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This page has been archived. The laest status update can be found here.

NEW! Welcome to our Christmas 2021 update.

Ivy Grove Surgery would like to 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 look after yourselves!

December 8, 2021

Dear Patients

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

It's another big issue, and in keeping with the season, we've tried to make things and bit more interactive and enjoyable this time, so, even though it's busy for everyone, please do put your feet up and take the time to read it when you can.

TIP OF THE GP ICEBERG

It's very demoralising to read that people think we are deliberately not answering the phones and letting them ring, or that we've just taken the receivers off the hook. It's equally demoralising to hear that people think we're lazing around doing nothing when we are all actually working our socks off.

Tip of the GP iceberg

We have 16 phone lines in and out of the building. When you get the engaged tone, this means that all 16 lines are being occupied by a staff member helping out a patient by speaking with that patient, or their carer or relative, or a professional colleague. We cannot get any more lines as we simply do not have the staff to manage any more.

Some people have complained about getting the engaged tone, suggesting why don't we get call queuing - well, when we did actually have call queuing, we had complaints from people who did not want to be spending their money being held in a queue, with lots of people in front of them, so we reverted back to no call queuing! Ultimately the phones are all busy because we ARE all busy.

We know it's difficult out there, but it's not our choice to be this busy. It's not our choice to be on our feet for 12 hours a day making criticial decision after critical decision (some of the doctors have invested in standing desks in their consultation rooms as they found that sitting in their chairs for 12 hours a day wasn't doing their backs, their health and their weights any good).

Busy phone lines and the recent furore over GP face-to-face appointments have been unnecessarily spotlighted at the expense of all the other important work that GPs and their teams do. We have therefore developed this poster to just remind everyone that we are still here, doing many other things besides.

We are not all sitting around twiddling our thumbs whilst we let the phones ring. We are all here trying to do our best for you and your family.

IVY.GS: Iceberg poster

WHAT NEEDS A FACE-TO-FACE APPOINTMENT?

In medical training it is traditionally said that 90% of the assessment of a patient comprises the history and only 10% comprises examination and investigation. Medicine is therefore mainly about having conversations with patients.

In telephone appointments, because they are working without the benefit of the patient in front of them, which would ordinarily allow a doctor access to a range of non-verbal cues, to easily gauge condition, behaviour or reaction, a doctor must make extra effort to ask a wider range of questions and to safety-net to ensure that all bases are covered. Therefore, rather than being unsafe or simply lazy, as widely portrayed in the media, telephone appointments actually represent a return to good history taking which is one of the main principles of medical care.

Ivy Grove introduced telephone appointments nearly a decade ago, well before it becoming the mainstream in other surgeries. Initially when we started, as this was all very new to everyone, many telephone appointments were inappropriately booked, either by patients themselves or by our staff. Many patients booked telephone appointments when they actually needed a physical examination for their issue. Up to a third or half of all telephone calls had to then be seen face-to-face.

However, as time went on, we all learnt, both patients and staff alike, how to use telephone appointments effectively and near enough 100% of calls were booked appropriately. The system of telephone appointments was already well embedded into our system of working pre-pandemic and our patients were used to it.

Therefore it seems strange that there is now a tremendous focus on more face-to-face appointments when remote working was actually recommended by government, when new technologies were put in place to support patients, such as video chat, text and photo messaging, when it was intended to keep all of us, but especially the vulnerable, or those at high risk of covid complications safe from waiting rooms full of coughing people and snotty-nosed kids. It is even more strange when you consider that, although cases seem to be declining slowly now, we are still in the middle of a covid pandemic, as witnessed by the intense focus on the new covid variant.

Things clearly are NOT back to normal yet.

The focus on appointments with the GP is also at odds with the progress made towards extending the primary health care team, with, for example, community matrons, care co-ordinators, social prescribers, mental health workers, community paramedics, first contact physios, pharmacists. We all know there is a drastic shortage of GPs. The future of primary care relies on everyone (including patients themselves) knowing which professional patients need to see as there is no longer the capacity for every patient contact and interaction to pass through a GP first.

For many years now, we at Ivy Grove have provided lots of information to help support our patients through self-care, self-referral and seeing the right professional, well before the ideas for the extended primary health care team came into being, as we long recognised the need to do this in order to remain sustainable. We continue to encourage patients to get the right help from the right person at the right time, whether that be by telephone, or face-to-face.

You can speak to and see almost all other professionals in the NHS without needing any assessment from a GP first:

IVY.GS: Self-referral page

Anyway, this long preamble is just a way of saying that there is and will always be a place for telephone appointments in modern General Practice and there will always be a place for traditional face-to-face appointments. In a bid to provide a balance to the binary 'face-to-face or die' debate, the following table of some examples might be useful as a reference point and to illustrate how we are currently working (please note this list is not exhaustive and may change at any time):

Suitable for remote working

More suited to face-to-face

Long-term disease reviews, e.g,, thyroid, asthma (with questionnaire response) Abdominal pain
Skin rashes (with photo) New lumps, e.g., breast
Most mental health problems Dizziness
Most minor illness, e.g. sore throat (with photo), coughs, colds, skin infections, urine infections Ear pain/discharge
Home blood pressure assessment (with home machine) Nursing procedures: dressings, injections
General advice  
Medication reviews and queries  
Reviewing results  
Administrative queries and forms  
Fit (sick) notes  
Conditions (even complex ones) amenable to detailed assessment and initial investigation prior  
Signposting and onward referrals  

COVID UPDATES

DO YOU WANT ANOTHER LOCKDOWN?
[sang in the style of that famous song from the children's animated film]

We know everyone is fed up of what is happening right now with the pandemic. We know that things are difficult for everyone. We are all tired and exhausted. We all want it to be over as soon as possible and for life to return back to normal.

Although not all of us subscribe to the idea of individual responsibility, as witnessed by the selfish events such as mask wearing refusal, lockdown protests and the antivaxxer movement, our individual actions all combine to form a collective response to the pandemic, which in turn contributes to government action (or inaction), policy change all of which may alter outcomes.

What you all do is important for those around you and in turn, for those around them. After all, this is how it all started about two years ago and how it then affected the entire world.

Please follow all current guidance and regulations for keeping yourself and your loved ones safe and we can then all get through this as quickly as possible.

IVY.GS: Coronavirus advice page

LATEST DEVELOPMENTS

You may all already be aware of the new omicron variant that is starting to circulate in the UK. Things are moving apace, and you may also have heard that the covid vaccination boooster campaign has been accelerated in response.

The whole vaccination infrastructure from vaccine regulations through to IT booking as well nursing injection directives through to surgery invite systems will need to be rejigged to accommodate the reduced interval of 3 months.

We are still awaiting further guidance on how the extra clinics required will be manned and managed by an already shattered and demoralised primary care workforce, having already given more than three-quarters of all covid jabs in this country.

We have heard news that many of the clinical targets that we have to work to have been suspended till April 2022 to allow practices to spend more time on getting the population vaccinated.

Of course, we will keep you updated when we hear more.

In the meantime, we are all in the dark about the implications of this new variant, as there are time lags between infection and symptoms, symptoms and hospitalisation and hospitalisations and deaths and until we run through all of these stages we will not know the real impact of this variant.

In the meantime, it is sensible to take precautions with hygiene measures, mask wearing and social distancing.

IVY.GS: Coronavirus advice page

MASKS AND FACE COVERINGS

UPDATE: DEC 10, 2021: Face coverings will once again become mandatory (required by law) in most indoor places due to concerns regarding the latest omicron variant that is now starting to circulate. This includes GP surgeries. Extract from current regulations:

"Face coverings and face masks are needed in healthcare settings to comply with infection, prevention, control (IPC) guidance. This includes hospitals and primary or community care settings, such as GP surgeries. They should also be worn by everyone accessing or visiting care homes."

We must remind patients that they must still wear a face covering whilst in the surgery building.

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

IMPORTANT MESSAGE TO ALL PATIENTS

We have a legal and moral responsibility to protect our staff and other patients, therefore, if a patient refuses to wear a face covering whilst inside the practice, without good reason, the practice reserves the right to choose to provide services to that patient by means other than a face-to-face appointment. This position is fully supported by Derbyshire LMC and the BMA.

Face coverings must cover your nose and mouth at all times. Visors alone are not considered as face coverings and provide little protection to either the wearer or to others.

If you enter the surgery building and refuse to wear a face covering, and without valid reason or exemption, you will be asked to leave the building and we will contact you.

face coverings poster

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

A visor is not classed as a face covering and provides very poor protection when compared to masks.

We do realise some patients will be medically exempt, however such reasons for not wearing a face covering are actually very few and far between and medical records will be checked accordingly. Please note that simply not wishing to wear a mask or disagreeing with government policy is not a valid exemption or reason.

As the surgery is a private building, any patient who enters the building and who still refuses to wear a face covering without good reason will be kindly asked to leave our premises. We will endeavour to provide any necessary services by other means than a face-to-face appointment. These moves are essential in order for us to fulfil our legal obligations towards protecting our other patients and our staff some of whom are extremely vulnerable.

IVY.GS: Face coverings page IVY.GS: Download face coverings poster NHSE: Face coverings GOV.UK: Face coverings IVY.GS: Coronavirus advice page

PLEASE DON'T TURN UP AT SURGERY WITH COVID SYMPTOMS

covid symptoms

Again, worryingly, we need to remind all patients that they must not enter the building unannounced if they have covid symptoms of any sort. This puts other patients and our staff at risk. Additionally, please do not attend if you are awaiting the result of a covid PCR test, as you should be self-isolating.

If you feel you need medical care, we encourage you to ring us, and if, following assessment, you need to be seen, appropriate and safe arrangements for a face-to-face review will be made by the clinician involved.

In this way, we can continue to keep everyone safe.

Please view this poster that provides a quick summary of what to look for.

IVY.GS: Symptoms poster GOV.UK: Book a PCR test GOV.UK: Stay at home guidance for covid infection IVY.GS: Coronavirus advice page

GET LAB PCR COVID TEST IF SYMPTOMS

Covid-19 tests

Lateral flow tests (slide tests) are NOT the same as a covid PCR test.

We need to remind all patients to please stop using lateral flow tests to rule out covid when you have covid symptoms. Lateral flow tests are ONLY for screening you if you have no symptoms.

Please check this poster which summarises the difference between to two tests.

If you have any respiratory or viral symptoms, please book a covid PCR test. You need to self-isolate until you get the result.

We get copies of all covid PCR tests performed, so if you report that you have taken one, we can check the result.

Needless to say, turning up at the surgery and mixing with other patients is not a good idea if you have covid symptoms. Please be considerate and think of others who may be more vulnerable than yourself.

IVY.GS: Covid tests poster GOV.UK: Book a PCR test GOV.UK: Stay at home guidance for covid infection NHS: What your test result means IVY.GS: Coronavirus advice page

SELF-ISOLATION RULES HAVE CHANGED AGAIN

UPDATE: DEC 14, 2021: Previously under certain circumstances household members would not need to self-isolate if coming into contact with a case of coronavirus. However, with the new omicron variant, these rules have changed.

Please see our coronavirus page for the latest rules and links to official guidance.

IVY.GS: Coronavirus self-isolation page

COVID VACC BOOSTERS

We are pleased to announce that nearly 3,500 of our patients have had their covid booster which represents 38% of our eligible population, so well done everyone! Coverage in our older population has been excellent, with 90% of 80+ year olds covered, 92% of our 75-79 year olds, 86% of our 70-74 year olds, with coverage continuing to decline moving down the age groups. If you are due for a booster, please read on below.

UPDATE DEC 13, 2021: All adults are eligible for a booster from December 13, 2021, and you will be able to book online via the national booking system from December 15, 2021. Please see our covid vacc page for details.

UPDATE NOV 30, 2021: Changes to the covid vaccination programme have been announced in order to accelerate coverage of the population with covid boosters.

Please try not to contact us about your covid booster. We will invite you! Or the NHS will invite you directly. Or you can book online without waiting for an invite.

Please try not to worry if it is more than 6 months after your last dose (or more than 3 months with the recent changes) - you will still be protected from severe illness after the first two doses of covid vaccination.

Please note that due to staff shortages, sickness and sheer exhaustion, capacity at the local hub at Church Farm is somewhat limited - the hub is only running clinics on weekends - you can still wait for us, or you can go ahead and book via the NHS or 119.

If you are in the eligible group and and you wish to book for your booster using NHS services you can click either button below:

NHS: Book online Ring 119 to book by phone

More information on the covid booster campaign can be found on our covid booster page using the link below:

IVY.GS: Covid booster page IVY.GS: Covid vacc page IVY.GS: Coronavirus advice page

FLU CLINIC FEEDBACK

Our final flu clinic will be held on December 22, 2021. This clinic is open to anybody. Stocks are now very limited and if you are one of those still hesitating, please contact us to book for a flu jab from our last remaining stocks as soon as possible.

IVY.GS: Flu page

BLOOD PRESSURES

As you will know, we have not been able to pack our waiting rooms full of people needing clinical care due to infection control risks - unlike other organisations attended by the fit and healthy, healthcare venues like hospitals, GP surgeries and others are full of sick, vulnerable and high risk patients who could be put at risk by others who may have no symptoms of active covid infection. This has therefore hampered the ability of many GP surgeries to check their patients' blood pressures.

As a result of these limitations, we have to think of novel ways to achieve this. One of the ways is to use a text messaging service, a method that has already been widely welcomed and used by many of our patient population.

Checking your blood pressure (BP) is important so that we can review any elevated readings and take action to reduce the chances of cardiovascular complications like heart attack or stroke for those most at risk.

Therefore if you receive a text asking you to respond with a BP reading, we kindly ask that you check your BP using your own monitor and let us have the reading by following the instructions in your text.

PROCEDURE FOR TAKING BP AT HOME

Please follow these instructions when taking your BP at home:

  • Do sit quietly, with arms and legs uncrossed, with no talking, for 10 minutes before taking your blood pressure
  • Do take two readings, at least one minute apart and use the lower reading as a true reading
  • Do follow the instructions in your text to submit your reading to us
  • Don't take your BP after an argument, stressful event or exercise as it may be much higher than normal
  • Don't panic if your BP is higher than normal, still submit your reading and we will get back in touch as needed

Those without BP monitors may wish to purchase their own - BP monitors are now relatively cheap, very accurate and can be bought for as little as £20. We believe this is a small price to pay for the knowledge that your blood pressure is being adequately controlled.

As an alternative, some local chemists might be able to provide BP measurements.

If you receive a text asking for a BP, and have no facility available to get it checked, please call us to book with one of our nurses.

Patients reporting raised BP will be followed up by a clinician, or asked to submit a week of readings to give a more accurate picture of their condition. If you are one of those needing a week of readings, you can download the chart below to complete and drop off in our letter box (please only do this if we have specifically asked you for one week of readings).

The excel version of the chart calculates average readings automatically for us and if you have the software, you should download this version.

Recommended monitors BIHSOC Recommended monitors BHF IVY.GS: BP chart (PDF) IVY.GS: BP chart (Excel)

HOSPITAL WAITING TIMES

More patients are now waiting for outpatient appointments or operations now than at any time since records began. We are finding many patients are coming to us with the expectation that we can resolve their difficulties or reduce their wait time.

Unfortunately, we have no influence on hospital waiting times and how the hospital is managing its workload at this difficult time.

We do get requests from patients to send letters to consultants to expedite appointments, however in our experience this does little to change matters, as huge numbers of patients are already on the waiting list and out of necessity, the hospital is already managing its services so that more urgent cases are given priority.

If, however, your condition is actively deteriorating, then please contact the hospital in the first instance and try and speak with your consultant's secretary. If you do not get anywhere with this, then please get in touch with us and we will do our best. But again, please note that any efforts on this front also have limited effectiveness.

We have created two pages on our website to provide a little information on the situation of hospital care (tests, results, procedures, operation wait) or expediting appointments.

IVY.GS: Hospital care IVY.GS: Expediting an appointment

THE WORLD IS SHORT-STAFFED - PLEASE BE KIND

We are all acutely aware of the shortage of HGV drivers and the impact it is having on society, but please let's not forget there is a workforce crisis in many other sectors, such as refuse collection, abbatoirs and animal welfare, social care, retail and hospitality. In health, there are shortages of nurses, paramedics, midwives, mental health practitioners, radiographers, occupational therapists, psychiatrists, anaesthetists and of course GPs as previously mentioned.

The public and media don't appear to be ranting away at HGV drivers for there not being enough of them (quite rightly), so let's not use the same mob mentality against other important key workers.

abuse not tolerated poster

We are currently down a full-time GP due to sickness and have not yet been able to replace all their hours with locum cover as GP locums themselves are also in scarce supply. We have also lost a nurse and have another off long-term sick. The clinical work and the admin doesn't let up and with fewer staff available to do this work, we know this is having an impact upon everybody, both staff and patients alike. We are all doing our best.

Therefore please be considerate to the person on the other end of the phone line or behind the front desk, as they might well have not only their own work on their shoulders, but also someone else's too.

abuse means poster

All health and care staff, but especially in A&E and General Practice, are experiencing an increased level of violence, aggression and discrimination, that has escalated during the pandemic.

Any form of abuse, whether that be shouting, swearing, racist or rude comments, will not be tolerated, and patients run the risk of their care being disrupted as a result. This is in line with policy in the NHS in Derbyshire.

We need to remind everyone that any patient who abuses our staff whatever the circumstance will receive a written warning. Repeated incidents will result in removal from our panel. Violent or threatening behaviour will result in the police being notified and immediate removal.

All of this is in line with NHS Zero Tolerance policy. Our waiting room video on this policy is shown below.

Zero Tolerance (2:48), Ivy Grove Surgery

'TIS THE SEASON FOR SNEEZIN' AND SNIFFLES

It's winter. This means that there will be plenty of coughs, colds, runny noses, blocked noses, temperatures and viruses all around. As we start to mix indoors instead of outside in the fresh air, it's easier for bugs to pass from one to another.

We should remember that before the pandemic, we all used to manage our coughs and colds without the need to grab the phone and ring the doctor as soon as the first sniffle appeared.

Unfortunately, either due to imposed self-isolation, or relative lack of exposure to upper respiratory infection in the last year or so, we all seem to have forgotten how to self-care and manage our normal winter illness.

What we've noticed is that people are ringing us after having a sore throat for an hour, or having woken with earache, or having had a cough for a couple of days. All of these examples are well within the normal duration of symptoms that we would expect with these illnesses.

In the vast majority of cases, people are not at all unwell. Admittedly they might feel under the weather and not performing to 100% but this is not unsxpected given any minor illness.

Symptoms that would concern us as doctors include high temperature not resolving with medication, uncontrolled shaking/shivering of the entire body, vomiting, poor fluid intake along with poor urine output, increasing breathlessness, becoming less responsive or not be able to perform most usual activities.

If you are managing to go to work, or school and able to perform most activities as normal, then you might manage to get better through self-care and a patient wait for recovery.

The following advice on minor illneses might be useful to follow, as not only is it official NHS advice, but also the information provided gives useful pointers on when to contact the GP.

For your information, we also share our waiting room quiz video which illustrates the duration of common conditions.

And don't forget if you have any symptoms of covid, please don't just turn up at surgery or just carry on as usual, at work or play, and please book a covid PCR test (not a rapid lateral flow slide test) and self-isolate till you get the result.

NHS.UK: Conjunctivitis NHS.UK: Common cold NHS.UK: Diarrhoea and vomiting NHS.UK: Earache NHS.UK: Flu and viral illness NHS.UK: Sore throat NHS.UK: Urine infections (UTI) NHS.UK: Health A-Z IVY.GS: Self-care page GOV.UK: Book a PCR test

Duration of common conditions (4:17), Ivy Grove Surgery

POORLY CHILDREN

Poorly children can be difficult to deal with. It's not always easy to tell if a child is seriously ill or not, or if they are just under the weather and suffering with this week's self-limiting viral bug.

In order to help parents, guardians and carers, the following links might be helpful. They include official links from the NHS and leaflets and apps from other recognised organisations. Also, at Ivy Grove we have written a leaflet on how you can tell if your child is poorly, by watching out for general symptoms of ill-health in an easy to use colour-coded chart.

All of these resources give helpful hints and tips on what you can do to help your child and when to contact health services for further advice.

And don't forget if your child has any symptoms of covid, please book a covid PCR test (not a rapid lateral flow slide test). There is no younger age limit for a child to have a covid PCR test, so please don't be put off - your child will not come to any harm from having a covid PCR test. We have had positive cases in very young children, so it is not at all unheard of.

NHS.UK: Is your baby or toddler seriously ill? NHS.UK: Fever in children NHS.UK: Looking after a sick child IVY.GS: How can I tell if my child is poorly? leaflet When should I worry? leaflet HANDi App poster HANDi App (Apple) HANDi App (Android) What to do when your child is unwell poster GOV.UK: Book a PCR test

TOP TIPS FOR WINTER

Winter time always carries the risk of increased illness and death, as the weather deteriorates and we move indoors with reduced ventilation and closer proximity to others.

There are things that you can do to keep yourself well and safe over winter, so as a reminder, please check our short video below for some practical hints and tips.

You can also visit our dedicated winter illness page for further advice on managing conditions over winter.

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

IVY.GS: Winter illness page

MEDICINES ORDER LINE (MOL) NOW ACTIVE

We are pleased to announce that the Medicines Order Line (MOL) is now active and taking repeat prescription requests.

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.

Prescriptions will be processed easily where:

  • Your medication review is in date
  • You are not overusing or underusing your medication
  • You have not requested extra/new items on your repeat

Once you have made the telephone call your prescription will be authorised by your usual GP and will then be sent to the pharmacy of your choice within two working days. Please then allow additional time for the pharmacy to get your prescription ready for you.

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

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

The MOL opening hours are Monday to Friday between 8am and 4pm.

If you wish, you can email a request for a callback from the MOL. When you do, please include Ivy Grove Surgery as the GP surgery name, your name, your date of birth and your contact number. Please note this email is only for requesting a callback from the MOL and no responses will be provided by email. The MOL will aim to call you back within two working days.

Download MOL leaflet Ring 0115 855 0260 for the MOL Request a callback by email

PERSONAL RESPONSIBILITY EXTENDS TO PATIENTS TOO

Whilst we won't go into the exact clinical details, a recent court case has caused a huge stir amongst the medical profession and the public alike. The verdict seems to be in line with the general reduction in personal responsibility that is rife amongst society at the moment, but which appears to bear no resemblance to long-held principles of real life.

Life is risky. Bad things happen all the time. But you can give yourself the best chance of these things not happening by doing the right thing. But this is NOT a guarantee and as we all know, everything in life is not guaranteed (besides, as they say, death and taxes!). Even if you do everything right and follow all the rules, bad things can still happen. But that doesn't mean you shouldn't try and do your best. Because if you can honestly say that you have done your best, and you cannot do more than that, then you know you will have given yourself the best chance.

But when bad things do happen, and inevitably they will, it can be human nature to want to blame someone or something for such events, such as a GP or another professional, someone in authority or the government or some other anonymous corporate body. Whilst in some cases that might be the correct course of action, we should not forget the important concept of personal responsibility.

With the New Year coming and that time of year in general, there is often much reflection, from which there may arise fresh expectations of a better life, a renewed focus on change and increased motivation to accept personal responsibilities to make those changes. Therefore in this spirit, we give all our patients some examples of what might seem obvious, but which in this day and age, we might not be too sure.

If you smoke, you have a very high chance (1 in 2 or 50%) of something bad happening to you, including cancer but also other things like heart attack, stroke, high blood pressure, impotence and dementia

If you abuse illegal drugs, beyond the inital highs, there can be serious physical and psychological effects and you run the risk of damage to your personal life, work life and your relationships

If you choose to become pregnant, there is a chance you might have a miscarriage, despite all efforts to continue the pregnancy, or you might give birth to a disabled child, even if you take all prevailing precautions

If you drink too much alcohol, you have an increased risk of liver disease, heart disease, stroke, brain damage and cancer

If you become seriously overweight, you could develop, amongst many, diabetes, bad joints, heart disease, stroke, infertility, breathlessness, high blood pressure and overall reduced life expectancy

If you don't look after your mental wellbeing, you may increase your risk of mood disturbance, depression and anxiety, leading to a deterioration in your physical health, and difficulties in your work, home life and your relationships

DISCLAIMER: Please bear in mind, the above are somewhat simplistic statements, they are not intended in any way to be victim-blaming of any sectors of our population, and ultimately are presented here only to illustrate the extremely obvious. We are aware that they make no consideration of anybody's individual circumsance, pre-existing conditions or level of motivation or willpower, however, they are all still true statements nonetheless.

Useful official hints and tips on each area are provided below.

NHS: What are the health risks of smoking? IVY.GS: Smoking page NHS: Drug addiction IVY.GS: Drugs misuse page NHS: Alcohol misuse IVY.GS: Alcohol page NHS: Keeping well in pregnancy NHS: Treatment of obesity NHS: 5 steps to mental wellbeing

LATEST FEEDBACK RECEIVED

Thank you so much to each and every one of you who continue to take the time to get in touch with us with your comments. We publish these not just to share with our own staff, but also with the rest of the general public at large - it's so gratifying to hear these positive stories that provide a balance to the huge amount of GP bashing that is going on all around. Thank you so much.

Thank you for your brilliant, informative newsletter. I have never had the time to read your newsletters before, so this one was a real revelation and certainly puts a GP’s perspective on the ‘shortage’ of appointments and the health service in general. Thank you for keeping us informed on this issue which will affect us all sooner or later. Power to your elbow! In the end everything will be OK, and if it’s not OK , it’s not the end. – AE

Thanking you all for your support and understanding – AR

Hi team, Just scrolling through Facebook with umpteen issues with GP practices in the area I'm struck with just how lucky we are to have mum in your care. Your receptionists are amazing, professional & kind, they make you feel listened to while pointing you in the right direction. Your care-coordinators are fabulous (even making me consider taking up their profession as a career!). Your Drs & Nurses are hard working but treat you with dignity & big hearts ...and everyone else behind the scenes I've not had the pleasure of dealing with - well done! Mum's quite frail and has been shielding fully so when she did eventually cave into my nagging to get seen, she's had multiple issues to sort. I'm hopeful in the next few weeks things will settle, but I've used your services A LOT and I just wanted to pass on my thanks as all too often people are happy to complain - credit where credit is due, thank you! Happy Friday – S & S B

Once again an excellent update very informative. Many thanks for continuing to work as near to normal as is possible. I appreciate the effort put in by all the reception staff as well as all medical staff. I certainly don't have any complaints and have always been extremely satisfied with all care and compassion I've received from everyone at Ivy Grove Surgery during the past 57 years. Thank you all so much. You all continue to take care and stay safe – DP

I attended an appointment on with Dr Greer and a nurse. I was extremely nervous for this appointment, due to a previous bad experience. However, I could not have wished for a better experience on this occasion. All members of staff were patient, kind and understanding. I’d like to thank the lovely lady on reception. Sorry for being emotional. Also, the nurse and Dr Greer who were equally as kind and lovely – OB

The regular updates we receive from the surgery are excellent and let everybody know just how overworked you all are at Ivy Grove. They provide information to us all about the things we need to know so we don’t have to ring the surgery and I always refer to these and your website first anyway. The work you have all been doing over the last 18-24 months is tremendous and you all deserve recompense. Well done Ivy Grove you’re the best – WB

What a wonderful service I have received from Dr Axten; I think the Ivy Grove team is amazing and I can't thank you all enough – AE

Ivy Grove are as efficient as always – RG

Thanks for your excellent help Dr Wong, much appreciated – DR

Thank you for the efficient running of the flu jabs – BM

I would like to thank all of you for the support that you have given over the last few weeks – RL

To all the staff and volunteers who ensure all the vaccination clinics run smoothly, with thanks and appreciation from the – H family

We, in turn, would also like to take this opportunity to thank all those patients who have presented us with Christmas gifts of chocolate, biscuits, mince pies and cakes this festive season. All of these are very gratefully received by our hardworking staff and help to make each day a little easier. Thank you.

FESTIVE OPENING HOURS

Please check our appointments page to find details of Christmas and New Year opening.

This is generally an extremely busy time of year, even more so this year, so we encourage all patients to self-care and self-refer where possible for their condition. You can also check your symptoms to find out who you should contact first, or check our help page to see how the other health workers in the NHS can help you.

If you still need our help, please ring us, but please be aware that the phone lines are extremely busy due to high demand. Please request home visits responsibly.

If you need medical attention or advice when we are closed, please ring 111.

IVY.GS: Appointments page IVY.GS: Elf-care page IVY.GS: Elf-referral page IVY.GS: Symptom checker IVY.GS: Help page IVY.GS: Requesting visits page Ring us Ring 111 NHS.UK: Health A-Z

VIDEO QUIZZES

So it's the time of year when everyone gets together and plays games. Or maybe not, if the virus has anything to do with it! But whatever happens, by way of a mild distraction, we reproduce here some of the video quizzes that normally play in our waiting room and which help our patients pass the time whilst waiting for their appointment.

Given that the waiting room by necessity is no longer packed to the rafters with people with coughs, colds, sniffles and runny noses, it makes sense to share some of these popular quizzes with a wider audience.

There are 20 videos in total, and 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.

PLEASE NOTE: 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

EMERGENCY MEDICAL / DAD JOKES

As a service to dads and Christmas cracker fillers everywhere, we now provide a series of ten spare and quite embarrassing jokes for those last minute bad dad joke emergencies that might crop up during the festive season. Please feel free to share as needed. This selection of so-called jokes was carefully curated with the help of Dr Wong's teenage daughter. The numbers in brackets give the indicative cringe factor as determined by a large and diverse studio audience (of relatives of dads).

What happened to the pony with a sore throat? (6/10)
ANSWERIt became a little hoarse

Why did the banana go to the doctor? (4/10)
ANSWERIt wasn't peeling very well

Did you hear about the chap who swallowed three forks and two spoons? (9/10)
ANSWERYes, his life is on a knife-edge right now

A patient rings for an appointment with the doctor today. Receptionist asks, 'How about ten?' (8/10)
ANSWERPatient says, 'It's OK, but I only need one' [Please take it! = Ed.]

Doctor: 'I'm afraid I've some very bad news. Your results show that your DNA is backwards...' (10/10)
ANSWERPatient: 'AND...?'

Did you hear about the Youtuber who got sick? (7/10)
ANSWERHe went viral

Doctor: 'You say you have a phobia of getting married. Do you know the symptoms?'' (8/10)
ANSWERPatient: 'I can't say I do'

Doctor: 'Are you in need of some emergency attention?'
Patient: 'Yes!'
(10/10)
ANSWERDoctor: 'You're amazing, wonderful and so talented, you're absolutely glowing, thanks so much for being you!'

What do you do with a boat that's sea-sick? (8/10)
ANSWERTake it back to the doc

Why did the radiologist laugh at the x-ray? (10/10)
ANSWERBecause it was quite humerus

And on that note, we must draw the frivolity and this issue of the newsletter to a close.

FINALLY...

With all the uncertainty with a new variant of coronavirus, the future remains uncertain. However despite this, we hope you can enjoy the festive season with family and friends in as safe a manner as possible. So look after yourselves and have a Merry Christmas and see you all in the New Year!

Kind regards

Ivy Grove Surgery

Do you have any feedback on this update?

With these updates, all of which are written in our own time, we try our best to keep our patients informed about what is happening at the surgery and also wider General Practice. If you have any comments to make on them, please let us know.

If you're looking to use our feedback form to have a rant, we would much prefer that you did not, as we already get enough abuse on a daily basis. However, if you have a formal complaint regarding our services, please do write to us or call us. Thank you.

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Written by Dr M. Wong