The
ElliottEar
Number25
October 2005
CONTENTS
Chairman's Report
Carer's Support Group
The Weekend Tea Parties
Transport Service
Flu Vaccinations 2005
How Does EHMC Work?
Falls: How Important Are They And What Can Be Done To Prevent Them.
Some News From Alan Byers....And Some Advice
Chaperones, Consent and Confidentiality
Missed Appointments
Information Technology and all that!
Single Assessment Process
The Expert Patient
Staff Report
Surgery Opening Times
CHAIRMAN'S REPORT
Cyril Flood
I concluded my last report
by saying that I was looking forward to the Luncheon to celebrate ten years of
the Carers' Support Group. This proved to be a great
success and was thoroughly enjoyed by about 40 people. My grateful thanks to
Beryl Peacop for organising
such a splendid party and to the doctor who provided us all with a box of
chocolates to take home! In early April, members of the Carers'
Support Group attended a performance of "The Music Man" by
The AGM was held on 17 May when all the existing officers were re-elected and
Lesley Walmsley was confirmed as Vice-Chairman,
having been elected by the Committee during the year. The business part of the meeting
was followed by an excellent presentation by Sister Alison Willis about the
Accident and Emergency Department at
That meeting was the first time the new microphone and loudspeaker were used
and seemed to be a great benefit. Its second outing was on the following
Saturday when the annual Fish and,Chip
Quiz Supper was held and proved to be a great occasion enjoyed by everyone
present. My thanks go to all who assisted with the serving and provision of
food, and to Eric and June Pleass for their posing of
the questions and the marking of the answers.
All the other services provided by the Association continue and are appreciated
by many less able patients of the practice. If
you feel you could give a little time to help with driving (mainly to Northwick Park Hospital, Mount Vernon Hospital and the
surgery), to assist folk by doing their shopping, or by visiting the
housebound, PLEASE contact one of the co-ordinators
listed at the back of The ElliottEar.
If you could help deliver
about 20 copies of The ElliottEar
twice a year, please
contact Hilary Morgan (8428 4191). She would be delighted to hear from you. As
I write this report we are looking forward to the Volunteers' Tea Party on 21
August when we hope the weather will be kind and we can enjoy meeting each
other in Pam Bertolotti's lovely garden. We are most
grateful to her for allowing us this privilege.
Finally I would like to thank all the people who give their time and support to
the Association, and the doctors and staff at the Medical Centre
for their unfailing support of the Association.
******
CARERS' SUPPORT
GROUP
The Group continues to flourish,
and we have been delighted to welcome two new members since the last issue of The ElliottEar.The long-standing members are so willing to give advice
and help based on their own experiences as carers,
and it is greatly appreciated.
Sadly, the Group will be saying
"Goodbye" to Anne Flood in December.
Anne has been associated with the Group for nearly 11 years, and her
role as Home Visiting Coordinator has fitted in so well by providing sitters
for our carers' loved ones. Anne and Cyril are moving to their house at Toddington "fulltime", which will enable them to
spend more time with their growing family, and also give them some quality time
on their own.
There are no words to express how much we shall
miss Anne, and we thank her from the bottom of our hearts for all she has done
for the carers, their loved ones, and, of course, the
Patients' Association as a whole.
We are determined that the Carers' Support Group will continue, and I am delighted
that Ann Kirby (a very good friend of the Group) has volunteered to take on a
larger role to help carers, and Margaret Wells has
also agreed to take on some of the organisation.
I know many of the carers,
past and present, will wish Anne every happiness in her new home, and I am sure
she will keep in touch. In the meantime,
I welcome the input by Ann and Margaret, and we will do our very best to
continue to provide a much-needed service to the cares in our Practice.
The Group will continue to meet on the third Thursday
in each month in members' homes, and the dates and venues are displayed on the
notice board at the Medical Centre. New members of
the Group are always welcome, or we will visit carers
in their homes if they do not wish to come to our meetings. If
you need support please talk to your Doctor or Nurse at the Medical Centre, who will put you to contact with us if you wish.
Contact Beryl Peacop or
(after December) Ann Kirby.
THE WEEKEND TEA
PARTIES
Tova Salomon
Continuing the success of last year, tea parties
for the elderly have continued this year. These Saturday afternoon events
provide a warm, friendly and family environment for the elderly and those
living alone - this is the reason for continuing to use my home as the venue.
We've held three teas in the last six months,
with around 6 or 7 guests each time, assisted by a few helpers as well as those
who provide transport. Their support is invaluable, so any additional offers of
help, just one Saturday afternoon every few months, would be enthusiastically
welcomed.
Enabling people on their own, especially the
elderly, to enjoy good homely company over a full English tea has been very
rewarding. The teas started on a trial basis but have now become a firm part of
the Elliott Hall annual calendar of events, something we intend to continue
into the future. For further information please ring me.
******
TRANSPORT
SERVICE
David and Pat James
If you have any spare time and could help drive
patients either to one of the local hospitals or to the Medical Centre, please contact
Flu Vaccination 2005
Helen Jenner NursePractition er
As in previous years, the national policy for 2005/06
is that influenza immunisation should be offered to:
All
those aged 65 years and over
All those aged over 6 months in a clinical risk group, such as
patients with diabetes, chronic respiratory disease including asthma, chronic
heart disease, chronic renal and liver disease
All those living in residential care homes
The Pneumococcal (pneumonia) immunisation programme
Current recommendations are for all patients over
75 years and those in risk groups as above who have not been previously immunised. Please note: re-immunisation
with pneumococcal vaccine is not currently
recommended.
Those who are housebound will be visited when times
are available, and patients will be contacted in advance.
******
How does the Elliott Hall Medical Centre work?
Lesley Walmsley
Things have changed greatly with regard to medical centres over the past years, and whereas when I grew up
"the surgery" consisted of one doctor and a receptionist (the
doctor's wife, who maybe did some filing as well as opening the front door),
today our practice has three partner doctors, 5 other doctors, 4 nurses of
various kinds, a phlebotomist, and an administrative team - including
receptionists - of 12 people.
Thinking that it might be interesting to see how such a practice operates, over
the next issues I shall be interviewing various members of the team, to find
out what they do and how they all mesh in together. The modern practice is a
far cry from my childhood doctor and his wife!
If the running of EHMC looks effortless and calm,
it means that a lot of careful work and planning is going on behind the scenes,
and at Elliott Hall that is largely due to the work of
The Practice Manager,
Denise Lavey.
The Practice Manager - Denise Lavey
Denise has over-all responsibility for eight main
areas: Patient and Community Services, Information Technology, Premises and
Equipment, Human Resources, Finance, Partnership Issues, Practice Development
and General. Specialist areas have their own leaders, e.g. Carole Dixey for Information Technology and David James for
Finance, but Denise keeps an eye on everything and ensures that the whole
practice functions smoothly.
A typical working day will see her arrive at
Contact with the Primary Care Trust and an almost
constant stream of changes in the Health Service, such as the new GP Contract,
bring added work needing more planning ahead for the Practice Manager.
The highlights of the job Denise
describes as being the hub of the practice and helping other people find
solutions to problems. The lowlights can
be the occasional overload of work and trying to take on other people's
burdens. There is also the frustration
of not being able to change something which someone - patient or staff - would
like changed.
The job of Practice Manager is a highly skilled one,
and apart from her own background in education and office work, Denise has the
qualification of the AMSPAR Diploma in Practice Management, and is working
towards her Fellowship by Assessment of the
There is life outside EHMC, and as well as running a home for herself and two
teenage children, Denise enjoys owning an ex-racing greyhound, as well as
spending a lot of time with horses, once a week working at a stable as a
volunteer with disabled children.
Next time I hope to bring you an insight into the
working life of one of the three partners.
******
ICE :
In Case of Emergency Campaign
This is an Emergency campaign, originally launched by
the East Anglian Ambulance Service, with the support
of
The idea is that you store the word
"ICE" in your mobile phone address book, and against it enter the
number of the person you would want to be contacted "In Case of
Emergency". Or for those of us who
don't have mobiles, write it clearly in your diary, address book or whatever
you generally carry in your handbag , wallet or pocket Then if you are involved
in an accident or any other mishap, the emergency services will know who to
contact for you.
It's a very simple and practical
idea. And please tell your friends about
it - send it to everyone in your address book if you do have a mobile phone.
A & E at Northwick Park
As mentioned in the Chairman's Report, at the AGM
in May, Sister Alison Willis, Senior Clinical Nurse A & E (Minors), and
formerly a nurse at our Medical Centre, gave a very
informative talk about the work of the Accident and Emergency department at
The department has four main areas:
Reception/Waiting area; "Minors" (Minor injuries and illness);
"Majors" (Major injuries and illness); and the Resuscitation area. It
is staffed by: 2 Consultants (with a third due in June 2005); 12 middle-grade
doctors, 12 Senior house officers, 1 Senior nurse across the emergency floor, 2
Senior clinical nurses, 76 nursing staff and 2 HCAs.
(???)
Patients can access the service either by referral from their GP or by self-referral. The department sees and treats 90,000 patients in a year, each day seeing between 260 and 310 patients, of whom 55-75 will be admitted as an emergency admission. This represents an increase of over 30 % in the last 12 months. Of these, 98 % are seen, treated and discharged or admitted in less than 4 hours!
A
& E is open 24 hours a day, every day of the year. Its busiest days are Friday - Monday, the peak times 11 a.m. -
4 p.m., and 7 - 11 p.m. Sixty per cent of the cases are "Minors", and
over a quarter of all patients are under 16 years old.
The London Ambulance Service receives one million 999 calls a year. It provides emergency roadside or home
assistance to seriously ill or injured people, taking them to the most
appropriate hospital. They also transport patients from one hospital to a
specialist centre as necessary, and they cater for
many primary care patients.
There are plans to introduce Emergency Care Practitioners (ECPs), first
within 5 London Primary Care Trusts but eventually across
There are alternatives
to A & E. These include self-care,
visiting or ringing your GP, Harmoni (the
out-of-hours doctors group), NHS Direct, the Minor Injuries Units (
However,
if the situation is life or limb threatening ring 999 !
******
CHECKING IN FOR YOUR APPOINTMENT
Sometimes when you reach the reception desk at
Elliott Hall the queue can stretch to the outside door, which is frustrating
for everyone. If you simply want to check in for an appointment with a doctor
or nurse there is now an extra way of doing this: THE TOUCH SCREEN which sits on the desk to the left of the
receptionist as you face her.
It's very easy to use, so do give it a try. There
are clear instructions printed out in front of the screen, but if you'd like
the receptionist to talk you through the process please ask her.
To use the screen all you do is: Touch the screen anywhere; answer the
simple questions it puts to you (i.e. are you male or female? What is the month
and day (not the year) of your birth? And then a very basic message comes
up using only your initials and the name of the doctor or nurse you are
visiting. If those details are correct, touch the screen where shown, and a
message appears, giving your full name, the name of the medical staff involved,
and also a note of how he or she is running as to time.
Then you just go to sit in the waiting room until called as usual. This new system will save you a bit of waiting time at the desk, but if you really don't like touch screens, just queue up to talk to the friendly receptionist as you always have done.
******
THANK YOU, SUZANNE
After
three years Suzanne Hearnden is resigning from the
post of Advertising Manager for The
ElliottEar, and we do
thank her for all she has done for us. Apart from running her own business,
Suzanne has a husband and small daughter, and we do appreciate all the time she
has given us when she could have been with them.
If
you'd like to try succeeding Suzanne, please contact Lesley Walmsey.
******
Falls: How Important Are They And What Can Be Done
To Prevent Them?
Dr
Chris Jenner
The Facts:
1 in 3
people aged over 65 will experience a fall each year, and half of those more
than once
40% of these falls result in
hip fractures
20% of injury-related deaths among older
people can be traced back to a fall
Older people are injured at
home more than any other location. The bathroom and stairs are particularly
dangerous
2.
Protect Yourself
Anyone can fall. But as we
age, our risk of falling becomes greater. That's the bad news. The good news is
that many injuries due to falls can be prevented. The first step to avoiding
falls is to understand what causes them. For example, poor balance, decreased
muscle and bone strength, reduced vision or hearing, and unsafe conditions in
and around your home can increase your chance of falling. Staying safe and on
your feet is a matter of taking some steps to protect yourself.
You can prevent falls by
making the needed adjustments to your home and lifestyle, and by making sure
you eat well, stay fit, and use whatever devices will facilitate your daily
life while keeping you safe. Your independence and well-being are at stake. Act
on it!
Here's a few Tips to see if you may be able to help yourself or someone you know and care for:-
In the home
Bathroom
Use a rubber bath mat for tub and shower. Install it when the
tub is dry
Install grab bars by the toilet and
bath to help you sit and stand. Make sure they are
well anchored .
Use a raised toilet seat, and a bath seat in the shower if
you need them
Wipe up moisture or spills
immediately
*
Living room and
bedroom
Reduce clutter! Get rid of loose wires and cords as well as any
other obstacles
Consider a cordless phone to avoid rushing
to answer
Have
good lighting throughout the house and install night lights
Make sure the path is clear between the bedroom and bathroom
Scatter mats are tripping hazards. Get rid of them or make sure
they are non-slip
Move slowly out of your bed or chair. Getting up suddenly can
make you dizzy
Kitchen
Store kitchen supplies and pots and pans in
easy-to-reach locations
Store heavy items in lower cupboards
Use a stable step stool with a
safety rail for reaching high places
Always wipe up any spills
immediately to prevent slipping
If you use floor wax, use the
non-skid kind
Ask for help with tasks that you
feel you can't do safely
Stairs
Make sure your stairs are well lit
Have solid handrails on both sides
of the stairway
Remove your reading glasses when you
go up or down the stairs
Never rush up or down your stairs.
It's a major cause of falls
Exterior
Keep front
steps and walkway in good repair and free of snow, ice and leaves
Keep
front entrance well lit
Put gardening implements such as hoses and
rakes away when not using them
*
Your
Health
Eat healthy meals
Nutritious meals keep up strength, resistance and
balance. Eat lots of vegetables and fruits
Don't skip meals. It can cause
weakness and dizziness
Keep fit
Engage in
physical activity every day. It's your best defence
against falls
Walk.
Try Tai Chi. Do what you can to maintain your flexibility and balance
Build
your muscle and bone strength by doing "resistance" activities or
exercises (such as
weight lifting). Remember
to take medical advice before you embark on an exercise program
Have your hearing and vision checked regularly
Use medication wisely
Ask your doctor or pharmacist
about possible side effects of prescription drugs or over-
the-counter remedies
Read directions carefully so you're aware of potential reactions with
other medications
If your medication causes dizziness or sleepiness, adjust your activities so you aren't at risk of falling
Don't mix alcohol and medications. Alone or in combination with drugs, alcohol can cause falls
Use safety aids [Really use them]
Don't be
embarrassed to use aids to daily living - they can keep you safe and active
Wear
your glasses and hearing aid
Consider using a walker or cane. If
you use a cane, make sure that it's
the correct height and that it's
rubber-tipped for safety
Find out
about other gadgets that can make your life safer: reachers,
anti-skid soles, hip protectors, etc.
Should you fall...
Attempt to land on your buttocks to prevent more serious injuries
Don't rush to get up. Make sure you are not injured before trying to get
up or letting others help you get
up
Don't let the fear of falling again prevent you from being active.
Inactivity creates an even greater
risk of falling
If you do happen
to fall and can't get up safely by yourself, it is quite legitimate to dial 999
and ask for an ambulance - 60 % of ambulance call outs are for this very
reason. Otherwise Helpline is available via Social Services (our
local SS office at Talbot House tel. 8429 4488 can provide details).
Finally if you
have fallen for inexplicable reasons please let us know, there may be something
we can do to help! Please let us know, falls are NOT a normal part of ageing.
******
SOME NEWS FROM ALAN BYERS
... AND SOME ADVICE
Dr Alan Byers
Time speeds on and it is now over a year since
retiring from Elliott Hall Medical Centre. It was
such a great wrench for me, and I am very much missing so many of the patients
and colleagues.
My extraordinary send-off, especially the surprise
concert, was such an exceptionally memorable event for me and my family. I was
overwhelmed by all the lovely items of the concert, and the gifting to me of
the wonderful horn and music writing Sibelius 3 programme, and I am very indebted to so many of you for
making it such a special occasion. It was really by far the best send-off I
have ever heard of.
I am getting lots of use from my spanking new
horn at the Watford Philharmonic Orchestra, in chamber music groups and various
music residentials, and am enjoying an Open
University course in Western music 1600-1900.
I still work a 4 day week but the work is now
"lighter" than before: 2 days as a part-time GP at Radlett/Shenley Surgery, Herts, 1
day a week as a long-term locum in
Well, that's enough about me. Now for a few words
about flossing teeth: Many people
are troubled by bleeding from gums and/or an unfresh
taste or odour in their mouths. In most cases this is
caused by low grade gum infection (gingivitis) due to food particles stuck
between the bases of their teeth and gradually rotting in their mouths!
Antiseptic mouthwashes like oraldene are insufficient
on their own to clear the problem.
This low grade gingivitis also aggravates the natural
gradual receding of the gums which occurs with age. That process of gums
receding also makes it easier for food particles to get stuck in the spaces
between the thus "elongated" teeth (hence the phrase "long in
the tooth"); so it is a vicious circle.
Tooth picks do help a bit, but not much. Simple toothbrushing is also insufficient. A visit to the dental
hygienist is a great way to get instruction on how to clean the teeth more
effectively, concentrating on the bases of the teeth at their junctions with
the gums rather than simply brushing the teeth themselves. The dental hygienist
can also give good advice on how we can floss our teeth, at least once at the
end of the day, or preferably, if we are keen enough, after every time we eat.
However, there are two cautions here: flossing with insufficient care may push
the food particles into the crevices between the gums and the teeth thus
actually provoking infection; secondly, over-enthusiastic flossing can dislodge
tooth fillings.
I have tried various brands of floss and in my
opinion the best ones I have found are called "Glide floss picks",
and are available from any pharmacist by order even if not on display, or by
telephoning 020 8459 7550.
An all-in-one gel?!
Last summer (2004), my wife
For patients with eczema we often suggest using an emollient such as aqueous
cream as a soap substitute. I have noticed on myself that e.g. aqueous cream
works well too as a hair conditioner, and as a pre-shaving cream. In fact, even ordinary liquid soap
makes quite a good pre-shaving cream too.
Perhaps there is a market niche out there for a single multi-purpose gel or
cream which advertises itself as the ultimate combined soap, shower gel,
shampoo, conditioner and shaving cream all-in-one! There must be a fortune in
it somewhere for some company! Or
maybe many of your cosmetic lubricating creams for dry skin could serve a
similar all round purpose. Try them and see what you think!
I often find myself thinking of so many of the excellent people I knew over the
years in Hatch End and wish you well.
******
CHAPERONES,
CONSENT AND CONFIDENTIALITY
Dr Reena Majus
The
practice has recently reviewed its chaperone policy in line with local and
national guidance and policy, some of which is detailed in the National
Clinical Governance Support team document "Guidance on the role and
effective use of chaperones in primary and community care settings."
The
chaperone policy is as follows:
This
organisation is committed to providing a safe,
comfortable environment where patients and staff can be confident that best
practice is being followed at all times and the safety of everyone is of
paramount importance.
All
patients are entitled to have a chaperone present for any consultation,
examination or procedure if they feel one is required. This chaperone may be a
family member or friend. On occasions you may prefer a formal chaperone to be
present, i.e. a trained member of staff.
Wherever
possible, we would ask you to make this request at the time of booking the
appointment so that arrangements can be made and your appointment is not
delayed in any way. Where this is not possible we will endeavour
to provide a formal chaperone at the time of the request. However, occasionally
it may be necessary to reschedule your appointment.
Your
healthcare professional may also require a chaperone to be present for certain
consultations in accordance with our chaperone policy.
If
you would like to see a copy of our chaperone policy or have any questions or
comments regarding it, please contact the Practice Manager, Denise Lavey. This policy is clearly advertised on notice boards
in the practice and on the website, www.ehmc.co.uk
For any examination
or procedure to take place the clinician needs to obtain the patient's consent.
For consent to be valid it needs to contain the elements of voluntariness,
appropriate information exchanged and capacity. The General Medical Council
states that it should be presumed that every adult has the capacity to decide
whether to consent to, or refuse, proposed medical intervention unless it is
shown that they cannot understand information presented in a clear way. Verbal
consent is as valid as written consent.Written
consent merely serves as evidence of consent. There is no lower age limit at
which young people can give consent provided that the doctor is satisfied that
the patient understands the intervention and its potential outcome.
The
content of any consultation or health professional/ patient interaction is
confidential and should not be disclosed to anyone apart from the patient.
Relatives may feel that the team is being obstructive in not sharing
information or answering queries. If
patients would like any other person, i.e. a spouse or child, to have access to
their medical information they can authorise this by
completing the specific consent form. This is available from the practice and
once returned a suitable prompt is added to your records, detailing who else
can be given information on your behalf.
All the
above are to protect patients and maintain good doctor/ patient relations.
Please let Denise Lavey, our Practice Manager, or me
know if there are any queries about the above points.
Thanks
******
Missed Appointments (or DNAs)
Laura Knight and Denise Lavey
In the Practice, we call missed appointments "DNAs" (Did not arrive) - this includes appointments
where we have no explanation for non-arrival and very late cancellations
(within one hour of the appointment time). We have done a survey of the first
six months of the year; the results are shown overleaf:
|
Month |
Number
of DNAs |
Total appointments available |
%
appointments which
were DNAs |
Time
wasted* (in
hours) |
|
January |
307 |
3287 |
9.3 |
51 |
|
February |
268 |
3124 |
8.6 |
44.5 |
|
March |
263 |
3225 |
8.2 |
44 |
|
April |
284 |
3050 |
9.3 |
47 |
|
May |
281 |
2947 |
9.5 |
47 |
|
June |
312 |
3223 |
9.6 |
52 |
As you can see, the results are staggering - nearly one in ten people booked
for an appointment did not attend! The picture is a