"Difficulty seeing a doctor amongst other problems!"

Thank you for taking the time to provide feedback.

When the surgery was re-awarded the new APMS contract, this came with a 23% cut in core funding along with other cuts to the funding we receive. This has led to fewer appointments in the system than previously; this is not something which the surgery is happy about, however we have little control over this situation.

This funding cut would have been the same, regardless of who won the tendering process. Further details of this can be found in an open letter I published back when our popular walk in clinic closed; https://www.nmhealthinnovations.co.uk/News/826fa753-3e2d-4fa9-946f-4767241fe64c

As per the 5 Year NHS plan (soon to be replaced by the 10 Year Plan) Primary Care is changing; we have a wide range of clinicians, who have different skill sets and are trained to deal with different problems and queries. There is a national shortage of GPs, especially female ones and therefore GPs are becoming more specialised in dealing with the most serious cases, whilst other, trained health professionals are dealing with lower level issues which have traditionally been seen by a GP. This includes Health Care Assistants, Minor Alignment Nurses, Advanced Nurse Practitioners, Nurse Clinicians and Prescribing Pharmacists.

Our on the day appointments are seen by our Nurse Practitioners; these are nurses who are qualified to treat certain medical conditions without the direct supervision of a doctor.

The Care Quality Commission (CQC) say they can;

• Prescribe any medicine for any condition within their competence (including some controlled medicines) provided they have completed an Independent Prescribing qualification.

• See patients with undiagnosed, undifferentiated medical conditions and make treatment decisions, including ordering necessary investigations.

• Refer patients to secondary care, although this can vary depending on local arrangements and protocols.

• Undertake appropriate home visits.

CQC May 2018

There is always an On Call GP who the Nurse Practitioners can refer to if they want a second opinion or believe that a patient presents with a condition that is outside of their competences.

This On Call GP has a number of appointments which can be booked, but only by the Clinical Team, not by patients directly or via the Reception Team.

In terms of response to your complaint, I agree that three months is too long, but a range of factors can impact on the response time including the need to speak with members of staff, the complexity of the complaint, the need for different people to review the complaint and potentially the requirement for indemnity providers to review responses.

I am sorry you have had a negative experience and I hope this explanation has helped you better understand the way the surgery operates.

Regards

Craig Lee

Practice Manager