A message from the Partners, Practice Manager and the team at Ringmead Medical Practice.
Thank you for bearing with us over these past 18 months which have been hugely stressful for everyone. Many of you have sent us kind messages of support for the care they have received during the pandemic, but we are also aware that many have been unhappy with the service provision.
General Practice is facing its greatest ever challenge, with GPs dealing with more patients than prior to the pandemic, along with dealing with the impact of covid itself, whilst also delivering the biggest vaccination campaign the country has ever seen.
There are a number of facts we wanted to share with you to help explain and understand the situation we find ourselves in. We are not alone – services up and down the country are suffering the same way we are. As an example of the pressure we are facing, this week alone there are four clinical staff and seven reception/admin
staff off sick.
- FACT: All GP practices are in a similar situation
- FACT: We have never closed and have seen patients that needed to be from the start of the lock-down
- FACT: Pre-Covid we were getting around 30 calls an hour. Since Covid we can get up to 140 calls an hour
- FACT: GP workload has increased by over 44% all over the country, and we are no different. We are working several hours longer to call our extra patients.
- FACT: We have successfully recruited 5 additional GPs since the pandemic started. But even still, the demand on GPs has risen. Despite the government’s promise to deliver 5,000 additional GPs, numbers have decreased since 2015 relative to patient numbers – there are now just 0.46 fully qualified GPs per 1000 patients in England – down from 0.52 in 2015. So there are fewer and fewer GPs left seeing more and more patients.
- FACT: in the last year we have also recruited four clinical pharmacists, three nurses, two Health Care Assistants (HCA), a Nurse Associate, one care coordinator, a social prescriber and a new Patient Services Manager. This variety of clinicians provide more options in better meeting a patient’s needs. We are trying!
- FACT: we have employed a First Contact Physio service to enable patients to be seen quickly with Musculoskeletal (MSK) issues.
- FACT: we have worked with local pharmacies to provide referrals to the Pharmacy Consultation service which gives patients with minor illnesses the chance for a personal consultation with a pharmacist (location) of their choice
- FACT: all Bracknell practices have accessed extra appointments locally to manage demand at a Bracknell Town-centre site
- FACT: Being a receptionist is stressful! Of the last five receptionists recruited – one left after two days, one after ten days and one after five weeks most citing the stress of the job. Another one withdrew the day before starting. All of this takes time, energy and resources. We are still actively recruiting
- FACT: Birch Hill is a Vaccination-centre staffed mainly by external clinicians, St John Ambulance volunteer vaccinators and our amazing local volunteers – we have transferred (not reduced) work on those days to the other sites. Ringmead opted to deliver the covid vaccine locally, which most other practices in the area and the country did not due to the time and resources required. Being a vaccine centre meant we could give patients their vaccines quickly and conveniently in their own surgery or even in their homes (if unable to come in).
- FACT: our phone company have been unable to tell us why calls get cut off when they are in the queue. They insist on being given three examples in one 24 hour period to ascertain the cause of this issue. Our practice manager has spent hours with the phone company trying to resolve the issues.
- FACT: NHSE guidance insisted on phone triage prior to booking face to face appointments in the safest location, you may have heard of HOT and COLD sites. These services are an extension of the practice clinical team, and were initially
staffed by our own GPs.
- FACT: eConsults have risen in use (quite rightly) and we have received over 12000 in the past 6 months. Each one has to be processed by an Administrator before being seen by the clinical team. Delays in replying are happening due to the
massive increase in numbers being sent to us, some of which are duplicated. For safety reasons we had to switch this service off at weekends
- FACT: Many patients don’t need face-to-face appointments and can be managed by seeing the chemist, by remote consultations and non-urgent and administration reasons by eConsult. You may feel that phrases like ‘self-care’, ‘self-help ’and
‘signposting’ are stopping you from contacting us or seeing us. This really isn’t the case and these concepts aren’t new – although they become increasingly important as we get busier and busier. A range of services are available including local
pharmacies for minor health concerns, NHS 111 online or by phone for urgent health concerns which are not life-threatening, and self-care at home. For more information please visit what0-18.nhs.uk or www.frimleyhealthandcare.org.uk/living-here/helping-you-to-stay-well/know-where-to-go-when-feeling-unwell
- FACT: we still recommend you contact the surgery if you have any concerning signs and symptoms that could relate to serious illness e.g. cancer https://www.cancerresearchuk.org/about-cancer/cancer-symptoms
- FACT: Hospitals are extremely busy. The impact of this and cancelled
- clinics/longer waiting lists, is that they are sending patients to their GP for assessment and advice, which further increases our work-load. There are also discharging patients early or not admitting them, but sign-posting to see their GP
- FACT: We remind patients not to attend A&E or call 999 unless it is a life threatening emergency
- FACT: Mental health has deteriorated greatly within the population nationally due to the pandemic
- FACT: We still have patients that do not attend (DNA) their face to face appointments. In one example on a sunny Friday morning, in just one clinic of 12 face to face patients, 5 either cancelled too late to rebook or DNA’d.
- FACT: The NHS has seen an increase in complaints and we are no different. Each formal complaint takes a lot of time to investigate and manage – some have taken weeks. Management at the practice has increased exponentially with
- FACT: There are further pressures with blood-bottle shortages, and the Flu & Third Covid vaccination campaign by the NHS.
- FACT: Covid is here to stay and its impact will be felt for a long time- Rates have started rising again. If you have suffered COVID you may find some useful information here www.yourcovidrecovery.nhs.uk
- FACT: We have changed the phone message and started a voicemail facility for the covid vaccine clinics as so many patients were calling us directly even when the national campaign asked them not to.
- FACT: We offer on-line access so that patients can book appointments, get medications and view results without having to call the surgery. And a lot of patients have done this very successfully.
- FACT: we are updating our website to make it accessible for patients: information sharing, advice and functionality
- FACT: we have tried to keep people updated via our social media and website platforms and newsletters emailed to patients.
- FACT: Protective measures remain in place across primary care to protect patients foremost and our general practice staff e.g. wearing a mask and social distancing.
Now we are in flu vaccine season, the NHS has been asked to deliver these alongside the covid booster vaccines. We want to keep our patients safe so have agreed to continue the use of our Birch Hill site to enable local access for our patients. This means that all other services will be transferred to our other sites, as
they have been up to now on covid clinic days. This means that the few receptionists we have working at the moment will be concentrated at our sites in Great Hollands and Crowthorne. The phones will still be the same, our online access and eConsult will not change, and the number of appointments available will not
reduce. The clinicians can call you from wherever they are working and face to face appointments will be booked as clinically needed.
We have worked tirelessly since the start of the pandemic in trying to manage all of this, and help patients – because we care. Many staff have worked very long days, and weekends; most have had little time off in terms of holidays. We are also human beings: have suffered illnesses (physical and mental), had to isolate when in contact with positive covid patients/family members as per national guidelines, personal crises and bereavements, and have families to consider. Staff have faced many unhelpful confrontations which do not help either the patient or us.
We hope this has helped to raise awareness of how much there is going on in the background, adding to the pressures. And we are not alone, as this picture is very
similar in all services within the NHS.
We have heard you and hear your comments and understand that we need to do better – but help us, support us. The British Medical Association (BMA) are
strongly encouraging patients and the profession to sign their petition calling on Government to provide the resourcing need so we can increase the number of GPs
in England – please show your support and sign it here. We are doing all that is possible to manage your attempts to access services from the practice. Every one of us wants to provide personal high quality care. We will keep trying and ask you to be patient, kind, understanding and considerate.
And if you are interested in joining the practice as a Patient Services Advisor (receptionist/telephonist), even for a short time if you are experienced, then please
see our advert on Indeed: uk.indeed.com/jobs?q=patient%20services%20advisor&l=RG12%207ww&vjk=c1ffd8f57a38708e
Or if you would like to join our supportive Patient Participation Group and help shape the future of Ringmead, then please contact them email@example.com
Thank you for reading
From all the team at Ringmead Medical Practice
24th September 2021