Blog Archives

Coronavirus update no. 6 - 21/3/20

21/3/2020

Dear Patients,
we appreciate your patience and flexibility regarding the changes we have made this past week and believe they have been sensible, proportionate and most importantly - keeping your families safe. We have managed to contact (on the same day), every person who has requested a telephone triage call (well over a hundred daily), and given face to face appointments to the patients who have required this. We have dealt with more than double the usual number of e-consults also, as well as maintaining a mostly routine nursing/phlebotomy service.

We are very conscious that this new system is a big change for everybody, both patients and staff, but have been delighted with the response we have had, and will continue to keep you up to date as best we can.  We are immensely grateful for all the kind words, support and understanding that we have received from our patients at this time.
However, in a small number of instances our brilliant staff have been on the receiving end of impatience, rudeness and even aggression, which we are sure you will agree is completely unacceptable at this difficult time.  Please remember our staff are willingly putting themselves on the front-line in the battle against Corona-virus, and they deserve to be rewarded with kindness, respect and smiles :-) Thankyou.

As you all know, the new government advice on coronavirus means, (like everybody else), we are increasingly losing staff to self-isolation measures. We continue to review our staff numbers from one day to the next, and would like to assure you that we continue to work on contingency plans for the weeks to come. As an example, last week we had 2 GPs self-isolating, plus one locum doctor, as well as a practice nurse, and unfortunately are fully expecting these numbers to rise.

In the meantime, you will find the front doors may be locked, as unfortunately despite multiple warning signs and news updates, we are still having patients enter the surgery who have not been invited, and/or who later disclose they have potential symptoms of Covid-19, potentially putting staff and other patients at risk. In the meantime, we will have somebody stationed by the door in order to assist you.

Also of note, please be aware that when triaging your request by phone, the GP may now ask you if you would like a video consultation, if they feel this is appropriate.
This is to enable the GP to see you without you coming down to surgery, which may be particularly useful when you have a rash, or if we need to assess your breathing etc.
In this situation, they will check your mobile number, before sending you a text which includes a link that you will need to click on in order to see the doctor .

We have also been getting asked how patients can secure notes for employers when self isolating, and can now advise that the following link will allow patients to produce a note reflecting their situation, so please do not contact the surgery for this reason. https://111.nhs.uk/isolation-note/

Finally, we would like to highlight that for many patients (where safe to do so) we have done 3 months prescriptions in advance in order to try and reduce the need for patients to visit the surgery in the coming months. Please contact your chemist if you are unsure if this applies to you.

Once again thankyou for adapting to so many changes in such a short time, these next few months will be a marathon not a sprint, and we can't do this without you!

Corona Virus Update 18th March

18/3/2020

Firstly, thankyou once again for your support and understanding at this difficult time. Further to our updated practice plan from 15th March, please read the following updates:

- Like everybody else, we are having increasing staff absence due to either illness, self-isolation or family commitments. Additionally, we now know schools will be closing next week, and this may impact staff resource futher. For this reason, we must continue to reiterate that we can only deal with urgent issues. You may be asked to travel further for an appointment but we are doing everything we can.
- Secondly, many patients took us up on the opportunity to convert pre-booked slots to telephone appointments, but with immediate effect, these are now cancelled, and as above, if the matter is urgent you will need to ring on the day for GP emergency triage, or submit an e-consult. This is because many of us are working 12 hour days and can still not get through the demand safely.
- Thirdly, owing to staff absence, our offer to honour minor surgery/joint injection appointments will now have to be withdrawn, also with immediate effect, for reasons as above.
- Next, many of you will be aware there are suggestions that some medications are unsafe in relation to corona-virus but if/when any of these are proved we will be in touch to switch medications as necessary and when safe. In the meantime please continue your prescribed medications (including ramipril). However, we can confirm that Welsh Government advice is now to NOT take ibuprofen if you have proven or suspected coronavirus. Patients taking it at other times is still acceptable.
- Finally, we are getting many queries concerning notes for employers when patients are self isolating / social distancing etc. We do not have the capacity to provide these currently and await further national guidance we assume will be forthcoming, but you can continue to self certify in the meantime. Please monitor the gov.uk pages for accurate, up to date info on this issue, as well as all corona-virus related government updates.

Practice Statement to ALL patients

16/3/2020

Dear Patients,
We understand that this is a frightening and unsettling time for all of you, as it is for us. We are navigating this unprecedented period with you, dealing with uncertainty and the daily changing of advice.

We are doing this to the best of our abilities with the resources we have, and with the health and well-being of ALL our patients in mind. We care for over 15,100 patients across 3 sites, one of which has been badly damaged in the floods and is only partially operational. We know that unfortunately many of you have been similarly affected, but worse for you, as it was your homes that were damaged.

We are trying to keep as many essential services active whilst trying to minimise the contact between potentially infectious people, and our staff and patients.

The staff who will be seeing these patients are doing so willingly at their own risk, and with the limited protective equipment provided to us.

We appreciate the inconvenience caused to you all, and that some decisions have caused disquiet among our patient population. We ask at this time of national emergency that you work with us if you can, to support our staff and help to keep us open and able to see and treat as many of you as possible. There are no perfect solutions - all sites are limited by location, space, parking and staffing levels and the decisions we make are based on keeping the largest number of patients and staff safe whilst still seeing as many of you as we can, when clinically appropriate.

With specific reference to Ynysybwl, the risks ‘outside’ the surgery are minimal just like anywhere else patients may choose to go in the open air in the coming weeks or months. The number of patients we are seeing there who could possibly be affected by Covid19 is minimal as we are speaking to them by phone in advance, and a cleaning regime is in place after all patient consultations. Any patients where we feel they have coronavirus will NOT be attending. Many other local surgeries are using one site for those with cough/fever similar to us, as this minimises risk for all patients attending other branches. Some surgeries are still having potentially affected patients attending amongst their usual patients for instance if they only have one site; but we believe with 3 sites this is the best way to mitigate risk to you all. We are working to ‘best practice’ amongst our peers across Wales, and are following all Public Health Wales advice as well as UK government recommendations.

We are liaising with the local health board, as well as local councillors, assembly members and members for parliament. We have discussed this situation with the local Community Health Council who are happy to discuss any concerns you may have. while we continue to manage this difficult clinical situation.

This is an exceptionally stressful time for everyone, and your understanding is greatly appreciated.
The Partners.

PATIENT NOTICE 3 - CORONAVIRUS - PLEASE READ IN FULL

15/3/2020

Following this weekend’s Welsh Government advice to hospitals to cancel all non-urgent work in the coming months, as well as our trial at telephoning all routine appointments on Friday which massively inhibited our ability to deal with urgent cases - we have decided as of tomorrow (Monday 16th March) to cancel all pre-booked GP appointments with immediate effect, and you will now not automatically receive a call from a GP if you did have something booked. We are constantly liaising with the University Health Board as well as other practices in our Cluster area, and will update this information as and when required.

If you feel your issue is urgent, then please ring and advise the receptionist of your problem (they are bound by confidentiality like your GP) and you will be added to an emergency triage list where we shall endeavour to get back to you over the day, prioritising by clinical need.
Alternatively, use our e-consult service which is proving invaluable at this difficult time, via our website www.eglwysbachsurgery.com

We will also not be allowing any GP appointments to be made in advance until further notice, and will not book any patients in to appointments if they simply turn up to surgery requesting an appointment. Please only attend surgery if you have been invited on the day by a member of staff / GP, with the following exceptions:

Blood appointments - if you feel they are urgent - eg shared-care drug monitoring, INRs etc and if you have no viral symptoms eg cough, temperature, sore throat etc.
Nursing appt’s - if it is for a smear / baby check etc (Ynysybwl baby clinic location TBC). All other pre-booked nurse slots will be contacted by phone similar to last Friday which worked well.
Minor Surgery - Joint Injections - Until further notice we intend to honour booked minor surgery / joint injections appointments etc, however you will be contacted on the day to discuss this, and check you do not have any viral symptoms etc.

We fully appreciate the above plan is not our normal practice, but these are not normal times, and together with the significant impact of our recent flooding, as well as the likelihood of staff needing to self-isolate and / or go off sick which will reduce our capability - we hope our patients can understand these are necessary measures to continue provision of essential services. We ask that you display patience with all our staff who are dealing with a rapidly changing situation day to day.

If you are unwell with flu-like symptoms that you feel are mild to moderate, we ask you to follow government advice , and only contact 111 if your symptoms are becoming severe. Most patients who get coronavirus will only experience a mild illness which can be treated with good fluid intake, rest and over the counter remedies such as paracetamol.
Government advice is that anybody with a temperature of 37.8C or above, and / or a persistent new cough (lasting more than half a day) should self-isolate for 7 days, click here for further info.

Our waiting rooms are significant potential sites of cross-infection, and part of the reason for speaking to all patients via phone before bringing anyone down to surgery is to minimise this risk, but again we would urge you to avoid coming to surgery unless you feel it is really necessary and you have been invited to do so.

In common with many other practices, we are utilising just one of our sites for our potentially infected patients to reduce exposure to others. Until further notice this will be our Ynysybwl site, which will remain locked and only open to these specific patients who are told to attend there, who will be let in through the rear door by the car-park. When arriving, please ring the surgery to inform us you are here, and then wait in your car where possible, again, to minimise risks.
The only other patients to attend Ynysybwl will be those needing blood tests, who will be let in through the front door and kept separately in the main waiting room.
Ynysybwl patients with non-infective symptoms and issues will need to attend Eglwysbach if needed.

All prescriptions will be sent to your designated chemist, if you do not usually use a chemist for this service, please notify us of your preferred chemist or we will likely send to the nearest one to your address. This is to reduce footfall within waiting rooms. The same applies to requesting repeat prescriptions which must now be done only online or via your chemist.
Please note, repeat prescriptions will be dealt with as usual with relaxed criteria for reviews to ensure no-one misses out on medication, and please bear in mind there is no suggestion of shortages of medication so please do not ask us for larger quantities than usual.

Once again we thankyou for your support and help in these matters, and re-emphasise that all changes have been carefully considered in terms of providing the best care we can to all of our patients. Rest assured, if your need is great, your concern is valid or your health is in doubt, we will be there for you.
But this does mean that if we don’t get back in touch immediately, then you must try not to worry as it simply means there are patients who are in greater need, and we are working our way towards dealing with your request.

Finally, can we please, please, please ask that you like/share this message and for friends/relatives you have who may not be online, please advise them of these changes to make this easier and safer for everybody.

CORONAVIRUS UPDATE 2 - PLEASE READ IN FULL

12/3/2020

PATIENT NOTICE 12/3/20
Following previous updates, and the most recent UK government advice this afternoon, we will now be escalating our plans to help mitigate the risks of Coronavirus to both our patients and staff.

Our waiting rooms are high risk places to pick up infection, and so in the current climate we want to minimise risks for everybody by utilising phonecalls and e-consult in order to reduce the number of people who need to come to our surgeries, thereby hopefully protecting us all.

For advice directly related to coronavirus, please ring 111, and be aware they are very busy so it may take some time for them to answer. There is also an online 111 service you can use for advice - https://111.nhs.uk/service/COVID-19/

For other patients who are acutely unwell and feel they will need emergency assessment, you will need to either complete an e-consult via our website, or ring the surgery where we will arrange for a GP/nurse to call you for triage of your problem. Please do not attend the surgery without being invited, as government advice has now changed to state that those with any flu-like symptoms (cough, fever, sore throat) should self-isolate for at least 7 days or until further advice.

From tomorrow, all routine (pre-booked) appointments (with GPs or nurses) will automatically be converted to telephone reviews, and if we feel a face to face review is then essential we will then invite you down to surgery, but anticipate for most patients telephone review will suffice at this time. The only exception will be blood tests which will be done as booked for tomorrow (Friday 13th), but we will review this into next week, and assess which bloods are required into the future. You will likely be called before the time you were originally booked in, though we cannot guarantee this.
PLEASE DO NOT TURN UP TO SURGERY FOR ANY PRE-BOOKED APPOINTMENTS AS YOU MAY NOT BE SEEN. PLEASE AWAIT A TELEPHONE TRIAGE REVIEW. PLEASE RING / EMAIL IF YOU THINK YOU MAY NEED TO UPDATE YOUR PHONE NUMBER.

Coming off the back of our recent flooding, we are already limited in capacity, but hope that the right measures will allow us to offer sufficient and necessary service to patients going forward. There will be no pre-bookable appointments available until further notice, unless made by a GP or nurse; appointments will only be given via telephone triage or e-consult. This is to ensure that patients are seen appropriately after clinical assessment, and when it is truly needed, thereby minimising unnecessary risks to both patients and staff.

We would encourage everyone who feels they need clinical advice or review, to use our e-consult service as we can nearly always respond on the same day, and can then offer appointments when necessary. However in most cases, we can deal with your issue without you needing to come down to surgery; many upper respiratory tract infections (coughs, colds etc) can be managed at home with self-medication available from your chemist. E-consult can be found easily as a pop-up banner on our website homepage.

We intend any changes we make to be proportionate and in line with other local practices. We will continue to monitor developments daily over the coming weeks and shall endeavour to keep you posted. However, we all need to be mindful this is becoming a serious public health concern with significant disruption in all walks of life; but we believe the health of our patients and staff to be our first priority, so hope you can bear with us as we do our best in this difficult situation.

Coronavirus Update 9/3/20

9/3/2020

We would like to reinforce that all patients returning from affected countries follow public health advice in terms of self-isolation, especially if you have any symptoms - temperatures, cough, cold, sore throats etc.
If you have similar symptoms but no obvious risk factors for coronavirus (eg travel, close contacts) we may wish to discuss with you over the phone before offering you an appointment.

Please call 111 if you feel you may be at risk, and click here to check which countries are affected.

As we await more formal guidance during this likely pandemic, we are currently looking at possible changes within the practice. Having researched the situation in Italy, and discussed with other local practices, we are keen to reduce the risk of spreading coronavirus between both our patients and staff to ensure we can continue to function. Coming off the back of the flooding we are already somewhat stretched, but hope that the right measures will allow us to offer sufficient service to patients going forward.

Our waiting rooms are high risk places to pick up infection, and so in the current climate we want to minimise risks for everybody by utilising phonecalls and e-consult in order to reduce the number of people who need to come to our surgeries, thereby protecting us all.

From Wednesday 11th March, if you have a pre-booked/routine appointment with GP/nurse/pharmacist, then we will be happy to convert this to a telephone appointment if you feel this would be more suitable- please let us know if you would prefer this, and ensure we have an up to date contact number. For many patients this will allow their problems/symptoms/issues to be resolved without putting themselves or others at risk by visiting the surgery.

We would encourage everyone who feels they need advice or review to use our e-consult service as we can nearly always respond on the same day, and can then offer appointments when necessary. However in most cases, we can deal with your issue without you needing to come down to surgery; many upper respiratory tract infections (coughs, colds etc) can be managed at home with self-medication available from your chemist.

We intend any changes we make to be proportionate and in line with other local practices. We will continue to monitor developments daily over the coming weeks and shall endeavour to keep you posted. However, we all need to be mindful this may become a serious public health concern with significant disruption in all walks of life; but we believe the health of our patients and staff to be our first priority so hope you can bear with us as we do our best in this difficult situation.