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Spring newsletter

Once again we find ourselves heading towards spring, although it did feel as though winter was clinging on as hard as possible at the time of writing! In this newsletter we talk about access at the Practice, new online tools for patients, medical records and more … 

Please do share this newsletter with family and friends by clicking on the links below – hard copies will be available in our waiting rooms and in various community venues.

Access update

It’s certainly been a busy winter at the Practice and we’ve seen a higher level of demand from the tail end of January through to the time of writing at the start of April. This is as expected in winter, when all General Practices typically see a surge in demand due to winter viral illness – we know that this can sometimes lead to longer waits to be answered when you call the Practice, and greater challenges in booking appointments. 
It remains extremely challenging for any NHS service to meet all patient demand – all of the time, and in a timeframe which is acceptable to patients – with the resources we each have available to us. Audit Scotland in March produced an excellent report which we encourage patients to read, which lays out these challenges which all services in Scotland are facing. 

As always though, we remain absolutely committed to doing the very best we can for our patients with the resources we have available to us. While we can’t recruit more staff, we do on an ongoing basis scrutinise all of our processes to look for marginal efficiency improvements we can make, for the benefit of patients. 
This month this has meant new scripting which aims to help our Reception team answer and process calls faster; more online tools patients can use for administrative requests rather than calling us; and new ways patients can have medication reviewed and re-prescribed. There are more details on some of these later in this newsletter. 
You can help us too! Each day at the Practice we see patients who could have considered using self-care advice on NHS Inform, visiting their local pharmacy to get over-the-counter medications (or free prescriptions for some conditions via the Pharmacy First scheme), or by calling 111 if they have a minor injury.  
Please think about whether the GP should be your first port of call, to help us provide the best service we possibly can for the whole community. Thank you all for your help … 

Team news

Since January we’ve welcomed Dr Emily Elston, Dr Megan Hall and Dr Sarah Hunt to Riverside, joining our now 21-strong GP team.  

Angie is another new face you might come to recognise, working on the front desk in the morning before joining the medical secretarial team in the afternoon. Kasia is our new phlebotomist, so those of you visiting the Practice for blood tests may meet her then.  

We’re currently recruiting for a Head of Operations but aside from this role the Practice clinical and administrative teams remain fully staffed, within the resources currently available to us. 

Text reminders & cancelling appointments by text 

We’re pleased to report some great final improvements for this project, thanks to all of you! 

Our Practice ‘DNA rate’ reduced from 11.8% in July 2023 to 6.98% in January 2024. These are appointments that aren’t attended, where patients don’t contact us before the time of the appointment to cancel them. 

The reduction has broadly been due to the introduction of text message reminders and all contributes to improving access and capacity – as if appointments are missed, patients will often call us back to book another one.  

The ‘cancel by text’ functionality has also proved popular, with around 80 appointments a month being cancelled by text, allowing us to open them up for re-booking by another patient.  

We’ve had some nice feedback from patients about the introduction of SMS appointment reminders:

‘Great idea. Hopefully cuts down on people not turning up’ 

‘Very helpful indeed – a great thing for you to be doing’ 

‘Great prompt – while I knew when the appointment was, this provided reassurance of the time. Thank you.’ 

Please help us to offer you and community the best possible service, by continuing to cancel unwanted appointments – thank you!

Mobile phone with icons on

Online contraception review

We’ve added to our suite of online medication review options this month, with contraception review now offered online, as well as HRT and SSRI review. 

If you’re aged 16-49 years, have already been prescribed the contraceptive pill or patch and want to continue using it, you can now complete our online review form the next time you need to request it, rather than calling us to book a review appointment. The nurse will then review your form and text you to let you know if they’ve been able to re-prescribe your medication. 

The new online form will help us to use clinical time more efficiently, and we hope some patients will find it a more convenient option.  

You can still call us to book a review appointment if you prefer to do that though, or if you want to discuss an issue with your contraception with the nurse. 

The Practice will be closed on Good Friday (Friday 29 March) and Easter Monday (Monday 1 April), re-opening on Tuesday 2 April and beyond as normal. Please place any prescription requests in good time before the Easter break – thank you. If you’re unwell when the Practice is closed over Easter and you think it can’t wait until we re-open please call NHS 24 on 111.

Happy Easter, everyone!

Easter Eggs on brown nest

Prescriptions – how, when and what to order 

We always describe General Practice as being like an iceberg, with the appointments above the surface – and a huge raft of other things going underneath, which are less visible! One of those ‘under the surface’ things is prescribing – a task which we estimate takes the equivalent of two GPs a week to manage. 
We issue around 1,000 prescription items a day and these are a mixture of repeat prescriptions (medications which the GP is happy for you to re-order a certain number of times before it needs re-authorising) and special/acute medication requests. Acute medications include those which you’ve had before but aren’t on your repeat, controlled drugs, or medications that need closer monitoring by the GP. 

You can help us manage our prescribing workload (and free up capacity to provide more appointments) by: 
1. Only ordering medications you’ve had before 
The GP will rarely be able to prescribe medications you haven’t had before, but still needs to take the time to assess your request – meaning GP time isn’t used as efficiently as it could be.

2. Ordering online via our website 
Ordering your medications online on our website helps us to process prescriptions more quickly and easily identify what date requests were made to the Practice. It also means you can add a note about your medication request – for example if you’re ordering early due to going on holiday. 

3. Allowing enough time when you order … 
Please allow up to 5 working days for us to process repeat prescription requests, plus an extra 2 days if you collect from a pharmacy – this allows the pharmacy time to come and collect the hard copy prescription from us and prepare your medication for you. 

Allow up to 10 working days for us to process acute medication requests – again allowing extra time if you collect from a pharmacy. 

4. … but not too much! 
If you order too early, the GP won’t usually be able to prescribe your medication – this is for reasons of patient safety. They’ll usually ask you to re-order it at a later date if you still need it then – which all adds unnecessarily to our prescribing workload. 

5. Check your prescription slip 
Items are added to your repeat prescription for a certain number of issues, and it tells you how many issues you have left for each item on your prescription slip.  

Once you’ve had the maximum number of issues the GP will need to re-authorise your repeat medication the next time you request it and this will take up to 10 working days, plus extra time if you collect from a pharmacy. 

Knowing this means fewer calls into the Practice, to query where a ‘missing’ prescription is.

Medical records and other paperwork 

Each week we get a large numbers of requests for paperwork – whether a request for medical records, a GP letter, or a form to be filled in. 

In the past, it’s taken a lot of time for our administration team to find out exactly what’s required and assess what we can provide to patients most easily to meet their need. 

To help us collect this information and help you as quickly as possible, we now have a new online form for patients to fill in whenever they want to request any type of paperwork from us. 

New East Lothian Health and Social Care Partnership campaign 

The team over at the East Lothian Health and Social Care Partnership (ELHSCP) have been doing some great work to promote the full range of primary care services available to patients, many of which don’t require you to contact your GP first. 

This includes self-referral to physio, mental health support and community nursing

There are new patient information booklets about all of these services available for patients in our main waiting room – many thanks to the team at ELHSCP for producing these and making them so widely available for patients across East Lothian. 

There’s also a new website where you can read more about all of these services and you might spot information on social media too.