Dr LAURENCE BUCKMAN

A GUIDE FOR PATIENTS

THE GROUP PRACTICE

TEMPLE FORTUNE HEALTH CENTRE

23 TEMPLE FORTUNE LANE LONDON NW11 7TE

Tel: 020 8458 4431 Fax: 020 8731 8257

Emergencies between 6.30 p.m. - 8.30 a.m., Weekends & Bank Holidays: 020 8492 9430

With Dr. Martin Harris & Dr .Cynthia Rowbury

DR BUCKMAN'S ASSISTANTS:

DR EILEEN ROSENFELDER

MB BS BSc DRCOG DCH MRCGP

DR JOHN BENTLEY

MB BS MRCGP

DR DEBORAH BENTLEY

MB BS BSc MRCGP

PRACTICE MANAGER:

Christina Brownson

SENIOR RECEPTIONIST:

Xenia Wafai

PRACTICE NURSES:

Lyn Deacon

Jessica Crespi

Adrienne Richards

DISTRICT NURSE:

Lian Panetta

COUNSELLOR:

Regina Sliw

About Dr Buckman:

MB BS (Lon 1977), MRCS. LRCP, FRCGP.

I qualified from UCH in 1977 and trained in hospitals in London and locally - initially in General Medicine then later in various medical specialities and Paediatrics. I trained in General Practice in Borehamwood and entered a practice there in 1983. I joined Temple Fortune Health Centre in 1993.

I teach medical students from University College London and abroad. I represent my fellow doctors on local and national committees and am therefore usually in the surgery on Mondays and Fridays only.

I am married to a retired dentist and have two sons.

Consultations

(by appointment only):

Mon – Fri 8.30 a.m. - 12.00noon

Mon , Tue, Wed, Fri

4.30 p.m. - 6.00 p.m.

Reception is open from 8.30 a.m. to 6.30 p.m. As far as possible, you can see me for routine appointments on the day you request. Separate appointments should be made for each person - it is impossible to see two patients in the ten minutes I allocate for one - and I would be grateful if unwanted appointments are cancelled as soon as possible. Priority is given to people who feel really ill and to those who might be infectious. At no time will our staff ever turn you away if you are ill. If you are not happy with what you are being offered or if you think you may need more time with me, please explain this to the staff who will try their best to help.

I can usually arrange to see you early in the morning, late in the evening or on weekends. Such appointments must have been agreed with me in advance.

You will be expected to pay for consultations to do with provision of certificates at the request of schools, gymnasia and beauticians, solicitors and the police, unless you want to see me because you are ill.

When I am absent on Tuesdays, Wednesdays and Thursday mornings, my assistants take my surgeries.

If you have a problem in obtaining a suitable appointment, leave a message for me and I will contact you to try to arrange one.

Urgent Problems:

If your call is urgent i.e. cannot possibly wait until my next surgery, then please telephone for advice. Please do not call a problem urgent if it isn't. Papers, insurance queries, certificates and renewals of prescriptions are never urgent. If you have been ill for more than three days or so, then it makes more sense to make a normal appointment, than to interrupt my care for other patients and to ask for an emergency appointment.

Please do not walk in and ask to be seen at once. I do not operate a casualty department and am under no obligation to see anyone who walks in if they could reasonably return to the next surgery. Someone who walks in pushes others out of the appointments for which they have waited patiently. I will not "fit people in" - every patient is entitled to a full consultation. If you are taken acutely ill, then I will always see you, but arriving at the surgery and demanding instant attention is selfish, unfair and an abuse of the service I try hard to provide.

Home Visits:

These are for patients who are immobile through ill health. Please call before 10.00 a.m. wherever possible as this helps me plan my rounds. When you ask for a visit later in the day, I have to stop doing other tasks for patients in order to come out to you.

Almost all of those who ask for "late" or "out of routine" visits have had their problems for many days and could have called earlier or waited until tomorrow. Such calls are thoughtless and waste other patients' time.

Please do not leave a message for me to phone you at the end of my surgery when you actually want me to visit you or a consultation in the surgery - this makes planning my day almost impossible - tell the receptionist that you might need a visit or an appointment so that she can inform me in advance.

You do not have an automatic right to a home visit. I will happily visit any patient on medical grounds but not merely to suit their convenience. I can see four patients in the surgery in the time it takes for one visit so please think carefully before asking for a home visit. It is perfectly safe to bring children out if they have a fever or a rash - it often cools them down and makes them feel better.

Emergency Service

Telephone 020 8492 9430:

Patients registered with me will be able to contact myself or my colleagues out of surgery hours for emergencies. Please remember that I need my rest too and also have a family at home. I am on call for most of every weekend – please call before 12.00 noon if at all possible as otherwise I have no free time at all.

On the occasions when I am unavailable, BarnDOC (the Barnet GPs Co-operative manned by other Barnet GPs) are always on call to deal with emergencies. You can reach them through my main emergency number 020 8492 9430.

Please think carefully before calling "out of hours". I and my colleagues are on call for real emergencies only - serious life-threatening illness that cannot wait until the next surgery. Not many of the calls we receive "out of hours" are for illness that has arisen suddenly since the surgery closed, nor for conditions that require a doctor to come before the next routine surgery. When one of us has been on call, we work the next day as normal - there are no shifts.

Doctors will often give advice over the telephone. This is not because they do not wish to visit, but because advice is more appropriate.

Most problems that have been present for more than a week are not emergencies and would be better dealt with by the doctor that knows you best.

Repeat Prescriptions:

These are prepared by our computer. 48 hours should be allowed after handing in a repeat slip before the prescription can be collected. Repeat prescriptions are not available by telephone as mistakes can be made this way. You can always request your computerised prescription by post, if you send a stamped addressed envelope, or by fax.

Telephone Calls:

Please try not to call for simple advice in the middle of my surgery as this interrupts me whilst I am seeing patients. You can always leave a message for me to phone you back, but if the receptionist is given some idea about the nature of the call, she may be able to deal with the problem without any further delay.

Non-urgent messages for me can always be left in my telephone mailbox. The staff will put you through to it if you wish.

Please do not use the emergency number to make appointments or to contact me when the surgery is open.

Test Results:

Results of investigations have to be checked by a doctor first and will normally be available between 3.00 p.m. and 5.00 p.m., about seven to ten days after the tests have been completed.

Facilities for the disabled:

The clinical parts of the Health Centre are on one floor with easy wheelchair access. There are two disabled adapted toilets suitable for wheelchairs.

Practice Nurses:

Our nurses work mainly in the treatment rooms and are qualified to do medical screenings, asthma and diabetes checks, blood pressure measurements, contraceptive advice, cervical smears, urine testing for infection and diabetes, dressings, injections, ear syringing, ECGs and other nursing procedures. They work closely with the doctors. You will generally need an appointment to see the nurse. They are happy to see you to offer advice or for minor conditions.

Special facilities I offer

ASTHMA CLINIC■

DIABETIC CLINIC■

FAMILY PLANNING ■

MATERNITY SERVICES●

MINOR SURGERY●

HELP TO STOP SMOKING■

"WELL MAN" SCREENING ●

"WELL WOMAN" CLINIC ■

INCLUDING CERVICAL SMEAR TEST

INOCULATION FOR

OVERSEAS TRAVEL○

IMMUNISATION CLINIC○

Details of all of these are available in Reception.

● Carried out by myself

○ Carried out by our nurses

■ Carried out by me and our nurses

and the Centre offers a CHILD DEVELOPMENT CLINIC provided by the Community Paediatric Service and a CHIROPODY Service provided by the Barnet Chiropodists.

The Temple Fortune Team:

As well as my assistants Dr Eileen Rosenfelder, Dr Deborah Bentley and Dr John Bentley, and my medical colleagues Drs Harris & Rowbury, I work closely with many other health professionals.

My Assistants:

Because of my work for doctors and patients elsewhere, my assistants have been especially chosen to give you the same high standard of care that I try to deliver. Please see them if necessary as I cannot possibly see all those patients who wish to see me on the days when I am in the surgery.

District Nurses:

They are attached to the Practice having had special training in community work and are experts in nursing care at home. Requests for a district nurse to call can be made through the Community Administration Office at the Centre after a GP’s request.

Health Visitors:

They are qualified both as nurses and health visitors. They work in local clinics and visit patients at home and at school. They have a particular interest in the care of children, the handicapped and expectant mothers. If you need to contact them, our receptionists can arrange this.

Midwives:

I refer newly-pregnant patients to the "midwives' booking clinic". Thereafter routine ante-natal care is carried out at the Surgery by myself and a midwife on alternate appointments. Delivery normally takes place in hospital, but on returning home, patients are visited by both doctor and midwife for the first ten days. Please let us know when you are coming home so that we can arrange to visit you.

Counsellor:

She is specially trained to work with patients who have reached a crisis in their personal lives, who are bereaved or who have relationship difficulties. I will arrange for her to contact you, if you wish to see her.

Practice Manager:

Christina Brownson manages the Practice and will deal with any enquiries or administrative complaints. We welcome constructive criticism as this helps to improve the practice.

"My Area":

I look after patients who live in NW11. Patients from N2, N3, NW3, and NW4 are only accepted by prior arrangement with me. I cannot accept patients who do not live in the Barnet borough.

I do not see patients privately who are resident in those areas and who are UK citizens.

New Patient Registration:

New patients are normally accepted from within the Practice area (NW11) and on joining the Practice are asked to complete a questionnaire. They will then be invited to have a consultation with the practice nurse to review their medical history and have a "check up". Medical treatment is available from the date of registration.

Please bring proof of identity and proof of residence when you register. The practice does not discriminate on the grounds or race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.

Students:

Medical, nursing and health visitor students are sometimes present in the surgeries - patients will be informed in advance when one is present. I appreciate your co-operation in this essential part of their education but respect the fact that you may prefer not to have them present. Please tell Reception if this is the case.

Data Protection

Everything I record in your notes oron the computer is utterly confidential. I will never reveal anything from your records to anyone else without your express agreement. Sometimes, the NHS management require access to the records to check that I am fulfilling my NHS contract. In the unlikely event that they were to need to look at your record, you would be asked first and if you refused them access, your wishes would be followed.

Complaints:

Although I try hard to please, I sometimes make mistakes. When that happens I would like the opportunity of saying sorry, correcting things if I can, and improving the service for the future. If you are dissatisfied, please come and see me, if at all possible, so that I can have the chance to deal with your complaint. The quicker you tell me, the quicker I can put it right. If you prefer, you can see one of the other doctors or the Practice Manager instead. Every complaint is taken very seriously - you will not get a "whitewash". We will investigate your complaint and then report to you on the outcome, within a week if possible. This is part of the NHS in-house procedure that I operate in accordance with national criteria.

Very infrequently things go so badly wrong that doctor and patient ought to part company for their own good. I am always sorry when this happens, as I pride myself on my ability to offer a good service to all my patients.

Unfortunately, I cannot accept:

Rudeness or threats to staff, doctors or other patients.

Repeated abuse of our facilities - including our emergency services.

Self-referral to specialists or other doctors - without prior discussion with and a letter from me. Asking me for a letter to cover an appointment you have already made without talking it over with me first is rude, may invalidate your insurance and wastes other patients’ time.

Patients who have a private GP.

Help Me to help You ....

We often suffer from minor illnesses that seem to take a long time to resolve. Patients - and parents in particular - are understandably anxious when things do not seem to be resolving as quickly as they expect. I thought it might help you to know what I expect to happen when you or your child are ill, what you should do before seeking advice and roughly when you should call me, if you feel the need.

Coughs and Colds:

The commonest cause of a cough is a cold. I never treat these and neither should you. A dry cough can be relieved by steam - the easiest way to do this is to take the lid off an electric kettle (so that the cut-out won't work) and to fill up the top few feet of a room with steam, then put yourself and/or the child into the steam. You never need to bring a child to see me for a cold. Blocked noses in babies and children are treated by wiping the nose or occasionally by ephedrine or Otrivine nose drops obtained from the pharmacist. A cold is a viral infection and will not respond to antibiotics, which I do not prescribe for this condition.

However hard you cough, you can never do any serious damage. Coughing may well disturb your sleep and make you ache, but it is rarely a sign of anything sinister, especially in a child. The only times you need to see me for a cough are:

1) Because the cough has persisted for more than a week in children or two weeks in adults, without other signs of ill-health. This can always wait until the next routine surgery.

2) Because the patient has asthma and has failed to respond to the normal treatment. You should contact me, or the duty doctor, as soon as you are aware that things are not right.

3) Because the patient is blue, breathless or cannot speak. Call the doctor now.

Chest infections are rare in children - the child is usually grey and sweaty with a cough and rapid breathing. Difficulty in breathing is usually due to mucus in the nose rather than infection in the chest.

Fever:

Often causes aches and pains, irritability, vomiting, confusion, headaches, tummy ache and lethargy. Fever usually rises in the evening. If the fever is very high, there is a risk that children may start to twitch. This is a warning that the child may have a fit if the temperature is not brought down soon.

Whether the patient feels hot or shivery, you need to:

1) Remove all clothing and blankets - even if the patient feels cold.

2) Take paracetamol in appropriate doses. Paracetamol never reacts badly with other medicines.

3) Drink plenty of cold fluids

4) If the temperature is over 100F or 38C, have a lukewarm shower or tepid bath.

You will need to do this every four hours to keep the temperature at bay. Many temperatures last for a few days and do not need a doctor provided no other features like earache, cough, unusual headache or drowsiness are present. If the patient cannot move the neck then call me at once as this can be a sign of meningitis.

Diarrhoea and Vomiting:

We have all had an upset stomach at some time. It is unpleasant, though only important in very young children. The diarrhoea, unless bloody, is nasty but harmless and requires little more than soothing cream around the bottom. If the patient is passing a large amount of liquid, or is a little child, then the best you can do is to replace the fluid loss with Dioralyte or Rehidrat powders dissolved in water, or another fluid - preferably not milk. Avoid food for 24 hours, then restart eating cautiously.