tag:blogger.com,1999:blog-1878338818453925292024-03-13T13:06:28.578+00:00Leatside Surgery BlogThis is a blog from the Leatside Surgery in Totnes, Devon.
The views expressed by the people posting blogs here are largely personal to them. They do not necessarily represent an "official" view of The Practice.dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.comBlogger59125tag:blogger.com,1999:blog-187833881845392529.post-63298479983203871362018-09-12T10:09:00.000+01:002018-09-12T10:10:22.748+01:00Out of Area Registered Patients<div dir="ltr" id="docs-internal-guid-92972fd3-7fff-a3cf-da56-a9b1a3a1fe0a" style="line-height: 1.2; margin-bottom: 0pt; margin-top: 0pt;">
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<i><span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">“From
5 January 2015 all GP practices are able to register new patients who live
outside the practice area without any obligation to provide home visits or
services out of hours when the patient is unable to attend their registered
practice. “<o:p></o:p></span></i></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">This was the NHS rule they brought in.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">For years we had had a sort of agreement with a lot of patient's that
if they moved “not too far” outside our practice boundary they could stay on
with us. This was good for patients: they might have lived in Totnes all their
lives but due to cost of housing (usually) were having to move to Paignton or
Buckfastleigh….<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">Now there are perfectly good doctors surgeries in those places - but
these towns are not far away and people do appreciate continuity with their
lifelong surgery so in instances where we as GPs felt it was safe to do so we
agreed to keep them on.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">It wasn’t necessarily so good for the doctors though if we had to
undertake a house call. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">The previous contract we held with the NHS said that we had an
obligation to visit to the patient’s registered address if there was a clinical
need. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">The new contract wording in italics above allowed us to keep those
people leaving Totnes on if they wished but if they did have to have<span style="mso-spacerun: yes;"> </span>a house call it would be undertaken via 111
and Devon Doctors.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">Now that doesn’t necessarily sound like the best arrangement to me: so
we do warn people of the implications of doing this, but then if they wish to
register with us in that way we can do that.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">What we can’t do though is pick and choose. We either have this clause
implemented or we don’t.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">So we did implement it.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We then managed to “officially” keep on a number of loyal patients who
had been in a sort of limbo in Blackawton or wherever… We were also able to
offer an alternative to patients who live in areas locally where there is only
one GP practice and for whatever reason they no longer feel that they are able
to register with their local practice.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">What actually happened next was a government “cull” of “ghost”
patient's- who had long since moved far away but not re-registered their
doctors.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">Many practices in the country seem to have been affected by this and
their list sizes fell… as ours did a little. Again a largeish number of patients
who had so wished to keep registered with us that they hadn’t reregistered
where they now lived; rather optimistically.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">So we could then easily accommodate an increase in numbers through out
of area registrations. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">But then of course developers started building.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We asked South Hams’ planning department a number of years ago how many
houses were planned and on what timescale. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">They couldn’t tell us.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">Now we are finding out of course. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">Many new people moving to the area. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We have taken on some and Catherine House have soaked up a lot of new
residents from St Peters’ Quay I’m sure. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">The Quayside development has been excellent in that a lot of local
people have found placements there. They are now proposing a large Nursing Home
be built adjacent to it.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">So our list size has now been increasing steadily and probably will do
further. Catherine House Surgery are moving into the old Job Centre building
and doubtless will hope to take on more patients with their new improved space.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">As it stands today we have a little under 15,000 patients registered
with us, fewer than 200 of which are registered as Out of Area patients. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We have adapted to the changes in a number of ways.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We have taken on a full clinical pharmacist, Kevin, to help with some
of the care and reviews of people with ongoing health conditions.<span style="mso-spacerun: yes;"> </span>Kevin is an expert in respiratory issues and
works closely with our more complex patients in the management of their COPD
and asthma. A significant amount of this work would have previously been
carried out by a GP. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We have taken on a new Advanced Nurse Practitioner, Steve, to help with
the more urgent needs of patients when they become ill. Steve works alongside
our duty doctors each day which has significantly improved our ability to
manage our on the day demand.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We have seen changes in our Nursing team with a new Nurse Team Leader
Lucy managing them. Two of our Practice Nurses (Lucy and Katie) are now
qualified prescribers which enables them to manage medications within their
Asthma/COPD clinics where appropriate.<span style="mso-spacerun: yes;">
</span>We have employed a phlebotomist to release the Health Care Assistants
away from just taking blood samples and are training them up to do more
advanced tasks; thus freeing the qualified nurses up to use their professional
skills to the fullest. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We’ve lost Dr Frankland and Dr Ingoldsby to retirement in the last 18
months but there are no Doctor retirements on the horizon for another nearly 10
years now. (I know: I’m counting…) We have just taken on Dr Tristan Michell as
a new partner and he has moved in to Totnes. Dr Fearon has been with us for 18
months and prior to her joining Dr Rosanna Berryman joined, which increased our
number of GPs from 8 to 9 for the first time. So we now have a pretty stable
team.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We are still having medical students as well as qualified doctors
training with us. Dr Morris and Dr Gelder look after the needs of the medical
students placed with us from Plymouth. Dr Hawker oversees the training of the
House Officer grade juniors. Dr Hossack and myself see to the training of the
registrar grade doctors on their way to becoming GPs.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We are just on the brink of converting one our very large clinical
rooms into two to make a bit more consulting room space for these trainees.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">The difficult task of balancing the need for people to be able to book
routine appointments ahead with the need to provide for poorly patient's the
same day has always been, and remains, very difficult. I think every practice
in the country finds it hard.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">Many, such as some practices in Paignton and Torbay, have moved to NO
bookable ahead appointments; relying on always ringing the same day you need an
appointment; speaking to a clinician and maybe or maybe not getting an
appointment.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We don’t quite like the sound of that so are continuing to look at ways
of helping people thay day they need help as well as allowing them the
certainty of an appointment booked ahead for more routine reviews.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We do know that many problems don’t need to be seen today but also
won’t wait 10 days for a routine appointment. That is the real conundrum. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We are considering perhaps another advanced nurse practitioner?<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">They work independently like the nurses on “24 hours in A&E” on the
telly do - ordering blood tests and xrays and dealing with problems they can
manage without recourse to the doctor. Very useful for managing more
straightforward illnesses. The GP can then be more free to deal with patients
with a greater degree of complexity.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">In fact we are having a partners’ meeting this week to consider and
plan for future possibilities.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">We are trying to improve online access with eConsults through the
website.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">The “Patient Access” app is good for booking appointments and
requesting repeat medications.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">Some people nationally are talking about Skype consultations but I’m
unsure of the use of that complexity. A telephone call will often suffice.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">The new Health Minister is very keen on technology based solutions to
problems so I wonder what will be next.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">Through all of this we will always encourage our patients to talk with
us about where we can do better and what aspects of Leatside that they really
don’t want to see change.<o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">To this end we have an active Patient Participation Group (PPG) run by
and for our patients. They meet every couple of months with our Practice
Manager, Martin; the Nurse Team Leader and a GP to discuss improvements that
can be made and to identify areas where they can become involved in order to
help us meet the needs of our population. <o:p></o:p></span></div>
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<span lang="EN-US" style="color: #202a30; font-family: Verdana, sans-serif; font-size: 13.0pt;">In recent years the PPG have supported us at our Flu Clinic, helped
with the redesign of our reception area, met with the CQC inspectors when they
visited and conducted a review of Boots repeat prescription dispensing, which
greatly reduced the turnaround times. <o:p></o:p></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="EN-US" style="color: #202a30; font-size: 13.0pt;">If you find yourself interested in this then just let reception know or
drop us an email at leatside.surgery@nhs.net</span><o:p></o:p></span></div>
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dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-84732287051727624692016-10-08T16:03:00.001+01:002016-10-08T16:03:15.854+01:00The Raft Race (yet again)This will be our 3rd go at the River Dart Raft Race.<br />
14km of the river Dart on a home made raft in an event organised by the Totnes Rotary Club to raise money for their chosen charities.<br />
As a surgery we like to help local charities where we can and entering the raft race allows us to do that while also having some fun.<br />
The first two times we entered a raft made of rubber rings - -tractor inner tubes<br />
This year we had a load of barrels donated by two local dairies, so, without sea trials, we will put it in the water tomorrow, with our 9 man team, and see if it floats!<br />
Then paddle all the way to Totnes.<br />
Wish us luck!<br />
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dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com1tag:blogger.com,1999:blog-187833881845392529.post-49990615985960750842012-12-06T13:54:00.001+00:002012-12-06T14:02:03.087+00:00Drug Warning<br />
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There have been reports from the Dawlish locality of 3 drug
users attending hospital for fitting in the last 4 weeks after having smoked a
substance sold as ‘crack mephedrone<a href="http://www.blogger.com/blogger.g?blogID=187833881845392529"></a><a href="http://www.blogger.com/blogger.g?blogID=187833881845392529"></a>’. Reports suggest that this is
being sold as a crystallised<a href="http://www.blogger.com/blogger.g?blogID=187833881845392529"></a> form or mephedrone<a href="http://www.blogger.com/blogger.g?blogID=187833881845392529"></a><a href="http://www.blogger.com/blogger.g?blogID=187833881845392529"></a>, however no
samples have been obtained that confirms the actual pharmaceutical
composition.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
None of these individuals were ‘drug naive’ and all are known
within the heroin/crack using communities.<br />
<i><b><br /></b></i>
<i><b><br /></b></i>
<br />
<i><b>In November 2012, 3 people in the Devon area have been admitted to hospital due to fitting after smoking a substance called ‘crack mephedrone’.</b></i><br />
<i><b>Reports indicate that this substance is being sold as a crystallised form of mephedrone.</b></i><br />
<i><b>The risks are: To short-term health: fitting and convulsions To long-term health: unknown</b></i><br />
<i><b>To reduce your risk of overdose (o/d): Make sure someone is around when you use (if you o/d alone nobody can help). Avoidmixing drugs. Usein smaller amounts, - please remember that very little is known about this substance and its risks (you can’t tell what’s in it by looking at it and your dealer probably won’t know what’s in it either).</b></i><br />
<i><b>Avoid products described as ‘crack mephedrone</b></i><br />
</div>
dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-49108085090152819662012-11-12T22:15:00.002+00:002012-11-12T22:16:59.942+00:00Recent Charity Things...<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-QfDwcONflEE/UKF0RwkcCDI/AAAAAAAAUY8/UqmkNVOhowk/s1600/P1090259.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="213" src="http://2.bp.blogspot.com/-QfDwcONflEE/UKF0RwkcCDI/AAAAAAAAUY8/UqmkNVOhowk/s320/P1090259.JPG" width="320" /></a></div>
<span style="font-size: x-small;"><span style="font-family: Verdana, sans-serif;"><br /></span></span>
<span style="font-size: x-small;"><span style="font-family: Verdana, sans-serif;">My latest Charity endeavours:</span></span><br />
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;"><br /></span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">I did my my skydive on Sunday 11th August.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">For the second time I got stuck on the A30 getting to Dunkeswell so was late this time and had to hand around as it were til the end of the day.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Really worth it though to zoom up to 15000 feet then get out.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">The whole getting out thing was quite odd.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Getting to that height the air gets a little thin so as they tighten the straps up for the jump it all gets a bit tight-chested. The hat is tight; the goggles are on...</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">You are strapped to your tandem partner who sits directly behind you on a long low bench running from the pilots chair to the back of the plane and the getting-out door.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">So sat low on this bench you do a sort of coordinated shuffle to the back door.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">When you get there you try to do as you were told in your training: to kneel at the edge of the door and lean your body back as you exit.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Strapped to the other chap I got to the door, and as I was thinking about how on earth to get my knees to the door so I could kneel on them we just sort of fell out the door; so I didn't have any time at all to worry about that bit!</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Tumbling over and over on exit was lovely really. No sense of falling or turning.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Rather like that disoriented feeling diving in water when you suddenly aren't sure which way is up.....</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">The settle into a proper free-fall position and fall for a full minute. Just like Felix Baumgartner!</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">All the while looking around at what seems to be a view of the whole of Devon. I could see the North Coast easily, and the moor, and Start point, and up towards Portland....</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">then after a tap on the shoulder we swing to vertical as the chute is deployed. No jump or jerk as it happens. Smooth.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Then goggles off and gently float to earth. The chap with me let me steer and showed me how to slow down / speed up / turn left and then right and so on.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Fantastic.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">I let him do the landing though....</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Must have raised £2000 for Totnes Caring.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;"><br /></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-cuAgkH0Nk6w/UKF0i_g57QI/AAAAAAAAUZE/z6GIiaokH7A/s1600/530856_10151224510453699_363302829_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="http://2.bp.blogspot.com/-cuAgkH0Nk6w/UKF0i_g57QI/AAAAAAAAUZE/z6GIiaokH7A/s320/530856_10151224510453699_363302829_n.jpg" width="320" /></a></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;"><br /></span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;"><br /></span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Then on Sunday October 21st I did the Raft Race with a team from the Surgery.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">8.6 miles down the river Dart from Buckfast to Totnes.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">The Raft went quite well despite some cynics' views on its construction!</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Took about 4 hours and was absolutely exhausted by the finish.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Not sure of our total raised but must be a few hundred pounds, for Rotary who will divide the proceeds among several charities.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Next year with a bigger number of entrants I'm sure they'll do really well..</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;"><br /></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-k5JWmjIXyLY/UKF0778Z03I/AAAAAAAAUZM/d1xEF3eXq6I/s1600/P1000308.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="180" src="http://1.bp.blogspot.com/-k5JWmjIXyLY/UKF0778Z03I/AAAAAAAAUZM/d1xEF3eXq6I/s320/P1000308.JPG" width="320" /></a></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;"><br /></span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;"><br /></span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Then this Saturday 10th November I was happy to be involved once again in the fundraising Bingo night in the Civic Hall.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">This to raise money for Totnes Caring.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">A night of Bingo - masses of people and £1061 raised.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;"><br /></span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">This week I shall be scoring the Darts in the Bull.</span></div>
<div style="font-size: small;">
<span style="font-family: Verdana, sans-serif;">Again, a fundraising night for Totnes Caring happening in many local hostelries.</span></div>
dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-82955366010307069022012-08-27T14:07:00.000+01:002012-08-27T14:59:12.351+01:00Totnes Show 2012<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-RXQH-8d0REA/UDtr1WjW4YI/AAAAAAAATrg/rA7vvSAOs0I/s1600/P1090274.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="213" src="http://2.bp.blogspot.com/-RXQH-8d0REA/UDtr1WjW4YI/AAAAAAAATrg/rA7vvSAOs0I/s320/P1090274.JPG" width="320" /></a></div>
<br />
<div style="text-align: center;">
<span style="font-family: Verdana, sans-serif;">Well, we got up to the show again this year.</span></div>
<span style="font-family: Verdana, sans-serif;"></span><br />
<div style="text-align: center;">
<span style="font-family: Verdana, sans-serif;">A small team of Dr Watkins, Dr Gelder, new Nurse Venetia Giles and Receptionist Deborah Trotman braved the early-morning mud.</span></div>
<span style="font-family: Verdana, sans-serif;">
</span><span style="font-family: Verdana, sans-serif;"><div style="text-align: center;">
I had meant to get onto the site the afternoon before to set things up but because of the heavy rain that afternoon the officials were keeping all vehicles off the field. </div>
</span><span style="font-family: Verdana, sans-serif;"><div style="text-align: center;">
I headed up for a 7am start on showday instead.</div>
</span><span style="font-family: Verdana, sans-serif;"><div style="text-align: center;">
I slithered sideways across the field in my loaded up car to our pitch. I can't have done too badly as the tractor only had to drag me about 10yards at the end!</div>
</span><span style="font-family: Verdana, sans-serif;"><div style="text-align: center;">
As I was first there I got the tent up ready for the others to arrive.</div>
</span><span style="font-family: Verdana, sans-serif;"><div style="text-align: center;">
Having got the others there and got set up we then got on with the business of the day which was - well, what were we there for exactly? While we worked that out I made a cup of tea in the boot of the car.</div>
</span><span style="font-family: Verdana, sans-serif;"><div style="text-align: center;">
It turns out we were there really just to be there. To remind people that we exist and to take a few blood pressures of people who don't otherwise come to the doctors often.</div>
</span><span style="font-family: Verdana, sans-serif;"><div style="text-align: center;">
We had some information about the new eBike scheme being run jointly with <a href="http://www.totnesonthemove.org.uk/">totnes on the move</a>. This week we should receive an electric-assisted bicycle which is to be loaned to patients whose health may benefit from a spell cycling, and where the electric assist may help then get going. Not got the details worked out yet of how this is going to run but we are working it out.</div>
</span><span style="font-family: Verdana, sans-serif;"><div style="text-align: center;">
We also discussed that we are partnering with <a href="http://tresoc.co.uk/">Tresoc</a> to have a solar panel array installed on our surgery roof. </div>
</span><span style="font-family: Verdana, sans-serif;"><div style="text-align: center;">
We had the chance to remind people about the benefits of vaccination as well as the business of the national summary care record.</div>
</span><span style="font-family: Verdana, sans-serif;"><div style="text-align: center;">
I had a really good day meeting many people I haven't seen in ages and managed to talk myself hoarse after a while.... I hope that in some way we have done some good. It is rather difficult to say how but I believe that people do need to have confidence and trust in their doctors surgery and I think being at the show, in the community we serve helps achieve that.</div>
</span>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com1A385, Totnes, Devon TQ9, UK50.434247224843247 -3.660464286804199250.43171872484325 -3.6653997868041994 50.436775724843244 -3.655528786804199tag:blogger.com,1999:blog-187833881845392529.post-81893408764612176572012-08-19T21:19:00.001+01:002012-08-19T21:19:27.452+01:00Parachute Jump<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-lnx3w_5eA0M/UDFJ2Ub4kjI/AAAAAAAATrE/aqicRy1WOk8/s1600/P1090259.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="213" src="http://4.bp.blogspot.com/-lnx3w_5eA0M/UDFJ2Ub4kjI/AAAAAAAATrE/aqicRy1WOk8/s320/P1090259.JPG" width="320" /></a></div>
<br />
<br />
<span style="font-family: Verdana, sans-serif;">Well, I did my Parachute Jump on Saturday the 11th.</span><br />
<span style="font-family: Verdana, sans-serif;">In total I was able to hand in about £1200 to Totnes Caring, so thank-you to anyone who put some coins in my bucket at reception.</span>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-90333902614097602872012-07-13T10:13:00.002+01:002012-07-13T10:13:39.458+01:00National Transplant Week<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: small;"><a href="http://2.bp.blogspot.com/-rg1i0xpuwD0/T__kXbJTazI/AAAAAAAATjg/HINzQr2kbjk/s1600/transplant-week-logo.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-rg1i0xpuwD0/T__kXbJTazI/AAAAAAAATjg/HINzQr2kbjk/s1600/transplant-week-logo.gif" /></a></span></div>
<div style="font-family: Verdana,sans-serif;">
<span style="font-size: small;"><br /></span></div>
<div style="font-family: Verdana,sans-serif;">
<span style="font-size: small;">People on Facebook can now show their intention to become an organ
donor in their Timeline. </span></div>
<div style="font-family: Verdana,sans-serif;">
<span style="font-size: small;">The Timeline is a new addition to Facebook profiles, which
allows people to record major life events. <br />A new 'Health and Wellbeing'
menu forms part of the Timeline feature from which people can highlight
their intention to become an organ donor and, if they wish, click
through to NHSBT's Facebook page to officially register.</span></div>
<div style="font-family: Verdana,sans-serif;">
<br /></div>
<div style="font-family: Verdana,sans-serif;">
<span style="font-size: small;">I personally think this could be one of the most significant changes and link-ups the transplant people could have made.</span></div>
<div style="font-family: Verdana,sans-serif;">
<span style="font-size: small;">If the majority of facebookers registered and encouraged their friends too as well then the number of registered donors could rocket.</span></div>
<div style="font-family: Verdana,sans-serif;">
<br /></div>
<div style="font-family: Verdana,sans-serif;">
<span style="font-size: small;">Traditionalists (at least those with internet) can register on the <a href="https://www.organdonation.nhs.uk/ukt/how_to_become_a_donor/registration/registration_form.asp">transplant website </a></span></div>
<div style="font-family: Verdana,sans-serif;">
<br /></div>
<div style="font-family: Verdana,sans-serif;">
<span style="font-size: small;">For the even more traditionalists there is a phone number: </span><strong>Organ Donor Line: 0300 123 23 23</strong></div>
<div style="font-family: Verdana,sans-serif;">
<strong><br /></strong></div>
<div style="font-family: Verdana,sans-serif;">
<strong><span style="font-weight: normal;">I appreciate that organ donation is almost always associated with personal tragedy, but ask anyone in Totnes who has received a donated organ, and there are many, and you quickly appreciate the amazing change it can make to someone else's difficult life with organ failure.</span></strong></div>
<div style="font-family: Verdana,sans-serif;">
<strong> </strong><span style="font-size: small;"> </span></div>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-84344595302124615462012-05-31T17:03:00.001+01:002012-05-31T17:03:23.808+01:00Doctors' Industrial Action 21st June 2012<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-aJTXvx_Vfeg/T8eWJ7P7qxI/AAAAAAAASow/Kw6W1-3wYcw/s1600/royalty-free-strike-clipart-illustration-1048677.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://4.bp.blogspot.com/-aJTXvx_Vfeg/T8eWJ7P7qxI/AAAAAAAASow/Kw6W1-3wYcw/s320/royalty-free-strike-clipart-illustration-1048677.jpg" width="304" /></a></div>
<br />
<br />
<span style="font-family: verdana,sans-serif; font-size: small;">At Leatside we will be participating in the BMA's day of industrial action on 21st June.</span><br />
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;">The Doctors </span><span style="font-size: small;">will be available for urgent cases only on that day but we will not be offering any routine care or telephone consultations.</span></div>
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;">In practice this means
we will have a duty doctor available for urgent cases from 8am until
6pm with a duty nurse available for urgent care also.</span></div>
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;">If you are ill ring in and you will be dealt with as usual.</span></div>
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;">If you aren't ill it might be better to leave it until another day.</span></div>
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;"> </span></div>
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;">In Devon this national day of action coincides with a county-wide training afternoon.</span></div>
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;">Ordinarily Devon Doctors On Call cover this session for emergency cases.</span></div>
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;">It is yet to become clear if this will still be the case. </span></div>
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;"><br /></span></div>
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;"><u><i> </i></u></span></div>
<div style="font-family: verdana,sans-serif;">
<span style="font-size: small;"><u><i>So why are we taking part in the industrial action?</i></u><br /></span></div>
<div style="font-family: verdana,sans-serif;">
<div>
<span style="font-size: small;"><b>The changes to the NHS pension scheme</b></span></div>
<div>
<span style="font-size: small;"><span style="line-height: 17px;">Doctors’ pension contributions increased </span></span><span style="font-size: small;"><span style="line-height: 17px;">in 2008 </span></span><span style="font-size: small;"><span style="line-height: 17px;">from 6% of their salary to up to 8.5% – a 42% rise.<br />
</span></span><span style="font-size: small;">The contribution taken from NHS employees pay for their pensions increased again in April 2012. </span></div>
<div>
<span style="font-size: small;">Contributions will go up again in 2013 and 2014, with, under
current proposals, the highest earners contributing 14.5 per cent of
their pay by 2014.</span></div>
<div>
<span style="font-size: small;"><span style="line-height: 17px;"></span></span><span style="font-size: small;"><span style="line-height: 17px;"><br /></span></span></div>
<div>
<span style="font-size: small;"><span style="line-height: 17px;"><b>also:</b><br />
</span></span></div>
<div>
<span style="font-size: small;">In 2015, there will be a switch to a new career average revalued earnings (CARE) scheme for all doctors. <br />For
hospital doctors, this means the end of the final salary scheme,
resulting in around a 30 per cent reduction in value on a like-for like
basis. </span></div>
<div>
<span style="font-size: small;">GPs already have a CARE scheme but they will also see their contributions rise very significantly. </span></div>
<div>
<span style="font-size: small;">In 2015, the </span><span style="font-size: small;">normal pension age will be linked to, and will increase in line with, the state pension age, with many NHS staff having to</span><span style="font-size: small;"> work to the age of 68 to be able to draw a full pension. <br />
The state pension age may well rise beyond this in future.</span></div>
<div>
<span style="font-size: small;"><br /></span></div>
<div>
<span style="font-size: small;"><b>Increase in Normal Pension Age</b></span></div>
<div>
<span style="font-size: small;">Under the proposals, NHS staff will be required to work until the state pension age (set to rise to 68, and probably further</span></div>
<div>
<span style="font-size: small;">in future) until they can draw a full pension, rather than 65 under the current scheme. <br />By contrast, members of the police and firefighter pension schemes are able to keep a normal pension age of 55.</span></div>
<div>
<span style="font-size: small;"><br /></span></div>
<div>
<span style="font-size: small;"><b>Affordability and sustainability of current NHS pension scheme</b></span></div>
<div>
<span style="font-size: small;">The Government’s main argument for its radical changes to the NHS pension scheme is that it is unaffordable and unsustainable. <br />This does not stand up to scrutiny. <br />In
2008, NHS staff agreed to major changes to their pension scheme to make
it sustainable in the long term. This involved a large hike in employee
contributions, and the introduction of tiered contributions to protect
lower paid workers. It also meant an increase in the pension age for new
entrants (to 65), and employees – not taxpayers – taking on
responsibility for future rises in the cost of the scheme (for example
because of increasing longevity).</span></div>
<div>
<span style="font-size: small;">Clearly, the country is now in a very different financial
situation. However, this has not affected the sustainability of the NHS
scheme. It is currently providing a positive cashflow of £2 billion to
the Treasury each year and a 2011 report from the Public Accounts
Committee found that the 2008 reforms are bringing substantial savings
to taxpayers, with the scheme set to be sustainable well into the
future.</span></div>
<div>
<span style="font-size: small;"><br /></span></div>
<div>
<span style="font-size: small;"><b>Pensions contributions for NHS staff compared with other public sector workers</b></span></div>
<div>
<span style="font-size: small;">Higher paid NHS staff already pay proportionately more for their pensions than most other public sector workers.</span></div>
<div>
<span style="font-size: small;">Contributions for NHS staff rose in 2008, again in April
2012, and are set to increase again in 2013 and 2014. By 2014, some
doctors will see deductions of 14.5% from their pay for their pensions,
compared to 7.35% for civil servants on similar salaries, to receive
similar pensions. Doctors currently at the start of their careers would
be hardest hit, having to pay hundreds of thousands of pounds extra –
double what they would have paid – in lifetime pensions contributions.<br />
<br /><br />We recognize that GPs are well paid for the work we do and on retirement will receive a healthy pension.<br />It seems to me unfair to be treating different areas of public service differently.<br />If
all Civil Servants and Police / Fire etc were asked to pay the same
proportionate increases in pension contribution as well as having to
work on til 68 to get a full pension then I think we would accept we
were being treated fairly.<br />
Being treated fairly with respect to other areas of is the crux of this I think. <br />We
know that longevity and an increasing elderly population is going to
make even more of an impact as the years go by and that pension age
would doubtless have to increase. It could I think be phased in more
gently with a plan for it to increase slowly over many years.<br />
So, we will withold our routine or non urgent work for a day to try to make this point.</span></div>
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<span style="font-size: small;"><span class="HOEnZb"><span style="color: #888888;"><br /></span></span></span></div>
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<span style="font-size: small;"><span class="HOEnZb"><span style="color: #888888;">Dr Dylan Watkins</span></span></span></div>
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</div>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com1tag:blogger.com,1999:blog-187833881845392529.post-38907649716015380122012-04-16T15:26:00.000+01:002012-04-16T15:26:04.731+01:00Dr Watkins' Parachute Jump<div style="font-family: Verdana,sans-serif;">
I've taken the plunge and booked in to do a Charity Skydive.<br /></div>
<div style="font-family: Verdana,sans-serif;">
In support of Totnes Caring I shall be jumping at Dunkeswell on 7th July.<br /></div>
<div style="font-family: Verdana,sans-serif;">
I've no idea how much I shall raise but hope to get above £500<br /></div>
<span style="font-family: Verdana,sans-serif;">If you wish to support Totnes Caring via me jumping out of a plane at 15000 feet then you can sponsor me via the Surgery Reception desk or online at </span><a href="http://www.virginmoneygiving.com/drdylan" style="font-family: Verdana,sans-serif;">http://www.virginmoneygiving.com/drdylan</a><a href="http://uk.virginmoneygiving.com/fundraiser-web/fundraiser/showFundraiserPage.action?userUrl=drdylan&faId=203379&isTeam=false" style="font-family: Verdana,sans-serif;"></a>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-55903598503269453652012-03-18T23:24:00.002+00:002012-03-18T23:24:54.410+00:00C-R-Y Charity Heart Screening.<br />
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<a href="http://www.c-r-y.org.uk/"><img border="0" height="57" src="http://3.bp.blogspot.com/-pdLqQ39H_zc/T2ZtQfBzgiI/AAAAAAAARRI/wHg1MX7CUbY/s320/2011topbanner.jpg" width="320" /></a></div>
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">This weekend Leatside Surgery hosted a 7-person team from the charity <a href="http://www.c-r-y.org.uk/">Cardiac Risk in the Young</a>.</span><br />
<span style="font-family: Verdana, sans-serif;">They had been invited by Kevin and Linda Marsden who had been fundraising for such an event since their 21 year old son Oliver died 2 years ago.</span><br />
<span style="font-family: Verdana, sans-serif;">He had been perfectly fit and healthy, right up to the moment he died.</span><br />
<span style="font-family: Verdana, sans-serif;">There was no clue at all that he had a life-threatening condition until it killed him.</span><br />
<span style="font-family: Verdana, sans-serif;">He was found to have ARVC or arrythmogenic right ventricular cardiomyopathy, which is one of many potentially fatal conditions of the heart affecting youngsters.</span><br />
<span style="font-family: Verdana, sans-serif;">Cardiac screening is the only effective way to identify these cardiac condition when they are causing no symptoms.</span><br />
<span style="font-family: Verdana, sans-serif;">On average there are 12-16 such sudden cardiac deaths each week in the UK.</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">The team below came and ran the screening event:</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">Tony Hill from CRY</span><br />
<span style="font-family: Verdana, sans-serif;">Rebecca Howes from CRY</span><br />
<span style="font-family: Verdana, sans-serif;">Dr Martina Muggenthaler, Cardiology Specialist Registrar and researcher from St George's Hospital in London</span><br />
<span style="font-family: Verdana, sans-serif;">Rob Pring, Cardiac Physiologist at Treliske</span><br />
<span style="font-family: Verdana, sans-serif;">Sam Bowen, Echocardiographer from University Hospital, Cardiff</span><br />
<span style="font-family: Verdana, sans-serif;">Kate Miller, Freelance Cardiac Physiologist</span><br />
<span style="font-family: Verdana, sans-serif;">Jon Senior, Warwick University Medical Student</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">Between the lot of them they managed to get 200 young people to fill in a cardiac and general health questionnaire; have a screening ECG, have an discussion about the findings with the doctor and have an echocardiogram if needed.</span><br />
<span style="font-family: Verdana, sans-serif;">Where any findings warranted further investigations detailed letter has been sent to their doctor with recommendations.</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">It is odd but the greatest result from all the effort involved is to find nothing wrong with anyone.</span><br />
<span style="font-family: Verdana, sans-serif;">Over the weekend we thankfully didn't pick up any really serious problems but there were a few cases where the heart will need a bit of a closer look-at.</span><br />
<span style="font-family: Verdana, sans-serif;">This happened to be the same weekend that Fabrice Muamba had a cardiac arrest on the football field. Thankfully he survived and got to hospital, which the majority don't.</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">It was a fabulous weekend of effort and a pleasure to meet and assist this dedicated team of staff who have chosen to help the charity in their weekend.</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
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<span style="font-family: Verdana, sans-serif;">L>R Tony, Kate, Rob, Kevin, Linda, Jon, Rebecca, Martina</span></div>
<span style="font-family: Verdana, sans-serif;"><br /></span><br />dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-62067709335115119312011-12-22T15:56:00.000+00:002012-02-08T14:40:25.974+00:00Cardiac Screening at Leatside<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-aubeI6QxzQk/TvNS4GhiOJI/AAAAAAAARCk/MgO0XuAKx00/s1600/omarsden2.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Verdana, sans-serif;"><img border="0" height="253" rea="true" src="http://2.bp.blogspot.com/-aubeI6QxzQk/TvNS4GhiOJI/AAAAAAAARCk/MgO0XuAKx00/s320/omarsden2.gif" width="320" /></span></a></div>
<span style="font-family: Verdana, sans-serif;">In March we are hosting a weekend Cardiac Screening event for local young people (14-35yrs).</span><br />
<span style="font-family: Verdana, sans-serif;"></span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">Details are </span><a href="http://www.testmyheart.org/Screening.aspx"><span style="font-family: Verdana, sans-serif;">here.</span></a><br />
<span style="font-family: Verdana, sans-serif;">You can book online for screening by going </span><a href="http://www.c-r-y.org.uk/ecg.htm"><span style="font-family: Verdana, sans-serif;">here</span></a><span style="font-family: Verdana, sans-serif;">.</span><br />
<br />
<span style="font-family: Verdana, sans-serif;">This event has been organised in conjunction with </span><a href="http://www.c-r-y.org.uk/"><span style="font-family: Verdana, sans-serif;">CRY</span></a><span style="font-family: Verdana, sans-serif;"> by the parents of the late Ollie Marsden who died at Rugby training on October 22nd 2008.</span><br />
<span style="font-family: Verdana, sans-serif;">Ollie had an undiagnosed heart condition which he was completely unaware of.</span><br />
<span style="font-family: Verdana, sans-serif;">It caused no symptoms at all until he died. </span><br />
<span style="font-family: Verdana, sans-serif;">Despite me being at the scene (admittedly armed with only a hockey stick) and, soon after, my GP colleague and BASICS trained Doctor, Dr Morris with a full paramedic crew with the full gamut of resuscitation equipment, we could not save him.</span><br />
<span style="font-family: Verdana, sans-serif;">If there had been some form of screening beforehand, his was the kind of heart condition that could have been picked up.</span><br />
<span style="font-family: Verdana, sans-serif;">If it had been he is likely to have still been alive today.</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">Cardiac screening takes two forms.</span><br />
<span style="font-family: Verdana, sans-serif;">An ECG is the simplest and easiest thing to do, and this is what will be being done at Leatside in March.</span><br />
<span style="font-family: Verdana, sans-serif;">The screening equipment, and the program as a whole, is supported by Philips.</span><br />
<span style="font-family: Verdana, sans-serif;">The benefit of screening in this way is that they are looking for the particular signs of these heart complaints that can cause sudden death.</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">As a GP I am used to looking at heart traces for signs of heart attacks or angina and so on.</span><br />
<span style="font-family: Verdana, sans-serif;">The traces in the younger people may show more subtle signs, so the expertise is on hand to look for these signs.</span><br />
<span style="font-family: Verdana, sans-serif;">If there are any worrying signs then an Ultrasound scan of the heart (Echocardiogram) may be undertaken there and then.</span><br />
<span style="font-family: Verdana, sans-serif;">If the ECG is entirely normal then no scan is required.</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">The testmyheart website has a </span><a href="http://www.testmyheart.org/QnA.aspx"><span style="font-family: Verdana, sans-serif;">Q&A</span></a><span style="font-family: Verdana, sans-serif;"> section that covers a lot of questions you may have.</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span><br />
<span style="font-family: Verdana, sans-serif;">I am pleased to allow CRY and Philips the free use of the whole of Leatside Surgery on March 17th to help them run this event.</span><br />
<span style="font-family: Verdana, sans-serif;">I don't think it can ever be a regular event, but if we only pick up one case we may save a tragedy.</span><br />
<span style="font-family: Verdana, sans-serif;">Better that we pick up none.</span>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-77949184110317400772011-10-06T17:03:00.003+01:002011-10-06T21:36:40.703+01:00Grasp-AF<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-UJULXCW9qb0/To3LOPZGHRI/AAAAAAAAQwk/ddcfKKsGI64/s1600/af.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="107" src="http://4.bp.blogspot.com/-UJULXCW9qb0/To3LOPZGHRI/AAAAAAAAQwk/ddcfKKsGI64/s320/af.gif" width="320" /></a></div>
<br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Atrial Fibrillation (AF) is an irregularity of the pulse.<br />Having this irregular pulse puts the patient at an increased risk of having a stroke.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">This risk can be reduced by taking aspirin or warfarin.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">The risk of having a stroke increases with age so we tend to recommend warfarin for the older folk with AF.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><i><b>So what is the risk?</b></i></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">If you are less than 65 with an otherwise healthy heart then the annual risk of stroke is about 1%</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">If you are between 65 and 75 that risk increases to 3% especially in those with diabetes or known vascular disease</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Over 75 or anyone with a damaged heart valve or a previous stroke, the risk is nearer 6%</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Imagine 1000 people at <b>1% </b>risk of having a stroke each year. <br />Without treatment about 10 of them will have a stroke. <br />So 990 of them will not have a stroke. </span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">However, if those same 1000 people each take low dose aspirin, over a year:</span><br />
<br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">• About 2 people will be ‘saved’ from having a stroke by taking aspirin</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">• About 8 people will still have a stroke, even though they take aspirin.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">If we look at the <b>6% risk category</b> in 1000 people it is likely that <b>about 60 would have a stroke.</b></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">If those same 1000 people each take low dose aspirin, over a year: </span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">• About 12 people will be ‘saved’ from having a stroke by taking aspirin</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">• About 48 people will still have a stroke, even though they take aspirin. </span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">So aspirin seems more efficient the higher the risk.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><i>Warfarin is better still</i> and in this same higher risk group being on warfarin <b>36 people a year would not have a stroke because of being on warfarin;</b> and only 24 would have a stroke even though they were on warfarin.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Statistically about 3 of those 1000 people in that year might have a <b>serious haemorrhage because they were on warfarin. </b>But it would save 21 more strokes than the aspirin, so in the end the benefits statistically outweigh the risks.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">There is a document <a href="http://www.npc.nhs.uk/therapeutics/cardio/atrial/pda.php">here</a> called a "Patient Decision Aid"</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">This shows those same figures somewhat more graphically.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">It is funny but when you look at the picture of 1000 people and who might have a stroke it seems to be to reduce the impact of the risk of a stroke.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">BUT you just can't tell which patients are the ones that will be the ones to have a stroke.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We are moving now to attempting to identify more people with irregular pulses and will then try to decide individually with them whether to recommend taking aspirin or warfarin to reduce the risk of stroke.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We have something like 250-300 patients on our list with AF. I haven't sat down and risk assessed them individually but we must be looking at a potential half-dozen strokes a year without aspirin or warfarin, so that may translate into a couple of strokes a year avoided if we had the majority of patients on preventive treatment.</span><br />
<br />dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-73802778305079229622011-10-05T21:38:00.003+01:002011-10-05T21:38:46.655+01:00New carers' support service launched in Devon<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-PdYZk58DxBI/Toy_2vhnOQI/AAAAAAAAQwc/g__eWbGTOWk/s1600/dvcc.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-PdYZk58DxBI/Toy_2vhnOQI/AAAAAAAAQwc/g__eWbGTOWk/s1600/dvcc.jpg" /></a></div>
<br />
<br />
<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: 13px;">Carers in Devon can now find out about support and information from one place for the first time, as part of a £1.3 million investment by Devon County Council and NHS Devon.</span><span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: 13px;"></span><br />
<div class="news_head">
<br />As part of the new <a href="http://www.devoncarerscentre.org.uk/">Devon Carers Centre </a>a new telephone helpline has been launched to give carers better access to support to help them stay healthy and live a normal life outside of caring.<br /><br />Carers will be able to access the following services through the helpline:<br /><br />• Support and information at the ‘first stop’ from the helpline advisor<br />• A network of local carers’ support workers who provide face to face support and activities for young carers to enjoy being young people<br />• Opportunities to meet other carers in their area for mutual support, friendship and time away from caring<br />• Short carers breaks<br /><br />The new helpline (08456 434 435) is open from 8am to 6pm Monday to Friday and on Saturdays from 9am to 1pm.<br /><br />The helpline is run by voluntary organisation Westbank, working closely with other carers’ voluntary groups, who will also provide support in their local area. A website has been launched at <a href="http://www.devoncarerscentre.org.uk/">www.devoncarerscentre.org.uk/</a></div>
dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-40606971254411709822011-10-05T21:03:00.002+01:002012-06-08T15:54:08.445+01:00Self referral for mood disorders<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/-RKb8pv6GpyE/Toy1kKZlBWI/AAAAAAAAQvQ/Y3a0C8yqNVA/s1600/435505-Royalty-Free-RF-Clipart-Illustration-Of-A-Line-Art-Design-Of-A-Worried-Businessman-Clasping-His-Hands-And-Sweating.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><img border="0" height="320" src="http://1.bp.blogspot.com/-RKb8pv6GpyE/Toy1kKZlBWI/AAAAAAAAQvQ/Y3a0C8yqNVA/s320/435505-Royalty-Free-RF-Clipart-Illustration-Of-A-Line-Art-Design-Of-A-Worried-Businessman-Clasping-His-Hands-And-Sweating.jpg" width="219" /></span></a></div>
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<i><span class="Apple-style-span" style="font-family: 'Trebuchet MS',sans-serif;">I had news this week that our patients are now able to self-refer for psychological treatment of anxiety and depression. The self-referral system for physiotherapy has been very helpful so extending into mental health areas should be too.</span></i><br />
<i><span class="Apple-style-span" style="font-family: 'Trebuchet MS',sans-serif;">If you wanted just a quick reference on helping yourself they have a leaflet you can download <a href="http://www.devonpartnership.nhs.uk/uploads/tx_mocarticles/5_ways_self_help_booklet_read_version.pdf">here.</a></span></i><br />
<i><span class="Apple-style-span" style="font-family: 'Trebuchet MS',sans-serif;"><br /></span></i><br />
<i><span class="Apple-style-span" style="font-family: 'Trebuchet MS',sans-serif;">I've lifted a few bits from their leaflet to post here.</span></i><br />
<i><span class="Apple-style-span" style="font-family: 'Trebuchet MS',sans-serif;">It doesn't really make it clear here that if you are already undergoing treatment with the mental health services then self-referral isn't appropriate.<br />They also would prefer that if you are low or anxious during pregnancy and seeking help that you go to your GP initially.<br />Common sense suggests that if you are significantly ill with mental health problems then this route of referral would not be appropriate initially either.</span></i><br />
<i><span class="Apple-style-span" style="font-family: 'Trebuchet MS',sans-serif;">Veterans and those with a complex history of childhood abuse should really start with their GP also.</span></i><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">The Depression and Anxiety service is a primary care service delivering evidenced based psychological interventions in line with NICE guidance.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">These include Cognitive Behavioural Therapy (CBT), Eye Movement, Desensitisation and Reprocessing (EMDR) and Applied Relaxation.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">Psychological interventions take place both in a group setting and via individual sessions.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">The service is for people in the South and West of Devon who are 18 years and over.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">Our team is able to help you with the following:</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Panic attacks</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Depression</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Anxiety</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Excessive worry</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Social anxiety/shyness</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Phobias</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Post traumatic stress disorder</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Agoraphobia</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">Your GP can refer you or you can refer yourself and we will let your GP know.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">You can refer yourself by phoning 01626 203500.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">Outside of office hours there is an answerphone. Please leave your name and contact details and we will phone you back.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">You can email on: tr.southandwestdevondas@nhs.net</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">We will talk to you about your difficulties and agree with you the best way forward.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">We can refer you on to other services and give you telephone numbers of alternative treatment options.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">We aim to see everyone within four weeks of referral and the initial appointment will take approximately 30 - 40 minutes.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">We will look at treatment options with you which are based on Cognitive Behavioural Therapy (CBT).</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">This looks at the way that thoughts, feelings and behaviours interact, sometimes in a helpful, and sometimes in an unhelpful way.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">We provide a choice of help that includes:</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Working with you to identify the difficulty you are having</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Help you in deciding where to start</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Recommending reading that would be helpful for you</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Providing information about other local resources that might be helpful for you</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Identifying thoughts and actions which may be unhelpful for you</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Identifying strengths and support to draw on</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Guidance in setting realistic goals and support in achieving them</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Providing support through self management programmes that have proven to be effective</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">• Group work and/or individual therapy.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">We also offer Eye Movement Desensitisation and Reprocessing (EMDR).</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;">This is a specific treatment for people who have experienced a trauma.</span><br />
<span class="Apple-style-span" style="font-family: Verdana,sans-serif;"><br /></span><br />
<br />dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-53106122758946624172011-09-07T22:29:00.001+01:002011-09-07T22:30:05.469+01:00Flu Vaccination 2011<div class="separator" style="clear: both; text-align: center;">
<a href="http://3.bp.blogspot.com/-C9k5QEV6FUM/TmffGfy5YkI/AAAAAAAAQtU/V8-ILRKucs4/s1600/influenza+vaccination.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><img border="0" height="222" src="http://3.bp.blogspot.com/-C9k5QEV6FUM/TmffGfy5YkI/AAAAAAAAQtU/V8-ILRKucs4/s320/influenza+vaccination.jpg" width="320" /></span></a></div>
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">This year our usual Flu vaccination "campaign" coincides with our move back to Leatside.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">For various reasons we are now going to have to try to do the bulk of the vaccinations from where we are now at the Creameries site by the Station.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">I had hoped we could do it the week after we moved back but technicalities to do with guaranteeing the cold-storage chain mean we can't really.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">SO - we will be getting the vaccines delivered on 6th Oct we hope, then will have a day set aside on Friday 14th Oct to do most of the jabs.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We don't want everyone to pile in at once so I will put an ad in the Totnes Times at the end of this month to explain how we hope to space people out.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">As usual it would be daft to have the jabs in the fridge and not be giving them out, so the week of the 10th to the 14th Oct, if you are in seeing the nurse or a doctor and qualify for a jab, then you will probably get one there and then. I'll be keeping a few available during each surgery that week, and I'm sure everyone else there will be doing the same.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">This year as usual we would expect to be giving the jab to anyone over the age of 65 and anyone with a long-lasting condition that would mean if they got flu they would be more at risk of serious illness or death. This usually means <b>heart</b> and<b> lung</b> conditions, <b>kidney</b> or <b>liver</b> disease, <b>diabetes</b> or <b>stroke/TIA</b>, people with <b>MS</b> or <b>cerebral palsy</b> and those with <b>Parkinsons</b>. Others where they may have a lowered <b>immunity</b> such as those on long-term <b>steroids</b>, have <b>no spleen</b> or are having <b>immunosuppresive therapy</b>.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">This year the Dept of Health has put a greater emphasis on jabbing healthcare workers. Only a third of hospital nurses had a flu jab last year. GPs weren't much better with only 38% having a jab. I had mine as always.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">The other emphasis is on pregnant mums. This is because during previous flu outbreaks it has become clear that pregnant women were much more prone to complications from flu than others. This was particularly evident during the swine flu outbreak, and there is still a concern that this strain might come back.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">I see people with Influenza every year and I still don't think most people appreciate just how bad it can be, particularly in the younger population. I have my jab every year because I <i>really</i> don't want to catch it.</span>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-81159543691086771152011-09-04T19:37:00.000+01:002011-09-04T19:38:02.027+01:00Registrars<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">I don't think anywhere that I had introduced the fact that we have two new registrars at the surgery.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">From August 2011 until the end of July 2012 we are lucky to have two registrars with us - Lorraine Hutchinson-Gale and Rizwan Irshad.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Lorraine's training is being supervised by Dr Frankland and Rizwan by Dr Watkins.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<br />
<div style="list-style-type: square;">
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Lorraine worked for many years as a nurse in Torbay and Exeter. </span></div>
<div style="list-style-type: square;">
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">She did her training at the Peninsula Medical School.</span></div>
<div style="list-style-type: square;">
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">She has a family of four children ranging between 14 and 23 years of age and when not busy with them enjoys walking her two golden retrievers in the Devon countryside.</span></div>
<div style="list-style-type: square;">
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span></div>
<div style="list-style-type: square;">
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Rizwan was born and raised in Newton Abbot and went to school and sixth form locally. <br />He studied medicine in St George's Hospital Medical School in London.</span></div>
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Outside of work he enjoys keeping fit and going to the gym.<br />He has competed locally in powerlifting for the BDFPA and regularly goes the gym. He also enjoys other sports (both playing and watching) and spending time with his family.</span>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-39362719043620747982011-08-31T23:13:00.000+01:002011-09-04T19:27:59.828+01:00Twitter & Facebook<div class="separator" style="clear: both; text-align: center;">
<a href="http://1.bp.blogspot.com/--VSgaPboP7I/Tl6s6hyroOI/AAAAAAAAQtA/JRZxDZQ6i88/s1600/SW-Twitter-Button2.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em; text-align: left;"><img border="0" height="200" src="http://1.bp.blogspot.com/--VSgaPboP7I/Tl6s6hyroOI/AAAAAAAAQtA/JRZxDZQ6i88/s200/SW-Twitter-Button2.png" width="200" /></a></div>
<div style="margin-left: 1em; margin-right: 1em; text-align: left;">
<a href="http://2.bp.blogspot.com/-yIjuze7wCjw/Tl6s5ydeDBI/AAAAAAAAQs8/op0ONtpQYYw/s1600/facebook_button_eu3g.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span class="Apple-style-span" style="-webkit-text-decorations-in-effect: none; color: black;"></span></a><img border="0" height="197" src="http://2.bp.blogspot.com/-yIjuze7wCjw/Tl6s5ydeDBI/AAAAAAAAQs8/op0ONtpQYYw/s200/facebook_button_eu3g.gif" width="200" /></div>
<br />
<br />
<br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">I have decided now to go even more "modern" and start a Leatside Facebook page and twitter feed.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">That just might be gobbledegook to you, but for many this means a quick way of getting any information we might want to disseminate.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">This Blog is useful for me to have a rant, or go on about something in more detail; but these other social networking sites are good for a quick, snappy bit of information about any small thing we might be doing.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">I suspect a different audience may see these than you here reading this blog. We'll see.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">I'll be putting the buttons up on the website in the next day or two.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><a href="http://www.facebook.com/pages/Leatside-Surgery">http://www.facebook.com/pages/Leatside-Surgery</a> (I think....)</span><br />
<br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">(Update- I can't seem to get the "buttons" to go quite where I want them to on our website yet- still playing - 4.9.11)</span>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com1tag:blogger.com,1999:blog-187833881845392529.post-27698439919195695332011-07-03T21:39:00.000+01:002011-08-31T23:14:30.303+01:00South Hams Health Profile 2011<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><a href="http://www.apho.org.uk/default.aspx?QN=HP_METADATA&AreaID=50421">This web site</a> shows some of the latest health stats for our area...</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">The two that jump out are our high incidence of melanoma and a high rate of higher risk drinking.</span>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-25232207222510879352011-05-10T23:02:00.000+01:002011-08-31T23:14:41.922+01:00Dr Loverock's retirement<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">As Dr Loverock has now retired his regular patients are now jockeying for position to see which GP they will end up seeing regularly instead.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Dr Thake is with us now finishing his GP Training before he joins the Doctors full time in August. He is the "official" replacement for Dr Loverock.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"> He has worked as a Doctor for many years here and overseas but only in the last few years decided to do the official UK General Practice training, which he is now concluding.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">The practice has also just changed one other technicality to do with registering patients.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Patients used to be registered with one or other partner, regardless of which Doctor they ended up seeing regularly.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We have now changed things so that all patients are registered with the practice rather than an individual Doctor.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Our computer system also allows patients to be allocated a "usual Doctor" and this is how we will now be dividing you up. This is the Doctor named at the bottom of your repeat prescriptions and the one who signs them.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">If you feel you have been allocated the wrong "Usual Doctor", let us know and we'll change it.</span>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-36366227008369622102011-05-04T22:49:00.000+01:002011-08-31T23:14:54.510+01:00More Measles<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">A letter recieved from Health Protection at NHS Devon a couple of weeks ago.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">As far as I am aware we have not seen any cases of measles recently.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">The majority of cases were in the under 30 age group.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">The European vaccination website euvac suggests that 18% of measles cases in France were hospitalised. There has so far though been only one death which seems an unusually low number for such an outbreak.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br /></span><br />
<i><b><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">"MMR and measles outbreaks</span></b></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">This is to you alert you that France is currently experiencing a large outbreak of measles with over 3,700</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">cases confirmed so far this year. Outbreaks have also been reported in countries bordering France and in</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">other parts of Europe. http://www.euvac.net/graphics/euvac/pdf/2011_jan_feb.pdf</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">There has been a much smaller increase in confirmed cases of measles in the United Kingdom during the</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">past month and the vast majority of cases have occurred in people who have not been immunised with most</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">relating to older children attending secondary school, university students and in adults. Many of these cases</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">have links to those in France.</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">In light of this information, we are asking practices to consider the following:</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">1. Immunise those children who present to your practice and have not received two doses of the MMR</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">vaccine</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">2. If a patient presents with a history consistent with the signs and symptoms of measles and you are</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">aware that they have recently been travelling, please take salivary samples for analysis to confirm</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">whether or not they have measles</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Measles, mumps, rubella (MMR) vaccine</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Immunisation with MMR vaccine is the safest way that parents can protect their children against measles,</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">mumps and rubella which are diseases that can have serious consequences for babies, young children and</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">their families. Not all people respond adequately to a single dose of vaccine, so to ensure greater protection,</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">people need to receive two doses of MMR. Two doses of measles, mumps, rubella (MMR) vaccine offer full</span></i><br />
<i><span class="Apple-style-span" style="font-family: Verdana, sans-serif;">protection against the three illnesses, provided the first dose is given from 12 months of age."</span></i>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-3220908776190642232011-04-14T22:16:00.000+01:002011-08-31T23:14:00.414+01:00Feedback and Patient Input Group<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-V36tbKoPlXI/Tadj0Ttm4NI/AAAAAAAAPYw/tSz41-QRDBQ/s1600/vis_feedback%255B1%255D.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><img border="0" height="200" src="http://2.bp.blogspot.com/-V36tbKoPlXI/Tadj0Ttm4NI/AAAAAAAAPYw/tSz41-QRDBQ/s200/vis_feedback%255B1%255D.jpg" width="176" /></span></a></div>
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">I think as a practice we could do with more feedback from our users (patients).<br />
We don't have, and have never had, a suggestions box.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We did have a patient participation group, which is currently inactive.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We get complaints, as all practices do. This is a form of feedback.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We get some plaudits, but being modest tend to shrug them off as nothing.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We can get feedback via the comments section on this blog.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We can see comments submitted via the <a href="http://www.nhs.uk/ServiceDirectories/Pages/GP.aspx?pid=5889C023-ADC5-4080-A665-FC7236C6AB7A">NHS Choices practice page</a>.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Another website people use is <a href="http://www.patientopinion.org.uk/">patient opinion</a>.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We do look at any feedback we get and see if it needs any changes to be made.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Of course we aren't always in a position to make changes, and if changes do seem appropriate what amount of discontent would we need to see before changing anything? ie I don't think we should always change something on the back of one bit of feedback; but we might do.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">It is a difficult time at the Surgery to get good feedback. Clearly the current accommodation isn't what we would like. We have few available appointments due to a combination of leave and Easter (and the Royal Wedding). We have a locum until Dr Thake can start properly in August. etc.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">I thought that we might initially invite comment or feedback in the main area that taxes us most of the time - the management of urgent cases. </span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">This might cover the process of phoning in- to access your own GP or the duty doctor to call you back. How your case is then dealt with- eg with advice or a prescription or an appointment to see you. Maybe a house call. Is that appointment suitable for you? </span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">and so on..</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">We shall be looking at reconvening a patient participation group. If this sort of thing fires you up perhaps you might want to get involved. We could do with a few people who are patients who have some sort of background in management or business who are used to systems and change? on the other hand any people who have a clear idea about how they would like things to be would be welcome. </span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">Perhaps if we just get that sort of input we'll get a "predictable result"- if you are a bit of a wildcard perhaps you might be able to have a useful if alternative input.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">If you do think you have something to add in this way then why not email in on <a href="mailto:leatside.surgery@nhs.net">leatside.surgery@nhs.net</a> for the attention of Andrew Moore. As the practice manager he will be the convener of the group.</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">If you would like to comment on the area of urgent or same-day appointments then please email in on the same address with the content line "Feedback".</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;">The third option is of course to use the comments section below the blog. Each comment is emailed to mine and Andrew Moore's inbox before it is published....</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Verdana, sans-serif; font-size: x-small;"><br />
</span>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com2tag:blogger.com,1999:blog-187833881845392529.post-75249583161115784212011-04-14T21:09:00.000+01:002011-04-14T21:09:23.205+01:00Leatside Statement of Intent 2010-2015<div class="MsoNormal" style="border-collapse: collapse; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm; text-align: left;"><span style="font-family: inherit; font-size: small;">I found this document the other day. It had been written by my practice manager in response to a revisit from the investors in people as well as the outline plans for our redevelopment coming to fruition, so a statement of intent was firming up the rationale for redeveloping.</span></div><div align="center" class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm; text-align: center;"><b><u><span style="font-family: 'Comic Sans MS';"><span style="font-size: small;"><br />
</span></span></u></b></div><div align="center" class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm; text-align: center;"><b><u><span style="font-family: 'Comic Sans MS';"><span style="font-size: small;">Leatside Surgery Statement Of Intent 2010-2015</span></span></u></b></div><div align="center" class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm; text-align: center;"><b><u><span style="font-family: 'Comic Sans MS';"><span style="font-size: small;"><br />
</span></span></u></b></div><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><b><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">What we are here for:</span></b></div><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><br />
</div><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">To provide healthcare to people who register with the Practice for their immediate and long term problems. In doing this, to build and maintain the relationships with individuals and families that allow them to visit our surgery with confidence and trust.</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">To deliver our services in a way that helps our society make the long term improvements in the general health of the public that it wishes to.</span></li>
</ul><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><b><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">What we value most highly:</span></b></div><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><br />
</div><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">Our ability to maintain the highest standards of healthcare and customer service</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">Our ability to make patients feel understood, cared for and safe</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">Our ability to make sure people working for the Practice feel happy and rewarded in their work</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">Our ability to ensure the safety of patients and people who work in the surgery</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">Our ability to deliver services that meet the requirements of the NHS</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">Our ability to respond to change in the NHS and society generally and use this change for the benefit of the Practice and its patients</span></li>
</ul><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><b><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">The most important things we want to develop over the next three years:</span></b></div><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><br />
</div><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">To develop the Practice business:</span><span class="Apple-style-span" style="font-family: 'Comic Sans MS'; font-size: 13px;"> </span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><ul style="margin-top: 0cm;" type="circle"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">by expanding our capacity to provide services to an increasing population, having regard to government plans to remove restrictions on patients registering with GP Practices such as ‘Practice areas’</span></li>
</ul></ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><ul style="margin-top: 0cm;" type="circle"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">in the context of the new NHS ‘market’ approach to healthcare provision by seeking out new ways of providing services locally</span></li>
</ul></ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><ul style="margin-top: 0cm;" type="circle"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">identifying areas of the Practice business where costs can be reduced or resources redeployed should the financial problems of the UK economy and the NHS lead to further restrictions or curtailment of the Practices NHS income.</span></li>
</ul></ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">To continue the organisational development of the Practice in respect of:</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><ul style="margin-top: 0cm;" type="circle"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">the numbers of doctors, nurses and administrative staff employed by the Practice and the distribution of workload and skills between these groups</span></li>
</ul></ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><ul style="margin-top: 0cm;" type="circle"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">the use of IT and communications technology to improve and streamline Practice operations</span></li>
</ul></ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">To continue to implement systems that assure the quality of care patients receive particularly through mechanisms for clinical governance, learning, appraisal and accreditation</span></li>
</ul><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><b><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">What are we going to do about this over the period 2010 to 2015:</span></b></div><div class="MsoNormal" style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><br />
</div><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">We will continue to work toward meeting achieving the highest targets under QoF.</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">We will develop new services through PBC funding following our successful implementation of schemes for COPD and continence.</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">We will consider further developments in our IT and records system, particularly a move to a web based medical record keeping system and greater use of voice recognition software</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">We will increase building capacity to reflect the continuing expansion of Practice services</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">We will continue to increase our involvement in graduate and post graduate training of doctors</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">We will implement changes that improve the way we deal with requests for same day access to doctors and nurses and find a better balance between ‘quick access’ and ‘booked’ appointments</span></li>
</ul><ul style="border-collapse: collapse; font-family: Tahoma; font-size: small; margin-top: 0cm;" type="disc"><li class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span style="font-family: 'Comic Sans MS'; font-size: 10pt;">We will improve the way we market the Practice to ensure we are able to take advantage of changes in government policy or increases in the local population yo increase our list size</span></li>
</ul>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-3658066210809398372011-04-04T21:24:00.000+01:002011-04-04T21:24:00.420+01:00Patient Survey 2010I have just seen that the latest patient survey results are <a href="http://www.gp-patient.co.uk/results/download/y5q3/factsheet/Y5Q3_PracticeFactsheet_5QQ_L83043_LEATSIDE%20SURGERY.pdf">available online here.</a><br />
The full reports can be found <a href="http://www.gp-patient.co.uk/results/results/factsheets/search/?code=L83043">here.</a><br />
The highlights in comparison with the PCT are noted on one of the pages, and, despite the limitations of the small sample size used, it seems that <i>we are easy to get hold of on the phone compared to other practices</i>.<br />
Having a modern telephone system allows flexibility in how people can phone in. It does also mean that by providing times when you can ring in to speak to your Doctor we set you up for disappointment if you can't get through because others are on the line.<br />
My patients often tell me that they waited but couldn't get to speak to me. The trouble is that there is only so much time available in the day and I have to do Surgeries and house calls as well as find time for a bite to eat.<br />
We could all spend longer on phone calls but it would likely be at the expense of some other area.<br />
Some of my patients have my direct email address and for them that is now becoming an easier way to get hold of me. Some of the other doctors don't use email to communicate with patients at all. It is debatable whether that is really an effective way of keeping in touch but I am trying it out with a select few- by invitation if you like....<br />
Perhaps in the comments here you could let me know what you think.dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com1tag:blogger.com,1999:blog-187833881845392529.post-80530214221660487892011-02-23T12:01:00.000+00:002011-02-23T12:01:52.977+00:00More on MidwiferyI wrote on a blog here back in October that there was the beginnings of a threat to local midwifery services.<br />
Since then things have moved on but I have to say that at this exact point in time I'm really not clear whether our midwifery service is going to be badly affected or just affected.<br />
I had let Richard Davies at the Totnes Times, and Steve Peacock at the Herald know that something was afoot.<br />
They did a dutiful bit of investigative digging but couldn't get any definitive word from Torbay on what the changes were going to be.<br />
Their getting in touch with Torbay must have put the wind up someone though, because within days we had had calls from the Consultant in charge of the changes and one of the midwifery managers literally popped in to the surgery to attempt to reassure the doctors that the changes were going to have no impact on our service at all.<br />
At that point I let the newspapers know of the reassurance, and Richard has since put in a piece to say all is well.<br />
Now it begins to look again much more like that might not be the case after all.<br />
<br />
South Hams had in 2009 a Home Birth rate of 11.3%- just below Glastonbury area I think, but the second highest in the country nonetheless. The England average is 2.7%. Some areas have <u>only</u> accidental home births.<br />
<a href="http://www.birthchoiceuk.com/Professionals/BirthChoiceUKFrame.htm?http://www.birthchoiceuk.com/Professionals/HomeBirthsMaps.htm">This page</a> shows a map on National Home Birth rates- demonstrating how high the south west is in general compared with other areas of England.<br />
Our midwives in Totnes have been working for years at supporting home births, and if the statistics are anything to go by must be national experts by now. In a national survey only 22% of mums had met the midwife delivering them beforehand. In our area that is 43%. That is one of the major findings of effective team working in midwifery, and it is valued. If the proposed changes go ahead then this might suffer.<br />
As doctors our main concern is that if midwifery services are reduced then midwifery led care will suffer. If that suffers then mums to be will end up more likely to deliver in hospital (possibly).<br />
We know from the stats that Torbay has a Caesarean rate of around 25% of all deliveries.<br />
It sort of flies in the face of progress doesn't it?<br />
And why?<br />
To attempt to save money.<br />
As I understand it one of the major costs in providing midwifery services is the massive insurance required.<br />
Having babies is still a dangerous business. 4.7/1000 births result in a dead baby statistically. (Not as dangerous here as in parts of Africa-184/1000 in Angola is the highest I could find) <br />
Health trusts have to insure their professional staff against mishap. I don't have the costs but I have been told that relative to cutting staffing levels, the insurance costs outweigh the staff-cutting cost benefits vastly. The insurance costs won't change for cutting staffing numbers.<br />
<br />
Torbay have written: <b><i>"following extensive consultative work, the service is being reconfigured to safeguard the current high standard of maternity care that is nationally recognised as an exemplar, whilst acknowledging and facilitating the needs of an increasing number of pregnant women who have additional health and social risk factors, and are vulnerable".</i></b><br />
They are doing this by<b style="font-style: italic;"> "reducing the number of midwifery teams, but each team will have more midwives". </b>So what was the previous ratio of midwives per birth, and what will it be after the changes? Expectant mums may now meet any of a large number of midwives, so the chance of continuity of care into their labour and afterwards is reduced.<br />
Because each larger team covers a larger area, the worry is that the on call midwife in the team will be pulled all over the place geographically- which must make responsiveness to needs less. Some changes have been made to respond to the European working time directive, but this will include travelling times within the larger areas, and to and from the base for each midwife team. Getting in and out of Brixham (which is where the base is proposed to be for our midwives) can be a nightmare in the summer.<br />
<b>Why haven't they consulted AT ALL with the public or the GPs in this.</b><br />
<br />
There are many more technical points and questions but that might make this all too long and boring.<br />
<br />
All of my GP colleagues at Leatside have signed a letter drafted by Dr Morris to the Chief Executive of South Devon Healthcare Trust asking her to stop the process of change and review what is going on here. <br />
This letter is copied below:<br />
<br />
<br />
<div class="MsoNormal"><b><span style="color: black; font-family: Arial; font-size: 11pt;"><i>Paula Vasco-Knight<o:p></o:p></i></span></b></div><div class="MsoNormal"><b><span style="color: black; font-family: Arial; font-size: 11pt;"><i>Chief Executive<o:p></o:p></i></span></b></div><div class="MsoNormal"><b><span style="color: black; font-family: Arial; font-size: 11pt;"><i>South Devon Healthcare Trust<o:p></o:p></i></span></b></div><div class="MsoNormal"><span class="Apple-style-span" style="font-family: Arial;"><span class="Apple-style-span" style="font-size: 15px;"><b><i><br />
</i></b></span></span></div><div class="MsoNormal"><span style="color: black; font-family: Arial; font-size: 11pt;"><i>Dear Ms Knight<o:p></o:p></i></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: black; font-family: Arial; font-size: 11pt;"><i>I am writing on behalf of Leatside Surgery with regards to our high level of concern over the upcoming changes that we have been informed second hand are going to take place within the midwifery service. We have been told that our current provision of midwives will be dropping to 2 covering the Totnes area and that the base will be in Brixham. We have real concerns over these changes. Ten years ago our midwifery team was a nationally recognised team of 13 midwives just serving the Totnes area. We also had the highest home birth rate in the UK and national recognition in the media. Over the years this team of 13 midwives has been reduced down to 6 and the home birth rate has dropped down from being the highest in the UK down to average. <o:p></o:p></i></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: black; font-family: Arial; font-size: 11pt;"><i>We have been in correspondence with the midwifery directorate and had reassurance that services to our patients will not be affected but we fail to see how dropping from 6 to 2 midwives will be of benefit to our patients. We are also concerned that there has been no sign of any negotiation or consultation with any of the usual parties. Certainly when this was brought up at the LMC last night there was general concern and surprise and I gather they will also be writing to you. I also believe very little has been negotiated or discussed with the PCT. Certainly for future commissioning the proposed set up is not one we would recommend as we foresee poor prenatal care and a substantial decrease in service to our local population. <o:p></o:p></i></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: black; font-family: Arial; font-size: 11pt;"><i>The whole change has caused a great deal of distress in the midwifery team who are concerned about the fragmentation of the team and increased journey times to their place of work. There are also simple practical problems with the team being based in Brixham with the increased travelling times in the summer months due to increased traffic. A simple journey which might normally take 30 minutes might very easily run into 2 hours or more. <o:p></o:p></i></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: black; font-family: Arial; font-size: 11pt;"><i>Andrew Lansley, throughout the white paper consultations, has stated that frontline services are to be protected and there has also been a push for an increase in home births and we fail to see how these changes would achieve either of these goals. <o:p></o:p></i></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="color: black; font-family: Arial; font-size: 11pt;"><i>We would welcome due process to be initiated on this project and it’s initiation date to be postponed until this occurs. </i></span></div><div class="MsoNormal"><span style="color: black; font-family: Arial; font-size: 11pt;"><i><br />
</i></span></div><div class="MsoNormal"><span style="color: black; font-family: Arial; font-size: 11pt;"><i>Partners at Leatside </i><o:p></o:p></span></div>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com0tag:blogger.com,1999:blog-187833881845392529.post-69840553674045231262010-11-28T15:38:00.003+00:002010-11-29T15:10:12.243+00:00The CreameriesWe are now moved in. Start work there tomorrow morning.<br />
<br />
No phones though. Somehow BT couldn't get their act together to plug in their end of our ISDN line at the exchange, so our phone computer is still at the Surgery. Hopefully get that sorted mid week though. It may of course make getting in touch a little tricky for a few days but we have a contingency plan of leaving some staff at Leatside manning some phones until it gets sorted. I am quietly pleased that the computer system works. You've probably little idea how much thought that took, and in some ways how much we rely on it nowadays.<br />
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I've been either amazed or amused by the number of people who seem to have no idea where the Creameries Social Club is. I've told them it is "down at Unigate" and I get a blank look back. I then say it is "just by the "Up" platform at the station" - but then someone came back with "where's the station?". Astonishing.<br />
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So, to help you along, here are a few pics. You can click on them to enlarge them.<br />
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<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/_CT5vZ-cNCcM/TPJz5hmqGgI/AAAAAAAANBs/eT2oc3H2D2g/s1600/P1050707_stitch.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="216" src="http://4.bp.blogspot.com/_CT5vZ-cNCcM/TPJz5hmqGgI/AAAAAAAANBs/eT2oc3H2D2g/s400/P1050707_stitch.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The view from Totnes Railway Bridge<br />
- you can see our big yellow sign from here.</td></tr>
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<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/_CT5vZ-cNCcM/TPJ0D0uaoWI/AAAAAAAANCE/9NVIz7TPdnM/s1600/P10507101.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="235" src="http://1.bp.blogspot.com/_CT5vZ-cNCcM/TPJ0D0uaoWI/AAAAAAAANCE/9NVIz7TPdnM/s400/P10507101.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">turn in by Redworth Traffic Lights</td></tr>
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<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/_CT5vZ-cNCcM/TPJz7WW6y7I/AAAAAAAANBw/HHJ13sWZD50/s1600/P1050711.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="262" src="http://4.bp.blogspot.com/_CT5vZ-cNCcM/TPJz7WW6y7I/AAAAAAAANBw/HHJ13sWZD50/s400/P1050711.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">(Free) Car parking this side of the building and in front<br />
Keep the commuters off it!!</td></tr>
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<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/_CT5vZ-cNCcM/TPJz9rlWTjI/AAAAAAAANB0/rMke6wvFGvM/s1600/P1050712.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://3.bp.blogspot.com/_CT5vZ-cNCcM/TPJz9rlWTjI/AAAAAAAANB0/rMke6wvFGvM/s400/P1050712.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The ramp up to the entrance</td></tr>
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<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/_CT5vZ-cNCcM/TPJz_A-QElI/AAAAAAAANB4/owS-2ZCD_tY/s1600/P1050713.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://2.bp.blogspot.com/_CT5vZ-cNCcM/TPJz_A-QElI/AAAAAAAANB4/owS-2ZCD_tY/s400/P1050713.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">...and here's the entrance..</td></tr>
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<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/_CT5vZ-cNCcM/TO-4EyXzTeI/AAAAAAAANAM/SajsOvZKU6c/s1600/DSC00929.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://2.bp.blogspot.com/_CT5vZ-cNCcM/TO-4EyXzTeI/AAAAAAAANAM/SajsOvZKU6c/s400/DSC00929.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">in the waiting room</td></tr>
</tbody></table><div class="separator" style="clear: both; text-align: center;"></div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/_CT5vZ-cNCcM/TO-4RTbp3mI/AAAAAAAANAc/y-cfQJC-Y18/s1600/DSC00931.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://3.bp.blogspot.com/_CT5vZ-cNCcM/TO-4RTbp3mI/AAAAAAAANAc/y-cfQJC-Y18/s400/DSC00931.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">...more waiting room.</td></tr>
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<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/_CT5vZ-cNCcM/TO-6PKnjRRI/AAAAAAAANAw/9idk6reQPcY/s1600/DSC00938.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://1.bp.blogspot.com/_CT5vZ-cNCcM/TO-6PKnjRRI/AAAAAAAANAw/9idk6reQPcY/s400/DSC00938.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">this is the corridor between the portacabins (it drips)</td></tr>
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<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/_CT5vZ-cNCcM/TO-4CTm8osI/AAAAAAAAM_k/jFG_9eZc2i8/s1600/DSC00926.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://3.bp.blogspot.com/_CT5vZ-cNCcM/TO-4CTm8osI/AAAAAAAAM_k/jFG_9eZc2i8/s400/DSC00926.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">my consulting room in the portacabin.<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_CT5vZ-cNCcM/TPPCF8Qk45I/AAAAAAAANDQ/08lecIyFMQI/s1600/Fullscreen+capture+29112010+091225.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="248" src="http://2.bp.blogspot.com/_CT5vZ-cNCcM/TPPCF8Qk45I/AAAAAAAANDQ/08lecIyFMQI/s400/Fullscreen+capture+29112010+091225.jpg" width="400" /></a></div><div class="separator" style="clear: both; text-align: center;">and here's a map.</div><br />
</td></tr>
</tbody></table><div class="separator" style="clear: both; text-align: left;">So there we have it. All ready for use I hope. If you still don't know where it is put TQ9 5JP into your SatNav and it will get you there.</div>dylthedochttp://www.blogger.com/profile/17779641502412541357noreply@blogger.com6