Paying to see a GP... What do you think ?

Having time on my hands as a NHS patient, reading everyday the emails and tweets it’s got me thinking. in fact its got me on my podium.  (had to use a self image otherwise I could get sued for copyright). 

I get it.. I really do that the NHS has to save money.  We have to free up A&E for ‘real’ Accidents & Emergencies not....  ‘I’ve had a sore throat for 2 days and could not get an appointment at my Doctors’.  Come on take some responsibility for yourself. This is what is part of the problem.  People think they are taking responsibility for their own health, but they are not!   There, I’ve said it. Many wont just in case it upsets someone.  Yes you have a sore throat… buy some lozenges and if its get no better see the GP not visit A&E.  Antibiotics are not always the answer, the quick fix.

Being in the trade (pardon the pun) I am very aware of what is going on in our back yard.  The media tells us patients groups are up there making decisions being consulted but I wonder.  Do our patients really know what the future could look like?  Would our patients really kick up a fuss now before the future is here if the future of GP Practice was none existent and you had to pay to see someone when you were ill?   This bank holiday, weekend whilst sofa bound it got me thinking.  Would I be happy knowing that if I needed a GP (not just at the weekend/out of hours) but at anytime that I would have to contact a call centre and be given an appointment to attend to see ‘someone, somewhere’.  I reckon this is the future.  Shoot me down if I’m wrong but I seriously believe this is what the politicians want. When would this be from?   I’m not sure.   Why?  Just read daily what’s in the papers and on twitter.. The government’s vision.  Shared budgets!!!  Shared care !!! joined up services.  It’s like it’s a new invention working together.  I remember when we tried the seamless service and where are we now?  Oh yes working on better care funds !!!  Look beyond the words on the paper I say.  What happens when it gets too big, when no-one knows what’s happening anymore and it’s no longer contained? Oh yes lets not forget we have to pay for it as well.  You decide, my opinion is dilute it to a point and we will have lost it all, our NHS, the one which has fixed me free of charge on many occasions.

My real concern is  patients  hear the banter but don’t think their voice will matter therefore do and say nothing.. Believe me it matters. Don't leave it until its too late. I keep telling you  what is  happening in GP land . Why is it that patients don't get involved.?  I think it’s because patients think its not going to affect them. Those in the know will.  Keep the NHS as the NHS, free at the point of contact.  I hope that following the Channel 5 programme ‘GP behind closed doors’ (excellent programme which I must say has caused a stir amongst managers in GP land as we can all relate to this) do a follow up on what the future will look like. Now that would be a challenge. 

How do we get ALL patients to help, get involved? I don’t think that will happen.  Yes the active groups will have a voice but it will take more than our patients’ voice to make much of a change.

Will be interesting to hear the parties’ views on this coming up to an election!  Believe me I have written to some including the Shadow Secretary of State for Health and asked for them to come and give a talk locally on the vision of the future.   Must say Sunderland must not be that appealing as given a full year of dates no-one wanted/could come!  The message to me is we must not be worthy! 

Those who know me will tell you I’m not one for being sucked in or following the crowd.  I will speak out if it’s not right for me as a patient. Whets the ‘thought for today’ Oh yes. Let’s charge patients to see a GP.  The start of the slippery slope..  the worlds gone mad and in a climate where many are on or below the breadline.  What next.. free 5 minutes at the food banks.  Let’s keep the NHS free at the point of contact and deter patients from failing to attend an appointment. If a charge needs to be levied then charge those who fail to attend appointment (unless of course patient admitted to hospital).  We do ourselves have a few patients who failed to attend on a regular basis and even though you speak to them it makes no difference and to be honest I don’t think some of them care.

GP practices are starved of income and have been for a number of years.  No money for premises improvements, making targets harder to hit and if you listen to the government they tell you they are throwing money at us. For goodness sake admit the truth, you took money away from us and we have to work bleeding hard to get some of it back.  Admit the reason why it’s happening.. ‘the future’.   

Did that line ‘charging patients’ make you stop and think or did you read it and think it’s not going to happen.  I really hope they don’t charge us for seeing a GP.  Being honest I don’t have a problem with charging when you attend minor injuries or walk in centres. (the cost to the practice budget is £68 when you attend, so would you pay that much from your own pocket or would you stop and think maybe I could help myself).   We have to pay if we go to a dentist; hence I dare bet people only go when they have to.  If you’ve read my previous blogs you will know why. I’m a great believer in the more you give the more people want hence 24/7 GP hours.  GP’s have a home and need to see their families as much as anyone else.  Our staff have homes and families.  With a little more compassion for each other, with a little more self care we could be on the right road.   My goodness what did we do years ago when it was because you had to see the Doctor you did.  And that’s when one of the three bottles on the shelf would make you better.  My grandparents lived to a good age, with a large family being the one who made sure we all were fit and well. Sore throats in them days you still had to go to work (down the pit) the magic cure was goose fat clagged onto your neck. It worked!

I’m all for innovation, looking to the future and embracing it, but only when it feels right for me as a patient. All I know am I want to keep seeing MY GP and I want the government to properly invest in General Practice.  

Let wait and see what the vote is on charging patients, in the meantime let me know your thoughts.

Gloria (from her sofa)

Engaging with our patients on and off line.

Engaging with our patients on and off line.

Sunderland CCG (Clinical Commissioning Group) is holding the next LEB (Local Engagement Board) on Thursday, 24th April 2014 , 10.30am – 12.30pm at The Hetton Centre, Welfare Road, Hetton-le-Hole  Tea and coffee will be available from 10.15am.

 

At this meeting the CCG will be talking about its Vision and Strategic Priorities for the next 5 years and give an overview of  our 10 ‘big priorities’ for 2014 - 2016

This is a good opportunity for you to advise the CCG how they can better involve

patients and the public with their plans

If you wish to attend or would like some information contact Jaclyn Hall on: 0191 512 8486 or email: jaclyn.hall@nhs.net

There is a lot going on in Sunderland, both within our practices, in our localities and also at SCCG.  All of us are looking at new ways of engaging with yourselves.  One would think this is an easy thing to do but must say not as easy as you think.  Our practice is trying to engage with everyone young and not so young.  Some via the website, the blog and even twitter.  Others in house but, we have to have the patients come into the surgery to let them know what’s happening.  If you can think of other ways then please do let me know.  I am off work now for the next couple of weeks and then only back here and there but I will be picking up emails gloria.middleton@nhs.net

An update on our patient group vacancies….  We have two and looking to recruit 2 young people 16 – 25 yrs preferably.  After discussions with the PPG we recognise we need to have the younger voice and idea’s.  If you are a patient and would like to be considered for the group please let me know.  We really do want to engage with our younger population.

The practice has offered a Learning Disability Health Checks to anyone over the age of 18 years.  This has now been lowered to 14 years. One of our team will be in touch over the year to offer an appointment.

I had to contact the police last week.  Its amazing how children get into the surgery when it is closed.  My main concerns are that if they get hurt no-one may know they are inside (as it looks all locked up and secure with an 18 foot fence from the outside) and secondly the damage they are causing whilst inside. It appears that the fence panels have been cut.  This is a cost of over £100 to replace.  As you can imagine,  I am not happy at all.

Fortunately we have cameras all around and inside the surgery.  Some you may not even recognise the cameras, you may not be aware of how far and wide the camera can see but an example is not only can I see everything in our carpark but I can also see the adjacent car park, and that is just one camera. I have many more.  The police have taken away still shots and action has been taken.

We try very hard to keep the surgery nice for our patients and I am not going to allow anyone to spoil that. Every time I have evidence I hand this over to the police.  A big thank you to Harvey our community police officer who has been fantastic and is very supportive.

And even though I am off for a short time, I have a system that I can log onto at home so I can still watch the CCTV. Just ask my staff, I often email them and ask them to wave at me. 

Be in touch with you all soon, possibly from my NHS hospital bed. 

Gloria

Looking ahead.. and beyond

It was a busy week last week with end of year, discussing the results of the practice questionnaire with the patient group (uploaded onto the website), meeting with the new NHS England Chief Executive Simon Stevens  listening to his first speech, taking part in a GP Pulse magazine 24 hours in GP land and going to the Sunderland Echo best of health awards. 

End of year is over and it all starts again. Figures I printed late 31.3.14 differ very slightly from national figures. Ok so only slightly BUT it should not differ at all. Think I know why it does BUT still should not differ. This is a system the government introduced and either that has flaws or the software system we use.  Thank goodness for the super spreadsheet that’s been developed locally and made cqrs end of year simpler with comparisons to match us against other practices.   

This year is going to be a challenge as constant code checking before monthly extractions is going to be a nightmare.

Your probably thinking ‘what is she going on about’ but just so you know if we don’t hit our targets, just like any other business we don’t get paid.

At our recent staff meeting we took the decision to email patients when they are due to be seen however as mobile numbers seem to get changed as often as Christmas comes around we are going to run a campaign to ensure the data we have is up to date. I will ask our web team to see if the form can be uploaded now more of you are using the internet.

Don’t forget to call in and buy a raffle ticket this week.. some lovely prices, a food hamper, a drinks basket, a box full of chocolates and more.  Tickets 50p a strip and all proceeds to the Sunderland ‘s Hug in a Bag appeal.    Later in the year we are holding a ‘handbag sale’ and then the two Lynn’s are doing the 3 peak challenge in September.  

Just before I go I attended the Sunderland Echo Best of Health Awards.  It was so nice to see those who work in the NHS being recognised for all their hard work. But a special mention from me to the lady who organised it behind the scenes Lynn Wild  (from the Echo).  The night was a huge success.  I tweeted a lot but must admit need some training on this.. 

Best go and press the button to accept my end of year so we can get paid.

Gloria

End of Year Giddiness or is it hysterics

With less than 2 hours to go I along with almost all Practice Managers in the country are checking that everything we have to do for end of year is done… excluding the accounts of course which is for another day including the tax man and his RTI submissions. (Reminder to self..must make that call to Tina at B W Medical Accountants)

Never before have we had to tick so many boxes, look at so many systems and report to so many different bodies…

Tick lists, check lists, coded lists and even a list of those things we think has been done but not received acknowledgement for.

Hairdresser this week will be shocked when she see’s the amount of grey hair I have.

The best thing….  Going shopping this weekend… We are free…. Well for another week anyway until we are hit with next years targets.

Yes,  we in general practice don’t just see patients (that’s for the clinicians), the rest of us have to run a business.

On a positive note we have uploaded our patient survey (after meeting with the patient group) onto the website.  The practice team and the patient group are very pleased with the results. As one of our patient group said ‘overall a very positive report’

Tomorrow is another day and  I am taking part in a 'day in a life of' survey.  Not sure how this will work but I do believe every hour I need to upload where I am and what I'm doing..  I can tell them now.. sitting with Joanne biting our nails to make sure the figures have gone through so that we can get paid....  then off to the CCG Executive meeting and then off to meet the new NHS England Chief Executive - Mr Simon Stevens. Now that should be interesting !   I think the giddiness and hysteria is going to last a while longer.

And breathe....

  

Sunderland Young Carers...Simply amazing

End of year and so many things to do. Targets to hit and end of year reports to be completed.

I usually decline invitations to meetings at this time of year but when the email came around from Sunderland Young Carers inviting me to their conference I put the pen down, shut off the computer and went along.

No-one warned me to take a hanky.

The conference was held in the Sandhill Centre and was open to all professionals organised by the Young Carers themselves. The purpose of the meeting was to bring together all relevant agencies, to raise awareness and share ways of working together.

I must say it got me thinking all weekend and I’ve put this on to the monthly practice agenda.

Young carers are young people aged 5 (yes 5) – 25 who help to look after a family member due to a long term illness, disability, mental health illness or addiction. Young carers may take on extra responsibilities at home such as cooking, cleaning or often they may worry about the person they care for.

You may be surprised at how many of our young children are Carers.  The Carers Centre say the numbers could be 2/3rds more than is registered with the centre.

Some children who are carers cannot get their homework in on time, some need to keep their phone on whilst in school in case they need to go home, whilst some are late every day.  If the school is aware of this they can give the young carer a school card.  The card helps teachers make allowances. There is so much support and if you think your child or someone you know is a young carer I would encourage you to point them in the direction of Sunderland Young Carers 0191 5493768.

The practice is actively asking patients if they are a carer or care for someone.  We are not being nosey,  all we want to do is direct you to those who can support and help you.

Same with the young carers, we need to do more to identify them. I’m looking for idea’s on what more we can do as a practice. If you come up with something then please get in touch with me by email. 

If you are a mother/father and worried about letting others know, please don’t be.  There is so much support for you all. 

Thank you Sunderland Young Carers, you are amazing and its young people like you that make this City and the world a better place J 

Photograph Sunderland Young Carers and Sharon Hodgson MP

Stop and Think just for a minute.

I wonder how many of your have been watching BBC2 ‘An hour to save a life’. For those of you have have not I must say you are missing out at just how fantastic our emergency services are.

After watching you realise this is what A&E is all about. Life threatening situations with only an hour to save a life.    I do hope people see A&E for just that, Accidents and Emergencies and when using the services stop to think just for a minute....

Stop and think can this be dealt with by other means.. self care, GP, Pharmacies.  Some people are quick to say they went to A&E because they couldn’t get an appointment. I am beginning to challenge this back.  I am looking at our reports coming in, looking at the times of the visits, our capacity in the practice and calculating  the cost.  I am even actively contacting patients.  I have some good examples of patients having an appointment with the GP yet still going the same day to A&E. Dental problems going to A&E.  I’m not sure if others know that all Dentists have an emergency out of hours service just like the GP’s. As some of you may know I work voluntary for the Ambulance Service as a first responder and hey ho my bleep has just gone off alerting me to ‘high demand’ and at full stretch. 

On a positive note it’s nice to see some of our health service providers being put forward for the ‘best of health awards’ that’s being run by the Sunderland Echo.  It seems a long time since we were winners of the GP Practice of the Year Award.  Here at Westbourne we would like to wish everyone who’s nominated good luck and you should be proud of your achievement.  Its also good to see one of our local pharmacies up for an award.  Well done to Jaz and the team at Penshaw Pharmacy.

Wembley Fever (the right kind of course)

I wonder how quiet our A&E departments will be this weekend.. very I hope.

With 32,000 people with tickets going to Wembley and who knows how many just going for a trip to London I do think this will have an impact.

Then there is the Monday morning feeling...  just to say if you go on the sick you will need to self certify. I’m not saying this will happen but I am preparing you for the answer!

There’s a lot to be said for the feel good factor.  Those niggles that usually gets us down have gone for the time being.  The sore throat and cold (man flu) is soon cured with two paracetamols. 

Take my son for example, “Mam I have the flu”...( strange that your still walking around)  “What should I do”.  My answer take two paracetamols.. and don’t go to the match at the weekend.  I can guarantee there will not be a sniffle in sight. 

When I was little my grandma was the one who taught us how to look after ourselves.  You only ever went to the Doctors if grandma could not make you better.  You would never ever dare go to A&E.  Ambulances only were allowed to go there with very poorly people (or that is what I thought).   Today I’m still not sure why people still go to A&E when it’s not an Accident or an Emergency!  

 

And on that note all I have left to say to those of you travelling to London, stay safe, dont drink and drive. Have a lovely time and take a packet of paracetamols with you ! Oh yes, bring back the cup!