We have received the following update from the Practice, it is rather lengthy however it explains the background to certain recent service issues.
We know everyone has had a difficult time since the onset of Covid, and we are keen to give you some information about the service we are doing our absolute best to provide.
As ever, it is the aim of the practice staff, many of whom have been with us for a long time, to provide the best services we possibly can regardless of circumstances.
This is a long read however taking time to read this through will help you put into context how we operate and why.
What have we been doing?
- The practice has never closed and never stopped seeing patients for face-to-face appointments when there has been a clinical need.
- Bloods tests and long-term condition reviews have continued throughout the pandemic.
- Patient records have been reviewed to support the identification of National Covid Shielding list.
- Every day work including issuing prescriptions, undertaking medication reviews, completing hospital referrals, home visits, safeguarding, mental health and palliative care reviews, reviewing and actioning hospital letters and test results and inviting patients for their reviews.
- Some services were suspended as we were directed to, and we are reviewing these regularly and re-commencing as capacity and demand allows.
- Supporting the national Covid vaccination programme.
We understand from some of your communications that our approach does not suit all our patients and recently some patients took to Facebook to vent their personal frustrations and perceptions.
The comments also include some from several years ago which have not been previously raised with the practice, these are being addressed separately.
On review of comments there are various reasons for current frustrations including:
- The ‘Total Triage’ system – to explain NHS England and NHS Improvement required all general practices in England to implement a ‘total triage’ system using telephone and online consultation This means that every patient contacting the practice first provides some information on the reasons for contact and is reviewed. This is an important process to reduce avoidable footfall in practices and protect patients and staff from the risks of infection. Lower numbers in our waiting room are a sign that we managing to reduce the risk of infection.
- Personal Protective Equipment (PPE) – the requirements on GP practices has resulted in longer appointment times for these being seen face to face, this time is to allow clinical staff to follow the required PPE and cleaning procedures pre/post patient contact which therefore reduces the amount of appointments that can be provided.
- Capacity – The pandemic has impacted on our service capacity as we have had some absent staff or staff working from home due to shielding, isolation, quarantining and general illness and there have been times we have had to postpone appointments. In addition, staff are taking their well-deserved leave entitlement.
- Covid and Covid vaccination programme – we have had to contact thousands of patients to book them for their Covid vaccines and we have had a significant amount of general and vaccination queries to deal with.
- Patient demand – our workload has changed significantly; this demand is higher than pre-Covid and has been increasing over the last 12 months. We are currently trying to recruit another GP to the practice; however, the national shortage of GPs is well documented, and, in the meantime, we are using locum staff. We admit we are overwhelmed by patient demand at times.
- Patient expectations – Patients and GPs can often have different expectations including what is an appropriate waiting time, how long it takes to make a diagnosis, how it should be treated and whether the outcome is the best that it can be. Our same day triage system allows for those needing urgent treatment to be spoken to and potentially seen on the same day. To make an accurate diagnosis it can take time and you and your GP will formulate a plan to follow with an appropriate timescale discussed and agreed. You will be asked what your expectations are and what treatment you are expecting to help the GP manage your expectations, this is very important to us. If you opt to have private consultations not all private treatments are provided on the NHS and you will have to pay privately for such treatments.
How you can support us and other patients
- Triage system acceptance – this system remains in place and when it’s safe to do so we can review our approach to patient bookings and response to managing increasing volumes of patient demands. We appreciate some patients prefer face to face appointments and can request these during the triage conversation, however our first duty of care is the health and safety of our patients and staff. Patients also need to be aware that increasing face to face appointments may also increase waiting times to allow us to continue to operate safely. Understandably, patients that request to speak to or see a specific GP may have to wait longer than those willing to speak with the next available GP.
- Care Navigation – our reception staff will ask questions to ensure you are seen by the right person, they have been instructed to ask these questions to support with managing patient demand and support GPs to prioritise contact.
- Self-Care – often minor illnesses can be effectively and safely treated with over-the-counter measures from a pharmacy or do not need to be dealt with as urgently as patients believe. We have lots of support on our website too: http://leyburnmedicalpractice.co.uk/index.php/self-care/
- Be honest – as a patient you need to be totally honest. This means sharing all information about your lifestyle and health, as holding back can mean not getting the care that you need as soon as you need it. Some conditions are very challenging to diagnose – you need to help your GP help you.
- Comply with investigation and treatment plans – since you and your GP will have worked together to agree on an investigation and/or treatment plan it is important to follow this plan.
- Follow requests – examples including responding to invitations to book tests and completing health questionnaires (not responding can lead to delays in medication reviews), arranging your own contact with a GP if another medical professional advises you to and manage your medication so you don’t run out before you reorder.
- Online consultation – if you don’t want to wait in a phone queue or would like to submit a routine request out of hours please consider using our online consultation tool: https://florey.accurx.com/p/B82078
- Hospital queries – if your query is relating to a hospital – please contact the hospital directly. You will have contact details on previous hospital letters or call the hospital switchboard and ask for your consultant or department. You should contact the hospital regarding results from tests that they have requested too.
- Unsure about which service to use? if you are unsure if you need to contact a GP, go to an Urgent Treatment Centre or even Accident and Emergency please contact 111 online https://111.nhs.uk/ or call 111.
- Read behind the headlines and what others say – in the media we see various views and opinions about GP practices. We hear and see other people’s comments on their opinion of their medical experiences. Generally, communications don’t tell the whole story. Sometimes the patient’s perception is that something went wrong when in fact, from a clinical perspective, the care or outcome was good or the best that could be given in the circumstances.
- Patient-Practice Relationship – we believe that a good patient-practice relationship, based on mutual respect and trust, is the cornerstone of good patient care. We understand that you get frustrated when things are not working as effectively as you would like because we do too. The practice, however, supports the government’s Zero Tolerance campaign for health service staff. This states that GPs and their staff have a right to care for others without fear of being attacked or abused. The removal of patients from our list is an exceptional and rare event and is a last resort in an impaired patient-practice relationship, more information on this can be found on our website http://leyburnmedicalpractice.co.uk/index.php/about/zero-tolerance/ .
If you feel there has been a breakdown in trust from your perspective and you do not wish to remain a patient with the practice you have the option to apply to register at another practice your choice (restrictions may apply).
We would like to take this opportunity to apologise to anyone who remains disappointed with our service.
To ensure our practice is well-led we are regularly review the way we work, and patients are asked to provide feedback direct to the practice. This can be done by sending an email to the practice (firstname.lastname@example.org ), requesting an appointment with our Assistant Practice Manager (01969 622391) or by joining or contacting our Patient Participation Group.
If you have feedback, a complaint or concern please let us know as soon as reasonably practical to do so.
We request that complaints are raised as per our complaints procedure rather than posting on social media. For more information please refer to our website: http://leyburnmedicalpractice.co.uk/index.php/contact/compliments-and-complaints/
Patient Participation Group (PPG)
We have a very active Patient Participation Group with the key purpose of acting as a link between the Practice and its patients. It is run by patients for patients and provides valuable feedback.
If you would like to know more about this group and would like to consider joining please follow this link for more information: http://leyburnmedicalpractice.co.uk/index.php/patient-participation-group/
The PPG are currently developing a patient survey – we would encourage you to complete this when available.
Final word …
Covid infection rates have been lower in our area than the national average and we thank those that have followed the rules and guidance, we genuinely believe it has been a community effort to achieve this and we are proud to be part of this community.
We have had a lot of praise, cards, and gifts. We also won the Northern Echo GP Practice of the Year nominated by our patients. We would like to take this opportunity to say thank you for all the support, which is very much appreciated by all the team.
Finally, adapted from a quote from Damian Barr and provided by one of our patients:
“We are not all in the same boat. We are in the same storm. Some have yachts, some have canoes, and some are drowning. Just be kind and help whoever you can.”
And if you feel you are drowning for whatever reason please give us a call.
Dr Julia Brown – Lead GP Partner
On behalf of all the Partners and staff at Leyburn Medical Practice