Friends and Family Test

You can now complete a Friends and Family Test questionnaire online or in the practice.  Tell us if you are likely to recommend us to your family and friends and tell us why you gave your response. Results from the Friends and Family Test will be published on our web site.

GP Ratings - The Dangers of Flawed Data

This week the health watchdog, the Care Quality Commission (CQC), published a list of rankings for the risk of providing poor care in general practice. The aim has been to give the public information regarding their surgeries and the quality of the services that they are offering. But are the rankings accurate or will they cause unnecessary anxiety

No serious professional would question the right of the public to know exactly what quality they are getting from their services, and this is even more the case when that service may mean the difference between life and death. General practice is an important part of many people’s lives, providing most of us with our entry point into the NHS. In fact for the vast majority it is the only contact we have with the health service from one year’s end to the next, as general practice deals with 90% of cases in house without any need for onward referral to hospital. For over 50 million of us, general practice is the only experience we will have of the NHS in the next 12 months, so these figures matter. The big question is are they reliable.

To answer this question we need to understand what the figures mean. They are an expression of the raw data gathered on each practice across a range of performance indicators and which CQC inspectors then use to guide their questions and inquiries when they visit the practice on an inspection. The data is bundled together and given a simple score from 1 to 6, the score of 1 marking a significant potential worry. In short these rankings are therefore the raw data that helps to guide the inspection process, but they are not the results of the inspection itself. It is not set in any context and is therefore free of any meaning. The CQC is clear about this in its declaration that these rankings “do not amount to a judgement of practices”, but the danger, of course, is that this is how the rankings will be seen by public and professionals alike.

In my everyday work as a GP I see many people who present with symptoms that are a very clear cause for concern. The likelihood is that the person sitting before me has some minor illness that is very simple and of no significant threat to them. However, their symptoms and the results of my examination may leave open the possibility of some much more serious diagnosis. I therefore arrange further more detailed tests to establish the diagnosis definitively before making any pronouncement. In ordering these tests I am at pains to explain to the patient what we are doing and why. I take time to set out clearly the extremely unlikely but potentially devastating diagnosis that we seek to exclude. What I do not do is scare them half to death with the blunt statement “You’ll need a test. You might have cancer.”

This is effectively what the CQC have done in publishing this data before the inspections have taken place and without any attempt to establish its validity. Of course there will be some practices within the cohort giving concern that do in fact turn out after inspection to have genuine problems. Some may even be deemed unsafe. For many, however, there will be perfectly good reasons to explain why they have recorded apparently low scores when the care they deliver is in fact excellent. There are 101 reasons why data can be skewed and it is not until one drills down in detail that it can be established whether the cause for concern is genuine.

For example, in Somerset this year an innovative deal has been reached that frees practices of the box-ticking bureaucracy linked to a scheme called QOF (the GP Quality and Outcomes Framework). This has allowed practices to do even more of their exemplary work as resources can be focused where they really matter - at the sharp end with patients who need them. In return a few boxes are left un-ticked. Better care, fewer ticks. Crucially, the CQC indicators are driven by those ticks, which raises the possibility that the rankings are completely inaccurate in Somerset. A similar scheme operated last year in Devon and Cornwall, raising doubts about the rankings’ accuracy there also.

The public deserves an accurate and robust inspection regime to assure quality in general practice. What it has been given in these misleading figures is a half baked and distorted picture that is likely to cause serious anxiety. General practice is close to collapse with chronic under funding and severe workforce shortages. It is likely that, for the first time ever, 2015 will see significant numbers of people simply unable to find a GP as some surgeries close their doors forever. On this background the public and the profession deserve better than this shoddy approach from a watchdog that is supposed to be the guardian of quality.

Dr Mark Sanford-Wood

Devon Local Medical Committee

20^th November 2014

Staff training 1.00pm - 2.00pm Thursday 20th November

The surgery will be closed between 1pm and 2pm on Thursday 20th November 2014 for staff training.  We apologise for any inconvenience this may cause.

If you need medical assistance when we are closed you can:

• phone the  NHS 111 service for medical advice by dialling 111.
• pop in to your local pharmacy for advice and over the counter medication.
• If your problem is urgent phone the NHS 111 service by dialling 111. To avoid putting undue pressure on this service, please only phone  if your problem cannot wait until we reopen.
• phone 999 immediately in the event of a life threatening, medical emergency.

How to get help for a minor injury

IF YOU HAVE A MINOR INJURY

THE NEAREST MINOR INJURIES UNIT IS

HONITON HOSPITAL

OPEN FROM

0800 UNTIL 22OO

Minor injuries are usually cuts, grazes, minor falls, animal bites, minor burns, bruising, sprains, strains, foreign bodies and minor bumps

OTTERY HOSPITAL MINOR INJURIES WILL BE CLOSED UNTIL FURTHER NOTICE

THERE IS NO MINOR INJURY UNIT AT THE SURGERY

Staff training 1.00pm - 2.00pm Thursday 13th November

The surgery will be closed between 1pm and 2pm on Thursday 13th November 2014 for staff training.  We apologise for any inconvenience this may cause.

If you need medical assistance when we are closed you can:

• phone the  NHS 111 service for medical advice by dialling 111.
• pop in to your local pharmacy for advice and over the counter medication.
• If your problem is urgent phone the NHS 111 service by dialling 111. To avoid putting undue pressure on this service, please only phone  if your problem cannot wait until we reopen.
• phone 999 immediately in the event of a life threatening, medical emergency.

Dr Sally Caswell

We are very pleased to be able to welcome Dr Sally Caswell to our practice team.   Many of you will know Dr Caswell as she has been working with us as a GP locum.  We are delighted that she has agreed to take up a permanent post here as from today.

Armistice Day

As a tribute to all those who lost their life fighting for their country we will be observing the two minute silence on Tuesday 11th November 2014 at 1100.

The Future of Community Health Services

The NEW Devon CCG has announced that the next public meeting on the future of community health services will be held on Wednesday 26th November 2014 at:-
The Institute,
Yonder Street
Ottery St Mary
EX11 1HD

1800 to 2000

If you would like to find out more about this event please contact Christy Thurlow on 01392 356117. Booking is not essential but is helpful for planning.

Minor Injuries

Tomorrow,  Thursday 6th November 2014, the minor injuries unit at Ottery Hospital will be closed.  The nearest minor injury unit to Ottery is Honiton Hospital.  Honiton is open from 0800 until 2200. There is no minor injury unit here at the surgery.

Minor injuries are usually cuts, grazes, minor falls, animal bites, minor burns, bruising, sprains, strains, foreign bodies and minor bumps.

Bonfire Night

Wishing Ottery St Mary and all our patients a safe and enjoyable tar barrel and bonfire night.  Here's the link to NHS Choices web site where you can find lots of info on firework safety.  http://www.nhs.uk/livewell/fireworksafety/Pages/Fireworksafety.aspx