Manor House Surgery

Emperor's Gate, Stevenage, SG2 7QX. Telephone: 01438 742639 Fax: 01438 746201

November 2017

Welcome To Our Newsletter

Dear Patient,
Our Patient Participation Group suggested this would be a great way to keep patients up to date on current issues about the Practice and also keep you informed of any hot topics that matter within the local Health Service. The NHS budget restraints impacts on all of us and this issue will focus on how we can all make a difference in these challenging times.

ALL CARERS Ė We have a Dementia Evening on 30th November 6.30 Ė 8pm. Guest speakers will talk about Dementia and give information and tips on how to manage this. You may have a family member, friend or neighbour that may need help & advice. Please let Sonia/ Wendy know if you are able to attend. Refreshments will be available.

The Practice was inspected by the Care Quality Commission (CQC) on 1st December 2016. We have been rated overall as a GOOD Practice with an OUTSTANDING mark in caring for vulnerable patients. A full report can be seen by using the LINK on the homepage of our website

We continue to have GP Trainees working here. We have Dr O Lawson who joined us in August. We are now very pleased to say that we recently become a Nurse Training practice affiliated to Hertfordshire University.

Our Practice is now undertaking hospital referrals by the Choose & Book system. This is an NHS Service which gives patients the chance to choose which Hospital they would prefer to be seen at and book their own appointment. Patients who need to be referred will be asked to collect the necessary paperwork from the Surgery to enable them to use this Service. More details are given within this Newsletter.

We are currently promoting awareness to the Bowel Cancer Screening Programme for patients aged 60 - 74. Please see details on our Website and information further in our Newsletter

Wishing you all a Merry Christmas and Happy & Healthy 2018!

Sandra Copping - Practice Manager



Policy concerning Patients' Rights to Privacy Pertinent to Student Attendances.

Manor House Surgery is a Teaching Practice concerned with the Education and Training of Student Nurses, Medical Students and Trainee GPs. However this function of the surgery, though most important, is secondary to its principal role of treating its NHS patients.

Every patient has an absolute right to privacy during medical consultations and this right is not to be compromised in order to facilitate student learning of any sort. Thereby, before any student or other observer is permitted to "sit in" on a patient's consultation, that patient's consent must be obtained.

Such consent is to be sought by ďReception StaffĒ, who advise patients that students would like to be present and offer the patient an opportunity to decline without reservation or having to provide a reason.

It is well known locally that this is a Teaching Practice and information pertaining to this and posters are displayed on our web site, our practice leaflet, in the waiting area and on reception to advertise that there may be a student present in the consultation and offer patients the right to refuse the presence of such an observer.

If the patient refuses or has any doubts what-so-ever about allowing an observer to be present, they are requested to inform Reception Staff, who will screen-message the involved Clinician, to facilitate privacy for the patient and enable students to vacate the consultation room.

Patients should feel totally at ease and freely able to refuse consent to the presence of students or other observers during their consultation and/or examination. They should be reassured that their decision will, in no way, affect their treatment.



Screening is a way of testing healthy people to see if they show any early signs of cancer.
Bowel cancer screening can save lives. Screening aims to detect bowel cancer at an early stage, when treatment has the best chance of working. The test can also find polyps (non-cancerous growths), which might develop into cancer. Polyps can easily be removed, to lower the risk of bowel cancer.
Bowel Cancer UK do not provide bowel cancer screening test kits or accept completed kits.
What is bowel cancer screening?
In England, Wales and Northern Ireland people over the age of 60 are invited to take part in bowel cancer screening. In Scotland, screening starts from age 50. You will be invited to take part in screening every two years until you reach the age of 75.
The national screening programme uses a home test called a Faecal Occult Blood Test (FOBT), which looks for hidden blood in poo. The test will be posted to you, so you can do it in the privacy of your own home.
Using the cardboard sticks provided, you will be asked to smear two small samples of poo onto a special screening card. You will need to do this three times over a two week period (10 days in Northern Ireland and Scotland).
You will be given a self-sealing, freepost envelope to send the card back to the screening centre. Full instructions and a more detailed information leaflet will be sent to you with your invitation and test.
UK bowel cancer screening programmes
At the moment, the bowel cancer screening programme in every UK country uses the FOBT test.
If you are aged between 60 and 74, you will be invited to take part in bowel cancer screening every two years.
-If you are aged 75 or over, you can ask for a screening test by calling the free bowel cancer screening helpline on 0800 707 60 60.
-Call the screening helpline on 0800 707 60 60 or visit NHS Choices for more information about bowel screening in England.
Bowel scope screening is another part of the national bowel cancer screening programme in England. The test is gradually being introduced, and will eventually invite all men and women in England aged 55 to take part.
-Bowel scope screening involves using a thin, flexible tube with a camera on the end to look inside the lower part of your bowel and your back passage (rectum). This is called a flexible sigmoidoscopy. The test looks for, and removes, any non-cancerous growths (polyps) that could develop into cancer over time.The NHS Choices website has more information on bowel scope screening.
-Download our leaflet and poster about bowel screening in England.­about-bowel-cancer/­screening/­

Benefits and risks of bowel cancer screening

The sooner bowel cancer is diagnosed, the easier it is to treat. But no screening test is 100 per cent accurate.

It is your choice whether to take part in the screening programme. Some of the benefits and risks of bowel cancer screening are listed here.

-Taking part in bowel cancer screening lowers your risk of dying from bowel cancer.
-Screening can pick up cancers at an early stage, when there is a good chance of successful treatment. If bowel cancer is diagnosed at the earliest stage, more than nine in ten people will be successfully treated.
-Screening can find non-cancerous growths (polyps) in the bowel that may develop into cancer in the future. Removing these polyps can reduce your risk of getting bowel cancer.

-Cancer may be missed if it was not bleeding when you took the test. The screening test works by finding traces of blood, which may be from a cancer.
-Screening may give a false positive result. This means that you may get an abnormal result when you don't have cancer. Other medical problems and some food and medicines may give a false positive result. This can cause worry and can lead to other tests, such as a colonoscopy. Your screening test will come with information about what may affect the test results.
-Bowel cancer can develop in the two years between your screening tests. Speak to your GP if you notice any symptoms or are worried about bowel cancer at any time.

Getting the results

You will get your test results in about two weeks.

Most people have a normal result, which means that no blood was found in the sample. This doesn't mean that you don't have or won't get bowel cancer so you should still see your GP if you have any symptoms. You will receive another test in two years.

If the result isn't clear, you may need to do the test again.

If the test finds blood in your sample, you will be invited to a local screening centre to talk about your results. This doesnít mean that you definitely have cancer. The bleeding could be caused by a non-cancerous growth or another health problem. You will be offered more tests, such as a colonoscopy, to find out what is causing the bleeding.

Faecal immunochemical test (FIT)

Over the next few years, a new bowel screening test will replace the current FOBT in some of the UK screening programmes.

Like the FOBT, FIT tests for hidden blood in your poo. It canít diagnose bowel cancer but if it shows blood in your poo, you will be invited to your local screening centre to talk about having more tests.

FIT is more reliable than FOBT because your diet and medicines are unlikely to affect the results. If you donít have bowel cancer, you are less likely to get an abnormal result (a false positive) with FIT. Another benefit is that you only need one poo sample.

FIT is due to replace FOBT in Scotland in 2017 and England in 2018. Wales will also change to the new test over the next few years. We don't yet know if the new test will be introduced in Northern Ireland.

Private screening

Some people who donít have any symptoms and donít fit the criteria for NHS screening choose to pay for a private test. Testing kits are available from pharmacies or from private healthcare companies. If you have any symptoms, you should visit your GP.

The self-test kits you buy over the counter from pharmacies vary in quality, so the results could be misleading. We canít recommend or comment on individual tests without a full review by independent experts. In the meantime, we recommend you speak to your GP.

Some private companies offer bowel cancer screening, where the samples are tested in a laboratory and the results sent to you. If you are thinking about paying for a private screening test, or your health insurance company offers you a test, ask the company what care or support they offer after you get the test results. They should also tell you how accurate their test is. If the results arenít clear or if they find blood in your sample, you will either need to visit your GP or get a referral for further tests.

The NHS in England has written a leaflet called Thinking about having a private screening test?.

Screening for people at high risk

If you have a high risk of getting bowel cancer, you can ask your GP about screening. This is not the same as the national bowel cancer screening programme. The most common test for people at high risk is a colonoscopy.

You may have screening tests at a younger age if you have:
-a genetic condition that increases your risk of bowel cancer, such as Lynch syndrome or FAP,
-a strong family history of bowel cancer,
-ulcerative colitis or Crohn's disease,
-a condition called acromegaly, where the body produces too much growth hormone.

You may also have ongoing tests if you have had treatment for bowel cancer or non-cancerous growths in the bowel (polyps).

More information

Bowel Screening Wales
Information on the bowel cancer screening programme in Wales.

Northern Ireland Cancer Screening Programmes
Information on the bowel cancer screening programme in Northern Ireland.

NHS Choices
Information on the bowel cancer screening programme in England.

NHS Inform
Information on the bowel cancer screening programme in Scotland.

Updated March 2017. Due for review March 2018.

- See more at:­about-bowel-cancer/­screening/­#sthash.7EZCNqMT.dpuf



Our Practice is now undertaking ELECTRONIC PRESCRIBING. This is an NHS Service which gives patients the chance to have their prescriptions sent electronically to their nominated pharmacy. This saves patients time in collecting the paper prescription from us and then taking it to the pharmacy. If you would like to start this Service visit the Pharmacy of your choice and they will contact us to enable us to initiate the service for you. Please see further details attached to this Newsletter and separate leaflets are available from reception


All patients registered here have Dr Michael Duggan as their named accountable GP.

The 2015-2016 GP contract in England now requires the named accountable GP to take responsibility for the co-ordination of all appropriate services and ensure they are delivered where required (based on the named GP's clinical judgement) to each of their patients. The named GP is largely a role of oversight, with the requirements being introduced to reassure patients they have one GP within the practice who is responsible for ensuring that this work is carried out on their behalf. There is no condition within the requirement for patients to see the named GP when they book an appointment with the practice. Patients are entitled to choose to see any GP or nurse in the practice in line with current arrangements



There are many advantages to having your flu vaccination done by your own GP or nurse

- Your GP practice has a copy of your full medical record so is able to best assess your risk and clinical needs, and will be able to record all the details of your vaccination in your record

- We run open booked clinics so you can have your vaccination at a time to suit you

- We can also check other aspects of your health at the same time, and even give you other vaccinations such as against pneumonia if this is clinically needed.

- We can answer any of your clinical questions about the flu vaccination

Your GP practice has been running flu vaccination for many years, and is an important and central part of our work to help keep our patients and local community healthy.



Antibiotics will not relieve the symptoms of most colds, sore throats, earaches or coughs, and do not speed up recovery in adults or children

Antibiotics are powerful medicines and in some cases may do more harm than good. They can cause unpleasant side effects, such as diarrhoea, thrush or skin rash

Antibiotics will only be provided when the likely benefits outweigh the risks. This is not the case for most respiratory tract infections

If you take antibiotics you are at risk of carrying resistant bacteria for up to one year. This resistance may make it harder to treat other infections in the future.

Respiratory tract infections causing a runny or blocked nose, cough, sore throat or other cold symptoms are extremely common. A healthy immune system can fight these infections without antibiotic treatment and most healthy adults and children will recover in one to three weeks

Products for specific symptoms will help you or your child feel better while the body fights the infection. It is natural to worry about symptoms, especially in children who may find it hard to explain what is wrong.

Your doctor or pharmacy can:

help rule out more serious illness

provide advice on how you or your child can feel better

It is also important to seek advice if you have an underlying medical condition that could affect your ability to fight off infection.

PLEASE PICK UP LEAFLETS IN THE WAITING ROOM – A guide to understanding your symptoms & When should I worry.



There is an opportunity for you to let us know if you would recommend the Practice to friends and family on this website - see home page or on the form in our waiting room which includes a short Survey. I would be most grateful for any feedback with regard to improving our Services
The Friends & Family Results for this Practice from July to October 2017 are as follows:

How likely are you to recommend our GP Practice to friends and family if they needed similar treatment?

EXTREMELY LIKELY..................37
EXTREMELY UNLIKELY.................1
DONT KNOW..........................4



The Survey questions and results for 2016 can be viewed on our website under the heading Patient Survey. We will be undertaking a further Survey in December 2016. However there is on-going opportunity for patients to feedback their satisfaction with the Practice available on our website and attached to our Friends & Family questionnaire in the Practice Waiting room.

The priorities from the Survey were discussed with the Patient Group at the meeting and it was agreed that the priorities for addressing were as follows:-

- Promotion of the Patient Participation Group by advertising in the covered area outside the Surgery building and by members of the group spending time at the Practice during the week to talk to patients.

- Promotion of our on-line services by the same method as above

- Review of the number of appointments available to book on line. This will help with telephone access to the Practice.

- Introduction of Choose & Book referral system. This will get patients more involved in decisions about their care

- Promotion of the Bowel Screening Service to improve uptake of this screening. The Practice will search for patients who have not engaged and offer an appointment at this Practice to discuss this service and its benefits with a view to increasing patient awareness and acceptance of the screening.

- Have hot-topic evenings at the Practice for patient information & engagement.

The Practice action plan to instigate change is as follows:

- Promotion of the Patient Participation Group by advertising in the covered area outside the Surgery building and by members of the group spending time at the Practice during the week to talk to patients Ė An information board will be obtained and displayed outside the Surgery within the coming months. This will enable patients to see this information as they enter the Surgery and when we are closed. Patient group members will engage with other patients during the week to promote the Group. We have already had 2 members here on 2 days selling cakes for the Multiple Sclerosis Society and encouraging the Group. A need to engage more males, younger patients and those from all ethnic backgrounds to represent the patient registered list will be monitored.

- Promotion of our on-line services - This information will also appear in our board outside the Surgery

- Review of the number of appointments available to book on line. This will help with telephone access to the Practice Ė Our Survey result showed of the patients asked 89% rated the ability to get through to the Practice between excellent to fair which was a slightly lower result on 92% last year. There were 12 patients that expressed a poor ability and these were by patients stating that it was more difficult to get through to the Practice at 8am. We do appreciate that some days are busier than others but there is no trend. We offer appointments to book in the mornings for those who want access on the same day. We will be reviewing the number of appointments available for on-line booking to assist in any access problems.

- Introduction of Choose & Book referral system. This will get patients more involved in decisions about their care Ė The Practice staff are expected to receive training on this system within the coming months. It will enable patients to make choices in where they would prefer to be seen when they need a referral to the Hospital. More details about this system can be found on
- Promotion of the Bowel Screening Service to improve uptake of this screening - All men and women aged 60-74 are invited to carry out an FOB (faecal occult blood) test at home. They're sent the home test kit every two years through the post, until they reach the age of 74. The FOB test checks for the presence of blood in a stool sample, which could be an early sign of bowel cancer. If you are 75 or over, you can ask for this test by calling the freephone helpline on 0800 707 60 60. The Practice will search for patients who have not engaged in this service and offer an appointment at this Practice to discuss this service and its benefits with a view to increasing patient awareness and acceptance of the screening

- Hot- topic evenings Ė The Patient Group along with our Carer Champion arranged a Carers Event on 21st September for all of our Patient Carers.



If you are aged between 40 and 74 years old and do not suffer with any chronic disease and do not take medication to lower your Cholesterol you may be entitled to an NHS Health Check. This will include, blood screening and Blood pressure monitoring which will assess your risk of developing a chronic disease such as diabetes or hypertension and cardiovascular disease.

If you are 75 and over we are offering specialised Health Checks. This is to ensure your on-going needs are met and that both the patient and the Practice can plan for your future care.

Please contact the Surgery to make an appointment with our GP or Nurse by ringing 01438 742639 or by using our on-line booking facility.



Patients are now able to


- Request repeat prescriptions

- Cancel appointments

- Change contact details

- Obtain a Patient Summary Record. This includes medication history and any recorded allergies.

- Obtain Access to Coded Medical Records Ė applications should be made in writing to the Practice.

Via our website:


You can also download the SystmOnline app (TPP Medical) on your smartphone. The new free of charge app allows patients to conveniently and efficiently manage their healthcare on the move.



This information below has been taken from the CQC website - We would like our patients to be aware of the inspections that are taking place within the Health Service. You maybe approached during an inspection at this Practice for your views on the Standard of Service we provide. In the meantime if you have any concerns about any aspect of the Practice we would be most grateful to hear about them so we have the opportunity to improve the Service we provide.

CQC inspections

We inspect care in hospitals, care homes, people’s own homes, dental and general practices, and other services against the National standards, and we publish our findings on our website and in our inspection reports.
We currently inspect most hospitals, care homes and home care services at least once a year, and we inspect dental services at least once every two years.

We also re-inspect services that aren’t meeting standards and we will inspect services more often if we think they are providing poor care that might be putting people at risk.

Are inspections unannounced?

Our inspections are unannounced unless there is a good reason for us to let the service know we are coming.

What do we do during the inspection?

During our inspections we:

ask people about their experiences of receiving care.
talk to care staff.
check that the right systems and processes are in place.
look for evidence that the service isn’t meeting national standards.
Sometimes our inspectors will be accompanied by clinical experts and Experts by experience (people who have experience of receiving care) who will also talk to people who receive care.

We judge services against the national standards which are the standards that people can expect when receiving health or social care.

However, we are now in the process of changing what we look at so that we answer the following questions about services.

Are they safe?
Are they effective?
Are they caring?
Are they well led?
Are they responsive to people’s needs?
We will publish more information about the fundamental standards soon.

Types of inspections

We carry out three types of inspections.

Scheduled: these are unannounced inspections that focus on a minimum of five of the national standards, and they’re also tailored to the type of care that is provided at the service.
Responsive: these are unannounced inspections that are carried out where there are concerns about poor care.
Themed: these inspections focus on specific standards of care or care services.




What is the Summary Care Record?

The NHS in England is using an electronic record called the Summary Care Record to support patient care. All the settings where you receive healthcare keep their own medical records about you.

These places can often only share information from your records by letter, fax or phone. At times, this can delay information sharing and this can affect decision making and slow down treatment.

About your Summary Care Record

Your Summary Care Record contains important information about any medicines you are taking, any allergies you suffer from and any bad reactions to medicines that you have previously experienced.

Allowing authorised healthcare staff to have access to this information will improve decision making by doctors and other healthcare professionals and has prevented mistakes being made when patients are being cared for in an emergency or when their GP practice is closed.

Your Summary Care Record also includes your name, address, date of birth and your unique NHS Number to help identify you correctly.

You may want to add other details about your care to your Summary Care Record. This will only happen if both you and your GP agree to do this. You should discuss your wishes with your GP practice.

Healthcare staff will have access to this information, so that they can provide safer care, whenever or wherever you need it, anywhere in England.

Who can see my Summary Care Record?

Healthcare staff who have access to your Summary Care Record:

need to be directly involved in caring for you
need to have an NHS Smartcard with a chip and passcode
will only see the information they need to do their job and
will have their details recorded every time they look at your record
Healthcare staff will ask for your permission every time they need to look at your Summary Care Record. If they cannot ask you (for example if you are unconscious or otherwise unable to communicate), healthcare staff may look at your record without asking you, because they consider that this is in your best interest.

If they have to do this, this decision will be recorded and checked to ensure that the access was appropriate.

What are my choices?

You can choose to have a Summary Care Record or you can choose to opt out.

If you choose to have a Summary Care Record and are registered with a GP practice, you do not need to do anything as a Summary Care Record is created for you.

If you choose to opt out of having a Summary Care Record and do not want a SCR, you need to let your GP practice know by filling in and returning an opt-out form (PDF, 245.9kB). Opt-out forms can be downloaded from the the website or from your GP practice.

If you are unsure if you have already opted out, you should talk to the staff at your GP practice. You can change your mind at any time by simply informing your GP practice and either filling in an opt-out form (PDF, 245.9kB) or asking your GP practice to create a Summary Care Record for you.

Children and the Summary Care Record

If you are the parent or guardian of a child under 16, you should make this information available to them and support the child to come to a decision as to whether to have a Summary Care Record or not.

If you believe that your child should opt-out of having a Summary Care Record, we strongly recommend that you discuss this with your child's GP. This will allow your child's GP to highlight the consequences of opting-out, prior to you finalising your decision.

Where can I get more information?

For more information about Summary Care Records you can

talk to the staff at your GP practice
phone the Health and Social Care Information Centre on 0300 303 5678
Read the Summary Care Record patient leaflet (PDF, 888.2kB)



At this Practice we have 3 Nurses these are:

Karen Smith

Victoria Pearse

Jennifer Prior

Karen and Victoria are both Nurse Prescribers which mean that they can prescribe in their own right.

Patients can make an appointment to see these Nurses for any minor illness and if necessary they will be able to prescribe.

They are also trained in managing patients with Long Term Conditions such as Diabetes, Asthma, Chronic Obstructive Pulmonary Disease and Hypertension


NHS 111

Anyone can now call 111 when they need medical help fast, but it's not a 999 emergency, life-threatening situation. NHS 111 provides a new way to ensure people receive the right care, from the right person, in the right place, at the right time. They will be assessed, given advice and directed straight away to the local service that can help them best. That could be an out of hours GP, a minor injuries unit, community nurse, late opening pharmacist, an urgent care centre or A & E. The 111 number is available 24 hours a day, 7 days a week, 365 days a year. Calls from landlines and mobile phones are free. For less urgent health needs, such as flu or stomach upset, patients should still contact their GP or local pharmacist in the usual way.



If you are a carer for someone, please make yourself known to the office staff and especially Sonia Sharma-Ladd our Carers Champion. We have a list of Carers, so that we may assist you in your future wellbeing.

If you support someone who could not manage without you, you are a carer. As a carer, you need to look after your own health and wellbeing too.

Carers in Hertfordshire is a local charity providing free help and support to any carer living or working in the county.

Am I a carer?

If you give unpaid help and support to a family member, friend or neighbour who would not be able to manage without you, then you are a carer.

The person you look after might have a physical or learning difficulty, be ill or frail, have mental health problems or misuse drugs or alcohol. They may be your child, partner or parent, or a friend or neighbour, and they might live with you or live elsewhere.

Whatever your situation, make sure your GP knows you are a carer and contact Carers in Hertfordshire for information and support.

Caring with Confidence

Carers in Hertfordshire runs free Caring with Confidence training courses for carers, covering all aspects of caring, including dealing with stress and emotions, balancing caring with a life of your own and maximising your income whilst caring. There are special courses for those caring for people with dementia.

Not only are these courses practical and informative, they are a great place to meet others in the same situation as you and to share experiences.

Make a Difference

Caring takes its toll. Make a Difference is a Carers in Hertfordshire initiative to provide funded breaks for carers. Grants are available for all sorts of things such as gym membership, massage, a weekend away or a new hobby – whatever will have the greatest benefits for your health.

As a carer, Make a Difference can give you a break and help you stay well. Talk to your GP about a referral or contact Carers in Hertfordshire for more information.

Prescription support for carers

GP surgeries in Stevenage operate a prescription support service for carers. Your GP can refer you for a package of support from Carers in Hertfordshire and Crossroads Care Hertfordshire North. Carers in Hertfordshire will discuss your individual circumstances and the type of support that is right for you, but this could include a supported break provided by Crossroads Care, something to enable you to pursue a hobby, or equipment to help improve your health. It will also include on-going information and advice, provided by Carers in Hertfordshire for as long as you need it. Talk to your GP about a referral.

Information and advice

Whether you need some help understanding benefits or accessing services, or longer term advice to support you in your caring role, Carer Support Advisors are just a phonecall away. They can help you understand what services are available nearby and how to access them, and help you to have a break from caring. Call today on 01992 58 69 69.

Carers in Hertfordshire also provides specific support for people caring for those with dementia, drug or alcohol issues, mental health problems or learning disabilities, as well as parent carers.



Pharmacists are experts in medicines and minor illnesses. They can give you advice on lots of common health problems, for example emergency contraception, and many can help you to give up smoking and advise you on how to lead a healthier life.

Most now have a private consultation room where you can speak to your pharmacist without other people hearing.

In Hertfordshire we have more than 200 pharmacies and Several open early (around 7am) and close late (around 11pm). You can find out where these are by visiting and selecting the “find a service” option or you can phone NHS 111 who will help you find the one nearest to where you are.

You don’t need to make an appointment to speak to the pharmacist.



DURING October 2017 we have recorded 95 appointments that were missed where patients did not turn up for their appointments. These appointments could have been allocated to other patients. It also means that 16 hours of clinicians time has been wasted!


We have introduced an appointment reminder system by text message. Please ensure we have your current mobile number.

Thank you for your consideration



All our clinical staff are making a conscious effort to reduce the waiting time to see the Doctor or Nurse on your arrival at the Practice. During October 2017 the average waiting time was 6.5 minutes. We are pleased that the waiting time for patients has improved.

Our administration team are making every effort to keep patients aware of any delays as they happen.

Most delays are due to the patient arriving with a shopping list of problems.

We will endeavour to deal with the urgent issues but patients will be asked to rebook so that the team can deal with other problems.

Please do not expect that the Doctor or Nurse will be able to deal with several problems in one appointment slot— REMEMBER ONE APPOINTMENT ONE PROBLEM



Last year NHS Hertfordshire spent over £7 million treating minor conditions in A & E ! It costs this Practice £52 each time a patient presents at A & E - this is without any investigation or treatments! We have been targeted to try to reduce the number of patients that attend inappropriately. Please remember A&E departments are for accidents and people with critical or life-threatening conditions.

Only call 999 if someone has a suspected heart attack, lost consciousness, a suspected stroke, severe burns, a severe allergic reaction, lost a lot of blood, or difficulty breathing.

Remember, A&E is for accidents or serious or life-threatening conditions only. Patients who continue to attend inappropriately will be at risk of removal from the Practice list !

See Out of Hours Service—Page 3



The Practice has an excellent out of hours service run by Herts Urgent Care. They cover emergencies Monday—Friday 18.30—08.00 during weekends and Bank holidays

Please call: 111

Please use this Service out of Hours rather than A&E for minor conditions.



If you would like to become involved in the priorities of the practice please join our Patient Participation Group ! We are especially looking for representatives from the younger population.

The group is meeting every 3 months. Our next meeting is in 10th January 2018 at 7pm please contact the Surgery for more details

Please leave your contact details at reception or email





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