September 1, 2021

Dear Patients

This is our latest news update following on from our last one in July. Previous updates issued throughout the course of the pandemic can be found here.

After a mixed summer and another extremely busy time in surgery, we have lots to tell you about in this issue.

   

COVID UPDATES

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INTRODUCTION

The pandemic is not over. After a short spell of reducing cases from mid-July, daily case numbers are now rising steadily. The Office of National Statistics (ONS) estimates that 1 in 80 people you meet will have covid. We are continuing to file a good number of positive results and advising patients who are unwell with covid infection. We are also having to deal with increasing numbers of patients suffering with the prolonged and debilitating effects of previous covid infection, so-called long covid.

At the rate we are going, not including the inevitable winter spike, we will be running at an average of about 1 million new cases a month and about 35-40,000 deaths a year from coronavirus, far exceeding annual flu deaths.

We therefore urge all patients to continue to exercise a degree of caution when going about daily activities and socialising.

MASKS AND FACE COVERINGS

Although the legal requirement to wear a mask/face covering was removed on July 19th, the government has urged caution and recommends ongoing social distancing and wearing of masks in closed spaces, small and crowded areas and where vulnerable people will be present.

Given that we are a healthcare setting where sick and vulnerable people are in close proximity, we have determined that all adults and any child over 11 years of age presenting to the building will be still be required to wear a face covering and maintain social distancing.

Therefore please ensure you wear a face covering that covers both your nose and mouth at all times throughout your appointment. Remember, face coverings are designed to reduce spread of disease from you to someone else, so when you wear a mask, it will help to protect others, such as vulnerable patients and our team, but as we will also be wearing a mask when we see you, it will also help to protect you from us.

Ruth May, the Chief Nursing Officer, said that continued adherence was vital 'so that most vulnerable people can continue safely to attend hospital, their GP surgery, pharmacy or any other healthcare settings.'

Professor Chris Whitty, the Chief Medical Officer, stated in a recent Downing Street briefing (July 9th) that he would still wear a mask in one of three situations:

• 1. Indoors and crowded, or indoors with close proximity to others
• 2. If asked by any competent authority
• 3. As a common courtesy, if others were uncomfortable

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

NHSE: Face coverings in healthcare settings Face coverings page Face coverings poster

DO NOT ENTER THE BUILDING IF YOU HAVE COVID

As we continue the process of recovery, and request long overdue blood tests and clinical readings, as well as conducting more and more face-to-face assessments, more and more people are entering the building for their appointments and to collect forms, sample bottles, documents, dropping off BP readings, specimens and so on.

We advise that if any patient is suffering with an active viral illness, either with symptoms of coronavirus such as a high temperature, cough or loss of sense of smell, or other general viral symptoms including headache, general aches and pains, vomiting, extreme fatigue, loss of appetite, that they please do not enter the building, regardless of whether they are wearing a mask or not.

We have vulnerable patients in the waiting room attending their appointments and also vulnerable staff on the premises and by coming into the building with highly infectious disease, you would put these people at risk.

If you are unwell with viral or covid symptoms and need to collect/drop off something, please always contact us by telephone first rather than turn up.

Covid symptoms poster

RAPID LATERAL FLOW SLIDE TESTS VS. LAB PCR COVID TESTS

We need to remind patients that cough, high temperature and loss of sense of smell or taste remain covid symptoms and therefore will require you to book a PCR covid test that you send off to the lab.

Please do not use the rapid lateral flow slide tests as these are only suitable for screening when you have no symptoms at all.

We are still speaking to many patients with covid symptoms who have not requested a lab PCR covid test. This is important as a positive test has implications not just for yourself but also for those around you.

GOV.UK: Book a PCR test GOV.UK: Stay at home guidance for covid infection NHS: Difference between the two tests NHS: What your test result means

WHAT TO DO IF YOU GET COVID

We have collected resources on our coronavirus page to help answer your covid query. This has recently been updated to provide you with all the latest advice and links. And if you do develop covid, hopefully we can help you to do the right thing to get better.

Coronavirus query page Need help and support? How to treat yourself If getting worse After covid infection

SELF-ISOLATION RULES CHANGED FOR HOUSEHOLD CONTACTS

Although self-isolation rules for household contacts changed from August 16, 2021, it remains the rule that if you yourself have covid symptoms or a positive covid test, you need to stay at home and self-isolate.

Slightly different rules apply depending on if you are a healthcare worker or a member of the general public.

General public

If you live in the same household as someone with coronavirus, you no longer need to self-isolate if any of the following apply:

• you are fully vaccinated
• you are below the age of 18 years 6 months
• you have taken part in or are currently taking part in an approved covid vaccine trial
• you are not able to get vaccinated for medical reasons

Even though you do not need to self-isolate in the above situations, you might wish to still take the following precautions whilst the person in your household is self-isolating with covid:

• book a PCR covid test for yourself
• perform rapid lateral flow slide tests twice a week
• reduce close contact with others outside your household, especially with anyone who is clinically extremely vulnerable
• wear a face covering in enclosed spaces and where you are unable to maintain social distancing

If you then develop symptoms, you need to self-isolate and book a PCR covid test as indicated above.

Healthcare workers

If you are a healthcare worker who has been in contact with someone with coronavirus, you are not required to self-isolate if you are both asymptomatic (without symptoms) and fully vaccinated. You must do the following:

• inform your line manager if you are required to work in the 10 days following your last contact with the case
• arrange an immediate PCR test (only if you have not had covid infection in the last 90 days) and have a negative result before returning to work
• perform daily rapid lateral flow tests for t0 days, and have a negative result before the start of each shift
• comply with all relevant infection control precautions and PPE
• undertake a risk assessment should be undertaken if you work with patients or residents who are highly vulnerable

If you then develop symptoms, you need to self-isolate and book a PCR covid test as indicated above.

Coronavirus query page GOV.UK: Book a PCR test GOV.UK: Stay at home guidance for covid infection GOV.UK: Guidance for staff in health and social care settings

COVID VACC AND YOUNGER AGE COHORTS

We are now working to invite 16-17 year olds for covid vaccine and also to target specific 12-15 year olds who meet certain criteria with regard to underlying health conditions (such as severe neuro-disabilities, being on immunosuppressant medication) and also if they live with an actively immunocompromised person (someone who is actively taking immunosuppressant medication or has an immune deficiency disorder).

We will be texting patients who are immunocompromised in order to try and identify eligible 12-15 year olds in this category who would be able to take up the offer of a covid vaccination in order to protect their vulnerable household members.

Despite our active work in continuing invites, demand for covid jabs has lessened in recent months as we go down the age groups. Some vaccination centres in the UK are reporting that they are working to only 30% capacity, with young adults feeling 'invincible' and feeling that they don't need the vaccine to protect themselves. Unfortunately this attitude misses one of the main points of any vaccination programme: the aim of vaccination, especially with something like coronavirus, is not only to protect oneself, but also others, and particularly the vulnerable, should you contract the infection.

For our younger patients, update has been generally very good, with 85% of 30-39 year olds vaccinated, and 79% of 18-29 year olds vaccinated and we thank all those who have taken their time to respond to invites and get jabbed. There is however still room for improvement, if we are to match the 94-95+% rates of some of the older age cohorts.

In total, across all age groups, an average of 86% of our patients have completed a course of two jabs, and with 5% of our patients having had one jab (and yet to have the second).

The great majority of adults have been vaccinated.

Four weeks working on a COVID ward makes stark the reality that the majority of our hospitalised COVID patients are unvaccinated and regret delaying. Some are very sick including young adults.

Please don't delay your vaccine. – Prof. Chris Whitty, August 20, 2021

We urge any patient receiving an invite either from ourselves or the NHS service to please act upon the invite and book your jab. The sooner we are all protected the sooner we can get back to normal.

If you are vaccinated, you are much less likely to suffer severe covid symptoms, less likely to get long covid, less likely to be admitted to hospital, less likely to need intensive care and less likely to die. Furthermore if you do get infected, you are less likely to pass the virus on to your loved ones, your parents, your grandparents and those you care about.

Young Covid (Official NHS video)

View on Vimeo

COVID VACC FAKE NEWS

In today's instant and digitally connected world, fake news is unfortunately a widespread issue that we all have to contend with. However, when it involves damaging claims that could affect your health or could even result in your death, it becomes all the more significant.

The Center for Countering Digital Hate (CCDH) found that much of the covid anti-vaccine misinformation that is currently circulating comes from just 12 people who have a combined following of nearly 60 million social media users.

It has been suggested that social media platforms deliberately chose not to alienate so-called anti-vaxxers because such activity generates an estimated $1billion in annual advertising revenue.

In the UK nearly 90 million covid vaccinations have been given (the majority in primary care) and the vaccination programme has undoubtedly made a huge impact. Recent analysis shows that an estimated 23 million infections and 85,000 deaths have been prevented as a result of the vaccination programme up to August 6, 2021. We therefore urge all our unvaccinated patients to take up the offer of a covid jab when you get an invite.

COVID ANTIBODY TESTING

Covid antibody testing is now being rolled out by the government as part of a new initiative to explore how much natural protection is obtained after coronavirus infection. This information could help to inform the covid vaccination booster programme and help to determine whether antibodies protect against other variants of the disease.

Anybody over 18 years old and who is taking a covid PCR (lab) test can now opt-in to the programme and they will receive an antibody test kit if they test positive.

The test consists of two finger-prick antibody tests to complete at home and to send back for analysis, with the first taken as soon as possible after the positive result, and the second taken 28 days later.

Regardless of the results of these new antibody tests, you must still follow all current guidance relating to your positive coronavirus test. Additionally the presence of antibodies should not be considered as evidence that you have more protection, nor that you will not be reinfected again.

GOV.UK: Coronavirus antibody testing GOV.UK: Book a PCR test GOV.UK: Stay at home guidance for covid infection

LONG COVID / POST-COVID

Just a reminder that all those with or having had coronavirus infection can visit the post-covid/long covid section of our website, where we have collected resources to help you cope with the possible after-effects of having had the virus, for instance, help with continuining breathing difficulties, managing the cough and dealing with extreme fatigue.

Coronavirus query page NHS.UK: Your COVID recovery Post-covid information pack Post-covid hub for breathing

COVID VACC BOOSTERS

At the time of writing, we still have not had formal notification of how the covid vacc booster programme will work. As flu season is now well upon us, like many other surgeries, we have continued to plan our flu jab programme and give flu jabs as normal, as giving covid boosters would completely disrupt the flu programme due to the required 15 minute wait following covid jabs.

Of course, we will update you as soon as we get any information. In the meantime information on flu clinic is provided below.

 

FLU CLINIC DATES AND BOOKING

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Flu clinic dates been confirmed.

Please save the following dates:

• Sunday October 10, 2021 - flu clinic no. 1
• Saturday October 16, 2021 - flu clinic no. 2
• Sunday October 24, 2021 - flu clinic no. 3

We encourage eligible patients to now book for their flu jab as soon as they receive their invit. You will find details on our flu page. As last year, we are booking appointments so that we can keep track of how many flu jabs are being used up, as we imagine demand and interest will be high.

We know that other providers like pharmacies and supermarkets offer flu jabs to patients. Like all other GP practices, we rely on funding from each flu jab we give to help cover running costs and to keep the practice viable and maintain services. Therefore every single flu jab you have elsewhere means loss of funding for your GP surgery, which puts them even more at risk.

You might be told by other providers that they are giving flu jabs to you to help ease your GP's workload - this is definitely not the case! We are more than capable of administering thousands of flu jabs each year as we have been doing for decades. Therefore please support your local surgery by having your flu jab with us

By choosing us, you will be vaccinated in a properly equipped consulting room or treatment room by a qualified member of our Nursing or GP Team; who will have access to your medical records and are properly equipped for emergencies. By having your flu jab with us, you are ensuring that crucial resources stay with your GP surgery.

If you are eligible for a free flu jab on the NHS but an outlet offers you an earlier jab if you pay a fee, please be aware that this is completely inappropriate.

Flu page  

VIOLENT AND THREATENING BEHAVIOUR

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A recent British Medical Association (BMA) survey found that half of all GPs have faced recent abuse from patients, or those close to them, with 20% of GPs reported being threatened, and two-thirds of GPs having witnessed violence or abuse against their staff. Most incidents seem to arise from dissatisfaction with the service, or with access issues.

We are sad to report that we are continuing to experience incidents of rude, offensive and violent behaviour from a certain subset of patients. There have been some instances relating to refusal to wear face coverings. As indicated above, face coverings are still required for all healthcare settings.

At Ivy Grove, we follow official NHS Zero Tolerance Policy and will not hesitate to send warning letters to patients who breach the policy, with repeat offenders being removed from our panel. In addition, those threatening violence will be notified to the police and met with immediate removal.

Working life is so difficult at the moment with short-staffing due to stress, sickness and self-isolating and escalating and increasingly demanding workload, when we are doing our absolute best day in day out, that we cannot and will not tolerate any degree of such unreasonable, unacceptable and completely inappropriate behaviour.

Such behaviour leads our staff feeling undervalued and alienated, fearing for their safety and deeply affecting their sense of wellbeing. This in turn can have an impact on productivity, the quality of our work and which can ultimately affect patient care. We are doing our very best in difficult circumstances, and we ask that everyone be considerate to this.

Having said all that we know that the vast majority of patients do really appreciate what we do for them and we are therefore very thankful. However given the trend of increasing abuse, after a year and a half of the pandemic with its consequent effects on everyone's wellbeing, and with increased levels of frustration and anger as a result, we feel there must be an honest debate with the public on what can realistically be expected from a chronically underfunded and short-staffed GP service. At the same time, there must be a serious commitment towards increasing support for General Practice.

 

SECURITY OF THE BUILDING

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Due to recent events where the safety of our staff has been put at risk, and in line with similar policies in other GP surgeries, we have had to enhance the security of the building. With immediate effect, we will now be locking the electronic doors leading from the waiting room to the consultation room corridors. Patients with appointments will be led to consultation rooms by their clinician.

In order to exit back to the waiting room via the electronic doors, simply wave your hand over the red light sensor to the side of the door and the door will open.

 

WEIGHT MANAGEMENT SERVICE

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Many patients would admit that they have put on a few pounds since the pandemic started. Some of us have put on more than a few! There is therefore currently an increased national focus on regaining the country's health and wellbeing after more than a year of lockdown.

We are now actively updating our records and have been texting patients asking for updated weight readings. We may then be able to offer help, support and referral to a range of services including a weight management programme.

If you receive a text, please do try and respond and we will do our best to help.

 

BLOOD PRESSURE (BP) READINGS

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We have been sending out texts to get BP readings from patients, and whilst some of these have come back successfully, we have found that not everyone can cope with having to text through BP readings on a regular and timely basis, with many missing the reminders for taking a reading altogether, leading to too few readings to provide an informed judgement on what needs to be done with their BP.

If you have been sent a text message asking you for BP readings AND you have difficulty with using your phone to text your readings through to us, please download and print your 1 week BP chart here. The instructions on how to use the chart are printed on the chart itself.

If you can't print it out, contact reception who can print a copy out for you. Please only download this chart if we've told you to provide us with a week of readings.

Once completed, please post it through our letterbox and we will get back to you if anything needs doing with the readings.

BP chart  

SOCIAL PRESCRIBING SERVICE

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Although some of our patients will already be familiar with the social prescribing service, we have been a little remiss in not introducing our patients to the social prescribing service which has been set up for some time now.

Amber Valley CVS Social Prescribing Service is a free service being provided in partnership with the Heanor, Alfreton and Ripley Primary Care Network (our neighbourhood of practices). The aim of the service is to work alongside GP practice teams to help you explore activities and local support that could improve your health and wellbeing.

Many things in life can make us feel unwell and a medical prescription is not always the answer. Social prescribing can help you to take control of your own health and wellbeing by giving you time to think about what matters most to you and how the service can work with you to improve your health and happiness.

Social Prescribing is about developing stronger partnerships, between you, your community and supporting services. It can help to tackle issues such as loneliness, money worries, isolation, unemployment, health and fitness, education, housing issues, all of which, we know as doctors can seriously affect your health.

You can refer yourself to the social prescribing service. The service will then contact you to discuss the referral and arrange to meet you in a place that you feel comfortable, which for most people is at home. Together, they will look at what is important to you and your wellbeing and develop a support plan, identifying how you can access local services and activities to help you reach your goals, with further support from a link worker if needed.

The social prescriber can explore other services in your community, such as housing, benefits and financial support and advice, healthy lifestyle and physical activities, befriending and support groups, training and volunteering, social and creative activities.

To refer, you can use these contact details:

Ring 01773 512076 Email Amber Valley CVS Amber Valley CVS site

Read more here:

Social prescribing leaflet Social prescribing page  

FIRST CONTACT PHYSIO SERVICE

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A new service has recently been introduced into the network neighbourhood of practices. The First Contact Physio service has been established to provide patients with quick and local access to physiotherapy assessment.

Low back and neck pain are the greatest cause of years lost to disability in the UK, with chronic joint pain or osteoarthritis affecting nearly 9 million people. In addition, musculoskeletal conditions can account for 30% of all GP appointments.

The vast majority of musculoskeletal first contact practitioners are physiotherapists with enhanced skills. They can help patients with musculoskeletal issues such as back, neck and joint pain by assessing and diagnosing issues, giving expert advice on how best to manage their conditions and referring onto specialist services if necessary.

Patients with any back or joint problem, arthritis or any other musculoskeletal problem, can self-refer to the service by simply ringing up the surgery and asking our receptionist to book in directly into a first contact physio slot.

There is no need to speak to a GP or see a GP first before booking into a physio slot. The first contact physio will assess remotely and then decide on the most appropriate course of management.

The aim of this service is to provide expedited access to a qualified and appropriate professional whilst helping GPs to manage their workload more effectively, and reduce the need for onward referrals from the GP.

Ask for the 'First Contact Physio' service when you ring.

Ring us and ask for First Contact Physio'  

CITIZENS ADVICE BUREAU (CAB) SERVICE

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We are pleased to announce that the Citizens Advice Bureau (CAB) has now reinstated their weekly clinics in the surgery.

The CAB can provide free and impartial advice to you about benefits and appeals, debt counselling, discrimination, employment advice, financial worries, housing, law and rights, tax problems and work issues amongst other things.

We know that many of the above issues impact upon a person's physical and mental health and wellbeing, and whilst we can and are happy to help any patient suffering with their health as a result, we cannot properly advise on issues such as employment, housing, benefits or financial matters.

Any patient can self-refer to the service. Find out more on our website and if you would like to book an appointment, please ring the service and ask for 'CAB'.

Ring us and ask for 'Citizens Advice' Citizens Advice Bureau (CAB) page  

GENERAL PRACTICE WORKLOAD

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Workload in General Practice remains at an all-time high. Ironically, toxic and demoralising GP bashing in the media also remains at an all-time high. Some exasperated GPs have labelled the sorry situation Schrödinger's GP: defined as simultaneously not doing anything [according to the media] whilst also being fully booked with no available appointments [as you know].

All practices continue to be under immense pressure as the pandemic continues. Recent figures from NHS Digital show that practices in England booked 3.5 million more appointments in June than they did in May, and 31% more than they did in the same month 2 years ago, long before the onset of the pandemic. There appear to be no signs that this trend is letting up in any way.

Workload has increased not only due to heightened demand, but also from increased need to maintain patients held on long hospital waiting lists and working through a huge care backlog whilst also continuing to plan for the ongoing covid vaccination programme and flu vaccination campaign. Meanwhile we are still being held to strict clinical targets on the presumption that everything is back to normal when it clearly is not (blood bottle shortage and limited waiting room space being just a few factors).

The European Union of General Practitioners has stated that 25 consultations per day is a sustainable GP workload. In the UK, GPs are now often dealing with double, and sometimes triple that number in a working day with telephone and face-to-face consultations, and home visits.

A BMA analysis of Organisation for Economic Co-operation and Development (OECD) data and NHS Digital General Practice and Secondary Care Workforce Statistics has indicated that it will take until 2046 before the NHS has the number of practising doctors to match today's EU nations' average. We are therefore 25 years behind where we should be when reviewed against our comparative neighbours.

In England, there are 0.46 fully qualified GPs per 1,000 patients (this is actually down from 0.52 GPs per 1,000 in 2015). The average number in comparable nations is 3.5 per 1,000 patients.

In a further illustration of how under-doctored we are in the UK, in a survey commissioned by the BMA, almost half of the public in England say if they could make just one improvement to their GP practice, it would be to increase the number of doctors.

BMA: Pressures in General Practice BMA: Medical staffing report

We have not been unaffected ourselves in the current crisis, and we are currently struggling with one doctor and one nurse off sick with illness in the midst of the already busy holiday season. We would kindly ask that our patients bear with us during these very difficult times as appointment availability and waiting times will be adversely affected.

Even if all our appointments have been taken up and we are full, help is always on hand in various forms. Please see the next section.

 

ALTERNATIVES TO THE GP

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We realise it can be very frustrating to ring repeatedly each morning and find that you cannot get through or that the phone line is constantly engaged. And then when you find that you do finally get through to a receptionist all the appointments for the day have gone.

We have 16 lines in and out of the building. These are being used constantly by receptionists answering calls and by clinicians ringing their patients. The doctors are literally ringing one patient after another, without a break, often from 8.30am right through to 6.00pm, interspersed with the face-to-face patients that they have brought in. Therefore the existing lines are constantly busy. We are not able to have any more lines as we simply do not have additional staff to answer them and to deal with the resultant calls. Everyone is already working flat out dealing with the unprecedented demand and having to cope with short-staffing.

If all our appointments are taken up, then we are full and we can only then assess you on the basis of clinical urgency. This is defined as a risk of coming to harm if you need to wait till the next working day or next acute care clinic. By doing so, we hope you can understand that we are aiming to practise safely, and to be able to give the time needed to those patients who have already booked in.

If you find yourself in a position of needing medical advice or care but we are already full, there are alternatives way to get help. Before we get the inevitable comments about GPs fobbing patients off, providing excuses or shirking responsibility, we would like to stress that these are all official sources of help and recommended for patients to access before deciding to call or see someone.

URGENT TREATMENT CENTRE (UTC) FOR SAME-DAY CARE

Urgent Treatment Centres* (UTCs) are specifically designed to take pressure off other services and to help with signposting to appropriate services. They aim to provide same day care to patients for urgent, but not life-threatening illnesses and injuries. They are run by highly skilled paramedics and specialist nurses with GP cover planned to further broaden the level of clinical expertise and supervision available in each of the centres.

*Urgent Treatment Centres are also called Walk-in Centres (WICs) and previously Minor Injury Units (MIUs)

The staff at UTCs treat everything from broken bones to cuts and gashes, diarrhoea and vomiting, minor eye infections, insect bites, throat infections, bumps and bruises, scalds, stomach ache, skin and wound infections and much more. Please visit our new UTC information page for more examples and locations of services.

UTCs are open 8.00am to 8.00pm 7 days a week. The nearest is at Ripley Hospital, but others exist at Ilkeston, Derby, Whitworth and Buxton Hospital.

If you have an existing problem that we are already treating, you are advised to get in touch with us. Otherwise for new conditions where you need urgent medical help the same day, then an urgent treatment centre is appropriate.

Urgent Treatment Centre (UTC) page NHS: When to visit an Urgent Treatment Centre

LOOK UP YOUR CONDITION ON OFFICIAL NHS SITE

We recommmend the official NHS website rather than some random unvalidated site from Dr Google. At the NHS website you will get official, validated and peer-reviewed medical advice for your condition, with information on what to do and when to seek further help if you get worse. It is very straightforward and easy to use.

In fact, in common with many GP surgeries, when we advise patients following consultations, we regularly refer to these advice links from the official NHS site in our text responses to patients.

NHS: A-Z of medical conditions

USE OFFICIAL NHS 111 ONLINE TRIAGE SYSTEM

We refer to this service frequently throughout our website. It is a recommended method of getting the help that you need.

It is extremely easy to use, quick and convenient. You enter some basic demographic details, such as age, sex, location and then your main symptom. You will then be asked a series of questions about your condition.

Using NHS 111 online means that you find out how to get the right healthcare in your area, including whether you need to see a GP or seek urgent care. You can get advice on self-care (referring to the same official advice links on the NHS website as mentioned above). Additionally, you can get a call back from a nurse, doctor or other trained health professional if you need it.

NHS 111 online is an accessible and convenient alternative to the NHS 111 telephone service and provides an option for people who want to access NHS 111 digitally.

NHS 111 online

WHICH NHS WORKER DO YOU NEED FIRST?

The following resources are not official NHS resources, but developed in-house and we recommend their use if you are not certain which health professional you need to see. We provide this information as a GP is not always the right person that you need and by directing you to the right person in the first place, it allows us to devote time to those patients who actually do need a GP first.

STEP 1 If you know your symptom or condition, you can check it on our symptom checker and it will tell you whom you should speak to/see first:

Symptom checker page

STEP 2 If you are not sure what each of the workers in the NHS do, you can check our help page:

GP team page Matching help leaflet

STEP 3 Once you know exactly which NHS worker you need to contact first, visit our index of self-referral pages and find details:

Self-referral page  

FEEDBACK RECEIVED

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We remain grateful for any feedback received - it is clear to us that many do appreciate what we are doing for you all under these trying times. We share all feedback with staff.

Everybody at Ivy Grove continues to do a magnificent job under the intense pressure of the Covid Pandemic. Well done Ivy Grove you continue to shine above the rest. – WB

To Dr Marval and the Reception Staff at Ivy Grove, I would like to say thank you to all of you for the excellent service you have provided to myself early this year and my husband too. It's really appreciated under these difficult times that you are all working in! Take care and stay safe! – WB/PB

A huge thank you, love from – LB

Clear information, especially appreciated the opt-out advice, thank you. – LR

Thank you for referring me to give me peace of mind. – SB

 

NHS 111 AND ADVICE TO CONTACT GP SERVICE URGENTLY

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We are getting increasing numbers of calls from patients who have been advised by the NHS 111 service to contact us within an hour of their 111 call.

We have several concerns with this advice.

The 111 service is manned by non-medically trained staff following computer algorithms. It is well known that such protocols are risk-averse by design and it is equally well-known that they refer too many callers to GPs and to hospital accident and emergency departments and dispatch too many 999 ambulances whilst too little is done to recommend self-care or provide appropriate health advice.

These assertions are supported by NHS 111's own figures which reveal that nearly 13% of calls result in an ambulance being dispatched, 8% of calls result in a referral to A&E, and a staggering 56% are referred to primary care*, with only 6% of callers given self-care advice and 1.4% of people given health information.

*With this high rate of call diversion back to primary care, can you imagine the benefits if the resources that go into NHS 111 actually went directly to GP surgeries for them to invest in staff, doctors, nurses, equipment?

Unfortunately due to the way the service is run, this does not allow the call-handlers any leeway to deviate from the chosen pathway or decision tree. We all know symptoms can be subtle, some symptoms have more significance and others less so, and people do not always fall into neat boxes.

As a result, there have been many instances of inappropriate 111 advice:

• Child sent a 999 ambulance for suspected heart attack (it is very unusual for children to have cardiac issues unless born with them)
• Stroke patient told to contact GP service within 1 hour (suspected stroke is a medical emergency needing 999)
• Patient passing altered blood (black stool) told to contact GP service within 1 hour (this is generally a medical emergency needing emergency admission)
• Patient requesting ongoing contraception told to contact GP service within 1 hour (not an emergency at all)
• Various patients with minor illness told to contact GP service within 1 hour, for example, minor urine infections, penis discharge, coughs (not an emergency)

Clinically, from a doctor point of view, it is recognised that anything needing contact with a health professional in 1 hour would be classed as a medical emergency, where any time delay could result in serious disability or death. For example, head injuries, severe road traffic accidents, bleeding.

By advising a 1 hour call back inappropriately for conditions that are not an emergency, 111 places the GP service under undue pressure and skews clinical priorities, meaning other more needy patients already on doctors' appointment lists may be disadvantaged. From the patient perspective, such advice raises expectations inappropriately which can then adversely affect the doctor-patient relationship when the doctor attempts to reset such expectations.

As a health professional, we will always assess any call, correspondence or other form of contact with us, based on our own individual knowledge, clinical discretion, the setting of the call and importantly, common sense and advise accordingly.

Cases will then be dealt with in accordance with our existing arrangements of daily acute care clinics, routine appointment slots, duty doctor emergency slots and urgent home visits, where this is deemed appropriate by the attending clinician.

Therefore please do not be offended if you do not receive a complete resolution or indeed any contact from a GP within the time frame that you have been promised by 111.

 

WORLDWIDE BLOOD BOTTLE SHORTAGE

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There is a worldwide shortage of blood bottles and this is expected to last for a period of time, at least until the middle of September.

GPs are being urged to cut the unnecessary use of blood test tubes after manufacturers warned of shortages in the coming weeks. NHS England (NHSE) has been told that soaring demand due to increased blood testing for covid cases, and increased demand from working through a backlog of blood tests required for routine care, coupled with ‘UK border challenges’ had hit production and supply chains.

NHSE guidance says that GPs should ‘reduce non-essential (non-clinically urgent) testing’, such as vitamin D testing, routine wellness screening (for instance, cholesterols and diabetes screen in well people), allergy testing, routine infertility with the exception of patients over 35 years of age.

We are awaiting further guidance with regard to having to delay routine testing as part of the clinical targets that GP surgeries have to meet for their patients, for instance, diabetes and cholesterol checks, kidney blood tests. This is important given that we must continue to provide ongoing care to our patients whilst also trying to tackle a huge backlog of care built up through the pandemic.

UPDATE AUGUST 26, 2021: ONLY CLINICALLY URGENT BLOODS TO BE DONE

We have been informed by the NHS that all primary care and community testing must be halted until September 17, 2021, except for clinically urgent testing. Examples of clinically urgent testing include:

• Bloods that are required to facilitate a two week wait (suspected cancer) referral
• Bloods that are extremely overdue and/or essential for safe prescribing of medication or monitoring of condition
• Bloods that if taken could avoid a hospital admission or prevent an onward referral
• Those with suspected sepsis or conditions with a risk of death or disability

We are advised that all booked appointments from August 31, 2021 until September 17, 2021 have been cancelled. Unfortunately, this includes appointments for clinically urgent blood tests as there is no easy way for those running the clinic to identify such requests.

If you are in one of the above clinically urgent categories, you will need to contact us so that we can authorise an urgent blood test appointment. Please note the phone lines are already extremely busy therefore please bear with us.

If you are not in one of the above categories, we kindly ask that you do not contact us. We would advise you to rebook your blood test appointment when they again become available.

More information can be found on this alert:

GOV.UK: Supply Disruption Alert

We will post any new information on our blood bottles informaton page:

Blood bottles page

Information on booking blood tests:

Blood test request page  

NHS DATA GRAB NOW ON HOLD

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The government's plan to grab GP data to share with private companies has been put on hold following significant efforts by privacy campaigners and a public backlash. The General Practice Data for Planning and Research (GPDPR) scheme has now been postponed, with no definite date for its launch. There will now be a consultation and a public information campaign.

Over one million people have opted out since news of the scheme broke. Even though there is now no closing date for opt out, those wishing to opt out can still do so. We encourage any patient who is not fully aware of the scheme to read our dedicated website page for more information, including important links and a web form should you wish to opt out.

NHS data grab page Online opt-out form  

MEDICINES ORDER LINE (MOL)

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The Medicines Order Line (MOL) is an initiative that has been working for some time for many practices in Derbyshire. It is now being rolled out to remaining practices. It is intended to reduce wastage of unused medications, which, in Derbyshire, accounts for a loss of £6million annually. By ordering only what you need, when you need it, this will save the NHS money to spend on other important services. Additionally it should help to ease some of the pressure on GP practices.

Ordering your repeat prescription will be a quick and simple telephone call. You will be speaking to a dedicated person who will have time to answer any queries you may have about your repeat prescription and discuss your medication requirements and be able to alert you if a medication review is needed.

Once you have made the telephone call your prescription will be authorised by your usual GP and will then be sent to the pharmacy of your choice within two working days. Please then allow additional time for the pharmacy to get your prescription ready for you. If you have an existing arrangement with your pharmacy to deliver your prescription please speak with them to ensure this will continue.

There will be some instances in which the MOL will query your medication request with us by sending us a task. The following are examples:

• Your medication review is overdue
• You have requested something not on your usual repeat, for instance past medication, new medication recently issued but not on repeat or medication never had before
• You have repeatedly not ordered some of your usual medication on repeat

The service will start on November 3, 2021. In the meantime, you are welcome to read the patient information leaflet below:

Medicines Order Line (MOL) Leaflet  

DR WORDLEY'S RETIREMENT PARTY

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Dr Wordley's retirement party was held in early August and was well attended by current staff as well as ex-staff members and retired doctors, including Dr Cox, Dr Jones and Dr Newport. It was originally meant to be held in Dr Wordley's stunning garden, however the heavy rain at the time meant the venue was changed to the local village hall. This did not dampen spirits though and everyone really enjoyed the lovely afternoon event.

There was a live band (for the adults) and a bouncy castle (for the children) and the party was lubricated with a keg of Dr Smith's famous home brew beer! Everyone really enjoyed the food too, especially the amazing desserts which had all been homemade by Mrs (also Dr) Wordley!

A lovely send-off to a hard-working and dedicated family doctor.

 

FINALLY...

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Autumn and schools restarting brings the threat of increasing rates of respiratory and viral illness. We therefore urge all our patients to keep to good hygiene, keep their houses well ventilated and be careful with socialising. We advise everyone to follow all current guidance in order to keep yourselves safe.

Additionally, as happens in other countries, you may wish to consider the use of face coverings to avoid spread of disease should you develop a cold or cough. By doing so you will help to minimise the impact of your own ill-health upon others, especially those most vulnerable.

Throughout this entire time of our lives, it remains important to remember that everything we are having to do currently is not just about ourselves, it is also about those around us, and that includes our loved ones.

See you next month. Take care.

Kind regards

Ivy Grove Surgery

 

Written by Dr M. Wong