WE ARE SORRY THIS IS A VERY LENGTHY MESSAGE – BUT WE FEEL IT IS IMPORTANT TO GIVE AN EXTENSIVE UPDATE ON THE CURRENT SITUATION IN OUR AREA.
The period since March 2020 has probably been the most challenging that many of us can remember, and we would like to respond to and reflect upon some issues which have influenced all people in the catchment area of The Croft Practice.
The Government and the National Health Service published various directives, but some of these have been influenced from a more local level; in our case, the Sussex Coastal Commissioning Group (SCCG) which is based in Worthing.
We are a member Practice of Regis Healthcare – the local Primary Care Network, which was formed in line with the new Government contract with Primary Care in 2019. We are 9 practices, split into the rural and central localities. We are in the rural sector together with Arundel, Avisford and Flansham Park Surgeries. The central sector is comprised of Bersted Green, Bognor Medical Practice, Grove House, Maywood and Westmeads surgeries.
All Practices are represented at the PCN monthly board meetings (which are currently held remotely), and our PCN has been innovative in providing new local services in a primary care setting. This has included the Social Prescribers (assistance with social or lifestyle problems), Mental Health support, Pharmacy support and First Contact Physiotherapy services.
Sadly, as a result of the Covid 19 pandemic, face to face services from the PCN have had to be restricted, but these are gradually being reinstated.
COVID 19 PANDEMIC
From March 2020, the directive for General Practice was
- Lock the doors
- Do not see patients face to face unless you have triaged or consulted by telephone first
- Stop routine appointments and screening for chronic disease management
- Avoid domiciliary visits – particularly to care homes
- Use PPE and introduce stringent distancing and infection control measures
We soon realised that in our rural setting not of all of these measures were practical.
First, we opened the doors again – and allowed people to enter using a queueing system, in order to resume some access to patient care within the Practice and also The Croft Pharmacy.
We still encourage people to telephone whenever possible to reduce footfall and infection risk to our community.
We know that this has put enormous pressure on the telephone lines, but we have done our very best to meet demand in these difficult circumstances.
Now, we are fairly unique in allowing patients enter the surgery, as most practices still have their front doors locked, and patients have to make contact before entering the building.
Given our space constraints, we have limited the number of chairs in the waiting room to four, and we ask patients to wait in their cars if they have appointments, and the reception team collect them from the car park.
The nurses are working to full capacity with face to face appointments, and we are now encouraging patients who have symptoms which will require examination (e.g. gynaecological problems, lumps etc.), to make an appointment directly with an appropriate health care professional, provided they do not have any Covid symptoms.
Appointments with the GPs and healthcare professionals are triaged by telephone; this means that the patient is asked a few questions about their condition, in order that they may be signposted to the most appropriate person or service within the Surgery. If you have a smart phone, we may offer video consultations via accuRx, and can also view photographs sent in by email to assist patients in receiving appropriate and timely care.
You may also use the “e consult” on line service for medical requests or queries, which you can access via the Practice website: www.thecroft-practice.co.uk
Throughout the pandemic we have continued to provide childhood immunisations, baby and postnatal checks, and urgent injections for the treatment of cancer etc.
We have followed guidelines, together with other local surgeries, in relation to ceasing procedures such as ear syringing, steroid injections, spirometry and ambulatory blood pressure monitoring, as the risk of infection or complications related to Covid far out way the possible benefits of the procedures.
Routine screening was stopped centrally.
We are now offering cervical smears again, together with long acting reversible contraceptive (LARC) services, and chronic disease reviews.
Most chronic disease reviews can be done over the telephone, but face to face appointments are available, particularly as part of diabetic reviews.
We must emphasise that face to face consultations are limited in order to protect the local community. Except in exceptional circumstances, you should always attend these appointments alone (as when attending hospital), and wear a face covering when in the building.
PRACTICE UPDATE – WORKFORCE
The practice is now under the continuing care and stewardship of three full time GP partners, Drs Rose, Medlock and York, who are responsible for more than 11,500 patients.
This inevitably means that they are responding to over a hundred queries and requests each day, when the Duty Doctor, in addition to dealing with all urgent matters, and providing support and guidance for the paramedics and nursing staff.
GP recruitment is extremely difficult at this time, not just in this area, but throughout the country.
In view of this, we believe we are extremely fortunate in having been able to secure long term assistance from local highly respected GPs on a sessional basis.
Drs Bridger, Handasyde Dick, and Plumb cover 14 sessions per week between them, together with additional sessions provided by Drs Hollis and Jones.
We understand that patients like continuity, and it for this reason that we have made this commitment, knowing that, particularly in these pressured times, it will not always be possible to see or speak with a partner.
We believe that the reception and administrative teams work hard to try to assist patients with their general needs, and also in times of difficulty.
However, we are also aware that the Practice has been the subject of some very negative remarks on social media.
You may be interested to know that:
- In September we received 25,000 incoming telephone calls, and made over 6,000 outgoing calls.
- Despite the restrictions in regard to patients attending for face to face appointments at present, on average we are currently seeing 50 patients per day, plus numerous telephone consultations and responding to messages from patients.
- Although the style of consultation may have changed, all of the Health Care Professionals continue to have the same, or a higher, level of contact with patients as they did before Covid.
- Domiciliary Visits currently average 6 per day, despite the fact that these should be avoided if at all possible – as we risk taking the Coronavirus into an otherwise secure setting. Pre Covid it was not unusual to have 15 visit requests a day. Some routine consultations, particularly with care homes, are now undertaken using accuRx video link, to further reduce the infection risk.
- Meadowcroft Surgery has been requisitioned by the CCG and the PCN as the Hot Hub for the Regis area during the Pandemic. Given that there is likely to be a considerable spike in illness again, we cannot see ourselves being able to return to normal service there for the foreseeable future.
PLEASE REMEMBER PATIENTS SHOULD ALWAYS ATTEND FACE TO FACE APPOINTMENTS ALONE IF POSSIBLE, AND WEAR A MASK WHEN IN THE BUILDING.
PLEASE DO NOT ATTEND THE SURGERY IF YOU HAVE ANY SYMPTOMS WHICH COULD BE CONNECTED WITH COVID 19.
PLEASE REMEMBER - EVERY UNNECESSARY CONTACT COULD SPREAD THE VIRUS.
Thank you for reading this update.
If you are interested in joining our Patient Group, you may email firstname.lastname@example.org. Alternatively you might prefer to speak with a member of the Management Team at The Croft, who will be happy to give you more information, or put you in contact with the PPG Lead.
Keep safe and all good wishes from the Team at The Croft Practice.
Update October 2020