Newsletter Issue 013

Consultation Hours Mondays 9.00am to 12.00pm 3.30pm to 5.30pm Tuesdays - Fridays 8.30am to 12.00pm 3.30pm to 5.30pm Papworth Surgery May 2014 Newsletter Issue 013 Extended Hours Monday 6.30pm to 8.00pm Home Visits 12.00 noon to 3.00pm Reception Monday - Fridays 8.30 am to 1.00 pm 1.30 pm to 6.00 pm Monday Extended Hours 6.30 pm to 8.00 pm Reception 01480 830888 - Urgent Care Cambridgeshire (Out of Hours) 0330 1239131 - NHS Direct 0845 4647 Introduction Welcome to the 13th edition of the Surgery Newsletter. We have included some topical issues and practice information which we hope you will find of interest. So read on for - Dr Paula Newton writes on Reducing the Risk of Catching a Cold - Do Vitamin Supplements Help? Dr Deryn Evans writes on Sore Throats Antibiotic or No Antibiotoic? Nurse Philippa Lord updates on Smoking and Immunisations. Upcoming closure dates for both the surgery and pharmacy. Articles on the Summary Care Record and CARE Data Schemes. Details of the patient survey and the action plan agreed with the Patients Link Committee. WHAT CAN WE DO TO REDUCE THE RISK OF CATCHING A COLD -DO VITAMIN SUPPLEMENTS HELP? As a small child I remember my father giving me various vitamins including high dose Vitamin C apparently to protect against catching a cold. I was rarely ill but did it help or was it just a coincidence? New research has recently been published which suggests that many of us are wasting millions of pounds buying Vitamin C supplements to ward off colds as they found them to have no benefit at all. The common cold affects adults approximately 2-3 times a year and children under age 2 approximately 6 times a year. Symptoms such as sore throat, stuffy or runny nose, cough and malaise are usually worse in days 1-3 and can last 7-10 days, sometimes as long as 3 weeks. Only about one in 20 colds involve bacterial infection, with the majority caused by a virus which cannot be treated with antibiotics. Details on some of the recent major changes to the GP contract and practice plans to meet them. Also are you interested in joining the Patients Committee to help liaison between staff and patients? The Committee are always looking for volunteers to offer the broadest representation of patients whom the practice serves. We are particularly keen to recruit some younger members and to find someone from the Gravely and Yelling village areas. If interested please contact the practice for further details. And...finally a date for the diary. We have arranged for Mr David Cremonesini Consultant Paediatrician at Hinchingbrooke Hospital to give a presentation on Paediatric Allergies on Thursday 20 June at 7:30 pm in the Varrier Jones Lecture Theatre at the Papworth Hospital Complex. See the included notice for further details. Vitamin C became popular in the Seventies after Nobel laureate Linus Pauling concluded it could prevent and alleviate colds. My father must have read about it! It is the UK s most popular vitamin with annual sales of around 36 million.it is a dietary antioxidant and so can neutralise the effects of free radicals and support the immune system's host defence. However the recent review found that regular Vitamin C supplements had no effect on the number of colds caught by those taking it. The study published earlier this year in the Canadian Medical Association Journal looked back at 67 studies examining the effectiveness of cold preventions and remedies and discovered that few live up to their claims. Traditional remedies like echinacea, ginseng, vapour rubs and cough medicine were found to have no clear benefits while antibiotics were likely to cause more harm than good, the researchers concluded. Out of all the studies, only taking a zinc supplement was found to be beneficial at preventing colds. Drugs Continued on page 2

like ibuprofen and paracetamol were found to be useful at reducing fever and taking honey soothed a sore throat. To quote the research findings: The best evidence for the prevention of the common cold supports hand-washing and possibly the use of zinc supplements, said Dr Michael Allan, of the Department of Family Medicine, at the University of Alberta. Although self-limiting, the common cold is highly prevalent and may be debilitating. It causes declines in function and productivity at work and may affect other activities such as driving Its impact on society is large. At least two trials indicated that children who took 10 or 15mg of zinc sulphate daily had lower rates of colds and fewer absences from school due to colds. Although the studies carried out on children the researchers concluded that: there is no reason why zinc could work only in children and not adults. It may not all be bad news for Vitamin C though - a large-scale study published in 2013 found that regular vitamin C supplementation seemed to have a consistent effect in reducing the duration and severity of common cold symptoms but these finding were not supported by the more recent Canadian study. So if you were going to invest in something to reduce your risk of catching colds the most evidence based option is zinc supplements and of course washing your hands! GP CONTRACT CHANGES Paula Newton Some of you may have read in the press, or heard on the news, recently how the Government and the General Practitioners Committee have agreed changes to the GP contract in England for 2014/15. NHS England have stated that the changes are designed to support emerging strategic objectives for primary care to provide more proactive care for people with more complex health needs, empowering patients and the public, giving parity to physical and mental health, promoting high standards of quality and reducing inequalities. So how will this impact on the practice and our patients? Some of the major changes will see: Named Accountable GP for people aged 75 or over. One of the first things that the practice will need to do is identify all older people aged 75 and over and let them know they have a named, accountable GP with overall responsibility for their care. We are working on this now and patients within this category can expect notification with the next few weeks. Out of Hours Service (OOH). The practice will be required to monitor the quality of OOH services offered to our patients and report any concerns to the NHS England Area Team and/or our Clinical Commissioning Group (NHS Cambs and Peterboro). We would therefore wish to hear from patients with their feedback on their experiences (good or bad) when contacting OOH. Reducing Unplanned Admissions. Separate to the contract changes, NHS England are looking for practices to engage with additional services to the GP contract on reducing unplanned hospital admissions. This is designed for patients identified with complex health needs and who need more proactive interactions with the practice or community staff. This will include putting together a personalised care plan in consultation with the patient and/or carer as needed, regular reviews of the care plan with patient and/or carer for any changes or updates and ensuring that the care plan is being delivered. Patients will be given a named accountable GP and care coordinator. Final details of the scheme are expected within the next few weeks after which the practice and community staff will begin identifying and contacting relevant patients. The practice had begun a similar scheme last year and has done some work with patients already; this new scheme will increase the number of patients significantly that the practice will need to identify and work with. FOREIGN TRAVEL Please contact the nurse at least 6 weeks before you travel to complete the paperwork and for immunisation Page 2

TEENAGER IMMUNISATIONS Teenagers are now receiving a Meningitis C vaccination at school. Meningitis C vaccination protects against infection caused by the meningococcal group C bacteria, which can cause two very serious illnesses, meningitis and blood poisoning. Meningococcal disease can affect all age groups, but the rates of disease are highest in children under five years of age, with the peak in babies under one year of age but it is already in the baby schedules. There is a second peak in cases in young people aged between 15 and 19. The disease tends to strike in winter. However they will still need to attend the surgery to have a booster of their Diptheria, Tetanus and Polio vaccination, traditionally known as the teenage booster, usually from the age of 14-17 years. Please make an appointment if you think you are due for one. FRESHERS IMMUNISATIONS The surgery is also offering a Meningitis C Vaccination to those aged 17-25 years, not previously immunised and who are starting university. Please make an appointment if you think you are eligible for one. SMOKING Despite there being a decrease in tobacco use, smoking still remains the biggest cause of preventable diseases, such as heart disease, some lung diseases, dementia and cancers. If you smoke 20 cigarettes a day in a year you can save 3,840. Just after 12 weeks after stopping circulation improves making it easier to walk and exercise, after three months breathing becomes easier and after five years the chance of having a heart attack is half that of a smoker. Quitting also boosts your immune system, making it easier to fight off colds and flu, and the improved levels of oxygen in the body means that ex-smokers can concentrate better and have increased mental wellbeing. It s a win win situation. At Papworth Surgery we are really happy to help you stop smoking. Every year about 40% of smokers attempt to stop smoking. Most try without any support and as a result only four percent still manage to abstain a year on. Evidence has shown that by having both behavioral support, such as visiting the practice nurse and discussing ways of coping, and support from nicotine replacement, the chance of abstaining increases three times. There are many different nicotine replacement therapies (NRT) to try and if you come and see one of us we would be happy to discuss with you the options available and which may suit you the best. Patches are the most common and work by slow release. They are usually used alongside another fast acting NRT such as, the inhalator, gum, nasal spray, mouth spray, gum, lozenges and micro tablet. These are all available over the counter or on a prescription. There are two tablets available but the newest tablet which has found to triple long term quit rates is Champix. Tablets are taken twice daily. They are not NRT but work by reducing the withdrawal symptoms and reduces smoking satisfaction. These are available on prescriptions only. E-cigarettes are becoming increasingly popular, they do contain nicotine but in some there have been low levels harmful contaminants. The main worry is that it reproduces the action of smoking but they have been found to be helpful in quitting smoking. These are not available on prescription. We look forward to helping and supporting you in quitting smoking further information can be obtained from contacting Reception or one of the Nursing Team. CARER S SUPPORT If you are a carer or are being cared for, please let Reception know. We have information on carer s support groups including short term breaks and longer term support Page 3

SUMMARY CARE RECORD AND THE CARE DATA SCHEME BOTH DATA COLLECTION BUT NOT THE SAME THING Some of you may be aware of these two schemes. They both involve patient data but they are NOT the same thing. SUMMARY CARE RECORD (SCR) The (SCR) is an electronic record that will give healthcare staff faster and easier access to essential information about you. It will help to provide you with safe treatment when you need care in an emergency, when your GP practice is closed or when you are away from home in another part of England. The SCR will contain important information about any medicines you are taking, allergies you suffer from and any bad reactions to medicines that you have had. It will also include your name, address, date of birth and your unique NHS number to help identify you correctly. The majority of GP practices within Cambridgeshire and Peterborough are already live with the SCR following on from a publicity campaign last year. Now that the practice has successfully migrated to our new clinical computer system (EMIS Web) we are contractually bound to do the same. We plan to do this in the final week of June 2014. If you are happy for us to make a SCR for you then you do not need to do anything. We will automatically make one for you. If you do not want us to make a SCR for you then you should fill in an opt-out form and return it to us. These are available to download from www.nhscarerecords. nhs.uk/options OR from the practice. Patients who have completed an opt form, or written to us saying they wish to opt out, have had it recorded already and need not do so again. CARE DATA All households in England should have received a leaflet early in the year titled Better Information Means Better Care which was about a new NHS scheme known as Care Data which was planned to go live in the Spring of 2014. The scheme involves extracting individual confidential information from GP practices clinical systems. This data along with postcode and NHS number (but not name) are then sent to a secure system where it can be linked with other health information and used to help shape health and social care planning in the future. However recent concerns that every household had not received the leaflet, or that many people may have disregarded it as junk mail, clearly indicated that many individuals were unaware of the scheme and the choices they had to opt out. As a result of mounting publicity, NHS England have announced a delay for 6 months, until the Autumn of 2014, in order that patients have more time to learn about sharing of information and their right to object to such information being shared. There is expected to be an increased public awareness campaign in the coming months. Further details of the scheme can be found at www. nhs.uk/caredata or on a dedicated information line 03004563531. If you are happy for your information to be used for the Care Data Scheme then you do not need to do anything. It will be automatically extracted when the scheme goes live in the Autumn. If you do not want the data to be extracted, and wish to prevent it happening, then you should write to the practice or fill in a locally produced template opt out form, available from Reception, and return it to us. Patients who have completed these, or written to us saying they wish to opt out, have had it recorded already and need not do so again. SO WHAT S IT MEAN AND WHAT DO YOU HAVE TO DO? These are entirely different schemes. Do nothing and you will be in both automatically. Concerns - you can opt out of one, or both, schemes but you MUST tell us. Page 4 nursing & support team Nurse Practitioner Claire Hodge Practice Nurses Philippa Lord, Muriel Holmes & Jenny Arshed Health Care Assistant, Corrine Bennett and Debbie Austen

PATIENT SURVEY AND ACTION PLAN 2011 14 A big thank you to everyone who completed a survey form for us over the last three years it is very much appreciated. We are also very grateful to our Patients Group for their help and support in working with us. A copy of the updated and agreed action plan plus copies of the reports and attachments can be viewed in the surgery please enquire at the Reception Desk. We carried out another large survey in the last quarter of 2013. It is called a General Practice Assessment Questionnaire (GPAQ) and allows the practice and individual clinicians to be benchmarked against the 100s of other surgeries completing the GPAQ survey. Several questions allow comparison against the National GP Survey results of 1000s of practices. These are quite long and can be difficult to understand. So we have produced some headline comparison results below that you can quickly view should you wish: BENCHMARKING SCORES PATIENT SURVEY QUESTION GPAQ COMPARISON NATIONAL GP SURVEY COMPARISON PRACTICE GPAQ MEAN PRACTICE NATIONAL GP SURVEY GP Listening to you 96.4 83.5 98.2% 88% GP Giving you enough time 94.7 80.0 97% 86% GP Involving you in decisions 94.1 81.4 98.1% 76% about your care Confidence that the GP is honest 100% 93% and trustworthy How helpful do you find Receptionists 96.3 77.2 Helpful v Not Helpful 100% 89% How easy to get through on the phone 80.3 59.4 Easy v Not Easy 95.6% 78% How easy to speak to a Dr or 76.9 60.6 Nurse on the phone How easy to book ahead Easy v Not Easy 93.5% 79% How do you rate how quickly you 81.8 68.8 were seen How long you waited 70.6 56.9 How often do you speak to the GP you prefer Often v Not Often 81% 65% Nurse giving you enough time 93.6 78 94.5% 81% Nurse Listening 93.2 81.0 96.4% 81.0% Nurse Explaining your condition and treatment Nurse Involving you in decisions about your care 93.2 81 96.4% 80% 89.9 59.4 93.8% 68% How does practice help you to: Understand Health problems 93.7 69.1 Cope with health problems 93.2 65.5 Keep yourself healthy 89.8 61.7 Overall experience of GP Surgery 98.2% 88.0% Would you recommend GP surgery to someone just moved to the area 100% 82% All the results highlight that you (our patients) rate the service the practice and our individual clinicians (Doctors and Nurses) provide to you as consistently above the average. In the majority of cases the results are much higher than the average. For example 100% of you would recommend us to someone moving to the area (The Family and Friends Test) and over 98% of you rate your overall experience of Papworth Surgery as a positive one. pharmacy Mondays - Fridays: 8.30am - 1.00pm & 1.30pm - 6.00pm Late Night Mondays: 6.00pm - 8.00pm Page 5

PAPWORTH SURGERY PATIENTS LINK PRESENTATION THURSDAY 19 JUNE 2014 PAEDIATRIC ALLERGIES AND OTHER ITEMS OF CONCERN The Practice and Patients Link Committee have arranged for Mr David Cremonesini (a Consultant Paediatrician from Hinchingbrooke Hospital) to be guest speaker. Please come along and, after the short Annual General Meeting, listen to his presentation on allergies followed by a question and answer session on any paediatric issue that is of concern to parents. The presentation will take place on Thursday 20th June at 7:30 pm in the Varrier Jones Lecture Theatre at the rear of the Papworth Hospital Complex. Direction. Signs to the venue will be displayed on the evening. All patients are welcome to attend. PRACTICE & PHARMACY CLOSURES The Practice and Pharmacy will be closed on the following Bank Holidays: Monday 5th May 2014 Monday 26th May 2014 Monday 25th August 2014 Thursday 25th and Friday 26th December 2014 Thursday 1st January 2015 The practice only will be closed (but the Pharmacy will operate normal hours 1:30 pm to 6:00 pm) on the following afternoons from 1pm: Tuesday 17th June 2014 Wednesday 16th July 2014 Thursday 16th October 2014 Wednesday 28th January 2015 Thursday 19th February 2015 Emergency cover will be provided as normal by a local service working on behalf of the practice or NHS 111. SORE THROATS - ANTIBIOTIC OR NO ANTIBIOTIC? Sore throats are common reasons for patients to consult their doctor. They are usually viral, often a result of a cold, and will settle with time. However some sore throats are caused by bacteria and will require antibiotics. Identifying which sore throats need antibiotics can sometimes be challenging, however a new study using a FeverPAIN score has shown good predictive results when identifying those with sore throats that need antibiotic treatment. The scoring system is out of 5 with the following criteria: 1 point if there has been a fever in the past 24 hours (eg a temperature over 37.5 degrees) 1 point if there is pus on the tonsils 1 point if the patient attends the surgery within 3 days of the onset of the sore throat 1 point if the pharynx( back of the throat) or tonsils are inflamed 1 point if there is no cough or runny nose Once a score has been calculated the guidance is as follows: Score 0-1/5 no antibiotics needed Score 2-3/5 a delayed script for antibiotics could be offered Score 4-5/5 give immediate antibiotics It is worth remembering that antibiotics generally only shorten the duration of a sore throat by 16 hours. As doctors we would need to treat 4000 people with a sore throat requiring antibiotics to prevent one serious complication. Other useful treatments, available over the counter for sore throats, include anti- inflammatory medications such as ibuprofen tablets or liquid or flurbiprofen microgranules which dissolve on the tongue forming a liquid that can then be swallowed. Flurbiprofen cannot be used by those under 12 and should not be used by those who are unable to take anti-inflammatories. Salt water gargles and paracetamol are also useful measures. Page 6 PERSONAL DETAILS if you have changed your address, main line telephone number, mobile number or e-mail please inform reception so we can amend our records accordingly.