The Abingdon Surgery
Newsletter
Spring 2017
www.abingdonsurgery.com
Welcome to another edition of our newsletter. I had hoped to issue this in March, but a broken arm has somewhat
curtailed the speed of my typing! Now we are well into Spring and have had some really good weather so I hope you are
all enjoying the outdoors as much as possible. I must say now that I am unable to drive for 6 weeks and am therefore
catching the bus to work, the extra walking has definitely made me feel a little fitter and the hips perhaps just a little bit
slimmer. I can also appreciate (if only a little) how difficult life is for anyone with any kind of disability, although people
are generally very helpful and kind. I consider myself lucky knowing that my ‘disability’ will come to an end in 6 weeks’
time.
As ever, lots of news in this edition, including an article by one of our patients on his fitness regime. It would be great to
have more patient input to the newsletter so please e-mail me with anything you think other patients, or indeed the
surgery staff, would be interested in.
Terry Cornford, Care Navigator - [email protected]
In the Surgery
Prescription Requests
Staff Changes
And….remember, we do NOT accept prescription
renewal requests over the phone. They must be in
writing or via the Patient Online Access. We are not just
doing this to be awkward – we must be completely sure
that a renewal is for the correct medication. Verbal
requests for ‘my usual medication’, ‘the medication
which runs out on Thursday’ or ‘the one in the blue
packet’ are open to misinterpretation!
Welcome back to Maria Harvey who returned to work in
March and is now our Senior Receptionist running the
team in her usual efficient way.
We have a new member of
the nursing team, Jane
Tennant, (left) who comes
to us from a hospital
nursing background. Jane
will be shadowing our
current practice nurses for
a while before she takes on
her own clinics.
Friends and Family
We get some amazing complimentary comments about
the surgery, but this one was a little different:
“I really valued the kindness and the hell offered by
Dr Salmon. I also was able to get an appointment
quickly. And the surgery is very clean.”
Facebook
Perhaps it’s all those little devils keeping the place up to
scratch?!
We are now on facebook.com/theabingdonsurgery.
Check out our page for surgery updates and news.
Lab & Scan Results
PLEASE! If you need to telephone for results, call after 2
p.m. – the phones lines are very, very busy in the
morning.
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Travel Vaccinations
necessary, and most types shouldn't be given to
children.
A plea from the nursing
team – please think well
ahead about any
vaccinations you may
need for a forthcoming
holiday.
Sepsis
Recent headlines about sepsis may have caused some
concern - Dr Salmon gives this advice:
What is sepsis?
Sepsis is a reaction by the body to severe infection. You
may also hear severe infection being referred to as
septicaemia. Strictly speaking, septicaemia is an
infection of the blood, whereas sepsis refers to the
whole body. The germs involved in sepsis can be
bacteria, viruses or fungi. If bacteria multiply and release
poisons (toxins) into the blood it can cause serious
illness. It can involve many different parts of the body.
If you require any vaccinations relating to foreign travel,
please complete and submit a travel questionnaire
(available from reception or our website) 6 to 8 weeks
before you are due to travel. At the same time please
book an appointment with the practice nurse allowing
10 working days from submission of your form. This
will ensure that the appropriate vaccines are available at
your appointment, which must be at least 2 weeks
before you are due to travel to allow the vaccines time
to work.
Sepsis statistics
Each year in the UK, there are 100 000 admissions to
hospital and 37 000 deaths from sepsis
(J of Antimicrobial Chemo 2011;66(Supp ii):11).
In the UK, more people die of sepsis each year than of
breast, bowel and prostate cancer combined.
What are the symptoms?
PLEASE NOTE THAT IF YOU FAIL TO TURN UP FOR
YOUR APPOINTMENT, YOU WILL BE BILLED £25
FOR THE WORK DONE ALREADY IN PROCESSING
YOUR TRAVEL FORM
The UK Sepsis Trust lists six symptoms to be aware of:
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Treating diarrhoea
Although cases amongst our patients have now eased off
after a winter rush, it is worth noting the following
advice, taken from the NHS Choices website:
slurred speech
extreme shivering or muscle pain
passing no urine in a day
severe breathlessness
"I feel like I might die"
skin mottled or discoloured
Symptoms in young children include:
Most cases of diarrhoea clear up after a few days
without treatment, and you may not need to see your
GP.
However, diarrhoea can lead to dehydration, so you
should drink plenty of fluids – frequent small sips of
water – until it passes.
It's very important that babies and small children don't
become dehydrated. Your pharmacist may suggest
you use an oral rehydration solution (ORS) if you or your
child are particularly at risk of dehydration.
You should eat solid food as soon as you feel able to. If
you're breastfeeding or bottle feeding your baby and
they have diarrhoea, you should try to feed them as
normal.
Stay at home until at least 48 hours after the last
episode of diarrhoea to prevent spreading any infection
to others. Medications to reduce diarrhoea, such as
loperamide, are available. However, these aren't usually
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looks mottled, bluish or pale
very lethargic or difficult to wake
abnormally cold to touch
breathing very fast
a rash that does not fade when you press it
a seizure or convulsion
Sepsis is a medical emergency but early treatment in
hospital saves lives. If you suspect sepsis - obtain
medical help immediately. It requires emergency
hospital treatment, often by 999 ambulance through
A&E.
As doctors and healthcare professionals it would be
normal for us to consider “is this sepsis?” as part of our
assessments. The recent media coverage has been in
part due to the recent national guidelines released by
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NICE for all healthcare professionals which we aim to
follow.
More generally, the UK has fewer doctors, fewer beds
and spends less per GDP on healthcare than most of
Europe.
GPs fight back!
A properly funded health service does not need GP
surgeries to open 8-8pm seven days a week. No other
country has a service like this or even aspires to it. It is
unnecessary and unaffordable. We already have access
to a GP at any time! Out of Hours provides urgent care at
weekends and evenings.
Earlier this year in the midst of the winter NHS crisis,
Downing Street issued a statement:
“Most GPs do a fantastic job and have their patients’
interests firmly at heart. However, it is increasingly clear
that a large number of surgeries are not providing access
that patients need – and that patients are suffering as a
result, because they are then forced to go to A&E to
seek care. It’s also bad for hospitals, who then face
additional pressure on their services.”
It is misleading to suggest routine GP appointments will
in any way lead to quicker discharge from hospital and
into the community which is at the heart of the A&E
crisis that prompted the comments in the beginning.
The government wants you to believe that further
efficiencies can be made, when in reality the NHS has
been going through efficiency savings for years. We
cannot continue providing more health care for less
money. There comes a time when the system breaks.
We understand that austerity needs to happen but let’s
have an honest discussion about the causes of all the ills
of the NHS. GPs are not to blame. We are propping up a
crumbling NHS. We would be happy to help come up
with solutions but fear that the government has a
different agenda.”
Not surprisingly the response from GPs across the
country was not a happy one! Our own Dr Charlotte
Treacy wrote the following response:
“Don’t scapegoat us Theresa May!
Long waits in A+E, bed shortages, long delays to see
specialists, cancelled cancer operations. According to
Theresa May it’s the fault of GPs. Her solution is to force
GPs to work 8-8pm 7 days week.
The Abingdon Surgery feels it is important to rectify the
government’s misconceptions about primary care and
why ordering an already overstretched workforce to
work longer hours is not the solution.
Maybe a timely message to us all now that a general
election has been called! Please consider the survival of
the NHS when voting in June and make sure that the
person you vote for has the success of the NHS at his or
heart.
Let’s put some perspective on the problem. Primary care
delivers 90% of patient care yet only receives 7.23% of
the NHS budget. This is a fall from 8.3% in 2010. In
contrast, hospital budgets are going up and are
prioritized over Primary Care. Despite cuts to our
budget, GP appointment numbers have increased from
310 million in 2010 to 370 million in 2016. GP practices
get £136/year/patient. It would cost more to insure your
pet. With this money, patients get as many
appointments, blood tests and telephone calls as they
need. Excellent value for the taxpayer we think!
Other News
Who pays for your wheelchair?
I recently had occasion to contact the Red Cross about
their mobility equipment loan service as I had heard that
this was about to cease. I received a reply from Jeremy
Eaton, Customer Experience Manager at the Red Cross
headquarters in London:
‘Please be assured we are not discontinuing our
Mobility aids service.
We have recently reviewed how we deliver this valued
service and this has resulted in a number of locations
closing or merging. However, we are in the process of
introducing a delivery option which will help us reach
more people.
In England there is no statutory provision for shortterm mobility aids; the other nations have their own
arrangements. We think this should change and have
produced a report:’
Not only are the finances extremely tight, but there is a
recruitment crisis in General Practice. 1/3 of vacancies
remain unfilled. 1/3 of GPs will be retiring in the next
five years as is evident by our own Dr Buttar retiring
early. More than 1/4 of GPs work beyond safe hours
every week and 20% of GPs suffered work related illness
in 2015. Thanks to Jeremy Hunt’s new junior doctor
contract and subsequent strikes, a significant number of
junior doctors are quitting medicine or going abroad.
Australia has finally reached its quota of doctors, all
thanks to the government’s strategy of attacking the
medical profession.
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wheelchair. (By 2012, only 24 out of 151 NHS wheelchair
services made any provision at all for short-term need.)
Below is an extract from that report:
If you come a cropper and need a wheelchair, your best
bet is to either get injured just a little or quite a lot.
Confused? You should be.
Wheels of fortune
Today, the Red Cross mobility aids service loans out
75,000 wheelchairs each year all across the UK (except in
London, sorry, but we’re trying to fix that).
In fact, our teams are often based directly in hospitals
and medical centres, where they work closely with
medical staff in identifying who needs help.
The benefits of such partnerships are obvious. Patients
are discharged earlier, freeing up much needed bed
space. Our wheelchairs also help people become more
independent at home, and to make follow-up medical
appointments.
In short, the service is a big help to the NHS and local
authorities.
Valued service
Here are three interesting health facts you probably
don’t know:
But sadly, there is quite a big glitch in the current
system. Perhaps precisely because the service has grown
so organically and higgledy-piggledy over decades, how
the Red Cross works with statutory bodies across the
country often doesn’t make a lot of sense.
So, for example, the Welsh government currently gives
the Red Cross a substantial amount each year to help
fund the mobility aids service, in recognition of its value.
Similarly, health and social care trusts in Northern
Ireland each commit a percentage of their budget to
‘voluntary providers’ – of which the Red Cross is by far
the largest.
1. If you twist your ankle or get a small mobility injury,
hospitals in the UK have to provide you with a ‘minor
aid’ – such as crutches or a walking frame.
2. If you have a serious illness or injury that will mean
long-term use of a wheelchair, hospitals are similarly
obliged to provide the equipment. But…
3. If you need a wheelchair for a ‘short-term’ ailment
(officially, anything lasting less than six months), then
good luck. No official body has any responsibility to help.
That’s a pretty huge gap in the system. It means that if
you’re facing weeks of immobility following a badly
broken leg, serious operation or debilitating illness
there’s no guarantee you’ll be able to get a wheelchair.
And in a curious way, it’s partly due to the way British
Red Cross and the NHS have evolved during the last
century.
Inconsistent approach
The situation is less promising in Scotland, where no
concrete assistance as such is offered to the Red Cross.
But it’s in England that things get really interesting.
Besides offering no financial assistance, in several areas
the NHS actually charge the Red Cross thousands of
pounds to rent the hospital rooms from which they
deliver the mobility aids service.
Let’s just run past that one again. The Red Cross is being
charged by the NHS to hire hospital space from which it
provides a service that materially helps the NHS.
No guarantees
Surprised? A quick explanation might help. Following
World War One (long before the NHS even existed), the
Red Cross started providing short-term loans of
wheelchairs for both injured servicemen and the general
population.
It was an immediate success – and over the next 20
years, the service grew quickly. By the time the NHS was
established in 1948, we were already the go-to
organisation for wheelchair loans. Having plenty of other
priorities to deal with, the NHS largely left this job to us.
Since then, the Red Cross and other voluntary sector
organisations have continued to deal with the
overwhelming majority of people temporarily needing a
‘Distressing situations’
Such a hotch-potch approach inevitably has an impact
on the Red Cross’ ability to provide its mobility service.
And amid all this financial wrangling, there is a very real
human cost to be paid.
Suddenly losing your mobility can be a rotten situation
to be in, and our volunteers see the effects every day.
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Ease the burden
The bottom line is that all the key players – the NHS,
local authorities and the Red Cross – want the same
thing: to help vulnerable people.
But the Red Cross already invests its own charitable
funds in providing the mobility aids service.
By paying ‘rent’ for hospital space, we’re essentially
paying twice over. It’s like asking someone to help you
out with the gardening, then charging them to use the
lawn-mower.
In our view, the best – and fairest – way ahead would be
for the statutory sector in all four countries of the UK to
each agree a legally binding arrangement to help fund
the service.
Working in a common cause to set guidelines, we could
significantly ease the burden of the NHS and reach more
of those who desperately need help.
available to all people over the age of 60. However, in
some areas of the UK, only a third of those who receive a
test in the post complete it, so thousands of people are
missing out on the best way to detect the disease when it
is easiest to treat.’
To detect cases of bowel cancer sooner, the NHS offers
two types of bowel cancer screening to adults registered
with a GP in England:
Make the Time – Stay on
the Line!
All men and women aged 60-74 are invited to carry out
a faecal occult blood (FOB) test. Every two years, they're
sent a home test kit, which is used to collect a stool
sample. If you're 75 or over, you can ask for this test by
calling the freephone helpline on 0800 707 60 60.
(taken from the February issue of ‘OUH & You’)
‘Oxford University Hospital is using an automated
telephone reminder system, which phones patients to
remind them about their appointments. In October 2016
alone, 5463 appointments were missed at our hospitals,
wasting over £775,000 of NHS funds. Other patients
could have taken these appointments slots and waited
less time for their care.’
An additional one-off test called bowel scope
screening is gradually being introduced in England. This
is offered to men and women at the age of 55. It
involves a doctor or nurse using a thin, flexible
instrument to look inside the lower part of the bowel.
I knew there was something to look forward to when I
reach 60 at the end of the year! Joking aside, if you
receive a test kit in the post, use it – what have you got
to lose?
The system is already helping to reduce the number of
missed appointments, but some patients say they are
being called too often. The solution? Listen to the end
of the message when you will be given a number of
options. If you do not choose an option, you will be
called again – up to 11 times! If you want to opt out of
this system and have reminder letters instead, please
ask when you book in at the hospital.
A Patient’s View
Monitoring and managing
Help! - I am facing the likelihood of heart disease, stroke,
diabetes type 2, obesity, asthma and cancer over the
next few years. We all are! I am a 67-year old man, and
we all face these diseases. It goes with the territory of
being old, male and living in the West.
Bowel Cancer Awareness
Month
(taken from the April issue of ‘OUH & You’)
But I can try to fend of these dreaded diseases by
improving the way I live. Nothing will remove the threat
from these diseases completely, but I can increase my
chances of avoiding them by living well. So I thought I’d
tell you about what I’m doing OK with and what I’m
struggling with. I’m currently focussing on four issues:
 Weight and body mass index
 General fitness
 Blood pressure
 Alcohol intake
‘Bowel cancer is the UK’s second biggest cancer killer,
and during April we will work to raise awareness of the
disease, in particular how treatable and curable it is.
Nearly everyone diagnosed early will survive bowel
cancer, and the best way to get early diagnosis is to take
part in a bowel cancer screening programme,
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to track your blood pressure in a similar way. I have also
kept a spreadsheet for my blood pressure, as you might
imagine!
Weight and BMI
Most of us will have bathroom scales at home, but many
of these tend to gather dust and soapy splashes in the
corner of the bathroom. I weigh myself each morning
after breakfast, before I dress. That way my weight is
always affected in the same way by eating and exercise
habits. I like to record my weight each day in a simple
spreadsheet, so that I can see the effect of holidays,
changed eating habits and so on.
Of course, just tracking your blood pressure does not
necessarily lower it, but it’s better to be aware of your
condition than not. I complained to the nurse at the
Surgery that I was disappointed to have high blood
pressure, as I was not overweight and I exercised
regularly. She said: ‘Do you drink?’ I said ‘Yes’ and she
said ‘Well, stop drinking!!’ Which brings me to my final
issue.
You can also calculate your Body Mass Index from the
following formula:
Body Mass Index =
Weight in Kgs
(Height in m)2
The BMI gives an indication of the level of stored fat in
your body as opposed to muscle, bone, major organs and
fat all being taken together, which is what your weight
measures.
Managing alcohol consumption
This is where I struggle. I know that I often drink more
than the recommended number of units of alcohol each
week, so much more that I hardly dare count the units.
Government advice on the number of units changed last
year (I think), to lower the recommended weekly intake
to 14 units per week for both men and women – and I
wasn’t even keeping under the previous limits.
Note that the BMI charts suggest that a BMI in the
range from 19.0 to 25.0 is a healthy level.
So now I am trying to cut out wine and all alcohol
completely on one day per week – I have introduced
‘Wineless Wednesdays’! So far this is going OK, but I will
let you know progress. After that it will have to be
‘Tequila-free Tuesdays’ and ‘Theakstons-is-off
Thursdays’, but let me see how I get on with the
‘Wineless Wednesdays’ first!
General fitness
I do a half hour of stretching and warm-up exercises each
morning after breakfast, five days a week. I could do
more, but fitting in half an hour each day is as much time
as I can find in a busy day. I use the Wii Fit Plus system as
it helps to provide the motivation.
Tom Hardy
On Saturday mornings I row in a 4 or an 8 with the
Abingdon Rowing Club. This is excellent exercise, good
fun and there is great camaraderie with my crewmates –
all equally old and decrepit. It can be truly wonderful to
be out on the river on a misty summer’s morning – and it
can be really horrible on a wet winter’s day! But even
then the exercise is good. (New members always
welcome at Abingdon Rowing Club: go to
http://www.abingdonrc.org.uk/)
And I go to the gym once a week for a 45 min session on
the weights machines, cross-trainer and rowing
machines. I don’t so much enjoy the gym machines, but I
feel that persisting with this is good for my general
fitness and also good for my soul! So I keep doing it.
Although one can always do more, I’m reasonably happy
with this level of exercise and my general level of fitness.
Blood pressure
Since being told at the surgery that my blood pressure is
on the high side, I have also been monitoring that.
Pharmacies these days sell simple blood pressure
monitors which are easy to use at home, and enable you
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Regular Surgery Opening Times
Monday
Tuesday
Wednesday
Thursday
Friday
Morning
8.00 a.m.
8.00 a.m.
8.00 a.m.
8.00 a.m.
8.00 a.m.
Afternoon
6.30 p.m.
6.30 p.m.
6.30 p.m.
6.30 p.m.
6.30 p.m.
Reception is open from 8.15 a.m.
The extended hours service in the evenings and at weekends is available for pre-booked appointments only.
Monday, Thursday
Saturday
From 6.30 p.m.
From 8.00 a.m.
Telephone Appointments
You may request a telephone appointment with your GP or one of the Practice Nurses and they will call you on the
contact number provided at or around the appointed time.
Prescription Requests
These cannot be accepted over the telephone or by e-mail. They must either be in writing (forms are available in
reception) or via patient online access for which you will need to register. Please ask at reception.
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