RIPLEY WELLBEING DROP-IN SESSION

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Jodie from ARCH PCN provides an exciting update for patients in the Ripley area.

We are working across the Primary Care Network to bring services into your neighbourhood.

After successful wellbeing drop-in sessions in Somercotes and Heanor we are excited to bring our wellbeing drop-in session to Ripley.

On Wednesday December 11th, 2024, come along to our session between 9.30-11.30am at Ripley Leisure Centre. We invite you to have your blood pressure taken by the Live Life Better Derbyshire Team as well as accessing stop smoking advice and healthy lifestyle information.

There will be a wide range of services including Citizens Advice, Derbyshire Carers, Futures Housing, Age UK, Derbyshire Police and The Fire Service.

Pick up information and free resources. The Places Team at Ripley Leisure Centre will be on hand to tell you about membership options and provide 5 day passes to give them a try for free.

If you would like more information please email jodie.cook11@nhs.net

We hope to see you there!

Ripley wellbeing drop-in poster

Please click the buttons below to visit any of the above-mentioned organisations:

Ripley Leisure Centre website Live Life Better Derbyshire website Stop smoking page Carers page Derbyshire Carers Association website Derbyshire carers page Citizens Advice Derbyshire website Citizens Advice page Futures Housing Age UK website Derbyshire Police Derbyshire Fire Service ARCH Primary Care Network website Amber Valley Health website

 

WE'RE STILL GIVING FLU JABS

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Ian, our Practice Business Manager wishes to remind all those eligible patients who have still not had their flu jab:

It's not too late to get your flu jab! If you are still unsure about 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 call and book an appointment, or simply ask your doctor or nurse when you see them and they will be only too pleased to fetch a flu jab for 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!

Flu page (ivy.gs/flu)

 

APPARENTLY, GPs ARE NOT PART OF THE NHS

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So, we've had the budget and the national insurance (NI) tax rises have been featuring heavily in the news. Business will bear the brunt of the massive tax rises. Even highly profitable large multi-nationals have expressed concern at the scale of the tax hike and have not ruled out passing costs onto customers in order to mitigate the financial damage to their businesses.

Small business is also disproportionately affected as the tax rise brings more low-paid and part-time workers into the scope of NI employer contributions. These businesses too, will be looking to pass on their increased costs of hiring staff to their customers.

The NHS, such as hospitals, and the rest of the public sector, like schools, are to be shielded from the NI tax increase.

But in a cruel twist, the government has indicated that GP surgeries are neither part of the NHS nor part of the public sector and will not be shielded from the NI tax increase and therefore must pay it.

More losses for General Practice

The vast majority of General Practice is made up of GP partnerships acting as small businesses. Those in our readership will be familiar with how General Practice works, and so will know that we don't and can't charge our 'customers', we don't have prices that we can raise, and therefore we cannot pass on the increased costs of hiring staff to anybody else. We have only one source of guaranteed income, and that is the capitation fee of £112.50 that we get each year for looking after each patient.

General Practice will also be hit by the double-whammy of increased costs from their own suppliers and service providers, being passed down the chain to GP surgeries, where again, we cannot increase prices to compensate, as we don't have any prices and we don't have customers we can charge.

The scale of the loss to General Practice has not been fully quantified, but the average practice could lose mid-five to early-six figures (£50-100K), especially when considering the additional living wage costs. Multiply this by the number of GP surgeries around, and the loss is likely to run into the hundreds of millions of pounds [the BMA has estimated that the losses to General Practice will be in the order of £260million]. This is money that would ordinarily be paying for staff, services and equipment, all used for the provision of patient care, but that is now going straight to the Treasury.

This loss of funding is from a service that has already been overstretched and underfunded for decades, that has already lost 5% of its GPs, that is already under significant financial strain, and that simply cannot stand any more losses. General Practice is already running on empty and has been for some time.

Health secretary says GP surgeries not part of the NHS

Almost immediately after the budget, the Treasury stated that GPs are not public sector and therefore must pay the NI increase. The health secretary, Wes Streeting, later confirmed mid-November that the government does not feel GPs are part of the NHS [Good Morning Britain, November 13, 2024].

So, there we are, with our NHS patients ringing in, on the phone system recommended by the NHS, booking them in to NHS determined appointment slots, seeing our NHS patients, working to targets set by the NHS, writing it all up on our NHS computers, messaging other NHS staff about these NHS patients using our NHS email addresses, sending them for NHS tests to NHS labs, referring NHS patients to NHS hospitals, with letters typed up by our NHS staff who pay pensions contributions into the NHS pension scheme, whose employers are NHS doctors, having been trained in the NHS, who must publish their salaries as part of NHS pay and public sector transparency and the entire GP team, all of whom happen to be NHS patients.

But we are told, we are not part of the NHS. What a slap in the face for hardworking GP teams! And we are also told, we are not part of the public sector either, when to all intents and purposes everybody already treats us as such. How patently ridiculous, inconsistent and spiteful can you get?

Our GP leaders have been hard at work lobbying the government to ask them to show some consistency, to provide assurance and certainty and to ask for a little something from the £22.6 billion earmarked from the NHS, to help the front door of the NHS that is General Practice. Huge amounts have already been allocated to hospitals, to manage waiting lists, to provide 40,000 extra appointments per week, but apart from upgrades to 200 GP surgeries*, nothing, absolutely nothing has been promised to General Practice. Indeed the proportion of total NHS funding going to General Practice has shrunk from 9.2% to 5.5% over the last five years.

Moving care to the community? More like starving it

One simple question to consider with this one-sided financial allocation, dealing with the backlog of people on waiting lists, and the backlog of people awaiting outpatient appointments - how do you think all those patients got there in the first place? Yes, they were referred by GPs and their teams, out in the community. At the risk of totally mixing up metaphors, if you want to properly tackle the tsunami of demand for hospital services, you don't provide the hospital with more mops and buckets, you actually need to shore up the defences, by providing more resources to the gatekeeper of the service, the GPs and their teams.

Once again, politicians talk the talk about shifting things out into the community, where everything is local to the patient, more responsive, vastly cheaper and more efficient, yet they don't walk the walk, and they don't match their rhetoric, with actual resources, actual money, actual help. And to top it off, after saying they want more services to migrate back to the community, to GPs and their teams, because it is better for patients and the NHS, they have the cheek to say that GPs are not part of the NHS...

You seriously cannot make this stuff up.

As GPs, we're obviously predisposed towards our role in the NHS, but we know from first-hand experience that patients and the public genuinely believe GPs and GP surgeries are synonymous with the NHS, since its inception in 1948. We don't have to drone on about General Practice, as those familiar with our blogs and videos will already know about what General Practice is, and what it truly represents, and whilst we are passionate about General Practice, clearly politicians have forgotten that General Practice is the first point of contact into the NHS for the vast majority of patients, dealing with 90% of all contacts in the NHS, providing care to NHS patients from cradle to grave. Truly it is the heart of the NHS.

Part of the NHS when it suits...

And that brings us to the polar opposite statements that government is quite happy to alternately promote whenever it suits:

On the one hand, when the government needs our help, when they need GPs to support the rest of the NHS, to vaccinate the population out of a pandemic, to be best placed to help the NHS patient or tackle whatever issue in society that is affecting NHS patients, General Practice is the jewel of the NHS, the bedrock of the NHS, the very heart of the NHS.

But then on the other hand, again when it suits, when the government needs to actually properly invest in General Practice, to provide us with more funding, so that we can hire more GPs, nurses and the staff we need, to provide us with more money, so that we can reward our staff for their hard work, no, we are not part of the NHS, we are filthy, money-grabbing, private contractors, who don't deserve any help whatsoever.

Come on, sir, you cannot have it both ways. Please sort it out.

Even now, over a month since the budget, the Treasury along with the Department of Health have not come out to say that GP surgeries will be directly reimbursed for the NI tax hike, continuing the state of uncertainty amongst GP partners [business owners of GP surgeries].

GPs are due a new contract in April 2025, and we feel the delay is to allow practices to stew a little whilst those contract negotiations happen, perhaps with the hope of GPs desperately accepting some form of inadequate uplift offer in exchange for agreement to jump through even more hoops (what is known as 'reform') in yet another unsuitable and inappropriate contract. Whilst this may sound like a deeply pessimistic view, the government has past form, and, in all persuasions, has behaved quite predictably in such matters.

The impact of these losses

So what has all of the above got to do with you, as a patient? Well, failure of the government to properly invest in General Practice and help it out will lead to GP surgeries necessarily cutting staff and patient services, therefore reducing capacity and increasing waiting times, or even closing permanently, as have 1,000 GP surgeries over the last decade.

This is how it could affect you, as a patient, and as mentioned, we are all patients, at some point in our lives, we all need GPs and their teams and GP surgeries. Yes, it all sounds too dramatic, and it sounds like it is all doom and gloom, but that is because it actually is.

GP partners are writing to their MPs to raise the above issues with the Health Department and the Treasury in a bid to reverse the decision and provide support for General Practice. If you are concerned about General Practice, you may wish to write too.

Write to your politicians, national or local, for free BMA: Letter from Dr Bramall-Stainer to Health Secretary BMA: Letter from Dr Bramall-Stainer to Treasury BMJ: If GPs aren't formally part of the NHS, what are we? BMA: National insurance blow for GPs BMA: GPs warn increase in employer NICs 'could be the end of us' PULSE: A Budget seemingly designed to punish GPs BBC: GPs demand protection from Budget tax hike BMA responds to the Autumn statement - 'New funding for the NHS is welcome, but there's scant regard for GPs and their patients

 

PATIENT GROUP UPDATE

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Sam, our Operational Manager, writes with the highlights from the introductory meeting of the reformed Patient Group (PPG).

After introductions, we gave the new members a quick tour and a brief understanding of the business structure of the practice. We then heard from the members themselves and learnt about why they have decided to join the PPG.

Christine, one of the members, gave her introduction:

"My name is Christine and I volunteered to be part of the patient participation group. Why you may ask? The NHS is something we are so fortunate to have and a service we will use at some point in our lives. Hospitals have various voluntary bodies that provide them with services such as WVS and League of Friends etc but Primary Care is not so fortunate. Therefore, being retired and with available time I felt where better to volunteer than my local Primary Care Team where, for many, the NHS journey begins."

We discussed what the practice would like from the PPG:

• This is to give a patient's perspective to the decisions we make, looking at things from a different viewpoint
• This would include reviewing the friends and family surveys
• Addressing any concerns or issues raised by other patients
• Looking at how we communicate and giving feedback about how this could be improved

We also discussed areas the PPG could lead improvements:

• Carrying out they own surveys or feedback requests
• Organising coffee mornings
• Raising awareness of issues or support groups
• Developing self-help projects, meeting the needs of fellow patients such as befriending and bereavement support etc

We agreed that we would like to meet 3-4 times a year. The next meeting date is to be decided but will be in the new year.

Anyone who is registered at the practice and would like to join the PPG can do so by contacting Sam on samantha.mair1@nhs.net .

 

CHRISTMAS OPENING HOURS

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We have now published our Christmas and New Year opening hours. We will be closed on all bank holidays and the weekends as usual and on Christmas Eve and New Year's Eve we will be closing early at 4pm. We will be open as usual on all other weekdays.

Demand is always exceptionally high due to the festive season, therefore we encourage all patients to order their repeat prescriptions well in time, and to consider getting the right help they need from the right professional at the right time.

For information on the same day hub service that is being provided over winter, please see the next article.

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

Opening hours Options when closed Mental health support Are you poorly? Refer yourself See the GP team

 

SAME DAY WINTER HUB

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The same day access winter hub is now open. As in previous years, this is an additional service funded by all nine practices in the network of practices to supply additional on-the-day capacity for new presentations of acute illness, such as abdominal pain, respiratory infections, skin problems and other minor illness.

When you ring, you may be directed to a same day hub appointment. These clinics will be manned by either other clinicians from neighbouring practices or employed staff from the network.

Contrary to some adverse comments we have received from a few patients, this service is not about offloading patients from practice work - the appointments in the same day access winter hub are actually funded by practice monies to provide extra appointments to cope with the additional winter demand that we inevitably see at this time of year. If practices did not provide this service, patients could find that their GP surgeries are full much earlier in the day and they would then have to be redirected elsewhere.

The extended access hub, which runs every evening and on Saturdays, continues as before.

Hub appointments page Hub appointments video Amber Valley Health Limited

Whilst this service is available, the appointments offered are not unlimited, and we therefore still encourage all patients to review self-care and self-referral resources available on our website, so that you can access the help and support that you need as soon as possible.

Try self-care (ivy.gs/selfcare) Options if full (ivy.gs/full) Options when closed (ivy.gs/closed) Check if you are poorly (ivy.gs/poorly) Self-refer to other workers (ivy.gs/selfrefer) Self-refer to the GP team (ivy.gs/team) Winter illness page (ivy.gs/winter) Flu page (ivy.gs/flu) Sore throat leaflet Earache leaflet Coughs and colds leaflet Diarrhoea and vomiting leaflet Antibiotics and viruses poster NHS: Winter health

 

PSA TESTING

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Dr Axten writes with the latest information on PSA testing for men over 50 without symptoms of prostate cancer:

Since Sir Chris Hoy, six-time Olympic champion announced his diagnosis of prostate cancer, we have had an increase in the number of male patients contacting us for a prostate cancer test.

We thought that we would put an article together explaining the testing process for prostate cancer.

Before this here are a few facts about prostate cancer itself:

• Prostate cancer is rare under the age of 50
• Prostate cancer is the most common cancer in men in the UK, making up 26% of all male cancer diagnoses
• Prostate cancer covers a spectrum of disease, from slow growing tumours (which are often asymptomatic) to very aggressive tumours
• About 1 in 8 men will get prostate cancer at some point in their life
• Prostate cancer is most common in black men and least common in Asian men
• Transgender women can still suffer with prostate cancer as the prostate is often left behind in gender affirming surgery

The symptoms of prostate cancer include a poor flow of urine, frequently needing to go to the toilet in the day/night and dribbling after you have finished passing urine. Some men also notice that they experience a long wait before passing urine, this is called hesitancy. Sometimes there is an urgent need to get to the toilet, this is called urgency.

Later symptoms of prostate cancer may include bone pain, particularly low back pain as the cancer spreads to the bones locally. Testicular pain, blood in the urine or ejaculate, constipation, stress incontinence or the complete inability to pass urine. Raised lymph nodes, jaundice (yellowing of skin) and sometimes seizures/fits are also late signs of the cancer.

The test used to alert clinicians to the possibility of prostate cancer is called the prostate specific antigen test or PSA for short.

Unfortunately, there is not a national screening programme for prostate cancer, like there is for cervical or bowel cancer for example. This is because the PSA test is not a specific test. In other words, the test is positive in prostate cancer but can also be falsely positive in infection and a condition called BPH (benign prostatic hypertrophy) or overgrowth of the prostate which is very common is men as they age. The PSA test result can also be affected by vigorous exercise, ejaculation, medicines (finasteride/dutasteride), urinary catheters, anal sex, or prostate stimulation.

Therefore, if the PSA test was used as a screening tool, lots of men would have a false positive test, leading to over-investigation and treatment which as you can imagine can be stressful and harmful in some cases.

The PSA test itself cannot distinguish what has caused the rise, so this is the first step in deciding if you need further testing.

The NHS says in its constitution that any man over the age of 50 without urinary symptoms may request a PSA test from their GP. Therefore, if you are over 50 and would like a PSA test you can contact reception to request one. The patient care navigator (receptionist) will then send you a text with some important counselling information on the test. If, after reading this, you would still like the PSA test please reply "yes" to our text message and we will arrange a blood form for you to have the blood test done. Once you have had your PSA test, a doctor at the surgery will review the result, this can take up to a week.

The normal values for PSA are listed below, it is normal to have some PSA in your blood.

• For those under 50 the PSA should be under 2.5ng/ml
• For those aged 50-69 the PSA should be under 3ng/ml
• And for those aged 70-79 the PSA should be under 5ng/ml

If you are a male patient, particularly if you are over 50 and have symptoms, please book an appointment with us to discuss your symptoms. You will need a more rigorous assessment including a history of your problem, an examination of your prostate, urine, and blood tests.

Listed below are the advantages and disadvantages of PSA testing in men who are 50 and over without symptoms, courtesy of Prostate Cancer UK:

Advantages

• It can pick up prostate cancer before you have symptoms
• It can help pick up a fast-growing tumour earlier meaning that treatment could stop it spreading and causing problems

Disadvantages

• Your PSA level might be raised, even if you don't have prostate cancer. Many men have a raised PSA but not prostate cancer
• The PSA test can miss prostate cancer
• If your PSA level is raised you may need a biopsy. This can cause side effects such as pain, infection, and bleeding. Most men will now be sent for an MRI and will only need a biopsy if an abnormality is found on the scan
• Being diagnosed with a slow-growing prostate cancer that is unlikely to cause any problems or shorten your life may still make you worry and may lead to have treatment that you don't need. Most men with local cancer now have their cancer carefully monitored instead and only have treatment if the cancer starts to grow

If you are concerned, please have a read of the information below and do get in touch with us if you would like a test or wish to discuss symptoms.

NHS: PSA testing PROSTATE CANCER UK: PSA blood test

 

BLOOD TESTS OUTSIDE DERBYSHIRE

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It has come to our attention that a number of patients are booking for their blood tests using hospitals outside Derbyshire, perhaps because they are seeing that they can get a quicker appointment on the SwiftQueue system. For example, patients have attended King's Mill Hospital in Nottinghamshire for their blood tests.

If you considering booking for a blood test in a hospital outside Derbyshire, we strongly encourage you not to do so. There are several reasons for this and they are all related to patient safety.

Hospitals and GP surgeries within Derbyshire are linked electronically, and we can request, see and download results from the hospital labs directly. Once bloods are done, results enter into your medical record directly, quickly and safely, for us to act upon as appropriate. Hospitals in Nottinghamshire and elsewhere are NOT linked with GP surgeries in Derbyshire.

If you attend for a blood test elsewhere, the results come through via a rough photocopy that is emailed to us, resulting in a delay, but not only that, the results do not enter your medical record automatically. Each result entry and value must be manually and laboriously transcribed into your medical record by our admin team, increasing the delay further but also introducing the real risk of a mistake being made. Just as an example, a routine full blood count, which you might consider to be a simple thing, requires at least 15 separate entries to be made, just to put it into your record, and that is just one blood test!

Further, the reference ranges for results from other hospitals may be different from the ranges provided by the labs in Derbyshire hospitals, meaning some results may be classed as normal when they are not, and vice versa, which could ultimately affect your treatment and care.

Finally, once the results are in your medical record, the clinician has greater difficulty in interpreting them, because, rather than showing up as a clean and straightforward entry on the results screen, they are listed one after another in one long line. This again increases the risk that something will be missed and a mistake being made.

All of the above constitute an unacceptable risk to patient safety and whilst we appreciate it might be more convenient to have a quicker appointment for a blood test in a hospital outside Derbyshire, we do not want our patients to subject themselves or us, as your doctors, to such risk.

Therefore please DO NOT book with hospitals outside Derbyshire for your blood tests. We will message you with a reminder if you happen to do so, so that you will know for next time.

Many thanks for bearing with us whilst we work to keep things clinically safe for you.

 

TEST RESULTS

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Whilst we are on the subject of blood results, it would be timely to remind patients regarding our policy on test results in general.

If you don't hear from us regarding your test result, you can assume that your result indicated that it was either normal, or that it required no action. Assume no news is good news.

There is therefore no need to ring us to check if your result is back, or whether we have looked at it or acted upon it. Additionally there is no need to book an appointment with your doctor or nurse just to review your result, unless you have been told you specifically require a further assessment.

We appreciate that on occasion, you might want to know the actual value of a result, for your own peace of mind, or your own records and in this case, feel free to call us, at least two weeks after your test, so that we can let you know the actual reading. We kindly ask that such calls be confined to the afternoons, when demand has eased somewhat and our receptionists are in a position to answer your query.

Please be aware that if your results could indicate serious disease, we will always call you urgently to either assess you further by telephone or to see you face-to-face, so please try not to worry.

If you are being asked to repeat a test, or to have additional tests, we have written a help page to support you, so again, please try not to worry.

Repeat tests page

 

TAKING THE URINE (OVER THE COUNTER)

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We are currently subject to large numbers of urine samples being dropped off to be dipped by the nurses in cases of suspected urine infection. We say suspected because many of these samples arrive at the desk with no information whatsoever, and with no corresponding entries in the medical record to indicate why such a sample has been dropped off. This means that any result from a urine dip cannot be interpreted correctly as there is no clinical context provided.

If you are dropping off a sample without any information, we will ask you to fill out our urine drop-off questionnaire, so that we know what symptoms you are having and what you have already tried.

You can download this questionnaire using the link below, or we will send you a text reminder to complete one.

If you do not provide any information to us by close of day, we will have no choice but to discard your sample.

We are not sure why people are getting more urine infections, but it could be because, in general, people are not drinking enough water in the day. We say this because many people's kidney blood test results indicate that they have not been drinking enough, meaning that such tests will often need repeating. Please check the advice links before for information on UTIs and what you can do to prevent them.

Urine sample form NHS: Urinary tract infections (UTIs) Minor illness leaflet: UTIs

 

FOLIC ACID DEFICIENCY

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Continuing along the above theme of blood results, another trend that we are noticing is a large increase in the number of patients showing folic acid deficiency, sometimes repeatedly. It could be perhaps because we are testing more, but it is perhaps a disappointing reflection of the state of the nation's dietary health, that we are seeing much more of this, or it could be because we are seeing it more due to the nation's dietary habits, or that we are testing for it more as we are more likely to find it!

Either way, there are things that you can do to help prevent folic acid deficiency. For the benefit of all patients, we reproduce our information leaflet here, so that everyone can make an active effort to improve their dietary intake of folic acid. This might be especially relevant as we enter the season well known for alcohol, poor diet or overindulging in the wrong things!

You can also download the leaflet using the link below:

Folic acid deficiency leaflet

One final point, if you have been given a two or three month course of folic acid tablets, as stated in the leaflet, this is generally not repeated, as it will have more than replaced and increased your folic acid levels in your body, so that you won't need a further course of tablets to continue with. But please note, in order to prevent folic acid deficiency from happening again, we do recommend you follow the dietary advice as indicated in the leaflet.

 

VETERANS SUPPORT

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Ian, our Practice Business Manager, and also Veterans lead, now writes on our Veteran Friendly Accreditation.

We are proud to be an Armed Forces Veteran Friendly Accredited GP Practice!

Supporting Our Veterans: A GP Practice's Role in Remembrance and Care

As a veteran-accredited GP practice, we take pride in providing dedicated care to those who have served our nation. Remembrance Day serves as a poignant reminder of the sacrifices made by veterans and their families - a reminder that their bravery, resilience, and commitment deserve our respect and support not just on November 11th, but every day of the year.

The Role of Veteran-Accredited GP Practices

Veteran accreditation signals a GP practice's commitment to understanding and meeting the unique needs of those who have served in the Armed Forces. Veterans often face distinct health challenges, ranging from physical injuries to mental health conditions such as PTSD, anxiety, and depression. Recognising these challenges requires not only clinical expertise but also a compassionate and tailored approach to care.

Our practice is trained to identify these needs and connect veterans with appropriate support systems, whether through specialised NHS services, via Op Courage - the Veterans Mental Health and Wellbeing Service, Op Restore - the Veterans Physical Health and Wellbeing Service or Op Fortitude – the new dedicated referral pathway for homeless veterans. Accreditation also ensures that veterans receive priority treatment for conditions related to their service, in line with the Armed Forces Covenant.

Remembrance Day: Honouring Service and Sacrifice

Each year, on Remembrance Day, we pause to honour those who gave their lives in the line of duty. The wearing of poppies, the silence at 11 am, and the solemn ceremonies across the country remind us of the cost of war and the enduring impact on individuals, families, and communities.

For veterans, this day can be deeply personal, evoking pride in their service but also memories of colleagues lost and the challenges they faced. It's a time when our practice makes an extra effort to reach out, acknowledging the emotional toll and offering support where needed.

Supporting Veterans Year-Round

While Remembrance Day focuses the nation's attention on the Armed Forces community, our commitment extends far beyond November. This is also recognised in the NHS Constitution, which states:

"The NHS will ensure that in line with the Armed Forces Covenant, those in the Armed Forces, reservists, their families and veterans are not disadvantaged in accessing health services in the area they reside".

It is important to remember that a veteran is anyone who has served for at least one day in the British Armed Forces, whether as a Regular or Reservist (previously known as the Territorial Army). It means the same as 'ex-service personnel' or 'ex-forces,' although not all veterans know the term or choose to associate with the term 'veteran.'

Younger veterans might refer to themselves as 'ex-forces,' in the belief that a veteran is someone who fought in the First or Second World War. Veterans include those who were Merchant Navy seafarers or fisherman who served in a vessel used to support the UK's armed forces at any time.

I have a personal interest in ensuring that Ivy Grove Surgery does all we can to support our armed forces veterans; I personally served for over 20 years in the Royal Air Force and know just how daunting it can be when leaving the Armed Forces and returning to civilian life – finding a GP Practice that understands the difficulties that ex-service personnel can face when visiting their GP practice, especially with service-related issues can be extremely daunting. That is why having an awareness of the issues veterans can face is so important.

Please visit our veterans page below for links to available resources for veterans:

Veterans page

 

A DIFFICULT TIME OF YEAR

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This time of year can be very difficult for some. If you are struggling, you can find details of support on our mental health pages. As indicated in our last newsletter, we have completely redesigned our mental health pages so that hopefully you will more easily find the resource you need.

You can self-refer to these services without seeing or speaking to a GP first. Click the image to go to the resource. = Recommended resource

If you can't find what you're looking for, please get in touch with us.

Help in a crisis

If you are in a crisis or at risk of self-harm, check these resources and speak to someone:

Help for different ages

If you want to check resources specific to an age group, check our specific pages:

Social support

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

 

WEIGHT LOSS INJECTIONS

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Dr Francis, our GP lead in diabetes, writes about requests for weight loss injections.

Following recent media coverage we are currently receiving a lot of queries regarding weight loss injection medications. At present they are not being prescribed across Derbyshire for weight loss. This is because of a complex set of reasons that are currently being reviewed by the health board. These reasons include patient safety, eligibility and issues around supply and demand. We hope that a clearer position will be decided on soon.

In the meantime, if you would like further support with weight management there are various services available locally. You can self-refer to a weight management programme with Live Live Better Derbyshire.

Alternatively, there is an online (digital) weight management programme we can refer you to. If you would find it difficult to attend a face-to-face service, due to physical issues or due to time pressures, this service may be more of benefit. If you would like to be referred to this service please get in touch with our admin team.

Contact us for digital weight management referral Visit Live Life Better Derbyshire to self-refer to weight management

 

TELEPHONE SYSTEM

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Ian, our Practice Business Manager, writes with the latest update on our New Cloud-Based Phone System – GP Voice.

We are pleased to share an update on the positive changes we made to help improve your experience when contacting our surgery. As you will know from previous newsletters, we introduced a new cloud-based telephone system in July this year.

The new system was designed with patients in mind, making it easier and more convenient to reach us.

Key benefits include:

• Queue transparency: You'll always know where you are in the queue
• Callback functionality: No need to wait on hold, simply request a callback, and the system will automatically call you back, as soon as you reach number one in the queue
• Improved efficiency in handling calls

Since going live with the new system on the July 30th, our average telephone wait time has been just 5 minutes and 14 seconds, something we're continually striving to build and improve upon.

Meeting Demand Head-On

The volume of calls we have received into reception also highlights just how busy we are; we are working tirelessly to meet that demand.

Here's a look at recent demand:

• August: 4,028 calls
• September: 4,965 calls
• October: 5,228 calls
• November (at time of writing): 4,524 calls

Despite this significant volume, our team is committed to ensuring that every patient receives the attention they need.

Our Commitment to You

We understand how important it is to have quick and reliable access to the surgery, and we are constantly looking for ways to improve. Your feedback is invaluable to us, and we appreciate your patience as we continue refining our services.

 

CARBON FOOTPRINT

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Dr Neely continues her series of articles on the green agenda.

Transport

I first reported on transport issues last year. As a practice, staff have continued to lift share, use public transport and be healthy and walk and cycle to work. We continue to offer telephone appointments as well as face-to-face to reduce the number of trips to the practice that are needed.

Digital carbon footprint

COP29 recently finished and made some great steps forward but not as much as many would want. During the summit, emphasis was made to try and help reduce digital carbon footprints. Because we can't see it, it is largely forgotten.

A few small changes that have been brought in over the last year are starting to help us reduce. Just our weekly meeting used to generate 13-26kg carbon per year (depending on size of documents attached to emails). Now it generates approximately 300g/year as we use a central resource to hold files and automatically send short emails or notifications with links.

Staff have also been having a clear out of old emails to help save space and reduce footprint further.

How much of a problem is the carbon footprint of data? Well, Google are planning on building 4 nuclear power stations and Microsoft is recommissioning three mile island in attempts to meet their energy usage in a carbon neutral way.

BBC: Why your internet habits are not as clean as you think Guardian: Concerned about your data use? Here is the carbon footprint of an average day of emails, WhatsApps and more Open CO2: Put the amount of your emissions into perspective with easily understandable, everyday things

Stay tuned for more updates.

 

WOMEN'S HEALTH SURVEY

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Women across Derby and Derbyshire are being asked to give their views and help contribute towards improved health services.

Joined Up Care Derbyshire (JUCD) is working in partnership with Community Action Derby and Link CVS to learn more about women's health. They want to know:

• What women know about women's health issues
• Women's experiences with health services around women's health
• How women prefer to access health services and get information
• How women prefer to communicate about their health issues and available health services

The survey takes around 10 minutes to complete.

Women's health survey Derbyshire Involvement JUCD: Women asked how health services should be improved

 

NEW BABIES IN THE PRACTICE

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Well, it is the season of the birth, and at Ivy Grove, we have had our own spate of new babies in the practice!

Carissa, our health care assistant, had a baby girl in 2023 and this year, Amy, in our admin team had a baby girl, Tamara in reception had twin baby girls and Alyssa, our advanced clinical practitioner, had a baby boy!

There must be something in the water, as we're sure there must be more babies on the way...

Congratulations to all these new (and new again) Mums, well done!

If you are a new mum, please visit our new baby page, where you will find some helpful resources:

New baby page

 

VIDEO QUIZZES

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As it's the time of year when we might traditionally play some games, here's a medically related video quiz from the selection that plays in our waiting room - you may have seen one or two of them yourself whilst you've been waiting for your appointment.

You can enjoy this in the comfort of your own home without the risk of catching a cough, cold or the sniffles.

A random one is chosen between medical anagrams and medical-related quizzes when you load the page, or you can actively refresh the page yourself to pick a new one. We hope you enjoy them.

Feel free to expand      and/or rotate your mobile device for the best results; if you leave the video running, it will progress to the next one in the series automatically until you refresh.

Medical Anagrams & Quiz Questions, various (4:02-7:47), Ivy Grove Surgery

Show another quiz

 

POSITIVE FEEDBACK RECEIVED

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Once again, many thanks for those patients who have taken their time to feed back about their positive experiences at the surgery. We know you may not always get the appointment you need, but please do know that we are trying our best in what are extremely difficult times for General Practice. It is gratifying to know that those who do come to see us have been able to express their appreciation of the service received.

We read every comment we receive and share them with the entire times and we want to say that it warms our hearts and makes us happy to keep striving to do our best for our patients. Please keep your comments coming in, we really do welcome it!

Hi, I just wanted to officially thank Dr Neely. I rang today and had a phone appointment. Dr Neely was so helpful and knowledgeable. I really appreciated it – SW

I wanted to express my heartfelt gratitude for everything you did for my dad yesterday. Special thanks to Dr Greer, Lindsey [nursing] and Tracey [nursing]. It was a very challenging situation and everyone dealt with it very well and kept my dad as comfortable as we could during the long wait for       . RG – family of EH

I just want to say how lovely Lindsey is and how she made me feel so much better! – MB

I'm calling to say how brilliant Kelly [nursing] was with my      . She really made a difference, and was so quick, caring and helpful :) – for PB

Mandy [reception], you were such a delightful, kind lady and so helpful during my recent interaction with you – DA

I am very impressed with the surgery and thanks all of you for doing a great job, especially Dr Francis who sorted out my       so quickly recently – for KB

I'm just calling to say that your TV monitor is very informative, well done – JH

Heaps of praise and admiration to Dr Wong, absolutely brilliant       and witch hunter expose; perfect finish to another tricky Tuesday – AP

Still had to ring many times, got over the main reasons for my call to the doctor – AH

Efficient and friendly doctors and reception – GM

Telephone call on time and helpful – RH

Lindsey was so helpful, and easy to talk to x – ZR

Couldn't be in better hands – AS

Took a while to get through on the phone, around 10mins but once through the receptionist was helpful and an hour later had a call for from the GP who took my concerns seriously and agreed a treatment plan – SR

Excellent experience this morning.       test. Carried out thoroughly and professionally by Dr Francis. Also, asked advice about a       and after an examination, got a       to help the symptoms. Very pleased with my treatment! – PD

Excellent experience. All my questions answered fully. Lindsey gave me a very comprehensive review. Agreed an action plan for the future. – RP

This was the first time I have had an       with very little pain and very little bruising afterwards. Dr Greer did a fantastic job! – RP [a different RP]

Got through to surgery on second try, appointment within 3 hours. Dr Lavender was kind, courteous and very helpful. – AB

Great doctors, nurses, practitioners and support staff. A very busy surgery but the staff try their best, only given 4/5 as the appointment slots often go very quickly. Both nurse practitioner Alyssa and Dr Lavender are a credit to you, both caring, non-judgemental and supportive. – GP

Very helpful and informative test being carried out just awaiting results – AL

Got through by phoning at 8.00am, number seven in the queue, booked in for phone call back which I received before 11.00am, after speaking with doctor prescription was sent to pharmacy in less than an hour – YS

Dr Pickard has been brilliant over the past few weeks with both me and my wife . She took time to listen to our problems and took appropriate action. She is really caring and understanding. I must also add, all staff at Ivy Grove are very good. So pleased Dr Pickard has joined our practice. Thanks – PJ

Dr Pickard was fantastic today - what a brilliant asset to the surgery – JC

Very smooth appointment – DQ

Very good and informative about all my tests – KS

I would like to pass on my praise and thanks to Danielle [reception] for getting me in so quickly to see the hub doctor – JS

Thank you very much to Dr Neely for helping mw out recently with his medication – RB

The doctor was very good, talked me through everything and was very professional, thank you – ID

 

 

DAD JOKES

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As it's nearly Christmas, it's time for another round of really very bad, very loosely medical-themed Dad Jokes. We cannot accept any responsibility for loss or damage as a result of reading these terrible jokes.

As before, numbers in brackets give the indicative cringe factor as determined by an extremely biased and small number of studio dads.

DOCTOR: So how can I help you?
PATIENT: I can't stop calling people by days of the week
ANSWER (8/10)DOCTOR: Here, take two tablets and call me Monday

Why is diarrhoea spelt diarrhoea?
ANSWER (7/10)Because it sounds like you've lost control of your vowels

PATIENT: Doctor, I collapsed at the airport and fell onto the baggage carousel
DOCTOR: So how are you now?
ANSWER (9/10)PATIENT: I'm fine now, luckily I came round

MOTHER: Doctor, my child just will not eat fish, what do I replace it with?
ANSWER (8/10) DOCTOR: A cat. Cats love fish...

RECEPTIONIST: Doctor, there's a chap in the waiting room who thinks he's invisible, what should I tell him?
ANSWER (5/10)DOCTOR: Tell him I can't see him today

PATIENT: Doctor, I keep seeing a little rabbit pop in and out of my nose
ANSWER (8/10)DOCTOR (examining): Don't worry, it's just a nasal hair

PATIENT: So, doc, I just can't stop gloating at people, can you give me something for it?
DOCTOR: Well, here's some cream for you
ANSWER (7/10)PATIENT: Yippee, I can't wait to rub it in

PATIENT: Doctor, I keep thinking I'm an ocean
ANSWER (3/10)DOCTOR: Can you please be more pacific?

PERSON 1: Did you hear about the child psychic who's on the run from the police?
PERSON 2: No, what happened?
ANSWER (10/10)PERSON 1: They said it was a small medium at large

 

FINALLY...

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So with all that frivolity, it's time to close another year of news at Ivy Grove Surgery. We wish all our patients the very best for the festive season and we send wishes for good health in the New Year!

Please take care and please do look after yourselves, and see you all in 2025!

Kind regards

Ivy Grove Surgery