Stop press - Covid 19 vaccinations.  GP Surgeries have been asked to support NHS England to deliver the largest vaccination programme the country has seen in a number of years and we are supporting the national campaign with this.

Unlike other vaccination programmes, such as flu, we are unable to provide vaccination from our Practice sites, with NHS England asking groups of Practices to come together and provide vaccination from a central location to patients registered with that group of Practices.

In the group we have established with surgeries in Attleborough, Poringland, Loddon, Pulham Market, Diss, Harleston and Long Stratton, the vaccination centre will be in Poringland and we are currently establishing our centre in line with NHS and Care Quality Commission (CQC) standards and guidelines to ensure safe vaccination.

Vaccine supply will be very limited in the first instance and there are characteristics of the vaccine that mean we are restricted in the number of patients we can vaccinate safely in a day.

For example, all patients vaccinated ae required to remain under observation in the centre for 15 minutes after receiving their vaccinations and of course we need to also respect social distancing guidelines during this time.

The Government has announced priority groups for vaccination and we are starting with invitations to those patients.  Those in eligible groups will receive a call from one of our booking team, which we are hoping will commence the week commencing 11th January 2020.

Please do not call the surgery, we will contact you.  This will keep surgery telephone lines free for other patient need.  

Updates on our service during the Covid-19 pandemic

Thank you for working with us over the past few months as we have responded to the coronavirus pandemic.  We now face a further period of lockdown to help control the virus.  We continue to work in a slightly different way following the NHS England guidance of managing patients where possible via telephone or video consultation.  This is not exclusive and if you are unable to engage with us in this way, please tell us. 

Routine telephone appointments can be booked up to three weeks in advance.  Booking appointments on line remains suspended but our reception team are here to book the appropriate appointments for you.  If the clinician you speak with feels the need for a face to face consultation, this will be arranged.  There are certain face to face appointments with our nursing team that can be booked direct by our reception team.  We continue to offer both routine and urgent blood tests.  We are still visiting patients at home who are genuinely housebound and unable to get to the surgery. 

Where there is a same day need, patients will be added to a 'call list' with details taken by our front line team and one of the clinical team working that day call you back within four hours of your call being received.  This standard is regularly met but may vary if demand is high.  Our reception team will flag with the clinicians if the need appears more urgent.  We will confirm the best telephone number to reach you on. 

We are still screening patients at the entrance to the two surgeries with the symptom questions around persistent cough, fever above 37.8 degrees C or a loss of taste or smell.  We may take your temperature before you enter the building.  Patients are asked to wear a face covering when entering the building.  We have a supply of face masks for patients who arrive without a covering. 

If you are not attending the surgery and you have these symptoms, then click here for the direct link to the latest advice on managing symptoms.  You may need to arrange a coronavirus test.  This link includes access to the online booking service.  Or you can call 119.

There are some limitations on the types of clinic we are offering.  Spirometry (a respiratory test), some minor surgery and cryotherapy are still restricted.  We continue to offer sexual health clinics.

Many of our services including national screening programmes, dressings, contraception checks, learning disability checks and child immunisation clinics have continued throughout the Pandemic and remain available to book in advance. 

With the reinstatement of national shielding arrangements after the Prime Ministers announcement on 4th January 2020, we will offer patients who are recognised as clinically extremely vulnerable to be seen in a designated environment.  

Our branch surgery site at Rockland St Mary remains open on Monday, Wednesday and Friday between 8.30am and 12 noon and then 2.30pm to 5pm each day. 

Our dispensaries at both surgery sites are open for collection of prescriptions.  We are aware that the local WELL pharmacy has some staffing issues and so if you collect your prescriptions from that location, you may like to consider giving them an additional day or two to have your prescription ready.

The Practice is adhering to national social distancing guidance and will continue to do so.  Please help us maintain this with safe distancing when in the surgery.  In line with NHS England and Public Health England guidance, all Practice staff will wear face coverings to help manage the spread of COVID -19.

The surgery is offering blood tests for Covid-19 antibody testing.  Please read, print, sign and return this form before booking a blood test.

The national and local guidance on managing the pandemic through this next phase continues to change regularly and we will continue to review our processes and protocols as necessary

Thank you for working with us since the pandemic started.  There are some pressures on appointments as patients start to present with their health needs, that in some cases that have been unaddressed over the pandemic and patient expectations have increased hugely.  There is still the need for patients to manage parts of their healthcare themselves and we look to them to take responsibility in the timely presentation of symptoms or concerns.  Not everything is 'urgent' and needs to be dealt with on the day you may call.    

A welcome from the Partners

Thank you for visiting our Practice website which we hope will provide you with a taste of the services available at our main site in Poringland and our branch surgery in Rockland St Mary.  Use the tabs to find out when we are open, how to reach medical services when we are closed, see the area we cover and learn more about the team at the Practice. 

You can order a repeat prescription on line, book and cancel appointments using our extended on line services, send us your comments (via the contact details tab) and tell us what you think of the services we offer through the Friends and Family Test. 

To register as a patient, you can visit either of our surgery sites where we will help complete the registration formalities.  The Heathgate team is committed to providing the appropriate care, at the appropriate time in the appropriate setting, working with you in the management of your health and wellbeing.   

Practice values

The Practice has a core set of values that are at the heart of everything we do.  They underpin our policies, objectives, procedures and strategies.  They also help us establish our behaviours.  The values were created and agreed by the whole Practice team at a staff meeting in Spring 2015 and are reviewed each year.  There are 5 simple values.    These are to be:

• Professional
• Caring
• Effective
• Flexible
• To have integrity in everything we do.

We hope you will recognise these values in your relationship with us.

Accessibility standards

For all organisations that offer NHS or Adult Social Care, compliance with The Accessible Information Standard, became law on 31st July 2016.  The standard aims to provide people who have a disability, impairment or sensory loss with information about their healthcare in a way they can easily understand.

This means that where possible we will provide information to patients in different ways.  For example if you would like us to write to you in a larger font, then we can do this.  If you need an interpreter in a consultation, with sufficient notice, we can arrange this and we are exploring with NHS England the options around providing information in braille.

Whilst we will be asking patients if they have information or communication needs, you can let us know by completing the online form under the Accessible Information tab to your right.  You will also find information in that section of our website on how to change the colour and font size of our website content.     

Aware of such needs, if we need to refer you for specialist care, we will pass this information onto the healthcare provider as part of the referral that we make.

PSA blood tests

There has been wide publicity recently around well known faces and names in the public domain and their diagnoses of Prostate Cancer.  Many patients have listened to some of the messages that have been relayed by the press and have asked us for 'the simple blood test' to test for Prostate cancer.  Things are not quite as straight forward as a one off test, and to learn a little more about PSA testing and more importantly the symptoms that may lead you to discussing this with the Practice, click here.   

Another leaflet (click here) from Cancer Research UK also provides a little more information on PSA screening in men without any symptoms. 

Sepsis

Previous editions of our patient newsletter have included article on sepsis awareness.  This followed a teaching session for our team on the importance of identifying this illness early on.  We have created a sepsis awareness noticeboard in our staff training room so this issue remains to the fore. 

Sepsis can be triggered by an infection in any part of the body.  The most common sites of infection leading to sepsis are the lungs, urinary tract, abdomen and pelvis.

Usually our immune systems keep an infection limited to one place and is known as a localised infection.  Our bodies produce white blood cells which travel to the site of the infection to destroy the germs causing the infection.  There are a series of processes that occur, such as tissue swelling, that help fight the infection and stop it spreading.  This is known as inflammation.

If your immune system is weak or an infection is severe, it can spread quickly through the blood into other parts of the body affecting the whole body.

There is a lot or information available to the public about recognising the  early signs of sepsis and here are two links you may like to look at.  The first (by clicking here) is the NHS website page on the subject and the second (click here) is the UK Sepsis Trust website.  Take a look.

NHS Breast Screening Programme Incident

You may have read or heard about the joint statement made by NHS England and Public Health England regarding the investigation into an incident where some women were not invited back for their final breast screen between their 68th and 71st birthday.  The routine breast screening programme is unaffected and the NHS is keen to reassure people that most women in these groups will have received their final screen as they should have done.

Patients which are affected will be written to by the end of May 2018 outlining how they can access the helpline which has been established and take up further screening if they wish.  The helpline number is 0800 169 2692.  Click here for further information from the NHS Choices website about this matter.

Patient consultation on accepting repeat prescription requests by telephone - the results

Thank you to all of you who completed our patient consultation on continuing to accept repeat medication requests by telephone.  Over 300 patients responded, which is a 32% response rate.  We consulted on this in response to a view from NHS safety organisations about how safe this method of ordering is.  Many Practices stopped accepting such requests a while ago.  A summary of the results of the consultation are outlined in our January 2017 newsletter, a copy is available here and a full copy of the analysis shared with our Patient Reference Group is available by clicking here.  

Aware of the number of patients that currently use the existing service (approximately 200 people a week) and considering how many of those that do, are our more elderly patients living in more rural parts of our patch and would have difficulty ordering in other ways, we have agreed with our Patient Reference Group to continue the service, with a few tweaks.

• We will accept requests just to the answerphone to be able to 'listen again' where necessary.
• We will continue to promote online ordering as our preferred option.
• Our answerphone message will request a succinct message with a daytime contact number.
• We will not accept messages that simply say 'I would like everything'.  This is not safe and can produce waste.
• We will continue to monitor the service and any incidents that occur. 

In summary, we hope you agree that we considered a possible safety issue, asked you for your views, listened to what you said and created a plan to deal with your responses. 

Generic medication

New imposed arrangements by our drug wholesaler means that we will no longer be able to guarantee a specific make of the generic medication we provide.

Where appropriate, we will continue to maximise NHS budgets and prescribe medication by its generic name but will be unable to guarantee that the medication provided each month will be from the same manufacturer.

Whilst one month you may receive, for example, a pack of tablets made by TEVA, the following month the same drug may come from ACTIVAS.  Both of these Companies are mainline suppliers of medication to pharmacies and dispensaries in England.  The type and strength of your medication will remain the same.

Learn more about generic (and brand) medication by clicking here.

Urine samples - policy and process

We have for a little while now, when someone thinks they may have a urine infection, tested a sample in the Practice, using a process known as 'dipping'.  This involves using a special testing strip that is placed into the sample that can identify whether there is an infection.

Unfortunately there is increasing evidence that dipstick testing is inaccurate and sometimes people with severe symptoms can have a negative dipstick test in spite of having an infection.  There is also a possibility that treating dipstick findings alone, may miss more serious conditions including chronic non-infective cystitis or even bladder cancer.

A face to face consultation with patients who have urinary symptoms will allow us to explore and discuss their symptoms and ensure that the correct treatment and advice is given.

Therefore following our change in policy, patients suggesting they have a urine infection will be offered an appointment with one of our clinicians and asked to bring a sample with them.

There are other reasons that patients are asked to provide samples, for example where a clinician feels that it should be investigated further at the hospital laboratory and in these circumstances we will accept urine samples without the need to be seen.

Our team have had a full briefing on the new process and will be happy to answer any queries you may have. 

Military veterans treatment policy

We have worked with Healthwatch Norfolk on a number of projects and have recently adopted their 'treatment policy' for military veterans.  By adopting the policy, we are encouraging veterans to identify themselves to their GP as a member of the armed forces community.

With their agreement, we will then include this information in any referral made for specialist services so their need can, where appropriate, be prioritised.  We are proud to support this policy and our own Practice protocol is available by clicking this link. 

Transport services

Transport Plus is a community transport service provided by Norfolk County Council.  It is a service using mostly volunteer car drivers to enable adult members of the public to access essential health and social care services.  Journey bookings are made via the Norfolk County Council Customer Service Centre on 0344 800 8020 from where staff organise the journey with an available driver.  This service is available for patients who have difficulty getting to the surgery for appointments with the doctors or nurses as well as hospital appointments.

A charge is made for each journey to cover the cost of fuel and general wear and tear of the drivers vehicle (45p per mile).  Payment is made directly to the driver.  More details can be found from the Transport Plus page of the Norfolk County Council website or by clicking here.   

ERS Medical continues to provide the NHS service for patients to get to their hospital or clinic appointments.  There are qualifying eligibility for this NHS service.  To contact ERS Medical to ascertain whether you qualify for NHS transport, call 0333 240 4100.  

Your accountable GP

Our contract with NHS England requires us to advise you of your named 'accountable GP'.  The named individual is the GP designated to take overall responsibility for your care at the Practice ensuring that services are offered and delivered to you at the appropriate time.

You will recall that when you registered with us you were also allocated a 'registered GP', and having discussed this matter with our patient reference group, there was strong support for not confusing patients advising them of another named individual; when most people are happy with the way we offer both continuity of care and choice of clinician to our patients.

We have produced a leaflet which explains our plan to meet out contractual obligation with NHS England.  Click here for a copy.  The leaflet is available in hard copy from our reception desks at both sites with notification of this approach on the top of your repeat prescription listing. 

NHS 111 for out of hours care and support

The NHS 111 service is available for patients to call when the surgery is closed.  Trained clinicians are on hand to answer health related queries, provide general advice or arrange for a doctor or nurse to discuss your more specific need.  NHS 111 is for when your need is less urgent that 999. 

Lost clinician time because of missed appointments (updated March 2020)

The number of patients not keeping their appointments continues to cause frustration and disappointment to our whole team.

We have been monitoring this now for over two years and whilst there has been a marked reduction, this is still around 18 hours of clinician (doctor and nurse) time every month.  This figure has risen again in March 2020 to 22 hours (132 appointments) and we will be monitoring this closely again. 

Very often our staff receive comments about the availability of appointments and whilst we recognise that sometimes, for a number of reasons, appointments with some of our clinicians may have to be booked a little way ahead, our audits on this subject show that this wait could be reduced for some patients if those not wishing to keep their appointments remembered to cancel them.

We appreciate that some of these missed appointments could very well include misunderstandings between patients and our team but even allowing for a couple of these a week, this is still a huge number simply because people forget or do not ring to cancel them when they are not needed.

Please help us manage this situation and save valuable appointment time by contacting us to cancel and or amend your appointment if it is not needed.

Reminders are sent by SMS text 24 hours before booked appointments.  If you have not provided us with your mobile telephone number, please do so (along with your consent to text) so we can send a reminder.  Thank you.   

Get our Practice App on your phone

You can now access our online services on your mobile phone.

Visit our website on your phone and you will simply be prompted to 'tap' and add the web app to your home screen on your phone; from where you can access our online services with your usual online login and password.  If you do not currently have online access, please contact the surgery by phone or by mail.heathgate@nhs.net requesting password access.

Prescribing of medication available over the counter in Norfolk and Waveney

The NHS is in the midst of a huge challenge.  Whilst the amount of money going into the service has increased, costs are rising.  So what are the reasons behind this?  The nation is ageing and being older is more expensive from a health perspective - a mix of more diseases and slower recovery.  As more discoveries are made in medicine, this can often mean increased care costs.

So what can we be doing to help preserve the NHS?  Many of you will have seen news and information around self care.  There has been advertising too in the press and social media.  This is about not expecting the NHS to supply you with every medication you may want, even if you are eligible for free prescriptions.  We have been in a similar position before when a black list of drugs was drawn up, including cough and cold remedies.  The list here details medications that can easily be bought from a pharmacy or even a supermarket and includes simple pain killers, moisturisers, treatments for constipation and diarrhoea.  What may cost you a few pence, could cost the NHS a few pounds and the more pounds that are saved, the more likely we are to have the NHS around when we most need it.