Covid Vaccines - UPDATE (2022)

We now have Covid Vaccines available in Practice.  If you are looking for your next (or even your first) vaccine, please call our Reception Team on 01508 494343 to discuss the options and when we may be able to offer you an appointment for vaccination.  Our availability may be determined by vaccine availability and delivery.

Click here for the guide to vaccination from the NHS website.

GP update - the retirement of Dr Andrea Meyerhoff

Doctor Meyerhoff has announced her retirement.  After over 20 years at the Practice, she is retiring at the end of June.  Read this special edition newsletter here. 

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.

Your views count

You have recently told us what you think of our services during the pandemic.  Healthwatch Norfolk spent a day with us recently gathering patients views on the services at the Practice.  The full report from their visit is here.  Click Health Watch Report for a summary of their findings  Thank you for your comments and to Healthwatch Officers for spending the day 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.

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.

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.

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

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

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.   

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. 

General Practice Data for Planning and Research (Data opt out's)

The wider use of data held in GP Surgeries is again in the press, with a new start date of 1st April 2022. 

This is a national programme and we are supporting the plans set out by NHS Digital.  NHS Digital is the national IT and data service that supports NHS clinicians at work, help patients get the best care and use data to improve health and care outcomes. 

NHS Digital's daily collection of GP data will support vital health and care planning and research.  The data held in GP medical records of patients is used every day to support health and care planning and research in England, helping to find better treatments and improve patient outcomes for everyone.  NHS Digital has developed a new way to collect this data called the General Practice Data for Planning and Research data collection (GPDPR).

NHS Digital has engaged with the British Medical Association (BMA), Royal College of GP's (RCGP) and the National data Guardian (NDG) to ensure the relevant safeguards are in place for patients and GP Practices.

NHS Digital is the national custodian for health and care data in England and has responsibility for standardising, collecting, analysing, publishing and sharing data and information from across the health and social care system, including General Practice.

NHS Digital has collected patient data from GP Surgeries for over 10 years and the process needs upgrading and changing.

Patient data collected from your GP record is needed to support a wide variety of research and analysis to help run and improve NHS services.  Whilst data is collected in other care settings such as hospitals is valuable in understanding specific services, it is the data in GP Surgeries that helps NHS England understand whether the health care system as a whole is working for patients.

NHS Digital will not collect patients names or addresses.  Any other data that could directly identify patients (such as NHS Number, date of birth and full post code) is replaced with unique codes which are produced by de-identification software before the data is shared with NHS Digital.  This process is called pseudonymisation and means that patients will not be identified directly in the data.  NHS Digital will be able to use the software to convert the unique codes back to data that could directly identify patients in certain circumstances, and where there is a valid legal reason.  Coded medical information relating to conditions, symptoms and diseases will be collected from patient medical records.

NHS Digital has engaged with the British Medical Association, Royal College of GPs and the National Data Guardian to ensure relevant safeguards are in place for patients and GP Practices.

Full details of the General Practice Data for Planning and Research (GPDPR) scheme can be found by clicking here.

If you do not wish for your data to be shared for purposes except your own care, you can opt out of the data collection and sharing exercises.  There are two types of opt out.

Opt out 1 - this will prevent your data being collected from your GP record by NHS Digital and we need a completed opt out form from you to mark the appropriate codes in your medical record to prevent your data being released to NHS Digital.  Here is the form you need to complete.  Click here.  Please return the completed form to the Practice.

Opt out 2 -  this is an opt out you will need to complete if you do not wish for any confidential healthcare data collected from all healthcare providers to be shared with other organisations for research and planning, unless there is an exemption to this.  This opt out is known as the 'National Opt Out'.  More details on this opt out and how to record an Opt out 2 is available in this weblink here.  Your preferences can be recorded online or via the telephone.  The number is 0300 303 5678.  The lines are open Monday to Friday 9am to 5pm. 

Please do not call the Practice to record opt out 2.

Loddon Community Gym

Our links to the Loddon Community Gym and Exercise Referral Scheme have resumed after the pandemic.  Our clinicians can refer you to the Gym, which operates three days a week at the Jubilee Hall in Loddon and offers an affordable, safe and friendly environment where you can improve your fitness and well-being under expert guidance.  Full details about the gym can be found at www.loddoncommunitygym.com