Practice Updates

22 June 2020

Firstly, we would like to thank all our patients for being accommodating and accepting of all the changes we have had to rapidly implement.  

At the end of March we moved very swiftly to a total triage model. This involved cancelling a lot of face-to-face appointments and replacing them with the eConsult system, telephone consultations as well as video consultations. This new way of working has been very well received by patients, some reporting the change as an improvement to our service. Thank you for this feedback; we appreciate such a positive response.

Our nursing team has also adapted well and although we have continued to see patients face-to-face, many of the long term condition reviews have been conducted over the telephone or via video.

We are now being asked by NHS England and the Government to increase activity at the practice; invitations for cervical screening are returning to normal recall,  and we are being encouraged to do as much as we can in the way of routine work now, to avoid a backlog when we hit the flu season.  

We therefore are encouraging patients, who receive an invitation, to attend the practice for their routine blood tests and health checks.

We can reassure you that we are cleaning all surfaces and equipment throughout the day, we are wearing appropriate PPE and taking all the advised precautions so that we can protect both patients and staff.

We understand that some patients will be reluctant to come to the practice but the number of patients being seen remains quite low.  We are restricting the number of patients in our waiting area to accommodate social distancing.

We ask patients to wear a face covering when they attend the practice.

If you have any queries or concerns, do please contact us.

Thank you for your ongoing support

3 April 2020 - 11:00

UPDATE -  A very small number of our patients will already have been identified as being high risk. They will have received a text message or letter from the NHS in the past week.

Those patients should stay at home for 12 weeks.

NHS Digital are currently working to identify the additional patients who will also be advised to stay home for 12 weeks. We anticipate this information imminently but currently we are not able to confirm which patients will fall into this group.  

Until we receive further guidance, we are unable to issue supportive letters regarding potential high-risk patients.

Our advice to all our patients is to stay home, apart from essential shopping, essential work and one form of exercise each day. In all circumstances keep a 2-metre distance from other people and wash your hands regularly.

Take care, stay at home, protect our NHS and save lives

SHIELDING  

1 April 2020 - 09:45

CORONAVIRUS (COVID-19) Frequently asked questions

We wanted to clear up a few of the frequently asked questions that our reception team are dealing with.

Who needs to isolate for 12 weeks?

All ‘high risk’ patients are advised to isolate for 12 weeks. There has been some confusion as to who falls into this category. Generally speaking, if you are eligible for an NHS flu vaccination for any reason, this puts you in the ‘at risk’ category but not necessarily ‘high risk’.

Every patient is different and if you feel your medical history makes you vulnerable or high risk, the decision to isolate for 12 weeks is one you need to make yourself. Our advice to patients would be to read the online information from reliable websites (111/NHS/GOV UK). Don’t rely on receiving a letter to tell you to isolate, as these are only being sent to a specific group of people (detailed below).

What is meant by ‘shielding’?

Shielding is a measure to protect extremely vulnerable people by minimising interaction with others. This means that those who are extremely vulnerable should not leave their homes, and within their homes should minimise all non-essential contact with other members of their household.

I haven’t got a letter, will I be receiving one?

The letters do not come from general practice, they are sent by NHS England. The groups defined as “extremely vulnerable” who should have received the letter are:

- Solid organ transplant recipients.

- People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer.

- People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment.

- People having immunotherapy or other continuing antibody treatments for cancer.

- People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or Parp inhibitors.

- People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.

- People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD.

- People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID and homozygous sickle cell).

- People on immunosuppression therapies sufficient to significantly increase risk of infection.

- Women who are pregnant with significant heart disease, congenital or acquired.

Can I have a sick note for my isolation period?

No, we are not issuing sick notes for any isolation reason. 111 website can issue sick notes for those isolating due to symptoms of COVID-19 or a household member having symptoms of COVID-19. Sick notes for other reasons continue being issued as normal.

Can I rebook my cancelled appointment for a couple of months’ time?

At the moment, all routine checks are suspended and we do not know when this will change. We therefore cannot book anything at this time but all patients whose annual reviews have been cancelled, will be contacted when normal clinics resume or sooner if the medical team feel this is necessary.

I have symptoms of COVID-19, what do I do?

Visiting the 111 website remains the first thing to do in this situation. There are a series of questions to answer and it will advise you of the path to take. If 111 advise you to contact us, then please do so. You will be put on the list for a phone call with the GP and they will assess you over the phone.

Am I allowed to contact the surgery about routine problems?

Yes! Please still contact the surgery via eConsultation for all routine health problems (if you have a medical need to consult with a GP). It is important for us to be keeping patients well in the community.

Please do use self-care where appropriate. A number of great factsheets can be found here, for most common complaints:

FACT SHEETS 

As before, if you struggle to complete an eConsultation, please call through to our reception staff, who will assist you. Please bear with us as our lines are incredibly busy, at all times, due to Covid-19.

How do I request a prescription?

SystmOnline is the preferred option for prescriptions requests. If you do not have online access, please submit an eConsultation. If you have difficulty with either, please call.

I need to collect my sick note/blood form/referral/prescription etc, can I come to the surgery?

All documents will be sent electronically where possible or posted to you to prevent gathering outside the practice doors.

25 March 2020 - 11:15

Pharmacy service

Dorset Pharmacy Leads are aware of the situation on the ground in all pharmacies across the county and are currently working with outlets to resolve the issues relating to "shielding", "self isolation", stock availability and queueing.

We expect to hear of a solution as soon as possible,

In the meantime, we understand your frustrations around this and  hope better processes will be in place in due course.

PLEASE do not stockpile medication - this is only adding to the disruption in the service.

Asthma medication

Asthma UK has reminded patients that any respiratory infection can trigger asthma symptoms, but this is not a reason to excessively stockpile. 

Requests for excessive quantities, especially of Salbutamol ("blue"/"reliever" inhaler) will be rejected and only sensible quantities issued for patients with a genuine underlying respiratory condition. 

For patients with normal cough and cold symptoms, standard clinical treatment does not require the use of Salbutamol or steroid inhaler.

23 March 2020 - 16:26

Guidance - no change for the general public. Please see advice on "social isolation" on our page. PLEASE take this advice and do what you can to protect your community.

"Shielding" of patients who are at the highest risk of coronavirus (COVID-19)

You will be aware that NHS England are contacting patients who are at the highest risk of being infected and may have complications following a diagnosis of Covid-19. 

Who is at high risk?

You may be at high risk from coronavirus if you:

have had an organ transplant

are having certain types of cancer treatment

have blood or bone marrow cancer, such as leukaemia

have a severe lung condition, such as cystic fibrosis or severe asthma

have a condition that makes you much more likely to get infections

are taking medicine that weakens your immune system

are pregnant and have a serious heart condition

Information:

If you're at high risk, you will be contacted by the NHS by Sunday 29 March 2020. Do not contact the medical centre at this stage – please wait to be contacted.

GP appointments

We are expecting the workload of our GPs and nursing teams to increase significantly; currently patients who are in hospital and are deemed medicallly fit to be discharged will be being discharged urgently over the next few days,.This is to free up space in secondary care. We will be facing an inevitable increase in demand from patients who are unwell and have recently been in hospital, in addition to those patients who have been diagnosed and are unwell due to Covid-19.

We are now working more closely with our community colleagues to ensure we meet the future challenges  that this virus presents.  We are looking to integrate our teams, with GPs and nurses working across all practice sites (Lyme Regis, Bridport and Beaminster) . We will also be supporting our colleagues in the community. Please be reassured that, if you require a face to face appointment, we will ensure this happens.

We will, however, try and deal with problems/concerns remotely via eConsult, where appropriate.

We ask that patients only request to access their GP for matters that cannot wait. Our eConsults have increased to nearly 500 per week, which is a huge amount of work for the GPs. Many of the eConsults are for issues that are minor/ not urgent; this puts pressure on our GPs, who may be better utilised caring for our most vulnerable and Covid positive patients.

We are currently reviewing our service to identify which appointments can be safely defered (to protect the patients and release GP and nurse resources). Please do help us to manage demand over this time by only using us only when you have a clear medical need that cannot wait.

Phone queues

Our phones are incredibly busy, in part due to patients calling to ask for advice about Covid-19. Please bear with us, we are answering calls as quickly as we can.  Please help free up lines by using our website links for guidance.

18 March 2020 - 17:00

Guidance - no change

Additional information on Corona link re self isolation/social distancing as well as a Corona tracker.

18 March 2020 - 16.30pm

NHSE BRIEFING

The UK Government is working closely with the Devolved Administrations, World Health Organisation, and our international partners to keep the whole of the UK safe. Our approach is clinically led, based on the expert advice of the UK’s Chief Medical Officer for England, the NHS and Public Health England.

For most people, coronavirus (COVID-19) will be a mild infection. If you have symptoms of coronavirus infection, however mild, stay at home and do not leave your house for 7 days from when your symptoms started. This action will help protect others in your community whilst you are infectious.

This Government is taking a phased approach to tackling the virus: to ‘contain, delay, mitigate, and research’. This approach is the result of direct and continuous consultation with the Chief Medical Officer for England.

We are now in the delay phase of our plan (our research and work to mitigate its impact is continuous). This is now not just an attempt to contain the disease, as far as possible, but to delay its spread.

If we delay the peak even by a few weeks, then our NHS will be in a stronger state and we have more time for medical research. We can also act to stretch the peak of the disease over a longer period, so that our society is better able to cope.

Our world-class NHS is at the front line of the UK’s response to Coronavirus. As the CMO has said, the NHS is will be coming under increased pressure from the virus. In line with what this Government has always said it will do, we are making sure the NHS is getting all the support it needs to continue its swift response.

The public has a crucial role to play in containing the spread of the virus. Washing your hands more often. For 20 seconds. Use soap and water or a hand sanitiser when you: get home or into work, blow your nose, sneeze or cough, eat or handle food. Protect yourself and others.

16 March 2020 - 3pm

Current guidance - remains unchanged.

Update on situation - the medical centre team are trying to minimise footfall to the surgery, to reduce the risk of transmission to the community and staff.

Patients are asked not to attend if they have:

  • A new continuous cough
  • A high temperature (of 37.8 degrees centigrade or higher)  

Surgery staff are trying to contact patients with pre-booked appointments to assess if the face to face appointment is required.  If not, patients are either being asked to defer or will be passed through to the clincial team for triage.

We have four "zones" set up:

Zone A - patients with low risk of Corona but who are symptomatic. These patients will be asked to enter the surgery via a rear door (ramped for access) and will be asked to sanitise hands and wear a mask before entering the building. They will be met by one of our GPs who will also be wearing Personal Protective Equipment. 

Zone B - asymptomatic patients who it is absolutely necessary to see face to face. These patients can enter via the main reception. The reason our staff are wearing masks is because patients are unfortunately not following guidance and are attending when symptomatic.  This is to protect them.

Zone C - staff only zone - we are cancelling any meetings/ practice visits over this time. We are using video conferencing where possible.

Nurse area - we are contacting patients to defer appointments, where this would cause minimal risk to the patient. We await further guidance on this from Dorset Clincial Commissioning Group.

Patients have symptoms of Coronavirus will be asked to return home and contact the NHS111 service

(see Coronavirus section for more information).

Examples of non-essential work that we will be deferring includes:

  • All private work - medicals
  • Minor surgery
  • Travel vaccinations

Thank you.

13 March 2020 - Coronavirus (COVID 19): Advice for the NHS in England

The NHS is now in the delay phase of our response to COVID-19.

Advice for NHS organisations is now as follows:

1. From today patients are advised to stay at home (self-isolate) regardless of travel history or contact with confirmed cases, if they have:

  • A new continuous cough
  • A high temperature (of 37.8 degrees centigrade or higher)  

OR  

2. The geographic element of possible risk has now been removed. Travel and contact history are no longer important for diagnosis, which is on the basis of symptoms alone. If patients who have travelled do not have symptoms they do not need to stay at home, regardless of their travel history.

 

When should patients isolate themselves?

Patients should stay at home (self-isolate) for 7 days from the onset of symptoms following the current advice.  

If a patient has serious symptoms and cannot manage at home they should use NHS 111 online LINK (people should only call NHS111 if they cannot get online). 

After 7 days of self-isolation, patients who feel better and no longer have a high temperature can return to their normal routine. If they have not had any signs of improvement after 7 days and have not already sought medical advice, they should use NHS111 online service before they leave their home or let visitors in.

The cough may persist for several weeks in some people, despite the coronavirus infection having cleared. A persistent cough alone does not mean someone must continue to stay at home for more than 7 days.

Up to date information can be found HERE 

We expect the medical centre be exceptionally busy in the coming days and weeks. If people have serious symptoms that they cannot manage at home, please use NHS111 online. They should only telephone NHS111.

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