It has been a fraught 6 months at North Meols, the incumbent GP moved out in June unfortunately due to the constraints of their new organisation a gradual transfer was not possible. . Since none of the nearby GPs had expressed an interest, Beacon Primary Care was approached to look after the patients. The incumbent GP was extremely hard working and dedicated but the structural problems outlined below proved quite challenging.
This has been difficult especially for you the patients. Please be assured we are aware of and trying to rectify problems but there are some issues that we are dealing with which are perhaps not clear during day to day practice. Sorry this is a long diatribe but an explanation and plan is due.
The practice has changed principal GP 4 times in the past 12 years. This is quite unprecedented for this area and we have tried to understand and rectify the reasons for this. These are;
There is a country wide GP shortage that has affected rural areas worst with newly qualified GPs preferring cities.
The Practice covers 3 large and high dependency nursing home -- almost double the national average.
The regular change in staff has meant that the prescribing had become quite uncontrolled.
The support staff have had little regular leadership or training over the years.
The geography of the area means that GP applications for posts are low.
The result is that we have had terrible difficulty recruiting GPs and nurses to a practice that faces above average needs. Despite advertising flexible well remunerated posts we have had absolutely no interest. The practice is therefore reliant on Drs Biswas and Bonsor with Locum support to run.
IT have looked into the phone system they have found a fault but the phone system was brought down for an hour today sorry for the inconvenience.
We have redeployed staff at peak times to keep the call waiting time down. We plan to make telephone consultation and nurse slots available on line to bypass the phone system.
How do we fix this?
Change the skill mix. We cannot rely on GPs alone to deliver the service. As a community we need to embrace a wider clinical team. For example repeat prescriptions are best handled by a pharmacist (practice based) or Pharmacy technician, most problems dealt with by GPs can be handled safely and well by Advanced Nurse Practitioners who hac prescribe and examine. We have invested in an Advanced Nurse Practitioner and are pleased to confirm that Karen has started her induction into the post.
Train the staff. We have invested in staff training and a management team from Beacon Primary Care. We accept things could be better and we aim to do this.
Change the type of consultations. We know from local and national figures that over half of consultations can safely be conducted by telephone / skype and importantly this is more convenient and allows us to treat double the number of patients.
Improve prescribing efficiency and safety. You have had problems with repeat prescriptions this is in part because we are faced with some potentially hazardous prescribing and an inefficient system we now have a medicines management lead (Mandy Johnson) and Practice based Pharmacist (Jack Davidson) we plan to expand this capacity.
Use technology. We plan to roll out online notes access and prescription ordering and booking telephone / nurse consultations on line.
Here's what we've done so far:
You used to wait 3 weeks for a blood test we now have 3 blood clinics a week.
We have increased the number of consultations available with the introduction of an advanced Nurse Practitioner.
You asked for more access to clinical staff so we have introduced 50 telephone consult slots per week.
You asked for more advanced services so we have started sexual health, joint injection and anticoagulation clinics.
The nursing home patients have in the past had little structured care so we have introduced regular nursing home word rounds and Skype consultations.
We know that visits have been difficult to accommodate so we have started using a community paramedic Mark Wenman to help out on one day a week.
We know this is not enough and there is more to do:
Time and sheer firefighting have meant that we haven't kept you as updated as we should have.
The website will change regularly now, also we have a member of the team dedicated to social media.
We will also beef up the patient participation group.
The GP recruitment crisis will not go away we need to make this medical centre and this community a place to WANT to work we want to make the way we work with Care Homes a reason to come here rather than stay away.
The North Meols team should be multiskilled and importantly not dependant on a single clinician to make sure there is continuity, the practice needs to be prepared for changes without chaos.
We know that lots of you work long hours, we know we need more after hours appointments so we will be opening till 8pm two evenings a week.
There have been complaints about reception, you will have seen new faces at the desk, we want to develop health navigators or patient friends to help you navigate the system as it changes.
We are imminently due to start walk in minor ailments clinics.
Thanks for your patience, bear with us these changes are going to take 18 months by necessity.
We will keep you updated
Dr Rosalind Bonsor, Dr Bapi Biswas, Sr Karen Sandison, Jill Foster, Sharon Edge, Jenni Green
The senior clinical and management team
PATIENT ACCESS SERVICE
This practice currently offers the facility for patients:
- To order, view and print a list of repeat prescriptions for drugs, medicines or appliances
- To view online, export or print summary information form their record, relating to medications, allergies, adverse reactions and any other items agreed between practice and individual patient
- We will publicise and promote our online services to our practice's patients through the practice website, practice waiting room leaflets, posters
North Meols Medical Centre has a virtual patient participation group, if you are interested in finding out some further information and or perhaps becoming a member please ring the surgery and ask to speak to the Practice Manager. We would appreciate any feedback.
NHS DATA SHARING:
Information about you and the care you receive is shared, in a secure system, by healthcare staff to support your treatment and care. It is important that we, the NHS, can use this information to plan and improve services for all patients. NHS England would like to link information from all the different places where you receive care, such as your GP, hospital and community services, to help us provide a full picture.
How your information is used and shared is controlled by law and strict rules are in place to protect your privacy and any information which may is used is anonymised.
If you require any more information regarding this we have leaflets available in the surgery or you could visit: www.nhs.uk/caredata
If you wish to opt-out of this service please contact the surgery ands speak to any member of our reception and admin team and they will assist you with this matter.
(Site updated 06/01/2017)