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Hebden Bridge Group Practice

From Gwen Goddard

Saturday, 25 August 2018

I was disappointed this week to see the following notice in the window of the Valley Road surgery.

From 30th August 2018 due to demand there will no longer be a telephone duty doctor system for urgent appointments. In its place there will be from Monday to Friday 8 am until 10.30 am a walk in surgery at Grange Dene Medical Centre where patients with a single urgent problem can sit and wait to see an appropriate clinician. Where the patient has a problem which is not urgent the Practice will be providing more routine appointments.

What does one do after 10.30?  Put more pressure on A&E I suppose.

No way do I want to criticise or complain about our hardworking and respected GPs.  

What I would like to know is what consultation took place about the removal of this much valued service.  I looked on the Practice's website for more information but found it to be unhelpful in this respect and out of date in several ways. 

We all know the NHS is in dire need of proper funding and there is a shortage of GPs and other clinicians  -  over the last twelve months four of our doctors (all female) have left or will shortly do so  -  but the loss of the telephone duty doctor system locally is very unfortunate.     

From Richard Peters

Sunday, 26 August 2018

Our surgery doesn't do consultation.

This is another arbitrary decision that you only find out when you happen to visit the surgery (previous changes to emergency issues, repeat prescriptions).

Never mind they could easily send us all a text about changes like this - maybe too much trouble.

The doctors will have had little to do with this decision. It is the Practice Manager who seems to treat patients with disdain. The patients committee? Many have tried and given up. Our surgery is in effect a private monopoly, so knowing we have nowhere to go, why should they bother to treat us like 'customers'

From Kez Armitage

Sunday, 26 August 2018

"The Practice anticipates that this change in the service will continue to ensure that we are able to provide the speediest access to those in greatest need." 

Right. So a visit to Mytholmroyd with its ongoing road works, sitting and waiting (as the response to Hebweb says) is going to provide speedier access to healthcare advice than a one or two minute call to your own home from a duty doctor? 

The current system of telephone consultations works well and is highly valued. Is there any evidence it's not used? Or it it simply too popular? And were the opinions of users solicited? And, most importantly, is there anything that we can do to reverse this decision?

From Mark H

Monday, 27 August 2018

What decision making process determined that the walk in service should be 0800-1030 in Mytholmroyd?

Spare capacity on buses or trains?

No, they're already full of folks going to work or to learn. It's Rush Hour.

Roads?

Luckily there's only 16 months until the flood works are due to finish. 16 months while the entrance to - and exit from - Grange Dene is at the epicentre of the traffic maelstrom. Always good to add a significant number of cars containing sick people and stressed drivers... 

Staffing?


Who asked the people working at Grange Dene about real problems or family issues around having to get there in time to start work at 0800?

If it must be done, please consider opening the sessions 1000-1230.

Thanks

From Arla R

Friday, 31 August 2018

As a vulnerable adult who has mental health crises from time to time, and has been turned away by the Community Mental Health Team following GP referrals several times in the last four years, the loss of this service will impact me hard.

How do they justify cutting a service they were finding difficult to manage "because too many people needed it"? Surely that's where they need to put more resources?!

However, I would also say that last time I used this service, which must have been only a week or so before it was stopped, I wasn't able to get through on the phone for more than half an hour after the practice lunch break. I was unable to cope with trying to get through on the phone again, and it was only because someone else was able to phone on my behalf that I was able to get a call back and then be seen face to face later in the day.  

So it's justifiable to say the service wasn't working very well - but not to scrap it.

I wonder if there is any way Upper Valley residents can find a way to make the GP practice listen to patient need?  Certainly, in a mental health crisis the last thing you want to be doing is forcing vulnerable, unwell people to find a way to get to Calderdale Royal A&E and then somehow cope with hours of waiting time, especially in school holidays when A&E is full of parents and children. When all you maybe need is some meds to see you through a few days - as long as you don't have all those added stresses.

From Zilla Brown

Friday, 31 August 2018

As someone who has a long term, indeed life long illness that can have serious exacerbations from time to time  I have always  depended on being able to get advice on any  new medication needed , and an emergency prescription, or seeing the doctor on the same day in an emergency.

What are people like myself supposed to do now if we need an urgent appointment? Do the Practice expect people who are bed ridden or too ill to leave the house to totter off to Mytholmroyd? Are they really implying that we must go to A and E in Halifax (however long that lasts) as a last resort?

I'm not aware of any alternative arrangements being offered and think the practice could have handled this better.They are supposed to offer primary care, what services are they offering now except passive ones like blood tests and appointments that you have to wait 3 weeks for? Even after being asked by letter to ring the practice  I was told I had to wait 3 weeks to speak to a doctor. What can be done? Write a letter?

From Eileen Cann

Thursday, 6 September 2018

 I acknowledge Richard Peters' point that patients have given up on the Patient Reference Group but it seems to be one of the only ways to get the patient's view across. The HBGP website states: "The aim of the Patient Reference Group is to work towards improving and developing patient services. This group of patients help voice the views, needs and requirements of our Practice Patients The group helps influence a positive change in the services provided by Hebden Bridge Group Practice. The Reference Group comprises of the group members, Practice Business Manager and other health professionals." 

I have emailed this group - prg.hbgp@gmail.com - to ask them to:

  1. Let me know what the consultation process has been prior to adopting the new system
  2. How I can attend a meeting of the PRG where the new system will be discussed with the Practice Manager. I understand meetings are open to all patients.
  3. Let me know the most effective way to register an objection to the way this decision has been made and implemented.

Can I suggest that if you object to the continuing deterioration of the service we patients receive from our local GP practice, especially this latest one, that you email the PRG and send a hard copy of your email to the Practice Business Manager - who does not publicise his email. There must be a way of letting our views be heard and getting some accountability from the management of the HBGP.

From Gwen Goddard

Friday, 7 September 2018

I have emailed the Patient Reference Group asking if their meetings are open to all patients and, if so, the date, time and venue for the next meeting.  I will post the reply here.

From Mal Campbell

Thursday, 13 September 2018

I went in for an appointment today. No-one in the waiting rooms when I went in, no one in the waiting rooms as I left. What is going on?

From Jae Evans

Sunday, 16 September 2018

I wish to add my concern at the removal of GP telephone 'call backs.'  As an adult, M.E (Chronic Fatigue) sufferer, I can be house-bound for days, sometimes weeks with pain and fatigue.

Suffice to say, that telephone 'call-backs' were perfect for me: 2 or 3 minutes to allay my fear of a new pain or to moderate a prescription. 

The sudden removal of this policy is shocking.  As when I am poorly, I simply am not able to get to the surgery, let alone have the energy to sit and wait until a GP could see me - then to get home.  

This is aside from the absurd time slot given to the new 'sit and wait' policy: Who - thought early morning rush hour would be a great time?  The appalling road and traffic situation is completely overwhelming for a vulnerable person - such as I am when poorly.

Presently, I have a question regarding a serious issue that I hope my GP can answer: I have just made an appointment - 4 weeks to see him.

I hope I don't die waiting!  

From Lisa M

Monday, 17 September 2018

I’d like to join you all in saying how cruel and impractical this change is. 

Surely we have some sway as patients. 

As someone with two chronic life long illnesses and one other long term condition I need to be able to get help at short notice for advice and prescription queries.

How can changes this severe but made without consultation? They must change this back. It was hard enough getting help as things were.

From Jenny Shepherd

Tuesday, 18 September 2018

Calderdale & Kirklees 999 Call for the NHS asked the Practice Manager Tony Martin what exactly is going on with changes to urgent appointments. 

He told us that routine and urgent home visits for patients who can't get to the Mytholmroyd walk in, and phone calls for patients with treatment plans, are still available through Hebden Bridge Group Practice's new urgent care system. 

More info here 

From Gwen Goddard

Friday, 21 September 2018

Tony Martin, the Practice Manager, told me yesterday that the Patient Reference Group met the previous day 18th September. He did not say when it would meet again.

The link given in Jenny Shepherd's recent post on this subject gives a lot of interesting information and I recommend its reading.

From David H

Friday, 21 September 2018

Very strange! Gwen Goddard asked on 7 Sept when the next meeting was to be held. They replied on 19 Sept to say that it had happened on the 18 Sept and not giving a date for any future meetings. What gives the impression that outsiders (aka patients) are not welcome? Or perhaps l’m being totally unfair . . . 

From Graham Barker

Friday, 21 September 2018

Thanks to the link supplied by Jenny, I’ve read practice manager Tony Martin’s comments about GP shortages and in that context the new scheme starts to sound very much like an act of desperation. I’m guessing that the deliberate aim is to cut demand to suit supply in a situation where the practice can’t increase supply.

One might be able to sympathise if all the facts were more out in the open, but it’s difficult to trust a practice that seems to prefer evasive spin to honesty.

From Michael Prior

Monday, 24 September 2018

One factor in all this is the status of the Valley Medical Practice which is that of a private-sector company/partnership (the exact status of the Practice is unclear) which has a licensed local monopoly to provide medical services under a contract with the NHS from which it makes profit. 

What is unclear is exactly what level of service it is contractually required to provide and whether the per capita fee which it gets from the NHS varies as this level changes.

Rude questions like this hardly seemed necessary in the 'good old days' of the family doctor on call 24-hours a day but they it are relevant to the current problems with the Valley Medical Practice. When a GP leaves the practice and its wage bill consequently falls as does its service provision, does its per capita fee also drop. Just what services does its (confidential) contract with the NHS require it to provide?

Companies like Virgin Care are not interested in moving into local practice out of the goodness of Richard Branson's heart but because there are good profits to be made out of GP-led health provision.

Sorry, but the Practice Manager's pleas are not convincing. If you want more employee-doctors try paying them more and taking less profit from whatever corporate body lies behind the Practice.

From Jay Jones

Monday, 24 September 2018

The Practice Manager's comment, “The Practice cannot be responsible for any transport arrangements our patients may have or choose to make." indicates either the lack of understanding or simple unconcern for the impact the new arrangement is likely to have.

From Sue S

Monday, 24 September 2018

 In response to the comments about the practice as a private business, contributors need to understand that all GP practices are contracted businesses to the NHS. The terms of the contract vary slightly each year but there is a consistent and clearly understood core GP contract.  It's publically available here.

GP's are also able to choose whether they wish to provide other services for which they are paid additional fees. Most of these are within the realm of Public Health need, such as vaccination programmes, and others are in order to provide services nearer to the patient (to save attending acute hospital care) and include joint injections and some medications for example.

There is a perception that GP's are paid a fortune and they are not. They are paid a few hundred pounds a year per patient. From this they need to cover, all staff costs, building related costs, insurances, rent/rates etc etc. as do all businesses. Once these are deducted, there is not a lot of 'profit'.

The decisions made will not be about cost, but about a national shortage of GP's which is hitting everywhere including Hebden Bridge. 

Patients (I am one too) do need to start to understand that the NHS, although free at the point of delivery etc, just cannot continue to be used as it has been in the past. There is a tipping point at which it will no longer cope with the increasing demand and (yes I will say it), misuse by some, and it seems that HBGP has finally caught up with the picture in large parts of the country already. 

Finally - I am - as you might have guessed - a PM in a GP Practice elsewhere. This decision will not have been taken in isolation - the GP partners would have made the final decision, not Mr Martin the PM.

Why not give the open access a try and see if it works for you when you have an acute need. I work in Manchester and used the telephone service. I will of course miss this, wonderful service. I will now need to leave work 2 hours early in order to attend an appointment - or take a day off even. However if everyone gets used to seeing other, very capable professionals, instead of automatically seeing a GP, it is likely that another review will take place and we might see the service change again.

To influence this you can join the PRG online, or call in and ask to join - you can then make your voice heard.

From Michael Prior

Monday, 24 September 2018

Susan S does really answer my question: when a GP leaves and the practice wages bill drops, is the annual fee claimed by the practice reduced? Or is it in the best financial interests of those who own the practice to reduce service provision whilst claiming the same per capita fee? To put it bluntly, when Valley Medical stopped taking emergency telephone calls did it continue to claim the same per capita fees? Just asking.

From Janet Moore

Tuesday, 25 September 2018

I am thankful that I have only had to see a doctor about simple, routine problems.  However, I know several people who have had serious, complex conditions.  I know women who have gone through pregnancy and childbirth, and I know 3 families who have had relatives die of long term illness.  The care and attention they received from doctors and nursing practioners, as well as reception and office staff is exemplary. 

Doctors going out of their way not only to deliver the very best medical care, but also to spend time they really did not have, to explain matters carefully and gently.  Time to be with patients and their relatives as they came to terms with devastating information.  Time to check and double check results and hospital arrangements.  Time to just sit as someone took their last breath. Doctors depriving their own families of time as they carried on working long after the scheduled shift had ended.

I do not envy anyone the job of trying to organise a medical centre, so many people, so many needs, so little money.  I believe this practise is trying to deliver the very best care to every patient in their area, and I just want to take this opportunity to say thank you.  Because I know that regardless of where this re-organisation may have reached, if I or those I care about, suddenly had need of a doctor, they would respond immediately and effectively.

From Michael Prior

Tuesday, 25 September 2018

Sorry to post again but Susan S inspired me to look at the general GP contract via the link she provided. It is actually rather opaque on the precise level of fees charged for what but it does have a very clear statement about the Patient Participation Group about which there has been some discussion here. It read:

Patient Participation
5.2.1. The Contractor must establish and maintain a group known as a “Patient Participation Group” comprising some of its registered patients for the purposes of:
(a) obtaining the views of patients who have attended the Contractor's practice about the services delivered by the Contractor; and
(b) enabling the Contractor to obtain feedback from its registered patients about those services.
5.2.2. The Contractor is not required to establish a Patient Participation Group if such a group has already been established by the Contractor in accordance with any directions about enhanced services which were given by the Secretary of State under section 98A of the 2006 Act before 1st April 2015.
5.2.3. The Contractor must make reasonable efforts during each financial year to review the membership of its Patient Participation Group in order to ensure that the Group is representative of its registered patients.
5.2.4. The Contractor must:
(a) engage with its Patient Participation Group, at such frequent intervals throughout each financial year as the Contractor must agree with that Group, with a view to obtaining feedback from the Contractor's registered patients, in an appropriate and accessible manner which is designed to encourage patient participation, about the services delivered by the Contractor; and
5.2.5 review any feedback received about the services delivered by the Contractor, whether by virtue of clause 5.2.4(a) or otherwise, with its Patient Participation Group with a view to agreeing with that Group the improvements (if any) which are to be made to those services.
5.2.6 The Con tractor must make reasonable efforts to implement such improvements to the services delivered by the Contractor as are agreed between the Contractor and its Patient Participation Group.


I drew particular attention to 5.2.3 and 5,2,6

Current GP contract

From Sue S

Tuesday, 25 September 2018

Michael, the contract isn't opaque. 

GPS are paid by patient population for the care given on an annual basis, as I said this is a few hundred pounds, about £180.00 per patient in fact. I'm not sure what other service could provide so much for so little. As I said they can then offer other services for the benefit of patients which may be paid on a price per item. An example is a vaccination for which they are paid less than £10.00.

If you want to have your say why not join the patient group.

From David Flint

Tuesday, 25 September 2018

I would like to thank Hebden Bridge Group Practice for all the care and support they have given to me over the past 30 years.

They are doing an excellent job in very difficult circumstances. 

From Anne H

Wednesday, 26 September 2018

Michael, you point to areas in the contract concerning the Patient Participation Group. I'm not sure if you are implying that the practice doesn't involve the group enough, but I can tell you from my own experience of several years' involvement, and Chair of the Group for a while, that the difficulty has been one of getting patients involved and not the Practice Manager and staff who have always been proactive and tried to review the group regularly, and rearrange times to allow for different groups of patients to be able to attend, such as elderly people, working people or parents with young children.

I had to stop going because it clashed with work so I don't know how much support the group has now. Why don't you go along and find out? Just a note of caution though, don't expect to have the final say on things like emergency appointments.

The surgery has to make business decisions that can be influenced by consultation with patients but not completely dictated by patients. Also, it's a two way process. The group helps out with things like the annual(?) patient survey, feedback from other health service forums etc. It's not all about complaint! I sat on the interview panel a few years ago for a new GP and I can tell you it's very difficult when nobody applies!

From Tony Goodall

Wednesday, 26 September 2018

As someone battling the late effects of Polio, Post Polio Syndrome - a chronic debilitating condition many professionals may not have encountered, I can only commend the Practice for the care and support provided over recent years. So sad Dr Gooch has departed.

From Michael Prior

Thursday, 27 September 2018

Sorry to press the point but Sue S. simply evades the point.

The opaqueness or otherwise of the draft contract can be disputed but, for example, she is wrong in asserting that the Practice is contracted to the NHS. It may or may not be, depending on whether the word [not] is included or deleted in the contract actually signed.

The Practice is actually paid rather more than she suggests. It was more like £230 on the video I saw in the waiting room. But that is not the point.

"The average pay for GPs working in this Practice based upon the above in the last full financial year was £85,004.52 before tax, national insurance etc. This is for 13 GPs, working full and part time."

(I quote from their webpage)

There are now 9 doctors working there and at least 2 more are planning to leave. This will reduce the the wages bill for the practice by about £500,000 annually and the Practice is in the process of reducing the services it offers. Just who takes this half-million? Is the per capita fee reduced? Or is it simply added into the bottom line of profit statement? 

I am sure that the patient representatives on the Reference Committee do their job. At the last meeting in July, Lesley Mackay  (her name is on the minutes so I assume that she can be named) stated that "HBGP was the worst practice for waiting lists for appointments."  TM asked where this data had come from and LMc explained that it was the perception of those in the meeting rather than any hard data.

TM explained the data from the Practice and other organisations contradicts this."

So that all right then.

Personally, I have always had reasonable care from HBGP apart from one disaster with out-of-hours provision which it has totally given up. But there are questions about getting appointments and telephone advice which should be answered.

From Graham Barker

Thursday, 27 September 2018

I don’t think one can assume that fewer GPs means more money left in the pot. The impression I get - though it’s a struggle to understand how general medical services contracts work - is that practices are being required year on year to do more with less, so there may be no saving when GPs leave. It may all be swallowed up in rising running costs, particularly if locums or agencies are used for essential cover. It may even be that the group practice isn’t financially viable unless it reduces the number of GPs.

It looks as though the early morning service changes are all about cutting provision to balance the books, and more cuts may be necessary. Maybe we’ve all been taking GP services too much for granted, but if so it’s time for the practice to be much more open about what can and can’t be afforded. 

From Jae Evans

Monday, 1 October 2018

Having read the comments from the Practice Manager, I remain completely confused!

He seems to be suggesting that nothing significant has changed, and that one can still call and discuss problems/medications: I have surely, misunderstood.  I'm simply a retired Tutor after all ...  my illness makes for confusing 'brain-fog' - ironic isn't it.

What to do?

I realise the country is in a terrible mess, financially and otherwise.  But I do wish the Practice would be more forthright - and respectful to its patients, about such serious matters, issues such as these before they occur, that's all.

It's all terribly depressing.

From Vivien Aspey

Thursday, 4 October 2018

As a retired NHS Manager who spent many years working with Primary Care, among other work areas, I fully understand the national GP recruitment crisis, the pressure on GPs and the importance of Primary Care in a modern NHS. I have to say that management of GP Contracts and indeed the whole concept of independent contractor status, was and is a Black Art. So I suggest we all stop trying to understand the economics of our local practice, and concentrate instead on getting the best out of what remains. Sadly, if we can't get what we need from our local surgeries we will have to access secondary care via A and E, but we need to give what is in place locally a chance to work.

However, the departure of key clinicians from the practice after serving local people for decades in some cases, has been communicated insensitively and disrespectfully to us, the patient population. I found out in the hairdressers, and I have since told others who had no idea. The practice will reap what it sows and could even disintegrate with as little advance warning. Should this happen, either we will be advised by NHS England to visit neighbouring practices, or NHS England will commission alternative services at least temporarily by employing salaried GPs. It is even possible that some of the departed GPs might sell their services back to the NHS....as I said, a Black Art. 

From Gabriel Serota

Thursday, 11 October 2018

I see there has been some discussion about GPs' earnings. I used to have to negotiate GPs' pay with the BMA and their contract is indeed a dark art. 

For information the national average net salary for a full time GP partner was around £115,000 in 2015/16. This is their gross income less all practice expenses i.e. their personal net income before tax. (This is for independent practitioners and doesn't include salaried GPs.)

Practices have to publish partners' net income annually but in a format that doesn't differentiate between those working full time  and those working part time, so isn't a very meaningful figure. The more part-timers the lower the average income of the partners. Nationally one headcount male partner  equates to 0.95% of a whole time equivalent, and a female partner 0.79%. 

From Sharon Slade

Monday, 15 October 2018

Got a letter from the surgery saying  I need to speak to a doctor about my blood test results.

Told by the receptionist that the earliest appointment  to do this is 5/11. That's 3 weeks just to speak to a doctor, 3 weeks of worrying what is wrong with my blood tests.

In reality, it's going to be at least 6 weeks because as I explained I am going to Sri Lanka on 1st and would be away most of the month so needed to speak to someone before the 1st.

All she kept repeating was that that was the earliest phone appointment was 5th Nov. Asked to speak the manager and then the message came back that a doctor may ring me.

This practice used to be fantastic, caring and understanding. Now it's a shambles.

From Brenda S

Monday, 15 October 2018

That seems to be normal for a few years now. Send out a letter second class post a long time after test results have been returned to tell you to discuss test results. Then it's not possible to have a phone call for three weeks. I agree its unsatisfactory and causes a lot of stress but what can we do about it?

From Dave J

Monday, 15 October 2018

I had a similar experience to Sarah. At a routine visit to the optician they suggested I needed to visit the hospital but my Doctor would need to refer me. 

I handed in the letter and a week or so later received a reply from the surgery saying I needed to make an appointment to speak to a Doctor and the first appointment was three weeks later.

When I finally spoke to him, he agreed to the appointment within about 10 seconds as he read it out loud to himself, clearly the first time he had seen it. What a complete and literal waste of time.

From Jenny B

Tuesday, 16 October 2018

If you register to access your patient record online, you can view your own blood test results. Often there is a link to what is ‘normal’. I find if there is cause for concern they do contact you sooner. 

From Ness Parfitt

Wednesday, 24 October 2018

I, like Sharon Slade, can also have a phonecall from a doctor 5 weeks after having a blood test. 

At the designated time I will be on a train with no opportunity to write down the results or indeed to feel freely able to ask questions. There is no waiting list kept if cancellations occur in the phone call system. I am advised that I could ignore the call if it is inconvenient and I may be called again.

Jenny B’s useful advice to access my detailed records seemed the answer. I tried and below is the message on the website - note particularly the last paragraph

Online access to your Detailed Record :

From 31st March 2016 the Practice is required to offer patients online access to all information from their medical record which is held in coded form. The Practice has a policy in place which ensures that this is managed safely in accordance with the Data Protection Act and Caldicott Principles.

Please note that clinical and non-clinical staff are required to access your medical records when necessary. All staff are bound by the Data Protection Act.

NHS England have advised us that a technical problem means that we are currently unable to offer access to detailed records as we intended. Our system suppliers are working to resolve this issue as soon as possible “

So no help there.

Also - why am I directed to Mytholmroyd all the time?

I have valued the care from my local Hebden Bridge surgery for many years.  I now find it bizarre that I have to travel to wait in an overcrowded Mytholmroyd surgery far more often than I can be seen in Hebden Bridge, where the waiting room appears to be near empty.

From Gwen Goddard

Wednesday, 24 October 2018

Having had an Over 65 health check I have been trying for three weeks to get access to my medical records online in order to see the blood test results.  

Jenny B in a previous post said this was the way to go. I did manage to see my 'summary record' which didn't offer much of use, just telling me about past medication which I no longer need.  I had to 'request' the full record, which I did.  Checking the website today I see that this is still listed as a request but no longer available as a service.

We are being encouraged not to use a GP's time unnecessarily but it seems we then have to in order merely to get a blood test result.

I have said before in this thread that I do not want to criticise our valued and hard working GPs.  The shortcomings locally as in most practices are the result of underfunding.  But now we have deficient administration as well. 

From Kez Armitage

Wednesday, 24 October 2018

NHS Choices is a starting point. It's a highly under-utilised service where you can leave comments about healthcare in your area. Just type 'GP' into the 'Find' box and 'Hebden Bridge' into the location box. You get an opportunity to comment on the service you're receiving.

From Jenny B

Thursday, 25 October 2018

Re accessing blood tests results: There are 2 records, your summary and your patient record. However, the blood test results can be accessed by clicking on the tab that says view test results. They stay on there for around a month and are also transferred to your record.

If you are struggling, I would ask at the desk. 

I know they have not made all information available but you can access test results easily enough as described. 

From Vivien Aspey

Friday, 26 October 2018

For a long time now I have been watching the at times anguished comments of the long suffering patients of the Hebden Bridge Group Practice, occasionally commenting myself. In particular I am noticing that, understandably, people don't understand the lack of democratic accountability of independent contractors, and the smoke and mirrors responses of "the Practice" sometimes enunciated by the Practice Business Manager.

Lack of consultation is a recurring theme, as is reference to the virtually defunct "patients participation group"  as moderated by said Practice Manager through whom all potentially interested members had to apply. I am sure group members did their best but when minutes of their meetings were available I noticed examples of blatant stonewalling. Plus the group was a convenient whipping boy for measures such as car clamping 10 years ago by cowboys whose methodology was later rendered illegal.

As I say, the threads of current behaviour patterns have been visible for a long time.

Most of us resident in the Upper Calder Valley are eligible to register with other practices but the HBGP is the biggest and its practice premises, funded directly or indirectly through the taxes we pay, most conveniently situated. Realistically, whatever this practice does, even if it folds, we will all be affected for the foreseeable future. There is one thing that has been completely absent throughout this sorry situation that we can, of our own volition, change, and that is our identity as a group of people. Only the Practice knows who we are, and what our experiences are of practice services. If we have problems with repeat prescribing, or availability of appointments, or the outcome of the Practice complaints procedure, the Practice alone has an overview and is sitting on a mine of our information.

My suggestion is that we set up our own patients' group independently of the Practice and open only to patients registered with the Practice. Even our registration with the Practice is confidential, but as patients we have the legal right to break that confidentiality wih each other. It may be that in the short term we can change nothing, but even knowing that we share a problem can be comforting and stress relieving. And we can tackle the rumour machine eg before the current open surgeries there was a rumour that all routine appointments were to be transferred to HB, which would have resulted in more traffic on the Burnley Road at a time when it is least able to cope.

What do readers think? Proof of registration would not be a prerequisite because why else would anyone want to spend time discussing problems that were not theirs?  Obviously Practice management might position itself to be aware of the content of discussion, but unlike the tenor of Practice based discussion, this discussion would not be held secretively behind closed doors. 

Some of use might worry about removal from the Practice list. But if there were enough of us that would be much less practical and the reason sufficiently transparent to discourage even the most draconian response. And given how services are presently being offered, removal from this list carries less weight as a penalty than it once did. In fact it would be good to hear from people who have possibly already exercised this initiative.

So I ask again - is this an idea worth pursuing?

From Brenda S

Saturday, 27 October 2018

Yes it is worth pursuing. 

It might be possible to produce a list of 'services' that are not working in the interests of patients. A good example of this would be the actioning of test results and reduction of waiting time for them. Very few GPs work to this extensive time lag.

From Jenny Shepherd

Sunday, 28 October 2018

Calderdale Clinical Commissioning Group is responsible for planning and buying primary care, which includes GP practices. This means the Clinical Commissioning Group is also responsible for monitoring the services GP practices provide and making sure they meet the contract specifications and provide a decent quality service that meets patients' needs. They do this through the Commissioning Primary Medical Services Committee - link here.  

If people are dissatisfied with the services provided by Hebden Bridge Group Practice then you need to let Calderdale Clinical Commissioning Group know. And that includes the way the Patient Participation or Reference Group is run.

The NHS in general is in a dire state of upheaval as the government's quango NHS England is driving through cuts-driven changes designed to introduce USA Medicare/Medicaid-style Accountable Care into the NHS (which NHS England has re-branded Integrated Care in order to avoid the American connotations of Accountable Care). 

Calderdale Clinical Commissioning Group and Calderdale Council are responsible for driving these changes in Calderdale.  They include big changes to Calderdale GP practices and other primary care services, as the plan is to cut hospital services and displace them into the "community" - ie large scale GP/community health service hubs serving around 50K patients. 2 have already been set up in Halifax and 3 more are to be set up in the rest of Calderdale.  

I am chair of Calderdale and Kirklees 999 Call for the NHS,  which campaigns to protect the NHS from cuts and privatisation. There is info on our blog about changes to GP services and primary care. 

We are contacting the Hebden Bridge Practice Manager again shortly, as follow up to our previous letter, that I posted in this thread some time ago along with Tony Martin's reply. This is because things have become apparent about the Mytholmroyd walk in clinic that we are worried about and that we want to draw to his attention. We will publish the new correspondence in due course.  

Here is the link   to the GP practices thread on Calderdale and Kirklees 999 Call for the NHS blog

From Vivien Aspey

Tuesday, 30 October 2018

In response to a suggestion that those concerned about what is happening in Hebden Bridge Group Practice complain to the Calderdale Clinical Commissioning Group, I have to point out that they must first go through the Practice Complaints Procedure which is administered by the Practice Manager. OK after that complainants can go through the CCG but without personalising any of this, I have to point out that GPs sit on the CCG which can hardly be categorised as independent or impartial. Or you can go to NHS England, but GPs are so thin on the ground that the chances of a complaint being upheld in a climate of scarcity are somewhat thin.

There is no-one in the system now who really represents patients independently. Once upon a time we had Community Health Councils but they were abolished.

Anyway, reading through earlier contriburions to this thread, I am shocked at a response that just refers people back through a system that is failing them. People don't sign up to a practice to complain - they just want their needs to be met. And yes GPs generally are overburdened but that does not give any practice permission to do less than its best.

And expecting patients to wait 3 weeks to talk to a doctor abour blood test results, or instructing receptionists to tell patients that doctors are no longer offering telephone advice, is just not the best that the practice can do.

Over the last few weeks and months many of us have experienced the inflexible application of principles designed purely to manage workload, not to meet patients needs, and the point is being reached where enough is enough.

No individual patient is likely to amass enough evidence of service failure, but overall a pattern may be emerging and it is nobody's job to acquire knowledge to demonsrate that. On the contrary the odds are stacked in favour of sweeping the problems under the carpet.

Coming back to the suggestion of approaching the CCG, this will only be effective if patients organise themselves to present a group complaint. The mechanism for this does not exist, unless enough people care enough to create this mechanism. Desperate times call for desperate measures, and my reading of some contributions to this Forum thread is that some of us are desperate.

From John Rhodes

Wednesday, 31 October 2018

Just phoned to make an appointment for a flu jab. They've run out. The poor receptionist is required to ask people to phone back in a week or so and then weekly until more supplies have arrived. I'll be phoning Friday week so if everyone else could avoid that day I'd be grateful. Otherwise I'll be around number thirty-three in the phone queue.  

Is it beyond their organisational capacity to take an email address and let us know when new supplies have arrived? Why is it not possible to book one on-line? I know all about under-funding but there are some simple ways they could make the existing staff resource stretch a bit further. 

From Mike S

Thursday, 1 November 2018

John Rhodes - you can get a flu jab at Boots in Hebden bridge or Todmorden. Just check Boots on line to make an appointment.

From Vivien Aspey

Monday, 5 November 2018

OK so it's not looking like anyone wants to set up a patients' group separate from that set up by the Practice. Fair enough. So where do we go from here? Can we hear from whoever speaks for the PPG about what consultation has taken place regarding the present open surgery arrangement and the undertaking to make more appointments available? 

When does the PPG next meet and how may patients access the minutes of the last meeting?

From David H

Monday, 5 November 2018

The PRG (Patient Representative Group) has a web presence. You can find the minutes here

From Ruth Walker-Cotton

Friday, 9 November 2018

Just was told by HBGP that my son (who is too unwell to go to Mytholmroyd to get to school) needs to go to Mytholmroyd to wait at the walk-in clinic to see the doctor. No option of a call back, no option of a nurse practitioner at Hebden Bridge, apparently I can call later to see if they have any cancellations - but by then I would have missed the walk-ins.

The receptionist agreed that 'it's not the best', but when I asked for the Practice Managers email, I was told it is policy not to give it out. I have asked for a complaint to be passed on and for him to email me, and I have filled in a Calderdale CCG complaint form which is online.

I am not hopeful of positive responses, but am very concerned for anyone who has more serious health problems and is in need of local same day care. 

See also

HebWeb News: Hebden Bridge Group Practice changes appointments system (25 Aug)