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April 10th BRIGHTON MARATHON
I fully expect to have numerous strained knees and blisters in to Surgery tomorrow... however well done everyone. My son Charles ran the marathon with friends to raise money for Help for Heroes and many patients helped sponsor him. He achieved 5hrs 10minutes and came in at number 5945 out of the estimated 26000 runners! Sponsorship, including money from Gift Aid came to £2700 which will benefit our soldiers returning from areas of conflict. WELL DONE and THANKYOU
February 5th Just come back from three weeks vacation cruising the Falkland Islands, Antarctica and Chile. A wonderful experience particularly the majesty and variations of Icebergs.... this particularly dramatic chunk of ice! Inherent blue radiating from the ancient ice within it
and of course our friendly penguins !
Managed to see brief glimpses and tail flicks of some whales and a lazy bunch of sea lions... A Condor graced us with its presence in Southern Chile and albatrosses followed the boat after we left the cold, windy and very wet Falkland Islands! Thank you for everyone's help while we were away - our locum doctors seemed to be appreciated and my colleagues were marvellous in managing the paperwork so that I did not have to return to the usual 1000 sheets of paper which normally await my return from vacation. Its difficult getting back into the way of things and the diet of porridge and soup has already started (1.7kg off this week already!) We wish everyone a very Happy New Year and we all look forward to the weather improving sometime soon!
December 12th Why cannot life be easy these days? Another stressful week with Sr Whittington deciding to cancel her surgery suddenly on Tuesday before resigning. Another hassle that we could have done without. However, as always, we cope and we apologise to those who have had to make alternative arrangements for certain procedures. We will be looking to appoint a new nurse in the New Year, but with everything going on at the moment we will just extend our existing nurse clinics to cope at present. Coupled with this, Dr Osman had to fly off suddenly back to the Sudan for family reasons... hopefully all is well and he will be back with us in a week. My daughter spent an hour last weekend trying to sort out our Christmas tree in the waiting room... just as we were about to put it into final position, the whole thing collapsed (plastic fatigue) and has since had to be consigned to the refuse! I hope we will at least get some decorations up in the next few days... Thanks to everyone who donated the odd coins (and notes) to our recent appeal on behalf of "Help the Heroes"... just over £68 was raised and we will make this up to £500 with practice donation. We will be trying to help the Children who rely on Tadworth Court over the next few months - so if you have spare coins when you pass the surgery, do take the weight out of your purse! It's amazing how time flies... Elaine and I are off on holiday from the 9th January (three weeks in Antarctica ) which is awfully close after Christmas. Rergrettably we will not have internet link to the Surgery while we are away - we normally manage to keep in touch and do some administration while away - hence it is taxing me to ensure everything flows while we are away. All being well, we have locum cover and our colleagues and staff in the practice are primed to keep everything rolling along. Don't know why we have decided to have a number of "cooler" holidays this year and next... Norway in the summer (Brrr!) Grampians and Cairngorm in October( at least we didn't have the snow they have at the moment) followed by Antarctica in January and Alaska in June for our 30th Wedding Anniversary.
On behalf of all the staff at our surgeries - may we wish you and your families a VERY HAPPY CHRISTMAS and a good NEW YEAR.
November 6th I suppose you could say that was the week that was! All hell broke out on Wednesday morning when we discovered that we had been locked out of The Eaton Centre by the landlords. Trying to fit a quart into a pint pot ... we managed and our staff did a tremendous job contacting and rearranging appointments for patients (not so easy when people don't give us up to date contact numbers!).
A sleepless night on Wednesday allowed me to ferment a plan to proceeed and this was put to the landlords on Thursday morning. I met with the landlord at lunchtime Thursday and we agreed a new licence to use the premises for the foreseeable future. I have to say that the landlord was most helpful in sorting out the situation to mutual satisfaction. Legal processes were completed on Friday and despite a hitch in the bank transferring the money on Friday afternoon, the licence payment was received by the landlords on Saturday and (at the time of writing) we hope to re-enter the premises on Sunday. Some repair work to the doors needs to be undertaken and one or two other administrative matters need to be dealt with on Monday before we can reopen to patient on Tuesday or Wednesday. We believe that Dr Jani has now resigned from the practice and will be looking to appoint a replacement doctor in the near future - in the meantime we will do our best to meet your needs, as ever! Of course, all this happened when we had a "flu clinic" booked on the Thursday morning at Eaton. As this was mainly a drop-in session it was impossible to contact patients in advance. However in order not to inconvenience everyone, we were able to arrange a shuttle minibus to take patients from Eaton to Goodwood (and back again if they wished). Despite some inappropriate grumbling from a minority of people, most patients seemed to appreciate this and understood our predicament... I would suggest that those who could do nothing but grumble that they should "get a life" and realise the situation we were in - particularly as I had to arrange all this while at a family funeral in Eastbourne!!!!! My thanks to my son Charles who stoically stood outside Eaton Centre for the three hours organising and helping people onto the bus. Hopefully next week will be quieter.
October 10th Have just finished arranging a mail shot of 1500 letters to everyone who is due their flu jab again this year. Clinics are listed on our website (influenza link) but everyone should get a letter this coming week. This is always a massive logistical process but seems to work out in the end and is enjoyable in some perverse way ! I had hoped that I would not have to keep cutting the new grass at Eaton, but with the wet and warm weather we have been having, it seems to grow an inch a week at the moment still! I think my lawnmower is on its last legs... hopefully it will see the season out. Certainly compared to this time last year, the garden looks 100% better.. however the weeds are still coming through and a lot of the plants I bought seem to have died off (probably because of a dryish spell after we put them in). Still waiting for the Landlord to get around to regular maintenance of the garden and pathway... he hasn't done anything in the last 15 years, so suppose I cannot expect too much Dr Kimble has now moved to Devon with her husband who has joined an Orthopaedic team down there... we wish her well. However we now have completed, I hope, our medical team for the next few months... Dr Osman has joined us working four days a week and Dr Corney has also returned from a paediatric stint at Worthing to work three days and one evening a week. In order to rationalise the workload a little, I have instituted a regular "child immunisation" session on a Thursday early afternoon to see if that will work for most parents... I may supplement this with an evening session later as it seems that many parents both want to attend - let me know what you think.
August 22nd 2010
Rain in Norway? - well what about today in Brighton then? Autumn seems to have arrived with vengeance and the spiders are spinning their autumn webs overnight. What do I expect, however, having arranged for the roof at Goodwood Court to be resurfaced this month! Thank you to all those who have kindly entered a comment on the NHS.UK website concerning the practice - it is heartening to our staff to learn that they are appreciated. A couple of patients have raised suggestions - one being that we should have a "01273" number instead of an 0844 number... we have and have had for 10 years !.... 01273 733620 is the number attached to Eaton Centre but which gives full access to appointments and computer information. Regrettably different telephone contracts now charge different amounts to phone different numbers. All our numbers are listed on the front page of this website, so if you are concerned about your telephone costs, you have the choice of: 01273 or 0870 or 0844 or internet or pen and paper! We have now appointed Dr Osman to join us at the end of September, so with him joining us and with the return of Dr Corney after working at Worthing for a couple of months we will be up to full strength again at that time. Thanks to everyone for helping us hold the fort. I have just spend a couple of days updating the prescribing at the practice for some patients... we are now advised to prescribe certain drugs by their "BRAND" name rather than by their chemical name (which has been the norm for some years). Hence you may notice a change in the name of your drug. If you are not sure, please ask you doctor or pharmacist... I have taken special care to check accuracy. This applies particularly to patients on drugs for epilepsy, patients on drugs which affect the immune process and patients on a particularly type of blood pressure pill (known as a calcium channel blocker). We forever need your blood pressure readings, your heights and weights and smoking status! The Government demands this data every quarter on all patients... hence please do not hesitate to use the machines in the entrance lobby at Eaton or the Waiting Room at Goodwood... but remember to put your name on the data you give us. Enjoy the Autumn!
July 24th 2010 Returned from holiday in Norway cruising the coast and fjords... beautiful
scenery and many rainbows
Came back to a 3 foot high pile of paperwork. Just about cleared it now but it never seems to get better. We have now completed a round of painting - handrails at Goodwood and the corridor at Eaton. Both look better and brighter. I have just placed an advert in the GP weekly journal - the BMJ- for an additional full time doctor to replace both Katy Preuveneers who leaves to move to London at the end of the coming week and also Helen Kimble who moves to Cornwall at the end of September. Both moving for their partner's careers. Good wishes to all concerned and thanks for their help over the last couple of years. I am currently bringing together a newsletter to our patients - this will be
posted on line and also sent by post to most of our patients (a major
undertaking!) This will contain important information about the practice
and what we are trying to achieve in the coming months, so hopefully will be of
some use to everyone. An important aspect of our work over the next few months is to increase the uptake of NHS Health Screenings in patients between 40 and 74 who have blood pressure problems... if you are in this group and haven't had a cholesterol checkup recently, do get in touch for a health check.
June 22nd 2010 Sorry its been so long since I last wrote... time passes (and I won't say I have been enjoying myself - its just there is so much going on at this time of year). End of financial year claims and audits had to be completed during April and May... We achieved a very high level (almost 100%) of clinical achievement points for the year 2009-2010. This a result of hard work by all members of the team. However our "patient survey" results have just been published for the last quarter of 2009-2010 which still indicates patients are reporting difficulties in making appointments beyond 48 hours.... I really cannot believe this, we have literally hundreds of appointments available for people who want to book in advance. I think the problem is one of people trying to answer a question when they have actually never asked for an appointment in advance! Fortunately the Government has decided to abandon some of its targets and there is talk that it will save millions of pounds by scrapping the quarterly patients survey. If anyone reading this receives a questionnaire about "advance access" - please answer it honestly and only if you have actually tried to make an advance appointment in recent times. Similarly if you know of problems with advance booking, would you let me know as I need to investigate what is happening. The only times when you may have problems booking for a particular doctor in advance is when that doctor is on leave. Talking about leave, I and Elaine will be away on vacation - cruising the coast of Norway - from the 5th July until the 17th July. We have appointed additional locums during that period but apologise in advance if there is slightly less availability for evening and Saturday appointments. Regrettably Dr Duncan has suddenly decided that she did not want to continue working as a locum at Eaton Centre - this has put a bit of a strain on the practice but that should settle down in a week or two. We are pleased that the grass at Eaton has finally started to come through and if you look at the garden through rose coloured spectacles it looks quite good down there now! We are having the woodwork painted in the corridor and entrance area in the next few weeks - should be fairly spruced up down there. The entrance porch and hand rails at Goodwood will be painted also in the next couple of weeks - notices will be posted to advise of wet paint so be careful! Have a good summer!
March 21st 2010 Spent the weekend removing over 100 bags of garden waste from the garden at The Eaton Centre. We have finally given up with the landlord there and taken matters into our own hand to try and improve the environment at that site. I spent £1500 on plants at the Garden Centre so hopefully it will look a lot better when it is finished in a couple of weeks time. We have also created a new examination room at The Eaton Centre and are busy putting final touches to the level of equipment down there with new CCTV surveillance and various other improvements. The carpets were cleaned on Friday which has left a bit of dampness in the air but should clear in a few days. We now have a full house of doctors with almost every room being used to its maximum capacity... there should now be no difficulty obtaining an appointment within 24 hours. We are presenting Dr Williamson with a dinner and gift in his honour this Wednesday, so the practice will close at 630pm that day to enable all staff to attend... apologies for any inconvenience caused. Our new repeat prescribing process comes in at the end of next week... this should make it safer and more convenient for everyone once the system rolls forward. There will be a little more inconvenience and confusion to start with but most patients should now have received written notification of the change and the need to consult with a doctor about their next prescription.
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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The
snow and ice could have been a problem last week, but thanks to strong shoes,
everyone got in to work and apart from the watery mess on the floors, all went
well. Many thanks to staff and clinicians for helping out and keeping our
services going. Fortunately after last year's snow and ice, I have a stock
of rocksalt together with a snow shovel and a mechanical grit spreader, so
spending an hour clearing the snow early on Thursday morning ensured that our
pathways were safe.
! Shame to have to come home. It seems that in
most towns, the GP is there for just half a day a week so the locals have to
manage themselves between times.... not sure that would work in Hove.
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!