NEW! This news update has just been published
If there is someone you know who doesn't have internet access and think they would like to read the newsletter, please feel free to collect a paper copy of the newsletter from the reception desk
We're sorry it's taken so long to come up with the latest newsletter - we have been so busy recently.
In recent weeks there has been an increase in covid and flu cases presenting at the surgery. If you have any flu-like symptoms, cough, sneezing, sore throat, fever or any other symptoms which are potentially infectious, we would be grateful if you would wear a mask whilst in the building to protect other patients and staff who might be vulnerable.
We need our staff to remain healthy in order to continue to provide a service to you. We therefore really appreciate your cooperation with this.
We have various bits of staffing news to let you all know about this issue.
Our recruitment drive for new clinicians continues. We are pleased to announce that we have hired a new Advanced Clinical Practitioner to join our team from November. We will introduce her fully in due course, but she will be able to see patients with a wide range of conditions and help to reduce some of the pressures facing our severely depleted clinical team.
We also continue our regular rotation of new GP trainees, who are actually fully qualified doctors, but still under training and mentorship. Dr Neely and Dr Greer act as their clinical supervisors, with contributions towards teaching and debriefing from the rest of the clinical team. We hope you can continue to welcome and support our trainees as they learn more about General Practice - after all, we all need each other!
We also have a number of new staff to tell you about in the next section and news on Dr Axten. In the meantime, we still have a number of job vacancies advertised.
We'd like to welcome Lindsey Reade, our new nurse:
Hi everyone, I'm Lindsey one of the new practice nurses here at Ivy Grove, I'm a Belper girl born and bred and live there with my husband and our 2 little girls. I trained as a degree level adult nurse over 11 years ago at the University Of Nottingham and have a background in District Nursing and school immunisations, I also work for DHU or the 111 service some evenings with the urgent district Nurses and palliative care.
Since becoming a practice nurse over three years ago there has been many changes and a vast amount of education and upskilling which has led me here today, I am currently training to be the new diabetic nurse for Ivy Grove. Wish me luck! I look foward to getting to meet you all.
We have to say, Lindsey, along with Mandy, our receptionist who manages diabetic follow-ups, and Dr Francis, who is our clinical lead in diabetes, all of them have made great strides in improving diabetic care at the surgery.
Here we welcome Sam Brien, our new Health and Wellbeing Coach (HWBC), to the team:
Hi my name is Sam and I am the Health and Wellbeing Coach at Ivy Grove. I used to be a personal trainer and class instructor and enjoy keeping fit and active when I am not entertaining my 3 young children.
I am also a trainee counsellor due to qualify this year, so life is pretty busy for me, but that’s the way I like it.
Being a Health and Wellbeing Coach is a perfect combination for me of my previous role as a PT and my training to be a counsellor and I find it incredibly rewarding to work with people to help them to change their own lives for the better.
I only work at Ivy Grove one day per week at the moment, but it is a privilege to work with both the staff and the patients alike.
You can self-refer to see the HWBC and find more information on the service at:
Here we introduce another Sam, this time, Sam Mair, our new operational manager:
Hi, my name is Sam and I recently joined Ivy Grove as an Operational Manager. I'm local, having lived in Belper most of my life so I know this area well. I live with my partner, and we have three girls, the youngest two having started high school this year.
I have previously worked in retail, banking, and education. Being new to primary care, I'm learning a lot about how integral a GP surgery is to the community but also the pressures it faces.
My role at Ivy Grove involves the facilities management, HR and improving our patients' experience. My ambition for the role is to forge stronger links to our community helping patients to access a wider range of services available to them.
We welcome Sam to the team and hope you will too.
Some have you may have noted my absence from the surgery in the last few weeks. Unfortunately, on the 9th of September I had a heart attack. Thanks to the wonderful care I received at King’s Mill Hospital, I am still here!
I am now recovering at home for the next few weeks before starting my cardiac rehabilitation programme.
My fellow partners, the staff at Ivy Grove and our management team have been working hard to cover work or find locum cover due to my illness and I hope that this will not disturb your care too much.
I thank you all for your ongoing understanding, patience and well wishes.
Best Wishes and Good Health,
Needless to say, all of us here at the surgery send our heartfelt (no pun intended!) good wishes to Dr Axten for a speedy recovery. If you too would like to send a message to Dr Axten, please use our contact form by clicking the link below and we will pass on your message:
Also a timely reminder to all our patients, if you suspect you are having a heart attack, please do not just shrug it off, or think it is nothing, please do not delay, do not book an appointment with us, ring 999 immediately.
We are aware many of you struggle with our telephone system. Ian, our Practice Business Manager, provides an update about the telephone system:
Ivy Grove Surgery is one of more than 1,000 practices who have signed up to make the switch from an analogue telephone system - which we know can leave our patients on hold and struggling to get through to the surgery - to a modern, easy-to-use digital, cloud based telephone system, designed to make sure more people can receive the care they need when they need it.
It is expected every practice in the country will have a cloud based system in place by the end of this financial year, helping put an end to the 8.00am rush, which is a key pillar of the Prime Minister’s primary care recovery plan to improve patient access to care.
The upgraded system will bring an end to the engaged tone and will enable our patient care advisors to have the ability to signpost our patients to the right professional sooner.
Successful care navigation can help direct 40% of requests more effectively and speeds up appointments for those who need them, by directing patients to other professionals within the practice or other medical professionals such as community pharmacists who can best meet the needs of the patients.
We are currently exploring options from numerous telephony providers to ensure we choose the best system available for our surgery. We are hoping to be able to share more information regarding the system we have chosen very soon as well as sharing our plans for when the system will be fully operational.
Just a reminder that you can refer yourself to most professionals working in the NHS by simply contacting them directly, without needing to ring the surgery first:
Here we provide a timely reminder on prescriptions and all relevant processes for our patients:
This is the recommended method of ordering your repeat prescription.
Ordering your repeat prescription involves a quick and simple telephone call to a dedicated person who will have time to answer any queries you may have about your repeat prescription and discuss your medication requirements.
Ivy Grove Surgery has made the decision to change how our patients order their repeat prescriptions. From January 2024, we will no longer be accepting requests that come from handing in your repeat prescription, either in our postbox or over the reception desk.
What does this mean for you? You will still be able to request your repeat prescription in a number of ways. More and more patients are now requesting their repeat prescriptions simply ringing the MOL as described above, or by using Patient Access online service. You can also use the NHS App. More details of these methods can be found on our repeat prescription page.
We will ensure a further update is given before we go live with this change.
Please note that writing requests or comments on your repeat or online may delay the processing of your entire prescription as we review your request and perform essential checks. In some instances, requests will be passed to the most appropriate or most recently involved doctor, which again will add to the time it takes for your request to be processed.
Unfortunately, increasing numbers of medications are going out of stock on a regular basis and it does not appear that this situation will be easing any time in the future. Issuing fresh prescriptions for medications that are out of stock is an extremely time-consuming process for the practice and which may cause a delay to your prescription. We therefore have some suggestions on what you can do to improve the overall experience not only for us, but also for yourself to ensure you receive your medication on time.
Hospitals must provide you with any urgent or same-day prescriptions
Hospitals are contractually obliged to provide you with any urgent or same-day prescriptions there and then. It does not matter if your appointment was face-to-face or remote, or if you have left the hospital already - it is still the hospital's responsibility to supply you with any medication that you require urgently. If the hospital has assessed you but is then telling you to contact or see the GP for an urgent prescription, then it is not fulfilling its contract of care towards you.
If you need an urgent prescription from the hospital, please contact the hospital, via the secretary of your consultant.
Hospital pharmacy prescriptions need to be dispensed at the hospital pharmacy
These are non-urgent prescriptions issued by the hospital to be dispensed at the hospital pharmacy. If, instead of using the hospital pharmacy, you decide to present such a prescription to us, for 'conversion' to a 'normal' prescription, please note this is at the discretion of the doctor and if accepted, will be processed within the usual non-urgent prescription timescales, which can be anything from 2 to 5 working days' notice.
If you wish to obtain your medication sooner than this, you are free to take your hospital prescription to the hospital pharmacy for dispensing.
Outpatient prescriptions for the GP to issue
These are non-urgent and will be processed within the usual non-urgent prescription timescales, which can be anything from 2 to 5 working days' notice, as indicated on the outpatient prescription itself.
If the hospital had required you to have your medication urgently or same-day, they would have issued you with a prescription there ant then.
Hospital requests for specialist or 'grey' medications
Prescribing comes under strict controls and any prescriber must ensure they are not prescribing outside of their skills, knowledge and experience.
If your medication comes under a specialist or consultant only category, or is being recommended 'off licence' (used for different reasons or patient groups from what the manufacturer specifies), then the requirement and responsibility to prescribe will lie with your consultant.
If we receive such a request, we will politely decline to prescribe and will either ask you to contact the hospital, or we will inform them ourselves we will not prescribe. This is to ensure that our prescribing remains safe for not only our patients, but also our staff.
Hospital can issue and send you any prescription you require
Contrary to popular belief, it is not solely the GPs responsibility to issue prescriptions. In fact, any hospital doctor can issue you with a prescription for what they recommend you have or what you require, at any time.
Please do not accept any suggestions that you would need to make a special journey to attend hospital to collect your prescription as the reason for the hospital not to issue a prescription for you; they can post prescriptions out to you or send it online to your chosen pharmacy in exactly the same ways that we use.
Verbal requests for medications recommended by hospital
We need to remind patients that for clinical safety reasons, we cannot accept verbal requests from patients for medications recommended by the hospital, even if the hospital has told you to ask us. In line with good medical practice and appropriate communication between colleagues, all requests for medication must be provided in writing by the hospital.
If you require an item on your repeat prescription urgently, for example, because you have run out, we will check your request against a universally recognised list of medications that have been deemed to be clinically urgent and that cannot be stopped suddenly, otherwise harm might arise.
Examples include heart medications, blood thinners, epilepsy treatments or certain painkillers.
If your medication is not on this list of clinically urgent medications, we will process your request within the usual repeat prescription timescales. This ensures that we can prioritise those patients whose medication is actually clinically urgent.
Please note, as already indicated above, if the hospital is requiring you to start urgent or same-day medications, they are contractually obliged to issue your prescription to you there and then. Please do not accept any request from the hospital to see your GP for an urgent prescription.
A private prescription might be issued as part of a private consultation. We must remind patients that NHS GPs are actually under no obligation to convert any private prescription to an NHS one - these will be considered on an individual case by case basis. Again such prescriptions are not clinically urgent and will be reviewed and issued if appropriate, as part of our normal processes and with timescales as described above.
If the medication requested is one that GPs would not normally issue in the course of their care for you, then for clinical safety reasons, we will politely decline the request and ask that you approach your private consultant for a prescription.
The government introduced some new cholesterol (lipid) targets in the GP contract for this year. Regular readers may recall from the last newsletter that this contract was imposed upon GPs ⧉ without agreement or negotiation.
The rationale behind these targets is that controlling cholesterol may reduce your risk of developing cardiovascular disease in the future. (For those with existing cardiovascular disease, such as stroke or heart attack, you should already be taking cholesterol lowering medication to lower the risk of a future episode).
Because this contract was imposed upon GPs against their will (for the second year running and for the fourth time in total), proper discussion and clinical debate between the government and GP leaders on the merits of achieving such targets did not occur beforehand, as would normally be the case each year when new contract requirements were mooted.
For example, as with any treatment, consideration needs to be given to whether patients are willing to add yet more medication on top of existing medication, whether meeting such targets would actually improve quality of life, rather than simply prolong it, given every medication has side effects and/or potential interactions and whether advanced age and/or multiple medical conditions would influence the shared decision making between patient and clinician to start more medication.
Furthermore, as well as personal preference mentioned above, one has to consider population dynamics. Despite our best medical efforts and political aspirations, it is our experience that the vast majority of people do not simply just 'age well' and then pass away. People generally get sicker as they get older, with medical conditions, disabilities or increasing frailty.
If we are working to prevent more heart attacks and strokes, so a smaller proportion of the population get these conditions, and therefore live longer, the likelihood is that a greater proportion of the population are instead going to get other conditions associated with aging and degeneration, such as cancer, dementia or Parkinson's Disease. This is not to diminish the importance of treating all the conditions mentioned or placing some conditions at higher priority than others, but merely to illustrate the point that such matters are not generally considered when looking at individual targets.
Unfortunately, the government has plunged headlong into this target, thereby adding to the many dozens of targets that GPs must work to in order to get essential funding. Onerous targets detract from the real job of a GP. Perhaps in a future article we will go in depth of the job of a GP but the most important aspects of a GP's work that patients and GPs themselves value most are actually looking after people, of forging long-term relationships with not only patients, but also their families, often over decades, of building trust and confidence, and of treating the whole person, not just their figures. It's a real shame that the government sees absolutely nothing of this.
Given the government is steadfastly continuing its agenda of micro-managing GPs out of existence, we are therefore obliged to offer all relevant patients cholesterol lowering medication, regardless of age, existing medication or illnesses, as no leeway has been given for GPs to narrow the remit when attempting to meet such a difficult target.
We will therefore be requesting many blood tests on patients to check their cholesterol levels, even those already on cholesterol lowering medication, as well as sending out many text messages to those who are not taking cholesterol lowering medication, or those who are not meeting cholesterol targets.
We should be grateful if you would respond to these offers with your preference on whether you wish to start or increase cholesterol lowering medication. We realise you may have questions or find it difficult to come to a decision, therefore any messages we send will reference information leaflets we have written a leaflet on cardiovascular risk, which can also be downloaded below.
Health Improvement Advisors from Live Life Better Derbyshire will be attending Ivy Grove Surgery on October 11th between 11.30am and 3pm. They will be available in the waiting room to offer advice on quitting smoking and the service they are able to provide to assist you.
During their visit they will be able to offer the following:
If you provide your details and would like to commence their stop smoking programme, you will be contacted within a two week time frame to be added on to the service, you will be required to set a quit date and then take part in the service for 12 weeks.
Their service includes free nicotine replacement treatments, telephone or face to face support with an advisor, behavioural support, use of the My Quit Route app and access to their private Facebook support group.
There is no requirement to book an appointment, you can just turn up on the day!
Meed a weight or blood pressure measurement? Our patient pod in the waiting room can be used by any patient for the purpose of providing clinical measurements such as height, weight and blood pressure and the results can then be transferred automatically into your computer record.
Patients can use the patient pod as an alternative to obtaining their own BP machine.
Using the pod is a quick and convenient process, but if you have any difficulties, please ask at the reception desk.
Ian, our practice business manager, writes about last weekend's main flu clinic:
On Saturday the 30th of September, our dedicated hardworking team of GPs, nurses, management and administrative staff arrived at the surgery at 8.00am, ready to begin the task of vaccinating the good patients of Ivy Grove Surgery, as our annual flu campaign got underway!
After the traditional bacon cobs and quick drink, and a final check that all of the clinical rooms had everything they needed – it was already 8.30am and we were ready to open the doors. We learnt valuable lessons from last year; we had more vaccinators working this time around and had car park marshals who ensured the traffic kept moving guaranteeing that everyone stayed safe. (The car park was pretty chaotic at times!).
The weather was again on our side, and we managed to vaccinate nearly 1,500 of our patients between the hours of 8.30am and 3:00pm - quite an impressive feat! We received lots of positive feedback regarding how quickly patients were in and out of the surgery which is something we really wanted to improve on from last year.
Flu clinics provide a relatively rare occasion where all the different roles who work at Ivy Grove Surgery can come together as a full team - and it was satisfying to see the team working so well together in a different setting to their normal day-to-day role.
It is also particularly nice for the staff to be able to chat to the patients, albeit briefly as they move along the queue. The gratitude showed to the staff from the majority of our patients, for giving up their precious Saturdays to ensure that as many of our patients as possible were offered protection against this year’s flu virus cannot be underestimated and really is appreciated!
This year’s flu campaign doesn’t end there though; we will be running regular Tuesday afternoon clinics, so if you are eligible and yet to be vaccinated, please call the surgery - our patient care advisors will be more than happy to find an appointment to suit you.
More information can be found on our flu information page:
We continue to receive many comments of praise from our patients which we share with all our hardworking staff. We thank each and every patient who has spent the time sharing your thoughts with us and we appreciate every comment you make. There's a lot to get through this issue because it's been such a long while since the last newsletter.
We make no apologies for sharing all this heartwarming feedback with everyone, as we feel it's just our way of spreading a little joy and happiness in what continue to be very difficult times for everyone.
How lovely Dr Rajan is and would like to see him again as he is a brilliant doctor – PC
To Dr Greer, very grateful for her help last Friday. You were marvellous – HS
Just wanted to say I was just sat having my morning coffee and thinking how wonderful Dr Okorare is, I've seen her three times now and she has been wonderful and most helpful so wanted to pass on my thanks. – PC
I wanted to pass on my thanks to Sally (receptionist) for being so understanding on Monday evening – NH
I would like to pass on my thanks to Michelle (reception team leader) who helped me today and also the rest of the staff who try their best under difficult circumstances. – MP
Please pass my compliments to Zahida, want to say how good she was with me – LR
Thank you to both Sally (receptionist) and Dr Neely for the great service I received from you yesterday – JT
To Sharon (admin), I have no family or friends and just wanted to thank you for caring – HH
I came to front desk with regards to my medication and wanted to thank Julie (receptionist) for ringing and making sure it was on the discharge letter. You're fabulous!!! – SF
Thank you for sorting out my referral. I just wanted to say what a wonderful job you are all doing. I really don't know how the receptionists manage to keep smiling when some of the patient seem to want the impossible, but they do. So please all give yourselves a pat on the back! :) – CD
Thank you Lisa (secretary) for taking the time to promptly sort out my daughter's referral! – AT
Michelle (reception team leader) 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. Always been blessed being in the lifelong care of Ivy Grove, thank you. – HH
Please pass on my thanks to Dr Axten for everything he has done for me, he has been brilliant – DS
Dr Greer was excellent and I felt that she really listened to me – DR
I want to thank the whole team, particularly reception and Sally (receptionist). Everyone has been wonderful and if I lived locally I would want to be a patient here. Well done all – MM
Dear Dr Neely and all the staff at Ivy Grove, I rang the surgery just two weeks ago and spoke to a very understanding receptionist who offered me a telephone appointment with you, you rang within an hour and then offered me a face-to-face appointment at 12 noon. What a service I thought and did tell you I was impressed at the time.
You decided to refer me to the clinic which came through on my phone the very next day. I booked in online and chose an appointment for this morning, the staff there were excellent and very professional I was seen in the clinic by an advanced nurse practitioner who gave me excellent evidence-based information and a really good examination which along with your examination found no evidence to refer to any other service. I was given written information to bring home and reassured that should anything change in my condition or I become aware of any changes I would come back to you to be re-referred.
I wanted to let you know what a positive experience this has been and congratulate the NHS in my experience over the past two weeks. I think you will agree I have had 5-star treatment. It's so nice to be able to write this positive email as so many people appear to be negative, (a happy story). Thanks again to all the team – LP
To everyone at the Ivy Grove Surgery, I would like to thank each and every one of you for your kindness and compassion over my sad loss loss of my wife . Nothing seemed too much trouble. When I rang up about , you always sorted things out for me. So once again from the bottom of my heart, thank you – D and family
Much improved service now being able to actually see a doctor rather than telephone appointments. Also excellent service from Dr Greer who injected my knee – JL
Good services, only the times we're in make it difficult – BC
Telephone appointment with Dr Greer. Absolutely amazing. So helpful and knowledgable. Completely put my mind at rest. Would recommend. – CR
Very friendly, helpful reception. Doctor and nurse made me feel safe and comfortable while undergoing minor surgery. – JW
Amazing surgery and ever so helpful! People who work here are so lovely to talk to, never feel anxious speaking to them. Defo recommend x – PS
Excellent but prefer face to face. – NF
The advice and care I receive from Dr Francis is very much appreciated, he has made me more aware of what I can do to improve my health – RM
I wanted to see a doctor but was told that no appointments were available that day or for the foreseeable future but I could have a telephone appointment which I wasn’t completely happy about, but booked it.
Having to tell the receptionist why I needed it was a little bit embarrassing in front of about 10-12 people in the waiting area. However I’ve had a text tonight saying that I’ve been prescribed and need to book a follow up blood test, so overall I’m reasonably happy. – KW
Overall experience was excellent. The reception desk friendly and helpful. Dr Greer was very professional and thorough, as a nice personality that puts you at ease – MT
I was asked to see a GP for a review. She was very thorough and I had a good experience. – KB
Brilliant doctors that think about you; the one that helps me is Dr Wong – KM
Have used Ivy Grove several times over past 20 years and have always been very happy with the medical care given. Can be difficult to get appointments as Ripley's population grows and grows, but nonetheless a very competent practice. – RJW
Flu clinic was brilliant and very nice nurses – BK
Already been up to flu clinic this morning. Very well organised and even had my pneumonia jab as well (over 65). Thanks to all the staff. – PB
Excellent service for flu jab. Also got a reminder about an appointment I need to make. Well done all who are involved. – KB
If you 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:
Last year's Christmas Dad Jokes were well received by both patients and staff alike. So much so that we have brought them back again a little earlier.
We hope you enjoy this terrible selection of so-called jokes, which have been compiled by Dr Wong and Ian, our practice business manager (in their own time of course). The numbers in brackets give the indicative cringe factor as determined by a large and diverse studio audience of relatives of dads.
PATIENT: Doctor, what's the difference between bird flu and swine flu?
ANSWER ➕ (9/10)DOCTOR: The first one requires tweetment but the second one needs oinkment!
Doctor: So you're having trouble sleeping? Describe your average night for me
ANSWER ➕ (7/10)PATIENT: They wear armour?
MORE ➕ (7/10) DOCTOR: No, I mean at bedtime
PATIENT: Well, they probably take it off!
Did you hear about the gingerbread man who went to minor injuries after hurting his knee?
ANSWER ➕ (10/10)They told him to try icing it!
PATIENT: I can't stop singing 'Delilah'
DOCTOR: Ah yes, you have 'Tom Jones Syndrome'
ANSWER ➕ (9/10)PATIENT: It is common?
DOCTOR: Well, it's not unusual
SURGEON (during operation): Relax David, it's only a small operation
PATIENT: My name's not David
ANSWER ➕ (5/10) SURGEON: I know, my name's David!
PATIENT: Every time I stand up, I keep seeing Mickey Mouse, Donald Duck and Goofy
ANSWER ➕ (9/10)DOCTOR: So how long have you been having these Disney™ spells?
PATIENT: Just checking in for my 10.30 appointment
RECEPTIONIST: Which doctor?
ANSWER ➕ (7/10)PATIENT: No, just a regular doctor!
HOSPITAL DOCTOR: What you have is incredibly rare
PATIENT: Oh no, what is it?
ANSWER ➕ (7/10)HOSPITAL DOCTOR: It's a bed!
Scientists have now grown human vocal cords in a test tube...
ANSWER ➕ (9/10)The results speak for themselves!
PATIENT 1: The doctor told me to watch my drinking
PATIENT 2: So what did you do?
ANSWER ➕ (10/10)PATIENT 1: I put a mirror up in the kitchen!
If you would like to submit your own awful Dad Joke to share with an expectant and grateful audience, please use our contact form below. Safe jokes only please!
We hope that the next update will give better news for staffing levels at the practice and a return to good health for Dr Axten. In the meantime, please keep yourselves safe and healthy as we approach the end of yet another tumultuous year.
At Ivy Grove, we take the time to keep our patients informed about what is happening at the surgery and also wider General Practice. If you have any constructive comments, please feel free to let us know.
Written by Dr M. Wong
© Dr Michael Wong 2022