Did you know that you don’t always need to see a GP or consultant to access some referral services? Self -referral is an option that can make it easier and faster for you to get help, rather than seeing your doctor.

You can register for most of them online. Click on the service you’re interested in, and find the help you need easily.

 Please be aware, the availability of self-referral services varies across Derby and Derbyshire.

https://joinedupcarederbyshire.co.uk/self-referral/self-referral-for-patients/

We have had lots of enquiries about the recent change to guidance for the shingles vaccine. The age criteria has recently been reduced for healthy patients – please follow the link below to see when you will be eligible.

SHINGLES VACCINATION ELIGIBILITY POSTER

For those patients who are severely immunocompromised, you will be eligible from the age of 50 years – if you feel you fall into this category and haven’t been called, please contact the surgery to discuss.

The Patient Participation Group (PPG) have created a handy poster for patients to use. Click on the poster to enlarge or print.

There are many clinicians available to book at Appletree, so we have created a leaflet to help aid patients with the most appropriate clinician for their problem.

Like all other GP surgeries, we are not an unlimited service. At a time of unprecedented pressure and workload, and with a shrinking workforce, we must follow recognised guidance on maintaining safe working practices so that we do not put the safety of our patients or the welfare of our staff at risk.

You may be referred to this section of the website as part of our processes, but you are also free to use any of the information provided below at any time.

Appointments

The reception team are trained care navigators and will signpost you to an appointment with the most appropriate clinician. Below are some of the appointment types or signposting advice the reception team may give you:

Pharmacy First

The Department of Health and Social Care have announced that they are introducing the HRT PPC to reduce the cost of HRT prescriptions.

This service will be available as of 1st April 2023.

For more information on this service, please follow the link below

www.nhsbsa.nhs.uk/help-nhs-prescription-costs/nhs-hormone-replacement-therapy-prescription-prepayment-certificate-hrt-ppc

Please be aware that if you are eligible for your COVID19 Spring Booster, the National Booking System should be live from 05/04/2023 at https://www.nhs.uk/nhs-services/covid-19-services/covid-19-vaccination-services/book-covid-19-vaccination or call 119. Please note that Babington Hospital is no longer a COVID19 vaccination site. Due to current GP demand, the Spring COVID19 vaccinations are not available at Appletree Medical Practice. 

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We are acutely aware that patients are currently frustrated with trying to get an appointment with a GP. We thought we would try and explain some of the issues that we are currently facing.

Currently we have approximately 11,100 patients and we offer around 700 appointments per week with a clinician, i.e. a doctor, Nurse Practitioner or Pharmacist. We offer a further 300 appointments with a practice nurse/HCA. Each day the demands for appointments far exceeds the number of appointments we can offer, so we need to manage these appointments carefully.

We are reviewing the number of face-to-face appointments vs telephone appointments that we offer on a weekly basis. However, patient/practice staff safety, as well as a clinical need, means that patient preference cannot always be offered.

Why aren’t you offering more face-to-face appointments?

There are many reasons why we are currently restricting the number of face-to-face appointments we offer:

1. We are trying to reduce risk. Many patients who telephone the surgery have a cough or fever etc. which are possible indicators of Covid-19. Cases of Covid-19 are currently high, and we need to protect vulnerable patients visiting the surgery as well as staff members. We have been following NHS England guidance to telephone triage patients first, which enables us to reduce this risk. If, having spoken to a patient, a clinician feels that it is appropriate to see you face-to-face, they will book you in accordingly. Also, many problems can be dealt with effectively over the telephone.
2. We have a finite number of appointments and by telephone triaging, we can prioritise patients accordingly, ensuring those with the most urgent clinical need can still be seen face-to-face if clinically necessary.
3. We have made available a number of pre-bookable face-to-face routine appointments for patients to book directly without the need for telephone triage. This is due to some ailments automatically requiring an examination, so receptionist can advise if they feel this appropriate.
4. Although isolation guidance has been relaxed for most of society, healthcare workers are still following strict isolation procedures. This means that if a member of staff has someone in their household who tests positive for Covid-19, that member of staff must work from home for up to 10 days. If this is a clinician, this has an impact on the number of patients that can be seen face-to-face.
5. This has a knock-on effect for reception staff who are not only trying to answer incoming calls but are also rearranging pre-booked appointments, often at short notice. To reduce this additional workload, the booking of future routine appointments is restricted to ensure unnecessary rearranging.
6. GP surgeries are required to ensure strict infection control procedures are followed. Consulting and treatment rooms need to be deep cleaned up to twice daily and all surfaces wiped down in between each patient as well as a change of PPE. This all takes additional time and resources.
7. We do also have to remember that many patients prefer a telephone call rather than a face-to-face appointment as they are often at work or it fits in with their lifestyle.

Why are the telephone lines so busy?

We recognise that the phone lines are extremely busy, which demonstrates how much pressure the receptionists are currently under. Please be patient and kind; they are working tremendously hard and they are working to the instructions of the GPs.

Some of the reasons why the phones are busy are:

• Patient enquiries regarding covid-19 vaccinations and the covid-passport. Each day we receive many calls relating to when patients will receive vaccine appointments or how to access the NHS app.
• Additional enquiries regarding hospital waiting lists due to delays in operations. These patients are requiring additional GP help, care and appointments.
• Every time the news/papers/social media report any sort of health-related story, patients ring their GP surgeries for advice and guidance. Over the last 18 months there has been a lot of media regarding the pandemic, which subsequently increases telephone traffic. For example:
  • Patients needing a covid passport to travel.
  • Covid Booster vaccination eligibility
  • The relaxing of isolation guidance
  • Do I need a PCR test?
• There has been a national blood bottle shortage. Patients have been contacting the surgery asking if their blood test is urgent or when they can get a blood test appointment. Many appointments have been cancelled as a result; all of this requires receptionist time.
• Many calls to the surgery are generally taking longer to deal with. There is an unprecedented demand for appointments and it takes time explaining the reasons why there are no appointments left that day, or that you will need to ring back at 8am the following day. Prior to booking an appointment, receptionists are also required to ask covid-19 related questions.

The phone lines are under regular review and we have recently increased the number of lines into the practice to help meet demand. We have also moved over to the Medicines Order line (MOL) for repeat prescription requests. This will hopefully reduce the amount of phone calls coming into the practice.

Why don’t you get more staff?

If only it was that easy:

Clinical staff
The setting up of the vaccination hub at the beginning of this year is having a massive impact on our staffing levels. Whilst we have been very fortunate to secure a large number of volunteers, along with the 3 other surgeries involved, we have had to supply our share of GPs, Nurses and administration staff to help deliver the vaccination programme. This will continue through to Christmas as we administer the flu and covid-19 booster vaccines. If clinicians are working at the hub, this obviously has an impact on the number of appointments we can offer at the surgery.
We have desperately tried to get some locum cover to help ease the pressure, but unfortunately, there is a national shortage of GPs. We have managed to secure one locum GP for half a day per week until Christmas. We have also secured a second locum GP for one day per week during November and December. Although this is still a shortfall of what we require, it goes a little way in bolstering the appointment availability.

Reception Staff
The role of a receptionist is a complex one. It takes approximately 8 weeks of intensive training to become a receptionist, and a further 6 months before they feel confident enough to be able to deal with the majority of queries that come in on any given day, so recruiting temporary staff is not an option.

Over the last year, we have increased the number of receptionists answering the telephone at any one time. We have employed a couple of members of staff to help out with ringing patients who do not have a mobile phone (and therefore no text facility) to invite them for the flu/covid/booster vaccines. We have also recently employed an apprentice to help support the reception team.

How you can help us!

• Symptoms which could be Covid 19 – get a PCR test via www.gov.uk/get-coronavirus-test (a lateral flow test is not sufficient if you have symptoms)
• Need a covid passport- ring 119, we cannot supply paper copies or go to: www.gov.uk/guidance/nhs-covid-pass
• If you cannot see your Covid-19 vaccine on your app and you were not vaccinated at the Babington Vaccination Hub, then you need to contact 119.
• Covid Booster queries – invitations are sent approx. 26 weeks after your 2nd vaccine. Please do not chase unless it is over 28 weeks since your 2nd vaccine.
• Covid vaccine queries, please check the NHS website for information first. www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-booster-vaccine/
• Covid Travel guidance – we are unable to offer advice on travel requirements during covid – www.gov.uk/guidance/travel-abroad-from-england-during-coronavirus-covid-19
• Need the Contraceptive pill? Go to www.sh24.org.uk – this is suitable for 16+ years
• A query not an appointment request- try ringing in the afternoon when lines are quieter
• We may have the answer to your query on our website which is regularly updated.
• Can I self-help first? Contact your local pharmacy.

I hope that this goes some way to explaining the challenging circumstances our staff are currently facing. Please show respect to all staff and treat them with kindness. Although it might look like our waiting room has very few patients sitting in it, this is to protect you and your loved ones. Whether it is our clinical staff, our receptionists or our administration team, we are all working extremely hard and we are all incredibly proud to be working for the NHS.

Thank you

Please see our support page for information on DVLA ‘fit to drive’ requests