From Vivien Aspey

Friday, 10 May 2019

Jenny Shepherd- you didn't give us much time to sign so I guess there won't be so many Hebden Bridge signatures.
Any plan to get practices to work more closely together has my vote. They have lived in their own glass bubbles for far too long in my book, with carte blanche to do almost as they please privided they meet the terms and conditions of service in the GP Contract. We were getting to the stage where provided they met their terms of service they could just about hold a cattle auction in the middle of Grange Dene and nobody would turn a hair.

No way do I agree that all our local Practice's problems emanate from Government policy on the NHS though I am no fan of this Government and have no illusions about their plans to drive the NHS into the ground. For example, the Hebden Bridge Group Practice does not consult patients on any decision affecting patient care, other than by ticking the PPG box and blaming them for policies people don't like, eg car parking policy at Grange Dene. OK that was ages ago but their accountability to patients has not improved since. 

Blaming the Government is a GP enshrined ploy of many years standing. It is well illustrated in the current display on the screens in front of patient waiting areas about the GP "state of emergency". This is propaganda promulgated by the BMA which is actually a doctors' trade union and is dominated by GPs. The same display is on show in other practices.

Of course there is a GP recruitment problem, but the figures quoted for how much practices get per patient are a gross oversimplification. They state only an average rate of remuneration per registered patient, which itself is oversimplified because they get more for some patients than others depending on age and health issues, but they say nothing about the fact that they get reimbursed additionally for rent and rates paid on premises, a high percentage of the salaries of practice based employees ...and so on.

Finally, because I could go on much longer about Practice exploitation of patients' naivety, there is the completely unmentioned fact that failure to recruit GPs is down in part to an understandable reluctance by young doctors to tie themselves into a legally binding partnership with a bunch of people who have been in the game for a lot longer than new doctors have been. The partnership model is an outmoded throwback to generations of tradition whereby GPs were once drawn from the ranks of those who had enough money to invest in property to house the practice. There have been radical shifts in social attitudes and personal finance resulting in a crumbling of the old social class sytem, and General Practice has not kept pace. 

So, apart from eroding this kind of foundation, national policy on primary care has my support if it empowers health care professionals other than doctors, and equips people to take more responsibility for their own health care. By equipping people, I mean educating and informing, while giving access to relevant and appropriate professional advice. It does of course mean dwindling patient naivety that is based on not being given a full picture but that would be all to the good. Time will tell.

From Arla R

Thursday, 16 May 2019

I saw my doctor yesterday and asked her about continuing to get the Voltarol gel on free prescription, and she said she's fine with that. It seems you need to tell your GP if you're on benefits or low waged, and at their discretion they can still prescribe things for you that you can get over the counter at the pharmacy, if you have a medical need for them.

From Michael Prior

Tuesday, 21 May 2019

There have been a long-running strand of complaints about our local GP service mainly phrased in terms of general practice or specific issues. I thought it might be useful to take one area of complaint, that of the time taken to get an appointment and at the same time compare it with other GP practices in the area. I did this on the morning of Tuesday, 21 May which seemed a normal day. I asked some friends outside the area to try between 9 and 9.30 to get a non-urgent appointment with a doctor. The results are as follows:

Hebden Bridge GP

At 9.15, there were 3 appointments available on 11 June at Hebden and 3 in the afternoon at Mytholmroyd. A further 3 were available on 12 June in Hebden and 3 in the afternoon in Hebden on 13th. In the week after, appointments were available only on 20 June in Hebden. All were with the same male doctor.

I visited the Mytholmroyd drop-in centre at 9.45 on the same morning. There were 20 people waiting. In the following 30 minutes, 6 people were seen by either a doctor or a nurse. When I left there were 18 people waiting. I then went to the Valley Centre in Hebden. There were 2 people waiting and in the following 30 minutes, 3 people were seen, 2 by a doctor.

I am still waiting on all the results from others outside the area but the results so far are:

In Halifax, an on-line inquiry offered 2 appointments that morning for urgent requirements; for non-urgent problems appointments were available next Tuesday, 28 May with either male of female doctors.

In Sowerby Bridge, an appointment was available next Friday, 24 May. An urgent appointment was available at 12.15.

In Milnrow, the earliest appointment was this Friday, 24 May.

It seems, therefore, that the waiting time for appointments in Hebden is badly out-of-line with neighbouring practices. 

Just why this is so is unclear. The screen in both waiting rooms notes that payment per patient is now £136/annually but presumably this is the same level for other practices. Delving back in a previous thread, I see that last year the payment were above £200 but also that the Practice website stated that average pay per doctor was £85,904.52 for 13 doctors working both full and part-time. The current situation is that average pay has dropped to £47,000 covering 7 doctors. It seems very likely that most of the current staff only work part-time. Indeed it was noticeable that the only doctor’s name in the future appointment schedule, indeed the only doctor apparently seeing patients at the Valley Centre, was not one of these 7.

This is a large practice with excellent facilities but there does seem to be something wrong. I ask myself the obvious question: as an ageing man do I feel safe with local medical provision and I have to answer, no. Thank goodness for the 111 service which the website helpfully notes is one’s out-of-hours resource. 

From Dave R

Monday, 27 May 2019

Has anyone else been moved onto 6monthly prescription dispensing without being given the choice? 

I ordered meds myself monthly online to collect from the pharmacy which worked well, providing Boots had items in stock.

I was moved onto a 6 month dispense by the GP  pharmacy. I rang to say I preferred the old way but was told this was how they do it.

Needless to say, it's not working. 

My last 2 prescriptions have not been dispensed on the due date, I then have to ring the pharmacy and order them and then go and collect usually 1-2 days later. 

This may be a pharmacy issue, but when I self ordered I would get a text to say the meds were ready to collect. Boots tell me it's the way the prescription 'drops down' to them without flagging up. 

As we only have Boots in Hebden Bridge, I can't change pharmacy, but why on earth change a system that was ok anyway ? 

Another issue is that I recently went into hospital as a day case. I was then told that day patients cannot be given a prescription for pain relief on discharge. This has to be dispensed by the GP.

We all know the problems getting a GP to do this and needless to say it took several days for me to get prescription only pain relief. 

I borrowed some of my mother's to tide me over as over the counter drugs were not effective. 

I am making a complaint about this but feel people could do with the heads up.

From J.Moore

Friday, 31 May 2019

A GP prescribed a gel as pain relief for my condition.  This gel contained 2.32% diclofenac diethylammonium.  I found this gel very helpful, it took away much of the pain without the unpleasant side effects of oral pain relief.  In due course I ordered some more as a repeat prescription. 

Someone referred to as the 'inhouse pharmacist', someone employed by the NHS and not the group practise, which is why they cannot be found on the website; someone I have never met or discussed my condition with, someone who is not working as a pharmacist and it has to be asked 'why not?', altered my prescription.  This person decided I should use a gel containing just 1% diclofenac diethylammonium.  I did not realise that this change had happened.  I didn't think that the gel had stopped being so effective, I had presumed that my condition was deteriorating, something I found quite depressing.  After a few months this same person decided I could now just have gel which is ibruproven, containing no diclofenac, the active ingredient which helps with pain.  This was actually brought to my attention by someone writing on this forum, thank you.  

I now have to by pass the 'inhouse pharmacist' by not using the repeat prescription online system and making an appointment with a doctor in order to ask for a medication that works.    

From Phil F

Tuesday, 4 June 2019

A new low yesterday - my wife rang up for a 'non-urgent' appointment and was told there were no advance appointments whatsoever, not even a month down the line. What should she do?

From Vivien Aspey

Tuesday, 4 June 2019

I am inspired, if that is the word, by a friend's experience not mine.

Yesterday she saw a GP who said she wanted to see her in a month but could not offer an appointment as they hadnt yet come up on the system.

This morning, my friend rang for said appointment to be told that the person who updates appointment availability on the website has been on leave so it hasn't been updated. But she usually does it on a Wednesday so it should be sorted tomorrow.

What kind of health care provider allows one person's annual leave to impact patient care?

If it's not true what kind of organisation fields a telephone responder whom they have so poorly informed?

The most cynical suggestion is that this is yet another ploy to reduce GP/ patient face to face time, previously existing examples being exposing patients to a humiliating overcrowded morning cattle market for urgent problems, pretending to be some sort of emergency Call Centre at lunchtime by answering as an emergency service and carrying some sort of triage whereby somewhere a nameless individual decides whether or not a patient should see a GP at all.

I've also noticed over the last 12 months that no-one in the Practice appears to be empowered to change anything. This applies to everyone from the GP you are consulting, to other health care professionals like nurse practitioners, to the receptionists who say that it's the same everywhere. As others have demonstrated here recently this is not true.

The factually correct shortage of GPs is being used as an excuse for God knows what standard of service  Meanwhile the main political parties know little and care even less about primary care. To the government of the day bulging waiting rooms are not on the same horizon as hospital waiting times or bed closures, and Labour's contribution is to wring their hands about how overworked GPs are - doesn't take much research to come up with that kind of approach.

I've suggested before that we patients as a group should take some sort of group action but there was no appetite for it. Some recent posts may indicate that views are changing. It's OK to suggest going to one of the other practices mentioned above, but why should people around Hebden Bridge not benefit from local buildings and services for which we have paid in taxation. It's all very well arguing that payment goes nowhere near true cost but until a government presents us with other choices our present contribution is all we can make.

And finally, in the midst of all this opacity we are confronted by partially presented propaganda about how little GPs get financially to look after us. We've all been bored by this for far too long. It's like having your flight postponed and having to learn about how little the airline gets per passenger to fly the plane.

From Vivien Aspey

Friday, 28 June 2019

One day people will look back on the present level of service from HBGP. I wonder what the picture will show and whether the age old question will be asked, "How could people let this happen?"

The way things are being done now is not necessarily or in all respects part of a nationally insoluble problem. There are alternatives, and you have only to look at neighbouring practices to see different ways of working. All other neighbouring practices of course have problems, but their patients get a service which is much better understood and serves their needs in a more coherent way.

I have not yet run out of suggestions but most require the involvement of other people. For example - could we request a meeting with the PPG?

From Michael Prior

Friday, 12 July 2019

Readers of HebWeb may be accustomed to complaints about the Valley Practice but this is a bit different.

A near neighbour of mine had chest pains after a viral infection. She is an elderly woman living on her own without a car or internet. After a while she went to the Valley reception and was given a doctor's appointment with a 5 week wait. When she went she was told she needed a blood test. At reception she was given an appointment with a further 5 week delay. She had the test and then, 2 days later in the afternoon, she heard someone banging on her door. It was the doctor. Apparently the surgery had been phoning her without result. (They had the wrong number). The doctor told her that she had to go to hospital immediately. Her son-in-law had to come from Ramsbottom to take her. 

When she arrived at CRI she was told that she had a blood disorder and needed an urgent blood transfusion with an unusual blood type. This was couriered over from Leeds and she was given her first transfusion in  the early hours. (An indication of how serious her condition was). After more transfusions, she felt better and the consultant told her that she was fortunate as she could have died in two or three days. When she mentioned that she had been referred by the Valley Practice, the response was on the lines of 'We know about them and they won't get away with it'

All of this comes direct from my neighbour and I have no reason to doubt her story.

The fact is that people can die, perhaps are dying or suffering harm, as a consequence of the Valley behaviour. If this woman had died, the Valley doctors would have killed her through their idleness though it is unlikely that they would suffer jail-time.

In a previous contribution, I wondered if I felt safe with current practice. I now know the answer. 

As of 8am, 12 July, the earliest GP appointment at the Valley Road Centre is 9 August.

From J Swift

Friday, 12 July 2019

So the patient's details were incorrect, possibly because they hadn't updated them, and a doctor took the trouble to call to their house, because they realised she was in danger?

And that's a reason to make very serious comments about the Practice?

Plus, of course, all this is second-hand.

There are clearly issues with Hebden Bridge Group Practice, but this sort of attack on hard working NHS staff is really out of order.

From Vivienne Crawford

Friday, 12 July 2019

I do urge everyone with a comment to make about the Practice 

(particularly what they are doing well & should keep, & what they are doing less well & need to change)

to complete the questionnaire, which has comment boxes in which you can write anything you want, as well as specific factual questions. 

The questionnaire can be completed online; or posted or hand-delivered to the Mytholmroyd, Luddendenfoot or Hebden practices. No one completing the form is required to give their name, although obviously those responding online will have less privacy. 

Patient Reference Group volunteers have been handing out the questionnaires at the surgeries. Once people have finished giving their views, we'll be able to see what the most important issues are, & perhaps, begin to address them. It's not going to change everything overnight, but we can make a start. 

From Michael Prior

Saturday, 13 July 2019

J. Swift rather misses the point. The patient in question had a progressive disorder which came close to killing her. If when she had gone to the practice she had received reasonably prompt attention, such as is normal in neighbouring practices, say two or three weeks then she would have got a letter asking her to contact the surgery etc. etc. I know this is what Valley does because it happened to me after a delay of only 7 weeks.

In this case it took over 10 weeks and she nearly died.
Incidentally, J. Swift refers to "hard-working NHS staff" Two issues. First, the employed doctors at Valley seem to only work part-time. This can be seen from the way in which average renumeration of doctors there has fallen from nearly £90,000 to just over £47,000. Not a small pay-packet but low for full-time doctors. I am sure they work hard in the hours they put in but these are clearly limited.

Second, they are not NHS staff but employees of a private company that had a contract to supply services to the local NHS. Details of the profits which this company makes are not published.

From Anne H

Monday, 15 July 2019

I think it's totally inappropriate to make comments about a specific medical case on a public forum. Especially when we re only given one side of the story and even that is relayed second hand!

In general, though, it's fair to say that the practice is overstretched to an extent where we should be worried about patient safety. They simply cannot recruit doctors to the practice. Its a general problem but made worse when several doctors leave at the same time as they did here.
My worry is that their solution to handling the situation - urgent cases going to The Mytholmroyd surgery in the morning - is that the onus is on the patient to decide whether it is urgent or not. There are many serious conditions which present with symptoms that might not seem urgent initially.

The telephone triage system did at least put that decision in the hands of the doctor on duty and I think we should return to that system 

From Michael Prior

Monday, 15 July 2019

I want to make it absolutely clear that the patient concerned has explicitly told me that she is happy for her story to be told as widely as possible. What I have related is just what she has told me and there are physical signs of its truth.

Incidentally, as of 8 pm on 15 July there are no appointments available to see a doctor at any site. None until at least 28 August which is as far out as the online service reaches. So if you have a pain just go to A&E. You will have to wait a while but at least you will get to see a doctor.

From Adrian Riley

Monday, 22 July 2019

Today in the Todmorden Pharmacy there is a notice saying it is getting increasingly difficult to obtain medications and this is also a national problem.

Does anyone know why it is getting difficult?

From Graham Barker

Tuesday, 23 July 2019

This BBC news item goes some way to answering Adrian's question. An alleged reason not listed is that many UK pharmacies have discovered that they can make more money by buying in at NHS prices, then selling on to other markets at higher prices. Good old globalisation.

From Vivien Aspey

Friday, 16 August 2019

If it's any consolation it's not only human medication that has supply problems. For some months now vets have had difficulty obtaining Pardale, a pain reliever for dogs that is a combination of paracetemol and codeine, a bit like Paracodol only with less codeine.

Instead they are having to dispense paracetemol and codeine separately which is less convenient from the point of view of getting dogs to swallow it.

I'm sure it's all about ingredients costs and negotiating strategies at ( inter) national level.

Just another thing outside our control.

From Vivien Aspey

Sunday, 15 September 2019

I am noticing a dearth of posts about our local practice. This is in contrast to a recent discussion thread initiated on Facebook by a new member of the Patient Participation Group, and closed down by her because of the overwhelming volume of response, most of it negatively critical.

I am also aware that Hebden Royd Town Council has scheduled a discussion with representatives of the practice.

The fact is that theoretically we patients of the practice can jump ship to Sowerby Bridge or Todmorden, but by and large HBGP has a monopoly in the Upper Calder Valley. If a significant proportion of us decided to move all at once the system would crash.

So what else can we do given that the bodies officially responsible for reflecting dissatisfaction are showing signs of awareness?

For starters we can encourage them and provide them with evidence through channels such as this. The complaints sytem itself is an inadequate vehicle for change because of its confidential nature which militates against general awareness of any kind of pattern or trend

It was with with alarm that I read in the closed Facebook thread that one or two people think care is unsafe, especially when one such comment came from a retired GP. If that concern is well founded, how will we ever know? The last visit by the Care Quality Commission was years ago, before the simultaneous exodus of a number of GPs. We ourselves are the sole custodians of information about our care and if we don't share it the practice alone has an overall picture. That seems to me to be an unhealthy state of affairs. Please keep sharing because one day it might pay off.

From Sue Kay

Tuesday, 17 September 2019

Currently, for the whole of the next 4 weeks, there are no face to face appointments with a doctor available to book online at all. There are a couple of telephone appointments but they are pretty useless if most types of physical examination are needed. Also there are many other reasons why someone might want to be physically present at a discussion.

From M King

Wednesday, 18 September 2019

The Care Quality Commission (CQC) last inspected Hebden Bridge Group Practice in 2016 and the rating was "good".

CQC will act on issues / complaints. However, they will not act on an isolated issue or complaint for re-inspection.

If anyone wants to "give feed back" on their GP care this can be done via CQC's web page.

From Vivien Aspey

Wednesday, 25 September 2019

To M King, 3 years is a long time in the history of a Practice and there have been major changes since the CQC last visited. The observation that no face to face appointments are available for 4 weeks is not an individual complaint but a reported state of affairs that can be checked out by anyone.

Hebden Royd Council have a public meeting tonight at which the practice manager and a GP will be asked questions by councillors.

Although the public are normally able to ask questions at these meetings, on this occasion public questions are not allowed because otherwise the Practice would not have attended - that says it all. It's not as if the Council regularly presides over a near riot - they have ample experience handling challenging situations. But this is a Practice that stonewalls the PPG and its patients, not a Practice that listens.