GP Practices, Like the Rest of the NHS, Are Having to Respond by Changing the Ways We Work

April 2017

Dear Patient,

These are difficult times for many in General Practice. As you may be aware from the level of media coverage, it’s a time of unprecedented demand on our services and there is real pressure on budgets and major problems with recruitment of both nurses and GPs.

GP practices, like the rest of the NHS, are having to respond by changing the ways we work in order to sustain services and make the kind of improvements that we want to see as your caring health professionals – and that you rightfully demand and expect as our valued patients. Many practices are merging so that they can share staff across larger teams, and many are adopting new technology (like online consultations) to help ensure that patients can get speedy access to advice and support.

We are currently experiencing major funding and recruitment issues at Whiteley which means that we have no alternative but to change the way we do things in order that we can carry on providing you with safe and quality care.

Over the past eight years the funding available for our Surgery to run the business has dropped by 30%. We have done everything possible to continue to deliver a high level of care within this dramatic drop in funding, by changing our systems – for example using nurses to deal with minor illness and injuries that were previously seen by GPs, allowing the GPs to focus on the more serious and complex conditions. To date we have been able to maintain a constant number of appointments – albeit with rising demand for them. However we are now facing further reductions in funding each and every year up to 31 st March 2022 as a result of a Government formula which means that, in five years’ time, we will be funded for only 10 in every 13 patients on our register.

We have always aimed to provide our patients with a high level of care and access to a full range of NHS services over many years, as can be demonstrated by our last Care Quality Commission (CQC) visit and a rating of “Good” in all sections of assessment. We remain totally committed to providing you with the best care and range of NHS services that we can but we now ask for your understanding and co- operation.

As you know, Dr McNicol and Dr Diggens have already left the practice - and Dr Saville will be leaving at the end of May 2017.

We are currently trying to recruit replacements, but this is proving a big challenge. Until this is resolved, and we continue to be down on numbers, we simply cannot sustain the existing number of appointments.

Regrettably we have no choice but to scale back our operation and reduce the number of appointments available to our patients, by approximately 120 per week (we currently offer approximately 1,000 per week).

We have discussed these issues with our Patient Participation Group (PPG) and the local MPs have been made aware of our situation. We have also discussed this with representatives from both the Fareham and Gosport Clinical Commissioning Group (CCG) and Local Medical Committee (LMC), and the partners at Whiteley Surgery now feel it important that you should be made fully aware of our current situation as well - and how you can help us. eConsult. Whiteley Surgery has introduced eConsult - a Royal College approved software package that you can now access via our website. It provides an online consultation for a medical problem or an administrative problem such as a sick note. All online requests are reviewed by a GP and, if appropriate, an appointment will be arranged for you – and you will get a response from the surgery within two working days and you can access it at any time.

It also provides:  Ways you can help yourself to manage or improve your symptoms without needing to visit your GP  Ways you can get professional advice from professionals other than your GP eg: your local pharmacist The Fareham area has pioneered eConsult in Hampshire and this scheme is now expanding successfully to other practices across Hampshire, where it has been well received by both patients and practices.

Sign Posting: There are other services that might help your needs more appropriately and you may be sign-posted to (either by the eConsult or via our practice team) and we will be promoting them such as:  Websites: o Wessex Healthier Together o Patient.co.uk o NHS choices  Pharmacists  Dentists  Social Services  Citizens Advice Bureau  Voluntary services of which there are many.

Self-care: Self-care is about avoiding becoming ill, treating common illnesses at home and seeking help when you need it. It is also about managing any conditions you have in a way that puts you in control and improves your quality of life. A well-stocked medicine cabinet can help with minor illnesses and injuries. The NHS Choices website (www.nhs.uk) is full of information, tips and tools to help put you in charge of your own health and wellbeing. There you will be able to find:  A symptom checker  An A-Z of treatments and conditions providing explanations on a wide range of ailments  Information, tips and tools to help you stay healthy and live well Colds, most coughs, sinusitis, ear infections and sore throats get better without antibiotics, as your body can usually fight these infections on its own. Please consider speaking with your local community pharmacist who can provide advice on over the counter medicines to treat these and many other symptoms so that GP appointments are only used when necessary. We also have a Fareham Carers board available in surgery and further information on our website.

Once again we thank you for your understanding and support.

Dr Roope & Partners