downsmail.co.uk
Help means youmay see less of your doctor
IT is a time of great changes for most doctors’ surgeries in and aroundMaidstone – and one sig- nificant result ispatients canlook forward to faster help from their practices, though not always pro- vided face to face by aGP. Various steps are in the pipeline
to reduce pressures on GPs, in- cluding the engagement of spe- cialist health professionals, and widening skills and responsibili- ties of existing practice teams, in- cluding nurses and receptionists. The shortage ofGPs acrossKent
has now risen to above 12% (30% for practice nurses). With the number of over 55-year-old GPs in Kent nowfourth highest in the country – and many retiring be- fore they are 60 – the situation is worsening. In some cases, prac- tices are merging, as has been seen in theMaidstone area. NHS England and the GP-led
NHSWestKentClinicalCommis- sioning Group (CCG), which plans and pays for the vastmajor- ity of healthcare, are supporting measures to ensure quality of care for patients is maintained, even improved. Dr Tony Jones, senior partner at
the Vine Medical Practice, Ton- bridge Road, Maidstone, and a member of the CCG Governing Body, outlined key changes to the
appointments THE GP clusters are co-operating to ensure greater availability of appointments for patients with GPs up to 8pm on Mondays to Fridays and also on Saturday and Sundaymornings. These additional appointments
may not necessarily bewith a pa- tient’s regular doctor and could be at another surgery in the clus- ter. This new system started on October 1, 2018, and is already in regular use by patients. GPs are finding the extra hours
help to spread the surgery work- loadmore evenly. If a patient is seen outside of the
usual practice the key informa- tion on a patient’s records is ac- cessible online. This is available under the “VisionAnywhere” on- line systemwhich can be accessed with patient consent.
DownsMail, emphasising the fol- lowing extra support increasingly available in surgeries: Practice nurses and reception-
ists are being ‘upskilled’. Patients ringing for an appointment may be asked for more detail by trained receptionists so that they can be directed to the most suit- able professional. About 20 per cent of patients need non-medical help, and may be best helped by counsel or voluntary services. Many others can be helped by an advanced clinical nurse practi- tioner – nurseswith an additional level of training.Dr Jones empha- sises that patientswill always see aGP if a diagnosis is required and can always request a GP. Physiotherapists are now more
readily available to surgeries. Paramedics are also likely to be
available and canmake home vis- its andmore timely assessments. Clinical pharmacists are be-
coming increasingly important in surgeries in making medication decisions. Some have prescribing rights. Patients are reporting sat- isfaction and attention to detail. Telephone advice – patients
and GPs communicate by tele- phone, with surgery appoint- ments arranged as necessary. DECEMBER editions of
DownsMail includedproposalsof an emerging CCGstrategy forGP surgery sites across Maidstone, MallingandWeald, largelytomeet demand (24,000 population in- crease over the next five years) due to additional housing and conver- sion of offices/commercial prem- ises to residentialuse, especially in the towncentre.
Out of hours Practicesworking in clusters
FOR the last two years, 55 GP surgeries in west Kent have been organ- ised into seven clusters and co-operate in increasingways. Four clusters are inMaidstone-wide area –Maidstone Central (eight
practices),MaidstoneWide (nine),Weald (11) andMalling (five). Within each cluster practice, representatives – GPs, nurses,managers
–meet to plan learning-time afternoons and discuss areas of jointwork- ing. They can air views, consider co-operation¸ broaden knowledge and build relationships, helping them ‘to work smarter’ in their own prac- tices aswell as togetherwithin the cluster. Practices in a cluster also aim to help each other when emergencies
arise, particularly on staffing issues. Clusterswork collaborativelywith the budget-holdingGP-ledNHSWest Kent CCG.
Multi-disciplinary teams help
EVERY cluster has access to an independentmulti-disciplinary team serving just that cluster.A practice canliaisewiththe teamto seekad- vice/assistance for specific patients. The team includes specialists in frailty, complex care, social care,
mentalhealth, end-of-life care, additionalGPs andcommunitynurses. Asignificant aimis to stabilise long-termconditions and prevent un- necessary hospital admissions. The team can give advice to a surgery on helping specific patients
andmay visit ormeetwith patients to give direct help or advice, per- hapswith occupational therapy, physiotherapy or consultant input.
Health |News GPs get help
with referral GPS ARE benefitting from local educationmeetings on improving referral practice to consultants for patients reporting what they be- lievemay be cancer symptoms. Maidstone and Tunbridge
WellsHospitals’ Trust isworking to resolve serious problems on missed national targets for con- sultants seeing referred patients within 14 days and starting treat- mentwithin 62 days. The trust and CCG, facing a
shortage of specialists at a time when demand is growing, are try- ing to ensureGPsmake urgent re- ferrals in good time, but have the knowledge to avoid unnecessary referrals.
Cancer delays
CANCER performance at Maid- stone and Tunbridge Wells Hos- pitals’ Trust continues to cause concerns. In October, the percentage for
62-day treatment after diagnosis was 62.1% against the 85% na- tional target. In one case (with other health problems) the level of harm was categorised as se- vere. Shortage of specialist staff is a
key issue. NHS England an- nounced an investigation into the trust for December, to include cancer services.
Care hub plan
MAIDSTONE is still seen as a top priority for one of the proposed newcare hubs inwest Kent. The next phase of the work is
identifying potential sites. There could also be smaller care hubs in theAylesford area and theWeald. The hubs will all have a core
range of services, including well- being and prevention, a wide range of community health serv- ices andmore integrated and spe- cialist services to support people with complex needs. A key objective will be to re- duce pressure on hospitals.
Diabetes aid
MORE than 500 of 2,300 patients inWest Kentwith type 1 diabetes are expected tomeetNHS criteria to benefit fromthe FreeStyle Libre device for monitoring glucose levels as an alternative to routine finger pricking. The NHS West Kent CCG ex-
pects annual costs to increase by about £53,000.
Malling February 2019 27
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48