Kings Medical Practice News www.kingmedicalpractice.co.uk

On the last day of 2010 it seemed an appropriate time to review staff births, deaths and marriages. Just before Christmas Dr Harding gave birth to a little boy - well not really so little, he weighed 8Lb 7oz - and you will be pleased to know that mum and baby are doing well! In July I announced the death of Mrs Audrey Atkinson at the age of 90 years after a short illness. Mrs Atkinson had been our practice administrator for over 50 years until her retirement in 1993. And finally I move onto marriages. We have not had any marriages in the practice in the last 12 months but we have had two divorces. Cathy Robinsons' divorce was made absolute in July and Jane (our diabetic lead nurse) has also got divorced and changed back to her married name of Jane Harrison. I wish all my readers a Happy and Healthy New Year.

The surgery is only closed on the statuary bank holidays - we are otherwise open as normal. If you need a doctor when we are closed ring our normal number - 0844 815 1340 - and your call will automatically be transferred to the out of hour service. Our opening times over the Christmas period are: Christmas Eve - 8.00 am - 6.30 pm Christmas Day - closed Boxing Day - closed Monday 27/12 - closed Tuesday 28/12 - closed Wednesday 29/12 - 8.00 am - 6.30 pm Thursday 30/12 - 8.00 am - 6.30 pm (and extended access surgery 6.00 pm - 8.00 pm) Friday 31/12 - 8.00 am - 6.30 pm Saturday 1/1 - closed Sunday 2/1 - closed Monday 3/1 - closed Tuesday 4/1 - 8.00 am - 6.30 pm (and extended access surgery 6.00 pm - 8.00 pm) Wednesday 5/1 - 8.00 am - 6.30 pm Thursday 6/1 - 8.00 am - 6.30 pm (and extended access surgery 7.00 am - 8.00 am) Friday 7/1 8.00 am - 6.30 pm Saturday 8/1 - two extended access surgeries 8.00 am - 11.00 am. I wish everyone a Merry Christmas and Healthy New Year.

This might be the week that Coronation Street had its 50th anniversary but this is also my 50th blog! My first blog entry was on 4th January, 2010. I have used the blog to (1) keep our website up to date by linking the blog entry to the website home page and (2) to send as a newsletter to members of the Kings Medical Practice Google Group. Currently the newsletter is sent to 53 people in the Google group. About half of the people I send the newsletter to our staff and the other half are patients who we have recruited either because they use our online services or they have said they would like to receive the newsletter when they have registered as a patient at the practice. In my first blog I said that I want to use 'this Blog to tell you about our staff, our services, our performance and to keep you up to date to issues that may affect either you own health or the health of our patients in Normanton'. Now seems an appropriate time to get some feedback about what you think ab

I don't know about you but I am thoroughly fed up with all the snow we have had. I was out at 6 am on three mornings last week to dig my drive out so that I could get to work and on Friday when there was no fresh snow to clear I spent an hour at the surgery (together with our GP trainees) making sure that pathways to the surgery and the slope to the car park was clear. Despite the snow we managed to provide an almost normal service in the surgery building last week. We were open till 6.30 pm every night as usual and the only services we cancelled were our extended access surgeries on Thursday morning and Thursday evening. We did however cut down visits to only really, really important visits but this week we seem back to normal. All our staff turned up except for Dr Firth. He lives off the M18 in the country and is a long way from a trunk road. He has sent us pictures of how much snow they have had and it looks impressive. He helps organise an annual ploughing match in his village

We are pleased to announce that the practice has started hosting an ultrasound service. An ultrasound scan is a procedure that uses high frequency sound waves to create an image of part of the inside of your body. As sound waves are used rather than radiation, the procedure is believed to be completely safe. Ultrasound scans can be used to help us diagnose problems in your liver, gallbladder, kidney, ovaries, uterus and many other organs. The service is paid for by the NHS and run by Specialist Medical Imaging Ltd - click here to go to their website. Currently our patients seem to wait ages for ultrasound scan and we hope that this new service will speed up the length of time patients have to wait. We are told that if we request a scan today it will be done either this week or next week. Now thats what I call quick ..........!

We have had quite a few staff changes over the last few weeks. Dr Rebecca Hilton has left us to become a GP partner at a practice in Bradford. Dr Hilton was a salaried doctor who had been with us since 2005. I would like to publicly thank her for all her hard work and commitment to our patients and the practice. We wish her all the best in her new practice. We have replaced her with Dr Johnathan Lewis - he is already doing some surgeries for the practice but starts full time in December. In addition we have a couple of doctors who are doing locums sessions for us whilst Dr Harding is on maternity leave. Dr Amy Kuck is doing two sessions a week for us at the moment and Dr Amesha Patel is joining us in December to fill the rest of Dr Hardings session. All of our new starters have had an induction period to introduce them to our practice staff, our procedures and last but not least the computer! This current week we are a bit short of doctors as we have more doctors on leave than we like,

Kings Medical Centre was built by RoK Building Ltd and early this week they went into administration. Click here for the full story on BBC News. We are not really surprised since in the summer they posted half year losses of £3.8 million. We are very sorry that the people we have established good working relationships at RoK will have lost their jobs and were initially anxious about what implications it might have for the building. We have been in the building just over 12 months and most of the major snags have been sorted out. There are a few mainly cosmetic things that need tidying up but they are fairly trivial and we have been told that we should sort them and send the account to administrators - we will be another creditor waiting to get paid! We understand that a lot of their suppliers had not been paid so it suddenly makes sense why the hot water boiler in the kitchen has not been replaced - because they had not paid for it in the first place! We are just very relieved that th

I have recently updated the pages on our website about some practice performance indicators. Click here to go directly to the pages. First the good news; 95% of our patients are satisfied or very satisfied with the overall care they have received from the surgery, patients say it is easy to get through to staff on the telephone and in the last 12 months 65,101 patients had an appointment at the surgery ... wow! To read the latest GP Patient Survey fact sheet click here . This fact sheet very clearly presents the practice GP Patient Survey results in comparison with both local and national practices. But, we did not achieve as many points in the Quality and Outcomes Framework (QOF) as in previous year. Last year we nearly achieved full points, this year we only achieved 957 out of 1000. We think that the explanation for this is firstly, because we changed computer systems during the year and we did not realise that we were not coding things in the correct way to achieve full QOF point

It is Dr Hardings last day today before she goes on maternity leave. Her baby is due at the end of November and she plans to come back to work in either August or September of next year. We gave Dr Harding a card, handmade by 'receptionist July' with a lovely poem inside - it nearly made Dr Harding cry - but she wouldnot read it out! Anyway, we wish Dr Harding all the best, I promise to post baby pictures on the blog when we get them, and look forwards to seeing her back next summer.

It is now exactly 12 months since we moved into our new premises - wow, doesnot time fly. It seems like a good time to review what its been like. The staff all like working in the new premises - all the doctors now have their own room, the office is much less crowded, we all now have a good working environment. I think our patients like the new building: there is much more room in the waiting room, privacy at reception is much improved and the surgery now feels bright, modern and clean. With more space we have been able to have more training doctors - we now have four full time trainees and one part time trainee and been able to provide more services. We now have onsite physiotherapy, mental health services, Age concern drop in and are just about to start doing carpal tunnel surgery in our dedicated day surgery suite. We knew that parking in the surgery car park would be inadequate for patients but we have had few complaints about this, although we are concerned about the inappropiate

The government has announced today that it wants patients to be in charge of their medical records online under proposals for an "information revolution" in the NHS. It says that in the future, patients will be able to log on to keep track of their treatment and make choices about the care they will receive. It has launched a consultation excercise about "an information revolution in which people have the information they need to stay healthy, to take decisions about and exercise more control of their care, and to make the right choices for themselves and their families. This includes an accurate record of their care, available to them electronically." To read the consultation documents and make any comments on them click here . Of course, we have taken some steps down that road. You can already order repeat prescriptions, make some appointments and register with the practice via our website - and people who use our online services say our online services are

Tom Clark is one of our training doctors and has been with us since April. Tom is a doctor in the Army and is training to become a GP. He is in his last year of training and has been attached to the practice so that he can complete his training. In order to work as a GP training doctors have to pass the MRCGP exam - Membership of the Royal College of General Practitioners. The exam consists of three parts; firstly an Applied Knowledge Test (AKT - an MCQ paper), secondly a Clinical Skills Assessment (CSA) where our trainees see 13 simulator patients in a mock surgery under exam conditions and thirdly a completed portfolio of learning. Tom has already passed the AKT and in September he sat the CSA. He found out last week that he had passed and he also been promoted. Warm congratulations to Major Tom - Well Done!

We have just completed two whole day flu vaccination Saturdays (remember the anthem - 'roll up, roll up'!) and have vaccinated 1048 people with this years flu vaccination so far. On both Saturdays we vaccinated exactly the same number of people - 452 on each Saturday. We estimate that we have another 700 people to vaccinate. Some of these people will be living in nursing homes or sheltered accomadation housing schemes and we will vaccinate them at home. But we still have a few people to vaccinate at the practice. The people we want to catch are those in the at risk groups - people with diabetes, heart disease, COPD and the over 65's. A new group this year is pregnant women. So, if you are in an at risk and have not had your flu jab yet, then either ring and make an appointment or next time you are in the practice, just ask! Of course we count the number of flu vaccinations given by every clinical team member (nothing like a bit of competition eh!) and I am pleased to annouc

Glucosamine is a dietery supplement that has been used to help people with joint pain. It has been in the news this week because a review article in the British Medical Journal found no evidence that it was effective. For the full story on this click here for the story on the BBC website health pages. The practice has in the past prescribed glucosamine but earlier this year we made the deicison to stop prescribing glucosamine as although it is safe there is very little evidence that it is an effective treatment for joint pain. We have been writing to patients telling them that we have stopped prescribing it. Of course the main motivation for doing this is to save money - our prescribing budget is forecast to be about £200,000 over budget and a no-brainer is to stop treatments that do no good - like gluocosamine. So, once gain we are ahead of the curve!

We are pleased to welcome back Dr Mamta Prabhu after maternity leave. Her baby is now 9 months old and she has come back to work part time. Since we have moved to Kings Medical Centre the practice has more room for GP trainees - Dr Prabhu is now our fifth trainee! Dr Prabhu is in her last year of GP training. She has passed the MCQ exam and only needs now to complete her Consulting Skills Assessment to get her MRCGP and be certified as a fully trained GP. She will be working half time, which equals two and a half days a week. She is well prepared to start back - she has a new doctors bag and has even arranged for her mother to stay with her for two months whilst her baby settles in nursery! Welcome back!

We are having flu vaccination session on two Saturdays - 25th September and 2nd October. We start at 8 am and finish at 4 pm. If you ring appointments they will give you an hour slot in which to come and have your flu vaccintion. Click here to download an information leaflet and consent sheet. Click here to download an information leaflet and consent sheet for the under 16's. So if you are due a flu vacc ring up now and book an appointment!

On a Wednesday the practice currently closes for 2 hours for staff training. This week we were updated about local plans and progress towards the Electronic Prescribing Service. We are currently at the first stage and about to move to the second stage. First Stage Over the past year or so, you may have noticed that your prescription form has had a barcode printed on it. This means that it was produced using the first stage of the new Electronic Prescription Service. Second Stage Now, the Electronic Prescribing Service is moving to the next stage of the service where there is less need for you to receive a paper prescription – unless you want one. At first, if you want the practice to send your prescription electronically, you must choose, or ‘nominate’, a place to receive your electronic prescriptions. This could be any pharmacy, for example, you could choose to nominate a place that is convenient to where you live, work or shop. Nomination works in a similar way to a prescripti

Roll up, roll up - is the catch phrase for this years seasonal flu campaign. We recommend flu vaccination to the over 65's and to people with illnesses that make them more likely to suffer complications if they get flu. This is for illnesses like diabetes, asthma, COPD or being the carer for either a disabled person or a person with these illnesses. In past years we have sent letters to people and then asked them to ring up and make an appointment for a flu jab. This has always created a huge amount of work in generating the letters, making the appointments and then patients have felt let down that they have not had their flu jab on time and have had to wait. This year we are trying something different. We are having flu vaccination session on two Saturdays - 25th September and 2nd October and inviting patients just to 'roll up' and have their vaccination. Click here to download an information leaflet and consent sheet. Click here to download an information leaflet and cons

Had a quick reminder this week about eight services available in Normanton. The services vary from supporting victims of sexual assault and rape to a drop in project for the over 50's who have recently been bereaved and includes details of Yorkshire Miners Convalescent Homes! On a Wednesday we have a regular education session for all staff in the practice. One of the items this week was the 'Wednesday Box' - this is a box of letters, flyers and information that has come into the practice that staff should know about but is not important enough to circulate around, and these services were in the box. Anyway, here is the list (in alphabetical order): Arthritis Care - challenging pain course . This is a self management course for people with arthritis and chronic pain. To find out about the next course email anthonym@arthritis.org.uk Awake Mentoring Scheme A mentoring scheme for disabled people by disabled people. Email awakementoring@scope.org.uk Beyond Existing A support gr

The practice is a member of Novus Health, which is an organisaiton of local GPs and hospital consultants who wish to provide high quality services to patients, close to their homes in innovative and cost effective ways. Click here for the the Novus Health website . Kings Medical Practice is going to host a surgical service for patients with Carpal Tunnel Syndrome. Typical symptoms of Carpal Tunnel Syndrome are numbness and tingling in the hand around the thumb. Click here for a good information leaflet from www.patient.co.uk about Carpal Tunnel Syndrome. When we refer a patient with Carpal Tunnel Syndrome to the Novus service patients will be first seen by a GP screener. In Normanton, Dr Dewhirst at Queens Street Surgery will be assessing our patients. The screener will confirm the diagnosis and then discuss the treatment options. Doing nothing is an option, as one in four get better on their own, alternately patients can choose to have a steroid injection and if that does not help t

We have two new GP trainees joining us in August. Dr Muhammed Sarfraz and Dr Richard Holborough. Both are in their final year of GP training and will be with us for twelve months. Richard has moved from a GP training practice in Wakefield and Muhammed from a hospital post. And as we get two new trainees it is time for two of our trainees to move on! Dr Sarah Renga and Dr Mohammed Shaikh have been with us for six months and have come to the end of their attachment. Sarah is moving to a training practice in Wakefield and Mohammed is back into a training post in hospital. We have enjoyed having them with us, we hope they have learnt something and we wish them all the best for the future.

Mrs Atkinson worked for the practice for nearly 55 years. She joined Dr Twist in 1938 as a dispenser and worked until 1993 when she retired at the age of 73. She died last week after a short illness in Pontefract General Infirmary at the age of 90. Her funeral at Pontefract Crematorium was well attended by her family, friends and members of staff who worked with Mrs Atkinson. Mrs Atkinson will be remembered by lots of our patients - she was always very clear about how patients should behave, and for that matter about what their doctors should do as well! I worked with Mrs Atkinson for nine years after I joined the practice in 2004 and found her quite intimidating to start with. But she was always very loyal to the practice and had clear ideas about how to treat patients. I am sure that I can categorically say that no-one will ever match her service to our patients in Normanton.

I was at a meeting two weeks ago where our Practice Based Commissioning Consortia had invited Julia Squires, the Chief Executive of Mid Yorks Hospital Trusts to discuss various things. One of the things that cropped up was the extra cost of the new Pinderfields and Pontefract hospitals and how the local health community is going to pay for it. I am not sure whether what was discussed was confidential or not so have not blogged about it until now, but in Fridays Wakefield Express there were full details about their financial difficulties - so I think I can now comment. To read the Wakefield Express story click here . The Mid Yorks Trust has a budget of about £400 million per year, the new hospitals in Wakefield and Pinderfields will cost an extra £30 million per year and inorder to fund this the Trust has to make savings. The Trust has planned to make nearly £50 million of savings over the next two years. This year Mid Yorks Trust have asked Wakefield PCT for an extra £12 million - £8 m

In a major reorganisation of the NHS announced yesterday by the Health Secretary, Andrew Lansley, GPs are to be given a hugely increased role in commissioning. Commissioning healthcare is about deciding what services the NHS will pay for e.g. hospital services, mental health services, community services. In these far reaching proposals two layers of bureaucracy will axed – Strategic Health Authorities and Primary Care Trusts. Their commissioning responsibilities will be handed to GP consortia that typically might look after 100,000ish patients. We have of course been here before, firstly with fundholding, that New Labour ended in 1997, but was more limited – did not cover the range of services that these new proposals will and was only taken up by about 50% of GPs – whereas this initiative will apply to all GPs in England. The initiative that it has been built on is Practice Based Commissioning. This has been in existence for about seven years. Kings Medical Practice is in a consortia

I blogged last month about Script Switch. This is a prescribing tool that helps GPs make more cost effective prescribing choices. I was at a Wakefield PCT Medicines Management meeting when we were updated about Script Switch. Since March, Script Switch has been in use in all practices across Wakefield and Pontefract. By accepting the choices suggested by Script Switch GPs have already saved £62,109 from prescribing budgets and Medicines Management Service has projected a 12 month saving of at least £337,652 across the whole of Wakefield. Suggestions made by Script Switch about prescriptions for acute conditions have been accepted by GPs on 50% of occasions, those for repeat prescriptions about 30% of the time. Not bad eh!

Lots of policy changes announced by the new government this week; scrapping of some key health targets, reduction in NHS management costs, GPs to be ‘lynch pins’ of NHS and some of these policy changes are having an impact locally. And there was the sport! Health Secretary Andrew Lansley has stated that "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes. Doctors will be free to focus on the outcomes that matter - providing quality patient care." Nationally it has been reported that the government is to scrap the 4 hour waiting target in A&E, the 18 week treatment target and the right to see a GP for a routine matter within 48 hours. But when you drill down a little bit into the detail then they are not actually scrapping the 4 hour wait target in A&E – just reducing the target from 98% to 95%. And announcing that the NHS locally can have more input in decidi

This is my first blog for nearly three weeks! Not because I have nothing new and original to say (?) but because I have been away on holiday. I have just spent two weeks in Italy, near Lucca. we had a great holiday and of course I followed the Slip, Slap, Slop message - 'slip on a shirt, slop on sunscreen and slap on a hat'. The message has now been extended to 'Slip, Slop, Slap, Seek, Slide' - 'slip on a shirt, slop on sunscreen, slap on a hat, seek out some shade and slide on the sunshades!' The practice provides a full travel advice service to our patients including travel vaccinations, travel health advice (Slip, Slap, Slop), advice about malaria prophylaxis and Yellow Fever vaccination. Most travel vaccination are free - the exceptions are generally if you are going to unusual places or doing unusual e.g. back packing trips or staying somewhere for longer than three months. The commonest vaccinations patients have to pay for are Yellow Fever, Hepatitis B an

Script Switch is a prescribing tool that helps GPs make more cost effective prescribing choices. I does three things; firstly it alerts us to drugs that cheaper if prescribed by brand name, secondly it tells us about some preparations that are cheaper and thirdly it gives us what seems like random advice about some of the drugs we prescribe, In the past GPs have always been advised to prescribe drugs ‘generically’, that is by their chemical name, because generic drugs are usually cheaper and thus more cost effective. However, because of the way the NHS pays for drugs some branded drugs are actually cheaper than when they are prescribed generically. Examples of this include generic chloramphenicol eye ointment that we prescribe for conjunctivitis costs the NHS £2.07 whereas brand name chloramphenicol, Choloromycetin costs the NHS £1.08 – a cost saving of 99p per prescription. When you start looking at drugs that are often on repeats the savings getting bigger; the drug sulfasa

Dr Sarah Renga is one of our training doctors and has been with us since February. She qualified in 2006 and is in her second year of specialist training to become a GP. Inorder to work as a GP training doctors have to pass the MRCGP exam - Membership of the Royal College of General Practitioners. The exam consists of three parts firstly an Applied Knowledge Test (an MCQ paper), secondly a simulated surgery where our trainees see 13 patients at 10 minute intervals in exam conditions and thirdly a completed portfolio of learning. Sarah finishes her training in July 2011 and sat the AKT test in March. She got the result this week and found out she had passed. Passing the AKT shows that Sarah knows her 'stuff'. She has got the knowledge of what to do, the challenge for her, and other trainees, is to apply it in real life to real patients. So, well done Sarah and good luck with the other parts of the exam.

In the post last week at home was an invitation from Life Line Screening to have a ‘Stroke/Carotid Artery’ screen to prevent a stroke from happening. There is a session at Wrenthorpe Methodist Church Hall in June and for the princely sum of £45 they will scan my carotid arteries. Trying to be an evidence based doctor I looked at the UK National Screening Committees website. They have recently mailed GPs about private screening like this and Steven Laitner, a GP and Consultant in Public Health Medicine, comments on the website "There has been a notable increase in the number of patients being offered private screening tests. All screening involves a careful balancing of risks and benefits and where screening falls outside of established criteria it can pose a significant risk to health. GPs provide valuable advice and support to patients in this area and I hope that this new guidance will help them in supporting their patients to make fully informed screening decisions." Bu

As I look out of my window today the sun is shining, summer is almost upon us and of course the hay fever season is about to start. For intermittent or mild symptoms we would recommend non sedating anti histamines like loratadine or cetirizine. At the weekend I was in Sainsbury’s doing our weekly shop and I was surprised at how cheap they are. In Sainsbury’s on Saturday 14 loratadine cost £1. This compares to an NHS prescription charge of £7.20. At Lloyds pharmacy they charge £6.69 for 30 loratadine tablets. I have searched the internet and the Money Saving Expert website has this very useful table that lists the costs of branded and generic anti-histamines. Branded drugs have a trade name and manufactured by well established drugs companies. Brand names are usually simpler than the generic name e.g. Clarityn, Zirtek. Generic drugs are the bioequivalent of a branded drug and the generic name is the actual chemical name of the drug. In the practice we usually prescribe drugs by the

Well, ... the short answer is that we have six patient parking spaces and that if you can’t find a space then they are being used! The slightly longer answer is that Kings Medical Centre has 28 parking spaces plus five disabled spaces. Nineteen of these (plus three disabled parking spaces) are allocated to the doctors’ surgery and the remaining nine spaces (plus 2 disabled parking spaces) to the dental practice and for PCT staff. Currently parking is a bit of a mess with staff cars parking in disabled spaces and also double parking. The double parking makes the car park dangerous for users – it restricts visibility and makes manoeuvring in the car park much more difficult. The parking of staff cars in disabled spaces is particularly irritating. Disabled access to the surgery is very easy as patients can park in the disabled spaces and get access to reception from the lift that can be accessed from the car park. Patients with mobility problems have only a short distance to get into the

On Wednesday the practice closed in the afternoon for staff training and development. We spent the time looking at Significant Events. We define Significant Events as where something did or may have led to some significant harm happening to a patient (usually) or member of staff. The whole practice was involved; doctors, nurses and administration staff. We split into small groups and worked through a proforma looking at the event and then produced an action plan. The Significant Event proforma looks at what happened, what issues did it raise, what was done well, what was not done well, what could be done differently in the future and what learning needs did it identify. The action plan each group was charged with producing looked at what we need to do differently, who is going to be responsible for implementing this change, when are we going to start and how are we going to measure any changes. We looked at five significant events; patients being sent letters about pathology results un

The practice is closed on Wednesday 28th April from 12 midday for staff training. If you need medical attention on Wednesday after 12 just ring our normal number (0844 815 1340) and your call will initially be answered by NHS Direct who will be able to arrange for you to see a doctor if necessary. But what are we up to on Wednesday afternoon? The practice closes every Wednesday between 1.00 and 3.00 pm for staff training when we do a variety of things; short educational meetings, audit, doctors business meetings etc etc. But once a month we are able to close for the whole afternoon when we spend the afternoon either in the practice or at a District wide event looking at a topic in more detail. This Wednesdays training is around Significant Events. Staff in the practice are encouraged to notice and report any significant events. These we define as any actual or possible harm to patients that may have been avoided. In this session we are going to look at significant events that have been

Yes its true, Ed Balls, the last Normanton MP, packed my shopping at Sainsburys on Saturday. Ed was packing shopping to raise money for Levi's Star a Wakefield charity that is raising money for children with brain tumours in memory of Levi Ringer who died from a brain tumour. You can see a picture of Ed packing his shopping on his twitter page. Ed said how impressed he was with our new surgery premises and how it has made the top of the High Street much smarter. I told Ed how helpful some of my patients had found advice and support from his consistituency office and I said how we were going on holiday on Monday but unlikely to fly due to the Icelandic ash cloud. But what I should have said was that I would like to cherry pick from all of the parties manifestos: 1) All the parties have expressed support for continued financial support for the NHS but I would trust Labour the most to deliver on this promise. I am particularly impressed by some of the NHS targets; two week wait for

We are just in the process of completing the sale of the Princess Street Surgery to the Fire Service. Behind our old surgery building is a fire station on The Grove. This fire station is currently a part time station. It is crewed by retained fire officers who come to the station when they receive a call. The Fire Service has bought our old building and intends to build a new, permanently staffed fire station on this site. The Fire Service has been successful in obtaining planning permission for this new station. Click here for full details of the planning application – if you click on documents you can see a site plan and what the Fire Service plans to do. Essentially they are going to build a new fire engine garage where our surgery is. Access to the garage will be from Princess Street and the fire engine will exit via The Grove. On either side of the garage will be offices and accommodation for the full time fire officers. We are very pleased that Normanton will now have a fire sta

The practice is pleased to welcome a new GP trainee - Capt Dr Tom Clack. Tom trained at Leeds University, has done some post qualification posts at Pinderfields and has a house in Pontefract. He is a doctor in the Army Medical Service and is training to be a GP. He has a lot of experience as a GP trainee - he has worked as a trainee in a training practice in Guiborough, but has also done some other interesting stuff. As part of his military duties he has done a tour of Iraq where he was a trainee at Basra Palace. He knows all about the practice as when he as a student he shared a house with Dr Campbell Murdoch - we have lots of patients (and staff) who remember Campbell with some fondness! He is with us for 10 months to complete his training - he has come to us as a sort of finishing school - nice thought that!

The surgery is only closed for the two bank holiday days – Good Friday and Easter Monday. We close on Thursday 1 st April at 6.30 pm, we have our normal Saturday morning surgery, 8.00 am to 11.00 am, for routine booked appointments and we re-open as normal on Tuesday 6 th April at 8.00 am. Outside of these times to get medical help or advice ring the normal telephone number – 0844 815 1340 – and you will be put through to the Out of Hours service. We wish all our patients and blog readers a good Easter, although looking at the weather forecast it looks like it will be a wet one!

From out website www.kingsmedicalpractice.co.uk it is now possible to order repeat prescriptions and make/cancel appointments. When you click on the big buttons labelled BOOK, REQUEST or REGISTER you are taken to the systmonline internet page where you can book and cancel appointments, request repeat prescriptions and register if you are a new patient. In order to be able to do this you need to get a username and password. To do this either come to reception in person with something that proves your identity such as a bank card, utility bill, passport or drivers licence or ask the doctor next time you are in surgery. When you logon for the first time you are able to change your password to something more memorable and you can see the repeats that you are allowed to order, your appointment history and appointments that you are able to request. For Kings Medical Practice using systmonline to order repeats works very well. When you order your repeat it is sent as a task for our prescript

The Summary Care Record has been in the news again this week with the BMA writing to the Department of Health expressing serious concerns that the roll out of the programme is going too quickly with not enough consultation with patients. The Summary Care Record is a national IT system whereby patients address details, medication, allergies, hospital appointments and past medical history will all be held on a central database and will allow anyone treating you to see this data. This will be very useful for doctors seeing you at hospital or as an emergency because they will know what drugs you are taking, what you have had in the past and if anything has been recorded about any allergies or sensitivities you have had. To access this information staff will have to access it via a SmartCard, will only be able to look at your information if they are treating you as a patient and the information they will see will depend on their role. So a receptionist will not see the same details that a d

Congratulations this week to three of our trainees who have taken the MRCGP Consulting Skills Assessment exam and have all passed – well done to Dr Aditya Narkar, Dr Linda Halliwell and Dr Duncan Marlow. The practice is a training practice and has doctors attached to the practice who wish to become GPs. These doctors will generally have done two years in hospital after they qualify and then join a three year GP training scheme. When they are attached to us they are either in the second or third year of their training scheme, so they have been training for at least four or five years after they have qualified at University. In order to become GPs they have to be a member of the Royal College of General Practitioners and obtain the qualification MRCGP. In order to get MRCGP they have to pass three assessments. The first assessment is a multiple choice exam about applying knowledge they have learnt to patients they might see in general practice. The second is a collection of Work Place Ba

The practice website is now up, running and probably error free (*). You can access the website at www.kingsmedicalpractice.co.uk From the website patients are able to access our online services. Patients can request repeat prescriptions and book appointments. To do this you need to first register and get a username and password by coming to reception with proof of your identity, such as a passport or driving licence, and our administration staff can give you a username and password. It is very easy to do and with two clicks all staff can generate patients a username and password. When you access the online services you can order any repeat prescriptions that you are allowed and send a message with the request. You can also book some appointments. Currently we have just set it up so that our extended hour’s appointments are available; Saturday mornings, early morning and late evening surgeries. You can also see appointments you have made in the past and appointments in the future. On

Treating women with cystitis seems fairly straightforward. Unlike many conditions. in women who attend with cystitis bacterial infection is likely to be present and treating women who complain of symptoms alone is cost effective. However treating on the basis of symptoms alone would mean that 10% of our adult female patients would receive antibiotics each year. Is there a better way of doing this and as the boys on *Top Gear say – how difficult can it be? In the BMJ this week is an editorial and three linked research papers which have investigated how best to manage individual patients and how to reduce the number of antibiotics GPs prescribe. The conclusions of these papers are however unclear. The use of MSU is unhelpful and expensive (if you delay prescribing till you get the result of an MSU women have more symptoms). Beyond this the best next approach is unclear. Prescribing based on patients symptoms, or a delayed prescription (that is advising women to start antibiotics if thei

The practice is set an annual budget for our prescribing costs. This is the costs of drugs that we prescribe. This year the budget is £1,603,110 and Wakefield Primary Care Trust has several ways of trying to get the practice to keep to this budget. The PCT has sent one of their pharmacy technicians to do various things with our prescribing. So far this year she has swapped patients from an expensive osteoporosis prevention drug to a more cost effective (i.e. cheaper on) and this week she rationalised seven patients Pregabalin treatment and made a potential saving of £5,400 per year. Pregabalin is a drug used in epilepsy and for neuropathic pain and all the drug doses amounts cost the same. A 50 mg capsule costs the same as 100mg and we had a few patients taking two 50 mg casules that she swapped to 100mg – easy if you know how! There is an incentive scheme whereby if we can keep our prescribing cost growth down to below 6.9% then if the practice achieves some quality indicators we ar

In the news this morning is a new campaign from the Family Planning Association – Conceivable? – about the rise in unplanned pregnancies in the over 35’s. Looking at the abortion statistics – the most obvious and reliable illustration of unplanned pregnancy – you’d expect the rate of abortion to be very low in the over 35 age group. However, in 2008, women aged 40–44 years old had the same rate of abortion as women under the age of 16. And almost 20,000 women aged 35–39 had an abortion. The message is that if you’re over 35, although your fertility is declining, it hasn’t disappeared completely. Fertility is an individual thing. It changes with lifestyle, varies hugely from woman to woman and essentially from couple to couple. So, if you are over 35, ovulating, having regular periods, unprotected sex and you know you or your partner is not clinically infertile, every month there’s a chance you’ll get pregnant If you don’t want to get pregnant the bottom line is to keep using contracept

Two new trainee doctors have joined us. Dr Sarah Renga and Dr Mohammad Shaikh started today and will be with us for six months. They are both on a GP Training Scheme as part of the West Riding GP Specialist Training Programme. This programme has training posts in Pontefract, Wakefield and Dewsbury. When new doctors join the practice they have an induction period when they meet members of the team and learn our systems and the computer! Learning how to use our clinical computer is one of the biggest challenges for new trainees – sometimes it feels more daunting than seeing patients! But we start trainees off with consultations of 30 minutes – 10 minutes to see the patient and 20 minute to make sure that it is entered correctly on the computer. Trainee doctors have an education programme in the practice and their clinical work is closely supervised. Anyway, we are very pleased that Sarah and Mohammad have come to us and hope we have given them a warm welcome to Normanton.

The practice closes between 1 pm and 3 pm every week for staff training and development and once a month we close all afternoon for an extended training session. These are called TARGET afternoons (not sure what TARGET stands for though but I dont think it has anything to do with targets!!!). Last weeks TARGET session was the annual fire training for all our staff. It is compulsory for everyone to attend - doctors, nurses and administrative support staff. We had a lecture from a fire officer, demonstration and practice outside using some live fire extinguishers and then went through how the fire alarm works. The fire alarm for the new premises are very complicated. There is a numbered sensor in every room, the premises are zoned and loads of things happen when the fire alarm goes off: the alarm starts screeching, the sensors start flashing, the fire brigade are called, all the fire doors close, all the doors that you can only get through with a fob open, the shutters which are down go

We have two new GP trainees start with us in February and as part of their induction pack I send them a practice booklet. The booklet includes details about the practice, how we work and about our patients. I last updated the booklet in February 2009 and was surprised to notice the growth in our practice list since then. In February 2009 we had 10,647 patients, today we have 11,232 patients on our list. This is an increase in the number of patients on our list by nearly 600 or just under 6%. New patients always mean more work because generally if patients move house they do not register with a new doctor or practice until they are ill! But it is also evidence that our current patients think we are doing OK as most new patients come from word of mouth. It feels quite good to think that our practice is well regarded that we are recommended by our current patients. Settling into new premises has been quite hard work and the challenge in the building is to continue to provide and quality s

Had a suggestion in our suggestions box today asking what the qualifications after the doctors names in our practice leaflet mean. Interesting questions so here is the list: MB - Bachelor of Medicine, ChB - Bachelor of surgery. These are the basic qualifications that all doctors get when they qualify. MRCGP - Member of the Royal College of General Practitioners. This is a postgraduate qualification that some GPs apply for. The form of the examination for this qualification has changed over the years. Dr Mooney obtain MRCGP by doing an MCQ, essay paper and an oral exam. Dr's Walsh, Hilton and Harding obtained it by doing an MCQ, essay paper, oral examination and submitting a video of their consultations. Dr Brown obtained it by doing Membership by Assessment of Performance - submitted a video of my consultations, a portfolio of my work and then had an inspection at the practice. Dr Deeley obtained the nMRCGP - she had to do an MCQ, pass a consulting skills assessment (saw 12 pati

This sounds a very dry and techy sounding post but today at our Protected Education Meeting we had a presentation from Mr George Zito (Business Change Facilitator with South Yorkshire Health Informatics Service) about a new way of ordering pathology tests and making radiology request. Currently we fill a form in send it off. This works Ok for most of the time but there are the occasional mishaps - tests not done, handwriting not decipherable, lost requests or samples. With this new system we will make an order or request for a test or Xray on our computer and the request is linked directly to both our clinical system and hospitals system for managing pathology tests and Xrays. The new system will generate a form and sticky labels from our printer that is bar coded. The forms and stickly labels (with the bar codes) are attached to specimen bottles and samples and hopefully will reduce the odd mishap that happens at the moment. The golive date is scheduled for the end of February and the

Welcome to the new Blog of King’s Medical Practice, Normanton. We want to use this Blog to tell you about our staff, our services, our performance and to keep you up to date to issues that may affect either you own health or the health of our patients in Normanton.