EMSWORTH SURGERY WINTER QUACK 2016
Dr James Collings-Wells
I am leaving the Practice at the end of March.
I started as Dr Ingram’s trainee in 1991 and have remained here ever since, apart from a brief stint in Truro. I noticed, when I arrived, that most people had lived here for years, sometimes all their life. Working here has therefore given me a unique opportunity to get to know many people and their families over a long period of time. It was the perfect learning environment, since I always got to see what happened in the end.
I was a GP Trainer for some years, my last Trainee being Dr Liz Lane.
I have written the Quack newsletter for the past 15 years.
My secretary thinks I can be a little too like “Doc Martin” from the TV and has been known to tone down some of my letters dealing with patients’ lifestyle if she deems the content too impertinent.
I am extremely grateful to all my patients who have been endlessly considerate over the years, in all sorts of ways. What I didn’t learn from them, I picked up from our truly amazing staff and my colleagues.
I will continue working in General Practice but mostly outside of the NHS. I can be reached at .
All of my patients will be re-registered with remaining Partners.
CQC Report on Emsworth Surgery
We were visited by CQC in the summer and their report is now available on our website www.emsworthsurgery.co.uk We were rated as “Good” though they highlighted some areas where we were outstanding.
New & Departing Staff
We are very sorry to lose Jenni Griffiths, who for 10 years has been responsible for running our repeat prescriptions (600,000 of them during that time, or 250/day) with amazing efficiency. Jenni is moving to somewhere called Lancashire. We are truly grateful for what she has done to help us and hope she will be equally appreciated in her new job.
Dr Ryan Thomas has now completed his training with us and has returned to the Royal Navy. We enjoyed having him with us and have received much positive feedback from patients.
A Big Welcome To:
Alex Kershaw is joining us as a Nurse Practitioner. She has been working in A&E at St Richards and will be working closely with the Duty Doctor to improve rapid and appropriate assessment of patients with urgent problems. Alex will hold her own clinics and is able to prescribe.
Sally Brook has joined us from Boots Pharmacy to take over from Jenni.
Chrissie Caton has taken over as Reception Supervisor.
Julie Carruthers is a new Receptionist, starting in January.
Dr Alexandra Marriott is a GP Registrar who is starting in February for 18 months attached to
Dr Wilson.
Appointments
We have noticed that more and more patients are not attending for their doctor and nurse appointments. Due to increasing patient numbers and demand for appointments it would be very helpful if you could remember to cancel your appointments in advance. Thank you.
Update on Telephone Triage
Towards the end of last winter we changed the way urgent problems are dealt with:
All patients requesting same day appointments are phoned back either by their own GP or the Duty Doctor. Some problems can be sorted out over the telephone.
If the patient needs to be seen, he or she will be given an appointment, ideally with their own doctor. There have been advantages and disadvantages to this change but we have felt, particularly since the summer that the system has improved our effectiveness significantly.
Some people have asked where the term “Triage” comes from. It probably originated in the Napoleonic wars and was in use during the First World War as a way of running an effective medical service during periods of seemingly overwhelming demand. Medical orderly staff responsible for removal of the wounded from the battlefield would divide them into one of three categories (hence Tri-age):
· Those likely to live, regardless of what care they receive (No need for immediate treatment)
· Those likely to die, regardless of what care they receive (No need for immediate treatment)
· Those for whom immediate care might make a positive difference in outcome (Given priority for treatment)
The modern term refers to the process of sorting that goes on at the time of the first point of contact.
It is in use in most emergency departments in the UK and an increasing number of general practices.
Do let us know if you would like to give us feedback about it.
Patient Participation Group
As many of you know, the Patient Participation Group organises twice yearly health education talks.
This Spring we have a very interesting talk by Nick Brunt, a very senior Paramedic from South Coast Ambulance Service, who is now a Paramedic Trainer and on call for the 111 service.
He will talk on cardio-pulmonary resuscitation; use of defibrillators, dealing with haemorrhage, epileptic fits and other first aid topics. He will also describe the life of a Paramedic.
The talk will take place at the Brookfield Hotel on Wednesday 6th April, 7.00pm for 7.30pm. Refreshments will be for sale over the bar and I urge all patients to attend. You could save a life with
the correct knowledge. Our thanks to Janet Barradell for arranging this talk and to Amanda Thomas, Manager of The Brookfield Hotel for her hospitality.
Jim Strudwick, Chairman of the Emsworth Patient Participation Group.
Topical Tips: Anxiety – What Can I Do
What is the point of it?
We all get anxious – that feeling of worry, often with physical symptoms, perhaps ‘butterflies’ in the stomach or trembling. It is caused when we meet a danger (real or perceived) and there is a surge of the hormone adrenaline in our blood stream, this gets us ready for ‘flight and fight’. Adrenaline raises our pulse, quickens our breathing and heightens our awareness, getting us ready to escape, using all our physical strength and cunning. It is not there just to escape the sabre toothed tiger, it helps us control our cars when the unexpected happens on the road, grab the child who nearly falls off the furniture, save ourselves when we stumble, prepare ourselves for a stress – exams, operations, interviews etc.
In other words if there is something to be worried about it is not necessarily abnormal to be anxious!
When should I worry about being worried?
There are no rules about how much anxiety is normal. If symptoms of anxiety – physical or mental are beginning to intrude on your daily life and prevent you doing the things you should or that you enjoy, and this has gone on for several weeks, perhaps it is the time to take stock.
There are times when the ‘fight and flight’ impulse back fires on us and we do not use up our excess adrenaline.
Anxiety can make us breathe faster, this causes the level of oxygen in the blood to increase and the level of carbon dioxide to decrease, bizarrely this can ‘poison’ nerve cells giving us tingling or numbness and muscle pain. In turn this can magnify anxiety, cause even faster breathing and more physical symptoms, this is known as hyperventilation and can cause ‘panic attacks’, a vicious circle of anxiety causing more anxiety. Panic attacks are very unpleasant and frightening events.
Low mood can be associated with anxiety and although the two conditions may seem opposites both can be linked with depressed levels of chemicals in the brain (neurotransmitters) which make our brain cells work efficiently. This is why treatments for depression may help the symptoms of anxiety.
What can I do to make myself feel less anxious or control my anxiety symptoms?
- Distraction – It sounds obvious but it works. Try changing your environment, go outside, even move to another room, turn over in bed – anything that gives your senses something different to concentrate on. Put on a favourite bit of music, an entertaining TV programme or film, look at an interesting magazine (something with lots of pictures works for me!), bake a cake, stroke the cat – the possibilities are endless but you need to choose something that you know grabs your attention and you enjoy.
- Tick something off the list – if anxiety is getting in the way of getting ‘anything done’, try breaking the task into smaller parts – start cleaning the house by tidying one drawer or putting the washing up away – a small achievement is more rewarding than none.
- Use up some of that spare adrenaline – if you are physically able – do some exercise or go for a walk – it is impossible to hyperventilate if you are climbing Kingley Vale.
- Self-help books. There is lots of help, information and guided management programmes available. The library will be able to help you if you do not use computers, ask about Reading Well – Books on Prescription
- Internet resources – there are many good websites – below are a selection that may be useful
- www.mind.org.uk Mind is the mental health charity – their website is full of information and advice
- www.nhs.uk/moodzone Advice and information from the NHS website.
- www.nopanic.org.uk Helpful information and a help line (there is a small charge for the help line)
- Mindfulness – is a technique to help learn to live in the moment despite the distractions of anxiety and other negative thoughts. There are self-help guides, internet courses (free and subscription) and therapists (usually private).
- Psychological therapy – either face to face, online, or even by phone – aiming to change thought processes by changing what we do or how we behave – There is very good evidence that it works. Our local NHS service – Italk – can be accessed online at www.italk.org.uk
or by ringing 023 8038 3920. You can do this direct without seeing your doctor, all you need is your NHS number.
- Discuss your symptoms with your doctor. If your symptoms are severe and interfering with your life – book to see or speak to us. There are occasions when medication may be indicated or advice from our Psychiatric colleagues is needed.
In summary – some anxiety is normal, try not to let your anxiety own you.