Cerne Abbas Surgery

Cerne Abbas surgery has held an outreach GP clinic at Hazelbury Bryan Village Hall for many years but for several reasons, the surgery felt that the service was no longer sustainable. Following discussion with Dorset CCG to ensure contract compliance, the following information was provided to surgery patients early in August 2018 via the following media:

• displayed at our main surgery and at the HB village Hall
• given to patients who attend the outreach service between August and October 2018

• shared with PPG members

• put in medication bags for rural patients in that area for a month from 10/08/18

• sent to PPG members with covering email

• sent to local PoPPs reps for information

• on our website

• in parish magazines.

The surgery has received five individual responses to the proposals plus comments from the Village Hall Committee, which have been responded to by the Business Manager by means of covering letter and this report.

Hazelbury Bryan Village Hall Committee initially sought clarification of the reasons behind the proposal, specifically infection control. Every effort was made to clarify that there was no issue with the cleanliness of the hall, more that as it was not a clinical environment it does not meet the strict guidelines for healthcare and therefore it is the risk of infection that is the issue rather than criticising the cleanliness of the hall. In addition, confirmation was provided on the date of the final clinic as well as our intentions regarding the phone and broadband which were contracted by Dorset CCG and therefore outside of the surgery’s control.

The surgery reiterated that it is likely to continue holding an annual flu clinic at the hall in future years and therefore would make ad hoc bookings for this and also thanked the Village Hall Committee for their support over the years. In addition patients in Hazelbury Bryan would, as for all other patients, be provided with appropriate home visits and be able to access the medication delivery service.

Individual patients’ responses are identified below:

“Having learned that a number of surgeries in the area are closing I salute your endeavours to keep things going with reduced doctors and still providing a service that most people can only dream of.”

“As member of the PPG and a Hazelbury Bryan resident I am sure there will be a great deal of disappointment in the village at the closure of this service, no matter how justified the reasons.”

“Outreach patients know that the facilities are not perfect and that physical or confidential appointments might not be possible.  They make this decision knowingly when they book through your surgery. For those who are elderly, with urgent care needs or for those who don’t regularly attend a surgery, the Hazelbury Doctor service is invaluable – it meets their requirements and provides a vital tool that outweighs any quality concern. “

“Is there any chance of re-instating the visit by a nurse which could well go some way to reducing the impact for your more vulnerable patients?”

“I do think it would be a negative move to close the Hazelbury service which provides an extremely important service, particularly to the elderly and for those with young children.”

“I am very sad to know that this clinic will not be running after November.”

“We shall be sorry to see the service axed but understand that unless well used by the community it becomes a luxury for the few and not economically viable for the providers. It has been appreciated and will be missed.”

In response to the comments above the surgery has stated that: 

If the Care Quality Commission (CQC) inspected the village hall the outcome would impact on the whole surgery not just the outreach service, because it is not a registered ‘branch’, the main issues being around the unsuitability of the village hall to deliver medical services, specifically as the infection control risks are high, as is the risk of lack of confidentiality. An alternative venue of the cricket club has been suggested, but again this is not a specifically clinical environment and therefore is not suitable.

 Although the surgery will be able to make better use of GP time that on its own has not been the deciding factor: although there will be some small financial benefits, it was about the quality of care we can (and are required to) provide.

Replacing a GP with a nurse for this session would not overcome the infection control, confidentiality and I.T. issues that exist. The surgery is also concerned about the risk of lone working for all its staff.

From November we will deliver an additional GP session at the main surgery instead on Wednesday morning and free up the health care assistant that was allocated to the HB session to do home visits. The huge advantage of having our Integrated Nurse Team (INT) means that we have the flexibility to support patients in the surgery or at home without having to handover to another team, therefore there should be no issues with more vulnerable patients accessing the services.

There are the local patient transport schemes that can help patients get to the surgery: although our staff don’t manage these schemes, they can provide contact details for patients to arrange transport.

In conclusion, the partners of Cerne Abbas Surgery have agreed that following this period of engagement, the Hazelbury Bryan outreach clinic will cease. The final GP clinic will be held at the village hall on 24^th October, with a flu clinic being held the following week on 31^st October 2018.

The partners would like to thank all of the patients for their continued support to the surgery.

Gillian Brindle

Practice Business Manager  

The 2018 FLU CLINICS will be on:

TUESDAY 16th OCTOBER 2018 at CERNE ABBAS VILLAGE HALL between 9.30am-1pm

WEDNESDAY 31st OCTOBER 2018 at HAZELBURY BRYAN VILLAGE HALL between 9.30 – 11am

TUESDAY 6th NOVEMBER 2018 at WIGHTMANS ORCHARD, PIDDLETRENTHIDE between 10 -11am

We will also be offering a clinic at Cerne Abbas Surgery for workers and children. These appointments need to be booked in advance by speaking to a member of the reception team. The appointments are available between 5 – 6.30pm on Monday 22nd October 2018.

Are you:

Pregnant?
Aged 65 or over?
A person with diabetes?
A person with a BMI >40?
Or do you suffer from a long-term condition of the:

Lungs, e.g. asthma or COPD?
Heart?
Brain or nervous system?
Kidneys?
Liver?
Immune System?
Spleen?
If so, The Department of Health recommends that you have a flu vaccination.

Dementia Workshop

A free 7 week course provided by the NHS for family and friends of people with Dementia, that aims to provide an opportunity, to gain knowledge, skills and support that will help in this role.   

Week 1.      Course welcome and introduction.   Understanding diagnosis, what is

Dementia?

This initial session will set the scene for the course. We will identify the differences between the common types of dementia as well as any other types participants may wish to know more about. We will provide an overview of some of the functions of the brain that can be affected by dementia and how this will affect a person’s ability to manage everyday tasks.  

 Week 2.       Unusual behaviour and wellbeing.

 In this and the following session we will discuss types of behaviour participants have observed in the person they care for and consider possible causes and helpful responses, medication and gadgets. We will also consider the impact of common physical health problems on people with dementia.

Week 3.        Unusual behaviour and wellbeing.

Continued from previous week.

Week 4.        As Dementia advances: changes and care.

 In this session we will consider the effects of dementia as it progresses.   Discussions will include personal care, incontinence, and changes in mobility, Advanced Directives and care.

Week 5.        Caring for someone with Dementia: It can’t be that difficult, can it?

This session will explore the reasons why carers are at increased risk of depression and anxiety. We will discuss how to recognise symptoms in yourself and raise awareness about how to help yourself.

Session 6.    Looking after yourself.  Where to get help.

This session will focus on enabling you to find practical help which will allow you to better care for yourself as well as the person you care for. For example, we will explore ways to get a break, grants and support.

Session 7.    Contingency planning:  Expecting the unexpected.

In this final session we will identify what might constitute a crisis for you and the person you care for. We will look ways to minimise this and consider any obstacles that might prevent you from accessing help. We will also outline what help is available if a crisis is unavoidable. 

Please note that this course is not suitable for the person with dementia to attend

Cerne Abbas Surgery: Hazelbury Bryan Outreach Clinic

As some of you will be aware, we have for many years run an outreach GP clinic at the village hall in Hazelbury Bryan. This has operated as a ‘sit and wait’ session, sometimes well attended but often with only a handful of patients.

We are now in a position where the demands on general practice have increased, developments within healthcare have continued apace, and we have struggled to offer the same level of service at Hazelbury Bryan as we do in the main surgery; for example:

• IT issues exist meaning the GP cannot reliably access your medical record, making consultations difficult and meaning duplicating work when they return to the surgery.
• The open room used in the village hall means physical examination is very restricted and equipment is limited to what the GP can bring on the day. In addition, confidentiality could be compromised as other patients could over-hear consultations whilst they are taking place.
• Infection control is very important in all healthcare settings and the village hall is not set up as a surgery and so does not reach the standards we are required to adopt by the Care Quality Commission when looking after patents.
• Finally, we need to get best value from our resources and I’m sure you would all recognise that more patients could be seen by the GP in the time they are currently spending driving to and from Cerne Abbas.

Given the information outlined above, we are now asking for responses to our intention to close the Hazelbury Bryan outreach clinic in November 2018, with the last session, including the flu clinic being held on 31^st October 2108.

Note that delivery of medication, appropriate home visits and flu clinics will continue, and that patient transport is available through local groups to get you to Cerne Abbas surgery should you require this.

If you would like to comment or raise any issues regarding this proposal, please email [email protected] or write to:

The Practice Manager

Cerne Abbas Surgery

51 Long Street

Cerne Abbas

Dorset

DT2 7JG

Sometimes you may have investigations that have been arranged by hospital consultants. The results from these tests do not automatically get forwarded onto the surgery.

If you want to know the result of a test you have had under the care of a consultant please phone the hospital and ask to speak to your consultant’s secretary.

We are required to provide you with a Privacy Notice by Law. It explains how we use the personal and healthcare information we collect, store and hold about you.

We understand how important it is to keep your personal information safe and secure and we take this very seriously. We have taken steps to make sure your personal information is looked after in the best possible way and we review this regularly.

If you would like to read our Privacy Notice in full, this is available here or paper copies are available from reception.

If you are unclear about how we process or use your personal and healthcare information, or you have any questions about this Privacy Notice or any other issue regarding your personal and healthcare information, then please contact our Data Protection Officer.

Staywell Dorset – Helping you keep well throughout the year

The 2018 FLU CLINICS will be on:

TUESDAY 16th OCTOBER 2018 at CERNE ABBAS VILLAGE HALL between 9.30am-1pm

WEDNESDAY 31st OCTOBER 2018 at HAZELBURY BRYAN VILLAGE HALL between 9.30 – 11am

TUESDAY 6th NOVEMBER 2018 at WIGHTMANS ORCHARD, PIDDLETRENTHIDE between 10 -11am

We will also be offering a clinic at Cerne Abbas Surgery for workers and children. These appointments need to be booked in advance by speaking to a member of the reception team. The appointments are available between 5 – 6.30pm on Monday 22nd October 2018.

Are you:

• Pregnant?
• Aged 65 or over?
• A person with diabetes?
• A person with a BMI >40?

Or do you suffer from a long-term condition of the:

• Lungs, e.g. asthma or COPD?
• Heart?
• Brain or nervous system?
• Kidneys?
• Liver?
• Immune System?
• Spleen?

If so, The Department of Health recommends that you have a flu vaccination.