Share review of Wawn Street Surgery

Thank you for your comments. We are very sorry that the practice did not met your expectations of the service. As a practice we take feedback on our service very seriously. An access review commissioned by the Kings Fund identified the level of staffing required for our Reception Services, and our structure reflects this finding, however, sadly we have experienced on-going difficulty in recruiting into these vacancies. We are very aware of how difficult it is to get appointments at the surgery and we regularly receive comments from our patients suggesting that the practice goes back to how it was run 20 years ago, where you ring up, get through straight away and don’t have to wait 4 weeks for an appointment. We deeply regret that we are not able to offer the service that we were 20 years ago. Our doctors, nurses and other staff share your frustration but we would like to reassure you that long waiting times do not reflect a lack of effectiveness in terms of how the practice is run. There are many contributory factors and we hope that this letter will provide some insight into the challenges we face. We are aware that the appointment situation 20 years ago was far better than it is now, for patients, doctors and staff alike. However, the NHS of today bears little resemblance to what it was then. We have far more available appointments now than we did then and each doctor has more appointments per day than we did then. The average member of the public now sees their GP 6 times a year and this is double what it was a decade ago. There has been a massive change in culture over the last 20 years and GP surgeries now treat many long term conditions that in the 1990s were treated in hospital. Older people often have complex health issues that require more appointments and South Tyneside’s elderly population is growing rapidly. The administration and bureaucracy surrounding our work has spiralled. Both doctors and nurses have to go through revalidation every few years in order to prove that they are still fit to practice. This is good in many ways, but it takes them away from seeing patients. In particular the new GP practice inspection regime under the CQC (Care Quality Commission) causes practices massive amounts of workload. Again whilst it may have some benefits, it takes many hours of doctor and nurse time away from their clinical work seeing patients. It is also a huge burden on our administration staff. There has been frequent reorganisation of the NHS and every time this happens, it creates changes in the way we work. These changes invariably take doctors and nurses away from patient care and it is becoming increasingly difficult to recruit staff, and in particular GPs. This is very much a national problem which sees practices repeatedly advertising for new GPs with the norm very much to have no applicants at all. The training scheme for new GPs which is compulsory to do 3 years of GP specialist training after fully qualifying as a doctor and to pass an exam, is now regularly not filled. Funding cuts mean that GPs are under great pressure to reduce prescribing costs, and to reduce the number of patients they refer to hospitals for specialist opinions, or admit to hospital as emergencies. Whilst many of these cost savings are reasonable in a cash-strapped NHS, they take a lot of extra time for GPs and often lead to patients feeling they have not got what they needed. Over the last decade there has been a large change in public expectations of what the NHS should offer. This is because of increased public awareness of many diseases, and in particular national advertising campaigns encouraging people who have any concerns to see their GP. We want to help our patients actively manage their own health but doing so requires a substantial amount of time. We are looking to recruit an advanced nurse practitioner, who can see and treat many of our patients who have urgent same day needs and we are also looking to engage the service of a pharmacist, who will help support the GPs and Nurses with much of the workload that surrounds prescribing and repeat prescriptions, as well as trying to ensure that patients who are discharged from hospital get the right medicines at the right times. If GPs spend less time seeing patients for repeat prescriptions, they will we have more time to see other patients. Our local MP’s are very aware of the pressures that General Practice is facing and we would encourage patients to make contact direct to ask MP’s to press the Secretary of State for Health to increase the proportion of NHS spending. We would like to reassure you that we are committed to high quality patient care and that we are doing everything within our power to address waiting times for our patients. We continue to welcome all feedback so please don’t hesitate to contact the surgery with comments, compliments or suggestions. If you would like to support the surgery in its determination to improve services for patients please consider joining the Patient Participation Group.