Practice update from 8^th June 2020

As we start to come out of lockdown and more businesses open and work towards a new ‘normal’ we have also changed the way we’re working.

Demand is already increasing and we encourage patients to adapt to our new ways. The following will be the plan from 8th June to 4th July, though may be subject to change as the Government issues more guidance.

• Front door: we will continue to run with staff member on door. Please wait to be invited in if you have an appointment and wait outside if you are collecting medication. You should maintain a 2m distance at all times for staff safety and for yours. 

• Medication collections will be extended to 4pm at Holbrook on Monday Tuesday and Wednesday. There will only be a morning collection on Thursday as usual and we will be open for collections until 5pm on Friday as before.

• If you have an appointment at Shotley please use the main door between 8am-11am and 2pm-5pm. Otherwise, you should use the door in the doctors car park between 11am-2pm and after 5pm. You should exit via the back door into the doctors’ car park. You should not wander into any other part of the building. 

• Please take care as we have a hole in the doctors’ car park and are awaiting an assessment from our insurers. This is clearly marked and surrounded by bollards.

• Shielding patients (those at very high risk with a Government letter) will only be seen at Holbrook Monday to Thursday and on Friday morning. Please come to the beginning of the queue and stand at the green “Appointments Only” marker which is distanced from where others stand to collect prescriptions. Do not arrive too early to avoid too many people. It is preferable that you do not attend on a Friday afternoon when we may be seeing other patients who are not shielding.

• Only the actual patient should come into waiting room. Children may be accompanied by only one parent. Elderly or infirm patients needing help should only have one person assisting them.

• If you are being seen for appointment, our clinical staff will wear appropriate PPE. This may include a face mask, gloves, apron and visor depending on your appointment type. Some of our non-clinical staff may wearing hospital type scrubs whilst working on the door. 

• We are able to see fewer patients face to face as more time is needed between patients to clean rooms and equipment and change PPE.

• We are in the process of having additional screens made for when we reopen our doors. We also have tape ready to mark out 2m distances.

• We will continue to offer telephone advice and video consultations.

• When you ring or come to the door, you will be asked if you have a temperature, a new continuous cough and/or loss of/change in taste or smell. If you are symptomatic we can still ring you to discuss but may send a car to visit you at home with a specially kitted out staff member from the Suffolk GP Federation.

• Repeat medication can be ordered online via NHS App or SystmOnline or you can put a query through eConsult (blue banner on our website). If you have no online access, you can drop your repeat slip through the door at either site.

• eConsult – we recommend patients use eConsult for non urgent queries including repeat Fit For Work Note/Sick Certificate requests, medication queries, referral to hospital which will send details to our GPs and staff and we can respond via a one way message. 

• Some annual checks can be done partially or fully on eConsult. Go to https://holbrookandshotleysurgery.webgp.com/reviews and click on your condition. There are templates for Asthma, Diabetes, Thyroid, COPD, Hypertension, Contraceptive pill and also for a medication review. Complete the information as fully as possible and we will contact you if necessary once we receive this.  You may still be asked to come in but this will reduce the time of your appointment as we can gather information before you attend. 

• Nurses continue to ring our shielding patients to offer help from community groups. Patients are still being added to this list by the practice, hospitals and Government.

• Coronavirus testing is available for patients with symptoms via the NHS website https://www.nhs.uk/ask-for-a-coronavirus-test website or ring 119 if no internet access.

• Antibody testing will available soon and will need a blood test taken which will increase our blood test appointment requests.

• Staff will be split into two teams from 8th June for four weeks to reduce risk of cross contamination between sites. One team will work only at Holbrook, the other only at Shotley. This may mean that you do not see the same person as usual when you attend. However, it will give us more flexibility if we do have an outbreak amongst staff.

• A lip speaker is available for those who are hard of hearing. Contact Natalie Farrugia at nfbslpro@gmail.com or on 07860 373317. Natalie has kindly offered to help but is not employed by the practice. By contacting Natalie directly you understand the confidentiality issues.

• Over 70s –should where possible ask a family or friend to collect medication for them. If there is absolutely no-one who can do this then we are very helpfully supported by the community groups. Please ring reception if you are not already in touch with them and we can give you the number of the nearest group to you.

• Childhood immunisations and baby checks– the midwife and health visitor are contacting patients and giving advice over the phone or organising for patients to come in when necessary. Parents should still bring their children for their immunisations and baby checks. Our usual 6 week postnatal check will now be combined with the 8 week immunisations so you only need to attend once and will see both the nurse and doctor.

• Cervical screening– if you receive a recall letter and are concerned, please ring reception and we will book a telephone appointment with the nurse who can advise you what to do.

• For mental health issues due to coronavirus visit https://www.mind.org.uk/information-support/coronavirus/

• And finally, I would like again to thank our staff and all of the voluntary groups who have been helping both us as a practice and our communities. Many of our staff are covering extra hours on a regular basis and have their own challenges at home and within the workplace. They are having to adapt to new technology, the loss of social connection and growing demand whilst keeping up with all the changes from NHSE and our CCG. We do appreciate the lovely comments we get from patients and I always forward these round. Sadly, we still have some patients who feel it is acceptable to shout at our staff. We will continue to always try to do our best for our patients and, if we fall short of this, please accept our apologies. If you need to complain, please contact our practice manager at the surgery so that we can look into this for you. Our voluntary groups have been such a help and we are grateful to them for all they do. If you are shielding and struggling to get medication delivered then please contact us. If there is no community group near to you then the NHS Volunteers or our staff may be able to do this for you.

Opening Times (telephone calls only)

Prescription collection times

Frequently Asked Questions

Do I have a medical condition that makes me extremely vulnerable to coronavirus?

You’re extremely vulnerable if you:

• Have had a solid organ transplant
• Have any cancer and are getting chemotherapy
• Have lung cancer and are getting radical radiotherapy
• Have cancer of the blood or bone marrow, at any stage of treatment - for example, leukaemia, lymphoma or myeloma
• Have any cancer for which you’re getting immunotherapy or other continuing antibody treatments
• Have any cancer for which you’re getting a targeted treatment which can affect the immune system - for example, protein kinase inhibitors or PARP inhibitors
• Have had bone marrow or stem cell transplants in the last 6 months, or are still taking immunosuppression drugs
• Have a severe respiratory condition - including cystic fibrosis, severe asthma or severe COPD (Chronic Obstructive Pulmonary Disease)
• Have a rare disease or inborn error of metabolism that significantly increases your risk of infection - for example SCID or homozygous sickle cell
• Are getting an immunosuppression therapy that’s sufficient to significantly increase your risk of infection
• Are pregnant, and have a significant congenital or acquired heart disease

YOU NEED TO PRACTICE SHIELDING FOR 12 WEEKS (SEE BELOW)

click here for guidance on protecting and shielding the extremely vulnerable

Frequently Asked Questions for Patients published 1st April 2020 for extremely vulnerable

What letter was sent to people classified as "extremely vulnerable" by the government?

Click here for the Standard Version

Click here for the Easy Read version

If someone needs help with daily living and is "extremely vulnerable" but has no one who can help, how do I access help?

If you need help with care but you are not sure who to contact, please visit www.gov.uk/coronavirusextremely-vulnerable or call 0800 0288327 which is the government helpline

OK I see I am not in the "extremely vulnerable" group but did the government not say that some people are "vulnerable"?

On Monday 16th March the UK government announced a package of measures, advising those who are or may be at increased risk of severe illness from COVID-19 to be particularly stringent in following social distancing measures.

 This group has been identified to the public as those who are:

• Aged 70 or older (regardless of medical conditions)
• Under 70 with an underlying health condition listed below (i.e. anyone instructed to get a flu jab as an adult each year on medical grounds): 
• Chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis 
• Chronic heart disease, such as heart failure
• Chronic kidney disease
• Chronic liver disease, such as hepatitis
• Chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
• Diabetes
• Problems with your spleen – for example, sickle cell disease or if you have had your spleen removed
• A weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy
• Being seriously overweight (a BMI of 40 or above)
• Those who are pregnant

But some of the conditions on the "vulnerable"list are the same as those on the "extremely vulnerable" list are they not?

Yes that is true but lets look at a couple of examples. In the case of respiratory conditions such COPD you have to have them severely to be classified as very vulnerable. Another example is pregnancy which would make you vulnerable, but you would have to be pregnant with significant heart disease to be classed as extremely vulnerable.

Why is this important? If you are vulnerable you need to follow strict social distancing measures. If you are extremely vulnerable you need to be shielded for 12 weeks

What is social distancing?

Social distancing measures are steps you can take to reduce social interaction between people. This will help reduce the transmission of coronavirus (COVID-19).

They are to:

1. Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough
2. Avoid non-essential use of public transport when possible
3. Work from home, where possible. Your employer should support you to do this. Please refer to employer guidancefor more information
4. Avoid large and small gatherings in public spaces, noting that pubs, restaurants, leisure centres and similar venues are currently shut as infections spread easily in closed spaces where people gather together.
5. Avoid gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media
6. Use telephone or online services to contact your GP or other essential services

Everyone should be trying to follow these measures as much as is practicable.

We strongly advise you to follow the above measures as much as you can and to significantly limit your face-to-face interaction with friends and family if possible, particularly if you:

• Are over 70
• Have an underlying health condition
• Are pregnant

FOR MORE DETAILED GUIDANCE ON SOCIAL DISTANCING CLICK HERE

What is shielding?

Shielding is a measure to protect extremely vulnerable people by minimising interaction between those who are extremely vulnerable and 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. This is to protect those who are at very high risk of severe illness from coronavirus (COVID-19) from coming into contact with the virus.

If you think you have a condition which makes you extremely vulnerable or have received a letter from NHS England you are strongly advised to shield yourself, to reduce the chance of getting coronavirus (COVID-19) and follow the face-to-face distancing measures below.

The measures are:

1. Strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough.
2. Do not leave your house.
3. Do not attend any gatherings. This includes gatherings of friends and families in private spaces, for example, family homes, weddings and religious services.
4. Do not go out for shopping, leisure or travel and, when arranging food or medication deliveries, these should be left at the door to minimise contact.
5. Keep in touch using remote technology such as phone, internet, and social media.

Do use telephone or online services to contact your GP or other essential services.

We know that stopping these activities will be difficult. You should try to identify ways of staying in touch with others and participating in your normal activities remotely from your home. However, you must not participate in alternative activities if they involve any contact with other people.

click here for guidance on protecting and shielding the extremely vulnerable

I have not received a letter from the government to say I am extremely vulnerable to coronavirus but heard that some people would be added to the list by their GP because of complex or multiple medical problems. Why have I not been contacted by the practice?

As of 1st April 2020 we have still not been contacted by the government about any guidance on this. However if you feel you need to be added to the list in the meantime because of your medical problems a doctor or nurse practitioner will be able to talk to you on the phone and make a decision. We have been advised that additional guidance for practices should come out by mid April.

Background and FAQs for Clinicians published 3rd April 2020

Do I need a medical certificate if I am self isolating for 7 or 14 days?

You should not need a fit note (medical certificate/sick note)

However get an isolation note online using the link below. Someone can do it for you if you have trouble with technology or don't have an email address.

• Use this service if you have been told to self-isolate because of coronavirus and you need a note for your employer.

This service is only for people who:

• Have symptoms of coronavirus
• Live with someone who has symptoms of coronavirus

Just click the link below

https://111.nhs.uk/isolation-note

Can I have a medical certificate for 12 weeks if I have to be shielded?

Yes. Just contact the practice.

Is there any guidance for employers and employees?

This is not an area we are expert in so have a look at this useful link:

https://www.gov.uk/government/publications/guidance-to-employers-and-businesses-about-covid-19

Is there any point in signing up for online services?

Yes as you can access all the services in the illustrations above. As of April 2020 nearly all prescribing will be electronic and you can view your GP record and easily access your test results. Just contact us and we will sign you up!

Welcome to Holbrook and Shotley Surgery

There are two main Surgeries, in Holbrook and Shotley. Both surgeries have dispensaries which will issue prescribed drugs to eligible patients (if you live within one mile of an independent Pharmacy we are not permitted to dispense to you.).

Both surgeries are well equipped, purpose designed buildings and are conveniently situated in the centres of their villages on bus routes.

Wheelchair access, disabled toilets and baby changing facilities are provided at both premises. In addition to the main surgeries, there is a surgery held at the Royal Hospital School, Holbrook, for pupils only.

We are confident that our website will provide clear and concise help and give our patients the information they require in an easy and convenient format. It has been designed with the patient’s needs at the forefront of everything, from checking surgery times to letting us know what you think of us.

Serving You

Our dedicated team are here to treat those minor ailments that occur as well as providing specialist management of long-term conditions and clinics covering a wide range of healthcare issues. The technology also means you can now do a lot of things from the comfort of your home such as order a repeat prescription or cancel an appointment.

Partners in Care

Once registered, patients and healthcare professionals work together to ensure the most appropriate care is provided. This partnership philosophy extends even further and our active patient group exists to make sure that patient needs and the practice offering are always heading in the same direction.

Our organisation is part of the My Care Record approach which is supporting the work of health and care organisations across the East of England as they respond to the coronavirus (COVID-19) pandemic. For example, we are working to make sure doctors, nurses and co-ordination staff at places you may receive advice or treatment can see important information from your patient record. This could include NHS  treatment centres such as the London NHS Nightingale Hospital. This will make it easier and faster for them to deliver effective care.

Exercising guidelines for patients with a diagnosis of dementia, learning disabilities or autism, or who has significant mental health needs.

Click here for more information.

Suffolk Wellbeing Service

Click here for more Information.