GREETINGS

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Welcome to the latest issue of the newsletter, published as we enter the festive period which is traditionally a very busy time for us at the surgery.

We bring news of joining staff and updates on various practice initiatives, as well as the usual crop of very bad Dad Jokes that are customary at this time of year. We hope you enjoy reading.

DR AXTEN UPDATE

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As was reported last issue, Dr Axten had a heart attack in early September and has been sick from work since then. He will be gently easing his way back into work with the aim of a full return in the New Year. We wish him all the best in his ongoing recovery.

Dr Axten would like to thank everyone for their good wishes.

WELCOME TO ALYSSA, OUR NEW ACP

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We'd like to welcome Alyssa, our new advanced clinical practitioner:

Hi everyone,

I'm Alyssa, the new advanced clinical practitioner at Ivy Grove Surgery. I trained initially as an adult nurse in 2011, working in hospitals and ITU before moving into general practice. I was a practice nurse for some years before going back to university to become an ACP. I am also proud to say i am a 'Queen's Nurse' .

I live in Swadlincote with my husband and 4 year old daughter, alongside a cat and tortoise! I work two to three days per week here at Ivy Grove.

Some of our patients have already fed back on their consultation experience with Alyssa, and we hope you will join us in welcoming her to the team.

NEW DOCTOR STARTING

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We will have a new doctor starting with us in January. She is called Dr Jenny Pickard and she will be working at Ivy Grove two days a week. We will welcome her formally with a brief introduction in the next newsletter, but some of you may have already met her as she has been doing a few locum sessions for us. We look forward to her joining the team and working with her regularly.

We are still on the lookout for more doctors to fill our vacancies.

HOW TO USE THE WEBSITE

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Our website has been designed from the ground up and follows NHSE England guidelines on GP websites to be both open and available for our patients. It adopts a 'mobile first' approach which means the content works as expected on all desktop (computer), tablet and mobile devices.

Most patients use their surgery's website to perform common tasks, such as finding out about appointments, how to get fit notes and obtaining repeat prescriptions, registering with the practice and using online services. Our website is therefore no different from those of other GP surgeries in that respect.

However, in addition to the above standard functions, at Ivy Grove, we use our website extensively as a portal to self-care, self-referral and medical information, as well as regular news and information on the surgery and the wider issues around General Practice. It is therefore by nature, more comprehensive than most. This might make it look rather overwhelming and seem difficult to navigate..

We have however, reviewed our users' online journeys as they go through the site, and redesigned it such that commonly required areas are made more accessible.

The home page

The home page is where most people 'land' on the website. It therefore provides the main options that most patients will need. Near the top of the page, in a light blue banner with a heading marked 'Popular', you will find five of the most popular areas as well as a link to scroll down the page for more:

Popular: Appointments | Mental health support | Self-refer | Repeat mMeds | Patient Access | More

Simply click the required link in this banner to take you to the section you want, or if that's not what you want, just scroll down the page to find the following headings and options underneath:

• 1. WELCOME to Ivy Grove - a brief intro to the surgery
• 2. SEE the right person - information on who to see first, self-refer, check your symptoms, different members of the GP team, find contact numbers
• 3. BOOK an appointment - types of appointment and options on getting help if we are full or closed
• 4. INFO to refer to - common tasks, such as how to get repeat prescriptions, look out for cancer red flags, check if you're poorly, home visit info, NHS Health A-Z
• 5. MORE stuff - other interesting things

Key areas on top of every page on desktop (computer)

When browsing on a desktop device, across the top of each page you will see main options across the top of the screen, like so:

Hovering over these self-explanatory labels should get you to where you need to go:

• Mental health - our mental health support page
• Get help - options on how to get help, for example, appointments, symptom checker, home visits
• Self-refer - options to self-refer to most workers in the NHS. for example, podiatry, physio, family planning clinic
• Self-care - try to help yourself, for example, self-help and minor illness leaflets, mental health support
• Meds - ways to get your repeat prescriptions
• News - Latest news and past newsletters
• Important - our messages to you
• Register - how to join the practice
• (popular) - commonly visited pages, for example, how to get blood tests, blood pressures, how to register with us
• (search) - if you still can't find it

Menu on left hand side of all devices

The full left hand menu (see left) is always shown on a desktop computer, but hidden when using a mobile or tablet device.

When browsing on a mobile or tablet device, you can reveal the full left hand menu by clicking the button marked MENU at top right of the screen. This menu button only displays on mobile and tablet devices.

The left hand menu gives the main categories and clicking these will give you more options:

• Popular right now - the most popular tasks or pages on the site, for example, ways to get your meds, booking blood tests, fit notes, current items like job vacancies, flu jabs - please note this section is continuously updated to reflect the most visited pages on the website
• Our practice - information about the practice, how to find us, transport links, the practice area, staffing
• Get medical help - all the ways you can get help
• Try self-care - ways to get help yourself, such as mental health support, leaflets, NHS app
• Services - information on services we provide, for example, clinics, carers, fit notes, home visits, online services, repeat prescriptions
• Admin - how to change address, forms and leaflets, our policies, private fees, records access
• Information - news, information pages, hospital care information
• Contact - how to get in touch with us
• Boring stuff
• Still can't find it? - search the site

Hopefully the above will give you some clues on how to get started with the website. We will continue to make improvements to the website in the New Year and will let you know of any further changes.

MEASLES CIRCULATING

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Measles is now circulating in England and the World Health Organisation (WHO) has warned that Europe is likely to see an increase of infections and is urging action to increase vaccination rates. We are being asked to ensure our staff are immune to measles, but also importantly, we must encourage all relevant patients to have the MMR jab.

We tend to forget that measles is one of the most highly infectious illnesses known. Just for comparison, the original covid strain in 2020 had an attack rate (R0 value) of between 1.4 and 2.4. This meant over 2 people could contract the virus from one person with the virus. With measles, the attack rate is up to 18.

Even if you ignored how infectious it was, the concern is due to the fact that in some people, serious complications may arise from measles infection.

Although most people make a complete recovery from measles with no problems, some patients may suffer from severe complications: if it spreads to the brain it can lead meningitis, blindness, inflammation of the brain and fits. If it spreads to the lungs, it can cause pneumonia. Luckily such complications are rare, but they are significant enough to warrant concern.

If your child gets an invite for an MMR jab, please do not ignore it.

FESTIVE OPENING HOURS

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For Christmas and New Year, we remain open as usual on all normal working days and closed on all bank holidays and the weekends.

Demand is always exceptionally high due to the festive season, therefore we encourage all patients to consider getting the right help from the right professional at the right time.

To access medical help during the times we are closed, please visit our new 'options when closed' section and check our other resources to help you get the help you need.

REPEAT PRESCRIPTIONS

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Just an update on repeat prescriptions; as mentioned in the last issue, from Jan 2, 2024, we will no longer accept paper repeat slips for the processing of repeat prescriptions. The vast majority of patients are now using digital means or the Medicines Order Line (MOL) phone line to request their repeat prescriptions. By making this change we will also be reduce our paper usage and carbon footprint.

The MOL team have asked us to relay some information to all our patients:

As we approach the festive period, the MOL service is expected to receive a higher number of calls with patients making sure they order their medication in enough time for Christmas.

Unfortunately due to staffing pressures, the MOL team are already operating at a lower staffing level than normal [know the feeling - Ed.]. This increased pressure and demand on the service will result in higher waiting times and the possibility of all the phone lines being full at peak times.

To relieve pressure from the service so the phone line is kept available for patients who have no other means of ordering, the MOL is encouraging all patients who have access to the internet or apps to order via one of the following alternative methods:

• NHS App
• MOL online ordering form
• Patient Access

You will find these digital options below:

To contact the MOL by phone, use the button below.

WINTER ILLNESS

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It's been a few years since we last showed our winter top tips video, so we think it's time to remind everyone to look after themselves as winter approaches. Winter always carries the increased risk of illness, as the weather deteriorates and we move indoors with reduced ventilation and closer proximity to others.

There are things that you can do to keep yourself well and safe over winter. Our video below and our dedicated winter illness page gives further advice on managing conditions over winter.

By the way, it's still not too late to get your flu jab. If you still haven't had one, please let your clinician or receptionist know when you attend.

Top Tips for Winter (2:42), Ivy Grove Surgery

ACCELERATED ACCESS TO RECORDS

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Last month we sent a few text messages to you all regarding the Accelerated Access to Records programme.

It appears there may have been some misunderstanding of the intentions of the text messages as, although we would have expected an increased level of interest on access to records due to the mere fact of mentioning it, we did not envisage the massive deluge of applications for this!

Therefore, if you have applied for access to records, please understand there will be a delay in your access being granted as we check each individual application and record.

Just to clarify: the reason we let everyone know about the accelerated access to records programme was that the government was forcing GPs, via a new and contested term in our contract, to switch on online access to records for everyone, regardless of their wishes. As GPs we have an issue with this, as everyone's records would need to be checked and we would need to ensure that the vulnerable, the coerced, those subject to abuse would not be harmed by the switch on. Accordingly, as a practice, along with many other practices all round the country, we took proactive steps to safeguard your data. Our job in keeping your data safe supersedes any contractual role as a GP.

We want to emphasise that you do not need to do anything, we have already safeguarded your data. We also want to emphasise that you are not missing out by doing nothing; you are not missing out by not applying for access to records right now. Your data is still there for you to access, and if you do wish to apply for access to records, you can do so at your leisure, or at a later date, it doesn't need to be all at once! And finally, if you don't want access to records, please let us know and we will switch off access.

Our new access to records page gives much more information on the situation and vital context to the concerns around data, and we encourage all our patients to read the page in full before committing to any particular course of action.

MENTAL HEALTH SUPPORT

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Christmas time isn't for everybody. We know some of you may struggle during what is already a difficult and stressful time for many. If you are in need of mental health support, please review the specific mental health support page on our website so that you can start to get the help you need.

There is a lot on this page! Specific sections outline help available to various age groups, from kids to teens and through to older and more vulnerable patients. Please take your time, read through the introduction, and perhaps go through the resources with a trusted friend or relative. You will find links and telephone numbers to take you to the required help.

Speak to someone

If you're still not sure what to do, or you need to speak to someone, 24 hours a day, every day, including Christmas Day, please ring the Derbyshire Mental Health Helpline on 0800 028 0077:

This helpline is available to anyone who is struggling to cope, suffering with anxiety, depression or anyone who is in immediate distress or in a crisis. You can speak to an advisor or be signposted to other services that are appropriate to your condition. More information is available on the link above.

You can also book to speak to a counsellor by self-referring to a free NHS counselling provider:

Social support

If you are suffering in isolation or need social support, get help from various sources:

Drug and alcohol support

If you need support for drug and alcohol misuse, please self-refer to appropriate services:

Bereavement support

Christmas brings the loss of a loved one into stark relief and can make an already difficult time of year much worse. If you are struggling, please consider seeking dedicated grief and bereavement support:

In a crisis or at risk of self-harm

If you are in a crisis, or at risk of self-harm, please visit our dedicate sections on what you can do, to either talk to someone, get in touch with a service, or find official sources of self-directed help.

PATIENT PARTICIPATION GROUP

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Ian, our Practice Business Manager writes about PPGs.

The PPG at Ivy Grove Surgery!

A Patient Participation Group (PPG) is a group of patients, carers and GP practice staff who meet to discuss practice issues and patient experience to help improve the service.

Since April 2015, it has been a contractual requirement of NHS England for all GP practices to have a PPG and to make reasonable efforts for this to be representative of the practice population.

What does a PPG do?

• To give patients and practice staff the opportunity to meet and discuss topics of mutual interest
• To provide a means for patients to become more involved and make suggestions about the healthcare services they receive
• To explore issues from patient complaints and patient surveys, contribute to actions plans and help monitor improvements
• To contribute feedback to the practice on National Patient Survey results and Friends and Family Test feedback to propose developments or change
• To support health awareness and patient education

What should a PPG look like

A PPG is open to every patient on the GP practice list. All communities, groups, genders, ages, ethnicities, and disabilities representing the patient list are encouraged to join. There are no other membership requirements except that patients must be registered with the practice.

PPG members should as far as possible, be representative of the practice population.

If you are interested in joining the PPG here at Ivy Grove, please speak with someone at reception who will put you in touch with the me, the Practice Business Manager. We are hoping to have our first meeting in early 2024 and we hope to see you there!

TELEPHONE SYSTEM UPDATE

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Ian, our Practice Business Manager, now provides a further update on the telephone system.

As part of the changes made to the GP Contract this year - it is a requirement for all GP Practices to move to a fully cloud based telephone (CBT) system by the end of March 2024.

The reason for this is two-fold, From the end of 2025, all analogue ISDN and PSTN lines will be removed for use in all home and business settings. From this point, only cloud-based platforms will be supported. But more importantly, Digital telephony (CBT) provides greater functionality for practices and patients.

The functionality includes call queueing and call back, which will provide a better patient experience when the lines are busy, but it will also provide the practice with relevant demand information and data which will allow us to gain a greater insight and improve our responsiveness even further.

As a practice, we have decided to stay with our existing provider Wavenet and their system 'GP Voice'. Wavenet and GP Voice has been approved by the NHS 'Better Purchasing Framework' and is an accredited provider of advanced cloud-based GP telephone solutions.

GP Voice is a cloud-based telephony solution that allows GP practices to transition from legacy phone systems to a flexible and adaptable communication system that continually meets the demands of busy practices.

It offers the ideal combination of powerful, yet intuitive call handling and recording, automated appointment setting and a wealth of management information. This should drastically improve the patient experience with reduced call waiting times, with place-in-queue notifications and it will also give our patients the option to request a call back when they reach the front of the queue.

We look forward to bringing you more information regarding the 'go live date' early next year; currently this is expected to be sometime during February 2024.

HOSPITAL CARE

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We get very many queries regarding hospital care. Examples include chasing up results, chasing up letters, prescribing medication, issuing sick notes. Recent studies have estimated that 25-30% of GP workload is related to work that should have properly been done by hospitals themselves. Just imagine if this significant amount of inappropriate and unnecessary work was released from General Practice, then GPs and their teams would have more time and you might then even be able to get an appointment with them!

We must remind all patients that we are not responsible for any aspect of hospital care. In particular, actioning results is the responsibility of the clinician who ordered the test. In the case of bloods, scans and other investigations organised by the hospital, responsibility lies with the consultant or doctor covering that team.

A further important note is that if the hospital requires you to have medication urgently, then under terms of their hospital contract, this must be prescribed in full, directly by the hospital and dispensed at the hospital pharmacy. Responsibility for urgent hospital medications does not lie with your GP.

Regarding fit notes after hospital care, these have always been the responsibility of the consultant you are or were under, and furthermore, as of November 30, 2023, changes to the hospital contract mean that all hospitals must have in place processes by which any patient can be sent a fit note electronically. This therefore means that there will be no excuse for the hospital not to be able to provide you with a fit note should you need it. We have been advised to log instances of any such breach of contract with our local medical committee for reporting and enforcement by the health board.

If you have an issue regarding any aspect of hospital care, please ring the hospital directly. Please do not be put off by calls from the hospital to 'ring your GP'. Please note that under terms of the hospital contract, the hospital is obliged to answer your queries in much the same way that we respond to queries from our own patients regarding matters under our care.

To help our patients, we have provided a page on our website which gives further information on hospital duties and responsibilities on a range of matters, including letters, prescriptions, fit notes, tests and results.

VOLUNTEER RESPONDERS

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Click to view poster

NHS and Care Volunteer Responders is a flexible volunteering programme supporting the NHS and adult social care across England.

Enthusiastic volunteers take on a range of activities to support the NHS and people drawing on social care. The organisation works with the NHS and care providers to make sure the activities provide the maximum benefit to those who need support.

Health and care teams can refer people for Check In and Chat and Check In and Chat Plus friendly telephone calls. They can also request Pick Up and Deliver support with the delivery of medication and supplies and Community Response support with essential shopping and prescription delivery. Steward Volunteers are available to help at vaccination sites.

Members of the public can request support from volunteers, either for themselves or someone they know (with that person’s permission), and there are lots of exciting volunteer opportunities available.

More information and to get support is available at the links below and we also have leaflets available at the front desk.

POSITIVE FEEDBACK RECEIVED

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We continue to receive positive feedback from our patients which we share with all our dedicated staff. Thank you for spending the time sharing your comments with us, it really does help keep us going.

I have had such good service from the surgery - better than the surgery that I am actually registered with and I wish I could move more local to be registered with you myself! I praise the care from Drs Neely, Francis and Greer, Enid and Sally on reception and Michaela, care co-ordinator – relative of MM

The telephone appointment I had today with Dr Neely was brilliant and I think the flu clinic on Saturday was well organised – MC

I'm ringing in especially to thank Lindsey after my appointment yesterday. Lindsey was "absolutely amazing" and put me so much at ease as I was very nervous and she even gave me a flu jab at the same time! I want to pass on my grateful thanks. – LG

The flu clinic was very well organised, everything went really well and it was nice and quick. Super job and a very BIG well done. – JC

I want pass on how much I think Dr Rajan is lovely – AR

I just wanted to compliment the surgery on the smooth running of the flu clinic. – DP

Dear Ivy Grove, please thank on my behalf Michelle (reception) who helped me out with my query on Monday afternoon, when I popped into Ivy Grove, very patient with me and very helpful. Nothing was too much trouble for her. I have always felt blessed being in the lifelong care of Ivy Grove, thank you. – HH

Thanks to Dr Greer for prescribing my treatment – MB

I wish to compliment the practice, one of my clients joined our practice a couple of weeks ago and this is the best practice that I have ever dealt with. I want to thank the admin team who responded to my email (first one in 7 years)!, reception, especially Mandy who not only listened but also understood the issues my client faces and everyone who helped resolve an issue with my client's medication when their pervious practice stopped prescribing a week early. – V

Alyssa was 'brilliant' and 'a breath of fresh air' – SF

Alyssa is brilliant and worth her weight in gold – LB

Just calling to say thank you to everyone at Ivy Grove, especially Dr Neely & Greer. Well done. – family of JJ

I want to say I don't know why people are so quick to complain about the NHS. I am so grateful for the care given by Dr Francis and Dr Ross with regard to my wife and very grateful to Dr Greer today for dealing with my problem – EH

I am asking you to pass on how pleased I was with the consultation I had with Dr Wong. He was like a 'breath of fresh air' – DK

Satisfied – KG

Ivy Grove staff are amazing. They are always extremely busy but always take the time to deal with patients no matter how long it takes . Thank you – DP

★★★★★ – MW

Well done to any member of our team that was mentioned above and thanks once again to any patient to took the time to leave us feedback. We do read each and every comment!

Please know that we are always trying our very best for you all - we know we don't always get it right and appreciate that you must let us know about it, so that we may take action to make things right for you.

If would like to leave feedback on your experience with the surgery, please feel free to use any of the following methods, or just drop us a line:

Please do not use any of the above methods to make a formal complaint against us as they are unsuitable channels for complaints. In these circumstances, please ring us and ask to speak to one of the managers, or write to us.

DAD JOKES

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Here we are with another set of Christmas Dad Jokes to lighten the mood.

We hope you enjoy this awful collection of apparent jokes. The numbers in brackets give the indicative cringe factor as determined by a large and diverse studio audience of relatives of dads.

SHORT-SIGHTED PATIENT: Doctor, please pay attention, I paid good money to see you!
DOCTOR: Erm, no, you haven't paid me anything
ANSWER (6/10)PATIENT: These glasses weren't cheap!

DENTIST: My advice is don't throw your false teeth at your vehicle
PATIENT: Why not?
ANSWER (7/10)DENTIST: You might denture car

What Christmas present do you give to someone who literally has everything?
ANSWER (5/10)Antibiotics

PATIENT: I've got a terrible addiction to Worcestershire Sauce!
DOCTOR: Why do you think that is?
ANSWER (9/10)PATIENT: It's hard to say

PATIENT: Doctor, I broke my arm in three places!
ANSWER (5/10) DOCTOR: Well, don't go to those places

Why did the pathologist cross the road?
ANSWER (7/10)To get to the other slide

PREGNANT LADY: I'm 3 months pregnant, when will my baby move?
ANSWER (8/10)OBSTETRICIAN: Hopefully when he finishes college

DOCTOR: So, what's your pain level like?
PATIENT: π
DOCTOR: Pi? Why do you say that?
ANSWER (7/10)PATIENT: Well, it's somewhere between a three and a four but neverending

PATIENT: I think I've got problems with my hearing
DOCTOR: Can you describe the symptoms?
ANSWER (9/10)PATIENT: Well, Marge has blue hair and Homer has a big belly

PATIENT 1: So, what are your plans today?
PATIENT 2: Well, my friend and I are going to the opticians to get some new glasses
PATIENT 1: And what then?
ANSWER (10/10)PATIENT 2: Then we'll see

FINALLY...

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We hope that the next update will give better news for staffing levels at the practice and a welcome return to work for Dr Axten. In the meantime, please keep yourselves safe and healthy as we approach the end of yet another tumultuous year.

Kind regards

Ivy Grove Surgery