy.

We have set up a new page on our website to tell you more about the NHS app and how to get it.

If you already use existing online services, like Patient Access, you can still continue to do so.


The NHS App is for accessing NHS medical services whilst the NHS COVID-19 App is for the test and trace system.


We continue to update the website with the latest information.

We have updated information on sexual health services that are still open and available during this pandemic. Services include free condoms by post, STI/HIV testing, emergency contraception, and virtual sexual health counselling and diagnosing of lumps/bumps/warts.

We have updated the shielding guidance for those patients who are clinically extremely vulnerable.

We have updated our information on post-covid syndrome or long-covid with the forthcoming NHS online service, for those who are suffering with long term effects of having contracted coronavirus.


We hope you all keep safe during these difficult times, and hope to catch up with you all before Christmas. Take care.

Kind regards

Ivy Grove Surgery

Please provide feedback on this news update

We do our best to keep our patients informed of latest developments at Ivy Grove, and feel that within the coronavirus pandemic, this has become even more important. We spend our own time co-ordinating efforts and writing these updates, so it would be nice to know if you find these updates useful? Do you want us to carry on with them? We welcome feedback on this, so please doget in touch.

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Previous updates

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Written by Dr M. Wong