Kings Medical Practice News www.kingmedicalpractice.co.uk

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: Friday 23/12 - 8.00 am - 6.30 pm Christmas Eve - closed Christmas Day - closed Boxing Day 26/12 - closed Tuesday 27/12 - closed Wednesday 28/12 - 8.00 am - 6.30 pm Thursday 29/12 - 8.00 am - 6.30 pm (and extended access surgery 7.00 am -8.00 am and 6.30 pm - 8.00 pm) Friday 30/12 - 8.00 am - 6.30 pm Saturday 31/12 - closed Sunday 1/1 - closed Monday 2/1 - closed Tuesday 3/1 - 8.00 am - 6.30 pm (and extended access surgery 6.00 pm - 8.00 pm) Wednesday 4/1 - 8.00 am - 6.30 pm Thursday 5/1 - 8.00 am - 6.30 pm (and extended access surgery 7.00 am - 8.00 am) Friday 6/1 - 8.00 am - 6.30 pm Saturday 7/1 - extended access surgeries 8.00 am - 11.00 am. If you ring our normal telephone number (0844

The Summary Care Record system is a national database of patient health details that can be assessed by health professionals all over the UK. Initially we thought that it was going to contain a summary of patients important medical conditions. We had concerns about the security of this and whether the NHS could keep confidential information properly private and confidential and refused to let our patients details be uploaded. But over time the contents of the Summary Care Record contents has got reduced and will now only contain details of medication you are taking, allergies you suffer from and any bad reactions to medicines that you have had. This seems fairly innocuous stuff to me and this week Wakefield District PCT has started sending letter to our patients informing them about what is going to be uploaded to the Summary Care Record. They are using a scheme of 'implied consent' that means that they assume you consent to this. If you do not want this to happen you have to &

The Quality and Outcomes Framework scores have recently been put in the public domain for all practices in England and we did very well. We scored in total 983.7 out of 1000 points and 696.1 out of a total of 697 points in the clinical domains. In our local 'league table' we were the fifth highest across all practices in Wakefield District. The Quality and Outcomes Framework (QOF) is a voluntary annual reward and incentive programme for all GP surgeries in England, detailing practice achievement results. The QOF gives an indication of the overall achievement of a practice through a points system. Practices aim to deliver high quality care across a range of areas for which they score points. So I think the practice deserves a pat on the back!

On the news this morning there was a report from the Health Protection Agency that a quarter of people wrong believe that antibiotics work on most coughs and colds. To read more about the story click here for a link to the BBC Health Website. I am not sure that is completely accurate for our patients though. The practice has always been a low prescriber of antibiotics for coughs and cold and I think that one of the 'cultural norms' of our patients is that they are not expecting a prescription for antibiotics, they just want to be checked that it is not our their chest. Anyway the Health Protection Authority has produced a list of helpful tips: Most coughs and colds get better on their own - antibiotics will not speed recovery Coughing up phlegm on its own is not a reason to need an antibiotic - even if it is yellow A sore throat plus runny nose with phlegm suggests the infection is less likely to respond to antibiotics A high temperature, red throat and feeling really ill

Mid Yorks Hospital Trust, which is the organisation that runs our local hospitals has recently announced that Pontefract Accident and Emergency Unit is to temporarily close overnight from 10 pm. To read the full story click here . But essentially it is because there are not enough junior doctors to work in all three Accident and Emergency Departments to maintain a safe level of service to patients. The Trust denies that it is accelerating the closure of Pontefract A&E. But a week later at the Trusts Public Board meeting it announced that it is considering proposals to change the way it provides services to patients in Dewsbury, Wakefield and Pontefract. To read the full briefing paper click here . In order to become a Foundation Trust, Mid Yorks needs to demonstrate that its services are financially and clinically viable. In a nutshell that means that it can live within its financial means (ie save £30 million a year) and make sure that its clinical services are safe and effective

I have always kept a sharp eye on the number of patients that are registered with us and this morning we have passed a milestone - we now have over 12,000 patients. Yesterday we had 11,997 patients and this morning when I looked we had 12,007 to be precise! I don't very often indulge in looking back but since we have passed such a huge milestone I think I can be afforded such an indulgence. When I first joined the practice in 1984 we had 4,500 patients and there were two full time GPs and Dr Ellis worked part-time. Oh how things have changed - there are now 8 fully qualified doctors, 5 doctors in training and we are open from 8.00 am to 6.30 pm every day with extra opening on some early mornings, some early evenings and Saturday mornings! We are very pleased that patients have chosen to register with us and I extend a warm welcome to all our new patients!

We have been reviewing our Repeat Prescription System and one of the issues that has come up is how do we ensure that Repeat Prescriptions are collected from Reception by the person who is authorised to collect it. If you order a Repeat Prescription then you can collect it in person but we will also allow your representative to collect and even a pharmacy to collect if for you. The issue we have identified is how can we ensure that the person collecting it is who they say they are and that they have your permission to collect it on your behalf. Some practices in our local area want proof of identity and a signature for every repeat prescription that is collected from Reception. We discussed this at length and concluded that this would impose a large workload on Reception for little benefit. We did however identify a subgroup of Repeat Prescriptions where we thought that we should implement such a system namely when people come to collect Repeat Prescriptions that are for Controlled Dru

We have started to look at the reasons why our patients visit our local Accident and Emergency departments. In the course of an average week about 90 of our patients will visit A&E and half of these visits will occur between 8 am and 6.30 pm when the surgery is open. When we look at the letters we get back following patients attendances it looks to us as if a lot of patients could have come and been treated at the surgery instead. It costs our commissioning budget at least £80 per each A&E attendance whereas if the patients had come to the surgery instead if would not have cost anything at all. We are about to start contacting patients and asking them why they went to A&E? What could the surgery have offered so that they could have seen us rather than A&E? Do our patients know about other NHS Choices instead of A&E? We are just at the start of this process and are going to use the data we collect to help decide if we need to change our opening times. For example w

We are getting closer and closer to that time of year when the leafs start to fall, birds emigrate, Santa's grotto appears in the shops and of course our flu jabs arrive. This year we have flu jab clinics on three Saturdays in October - the 8th, 15th and 22nd. We have nearly filled all our appointment slots on Saturday the 8th but still have plenty of availability on the 15th and 22nd. We recommend a flu jab to everyone over 65 years of age and those people with conditions that flu would make more dangerous for example people with diabetes, asthma or other long term conditions. To book an appointment dial 0844 815 1340 option 1 or click here to make an appointment view our online booking system. You know it makes sense!

We are very pleased to welcome Dr Harding back from maternity leave. Today was her first day and despite not being able to get her SmartCard to work first thing got on very well. Dr Harding will be working 3 full days a week. As with most doctors starting or returning from a break; the computer system can be problematic but patients are easy!

This is Dr Firths last week at the practice. He was a trainee at the practice and then joined the practice as a salaried doctor in 2005. He is moving to become a partner in a practice at Thorne, near Doncaster. Dr Firth lives in North Lincolnshire and currently he commutes 80 miles a day but his new practice is only 13 miles away. Dr Firth will be missed by all the doctors and staff at the surgery - he gets on with seeing patients with no fuss or bother and the staff love it when he is the on-call doctor because he just knuckles down and gets on with things. At the weekend we went Go-Karting and then out for a meal for a 'leaving do' for Dr Firth. Dr Firth was the fastest from the surgery - in 30 minutes he did 54 laps with his best lap being 41.30 seconds, Dr Walsh was second fastest doing 51 laps with a best lap of 43.04 seconds. I was nearly last doing 27 laps with a best lap of 53 seconds. But I do claim that I had the slowest Kart and retired before the end feeling awfully

We are keen to help our patients who smoke, stop. You can access help in a variety of ways and in a variety of settings We are referring a lot of people who want help to stop to our local Health Trainers. They see people in our surgery in a one to one setting to help you to stop. To get access to this service ask at reception, fill in a referral form and they will be in touch. We refer people to the Wakefield District Smoking Cessation Service - they will visit the housebound and are very helpful for people who have previously had failed quit attempts. You can ask at the pharmacist. All the pharmacies in Normanton provide Quit Smoking services and we regularly write prescriptions for some of the medications they recommend. Our practice nursing team will also provide one to one help if you want help quitting. And we are just about to start a new mass mailing to all our patients with long term conditions that are worsened by smoking (heart disease, asthma, COPD , diabetes etc) and

Diclofenac is a non steroidal anti-inflammatory drug (NSAID) that is used to treat arthritis and other painful conditions. But there is increasing evidence that it is not as safe as other NSAIDs. For example in February this year the UK National Prescribing Centre reported on a meta analysis that showed that people taking diclofenac had a four fold increased risk of cardiovascular death compared to people taking naproxen. A meta analysis report pools data from many drug trials and it can be used to analyse lots of data. In this meta analysis there were 116,429 patients who had been involved in 31 trials and had taken NSAIDs for 117,218 years. To read more about this analysis click here . We have started writing to patients and swapping their diclofenac to naproxen. Naproxen is as strong as diclofenac and the only difference is that it is usually taken twice a day instead of three times a day. And for once this drug switch is not due to cost as both drugs cost the same. We are

We are holding 'flu vaccination clinics on three Saturdays in October - the 8th, 15th and 22nd. We recommend 'flu vaccinations to anyone who would be at more risk of the serious complications of 'flu than the general population. This means people over 65, those with a chronic lung or chest condition like asthma or COPD, people who have diabetes and people with heart disease. If you click here you can follow a link to the page on our website where you can download our 'flu information leaflet and consent form. The 'flu vaccination clinics are being held between 8.30 and 12 each Saturday morning. To make an appointment you can either ring our appointments number on 0844 815 1340 option 1 or click here to go direct to our online appointments booking. To book an appointment via the Internet you have to be registered with SystmOne Online - to do this either ask at reception or the next practice member of staff you see for a user name and password. The online flu

I am now a GP Board Member of Wakefield Alliance - the Clinical Commissioning Group responsible for commissioning services for our patients. Just over a week ago I went to a top secret meeting with other board members from Wakefield Alliance and staff from Mid Yorks Hospital Trust. The meeting was to tell the Board about Mid Yorks plans for reshuffling hospital services across Wakefield, Pontefract and Dewsbury. They are only just at the beginning of this project. They need to reshuffle their services because they need to substantially cut their budget over the next two years as well as continue to meet access targets (for patients referred for treatment and patients in A&E) and continue to improve the clinical quality of the services they provide - quite a few plates to juggle and keep in the air at the same time! The meeting I went to outlined some of the criteria against which any changes options would be assessed. Their were a few things that the changes must do. The changes mu

It is the first week in August and it is all change for doctors in training. We are saying goodbye to Dr Mamta Prabhu - she has passed all her exams and needs another 12 months part time training to complete her workplace based assessments to qualify as a GP. She is moving to College Lane Surgery at Ackworth. Dr Azeem Sarfraz has also passed all his exams and has another 3 months with us to complete his workplace based assessments and qualify as a GP. Dr Richard Holborough has passed everything, has got is Certificate of Completed Training and will be joining us full time at Kings Medical Centre from Wednesday 3rd August. We are very pleased he will be staying with us. We have three new doctors joining us; Dr Uzma Aziz for 9 months, Dr Hadiba Mirza for 12 months and Dr Annette Kemshell for 6 months. And not forgetting Dr Katie McGowan who is with us till April next year (I think!) We wish Dr Prabhu 'Bon Voyage' and a very warm welcome to all the new doctors who are joining us.

We are delighted to report that Sister Helen Wright has recently successfully passed a Non Medical Prescribing Course at Leeds Metropolitan University. The course was over 12 months and gives Helen 40 credits towards a masters degree. Passing the course allows Helen to independently prescribe in areas that she is competent to do so. Helens competency areas are family planning, ear care, wounds and dressings, travel advice and respiratory conditions. Helen did not merely pass though, she passed really, really well. She got 100% in her pharmacology exam and 100% in the drug calculation exam. The practice team sends Helen our warmest congratulations. So .... if you are about to go on holiday, need malaria pills, have a painful ear, want a repeat prescription for the contraceptive pill, a check up for your asthma and a blister dressing on your heel - then Sister Helen Wright can deal with it all!

I am delighted to report that last weekend Dr and Mrs Sarfraz had a baby girl. She weighed 7lb 14oz and mum and baby are doing well. They are going to call her Maryam which is an arabic form of Mary. Congratulations!

At the end of August last year I blogged about Stage 2 of the NHS Electronic Prescribing Service. With Stage 2 the practice will be able to send prescriptions electronically to pharmacies that you nominate to get your prescription from. It will save you from having to contact the practice for a repeat prescription and will save the practice loads of time in not having to print our and deal with every single repeat prescription request. My blog about Electronic Prescribing has received the most hits of any of my blogs. When I blogged I said that we would be implementing it by December, 2010 but now as I write this in the second half of the year we are no closer to an implementation date. The practice is keen to be an early adopter for this but our clinical software supplier has not satisfactorily completed tests on their Electronic Prescribing module and we are still waiting ... So, yet again it is watch this space ...!

This is the first blog I have written for nearly three weeks because I have been on annual leave and this is my first day back! Whilst I have been away we have had some really good results about some of the things that can be measured about our performance. We have had the end of year outturn for our prescribing budget. Our prescribing budget for 2010/11 was £1,697,945 and our outturn was £1,931,885. The outturn is only (!) £230,000 above the budget but the good news is that the annual increase in our prescribing has reduced from 10.5% in April 2010 to 2.9% in March 2011. Our budget for 2011/12 is being increased by nearly 16% so if we continue to keep the annual increase in costs down we may end up in budget next year. The other really good news is the publication of the last quarters NHS Patient Survey results. When asked if they could see their doctor within 48 hours, 78% of people said yes and 87% of people were able to make an appointment more than 48 hours in advance. We cont

Our 0844 surgery telephone number is under the spotlight again from the PCT and patients. The 0844 number allows us to use a sophisticated digital telephone system so that patients never get an engaged tone and we can arrange how our staff work so that we have more people answering the phone at peak times. Calls to our 0844 number costs just over 5p per minute from a BT landline. This is less expensive than the standard BT rate to a normal geographic number but will cost patients more than calling a normal geographic number if you have a telephone package that includes free daytime local calls because calls to 0844 numbers are often excluded from the package. Of course calls from mobiles are considerably more expensive. It varies according to your package but I found prices varying from 40p per minute from Orange to 20p on an o2 monthly contract. If you are concerned about the cost of the call to the surgery then do ask our staff to call you back. We will do this and of course we routi

Wakefield District L ocal I nvolvement N etwor k is a new organisation that is bringing together local people, organisations and groups who want to improve health and social care services. The organisation is independent from the NHS and local Councils which will allow it to take a critical look at services they provide. A key part of the governments NHS changes is the involvement of patients at the heart of everything that health and social services do. They plan to do this through an independent consumer champion for the public called HealthWatch. HealthWatch will be representative of various communities and local LINk groups will feed into this. If you have any comments about local health our social care services and would like to get involved in feeding back about these then Wakefield LINk is the place to go. To find out more about them click here to go direct to their website . Of course if you have any comments about the services at Kings Medical Practice then click here to em

No, its not a spelling mistake, we have a new GP trainee with us. Dr Katie (not Kate!) McGowan joined the practice last week. She is working part time and will be with us till she completes her training next year. And Dr Amesa Patel has left us. She got married on Sunday 1st May and has left us and moved to Norwich to be with her new husband. We wish Amesha well in the future and give Kate a warm welcome to the practice

The interim board of our local Commissioning Consortia was announced this week. Wakefield Alliance Consortia will replace Wakefield District PCT for commissioning care for our patients in 2013. There are eight doctors on the board. I have been successful in getting a place on the board together with two other Normanton doctors. The chair person is Dr Phil Earnshaw, he was brought up in Normanton and although his main practice is at Ferrybridge he occasionally does sessions at Park View Surgery on Castleford Road. The other Normanton GP on the board is Dr Paul Dewhirst from Queen Street. Both Dr Earnshaw and Dr Dewhirst were former trainees of Dr Ellis when the practice was at 63 Princess Street. There is lots to do and although I do not agree with all the changes it is the only show in town so it is imperative that GPs with a vision of how we can meet all the challenges put their heads above the parapet and get involved. Dr Joe Firth, who often has a wicked sense of humour, says that I

You may have been watching the Royal Wedding on Friday but I was reading my BMJ and there were a couple of interesting papers about the risks of DVT for women who take the combined contraceptive pill. One of the papers used data from the UK GP Research Database - they had a database of 318,825 women aged between 15 and 44. They found that women taking contraceptive pills containing drospirenole (brand name Yasmin) had nearly a two and half times the risk of having a DVT compared with women taking contraceptive pills containing levonorgestrol (like Microgynon or Logynon ). Of course when you unpick the statistics the numbers are not so scary - the risk of DVT for women taking pills containing levonorgestrol was 9 per 100,000 compared to 23 per 100,000 for women taking pills containing drospirenole - only a very small increase in absolute numeric terms. And the advice to women taking Yasmin who might be concerned is not to stop but to make a routine appointment and come and talk

The surgery is only closed on the statutory 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 hours service. We normally need two working days notice for repeat prescriptions but if you are going to run out over the holidays then let our staff know and we will be able to run it off quicker. Our opening times over the forthcoming holiday period are: Thursday 21 April - 8.00 am - 6.30 pm (and extended access surgery 6.00 pm - 8.00 pm) Good Friday 22 April - closed Easter Saturday 23 April - Extended access surgery 8.00 am - 11.00 am (pre booked only) Easter Sunday 24 April - closed Easter Monday 25 April - closed Tuesday 26 April - 8.00 am - 6.30 pm (and extended access surgery 6.00 pm - 8.00 pm) Wednesday 27 April - 8.00 am - 6.30 pm Thursday 28 April - 8.00 am - 6.30 pm (and extended access surgery 7.00 am - 8.00 am) Royal Wedding Bank Holiday Fr

The practice has had a Patient Participation Group for a number of years. It meets about once every six to eight weeks a year. The group is an opportunity for patients to feedback to the practice about our performance, services we offer and suggestions to how we can improve. The group has made many suggestions to the way we can change and improve things. A list of some of the things that have changed following it being raised by the group include; name of new building, two people on reception, website tweaking, leaflets in the waiting room and many more. But the group would like some new bloods and extends a warm invitation to any patients who might wish to join. If you would like to join or would just like some more information about the group and what it does then contact Christine Sanderson, Practice Managing Partner - either by email click here , or by ringing the practice 0844 815 1340 option 2. Your Surgery Needs YOU!

In the last week we have had more statistics about the practices performance in the last 12 months. About a quarter of practice income is performance related and comes via the Quality and Outcomes Framework (QOF) targets - to read more about QOF click here. Last year the practice achieved 957 out of 1000 points in total. In 2009/10 in the clinical domains we achieved 685 our of 697. This year we have achieved 693.1 out of 694 points in total. Achieving high points in QOF is mainly about making sure that patients with chronic disease are called and recalled for assessment and treatment. Our performance improved this year for two main reasons, firstly we have not had the distractions of moving premises (this was a big influence last year) and we have finally got to grips with how our new (July 2009) computer system codes diseases. The other statistic that has come out is the National GP Patient Survey results. Survey results for Jan-Mar 2011 will feed into our total QOF performance - bu

We had some good news about our prescribing today. Keeping our prescribing costs under control and changing what we prescribe to more cost effective preparations is something that the practice can and does do. Over the last 12 months the practice has, with the help of a Community Pharmacist from Wakefield NHS, done several things to reduce our prescribing and ensure cost effective prescribing Extensively used Script Switch - this is a computer programme linked to our clinical system that suggests more cost effective drugs. I have previously blogged about this. Click here to read how it works Script Switch - in the quarter ending 31/12/10 we accepted 37% of Script Switch suggestions. Stopping prescribing glucosamine - we have reduced our prescribing of glucosamine from £456.26 per 1000 patients to £26.10 per 1000 patients in the quarter ending 31/12/10 Continuing to prescribe low cost PPIs (to stop stomach acid) - 94% of our prescriptions for PPIs in quarter ending 31/12/10 were for l

We had our annual practice basic life support update on our training afternoon on Wednesday. All practice staff attended - doctors, nurses and admin staff and we were all updated and drilled in what to do if a person suddenly collapses in the practice (and indeed outside the surgery as well). We practiced on adults, children's and babies. The trainers had brought a super training vest for dealing with patients who are choking (click here for details) . The procedure is to bend the patient over and give them five back slaps to help relieve the choking, if that does not work you give five abdominal thrusts. The vest has a little gadget on the front that if you do the abdominal thrusts correctly you relieve the obstruction and a polystyrene bung goes floating across the room! Doing it together as a practice teams embeds what you have to do very deeply so that all members of staff know what they have to do, have practiced it and are confident that they can do it. Of course the resuscit

The practice provides a full travel advice service to our registered patients including travel vaccinations, travel health advice, 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 things 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 and Rabies vaccinations. You will also have to pay for malaria prophylaxis but the practice doesnot charge if you need a private prescription for malaria prophylaxis. The practice is a registered Yellow Fever Vaccination centre. We are able to provide just Yellow Fever vaccinations and advice to patients who are not registered with the practice. Our travel advice service is run by our nursing team and they would like patients to fill in a Pre Travel Questionnaire before you attend

At our regular Wednesday practice education meeting last week we met our local NHS Health Trainers and they told us about the new 'Get Active! Exercise on Prescription Scheme'. This is a scheme whereby health professionals (doctors and nurses) can refer patients to a local leisure centre for an individualised exercise programme. Suitable patients include patients with asthma, high blood pressure, depression, COPD and many more conditions. Thirty minutes of moderate exercise, five time a week, reduces you blood pressure, risk of heart disease, weight and stress levels. The scheme is a joint initiative between NHS Wakefield District and Wakefield Council and it is funded until December 2012. If you are referred into instructed exercise the costs of each session is £2.60. However, you may be able to access other options that are lower cost or free. All the doctors and nurses in the practice have referral forms so if you think that exercise might help your health then just ask!

Last weekend the new A&E at Pinderfields has opened and if you have an accident or emergency this is the place to go. Other services that have also moved into the new Pinderfields Hospital include maternity care, children's ward and the Acute Assessment Unit. For an up to date list of services that have moved click here. The other thing that has changed is phone numbers of wards and departments. The new hospital has numbers that begin 54XXXX rather than the 21XXXX from the old hospital. To get a complete list of telephone numbers click here. And of course please remember that A&E is for Accidents and Emergencies. If you are thinking of going to A&E because you can't get an appointment in the surgery then tell us...

I have been really good and careful since starting writing this blog to keep everything reasonable and in moderation but sometimes we receive letters that just beggar belief. We received such a letter last week and I can no longer contain my frustration .... So if you don't want to read a rant click delete now! RANT ON As I am sure you are aware our local Acute Trust is moving into the brand new Pinderfields Hospital during February and March with the bulk of the move happening this weekend (25th to 28th February). Last week we received a letter from Wakefield PCT telling us that the hospital has been coping with high demand since before Christmas (we had noticed because we keep getting faxes about the hospital being on RED alert and when we do try and get a patient admitted they have no beds and we are told to send them to A&E) and asking us to do the following actions to help 'suppress' demand (sounds like they are a dictatorship talking about a democratic uprising!).

Our local Accident and Emergency departments at Pinderfields and Pontefract say that are struggling to cope with increasing numbers of patients. They are particularly concerned at the moment because they are about to move into the new hospital at Pinderfields and are concerned that with a recent rise in the number of attendances they will not be able to cope with the move AND provide a safe service. One of the issues that they say is increasing their demand is the number of patients they are seeing who say they cannot get an appointment with their GP. They are particularly concerned about the number of children who are attending between 5.00 pm and 7.00 pm who they think should have been seen by their GP. The practice does lots of things to unsure that we have enough appointment slots for patients who either need to be seen or think they need to be seen on the same day. We have an on-call doctor who does a lunchtime surgery that is not booked until the morning and the on-call doctors a

Novus Health has started doing vasectomies at Kings Medical Centre. Novus Health is a company set up by local GPs and Hospital Consultants to provide excellent healthcare close to where our patient live with the clear aim of developing and strengthening relationships with Pinderfields and Pontefract. Pinderfields and Pontefract have stopped offering vasectomies and the only way patients can get vasectomies now is to be referred on the NHS to the independent sector. This has in the past usually required travelling away from the local area but with Novus now starting to do vasectomies in Normanton it is much more local and convenient. The vasectomies are undertaken by consultant urologists who did vasectomies at Pinderfields and Pontefract but now will be doing them at Kings Medical Centre on Saturday mornings instead. I can reassure prospective patients that the pile of bricks in our car park has nothing to do with the operation at all ....

The practice is an approved GP Training practice and we have doctors undertaking specialist GP training with us for six or twelve months and sometimes longer. This week two of our doctors have successfully completed their training and going to 'fly the nest'. Dr Aditya Narkar have been with us for 18 months. He is currently on holiday in China - we keep getting regular updates about his progress and experience - and when he returns he is going to do some locuming and shifts for NHS Direct. We have got to know Aditya very well and we wish him all the best in his future career. The other doctor leaving us is Major Doctor Tom Clack. Tom is in the Army and joined us in March last year to complete his GP training and get signed off with all the exams our trainees have to do to get certified to work as a GP. Tom is going back to Colchester to join the parachute regiment. He is likely to be deployed to Afghanistan in the next 18 months - so we not only wish Tom all the best but we als

Last week the government announced sweeping reforms to the NHS which will place GPs in the driving seat of commissioning care for our patients. Commissioning is the process whereby the NHS agrees with hospitals what services they are going to provide and how much they are going to pay for them. Currently this is all done by Primary Care Trusts with very little involvement of the GPs . With the new reforms all GPs will be in consortium that will undertake this commissioning role. We are part of the Wakefield Alliance Consortium that has GP practices in Normanton , Wakefield, Castleford and Pontefract . I believe that in order for the NHS to continue to improve and meet the challenges of increasing demand from an aging population and increasing cost pressure the NHS needs to become more efficient. Increasing cost pressures is because we are able to do more due to advances in medical technology and drugs - we need to do more for less. Currently I see lots of inefficiencies in the

I went on a tour around the New Pinderfields hospital last week. I was part of a group of GPs who were shown around by the New Hospital Development Manager. We were shown A&E, Intensive Care, Theatres and Recovery and a typical ward. It was very impressive. Pinderfields needs to become more efficient to afford the new hospital and it was easy to see how the new hospital will be more efficient. One block of operating theatres instead of four, a large recovery ward instead of four small recovery wards, very close access to surgical wards and much easier communication between core parts of the hospital. The Emergency Department was particularly impressive - lots more clinical space, separation of adults and childrens and close integration with both adult assessment beds and paediatric assessment beds. So overall I was most impressed. But, and there always was going to be a but ... the new hospital at Pinderfields has 708 beds and at Pontefract there will be 66 beds = 774 beds in total

There seems to have been a bit of panic in the news this week about 'flu vaccination and we have certainly had a few telephone calls from people wanting a 'flu jab, but is it just media hype or is there anything more substantial to the panic we have seen in the news. I have looked at how we are doing with 'flu jabs this year and so far we have given 1,905 - that's a huge number, just under a fifth of our practice population. Our computer system lets us easily check on 'at-risk' groups and 87.5% of our patients on our heart disease register have had a 'flu jab, 87% of patients with COPD and 84.2% of patients with diabetes have had a 'flu jab. We have a target to vaccinate 90% of patients in 'at-risk' groups, so we are well on our way to meeting our target. Another expressed concern is that surgeries have run out of vaccine. We currently have 300 doses left - 150 of these have been reserved (usually for patients who were ill when they were due a ja