GREETINGS

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Here we are, already into the third month of the New Year, how time has flown! We apologise for the delay in getting a newsletter out to you, but we have been rather busy working behind the scenes to build our staff complement back up. This issue we give news of such staffing updates, as well as an update on the imminent new telephone system. Given the New Year, there's also a focus on getting healthier not only for yourself, but also for the environment.

We hope you enjoy this issue. Please don't forget to let us know what you think - we take all feedback seriously and use your comments to help us continue to improve our services.

DR AXTEN IS BACK

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We are pleased to report that Dr Axten is now back at work after his heart attack last September and he has returned to full duties.

Many thanks to all those who gave good wishes for his speedy recovery. All messages were very gratefully received and much appreciated.

WELCOME TO DR PICKARD

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We'd like to welcome Dr Jenny Pickard, our new retained GP:

Hi, I am Dr Jenny Pickard a new GP at Ivy Grove Surgery. I qualified as a GP in 2018 and have a particular interest in cancer care.

I work on Mondays and Thursdays and have been made to feel very welcome by the whole team at Ivy Grove.

I live in Derby with my husband, and our three young children, who take up most of my spare time!

NEW DOCTOR STARTING

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We will also have a further new doctor starting with us in March. She is called Dr Georgia Lavender and she will be working at Ivy Grove three days a week. We will welcome her formally with a brief introduction in the next newsletter.

With this appointment, we will have reached our intended complement of clinical staff, and hope that this will improve access to much needed appointments for our patients.

THE LONDON MARATHON

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Both Dr Riva Greer and Alyssa, our advanced clinical practitioner, are running in the London Marathon this year. Here they share their stories and inspiration behind their plans. We hope that you can support both of them in their fundraising efforts by donating.

Riva's story

On Sunday 21st April I will be running the TCS London Marathon to raise money for the Miscarriage Association.

In 2018, two years after having my daughter, I fell pregnant again with a much wanted second baby. I went for my 12 week scan excited about the prospect of getting to hear my baby's heartbeat for the first time to be told there was no heartbeat. In that moment my whole world came crashing down and I remember sobbing hysterically and thinking that this couldn't be happening to me, like I was in a bad dream. I needed to return for another scan two weeks later to confirm that I had lost my precious second baby. The intervening two weeks were agonising, just waiting in limbo for the inevitable to happen. I subsequently had failed medical management (where tablets are given to try and induce bleeding) with a resultant infection of my womb that then required surgery.

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In 2019, I fell pregnant again and the anxiety I felt throughout made it impossible to feel excited about being pregnant. My worst fears came true again when I had a scan at 10 weeks to be told again that there was no heartbeat. To make matters worse I was told it was highly likely that I had a molar pregnancy that may require more intensive treatment. I needed surgery again and after several weeks of waiting, I was told that it was not a molar pregnancy but another miscarriage.

Miscarriage affected me profoundly, physically but more significantly mentally. I felt isolated in my grief as miscarriage was still a somewhat taboo subject and having not known anyone else who had gone through it I felt like no-one could understand how I was feeling.

My job as a GP was all the more difficult as I had to continue caring for patients who were pregnant or look after newborn babies whilst going through my own loss.

Since then several friends and family members have experienced miscarriage and it has bought home just how common this is and how many women and families have to navigate these complex emotions.

Happily, after all the heartache, I was subsequently blessed with a beautiful baby boy during the pandemic to complete my family.

I've chosen to raise money for the Miscarriage Association so that hopefully women who have been in the same position as me can access information and emotional support.

The Miscarriage Association is a national charity that offers support and information to anyone who is affected by miscarriage, ectopic or molar pregnancy. They work with health professionals to encourage good care; with workplaces to promote compassionate policies and with the media to raise public awareness of the facts and feelings of pregnancy loss.

My fundraising will help pay for the staffed helpline and the production of high-quality information online and in print.

If you would like to sponsor me to help support this amazing charity then any amount, no matter how small, would be very gratefully received. Please follow the link below to visit my Just Giving donate page. Thank you for your support.

Support Dr Greer now Miscarriage Association NHS: Miscarriage

Alyssa's story

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I am running the London Marathon this year on 21st April. I am running to raise money for the Roy Castle Lung Cancer Foundation as I sadly lost my Grandfather (my hero and leading man) to lung cancer in 2012 at the age of 83. He was a Londoner (East End) and played for Fulham Football Club in his youth! So I thought a little jog around his home town would be fitting!

In both my personal life and professional life as a nurse, I have seen so many patients and their families affected by lung cancer. What Roy Castle Lung Cancer Foundation aims to do is to support patients and families, have specialist nurses, a support telephone line and push for screening and research into treatments, prevention and cures.

Any donations would be extremely appreciated during this time as I have a rather large fundraising target to achieve... until then I'm off for a jog!

Please support Alyssa in her fundraising by visiting her London Marathon donate page:

Support Alyssa now View Alyssa's poster Roy Castle Lung Cancer Foundation NHS: Lung cancer

THE BENEFITS OF EXERCISE

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The New Year brings fresh hopes for a better life, improved health, increased motivation and willpower. After Dr Greer's and Alyssa's inspirational stories, Dr Greer writes further about the benefits of exercise.

As well as running to raise money for charity, I run to help keep my mind and body healthy.

Regular exercise is proven to help prevent and manage diseases such as heart disease, stroke, diabetes and several cancers (including breast cancer and bowel cancer). It also helps hypertension (high blood pressure), strengthens our bones and reduces the risk of falls and fractures or the hips and spine. It can help us maintain a healthy body weight and can improve mental health, quality of life and well-being.

The World Health Organisation (WHO) recommends adults should do at least 150–300 minutes of moderate-intensity aerobic physical activity per week.

In addition adults should also do muscle-strengthening activities that involve all major muscle groups on two or more days a week, as these provide additional health benefits.

We all have busy lives and fitting in exercise can be difficult but some physical activity is better than doing none. By becoming more active throughout the day in relatively simple ways, people can easily achieve the recommended activity levels. This might be by walking short journeys instead of getting in the car, doing a spot of gardening, taking the stairs at work instead of the lift or even chair based exercises if you have limited mobility.

If you would like more information on how to increase your levels of physical activity please visit our website or contact our health and wellbeing coach Sam to see how we can help.

GOING GREEN

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Dr Neely, our lead on Green issues writes about latest developments:

We are trying to improve the 'greenness' of Ivy Grove Surgery and I attended a series of workshops towards the end of 2023.

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The area I want to cover this issue is transport. As a practice we try and improve in whatever way we can.

Reducing our carbon footprint from travelling can help improve health by reducing emissions, improving physical and mental health and saving money.

Most of our staff members live within 5 miles of work and 3 currently car share. Some are planning to walk, ride and run in the summer when able. We'll be reviewing this annually and looking at what we can do to encourage better transport choices.

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In the last year, I have ridden to work once or twice a week and over the year this has added up to 1000 miles. That's £500 of fuel/running costs saved and 50,000 kCal (roughly equivalent to 13.5kg chocolate cake) as well as the benefit to my overall physical and mental health.

When you come to see us, the bus stops outside the surgery, so please consider walking or using public transport if able to. Also make use of telephone appointments if appropriate to reduce transport need.

SHINGLES VACCINE

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Shingles is a common condition that causes a painful rash. It can sometimes lead to serious problems such as long-lasting pain, hearing loss or blindness.

You are more likely to get shingles, and it is more likely to cause serious problems, as you get older or if you have a severely weakened immune system.

The shingles vaccine helps protect against shingles and is recommended for people at higher risk from shingles, including all adults turning 65 years of age, those aged 70 to 79 years and those aged 50 years and over who are immunocompromised.

The shingles vaccine helps to reduce your chances of getting shingles and reduce your chances of getting serious problems if you do get it.

Various age groups are being invited in batches each year so that eventually those of all eligible ages will be covered.

If you are in one of the above eligible groups, please wait to be contacted, or if you had an invite but missed out and you are still under 80, please get in touch with us.

More information on the shingles vaccine is available in the link below:

SAME DAY HUB

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Some of you will have already been seen in the Same Day Hub this winter. This is a new service which has been operating since December. It has been specifically set up to deal with the surge in respiratory and acute minor illness cases that we always experience during this time of the year. The hub is aimed at providing local surgeries in the network with some extra appointments every day for managing such cases.

The types of cases seen in the hub are those conditions for which patients commonly require same day assessment. For instance, those with respiratory illness, like sore throat, cough, sinus problems, earache, asthma; urine infections, skin problems, like rashes, spots, infections; unwell children over the age of 1 years, tummy ache.

If you feel you need an appointment for any of the above conditions, please contact us and we will try and accommodate you in the hub, subject to appointment availability.

The Ripley neighbourhood clinic is held here at Ivy Grove and is manned by Amber Valley clinicians, which means you may be seen by any clinician working in the Alfreton, Ripley, Crich and Heanor area.

Given the success of the service, it has been decided that once the winter phase is over, the Same Day Hub will continue, but at a somewhat lower capacity, so that practices and patients will not be without some form of service for acute same-day illness.

The extended access hub, which runs in the evenings and on Saturday continues as before. The links below will provide some information.

All patients are reminded that appointments at the surgery or at the hub are a finite resource, and if we are full, you will be informed. If we are full, there are still options for getting the help that you need, including self-referral and self-care.

REMAINING FLU JABS

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Ian, our Practice Business Manager writes regarding flu and with an encouragement to remaining patients to get their flu jab as soon as possible:

There is still a way to go before the official end to the flu season, and in line with the NHS flu vaccine PGD, and the continuing circulation of flu, we are encouraged to continue using our vaccines until March 31, 2023.

For those eligible patients who have not refused and are still in two minds on having the flu jab, just a reminder on some key points:

• Flu is much worse than a heavy cold flu symptoms can be severe and can come on suddenly. You’re likely to spend several days in bed and feel very unwell. Some people become seriously ill and have to go to hospital
• You are at greater risk of complications from flu - you’re eligible for flu vaccination because you need it
• The flu vaccine is very safe
• The flu vaccine is the best protection we have against an unpredictable virus
• The flu vaccine CANNOT give you flu; your arm might be a bit sore where you were injected and some people have a slight temperature
• The flu vaccine stimulates your body’s immune system to make antibodies to attack the flu virus - if you’re exposed to the virus after you’ve been vaccinated, your immune system will recognise the virus and produce antibodies to fight it
• It can take up to two weeks for the flu vaccine to work, so get vaccinated as soon as you can
• You need to have the flu vaccine each year because the circulating strains of the virus change and so different vaccines are produced to match
• Pregnant people can have the vaccination at any stage of pregnancy, flu can make you and your baby very ill. Vaccination can also protect your baby against flu after they’re born and during their first few months
• Your vaccination helps to protect those around you too, so elderly relatives, those with long-term conditions and other family members are all protected by your vaccination

If you want your flu jab, please get in touch with us! Thank you

And if you don't want your flu jab, no problem, please simply let us know, so that we can stop pestering you about it!

TEXT COMMUNICATIONS

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We are a practice that does not shy away from technology and new initiatives. General Practice continues to evolve along with new developments in IT.

Our part in this involves increased use of text messaging services to patients. Ivy Grove makes extensive use of text messaging with examples such as communicating that prescriptions have been sent to the chemist, advising on medication changes or treatment plans, or to obtain blood pressures and weights from patients.

Whilst some might take offence to the use of text messaging as part of clinical care, we would like to assure all our patients that there is no intention at all of being abrupt or impersonal when we make such approaches. Text messaging and responding to questionnaires via text are in fact now very widespread in many clinical fields and many patients do find it very convenient.

Keeping up with such technological developments does mean that we have shorter processing times as issues are dealt with more quickly and efficiently. By doing so, we are also able to free up capacity to deal with more patients, both in face-to-face and also telephone appointments.

PATIENT INFORMATION LEAFLETS

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We also use text messaging to refer patients to our website, where they can self-refer to other more appropriate services, or download forms and leaflets, including diagnoses relating to their results and urgent hospital referrals.

Some of you will have received leaflets on statins and prediabetes and kidney impairment or vitamin deficiency diagnoses amongst many others. Please do not be offended if you receive such leaflets - they have been personally authored for Ivy Grove patients by Ivy Grove doctors.

By sending these leaflets out to patients, we are able to increase productivity, whilst also imparting essential information to our patients in a form that is more comprehensive and retainable than a phone call. In our experience they have been very well received by the overwhelming majority of patients and are a useful preamble towards further discussion should it be required.

All the leaflets that are sent to patients are also available to download from our website at any time from our downloads page. You can find some of these below:

TELEPHONE SYSTEM UPDATE

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

As you will be aware from the previous newsletter, as part of the changes made to the GP Contract this year - it is a requirement for all GP Practices sign up 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. Offering the ideal combination of powerful, yet intuitive call handling and recording, automated appointment setting and a wealth of management information. It will drastically improve the patient experience with reduced call waiting times, with place in queue notifications, it will also give our patients the option to request a call back when they reach the front of the queue.

Since our previous update, I have attended a project initiation meeting with Wavenet. During this meeting, the next phase of the project was planned, which is for one of their engineers to complete a physical site survey. This is planned for March 8. Following this site survey, BT Openreach will be installing a brand new FTTP connection into the Surgery - FTTP stands for 'fibre to the premises' and is a type of fibre optic broadband. FTTP is supplied by fibre optic cables from the local internet exchange directly into the surgery's premises, meaning a much faster and more reliable connectivity than we have currently. Whilst we don't have a definite date as yet in the diary to 'Go Live' with the new system, it is hoped this will be somewhere in the region of 6-8 weeks from the site survey taking place.

We will of course keep you up to date with any further developments in this exciting project as we get them.

MISSED APPOINTMENTS

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A very important note now about missed appointments. Nationally, around 7.8 million appointments are missed each year. This equates to around 650,000 missed appointments a month.

This is shocking, given the difficulties patients experience in obtaining those appointments in the first place, and given huge waiting times for appointments including those for operations and procedures.

Across Derbyshire, 2,500 appointments in GP surgeries are missed every month.

At Ivy Grove, the figures are equally shocking. In the last three months, 214 patients missed 324 appointments, 117 patients missed 135 telephone appointments and 34 children were not bought to 39 appointments.

Looking back over the last year, at Ivy Grove 1,059 patients missed 2,115 surgery appointments, and 462 patients missed 648 telephone appointments and 72 children were not brought to 92 appointments.

Just looking at these headline figures, you can see immediately that certain patients missed more than one appointment. We also find that most of these same patients rebook another appointment within 48 hours. Overall, this means more calls into reception and more appointments being used up overall.

In one year, all these missed appointments are equivalent to five doctors sitting idly with completely empty morning and evening surgeries every working day for a full month! Such a waste!

Even though patients do not pay to see their GP at the point of contact, this does not mean that a missed appointment hasn't cost anyone anything. If you factor in staff time, room costs and the nominal cost of a GP consultation (around £40), including the cost of not being able to get another patient into the slot, including lost targets that cannot be met, you are looking at tens of thousands of pounds lost to the surgery.

You can therefore see that missed appointments have a huge impact on the surgery and on appointment availability for other patients. Please bear this in mind the next time you ring and find that you cannot get an appointment. It might be because someone else had used that last appointment slot but then did not bother to turn up.

Unlike other organisations, such as dentists, we are not allowed to fine people who miss appointments, even those who do so wilfully or repeatedly. But we can send warning letters to those who miss appointments, and repeat offenders may be removed from our panel.

If you cannot make your appointment, or feel that you no longer need your appointment, or you are now better, we kindly ask that you give due consideration to the needs of your fellow patients, and please let us know and cancel your appointment in good time, so that we may offer it to another in need. Aside from the methods linked below, you can also drop in at the front desk and let us know.

We will be verygrateful, as will other patients, we're sure. Many thanks

POSITIVE FEEDBACK RECEIVED

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Thank you for all the positive comments that we continue to receive. We share all feedback with our wider team and can tell you that each one is very gratefully received and much appreciated. Where applicable, certain aspects of feedback have been anonymised to protect individual patients.

I came to the desk to say how lovely Dr Saddu was, and how he took away my worries that day with how kind and helpful he was, I'd like to request that I have my next appt with him – MS

I was seen by Dr Marval yesterday and she is absolutely wonderful. She has put my mind at rest about a few things I have been worrying about – MW

I would like to pass on how fantastic Dr Saddu is, he's the best doctor I've ever seen! – LN

Thank you for your continued hard work. You're a great practice! – JW

It was 'an absolute pleasure' to speak to Dr Wong. He was very reassuring and attentive and answered all my questions to put my mind at rest and when I had finished I felt 'a weight had been lifted'. It was a very positive experience and wanted to pass on my grateful thanks – DY

I have a bunch of flowers for Cath [receptionist], thank you very much for your help in sorting my script out – SM

I would like to thank Ivy Grove Surgery for the service I received last       I spoke to a member of the reception staff I think I am right in saying her name was Sally she was very helpful and put my name down for a telephone consultation this was at about 8.20am around 10.00am I received a telephone call from Dr Axten who took the time to listen and gave me different options to control my       between us we decided on a       and Dr Axten said he would get my prescription sent to Hursts Chemist.

I then received a text message from the chemist about 11.15am that morning to say my prescription was ready for collection. Now that's what I call service! As I work for the NHS each working day, I hear people complaining about the NHS, GPs and different surgeries; as for myself I can only praise you all – JW

Very helpful and informative – AL

Always good service at Ivy Grove, staff always friendly and cheerful – PJ

I had occasion to visit Ivy Grove Surgery on Wednesday 8th February. and received exceptional care as usual. I have to mention Mandy and Julie on reception both just couldn't do enough for me which is not unusual for those two wonderful ladies. I really appreciate their help in a difficult situation so thank you so much.

Dr Wong, as usual, was very thorough and compassionate so thank you, Dr Wong. I've never had a problem of any kind with this surgery all staff have always been so kind and helpful so thank you so much to all staff at Ivy Grove. – DP

As a new patient, so far I am very impressed with the surgery. They have been quick to sort out a couple of issues with my medication and my telephone appointment left me reassured. So far everyone I have come into contact with has been friendly and helpful. Thank you – C

★★★★★ – RM

Please do not use any of the above methods to make a complaint. In these circumstances, please ring us and ask to speak to one of the managers, or write to us.

FINALLY...

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With the onset of the New Year, we hope this issue has inspired you to make positive changes that will help to improve not only your own health and wellbeing but also, by consequence, improve the outlook of others around you, including those who love and depend on you.

Kind regards

Ivy Grove Surgery