Hurst Healthcare

Interview with Dr Winn partner GP, Mid Sussex Health Care in Hurst

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By Louise Evatt, Chair of Mid Sussex Health Care Patient Participation Group

The past year plunged our National Health Service into a state of emergency, requiring many sudden changes to the ways patients access health care. It’s been frustrating, worrying and difficult for the community and the practitioners alike. The demands on doctors’ surgeries are higher than they have ever been. The Times reported that in March this year the UK had hit the highest consultations on record, a staggering 28 million. So how has this impacted locally?

The PPG interviewed Dr Miriam Winn, Partner GP at Mid Sussex Health Care, who shared her experiences over the past 19 months. “In early 2020 the practice had to adapt its ways of working. We rapidly needed to move to a total triage model - this was under the direction of NHS England and it was very different to the way we had previously been working. We needed to start screening our patients by finding out what their problem was and how best to manage them whilst keeping patients safe and keeping staff safe.”

Dr Winn recalled the amount of unknowns they had to work with and the speed at which they had to react. She explained how they set up systems to be able to quickly adapt, including the creation of a team to make rapid decisions on a daily basis. “The team met every morning to respond to the information coming through. We also held daily huddles with all staff to explain changes being made and get feedback on how things were going, ensuring staff concerns staff were heard.”

At this time the community was concerned to see the sudden changes, particularly the closure of the Ditchling surgery and the limited access to the Hassocks surgery. Dr Winn explained the rationale for these changes. “We were worried about patients coming into the practice who may be potentially infected and therefore we needed to limit the amount of contact that our staff were having with patients, and we were also rapidly losing staff because they were developing coughs themselves, so needed to isolate, or needed to be at home with family members that were isolating. So we didn’t have enough staff available to open all three sites in a safe way.”

It has been a common misconception that GP practices have been closed throughout the lockdown. “We’ve been here all along,” said Dr Winn, “seeing patients face-to-face in the safest way that’s possible”. She explained how they needed to triage patients to know whether they should be seen in a Covid-secure environment or whether they had potential Covid symptoms and should be seen at the ‘hot hub’. “It was also important to keep our Hurstpierpoint site as a ‘cold site’ so that we could bring in vulnerable patients for blood tests or other appointments and they could be assured that it was as safe as possible. Vulnerable staff could also be assured that they were safe to be at work and worked only at the cold site.”

It’s now been well over a year since the rapid response to Covid began and unfortunately things are still very different to what they once were. We asked Dr Winn how it is now for the practice and its staff. “We’re still doing total triage all day. That will hopefully change soon. At 8.30am it’s all go. Our phone lines open and morning clinics start.” She explains that each GP sees 32 patients either over the phone or at the surgery, during morning and afternoon sessions. In between the two sessions they make home visits, put through patients, send off prescriptions and respond to contact made via E-consult. We all stay on until the job is done, so currently it is an extremely long day for us all.” Dr Winn chatted at length about all the changes, what might remain long into the future and what should eventually come to an end. We discussed reduced contact with the GP, and an increased digital service that the media recently predicted. She remains very positive that MSHC are on the right road ahead. “The rapid pace of change has certainly forced the practice to try new things such as online appointments, but all of us miss that face-to-face interaction with patients. We don’t have any intention to work only remotely, but we will still have online services so that patients have a choice.”

Dr Winn talked about the increased patient choice as a positive to have come out of the changes. She also explained that within the practice, it has also brought teams together to think about how best to manage the problems and to think outside the box, like providing oxygen monitors at home to patients with Covid symptoms. She hopes that patients understand the challenges they have had and welcome any feedback patients may have. The PPG would like to thank Dr Winn for this interview and also thank her and all MSHC colleagues for the efforts they have gone to, to keep our local health care going to support us through the pandemic.

Mid Susssex Healthcare - How we are working

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Firstly, I would like to say thank you to all of our patients for both your understanding and for the support that you have all shown us at the practice since March of this year. We have been listening to the feedback that you have shared with us and our Patient Participation Group (PPG) over the last few months. We now realise that despite our belief we are keeping everyone informed of changes to how we are working with newspaper articles, SMS messages, website updates and lengthy phone messages, there are still patients who feel they are struggling to know how they can access our services. We therefore thought that placing an article in the local magazines would reach a wider audience and particularly help those patients who are unable to access our website for information.
GP Appointments – In keeping with Public Health England and NHS England guidance, we are running a telephone first appointment system. What does this mean in reality I hear you ask? If you are unwell or worried about your health and feel you need to see a doctor please contact the practice by phone. Alternatively you can complete the e-Consult form via our website. Your appointment will initially be booked as a telephone appointment and the doctor will call you to discuss your concerns. If, during the course of your conversation they think you should be seen in person, they will arrange for you to come in for a face to face appointment.
e-Consult is a recent addition to our service provision and allows patients to submit their symptoms or requests to their own GP electronically avoiding the need to call the practice. It offers around the clock NHS selfhelp information, signposting to services, and a symptom checker.
We can’t stress enough, that we are still here and seeing patients. Please don’t think we are too busy for you or you don’t want to bother us at this busy time. If you are unwell or worried about your health get in touch!
Our aim with having doors closed and first contact by phone or e-consult is us being very careful to ensure as much as is possible our sites remain safe for patients that need to be seen, and we are managing the more routine care issues via telephone and video consultations.
Nursing Team – our nursing team are continuing to see patients, as they have been throughout this pandemic. To allow for the additional use of PPE and reduce the number of patients in our waiting room areas at any one time, we have adjusted appointment lengths. The Practice Nurses and Chronic Disease nurses focus is on essential care, such as smears, childhood immunisations and chronic disease management (diabetes, Asthma and COPD). Our Health Care Assistants continue to support those patients needing INR monitoring, ECGs, dressings and supporting our flu vaccination program.
We are this month trialling the opening up of on-line booking for our phlebotomist’s blood test appointment, these are for blood test requests by your GP and cervical smears with a nurse, for which patients will receive a letter advising them how to book these.
Telephones – To help us support our most vulnerable patients, we are asking that for an hour between 10am and 11am each morning the phone lines are kept as free as possible to enable patients in this category to make contact with us more easily.
Volunteers – I think you would all agree with us that the volunteers in the local community did a phenomenal job of supporting our most vulnerable patient during lockdown. We will be working together with the volunteer organisers to see how together we can continue to support everybody.
Keep safe and remember the Practice is here for you!!!