Why have you stopped letting patients see their doctor?
Prior to the pandemic, we were pretty happy with our appointments system. Most of the time we were able to offer routine appointments within a reasonable time limit, whilst ensuring that all urgent issues could be dealt with on the same day. However, when lockdown started, we were instructed by the government that all patient consultations must be initiated remotely (a ‘total triage’ system). Face to face contact should be minimised, and only offered where clinically necessary. This was not something we wanted to do, and in an ideal world we would love to go back to the way things were. The government advise that approximately 10% of remote consultations are being converted to face to face appointments nationwide, but currently we are converting more than 16% of our consultations, well above the national average.
We needed to reduce our face to face contact to reduce the risk of COVID transmission, both from us to you, but also from you to us. If we have an outbreak at the surgery, we will likely have to close for a period of time which we must try and avoid. However, please be reassured that if you do need an appointment we are taking all appropriate safety measures; washing hands, cleaning surfaces, wearing PPE, and because there is less traffic through the surgery, it is a much safer environment.
Why do I have to use eConsult?
The sudden switch to a total triage system meant that we needed to find a way for a large number of patients to contact the surgery, and we needed some basic information from them in order to prioritise urgent cases. Getting this information obviously takes more time and effort by our reception team. If the only way to speak to a doctor was to call first, our patients would be stuck on hold for hours and this would clearly not be safe. As an example, on Monday 24th August we had 301 calls to the practice. If we did not have eConsult there would have been an additional 148 phone calls to the practice on this day, which, at an average call length of 2min 30sec would have taken up an additional 6 hours of receptionist time! In real terms this just means that many patients would simply not be able to contact us.
There is also a real possibility of a COVID outbreak amongst staff which would mean we may not have receptionists available to answer the phones and the only patients able to contact us would be those who use eConsult. The rest would have to go via 111.
But eConsult takes so long to fill out!
On average it takes 3-4 minutes to complete an eConsult. It takes nearly 2 minutes just to get through our telephone message! Obviously, some people will not be as quick as this, but even if it does take a bit longer, you are helping to keep our reception staff available to deal with urgent matters. Some patients will not be able to access eConsult for various reasons, and will have to call, but if everyone did this, the system would collapse. We are well aware of patients blatantly lying to our reception staff to avoid completing an eConsult, and really this just makes us sad. It is so easy for the selfishness of some to overwhelm the altruism of many.
The eConsult questions are not relevant
Firstly, we would recommend taking a good look down the page of conditions when you start completing an eConsult, and if you cannot find something relevant to you, then click ‘general advice’. You can also search for your condition. You may find that you are asked questions that do not seem appropriate to you, but often there is a good reason for this question, and the answer is more helpful to us than you might think. If a question is really not relevant it is fine to leave it blank (you can type NA or not applicable), but please fill out as much detail in the other areas as you can.
When will things be going ‘back to normal’?
The simple answer to this is – probably never. Lots of our busy patients have really benefitted from the technological advances we have made in a few short months and find it much easier to consult remotely whilst at work or looking after children. We would like to be able to see patients face to face more often, but at the moment the risk of transmitting COVID19 is too high to offer this, and we must only see patients where the clinician feels it is absolutely necessary.
Can I have my flu jab?
We are prioritising our flu vaccine delivery, starting with those patients above the age of 65 with certain medical conditions. This will be extended to all patients with certain health conditions shortly, then to the over 65s with no underlying health conditions relevant to flu, and then to all healthy patients from the age of 50 – 64 later in the year assuming the government supply us with the additional vaccine. All vaccinations will be carried out in specified clinics, and you will be allocated an appointment and contacted by letter if and when you are eligible. Due to potential supply shortages, we are unable to book patients for vaccines outside of these clinics and are also unable to give the vaccine if you are attending the surgery for another reason. Please do not contact the surgery asking for a flu jab, please wait to receive an appointment. If you cannot wait for an appointment with us, you may like to try contacting one of the local pharmacies who are also administering NHS flu vaccines.
My consultant says I should be top of the list for a flu jab, why have I not received a letter yet?
Due to additional patient cohorts being made eligible this year for the flu vaccine, we have a vast number of patients we need to inoculate. In total, 8207 patients are eligible this year, out of our total practice population of 12,155 (68%). All our clinical staff are working overtime to help, but even with 8 staff working every Saturday we can only get through about 430 patients each day. Even though you may be high risk, there are many other patients in the same boat and unfortunately, we do not have an option but to make you wait your turn. If you have been given an appointment, please make sure you attend, or let us know if you are not available so that we can offer it to someone else.
When will my child have their flu vaccine?
Parents of children under school age will be sent an appointment for the vaccine to be given at the surgery. School children will have the flu vaccine given at school. Home schooled children will be contacted by Public Health England to arrange the vaccination, but if you are concerned that your child is at risk (for example has severe health problems) then we can offer the vaccination at the surgery.
Can you tell me when I will be seen in hospital?
No. We know that hospital waiting times are longer than ever thanks to the pandemic, but we have no access to projected waiting times. We recommend patience, but if you are concerned you will have to contact the hospital directly.
Can you speed up my appointment?
No. We have no way of expediting appointments if you are unhappy with how long you have to wait. If there has been a significant change in your condition, then we may need to change the way we are managing the situation, so please contact us only if this is the case.
Can you give me an exemption letter for wearing a mask?
No. We are categorically unable to provide this. Those who have an age, health or disability reason for not wearing a face covering should not be routinely asked to give any written evidence of this, this includes exemption cards. No person needs to seek advice or request a letter from a medical professional about their reason for not wearing a face covering.
Some people may feel more comfortable showing something that says they do not have to wear a face covering. This could be in the form of an exemption card, badge or even a home-made sign.
This is a personal choice and is not necessary in law.
Can you tell my holiday company I no longer want to go away because of the risk of COVID19?
No. If you choose to cancel your holiday because you are concerned about the COVID19 risk, we are unable to provide medical evidence to support this decision, and you are unlikely to be able to claim the holiday cancellation on insurance. We are only able to provide medical evidence to travel insurance companies if you are currently too unwell to travel and you have been advised by a doctor not to. The travel company will provide you with a form for us to complete, which is chargeable.
Can you tell my employer I cannot go to work because I am high risk?
No. It is up to your employer to determine whether it is safe for you to go to work and make reasonable adjustments as they see fit.
I am self-isolating, can I have a fit note for my employer?
No. If you need to self-isolate; because you have symptoms of coronavirus, live with someone who has symptoms of coronavirus or have been advised to self-isolate by a test and trace service, then you can access an isolation note for your employer online here.