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Practice Policy in relation to prescription of sedatives for patients attending hospital or dental appointments, for imaging investigations or other procedures.
Sometimes we are asked to prescribe 'a low dose sedative' for patients attending hospital or dental appointments, for imaging investigations or other procedures. These are the reasons we do not prescribe this medication:
- Small doses of benzodiazepines such at 2mg diazepam are probably sub-therapeutic for most adults for any effective sedation. Conversely anxiolytics can have an idiosyncratic response in patients, and even very small doses can cause increased agitation in some subsets of patients.
- A patient may take a sedative 'an hour' before their assumed procedure, to then attend the hospital to find their procedure has been delayed, therefore the timing of the anxiolytic being sub optimal.
- GPs are not regularly involved, skilled, trained or appraised in sedation skills.
- All hospital consultants, both those requesting imaging and those providing it, have access to the same prescribing abilities as GPs. If a patient needs a certain medication to enable an investigation to go ahead, they are just as well positioned to provide a prescription, either through the hospital pharmacy or a hospital FP10.
- Sedated patients should be regularly monitored, and I have been made aware of a case where a GP-provided sedative was given, the patient not monitored, and subsequently had a respiratory arrest in an MRI machine.
- The Royal College of Radiologists‘ own guidelines on sedation for imaging makes no mention of GP involvement or provision of low dose anxiolytics and stresses the importance of experienced well trained staff involved and the monitoring of sedated patients: This is the web link to find out more
We maintain that we are not being 'obstructive’ but adhering to our duty of care to provide safe, consistent, and appropriate care for our patients.
We would be grateful if you could discuss this with the relevant specialist who has requested this, to prescribe this as they see fit.
Message from EMIS: Information about a software issue that prevented documents from being visible to patients.
We understand that some of our patients may have been unable to view certain documents (e.g. letters from the hospital) when using online services due to a software problem. We sincerely apologise for any inconvenience this may have caused. We are pleased to inform you that this issue has been resolved; any new documents added to your electronic GP health records will be visible and it may take up to a month for older, affected documents to become visible.
Your GP team will have been able to access the letters, so your care will not have been affected during this time.
MMR Vaccinations
If you have been contacted by the NHS saying you/your child may not be up to date with their MMR vaccinations but you think they are, please be assured, we are aware that data held nationally may differ from what is held locally and NHS England continues to work with NHS services delivering vaccinations to ensure that patient records are as up to date as possible.
If you are satisfied that you/your child is up to date for MMR vaccination and other childhood vaccination and the general practice are satisfied that the practice record is complete, then no further action is necessary.
Please check your ‘red book’ in the first instance as all your child’s vaccine information should be present there.
IMPORTANT INFORMATION: When you temporarily change your nominated pharmacy
A reminder that when you change your nominated pharmacy for any reason, on your return, please advise Dispensary to change the nomination back to a Dispensing patient. Email us at: Cropredy.surgery@nhs.net
Pharmacists can assess and treat without need for GP appointment
From today, thousands of pharmacists across England will be able to assess and treat patients without the need for a GP appointment or presciption for:
- Sinusitis
- Sore throat
- Earache
- Infected insect bites
- Impetigo
- Shingles
- Uncomplicated urinary tract infections in women under 65.
Dispensary
IMPORTANT INFORMATION: Repeat Prescription Requests - 4 Working Days Notice
Due to unprecedented repeat prescription requests within our Dispensary, we are now asking patients to give 4 WORKING DAY'S NOTICE when requesting repeat medications.
Please note: Any prescription requests received after 4pm, will count as arriving on the next working day. This time increase will allow the Dispensary team more time to order in the required medications that we do not have in stock and will also, and more importantly, allow our staff to work at safe levels.
Please can we ask that you keep a close eye on your medication levels and ensure you order in plenty of time (but not too early!)
For those who have forgotten to order, and need medication urgently, we will only be able to offer a signed prescription to collect from another pharmacy.
Flu Vaccines - Over 65's Only
You may not be aware that we have to order our flu vaccines one year in advance and in multiples of 100. Many things change in a year and this year we have been hit with patients being offered a flu vaccine at the same time as their Covid vaccine which is resulting in patients cancelling their flu vaccines with ourselves.
We are unable to return any unused vaccines but still have to pay for them.
We run weekend clinics where our staff give up their free time to provide the service and the flu vaccinations cost us thousands of pounds so we like to use them all if we possibly can.
If you have an older relative that is registered at the surgery and still hasn't made an appointment to get their flu vaccination, we would be very pleased if you could make an appointment to get their annual jab. It only takes a few minutes and it could save being seriously ill over the winter.
Covid Autumn Booster
Cropredy Surgery will not be taking part in the Autumn Booster Programme
People at greatest risk of serious illness from Covid, including care home residents, over 65s and frontline health and social care workers, are eligible for an autumn vaccine booster.
Here’s everything you need to know.
Am I eligible for an autumn Covid booster? The following people are eligible for an autumn Covid booster:
· Residents in care homes for older adults.
· All adults aged 65 years and over.
· People aged 6 months to 64 years in a clinical risk group, as defined in tables 3 and 4 of the Covid-19 chapter of the UKHSA Green Book on Immunisation
· Frontline Health and Social Care workers.
· People aged 12 to 64 years who are household contacts of people with immunosuppression, as defined in the UKHSA Green Book.
· People aged 16 to 64 years who are carers, as defined in the UKHSA Green Book, and staff working in care homes for older adults
This is because the risk of severe Covid continues to be strongly associated with increasing age and underlying health conditions.
When is the booster available and how do I book an appointment?
· Vaccinations will begin on 11 September 2023 for those most at risk, including adult care home residents and people who are immunosuppressed.
· From 18 September 2023, the NHS will start to invite people in priority order of risk and those eligible will be able to book an appointment on the National Booking Service.
GP Patient Survey 2023
We are proud and delighted to be ranked 125 out of 6402 surgeries in England in the recent 2023 GP Patient Survey, for the % who say the overall experience of the surgery is good.
View the most recent GP Patient Survey - 2023
Health Visitors
Health visitors are registered nurses/midwives who have additional training in community public health nursing. We provide a professional public health service based on best evidence of what works for individuals, families, groups and communities; enhancing health and reducing health inequalities through a proactive, universal service for all children 0-5 years and for vulnerable populations targeted according to need.
For support or advice, please TEXT the Health Visiting messaging service, Chat Health on 07312263081. All questions about your child’s health and/or development is welcome and no question is too 'basic'. We are here to support you.
Serving You
Our dedicated team is here to treat those minor ailments that occur as well as providing specialist management of long-term conditions and clinics covering a wide range of healthcare issues.
The technology also means you can now do a lot of things from the comfort of your home such as order a repeat prescription, cancel an appointment or view your electronic records.
Important Message from Dispensary - 22 June 2023
You may be aware that there is a national shortage of the medications Ozempic & Victoza & some insulins.
If you order these medications, it is almost certain that we will not be able to obtain supplies. There are limited alternatives available and we are awaiting a response from manufacturers to ensure there is enough supply of this alternative medication.
Please order your medications as you normally would. Any duplicated orders will be rejected.
We are waiting for national guidance and once we receive this, we will advise further. Unfortunately, this matter is completely out of our control and all GP surgeries are experiencing the same difficulties.
We fully appreciate your frustrations and our Dispensary Team are working hard to try and limit the impact on this to our patients.
First Aid Unit Clinic (FAU) - Enhanced hours. Only at Chipping Norton Health Centre
We are now able to offer appointments at the new First Aid Unit (FAU) for all patients (adults and children over 1 years old) with enhanced access hours at Chipping Norton Health Centre.
FAU appointments will be available on weekday evenings from 18.40–20.00 and on Saturdays from 09.00–17.00. They will be 20-minute appointment slots and ALL be face-to-face.
Please note: This is NOT a walk-in service and patients will not be seen without an appointment.
For data protection purposes, it is really important our patients are aware they are being seen at a clinic which has been contracted to provide this service on behalf of Cropredy Surgery and that patient's medical information will be shared with the 3rd party.
First Aid Unit Clinics (FAU) patient data will be shared with South Central Ambulance Service (SCAS). When Cropredy Surgery book an appointment, it is for attendance at the FAU in Chipping Norton. You should also be aware that the service is being provided by South Central Ambulance Service (SCAS) on our behalf.
FROM NHS ENGLAND Patients Chasing Referrals
There is a service whereby patients can go online and check the length of waiting lists and when to expect treatment.
My Planned Care NHS
Helpful information and guidance for patients waiting for a hospital consultation, treatment or surgery at in England.
Prescriptions - Price Increase
From 1st April 2023, Prescription Charges have risen from £9.35 per item to £9.65 per item.
Prescription Price Increase Information
The new HRT Prescription Prepayment Certificate (PPC) also comes into effect from 1st April 2023.
The cost of an NHS Hormone Replacement Therapy (HRT) PPC will be £19.30. Patients who take eligible HRT medications can apply for an HRT PPC in the same way as the regular PPC. If on HRT only, this will cost £19.30 for twelve months.
The cost of an NHS Prescription Prepayment Certificate (PPC) has increased to:
£31.25 for 3 months
£111.60 for 12 months (patients can spread the cost and pay in 10 monthly instalments)
People who pay for their NHS prescriptions could save with a PPC. Rather than paying £9.65 for each prescription, the 3 and 12 month PPC covers unlimited NHS prescriptions for the one-off set price.
This means if people need 4 or more items in 3 months, or 12 or more items in 12 months they will save money by buying a PPC. How much, depends on the number of prescriptions they need each month.
The quickest way to buy a 3 or 12 month PPC is online at www.nhsbsa.nhs.uk/ppc
The HRT PPC will be available from 1 April 2023. For more information visit www.nhsbsa.nhs.uk/hrt-ppc
Strep A
We are aware that Step A cases are currently in the news and therefore we felt it appropriate to share some official information.
There are lots of viruses that cause sore throats, colds and coughs circulating. These should resolve without medical intervention. However, children can on occasion develop a bacterial infection on top of a virus and that can make them more unwell.
As a parent, if you feel that your child seems seriously unwell, you should trust your own judgement.
Contact NHS 111 or your GP if:
your child is getting worse
your child is feeding or eating much less than normal
your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
your baby is under 3 months and has a temperature of 38°C, or is older than 3 months and has a temperature of 39°C or higher
your baby feels hotter than usual when you touch their back or chest, or feels sweaty
your child is very tired or irritable
Call 999 or go to A&E if:
your child is having difficulty breathing – you may notice grunting noises or their tummy sucking under their ribs
there are pauses when your child breathes
your child’s skin, tongue or lips are blue
your child is floppy and will not wake up or stay awake
STREP A - what to look for:-
High temperature
Swollen glands
Sore throat
Muscle aches
Rash - feels like sandpaper
Referral Centre for Banbury Foodbanks
You may be interested to know that we are now a Referral Centre for the Banbury Foodbanks. If you are struggling, then please make an appointment to speak to one of our GPs/Nurses who can arrange a foodbank voucher (please note: there is not a delivery service and therefore you will need to be able to collect from Banbury).
The website to learn more is: How to get help | Banbury Foodbank
GPs can now Refer Patients with Health Conditions who have Cold or Expensive to Heat Homes for Free Support
Our GPs can now refer patients with health conditions who have a cold or expensive to heat home for free support and patients can also self-refer through this website Make a Referral - Better Housing Better Health bhbh.org.uk
Details:
Better Housing Better Health is a service available to help residents with health conditions to stay warm and well in their home.
Support can be offered via a Free helpline (0800 107 0044) and can include:
Understanding/accessing financial support to help pay for energy
Understanding energy bills, tariffs and heating controls
Accessing grants/funding for home improvements and heating system upgrades
Free home energy visits which offer personalised energy advice and support with bills
Referrals/signposting to local organisations to access additional support.
Flu Vaccines - Over 65's Only
You may not be aware that we have to order our flu vaccines one year in advance and in multiples of 100. Many things change in a year and this year we have been hit with patients being offered a flu vaccine at the same time as their Covid vaccine which has reduced expected uptake.
We organise weekend clinics where our staff give up their free time to provide the service and the flu vaccinations cost us thousands of pounds and therefore we like to use them all if we possibly can.
We have over 100 flu vaccinations for the over 65’s still unused in our fridge.
If you or an older relative that are registered with us, still haven’t made an appointment to get your flu vaccination, we would be very pleased if you could make an appointment to get your annual jab. It only takes a few minutes and it could save you being seriously ill over the winter.
Travel Vaccinations - Update
If you require any vaccinations relating to foreign travel you need to visit a Travel Clinic such as Boots or Superdrug for immunisations and advice.
We do not provide private travel services.
We do offer vaccinations that are provided free to NHS patients, but will no longer be providing comprehensive advice and recommendations.
The following travel vaccinations are usually available free on the NHS:
• Diphtheria, polio and tetanus (combined booster)
• Typhoid
• Hepatitis A – including when combined with Typhoid or Hepatitis B
• Cholera
These vaccines are usually free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.
See more information on vaccines
Midwife Appointments
We have made the very tough decision to cease Midwife appointments within the surgery. We have been very late to this point compared to other local surgeries, but the pressure on our consulting rooms is now so severe that we have no other choice.
The last day for appointments within the surgery is Friday 29th July and the Midwife will be contacting those patients who are booked in beyond this date.
Appointments will now be at the Horton Hospital and your Midwife will provide you with full information regarding this.
Please be aware that we have not made this decision lightly.
Urine Samples
In order to keep our patients (and staff) safe and to keep within national guidelines, we can no longer accept urine samples without an accompanying appointment. Therefore please don’t drop off a urine sample without having made an appointment to see one of our GPs or nurses first.
Urine samples also need to be in the correct container which reception will be happy to give you. This way we know the bottle is clinically clean and has a good screw top which won’t leak!
Update COVID-19 Booster Vaccine
See our latest surgery update here: Covid-19 Booster Vaccine
For more information Click here
Have you thought about your winter plan?
People are encouraged to have a personal winter plan so they are well prepared when the weather takes a turn for the worse and the season for flu, coughs and colds really kicks in.
Tehmeena Ajmal, the county's first Winter Director, said: "We would like everyone in Oxfordshire to have a winter plan for themselves and their family, so that they know what they can do to keep as well as possible; what they can do if they start to get unwell; and how they can look after older family members, friends or neighbours who might need some help.”
Personal winter plans should include:
- Having a free flu vaccination if you are in an ‘at risk’ group.
- Getting help early before your condition worsens.
- Getting repeat prescriptions in plenty of time.
- Having a well-stocked medicine cabinet.
For more information see here: Have you thought about your winter plan?
You can also download or link to the Age UK Oxfordshire leaflet ‘Staying Well this Winter’ which is full of useful advice on how to stay well this winter.
Use Antibiotics on your Doctor's Advice
Antibiotics are essential to treat serious bacterial infections, but they are frequently being used to treat illnesses such as coughs, earache and sore throats that can get better by themselves. Taking antibiotics encourages harmful bacteria that live inside you to become resistantm, which means that antibiotics may not work when you really need them.
Despite the risks of antibiotic resistance, research shows that 38% of people still expect an antibiotic from a doctor’s surgery, NHS walk-in centre or ‘GP out of hours’ service when they visited with a cough, flu or a throat, ear, sinus or chest infection in 2017.
Note: To access material on the Public Health England resource website you will need to register if it’s your first visit to the site).
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Pharmacy2U is NOT part of Cropredy Surgery
There appears to be some confusion about the leaflets that are being delivered to our patients doors from this commercial company. It has no connection with Cropredy Surgery.
Please be aware that if you are a patient who normally has your repeat medicines from us and you sign up with this company, all your prescriptions will go to them for dispensing.
If you need a prescription after seeing the doctor, you will be given a paper prescription to take to a pharmacist for that person to dispense. We will not dispense them at the Surgery.
The Surgery provides a wide range of services to our patients, partly supported by the income derived from our dispensing services. If that income is reduced, it puts at risk some of the services that we offer.
Whilst we support patient choice, you should understand before you change.
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We are occasionally closed for staff training
Click here for training dates.
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See the posts from our blogger…
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Citizen Aid App - YOU can save lives
Simply download the free, no ads CitizenAID App from either Google Play, Apple App or Windows store.
The CitizenAID App will reduce the anxiety from difficult decision making in an unfamiliar situation. Follow the logical steps to do the right things in the right order. Stay safe and help us... to help you... to save lives.
The CitizenAID app is free to the UK public and is designed for use in the UK. Access is left open internationally for the wider public good, but recognising there is detail that relates only to the UK (such as emergency service phone number).
http://citizenaid.org
Website
We aim to provide the highest quality, holistic, patient-centred healthcare delivered with respect, compassion and understanding. We are confident our website provides clear, concise help and gives our patients information they require in an easy and convenient format. Designed with the patient’s needs at the forefront of everything, from checking surgery times to letting us know what you think of us.