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Partner Update- Surgery Funding- Some Perspective and Context - 09/06/2021

Firs House Medical Partnership receives £96.78 of funding to care for one of our patients for an entire year. For this, any patient can consult with us as many times as they need, including face to face, telephone or home visit encounters where there is a clinical need.

Our patients consult with us, on average, ten times a year, with some vulnerable patients each having up to 95 consultations a year. On average we provide 7500 consultations per month.

Firs House Medical Partnership (Firs House and Telegraph Street Surgeries) care for just under 12,500 patients, of which 9446 patients had a consultation with one of our clinicians in the last 12 months. To be clear, 76.5% of our patients have had a consultation with us since the pandemic began, with many of these patients having multiple consultations.

From this £96.78 figure, as with other GP practices, we pay our staff wages including numerous back office and administration team members, heating, lighting, cleaning, building maintenance and other bills, licences, buy all our equipment and anything else that is required for providing safe and appropriate care and running a practice.

International researchers repeatedly demonstrate evidence that the independent contractor General Practice model of care within the NHS provides a highly efficient and cost-effective healthcare provision when compared with other nations, despite the significantly lower levels of funding.

£๐Ÿต๐Ÿฒ.๐Ÿณ๐Ÿด ๐—ฝ๐—ฒ๐—ฟ ๐˜†๐—ฒ๐—ฎ๐—ฟ ๐—ฒ๐—พ๐˜‚๐—ฎ๐˜๐—ฒ๐˜€ ๐˜๐—ผ ๐—ท๐˜‚๐˜€๐˜ ๐Ÿฏ๐Ÿณ๐—ฝ ๐—ณ๐˜‚๐—ป๐—ฑ๐—ถ๐—ป๐—ด ๐—ฝ๐—ฒ๐—ฟ ๐—ฝ๐—ฎ๐˜๐—ถ๐—ฒ๐—ป๐˜ ๐—ฝ๐—ฒ๐—ฟ ๐˜„๐—ผ๐—ฟ๐—ธ๐—ถ๐—ป๐—ด ๐—ฑ๐—ฎ๐˜†,
๐—ผ๐—ฟ £๐Ÿญ.๐Ÿด๐Ÿฒ ๐—ฝ๐—ฒ๐—ฟ ๐˜„๐—ฒ๐—ฒ๐—ธ,
๐—ผ๐—ฟ £๐Ÿญ๐Ÿญ.๐Ÿญ๐Ÿฌ ๐—ฝ๐—ฒ๐—ฟ ๐—บ๐—ผ๐—ป๐˜๐—ต.

Also bear in mind that with this level of funding (which realistically would only provide for two consultations in a year if paid at normal market rates), GPs do not aim to simply provide basic low rate care. The vast majority of GPs provide not only high quality care and but also, more importantly, safe care, whilst also striving to achieve difficult and often challenging government targets; all of this is often at immense personal cost to themselves and their families. In the last 24 hours we have read further reports of the diminishing number of GP’s in England, the decline in number predating the pandemic, with increasing difficulties in recruitment and retention and workload cited as the reason for NHS staff burnout.

Comparing the annual costs to other care provisions:
£๐Ÿต๐Ÿฒ.๐Ÿณ๐Ÿด ๐—ถ๐˜€ ๐˜๐—ต๐—ฒ ๐—ณ๐˜‚๐—ป๐—ฑ๐—ถ๐—ป๐—ด ๐˜๐—ต๐—ฎ๐˜ ๐˜„๐—ฒ ๐—ด๐—ฒ๐˜ ๐˜๐—ผ ๐—ฝ๐—ฟ๐—ผ๐˜ƒ๐—ถ๐—ฑ๐—ฒ ๐—บ๐—ฒ๐—ฑ๐—ถ๐—ฐ๐—ฎ๐—น ๐—ฐ๐—ฎ๐—ฟ๐—ฒ ๐—ณ๐—ผ๐—ฟ ๐˜†๐—ผ๐˜‚ ๐—ณ๐—ผ๐—ฟ ๐—ผ๐—ป๐—ฒ ๐˜„๐—ต๐—ผ๐—น๐—ฒ ๐˜†๐—ฒ๐—ฎ๐—ฟ
£101-£303 paid to hospitals per patient per visit to A&E
£23.80 per NHS dentist consultation
Up to £120.00 per private dental consultation
£120 per consultation with private GP provider
£40 for a single vet consultation for your pet.
£120 to insure your pet hamster for a year.

I can confirm we did receive funding to carry out the Covid vaccine clinics. For those that attended our clinics, they can testify this paid for Nurses and Doctors to administer the vaccine, administrators to record your vaccination in your medical records, administrators to book your vaccine appointments, pharmacy staff to prepare the vaccine, and clinic supplies from masks, sanitiser, to screens, premises costs, insurances, and other associated costs. The funding received paid for the staff and equipment to provide the 26,000 vaccines to our local community.

Each additional service we are funded for, pays for the staff and the supplies to provide that service.
Please also be aware that we cannot close our patient list meaning that we will provide care for all patients from our area who request to register with us.

Stay Safe, Be Kind

Partner Update- New NHSE Guidance - 14/05/2021

There is a lot of negative media directed at GP Practices at the moment, particularly that GP surgeries have been closed and GP’s do not see patients face to face.

We, as a practice, have continued to see patients face to face on a clinical need basis throughout the pandemic. Our surgery door being closed is to prevent potentially Covid infected people coming in and infecting staff and other patients. A closed door does not mean a closed surgery. However, staff infected by Covid will mean surgery closure and no service at all. We are proud to have maintained a Covid Safe Environment throughout the last 15 months and ask patients to support us to maintain this by accessing the surgery appropriately and safely and only when necessary.

Despite what some media outlets have said about accessing General Practice, throughout the Pandemic we have seen patients face to face where clinically appropriate. Our GP’s, nurses, ANP’s, HCA’s and many other team members have all seen patients throughout the last 15 months and this is not going to change. It should also be noted that many of our patients have welcomed and very much appreciated the remote consultations, allowing them to access GP services whilst not negatively impacting on work and other commitments. We do not intend on removing this functionality and flexibility from the patients who prefer this service.

Contrary to what is reported in the media, we are busier than ever before with our surgery workload having increased significantly since March 2020. In the month of March 2021, NHS England recorded 20% more GP appointments delivered than the month before. Throughout the pandemic, we as a surgery have recorded a 50% increase in demand than pre-pandemic. It is clear this increased demand we are experiencing is being felt nationally by General Practice.

At Firs House our team have been trying incredibly hard to respond to this high demand which has been growing throughout the Pandemic, with no additional staff resource available. We have been working flat out to provide care to our patients. We are providing this care on top of also staffing the COVID vaccination community hubs. Many of our staff are doing these vaccination hub shifts on weekends, days off and annual leave as extra to their normal working days. We are providing these vaccinations as part of a Primary Care Network of GP Practices in the area, of which we are the lead practice. The organisation, planning and running of these vaccination clinics takes a great deal of time away from our normal duties, both clinical and administration. We are incredibly proud that we have delivered over 24,000 vaccinations to our community on top of continuing to respond to the highest level of a patient demand we have ever known in the surgery. We hope you can understand why we find the suggestion that “GP’s are not working hard enough”, or “not at all” as claimed on some media platforms, is offensive, irresponsible and not reflective of the vast majority of practices across England.

When exploring the increased demand, we are finding that patients often contact the surgery in the very earliest stages of their condition with expectations that we are able to provide immediate treatment and resolution, without having considered any attempt at self-care in the first instance. As an example, patients have contacted us with fungal nail infections or within a few hours of developing a headache without trying to use bathroom cabinet mediations that are available from the pharmacy such as paracetamol.

We have also found that patients often ignore national guidance and contact the surgery to request face to face appointments for a cough, query Covid shielding, self-isolation, trying to secure a vaccine when not yet eligible, and requesting carer status without caring responsibilities. We appreciate the anxieties about securing a vaccine as early as possible, however, we are not able to override national policy. We can, however, offer assurances that everyone will be vaccinated when it is their time. We would also like to remind patients that if you have symptoms of Covid, you should be following national guidance by securing a Covid test and isolating and not attending the surgery.

Most of our patients have expressed their gratitude for the care we have continued to provide throughout this most difficult of years. We are very grateful for their continued support during this ongoing pandemic. However, some patients have directed derogatory, unfounded and sometimes aggressive and threatening comments towards and clinical and administration staff and made inaccurate social media comments without any attempt to contact the surgery to resolve issues they may be experiencing. This is incredibly disheartening for our team who have tried to maintain the highest level of care possible during the pandemic, while keeping our staff and patients safe. Please understand that every member of the practice team has gone above and beyond, sometimes at the cost to themselves and their family, to ensure that the patients get the best possible care that we can deliver.

We are aware that on the 13th May 2021 NHSE guidance was published outlining national changes to how patient appointments are offered. Some media outlets have reported inaccurate and false claims that “GP must offer patients face to face appointments and telephone and online consultations are scrapped”. This is simply not true. The NHSE guidance published 13th May 2021 has requested the following-

· GP Surgeries should offer patients face to face appointments alongside remote services such as video and telephone consultations. We already offer this.

· GP Practices can refuse face to face appointments and offer remote consultations if there is a clinical reason to do so, for example, patient is exhibiting Covid symptoms. The option of having a face to face appointment should be a joint decision between patient and clinician which maximises our ability to see patients in a way that helps them and allows us to manage demand, give best care and keep all parties safe.

· GP Practices are to open to patients adhering to social distancing and Infection Prevention and Control guidance.

Due to the restrictions posed by the building, in particular the narrow hallway and entry, we are exploring how we will be able to keep the front door open whilst maintaining social distancing as any queue at the reception desk would prevent patients and staff from accessing clinical rooms and exiting the building and would breach social distancing. Please bear with us whilst we ensure we can open our surgeries in the safest way possible. In the meantime, please understand that the surgery remains open, as it has done throughout the pandemic, and even with the front door locked if you want to talk to staff, you can press the intercom on the front door and we will attend to you.

We would also like to remind patients that they must wear a mask whilst in the surgery building and not to attend in person if they have any symptoms of Covid, have been in contact with someone who has tested positive for Covid in the last 10 days, or have been contacted by Track and Trace.

We need your help to keep our vulnerable patients and staff safe and request you respect our guidance and be kind to our staff.

Stay Safe, Be Kind

Firs House Partnership


Practice Manager Update- 26/02/2021- Please be Kind

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We have experienced a significant increase in negative behaviours directed at surgery staff in the last few weeks, including threats, inappropriate demands, shouting and swearing, and personal insults.

We appreciate there are anxieties regarding the vaccine programme and priority placement criteria, but please can we remind patients that we are following strict national guidance and cannot change priority levels without approved reasoning, and we will not provide appointments or vaccines in response to threats.

We have a clear zero tolerance policy with repeated violations and continued abuse towards staff resulting in the patients removal from our surgery list.

We are sure the vast majority of patients appreciate that GP practices are busier than ever with national data showing that consultation rates are higher than before the Pandemic, at the same time as GP surgeries delivering the vast majority of the vaccination campaign. GP surgery teams are working incredibly hard in these difficult circumstances to undertake what is widely regarded as the most challenging operation in peacetime and the history of health provision. We are committed to providing the vaccine as quickly as possible to our most vulnerable communities in order of priority to save lives and protect the NHS.

We want to thank those of our patients who have continued to follow guidance and who have offered their support and understanding during this very challenging time.

Stay Safe, Be Kind.

 

 


 

Prescription Requests - Update 19/10/2020

The Partners and management at Firs House are constantly reviewing surgery processes to ensure our patients are offered a safe and accessible service.  Following lockdown in March 2020 Firs House introduced the option of calling the surgery to request prescriptions to support those who were shielded and could not travel to the surgery to post their requests. 

More recently we have become aware that this service is now being used by a large portion of our patient population, which increases demand on our reception staff.   Following the lifting of lockdown in August 2020, and in response to feedback from patients about queue times when calling the surgery, we have taken the decision to stop the option of calling the surgery for prescriptions to allow us to review demand and impact on our call times.

Firs House will re-introduce our previous system where patients have to put their prescription requests in writing, or request prescriptions using Patient Online Access. We will continue to review this process and ensure that it is reflective of local needs and in line with national guidance.


PRESS RELEASE 14/09/20 09:00hs Press Release

Responding to a letter from NHS England to GP practices which instructs them that they must offer face-to-face appointments to patients, Dr Katie Bramall-Stainer, Chief Executive of Cambs LMC said,

“Cambridgeshire and Peterborough GPs and practice teams have been working incredibly hard to keep their services as accessible as possible during the Covid-19 pandemic. NHS England encourages all surgeries to undertake virtual triage of patients as their first point of contact, to minimise the numbers of patients having to be physically brought into surgeries to be examined, lest it put them at risk. Practices are not closed – according to NHS Digital in July 2020, Cambs GPs offered 398,206 appointments across our 86 practices – and NHS Digital believes this represents an under-estimate. Where face to face appointments are offered, they need to be both necessary and safe.

“Cambs LMC strongly protests against NHS England using a letter to paint an utterly false impression of the vast majority of GPs who have taken their professional responsibilities to their patients extremely seriously, at some considerable personal cost and risk to the GPs themselves.


“Surgeries across Cambridgeshire and Peterborough should be commended for adapting so quickly and seamlessly to what was – and remains - a massive shift in their usual working pattern. Government needs to do much more to recognise and support practices in doing this, especially since local hospitals have advised they are not presently able to operate at their usual capacity.

“There will always be a need for some patients to see their GP or another clinician in person. Where it is both safe to do so and clinically appropriate, practices will always ensure this is facilitated. Practices across Cambs remain committed to making sure their services are accessible to those without access to digital consultations, or who struggle to use technology.

“Cambs practices are seeing in excess of 10,000 patients every single day – their workload has significantly increased as a result of the ongoing impact of the pandemic on other NHS services and the unprecedented number of people waiting for postponed procedures. NHS England and Government have so far failed to recognise the significant impact this is having on general practice and should be tackling this as a priority for our patients.

“Technology can support GPs and their teams deliver good quality care to their patients, and improve access at the same time but it is clearly not a complete solution – as we have always maintained. This winter we will need to vaccinate an extra 110,000 Cambs residents. Whilst we remain under enormous pressure, and without additional resource from government, Cambridgeshire general practice remains open and GPs continue to give communities the care they need.”

https://cambslmc.org/…/…/cambs-lmc-press-release-14-09-2020/

 


Soup & Shake Diet

Despite media reports or a national offer, Cambridgeshire is not currently taking part in the pilot for the new NHS Soup and Shake diet for Diabetes Type 2 and weight loss patients. Please keep checking the link below for updates.

https://www.england.nhs.uk/2020/09/thousands-to-benefit-from-soups-and-shakes-diet-on-the-nhs-from-today/

 


 

Please don’t be a DNA! Missed Appointments are causing the NHS Millions each year.  If you cannot make your appointment or no longer need it, PLEASE CANCEL IT!

At Firs House and Telegraph Street surgeries, a total 330 appointments were lost to patients who did not cancel nor attend their appointments in November and December 2019. 

The total number of Doctor appointments lost to patients who ‘did not attend’ during these months was sadly 107. This is the equivalent of 3 and a half days of a Doctors time lost, or closing the surgery for a whole day, and £2000 worth of wasted NHS funding.

You are able to cancel your appointment online through patient access regardless of how you booked it, or by emailing capccg.cancellations.firshouse@nhs.net.

https://www.england.nhs.uk/2019/01/missed-gp-appointments-costing-nhs-millions/

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