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March 7th 2010 The call-centre system has been live for the past week and has been used already - seemingly successfully. We also, found, after revamping the telephone system that there were 272 messages cancelling appointments dating back to 2006 !!! We did not know about that facility previously, so have cleared the outstanding messages - hopefully cancellation messages will now get through to us. The Garden at The Eaton Centre is being landscapped at the moment - I was fed up with the landlord doing nothing about it... even just with the clearing of some overgrown shrubbery and ivy it looks a whole lot better already. We will create a low-maintenance garden which will be reasonably welcoming - thanks to Terry for his ongoing work there. With the end of the fiscal year looming, have been purchasing some new equipment for the practice which has meant filling the car with empty cardboard boxes and packaging. A few things still awaited such as adjustable couches for The Eaton Centre and an additional ultrasound scanner for the doctors to use down there also... we are probably one of the better equipped medical centres now with everything that we need. It has been a long uphill struggle since I reopened Goodwood Court in 1996 .. but just about got there now. We will be losing Dr Williamson at the end of this month - he has decided to retire from the practice. Our thanks to him for all his help over the past few years. I am sure he would be pleased to receive good wishes from his many patients for a happy retirement. It is hoped that Dr Alison Corney will be joining us to replace him at the beginning of June and we should have some additional locum cover between times to meet demand. The Doctors and Nurses got down on their knees this last week on an annual refresher course for CPR training (heart- lung resuscitation)... we now know who has the most energy to keep heart massage going in the event of collapse!
Valentine's Day 14 February 2010 Early morning waking yesterday which allowed me to think through some options for the practice. We are instituting a major change in telephone access during March by the use of a Call Centre - particularly for those who want to make an appointment to see a doctor routinely but who prefer not to use the internet. Coupled with this we are making the telephone option selection slightly less confusing - hopefully once these changes are set up everyone will be happier. We have appointed an additional receptionist to start work at the beginning of March - once she has trained this will allow more calls to be taken away from the "front desk" at Goodwood and for the staff to deal with other matters away from the reception desk which will decrease disruption and hopefully increase efficiency. A survey is going out to about 100 of our diabetic patients this next week - spent yesterday afternoon putting everything together but ran out of envelopes after 100 ! If you receive one, please do complete and send it off - a freepost envelope is enclosed. We have now vaccinated 80% of patients over 65 years of age and 60% of those under 65 classified as "at risk". One more flu clinic is being held at the end of this month. Thereafter will probably do a clinic once a month to continue the swine flu vaccinations. Now we turn to offering meningitis C vaccines to all the students studying at Bellerbys College. Our practice inspections went well with the only criticism being the radiator in the corridor at Eaton - not protected from the public who "might touch it and find it hot" !!! One wonders really about commonsense. Dr Williamson is now away for a couple of weeks, followed by Dr Wilson for a week We have created some blood pressure clinics over the next week to try and encourage those patients with hypertension to come in and have their blood pressure checked......it does create a lot of extra work when patients ignore something as important as their blood pressure when they are known to have problems - strokes are devastating ! Now that I have worked-out how to mailmerge person-specific information from one of our analysis programmes, I will be assembling a major mail shot to all adults to raise individual awareness of their personal risk of heart disease and stroke. This will be coupled with a newsletter about all the changes that are going on within the practice.
Saturday 30th January 2010 Another month has gone by already... a month of snow, cold, rain and coughs. Will be glad when the range of winter illnesses finally takes its leave of us. For some reason the waiting room seems noisier than ever in the last couple of weeks. Its cold again today but bright, so hopefully we will have a typical February - dry and "brisk". We have a number of locum doctors working regularly for us over the next few months - welcome to Drs Alex Novak, David Robertson and Mari Jones. They are helping us cope with the loss of Dr Fell. Dr Katy Preuveneers will be returning from mid March on a sessional basis until later in the Summer. We will also be welcoming Dr Alison Corney in April who, hopefully, will be working for us on a permanent basis from the beginning of June. We hope that this will allow us to provide enough access for you. All these doctors will be working regular and "future" sessions so you will be able to see the same doctor for follow-up if necessary. I spent a day this week at a workshop looking at increased access and the "patient experience". Quite a few ideas have come out of it and we will be looking to implement some changes over the coming weeks... particularly in respect of improving access by telephone and by decreasing the noise of telephones ringing at the Goodwood Reception! We are also going to be looking at releasing more appointment slots to the online booking service to avoid the need for people to keep telephoning for appointments. Flu vaccine clinics have started once again now the weather is less unpredictable. I hope that we will complete the Swine Flu High Risk vaccination programme by the end of February as it encroaches considerably on the demands at the practice - every weekend is taken up vaccinating people at the moment which is personally exhausting and does create an ever-increasing pile of "pending" paperwork. Amused by a letter I received back from a consultant dermatologist this week... "thank you for sending this patient to see me who was concerned about her moles. She does not have any moles, but the ones she does have are normal"..... I am sure the consultant knew what he meant to write, but perhaps lost in translation. I suppose at least we got a letter back within a few days of the consultation, orthopaedic letters take an average of 6 weeks following being seen in clinic before we receive our copy. We are currently blitzing blood pressure at the moment... those with a history of high blood pressure are being offered their own personal blood pressure monitor free of charge - there hasn't been a mad rush yet which surprises me as most people want something for nothing. We will now have to start phoning to remind them.... We have a practice "inspection" coming up on Tuesday... suppose I will have to spend another evening polishing and scrubbing and moving pieces of paper around to satisfy the inspectors. One day I will be able to keep ahead of the administrators.
Friday 1st January 2010 Happy New Year to everyone. Started off sunny but cold... hopefully will stay dry for a few days at least. Productive day - polished the corridor floors; scrubbed the waiting room, toilet and treatment room floors.... horrendous amount of bad weather in the last few weeks resulted in the floors looking a bit dim, so a bright shiny start for the New Year! Also managed to bring most of the practice accounts up to date and sent off 400 letters to various patients who need various blood tests etc. Hopefully over the rest of the weekend will manage to get the paperwork out of the way ready for a fresh start on Monday. Have also re-set up my appointment timetable to allow some extra appointments in the week on a Monday and Tuesday morning. Still not found anyone to replace Dr Fell who resigned from the practice. Have arranged some regular locum sessions for the Eaton Centre so we should be in a position to cope for the next few weeks. Am considering whether or not to appoint a "triage" nurse to take off some of the pressure with the minor illnesses and routine blood pressure checks etc - however people's experience of such systems elsewhere has not been over favourable - will have to a bit of market research for this. Typical of the NHS - they request that we forward them statistics about uptake of flu vaccines every month - this takes some two hours to run on the computer stopping anyone else accessing the database. So ran it today only to find that the NHS website to whic we have to upload the data is closed until Monday 4th !
At least home for tea today!
Monday 28th December 2009 Nearly at the end of another year. Not one of the best for the practice in terms of workload and pressures on everything that we do. However, a New Year is always a time for change and "early spring cleaning". To this end, have spent most of today tidying up a few loose ends in terms of things to be done - patients to be called in for various checks have all been identified and letters composed ready for sending out in the next couple of weeks. Another batch of invites have gone off to patients who have still not attended for their flu jabs and I have also written out to 350 people who need their blood pressure checked, offering them a free blood pressure monitor at home- have only purchased 200, so if we get a full response, I will be going to the shops again. Also spent a part of the morning today attempting to remove the old floor polish from the corridor at Goodwood Court. Not very successful - there seems to be some ingrained polish from years ago. Never mind, have asked our temporary cleaner (who cleans commercial floors for a living) to see what can be done. If no idea, then will be scrubbing it again on Friday. Hope to get some more fresh floor polish down next weekend. Tomorrow will probably be a rush... am on my own in the afternoon as other practitioners finish up their leave allowances etc. Still not found a replacement for Dr Fell who has now finished. We will have to do our best until one can be found. Again, not helped by the Primary Care Trust who now expect everyone to provide even more access hours - cannot understand how other practices still manage to close for at least half a day a week or at lunchtimes... surely would be better for the PCT to concentrate their efforts and criticism on those practices rather than keep pushing at practices such as ours which are open many hours a week. However, as with many other things this PCT does - it cannot understand that it is driving us to exhaustion ! Very best wishes to you all for the New Year. Saturday 12 December 2009 Decided to set up a blog on our website tonight. Having spent the whole day
giving flu vaccines at the surgery and then spending three hours driving around
administering the same to those who were housebound, may as well spend an hour
or two updating the website. One person recently commented that the website was
looking a bit tired and outdated.... partly intentional in order to keep it
simple and easily updated (after all, I do everything myself !). However I have
found a futuristic image for the home page and tidied it up a little which may
make navigation a little easier. Good news this week that the swine flu is perhaps less dangerous than was previously thought, however it is still imperative we proceed with the vaccination campaign otherwise more children and susceptible adults will be affected in the next twelve months. Flu pandemics have a habit of rearing their ugly head every few months until the virus has become so widespread that the level of population immunity become high. Currently we have managed to vaccinate about a 1000 people and have made a significant inroad into the latest campaign - to vaccinate the under 5s. I was very annoyed with the so-called "doctors leaders" this week who failed to agree a way forward with the vaccination of the under 5s such that I received an email from the local medical committee (which purports to represent doctors in Surrey and Sussex) telling all GPs not to go ahead with the vaccination of the under 5s until finance had been agreed. This is totally unethical and I immediately wrote back accordingly telling them that clinical urgency required such vaccination to proceed - money can always be sorted out afterwards. Currently looking a more ways to save energy in the practice. At Goodwood
Court we use nearly 100 units of electricity a day - mainly seems to be on
fridges, computers and lighting. So far this winter we have introduced
"occupancy detectors" in the patient toilet and staff kitchen to try and reduce
wastage. We have also put a 5 minute switch into the staff toilet to encourage
speedy use! We have joined the 10:10(http://www.1010uk.org) campaign to further reduce Staff have gone out for their Christmas Dinner tonight.... hope that they enjoy themselves. They should have sobered up by Monday!
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our carbon footprint by at least 10% in 2010. Hopefully we will be
installing electricity generating solar panels in the spring which should
generate half our electricity usage on sunny days! We have also installed
an anemometer on the roof of Goodwood Court in order to assess whether or not a
wind generator would be worthwhile for the "non-sunny" days. Having done
this at home over the last few months, despite living at a high point in
Brighton the anemometer analysis suggested it would take 573 years to pay back
the cost of installation - needless to say I haven't bothered to install one!