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PARTNERSHIP for HEALTH Davenport House Surgery & Patient Participation Group

The Joint Quarterly Newsletter www.davenporthouseppg.org.uk

Issue No 41 December 2008 www.davenportsurgery.demon.co.uk

THE BEST POSSIBLE £10 INVESTMENT IN YOUR HEALTH?

It is a great pleasure for us to share the front page of this special edition of our PPG Newsletter, which is being distributed to every family in the Practice for the first time on a trial basis. It is a particular pleasure because the Patient Group and the Practice have worked hard as a team to put patient care and wellbeing at the centre of our activities, where we believe in effective

communication as a great way to improve that quality of care.

With a membership of just under one thousand families, or about 20% of the Practice, Davenport House PPG is considered to be one of the most successful patient groups in the country. Every member receives four copies of the Newsletter each year, and an opportunity to take part in a lively programme of talks and discussions which cover every aspect of health care. The

programme for 2009 can be found on the back page.

Members can also help shape future development of the Practice with the PPG recently contributing to decisions on the appointment system, helping to select a new Partner, liaising with the Practice Manager and meeting regularly with the Partnership to discuss Practice matters in general. This provides a very helpful and useful input from the patients‟ perspective. At our AGM on Monday 2

February 2009 all the Practice partners will form an „Any Health Care Questions?‟ panel to field questions from the members. At a time of bewildering change in the NHS and an imminent phase of major development of the facilities at Davenport House this should be a real opportunity for members to get involved.

If, when you have read this newsletter, you would like to receive the full complement of four editions each year, do complete the enclosed membership form and return it to Davenport House. Our aim is to raise our membership to the level where we can achieve an even more effective level of partnership in improving patient care and deliver an increasingly varied programme of educational activities to a wider cross section of Practice patients. Existing members will receive their invitation to renew their subscription under a separate cover, so please continue to support us.

We look forward to meeting members old and new at our AGM and Question Time on Monday 2 February, which we anticipate will be a most lively and rewarding session. It will also be an ideal occasion for non members to

consider joining the PPG.

Dr Alan Stranders, Senior Partner

Appointment System 2

The NHS Maze 3

The Partners 4

Andrew Chafer feature 5

PPG Meeting Reports 6

Behind the Scenes 7

Contacts & Calendar 8

Inside this issue:

PPG COMMITTEE MEMBER CONTACT DETAILS

Chair Roger Gedye 832374 roger.gedye@homecall.co.uk

Secretary Rosemary Horne 762620 rmh.harpenden@tiscali.co.uk

Treasurer Ian Drew 460597 drew1@hotmail.com

Membership Helen Hartley 767462 ahhartley@talk21.com

Newsletter John Harris 713246 j_harris@tiscali.co.uk

Education Tom Love 766242 tomlove@btinternet.com

PCT Liaison Malcolm Rainbow 762590 malcolmrainbow@btinternet.com

Recruitment Pam Morris 620306 pamelamorris@amserve.com

Education Sheila Uppington 764230 suppington@hotmail.com

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Appointment provision and access to General Practice has long been a subject of controversy, both in local circles with patients and primary care teams and also nationally and in the media.

Over the years, and particularly since the introduction of the new GP contract in 2004, the Government have imposed legislation to ensure that access is improved.

This primarily has centred around provision of access within 24 and 48 hours of patient need, and introduced the idea of “Advanced Access”. In the true form of this idea there are no pre-bookable appointments and patients phone on the day of need to see a doctor. But this has limitations. It limits availability to a patient‟s GP of choice, and prejudices against those who

have acute medical problems rather than chronic ones. In addition, questions have been raised as to whether this method may compromise continuity of care.

So what have we done about it?

Many practices, including Davenport House, have tried to maintain equality in care provision by offering both pre-bookable appointments and advanced access ones. Recognising this need, particularly with our more elderly population and those with chronic disease, in November 2007, we increased the proportion of pre-bookables to 50% of all doctor appointments.

Other methods adopted at Davenport House to improve access and availability of primary care services have included introduction of web prescription requests in 2005, introduction of touch screen check in funded by the PPG in March 2007, employment of a health care assistant in early 2008 to offer blood pressure check and ECG appointments, thus freeing

more nurse appointments and the introduction of Early Bird surgeries from 7-8am from mid 2008

What‟s on the way?

Telephone access to the Surgery has long been an issue highlighted by patients and the PPG. We currently provide five receptionist manned phone lines for appointment services plus enquiry and prescription lines. This exceeds provision at some other local surgeries. However, our current telephone system limits our capacity to take a greater volume of calls.

In November 2008, we commenced an extensive and costly upgrade to the telephone system which should exhibit

significant improvements for callers. This is to be closely followed by the introduction of a system called “Patient Partner”. This system will permit booking and cancelling of appointments via use of a touch tone telephone using an automated service. It will permit booking of appointments outside of Surgery hours, i.e. evenings and weekends. We will release a proportion of our total appointments, including nursing ones to be booked in this manner so as not to prejudice against those wishing to call or walk in as emergencies.

What else are we looking at?

Since 2006, we have been actively chasing software to permit web appointment booking. However, despite its early promises, a number of problems were highlighted in the early stages of its testing. As a result, we are still waiting for the go ahead with this service but hope to take it on once it is available.

Save our Surgery

As you may be aware due to current Government enforced changes to primary care provision, such as the introduction of Polyclinics by Lord Darzi, the future of general practice as we know it is being threatened. Practices such as Davenport House could in time be forced to close. As a result of this patients nationwide have started a “Save our Surgeries” campaign involving petitions to Government. You may have seen these in our Surgery. The current petition is available for signing until January 2009, and you can access the campaign at the

following web address: www.saveoursurgeries.co.uk

Appointments and Access at Davenport House

By Dr Sneha Wadhwani MBChB DCH DRCOG DFFP MRCGP

TELEPHONE

APPOINTMENT BOOKING

AVAILABLE

Easy to use 01582 767821

WEB BOOKING COMING SOON

WHAT IS HAPPENING BEYOND THE PRACTICE?

by Malcolm Rainbow

Following two meetings, a group is being set up to represent patients/users of health and social care services to work particularly with the Practice Based Commissioners for St Albans and Harpenden. We are recruiting individual and organisation members. Both Roger and I have joined as individual members and the PPG has been joined as an organisation. There is a £10 joining fee to meet setting up costs particularly for the website which, with emails, will be the main means of communication. More de-tail to follow in the next Newsletter but if interested now please contact me.

The Primary Care Trust is in a good financial position. The next major proposal is likely to be on the whole aspects of intermedi-ate care from the provision of wards at St Albans right down to social care at home. It is good to see that the NHS and Adult Care Services will be working together on this. We might at last get some proper joined up thinking.

The L & D experienced a severe outbreak of a special form of E coli in the Baby Unit, with tragic consequences. The outbreak has been contained. On a more happy note, the L and D are to re-advertise the vacant Patient Governor post for Herts and

Beds and our John Harris is willing to stand so I urge you all to support him when the voting comes round.

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The NHS MAZE

Dr Charli Barber-Lomax starts a series of articles to guide patients around the

fast changing NHS

I have been asked to explain how the NHS and all its associated acronyms work in providing us all with the care we need to keep us as well as possible. In reality, however, more care goes on outside the NHS and without the help of doctors and nurses than within it. We treat the majority of illness ourselves – perhaps with the help of other family members and neighbours, and certainly with the help of our local pharmacist – and it‟s only when our efforts fail that we cart ourselves off to the GP. Coughs and colds, rheumatism and lumbago, black eyes and sticky eyes, indigestion and heart burn, constipation and wind – on and on the list goes. (Remarkably the Welsh Assembly apparently hadn‟t budgeted for the fact that when all prescriptions became free for Welsh patients, the drug bill would immediately increase by 10% with people visiting their GP for things they had previously managed themselves!)

But once our domestic measures fail then it‟s to the GP or other stations within Primary Care that we go. These agencies – GP surgeries, dental surgeries, opticians etc are all contracted to the Primary Care Trusts whose job it is to commission primary care from the GPs, and secondary care from the hospitals and mental health care units. In addition, the PCTs commission the services of the Ambulance Trust to provide the emergency response to calls for help and transporting patients to the necessary hospitals. There are 152 PCTs overseeing 29,000 GPs and 18,000 NHS dentists, and controlling 80% of the NHS funds.

Now, for the past three years the Department of Health has wanted GPs to be more involved in those commissioning decisions. They therefore „invited‟ practices to form Practice Based Commissioning (PBC) groups which might gradually take over commissioning responsibilities from the PCTs. In our patch, all the local practices agreed to form one PBC group – STAHCOM. We were already providing out-of-hours care together and it seemed sensible to keep together to form a large group which might therefore have more influence

and opportunity to shape things. One of our first innovations was the commissioning of the CATS - Clinical Assessment and Treatment Services.

These are similar to Out Patient services in the local hospital, but the GPs have invited consultants to come to specific surgeries to provide the service closer to the patients: dermatology (Davenport), urology and also ENT (The Elms), gynaecology (London Colney), cardiology and musculo-skeletal (St Albans). The practices cover the overheads and the costs to the NHS are reduced and, more importantly, the waiting time to get a second opinion is much shorter.

To look at the organisation from another perspective, we have Parliament at the top of the pile, with the Secretary of State for Health in charge and then the civil servants cascading

downwards. You can see that there are Strategic Health Authorities supervising the PCTs and Trusts. However if a Trust (the Luton & Dunstable Hospital is a good example) demonstrates both efficiency and financial responsibility (i.e it lives within its means) it may apply for Foundation Trust status, which allows it much greater independence from the constraints of the SHA and DoH.

So, there you have it; another reorganisation. To be honest, running the NHS must be an impossible task. Nye Bevan (who, by the way, continued to access private health care after 1948!) thought that as the major diseases of the day – TB, polio, chronic bronchitis and the like - were conquered, the costs of the NHS would decrease, not realising that with increasing standards of living came increasing expectations of health. Each decade sees magnificent change: hip replacements, heart transplants, dialysis, cataract extractions, knee replacements, cancer care, ITUs CCUs and AAUs. The list is endless and the costs ever rising. So of course there are economy drives and rationing exercises, and new initiatives to try and use the limited funds to best effect, but as they say – you can please some of the world all of the time ……

And if I have helped you to understand the organisation then I have accomplished my commission. But I fear I may have sent many of you off to sleep which, come to think of it, might reduce our drugs bill a little so that can‟t be a bad thing either! Thank you for bearing with me.

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DAVENPORT HOUSE SURGERY – THE PARTNERS

These are the partners at Davenport House. Periodically a full profile of a

doctor will be featured which in this edition is Dr Andrew Chafer

Dr Alan Stranders

Senior Partner of the Practice and since turning 60 last year works part-time. He specialises in blood disorders (haematology) with a particular interest in the medicine of older people and prostate disorders.

Dr Charli Barber-Lomax

(Full profile – Newsletter March 2008)

Charli works „full time‟ for the Practice, including being a GP trainer. As with other partners he is a keen supporter of Herts Urgent Care, the “out of hours” service.

Dr Alka Cashyap

Specialities include the health of children and women, being experienced in all aspects of women's health but especially in the menopause and in family planning. She also does basic acupuncture and is fully involved in extensive teaching within the Surgery.

Dr Andrew Chafer

(See the full profile opposite)

Dr Kirsten Lamb

Special interests include child health and child development being a specialist advisor for the PCT in safeguarding children. She regularly acts as an examiner for the Royal College of Paediatricians.

Dr Mark Sandler

He has particular interests in diabetes, smoking cessation and cardiology. He examines class 1 and class 2 pilots for the CAA as a JAA approved Aviation Medical Examiner.

Dr Chas Thenuwara

He has a special interest in dermatology. Is currently the practice lead for Diabetes, smoking cessation and obesity . Is interested in research studies and clinical trials.

Dr Sneha Wadhwani

She has an interest in women‟s health undertaking an Urogynaecology Clinic for women with incontinence or bladder problems at Hemel Hempstead & St Albans City Hospital one morning per week. She is the partner responsible for appointments and advanced access (see article on page 2), working closely

Doctors Availability and Current Timetable

Monday Tuesday Wednesday Thursday Friday

am pm am pm am pm am pm am pm

Dr. Alan Stranders No Yes Yes Yes Yes* No No Yes No No

Dr. Charli Barber-Lomax Yes Yes Yes Yes Varies* No Yes Yes Yes Yes

Dr. Andrew Chafer Yes Yes No Yes Varies Yes Yes* No No Yes

Dr. Alka Cashyap Yes No No No Varies Yes Yes Yes Yes No

Dr. Kirsten Lamb Yes No Yes No Varies Yes No Yes Yes No

Dr. Mark Sandler Yes Yes Yes* Yes No No Yes Yes Varies Varies

Dr. Chas Thenuwara Yes Yes Yes Yes Yes Yes Yes* No Yes Yes

Dr. Sneha Wadhwani Yes Yes Yes* No No Yes Yes Yes Yes Yes

* or * indicates an Early Bird Surgery which runs from 7am-9.40am.

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A DAY IN THE BUSY LIFE OF

DR ANDREW CHAFER

I have been a GP in Harpenden for nearly twenty-three years

now and I still don‟t know what a typical day is! Whilst some

things have stayed the same over this time others have

changed dramatically. Certainly the way medicine is practised

and delivered has become unrecognisable since I started out in

general practice in the mid 1980s. Some of this has been good

– others less so.

Specialism in Gastroenterology

The major part of my work still revolves around care of patients

at the Practice although I have maintained some of my original

hospital training in Medicine and Gastroenterology by spending

two half days per week at the Luton and Dunstable Hospital

where I see patients with digestive disorders in both an

outpatient clinic and in the endoscopy unit. It is here where I

work with a team of nurses to examine the inside of the

gastrointestinal tract using various types of flexible fibre-optic

telescopes to help diagnose conditions such as ulcers, polyps

and sadly sometimes very much more serious conditions. Each

clinic I will see about twenty patients along with the consultant

who sees a similar number. I estimate that I have performed

one or other types of investigations on between 200 -300

patients registered at Davenport House over the years, some

more than once!

Doctor Training

One area that has rapidly changed is the supervision and

training of young doctors, whether they are ultimately going on

into hospital careers or into general practice after a period of

apprenticeship, where they must now demonstrate a whole

range of competencies through assessment and examinations.

The number has increased from one to up to six doctors at any

time, some at more senior stages of their training than others.

This means that increasing time is needed to spend monitoring

and assessing them, including taking part with three other

trainers in the Practice in regular educational meetings which

are vital in planning and organising their education and

experiences.

The pressure to maintain time with our patients means that the

day often has to start earlier than it did, with meetings starting at

7:30am before Surgery sessions start. Tutorials have to be

arranged and organised, though I no longer have to do this

alone. Instead of having every Wednesday morning being

associated with teaching I now share this obligation with the

other trainers so most Wednesday mornings are now available

for me to consult with patients. Nevertheless I estimate that I

spend at least 3 or 4 hours a week on educational preparation

and commitment, though this is mostly outside normal Surgery

time.

“Early Bird” Surgeries

Once a week I start at 7:00am with what are now called „Early

Bird‟ Surgeries, a name chosen to replace the old „commuter‟

clinic, since many more „non-commuters‟ are using them. A joy

in summer, but I suspect like many, less so during winter

months when you go and come back to work in the dark. Often I

go on to doing minor surgery upstairs in the treatment room.

Whilst not quite ‟brain surgery‟ quite a lot of minor problems

including, the removing of moles, cysts and toenails, can be

dealt with very much more cheaply avoiding longer waits to

have these performed at hospital.

“Out of Hours” Service

Whilst the new doctors‟ contract brought in 2004 removed the

obligation for GPs to work out of hours I have continued to work

within the local out of hours service, formerly known as

STARDOC (St Albans & Region Doctors) now Hertfordshire

Urgent Care. Sessions are often held within the Minor Injuries

Unit at St Albans City Hospital but also at Welwyn Garden City,

Hemel Hempstead and more recently even Watford. Therefore

most weekends involve working a session as well as one

evening a month. I also continue an overnight shift, again

usually at a weekend, so I can consult normally during the

week. This „Red-eye‟ shift is always tiring and busy but out of

hours sessions help to maintain my acute medical skills and

knowledge as well as allowing me to teach the doctors in

training and help them gain these experiences. I still enjoy this

and think it is important for older „grey haired‟ doctors to treat

patients rather than leave most of out of hours care to younger,

less experienced, doctors as in so many areas in the country.

As I get even older I may of course have to reassess this!

Normal GP Duties

Yet the main part of my work entails seeing patients at the

Surgery with often a widely diverse and varied number of

problems. Patients are more involved and interested in their

health and knowledgeable about illnesses and services which,

whilst being excellent, is also more demanding. Constantly

keeping up to date and keeping abreast of new innovations and

approaches is stimulating yet challenging to me. Like most

doctors, keeping up-to-date requires us to spend increasing

amounts of personal time achieving this whilst proving our worth

with the introduction of national re-accreditation.

There has been an explosion of administrative work associated

with justifying the care we give to patients that has to continually

recorded, audited and shared with various authorities as well as

our paymasters.

My biggest regret is the inability to provide the continuity of care

still needed and demanded by my patients. Availability is not

always possible to balance against the newer demands and

pressures to provide rapid or same day access to care and

advice. The list I originally inherited from my predecessor was

largely middle aged. Many have now become elderly and less

healthy and require even more frequent contact despite, a fixed

amount of personal doctor time and availability.

Yet I still enjoy my job and feel privileged listening to and, where

I can, helping patients I see. As I finally reach home on a Friday

evening after a typical average 50 – 60 hour week, I kick off my

shoes, sit back in a chair and have a drink and think how

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PAIN RELIEF, CONTROL AND PALLIATIVE CARE

An Inspirational Talk and Slide Presentation by

Dr Ros Taylor, Medical Director and Chief Executive at Hospice of St Francis, Berkhamsted

A report of the open PPG meeting at Fowden Hall, Rothamsted on Monday 20 October by Tom Love

Those PPG members who braved the elements on this very wet evening found the presentation by Dr Ros Taylor on a range of challenging subjects, including pain relief, the work of the Hospice and death, absolutely inspirational and hugely reassuring. During a lively question session all agreed that most patients of all ages at Davenport House would

have found this meeting extremely valuable. Here is a brief flavour of this humorous, sometimes emotional and immensely informative talk, which was illustrated with a most impressive PowerPoint slide presentation, available

on the PPG web site. Www.davenporthouseppg.org.uk

Hospices provide a holistic approach to dealing with patient care covering both the physical and emotional support necessary to patients and their families in a bright and cheerful environment. It is important to note that they deal with a variety of conditions including serious heart, kidney and lung diseases as well as cancer. Not all patients in hospices die and in fact 65% return home.

Managing pain is not just about administering drugs but the need to be at peace with one‟s condition, being prepared (e.g. lists of things still to do) and planning the future with family members. Patients do not have to be in pain as round the clock relief is available and side effects

can be controlled by appropriate drug choice and dosage. 80% of terminally ill patients wish to die at home and, whilst 50% of relatives support this, only 5% of those feel they have the skills and ability to cope. The Hospice provides home support as well as support to Grove House and undertakes a wide range of education programmes for GPs, hospitals, nursing homes and various other care providers.

The new Hospice of St Francis, which serves Berkhamsted, St Albans, Harpenden and Tring, was opened last year with 14 beds. Care for patients is free. At present the NHS funds only 19%

of costs, so voluntary support is

HELP

Donations to the Hospice should be addressed to: -

Dr, Ros Taylor, The Hospice of St. Francis, Spring Garden Lane, Shootersway, Northchurch, Berkhamsted, Herts.

COPING WITH MENTAL HEALTH DISORDERS

A PPG small group meeting led by Dr Kirsten Lamb (Report by Sheila Uppington)

After a beautifully illustrated introduction, Dr Lamb started our discussion by outlining how some of life‟s problems altered mood, as well as explaining some of the more serious conditions which had shared care with a psychiatrist. She explained the tools that are used in Surgery to help diagnose conditions. These often take the form of various questionnaires. Answers could then be explored with the patient to highlight the severity of the problem along with other contributing factors. A mini-mental health test is also used for dementia screening.

Treatment for mental health issues is wide-ranging, including:

talking therapies such as counselling and cognitive behaviour therapy - we did an exercise using the latter showing us how to look at a situation from two points of view - as well as keeping a „mood‟ diary for a discussion basis.

increasing exercise levels to raise mood-enhancing chemicals (eg serotonin) in the brain.

books – „Mind over Mood‟ & „Think Good, Feel Good‟ (for children) were recommended.

referral to the statutory services – Community mental health team (in St. Albans Edinburgh House for outpatient appointments and Albany Lodge for inpatients), Drug & Alcohol team, Child & Adolescent services, private psychiatrist. In Harpenden there is a mental health team for the elderly offering in-patient specialist dementia care at the Stewarts as well as a day-care assessment team.

voluntary organisations such as Mind (offers 1-1 counselling), Relate, Youth Talk. Alcoholics Anonymous.

medication, which often needs to be long-term to be effective and monitored regularly. For instance prozac, a commonly used anti-depressant, which acts to keep serotonin in the brain, should be taken for 4-6 months after recovery. Drug therapies are often combined with other therapies listed above.

patients with significant mental health problems often have poorer physical health so this is regularly checked.

Our grateful thanks must be recorded to Dr. Lamb for leading such a wide-ranging and informative discussion and answering our questions.

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BEHIND THE SCENES AT DAVENPORT HOUSE

Anthea Doran, the Practice Manager, describes how the team at Davenport House supports

the Doctors and Patients during a typical day

6.45am The computer clerk arrives, de-activates the alarm and

opens the Surgery ready for the 7am Early Bird appointments.

Prior to opening the doors she turns on a computer in the main

reception and checks that the main computer system is running

OK. She then starts to work through the electronic mail received

overnight whilst greeting and checking in patients. Electronic

mail comes from the “Out of Hours Service” (HUC) and the

pathology lab at Hemel Hospital. All this information has to be

printed for the duty GP to review and check whether any

patients require urgent contact. She then starts on the GP

prescription queries from the previous day, which arise when a

patient either requests medication that is not on repeat or has

run out of the allowable issues. These requests are passed to

their GP for review.

8.00-8.15am The GPs and receptionists begin to arrive. They

turn on the remaining reception computers, switch the phones

over from the overnight service ready to welcome patients and

take phone calls from 8.20am, which is by far the busiest part of

the day.

8.30am The prescription clerk arrives,

empties the prescription request box in

reception and gets ready to process

some 100-150 requests received daily.

Periodically she accesses the Practice

website to retrieve e mailed

prescription requests.

9.00am The secretaries, summarisers, bookkeeper and

Practice Manager arrive. The secretaries check for letters

returned from GPs and dictation tapes awaiting transcription.

During the course of the day they will also deal with queries

from patients regarding referrals, chase consultant secretaries

for information on behalf of our doctors, arrange transport for

eligible patients, ensure faxes are dealt with appropriately,

photocopy patient records for solicitors where patients have

given explicit consent and monitor the “choose and

book”system. The summarisers deal with new patient records

which are a mixture of computer printouts and old written record

cards. The summarisers read through the records and extract

the key health issues, recording them on the computer for ease

of access by the doctors.

9.30am The computer clerk, who has been assisting in

reception, comes upstairs via the server room, which is vitally

important as it houses all four servers that must be fully

operational for the Surgery to function. The clerk checks

everything is in order and that the backup of the data has

happened successfully overnight. The tapes with the backed up

information are placed in the fire proof safe and new tapes put

into the servers ready for the next night‟s back up. The clerk

then starts to recall patients for routine checks at the Surgery.

Working from computer generated lists she ensures that

patients are invited to see a healthcare professional according

to specific clinical criteria i.e. hypertensive patients should have

their blood pressure taken at least once every six months. She

generates a letter of invitation and books an appropriate

appointment for the patient.

9.30am The scanning clerk arrives and picks up the post

delivered both via the postman and hand delivered by patients.

She opens all the mail and then sorts via registered GP and by

department. All mail relating to a patient is scanned into the

computer and e-mailed to the patient‟s GP for review. It is also

filed electronically in the patient‟s clinical record.

10.00am The bookkeeper enters income and expenditure onto

the Practice accounts package and updates the latest cash flow

forecast. The Practice is a small business and its accounting

procedures are rigorous. Later one of the receptionists will write

cheques for all this month‟s invoices after the book keeper has

ensured that all expenditure has been authorised.

12.00pm GPs finish Surgery and head to reception to check for

visits and messages. All visits are allocated and the appropriate

doctors informed. Before a GP leaves they must check with the

enquiries desk that they have dealt with all urgent issues. As

they begin to work through their messages, they e-mail

instructions to the receptionists to pass onto patients by phone

or, if no response, by letter.

2.00pm GPs have reviewed the electronic pathology reports

and, via the computer, leave instructions for reception. The

receptionists action their requests, sending letters for

appointments or filing to patients‟ records where the GP is

satisfied that no action is required. Reception is still fielding

calls for appointments and requests for information.

3.00pmA receptionist checks the progress of the various

reports that are waiting GP completion. These vary from

insurance companies needing medical information to support a

mortgage or a life insurance application to claims forms for

private health cover or sickness benefits. They check that the

appropriate patient consent has been given and then return it to

the requestor.

3.00pm Another receptionist is typing in the x ray and histology

reports to patient records, which sadly are not received

electronically. She checks that a GP has reviewed the reports

and chases those that are outstanding.

4.00pmThe phones begin to get busy again with patients

wanting late appointments for problems that cannot wait until

tomorrow. Many staff start to leave but reception stay until

6.30pm.

6.30pm After a final check that the phone will direct patients to

the “Out of Hours Service” in an emergency and that all the

8

USEFUL TELEPHONE NUMBERS

SURGERY

Practice Manager 01582 463007

Enquiries 01582 463004

Referral queries 01582 463005/16

Fax 01582 769285

OUT OF HOURS GP

Hertfordshire Urgent Care 03000 33 33 33

REPEAT PRESCRIPTIONS Order on line:

www.davenportsurgery,demon.co.uk

CHEMISTS

Boots 01582 713339

Springfield Pharmacy 01582 712104

Manor Pharmacy 01582 760624

Southdown Pharmacy 01582 712783

Topkins Pharmacy 01582 712708

Busby 01582 832102

GENERAL

HOSPITALS

Luton & Dunstable 0845 127 0127

Hemel Hempstead 0845 402 4331

Watford 0845 402 4331

QE11 01707 328111

Minor Injuries Unit - St Albans 01727 897182

Spire Private Hospital 0800 585 112

OTHER HEALTH SERVICES

NHS Direct 0845 4647

District Nurses 01582 460429

Harpenden Memorial (Red House) 01582 760196

Health Visitors 01582 715675

Luton & Dunstable Midwife 0776 992 5348

GUM (Sexual Health) clinic 01727 897333

HOSPICE

Runcie Day Hospice 01727 858106

Grove House 01727 897552

PALS - Patient Liaison 01707 309855

Social Services 01438 737500/400

Citizens Advice Bureau 01582 769387

Helping Hand 01582 460933

Isabel Hospice 01707 334222

The Hospice of St Francis 01442 869555

Bereavement Counselling - Cruse 01582 595300

PPG FORTHCOMING EVENTS 2009

Non members are cordially invited to the “Any Questions” forum on Monday 2 February

DATE TOPIC SPEAKERS/PANELLISTS

Open Meetings Fowden Hall, Rothamsted Commencing 8.00pm

Monday 2 February AGM and “Any Questions” to the doctors Practice GPs answering your questions

Monday 11 May Small Joint Replacement Mr David Williams - Orthopaedic Surgeon

Monday 13 July First Aid To be announced

Monday 19 October Children‟s Issues To be announced

Small Group meetings Held at the Surgery by application Commencing 7.30pm

Tuesday 28 April Back Problems Matthew Tant

Tuesday 2 June Managing Infections Dr Kirsten Lamb

Tuesday 2 November Respiratory Disorders Dr Alka Cashyap

Tuesday 1 December Weight Control Dr Alan Stranders