News Newyddion Last Update: 20 June, 2008
Missed Hospital Appointments - Powys Local Health Board (20/6/08)
Between April 2007 and March 2008 Powys Local Health Board lost a minimum of £200,000 on wasted outpatient appointments.
Each appointment costs around £85.00.
2,318 patients did not turn up for their consultant outpatient appointments last year.
These missed appointments could have been given to other patients.
If you can’t make your appointment,
please notify the hospital as soon as possible.
Your help and support is a vital to reduce waiting times for outpatient appointments.
Injury Service Moves Out of Practice Area (2/6/08)
From today there is no longer an acute injury service in Builth Wells or Llanwrtyd Wells. This includes Builth Hospital and the doctor surgeries.
As we do not have appointment systems at our surgeries we have treated a large number of patients with injuries on a "walk in" basis. This service is no longer funded and is not part of normal general practice work.
As a result, Powys Local Health Board advises patients with new injuries to be assessed at a hospital outside the Practice area such as Brecon or Llandrindod.
This reduction in local service is a result of decisions made by Powys Local Health Board (see below).
End of Minor Injury Services in Builth Wells (1/5/08)
Powys Local Health Board has decided that the Minor Injury Unit (MIU) at Builth Hospital is unsustainable and have made the decision to relocate this service to Llandrindod Wells Hospital. This change will take effect from Monday, 2nd June 2008. Builth & Llanwrtyd Medical Practice is saddened by yet another reduction in service at Builth Wells.
However, in the light of recent Clinical Governance reports the practice ultimately understands this decision.
We did not feel that a wholesale transfer of Minor Injuries from Builth Hospital to the surgery was the appropriate response to the concerns raised by the Clinical Governance reports. For instance, the level of service could not equate with that provided by the MIUs in Llandrindod or Brecon Hospitals. Patients in Builth would therefore not have an equivalent level of service to patients in neighbouring localities.
We wish to see safe, effective and appropriately staffed Minor Injury Units that have necessary facilities such as Xray. It is regretable that the Local Health Board have chosen not to maintain and develop the existing service in Builth Hospital.
Further information will follow detailing how patients with minor injuries can access the service at Llandrindod Hospital.
Surgery Donations - Emergency Equipment Purchased (14/4/08)
Builth & Llanwrtyd Medical Practice thanks all those who have contributed to our surgery fund over recent months. Large donations were received in memory of Howard Hamar and Thomas Jones.
We have used the fund to puchase emergency trolleys to house all our resuscitation equipment.
Dr Richard Walters says, "The trolleys will make a huge difference. Medical Emergencies do happen at the surgery and it's vital to have all necessary equipment quickly to hand. Everything is now organised, layed out and can be moved easily to the patient".
Trolleys have been purchased for both Builth Surgery and our Llanwrtyd Branch Surgery.
Practice Position Statement: Clinical Governance Service Development Unit Phase II report (12/3/08)
The Phase II report from the CGSDU was published yesterday. This follows on from the initial report back in August 2007. Both reports can be downloaded via the following links:
Phase I report (pdf)
Phase II report (pdf)
The first report back in 2007 was very critical of the management structure at Powys LHB and many of the problems highlighted in the second report relate to the inadequate systems for patient safety and staff support put in place by that regime.
Clinicians at the 'coal face' do the best job they can with the resources and support available.
It is very difficult to fundamentally disagree with the report and here in Builth we have already taken on board many of the recommendations. For example we no longer admit acutely ill patients to our cottage hospital (concentrating more on terminal and nursing home type care). Furthermore, a major reconfiguration of services in Builth is planned in the near future using a health and social care model, the Builth Project. This is fully in line with report's recommendations
We recognise there have been many changes at Powys LHB over recent months and we continue to work with them to address the issues raised in the reports in order to develop the quality, local services that all Powys patients require.
BBC news: NHS uncovers hospital 'failings' (12/3/08)
BBC news: Report 'must not shut hospitals' (12/3/08)
Minor Injury Unit Closure Pending? (1/3/08)
The practice is committed to ensuring its patients receive a safe and effective Minor Injury Service and will continue working with the Local Health Board to achieve this.
Precipitate closure of the Minor Injury Unit in Builth hospital, and relocation of a Minor Injury Service to the surgery is not appropriate. The surgery does not have either the facilities or trained staff to provide such a service. Changing the location of a service does not in itself make it better or safer. It does however allow the LHB to ditch responsibility!
The concerns raised in last year's Clinical Governance Support and Development Unit interim report need a more measured response to developing equitable and high quality Minor Injury Service across Powys.
See full Practice Position Statement
New Podcast - "Glandular Fever" (17/2/08)
Glandular Fever (or infectious mononucleosis) is an infection caused by a virus – the Epstein Barr virus.
It is sometimes known as the “kissing disease” because the virus can be passed on via saliva. Coughs and sneezes and sharing food utensils can also pass it on. It’s harder to catch than a cold. It is not a sexually transmitted disease.
It generally affects teenagers and younger people. A full and quick recovery, without the need to see a doctor is the usual course of events...
Podcast page
Patient Survey 2007 (6/2/08)
Each year we carry out a survey of patient views. The results are discussed by the practice team and this can lead to positive changes in the way we work.
In addition to this internal review we present findings to members of the Community Health Council and Local Health Board. This external review took place today.
A summary of this year's survey is available via the following link:
Patient Survey 2007 (pdf document)
YouTube Channel Hits 100,000 Views (22/1/08)
Today the 8 films on our YouTube Channel clocked up a total of 100,000 views between them. The most popular film is "Cervical Screening", closely followed by "Chlamydia".
All our films can also be seen on our Podcast page and are available from iTunes.
Our most recent effort was "How To Use a Peak Flow Meter" and we are currently working on a new release, "Glandular Fever".
BBC News item
Printer and Viewer Friendly Pages (17/1/08)
If you wish to print out a page from this website then just press your "print" button. A separate style sheet, especially for printers, is embedded on this site and should provide a clear A4 printout without cluttered navigation and side columns.
If you wish to increase the size of the text on this website then click the "Large Text" link in the top right hand corner.
For more website information please visit our access page.
Wyeside Arts Centre Under Threat (10/1/08)
Builth & Llanwrtyd Medical Practice recognises that the greater health of a community relies on far, far more than it's doctors. Wyeside Arts Centre could face enforced closure this year.
Please consider signing this online petition to Wales’ Minister for Heritage, Rhodri Glyn Thomas? Click on the link below:
http//:www.gopetition.com/petitions/save-wyeside-arts-centre.html
For more information please visit:
www.wyeside.co.uk
Lost Our Online Repeat Prescription Form?? (8/1/08)
During a recent recoding of this website the location of the Repeat Prescription Form on our secure server had to be changed.
Those who have Bookmarked or Favourited the form previously will need to do so again through this website or the following link.
Repeat Prescription Form
If new to this service then please do try it out. It uses a secure directory and hence your prescription request is safe
from prying eyes.
The service uses a form. To request
your repeat medication just fill in the form and submit it!
This service is available to registered patients only and medication requested
must already be on repeat.
Email can still be used but this it is not secure and is not recommended.
In total there are six ways of requesting a repeat
prescription
Co-Proxamol Withdrawal (20/12/07)
The withdrawal of the pain-killer co-proxamol will be completed at the end of this month. From January 1st, 2008 it will be Practice Policy not to prescribe co-proxamol.
This follows recommendations made by the Medicines and Healthcare products Regulatory Agency (MHRA), the drugs regulator. An MHRA risk and benefit review back in 2005 advised that doctors no longer initiate new prescriptions of the drug and that it should be phased out.
BBC News item
The Builth Project (20/11/07)
Following on from this year's Assembly Elections a new plan is being developed for health and social care in the Builth and Llanwrtyd area. The plan is being promoted by the Local Health Board and County Council and their recent consultation document is available here.
Builth and Llanwrtyd Medical Practice is actively involved in the process and Dr Robbie Gibbins is a Project Board member.
The Project Board is keen to hear your views and an online questionnaire is available here.
New Practice Manager for Builth & Llanwrtyd (2/10/07)
We are pleased to report that Mrs Jane Stephens has joined our team as Practice Manager. She lives locally and has extensive experience in business and management.
Our Staff
Medical Students and GP Training (20/9/07)
We are committed to training and frequently have final year medical students
attached to the practice from the University of Wales College of Medicine. Patients
will be notified in reception when and where students are placed. It is hoped
that patients recognise the opportunity they can provide for these future doctors
to gain vital experience of community medicine.
Occasionally
all surgeries in Powys close for training organised by the Local
Health Board.
If you need to contact a doctor during this time please call SHROPDOC.
No details of future dates are available at present.
Non Emergency Patient Transport (15/9/07)
For Transport call free: 0800 169 5593
The following are eligible for transport through the ambulance service
- Patients who require a stretcher
- Patients receiving treatment for cancer
- Patients receiving dialysis
- Patients who are immobile and unfit to travel without the assistance of two
people
Also see Builth Wells Community Support
Practice Position Statement: Minor Injury Services (2/8/07)
Builth and Llanwrtyd Medical Practice initial response to Clinical Governance Support and Development Unit report
2nd August 2007
Background
An interim report (available for download here in pdf form) from the Clinical Governance Support and Development Unit (CGSDU) has identified serious concerns with the provision of Minor Injuries Services (MIS) at Builth Hospital. This emerged as part of a wider review into the arrangements for clinical governance and patient safety within the provider services of Powys Local Health Board.
It has been suggested by the CGSDU that the best way of resolving these concerns is to transfer the MIS from the hospital to the GP surgery in Builth Wells.
This paper details the practice response to this proposal.
Areas of concern
The CGSDU felt that the MIS in Builth was of concern because:
1. There were not enough patients attending the unit to ensure continued staff competence in providing appropriate treatment
2. Patients did not appreciate the limitations of the service provided by the MIS and this could result in patients with serious conditions attending inappropriately thus delaying their treatment
3. Unscheduled closures of the MIU meant that patients arrived when the unit was closed, with nurses then having to leave their ward duties to deal with problems
The CGSDU acknowledged that similar problems may exist in other MIUs in Powys, and that their focus on Builth (and Newtown) resulted from the incidents that had been brought to their notice during their initial examination of Powys LHB board and management team’s role, and that patient safety and clinical services across Powys have yet to be reviewed.
Practice response
The practice’s primary concern, like the CGSDU and Powys LHB, is to ensure an equitable and safe MIU service to people in the Builth Locality. The practice agrees that patients have a right to expect, in the words of the CGSDU report, ‘safe services as locally as possible’.
The practice notes that, following the clinical incident in 2006, remedial action was taken and a staff member disciplined. All staff providing cover for the unit have since received a basic level of training and the hours of opening have been reduced so that a doctor from the practice is always available to provide medical cover.
Staff have been commended by the clinical governance department at the LHB for the way they dealt with a recent medical emergency attendance at the MIU out of hours.
The practice does not feel that a precipitate wholesale transfer of MIS from the hospital to the surgery is the appropriate initial response to the concerns raised by the CGSDU report for the following reasons:
1. Simply transferring the service does nothing to improve its safety. The practice currently has no facilities to provide MIS, unlike the hospital which has a well equipped MIU room. The level of medical supervision of the service would be no different in the practice from that provided in the hospital and the service would still be largely provided by nurses. Of the 4 practice nurses, only one has any MIU experience, whereas all the nurses working in the MIU have at least a minimal level of training, and more current experience, albeit limited.
2. Similarly, transferring the service will not increase the number of patients attending the service, and will therefore do nothing to ensure continued staff competence.
3. Provision of the service from the surgery would not resolve issues of inappropriate attendance. This has more to do with patient expectations – despite the fact that it has been widely advertised that the MIU service at the hospital has limited hours, patients continue to attend out of hours and nurses have to attend them. If anything confusion amongst patients would be greater since they would be expecting an equivalent service to that provided from MIUs in other neighbouring hospitals. The issue of unscheduled closures mentioned in the CGSDU report is largely historical – the hospital now has a more acceptable level of nurse staffing and the MIU has been operating on fixed but limited opening hours without change for many months.
4. The relocation at short notice of MIU services into the practice could compromise the existing services provided by the practice. The surgery focuses strongly on providing GMS services and would have to amend current staff timetables, arrange appropriate training (taking staff away from existing duties), and rearrange facilities and opening times to provide even a basic MIS.
5. Very importantly, the level of service provided from the surgery could not equate with that provided, for example, by the MIU in Brecon Hospital. Patients in Builth would therefore not have an equivalent level of service to patients in neighbouring localities, and would be in greater danger of receiving a substandard service than they are currently.
6. Even though the issues raised by the clinical incident in the Builth MIU are significant, the CGSDU has not examined practice in other MIUs where similar problems may exist. A more measured approach to the provision of MIU services across Powys is needed to ensure that all patients receive an equitable and safe service, rather than an isolated response at short notice in one locality.
Summary
The practice is committed to ensuring its patients receive a safe and effective MIS, and will continue working with the CGSDU and LHB to achieve this. Precipitate closure of the MIU in Builth hospital, and relocation of MIS to the surgery which is does not have either the facilities or trained staff to provide such a service is not an appropriate way to respond to the concerns raised in the CGSDU interim report, and a more measured response to developing equitable and high quality MIS across Powys is required.
Downloads:
Builth statement pdf copy
Interim Clinical Governance Report