Running to catch up

I can hardly believe that so much time has passed since I last wrote on the blog. So  many things have happened within the surgery that I rather took my eye off the ball. It has been a busy couple of months, with our new practice manager starting in early July, two new receptionists starting around the same time and the loss of our wonderful healthcare assistant, Mary, to a larger practice who could afford to employ her full-time. (boo, hiss!)

Our new practice manager Chrissie, comes to us from a practice in Lambeth and brings with her a wealth of experience. She has had a bit of an induction of fire as Sue our outgoing practice manager was unwell in the run-up to leaving, so Chrissie had to leap straight in, without a handover and unscramble a host of hefty documents which I had been studiously avoiding as they piled up on the manager’s desk. I had paid the bills and other essentials but not dealt with the complexity of the premises survey,  CQC findings, infection control, fire safety, refuse collection audits and all sorts of other baffling things that make up modern day practice. All credit to her she has waded through it and sorted it all.

We have interviewed and appointed a new healthcare assistant.Polly who will be joining us from mid-September. Polly has a great deal of experience having trained initially as a physician's assistant and worked in a number of countries abroad (and Wales). It will take her a little time to familiarise herself with our system but she will be mentored by June, our splendid nurse practitioner.

Manisha who joined  as a receptionist earlier this year has slipped effortlessly into her role and helped us enormously both on the desk and administratively. We are grateful to her for helping things run so smoothly during the staff transitions. Some of the changes that we have had to face are because some of our reception staff have chosen to retire (and Chris, plans to retire in October, though she has promised to cover in times of need).

Janet and Sophie, are our remaining two appointments to reception posts and are currently working through their induction and probationary periods.

Well that seems to have brought the staff information up-to-date. What else has been happening?

Once again I have spent Saturday at the surgery while we replaced the front door for the second time. Having discovered that such a thing as "public access doorways" exist, which allows us to have an entrance without a lip, this should be much safer for all concerned. This time it was fitted by Roberts Windows of Elmers End who seem to have made an excellent job of it. Hopefully this present version will last us for a good long time. Long enough to see us into new premises!

This leads me to the best news which I have kept until last. It finally looks as if the practice has secured a new and purpose-built surgery premises for the future. The planning application was approved at the end of July and now we can begin working on the nitty-gritty. This is only the beginning and after our previous disappointments we are trying to keep the excitement in check. Our hope is that by 2014 you will have access to the best possible facilities.

Haven't the Olympics been a wonderful two weeks? I believe that the forthcoming Paralympic games will be just as uplifting and inspiring and am confident that our teams will surpass the efforts of the Team GB Olympians.

I will be absent from the practice for the two weeks of the Paralympics having been fortunate enough to be selected to work as a general practitioner in the medical centre on the Greenwich site. I am certainly not keeping my excitement in check about this as I can hardly wait for it to start. What a pleasure and a privilege to be involved in such a positive and exciting time for our country. I plan to leave the flags up in the surgery and the bunting up outside until it least the end of the Paralympic games! 

See you after the games! 

Change always comes bearing gifts.

It was good to see Manor Road decked out today for the Jubilee. I hope all of you have enjoyed the extended weekend's celebrations in one way or another.

My Friday surgeries sandwiched interviews for the new practice manager. We had also held some interviews earlier in the week and are happy to report that we saw a good range of high quality candidates with a mulitude of different strengths and experiences. We think we have found an excellent replacement for Sue and will share the details once we know they have accepted the challenge.

Saturday started with a return visit to the surgery for a new front door to be fitted, while Wickham Windows were doing the hard physical work, I had the chance to catch up on a backlog of my own work so started the weekend feeling virtuous. There are still a few teething problems to be sorted out with the ramp to the door (which will require some adjustment)  but we hope that it will make the waiting room lighter all year round and warmer in winter.

My Saturday afternoon involved a stroll along the Thames to enjoy the decorations and boats in advance of Sunday's pageant. Fortunately we had a drier time of it than those who braved the crowds on Sunday. Saturday evening was spent at the Emirates Stadium watching Coldplay (a fantastic spectacle in spite of the incessant rain) and following a splendid piece of advice from Chris Martin, to put all your worries and cares aside for the evening and have a good time. I suspect my husband and son attended largely in order to say they have stood on the pitch and imagined following in the footsteps of their favourite players but for me the concert was enough to make a splendid evening.

I am off to enjoy a street party tomorrow and have spent my afternoon creating some rather experimental red, white and blue muffins. The taste OK but do look rather odd!

Wednesday will bring us all back down to earth and normality. The surgery is set to activate electronic prescribing on Wednesday and if you wish you can nominate the pharmacy of your choice to receive your prescriptions in this way. Pharmacies notify us if you have signed up with them and the rest should all happen easily, speedily and smoothly (watch this space...).

Those of you who book your appointments online will very soon be able to request your repeat prescriptions through the same portal.

We are now able to send you a text to remind you of your appointments at the surgery. Let us know your current mobile number and you will receive a text confirming booking and a reminder a day before. Texts are only sent between 9am and 5pm so should never disturb you at antisocial times. If you would prefer not to be texted but are happy for us to have your mobile number please let reception know and they will opt you out of the service.

Our premises negotiations are progressing with Essential Land and the General Practice Investment Corporation Ltd and we have confirmed our interest in moving the practice to their new build premises in due course.  This is likely to be a few years away yet but with the new CQC regulations for General Practice coming into force and a current building inadequate to the task we have to plan ahead. We want to involve patients in the planning and discussions and as soon as it looks as if this plan may become a reality we will be asking for your input. We have been stung so many times it is difficult to allow yourself to believe this plan may deliver.

That is probably all the news for this month but heralds quite a lot of change. I am confident that these will bear gifts.

You can't have everything... where would you put it?

We are sad to report that our fantastic Practice Manager, Sue Robinson has decided to move on to bigger things. After a successful interview in April she has been appointed as Practice Manager to a much larger surgery in Orpington and will move at the end of June. We are very sorry to see her go and cannot thank her enough for all the enthusiasm and effort she has put into keeping us performing at the highest level over the years. We wish her well in her new job.

June our Nurse Practitioner has been away on holiday and will hopefully be back very shortly to regale us with tales of her travels and adventures. We hear that she has been having a great time.

I am off this Friday morning to visit a practice in Blackfriars who are already up and running with the new electronic prescribing system that will enable you to nominate any pharmacy of your choice and have your prescriptions sent there electronically. This will include Pharmacy2U and all our local pharmacies as well as those near your workplace or relative's address, if you chose. I hope to be able to come back and share the information with other members of staff so that we can switch the system on by the end of the month. Our planned "go-live" is May 21st barring hiccups.

Another new innovation which we hope will make communication with the practice easier is the facility for us to text you to remind you of appointments and to let you know if your results have come in. In order to make this work we will need written permission from you to use your mobile number. Once permission is logged we will be able to send messages direct from our system to your mobile phone. Messages will not give the test or result details but will say something like "your result is back and is satisfactory" or "your result is back, please contact the surgery". If this sounds as if it might help you, please ask at reception for a permission slip to confirm we have your correct number.

Our final change for May is the arrival of a "huge" machine now parked in the hall between the consulting rooms. (Everything looks huge in a building this small). Our latest addition is a height, weight and blood pressure measuring machine. Collect a token from reception (no charge) stand on the platform and listen to the instructions. I promise it does not speak your weight even though it looks as if it will! Once you have been weighed and measured it will print out two identical slips. We ask you to put your name and date of birth on one and return it to reception for later entry onto the computer, the second is for your own records. Most of the staff can talk you through it if you are not sure about using it as we have almost all tried it out.

No other major innovations this month except elbow taps for the nurses room to improve infection control. Who knows what next month may bring! Watch this space.

Easter Greetings

Easter is a wonderful time of year all about love, forgiveness, redemption and new beginnings. We wish all our patients a very Happy Easter.

The surgery has come through a difficult year and survived the challenges and disappointments. We have weathered what has felt like a fierce storm, submitted the end of year returns (more onerous than ever before), coped with a new computer system and have achieved better ratings in the quality of care targets than last year. Although we are all tired we are girding our loins to start all over again this year.

We want to thank all of you for being so patient with us when things have not gone so well - we know our electronic prescribing (Pharmacy 2 U) has not been working well since the new computer system was installed. It should be back on track by May and in the meantime we are working hard to shorten the turnaround time. We also hope to pilot an electronic prescription service with local pharmacies from May so that your paper prescriptions for repeats will no longer have to be collected but can be sent securely electronically to your chosen pharmacy where the dispensed medication can then be collected.

 We recognise as well that the new system has made us slower in responding to queries and that there are problems for those of you who book your appointments on line. Please keep telling us about the problems and we will try to fix things.

Thank you also to all those who agreed to be members of our virtual patient participation group and those who responded to our questionnaire seeking your opinions and suggestions. The results are available on the practice website. If you would like to join this group please drop in and pick up a form or email us on:
 bro-pct.wickhamparksurgery@nhs.net and we will send you a sign up form & add you to the group.

We have had our premises inspection and are waiting to hear what the CQC expects of us. We are not expecting good news and with that in mind have started to explore the possibility of relocating the surgery to a new build site within the practice area. This is at a very, very early stage of discussion and would be a long term plan with no move envisaged before 2014 or 2015. We will keep you posted with news as conversations progress.

On a personal note I completed the first part of my training to be a GP at the Paralympics and had a wonderful day meeting new colleagues from all areas of healthcare who will be involved in this very special event. I have to admit I was slightly relieved to hear that the dentists are usually busier than the doctors! I am waiting to be called for my uniform fitting (so its back to the diet) and then further training (medical not exercise).

Finally some publicity for the Diamond Jubilee Manor Road Street Party which a flyer tells us is to be on Monday 4th June from 2-6pm (with the road being closed from 8am to 9pm). We look forward to more details from Candy and Doreen who are organising the event.

Bells and Shovels!

I am not sure that writing this at the end of a long week and after a glass of red wine is the best timing but here goes. We have survived our first full week with the new computer system and that in itself is cause for celebration and bouquets all round. Our receptionists have been magnificent coping with the new system admirably and the back log of tasks with good humour and perseverence. Patients too have been very tolerant of our hiccups and glitches for which we thank you. We also thank the marvellous trainers who supported our transition with infinite patience and kindness, hovering near at hand so that we could shout for help when we got stuck. Doubtless we will have to make a few more calls on their expertise over the next few weeks as we discover things we cannot do. Every day this week has had challenges and rewards and I for one have found the stimulus invigorating.

In other news - we welcome Manisha our new receptionist who is filling the vacancy left by Amy. Manisha brings with her a wealth of experience in other surgeries. She has survived an induction of fire and we hope she will get a chance to settle in more gently over the coming weeks.

We were relieved that our first fall of snow was both light and short lived. The surgery has registered for the council's "Snow Friends" scheme. Snow Friends are local residents who volunteer to clear snow and ice in their street. We now hold some salt supplies and a big snow shovel at the surgery provided by the council. Some of you will have witrnessed our practice manager Sue shovelling snow and gritting pavements on our side of Manor Road earlier this week. If any able bodied among you would like to lend us a hand so we can clear more of the road please make yourself known to us at reception and we will be only too happy to sign you up to help with any further snowfalls.

Almost a year after being interviewed I am delighted to report that I have been selected as a volunteer to work as a GP at the paralympics and will be taking leave from the practice in late August and early September to do this. I start my training next month and am looking forward to being part of this wonderful event.

Finally our sincere apologies to those of you disturbed by the surgery alarm in the early hours of Monday morning. Dr Mustapha was there along with the Police as soon as he was alerted by the alarm company, we still do not what triggered the two zone breach that disturbed you all. Fortunately it has not recurred.

No pain, no gain

Everything will look the same on the surface (though possibly not the composure of the staff) but underneath lots will have changed. We are all on tenterhooks as tomorrow we switch over our software computer system from the one we have been using for the last 10 years (and know pretty well) to an all singing, all dancing, upgraded system from the same supplier. It is called EMIS web and will set us up to cope with all the new electronic cleverness coming our way.


Image by  Dixie Allan



You may experience some initial delays due to our unfamiliarity with the system but we have all had training and hope that once the system is live we will get up to speed fairly quickly. Our engineers arrive at 7am tomorrow and have promised to have us functioning in time for the first appointment at 8.40am. Training staff will be on site to bail us out if we run into any major difficulties.

So what will it improve? It will make record keeping, data coding and searching for information much easier, will flag up overdue tests, will update and backup in real time to a secure remote server so that we will hopefully never lose access to your records because of server failure. It will allow us to show you trends in results in  graphic form and will link conditions to information sheets and other information.

Eventually (in about 10 to 12 weeks) we hope to be able to send your prescriptions electronically to which ever pharmacy you nominate, so no one has to collect a paper prescription unless they wish to. In time we will also be able to send your pathology tests directly to the laboratory so you won't need to remember the paper request form. We hope that it will also allow us to look at blood tests ordered by the consultants who care for you and by people like the warfarin clinic so that we do not duplicate tests and you will not have to bring your warfarin results too us before we can issue your prescription.

In some areas of the country where this system is used limited records are being shared (with permission) with the out of hours doctors, community services such as district nurses and physiotherapists and palliative care teams, making care safer and smoother. You will always have the option to say you do not want your records shared in this way on the national spine and we will code your notes accordingly which automatically prevents them being shared. 

Further in the future you will be able to use the same system by which you book appointments electronically using your password and pin number to request medication from your repeat prescription list, to register with the practice and one day to read your own medical notes.

We ask for your patience with us over the next week or so as the system beds in and we adjust.

Long time no post

Despite a long period of silence on the blog the practice has been busier than ever. The purchase and development of the premises will not go ahead and we have been looking carefully at our choices.
The government is introducing regulated standards for General Practices and all other care providers through registration with the Care Quality Commission (CQC). This organisation will monitor and 28 essential standards laid down in law with which we are legally obliged to comply. Some of these regulations cover the suitability of premises for their purpose and for both patients and staff. It has been argued that the standards are too onerous and the onset of regulation too quick - as a result the Government has delayed the registration of GP surgeries until April 2013. As you can see this gives us very little time to make changes and makes us feel very vulnerable.
The SE London Sector (who replaced the PCT) as our bosses have told us our project is not "financially viable" and have said that their preferred option would be for us to find a vacant site or a premises that could be demolised and rebuilt tailored to purpose. We think in West Wickham that this is an almost impossible dream, but we will keep our eyes open and we know that you do too.

On a more positive note our two big flu clinics at West Wickham and Shirley Baptist Church have been a big success once again and we are grateful to them for the use of their large and accessible rooms. It is always a pleasure to see so many of our patients together outside of the practice. Our thanks to you also for supporting the Children's Society with purchases of Christmas Cards.

If you haven't had your jab and you should have done we will be running some sessions in the surgery over the next few weeks so phone and book an appointment (but you will have missed out on the tea and biscuits!)

Finally we hope to get the patient participation group up and running properly soon and many of you have been kind enough to share your email addresses with us for this and we will be in touch very soon.