Getting the most from your surgery

Getting the most from your surgery

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GP surgeries have changed the way they work to meet patient needs and increased demand. There is now a wider range of medical staff at surgeries and different ways to get help such as telephone, video, and online consultations, as well as face-to-face appointments.

Access to GP services is an issue we hear about regularly at Healthwatch Northumberland. In our ‘getting the most from your GP surgery’ booklet we explain more about the range of staff roles at surgeries, different ways to access healthcare and how to make the most of your GP appointment.

Why do I have to tell the receptionist so much about my concern?

Reception staff need to ask enough questions to make sure you get the best appointment with the right person. This may not always be your GP, as there are specialist services that may be more appropriate for your needs, for example, a dietician for
concerns around food allergies or intolerances.

Who might I see at the GP surgery?

Your GP surgery will employ some or all of the healthcare professionals listed below.

Advanced Practitioners: include nurses, pharmacists, paramedics, physiotherapists, occupational therapists, dieticians or podiatrists. They can help with a variety of health conditions and can prescribe medication and make referrals to other specialist services.

Clinical Pharmacists: can carry out medication reviews, particularly for long-term and chronic health conditions. Some can also prescribe medication and manage prescriptions.

Care Coordinators: ensure patients have more joined-up care and that their care needs are met, particularly for those who are frail and/or elderly, and people with long-term health conditions

Dieticians: diagnose and treat dietary and nutritional problems, give advice on food and nutrition, and offer support with diabetes, digestive issues, food allergies and intolerances and weight loss/gain.

General Practice Nurses: can do many of the same tasks as GPs. They assess and treat people of all ages, provide wound care, screenings and blood tests, as well as vaccinations. They also offer advice on contraception, women and men’s health issues, weight loss and stopping smoking.

Health and Wellness Coaches: find solutions or lifestyle changes to enable people to lead happier lives. They help people to form a personalised health and care plan to achieve their goals.

Mental Health Practitioners: support people with severe mental health illness to live well in their communities. They can work with patients whose mental health needs cannot be met through, for example, talking therapies, but who may not need care from more specialist services such as psychiatric care. They can often help children and young people as well as adults and can help make referrals to suitable services for support.

Occupational Therapists: work with ill, disabled or injured patients,including those who have returned home following a hospital stay. They help with adaptations to people’s homes so they can continue to live independently.

Physician Associates: work alongside GPs. They cannot prescribe medication but can prepare prescriptions for GPs to sign and can diagnose, order tests and make referrals.

Physiotherapists: work with patients who have joint or muscle problems including those recovering from serious injuries or illness and those with new injuries. They can book scans and tests and are trained to recognise when a joint or muscle problem may be a sign of something more serious. Patients can often make an appointment with a physiotherapist directly themselves (self-refer) or can be referred by a GP or other healthcare professional.

Paramedics: can provide a rapid response to patients with long-term conditions, minor injuries and minor illness. They can supply a range of medicines and support patients who require wound care, have fallen, or have musculoskeletal problems, and can treat some types of infections.

Podiatrists: can diagnose and treat foot and lower leg conditions and provide foot care for short-term or long-term conditions.

Social Prescribing Link Workers: help address the non-medical issues that may be affecting your health and wellbeing. They can connect you to local services and community groups for practical or emotional support.

 

Find out more by viewing our ‘getting the most from your GP surgery’ booklet or download as a pdf.

 

Tell us your experiences of making appointments and visiting your GP surgery.

 

 

 

Health visiting services in Northumberland

Health visiting services in Northumberland

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Growing Healthy: Hearing people’s experiences of health visiting services

Last year we started to hear a small increase in concerns from local families and those supporting them about health visiting services. To get a better understanding of people’s experiences we asked people in Northumberland who were pregnant or had pre-school aged children for anonymous feedback about their experiences of the health visiting service, delivered by Harrogate and District Foundation Trust (HDFT), including what is working well and what could be better. We also wanted to understand people’s awareness of the health visiting service and any barriers to using it, including those who were not routinely taking advantage of the services on offer.

Summary

During this piece of work we looked at people’s awareness of how to access the health visiting service and what it offers, whether they were routinely accessing the service, as well as how happy they were with the support provided.

Whilst most people we heard from were aware of how to contact the health visiting service there were many others who were not very clear on how or who to contact. Around half of people responding were also unsure or did not know who their child’s named health visitor was, either due to staff changes or not having had recent contact with the service. Those who did have a named health visitor and who saw them at each appointment were generally happier with the support received from the health visiting service than those who did not, with many mentioning continuity of care or having a good relationship with their health visitor.

Many people had a good awareness of the universal offer in terms of key developmental reviews or if not, how they could find out about it, but there were still some who had limited awareness of when they would next expect a review or whether they may have missed a key review. Similarly, some people had a limited understanding of other possible targeted support and advice on offer outside of the key developmental reviews, for example, around parenting and other topics. These people told us they would not think to contact health visitors outside of reviews, or more generally were unaware that the health visiting service could provide this. Positively, many parents had used the health visiting service for targeted advice and support, particularly around feeding, nutrition, growth and development.

Most people we heard from had either not heard about the new Growing Healthy app, or had heard about but had not used the app. Many of those who had heard of but hadn’t used the app seemed unaware of its functionality. Those who had used it gave mixed feedback but were generally positive about the health chat feature and
self-help articles and information available.

In terms of how happy people were with the support from the health visiting service most selected the ‘partly’ response. Those who were completely happy praised the support given by the health visiting service or their named health visitor using words like ‘supportive’ and ‘helpful’. Many who did not necessarily have routine or regular contact were still completely happy as they felt confident in being able to make contact and get support should it be needed. Those who were less happy with the service generally had concerns around staffing, having limited support, being unaware of how to access support and being unhappy with a particular health visitor or specific advice given. We also received multiple comments around accessibility and availability of clinics and concerns these were no longer a ‘drop-in’ facility.

 

Read all of our findings and recommendations in Growing Healthy: Hearing people’s experiences of health visiting servicesordownload a pdf version.

 

Share your own recent experiences of health visiting services in Northumberland.

 

Physician Associates

Physician Associates

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The NHS plans to triple the number of Physician Associates it employs. But how much do patients know about this role, and how can their role be safely expanded?

In recent years, the NHS has expanded the use of ‘medical associate’ roles to help tackle staff shortages and improve access to care. One of these roles is the Physician Associate (PA).

With plans to employ 10,000 PAs by 2037, Healthwatch England looks at how aware patients are of PAs and how NHS staff and medical regulators can improve their understanding and experience. 

What is a physician associate?

PAs are healthcare professionals who work under the supervision of a senior doctor and can assess, diagnose, and treat patients within certain limits.

They don’t prescribe medication or request X-rays, and they are supposed to supplement – and not substitute – fully qualified doctors.

PAs are not a new role.

Physician Associates have worked in England since the early 2000s, but the number employed in the NHS has grown significantly in recent years.

The Faculty of Physician Associates found that 2,833 PAs were working in England in October 2022, more than double the number recorded three years earlier.

The previous Government asked the General Medical Council to take on formal regulation of PAs alongside its main role of regulating doctors. This move aimed at assuring patients, clinicians, and employers that PAs have the knowledge and skills to work safely and that they can be held to account if serious concerns are raised.

With the regulation of PAs due to start at the end of 2024, we have looked at what patients have told us about PAs and the lessons the NHS and the GMC can learn from our evidence.

What patients and the public think 

It is challenging to accurately gauge people’s experience and understanding of PAs. There are still not many PAs practising in the NHS, and there is little national data about which services employ them and in what capacity.

To establish the first national picture of the patient experience of this new role, we commissioned a poll of 1,914 adults living in England . We also spoke with Local Healthwatch services about the stories people had shared with them.

The previous Government asked the General Medical Council to take on formal regulation of PAs alongside its main role of regulating doctors. This move aimed at assuring patients, clinicians, and employers that PAs have the knowledge and skills to work safely and that they can be held to account if serious concerns are raised.

With the regulation of PAs due to start at the end of 2024, we have looked at what patients have told us about PAs and the lessons the NHS and the GMC can learn from our evidence.

Key themes

General awareness is mixed

In our polling, we found a mixed picture on awareness of PAs.

In our polling, we found a mixed picture on awareness of PAs. Over half of those surveyed (52%) agreed or strongly agreed that they “understood the difference between a PA and a doctor”.

However, there were differences when it came to age.

Respondents aged between 18-34 were more likely to agree with the statement (58%) than those in older age groups (47% of 34–54-year-olds, and 49% of those aged 55+ agreed).

Some Local Healthwatch explained that while patients might have heard of PAs and understood that they were not doctors, understanding what they can and can’t do is more limited.

In many cases, patients were not aware of the local presence of PAs and often only found out about the role when given an appointment with a PA.

Knowing who you are seeing is key

Where people knew they had received care from a PA, their experiences tended to be positive. People particularly valued that they could have their needs addressed quickly when they saw a PA.

“My appointment with the physician associate went wonderfully well. She answered all my questions, was very thorough in her examination and had a lovely manner. I am very happy with the service provided.”

Story shared with Healthwatch Solihull

However, we heard about several cases where patients were not made aware of who they were seeing before or during their appointment. In some instances, patients had specially asked to see a doctor but were instead assigned to see a PA.

“I was in a lot of pain and was surprised to be offered an appointment the next day. I specifically asked for a doctor as I wanted to discuss having an operation but when I got there I was told I was seeing a physician’s associate and all I got was a year’s supply of opiates. It has put me off contacting the surgery except for repeat prescriptions and I have now paid to go privately for assessment and treatment. I have no faith in the practice now and no longer feel cared by them.”

Story shared with Healthwatch Richmond

Guidance from the National Institute for Health and Care Excellence (NICE) states that staff must explain their role and responsibilities while interacting with patients.

Our research revealed significant support for this among the public. Over three quarters (76%) of the survey respondents thought it was ‘important’ or ‘very important’ that the person providing their care ‘explains what their job involves’.

However, our evidence suggests that not all staff are following the NICE guidance. Only 60% of those surveyed said that during their last NHS appointment, the person providing their care clearly explained their role.

It is vital for every clinician to state and explain their role, and clarity is more important than ever as more roles like PAs are used across the NHS.

Five steps to improve clarity

In partnership with the Patients Association and National Voices, we’ve made five recommendations to policymakers and regulators about how they can better support the roll-out of PAs. A commitment to clarity about the PA role underpins these recommendations.

1. Clarity in direct patient care

Practising PAs and those in training must explain their role to all patients they see. Providers of education and training, including medical royal colleges, should make clear that informing patients about roles and responsibilities is core to providing high-quality care.

2. Clarity on choice

While PAs can provide high-quality care and improve patient access for more straightforward health problems, national and local NHS organisations must make clear that patients have a choice e to request an appointment with a fully qualified doctor if they prefer.

So people can make an informed choice, services should tell patients before an appointment:

  • The types of clinicians available to see them
  • The lengths of time they may have to wait to see different professionals, and
  • If they see a PA, the PA may have to refer the patient to a GP or other senior doctor if the patient’s problem falls outside their scope of practice

3. Clarity on training and regulation

In our polling, we found that the factor which made the public most confident in the person providing their care had ‘their skills and knowledge regularly reassessed’.

National bodies, including the Faculty of Physician Associates and the General Medical Council should be clear about the scope and content of the initial training of PAs and their ongoing assessment and revalidation.

4. Clarity of communication

Given the increasing use of new roles in services, NHS England and other national bodies should adopt a proactive approach to communicating with the public in this area.

Alongside broader awareness campaigns, Integrated Care Boards should set up patient forums to explicitly examine the deployment of new workforce roles. Patients and their representatives must be centrally involved in all future discussions about the use of PAs and other new roles.

5. Clarity on effectiveness

NHS England and the General Medical Council should commission a formal evaluation of patient experience of PAs in GP and hospital settings. This research would help to learn lessons to inform the expansion of this role and provide assurance that PAs are being used appropriately and not as substitutes for fully qualified doctors.

Want to learn more about Physician Associates?

Find out what care they can offer you and how their role differs from fully qualified doctors in this article from Healthwatch England.

Tell us your experience of Physician Associates

Online event – NSPCC Building Connections

Online event – NSPCC Building Connections

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Join us for our next free online event on Friday 9 August, 1pm-2pm, with NSPCC’s Building Connections service.

Research shows that 73% of young people between the ages of 16-18 do not feel equipped to deal with loneliness (Vote for Schools survey, 2023). The NSPCC’s newest service Building Connections is looking to change that.

Ellen Watling and Jess France from Building Connections will share how their service is supporting young people to overcome and manage feelings of loneliness.

This presentation will last around an hour including time for attendees to ask questions at the end. It is suitable for public and professionals who want to know more about the support on offer through the NSPCC’s Building Connections service.

This event has now passed.

Sign up to our newsletter to hear about future events or catch up with previous events.

Have your say on SEND services

Have your say on SEND services

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Northumberland County Council would like to hear your views on services for children and young people with special educational needs and disabilities (SEND) in Northumberland.

Families are invited to complete an online survey sharing their experiences about what is working well and what needs to change.

The survey has been developed with the Northumberland Parent Carer Forum and a group of parents and carers who are working with Northumberland County Council and NHS commissioners. The feedback will help to set the county SEND partnership’s vision and priorities over the next three years.

You can complete the survey online, or if you require a paper copy please contact sarah.elliott@northumberland.gov.uk and a copy will be posted to you.

​If you would like support to complete the survey over the phone, give us a call on 03332 408 468 (option 3) or text 07413 385275 for a callback.

Please leave your feedback by Friday 20 September 2024.

This survey is now closed

What you told us: June 2024

What you told us: June 2024

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This month we continued to hear about communication issues and poor quality of care at hospitals in the region. There were also several positive comments about the quality of care received from GP surgeries.

We raised with a primary care group that a link on its website wasn’t working. The practice manager replied to say that they had fixed the link and thanked us for letting them know. Patients were now able to access the information in the weblink.

Negative feedback

A woman told us about the problems she and her husband had with the Anima system at their GP. They have to use Anima to book appointments and patients are actively discouraged from ringing the surgery. They say Anima is not intuitive – when the email is received about the appointment, the only option to reply is ‘yes’ or ‘no’. Husband wrote “I would like to see someone in person about this” and got a reply saying, “You have cancelled this appointment”. Husband now chooses to go to A&E for assistance as says it’s quicker than waiting two to three weeks for a GP appointment. (Castle Morpeth resident)

Positive feedback

A gentleman contacted us and said that he has experienced very good care at his GP surgery. He needs regular repeat prescriptions and likes that fact that he can walk straight in, fill in a repeat prescription form at the desk, hand it in, then walk just two minutes down the road to the pharmacy. On one occasion he fell over at home and went straight to his GP surgery expecting to be told he’d have to book an appointment. They asked him to take a seat and he was seen by a GP within 20 minutes. He likes knowing that he can drop-in in this way if he needs to and won’t be turned away. (Cramlington, Bedlington and Seaton Valley resident)

You can read more in our short feedback report for June 2024

The value of listening: Annual Report 2023-24

The value of listening: Annual Report 2023-24

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Healthwatch Northumberland Annual Report 2023-24

This year over 12,000 people shared their experiences of health and social care services with us, helping to raise awareness of issues and improve care, or came to us for clear advice and information about topics such as mental health and the cost of living crisis. We published 20 reports about the improvements people would like to see in health and social care services. Our most popular report was Lloyds Pharmacy Enter and View which highlighted the negative impact for patients at the start of pharmacy closures in the county.

How we’ve made a difference this year

  • We drew attention to the impact of pharmacy changes on vulnerable people in the South East of the county
  • We helped the NHS understand why parents in Blyth might attend A&E with a poorly child rather than contact a GP
  • Two young volunteers moved onto higher education with knowledge and experience gained from their time at Healthwatch Northumberland
  • Our website gave people the health information they needed. Our most popular pages were mental health, dementia and LGBT support
  • Our ‘Listening AGM’ enabled members of the public to speak directly to senior decision-makers about the health and care changes they wanted
  • 60 people at our online session heard from the charity Battle Scars about the myths and realities of self-harm
  • We published a guide to help with cost of living pressures and distributed it widely across the county
  • We listened to parents about Health Visiting Services. The provider is now working on an action plan based on our recommendations

Listening to your experiences

Services can’t make improvements without hearing your views. That’s why, over the last year, we have made listening to feedback from all areas of the community a priority. This allows us to understand the full picture, and feed this back to services and help them improve. Our report outlines how we’ve listened to the experiences of local people, including our work to hear from families their experiences of Health Visiting Services, our information on how to get the most from your GP surgery, and how we made sure the views of people living in Harbottle were listened to around a proposal to introduce a mobile healthcare unit in the village.

Hearing from all communities

We have continued to make sure we hear from communities we hear from less frequently. Over the past year we have done this by:

  • Holding monthly drop-in sessions in all areas of the county
  • Hearing from people with learning disabilities about their experiences of health and social care
  • Being part of the Fishermen’s Mission Seafit events at Amble Harbour, bringing services to fishermen, who can find accessing care services difficult due to the nature of their job
  • Working with senior Adult Social Care staff to create the Adult Social Care People’s Advisory Panel
Information and signposting

We can provide confidential and free information to help you understand your options and get the help you need, in line with a ‘making every contact count’ approach. Whether it’s finding a GP practice, making a complaint or choosing a good care home for a loved one – you can count on us. For example, we heard from someone who was having some struggles in their home, and it was unclear what support was already in place. They were unaware of their GP’s Social Prescribing Service, so we referred them on for some help. As a result of this referral and the excellent work of the Social Prescribing Link Worker, the person now has help with weekly cleaning and household tasks as well as receiving a small cash grant for help with heating, some shopping vouchers and other food items to help with the cost of living.

Our online information sessions were a chance for over 250 people to hear from a wide variety of local and national charities and organisations. These included Eating Disorders North East, NECA Gambling North East, Arthritis Action, The Menopause Charity and The Chartered Society of Physiotherapy, which spoke about the benefits of strength training.

As we were increasingly hearing about the effects on people’s health due to the rising cost of living, we decided to collate information on different support services that exist in Northumberland and produce a printed ‘cost of living support in Northumberland‘ booklet.

Next steps

Over the next year we will keep working across the county, reaching out especially to people less often listened to, for example, people whose work or lives mean they face difficulties in using health and care services. Thank you to everyone who responded to our Annual Survey and for telling us what you think we should work on next year. You said these are

  • Care in the home
  • Hospital discharge
  • Pharmacy

We will continue to work on GP access, dentistry, mental health and audiology services.

View the Healthwatch Northumberland Annual Report 2023-24 or download a pdf version.

 

What we heard in May 2024

What we heard in May 2024

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Health and social care feedback Northumberland May 2024

Poor communication was the common theme we heard about again this month, with negative comments about hospitals and GP surgeries not communicating with each other, and patients not getting clear communication from the services either.

We were invited by Healthwatch England to give a presentation on our Autism and Young People Report that we produced in the summer of 2022, as an example of good practice. The presentation was given to Healthwatch England’s Research and Insight Network Group. Partly as a result of the feedback on this presentation Healthwatch England has set up a special forum devoted to working with patients with ADHD and autism on its internal webchat site.

Positive feedback

A patient told us “I had an appointment for an ECG. I reported to hospital outpatients reception where I was quickly and efficiently checked in. When I entered the ECG waiting room I was met by a nurse who greeted me politely and confirmed my appointment. One minute later I was taken by another nurse who carried out my ECG check. He was professional and polite and confident. My whole visit lasted around 20 minutes but I must say I felt in very safe hands and these guys were a shining example of pure professionalism. Well done and thanks.”

Negative feedback

A lady reported that her husband had been waiting for two years for keyhole knee surgery. There had been poor communication between the GP, the consultant and the physiotherapist, with each one referring to the next one and going round in circles each time, leading to the long delay.

Find out more in our short report

 

Online event – Northumbria Joint Musculoskeletal and Pain Service (JMAPS)

Online event – Northumbria Joint Musculoskeletal and Pain Service (JMAPS)

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Join us on Friday 12 July at 1pm to hear from Nick Livadas and Kathy Mills who will give us an introduction to Northumberland’s Joint Musculoskeletal and Pain Service (JMAPS).

This online session will give an overview of what JMAPS is, how people can access the service and how it can help people with musculoskeletal conditions or persistent pain. There will be a chance to ask questions after the presentation.

This session is suitable for anyone who wants to know more about the support on offer through JMAPS.

This event has now passed.

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Your feedback April 2024

Your feedback April 2024

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Health and social care feedback Northumberland April 2024

In April the most common issue reported to us was poor communication from service providers. This includes patients having trouble navigating telephone systems or difficulty using online triage systems such as eConsult, at GP surgeries. We also had comments around the cost of accessing private podiatry and dental services.

Our online talk was from Northumberland County Council’s Health Trainer service. We were able to record this session and A good number of people came along to the session and we had permission to record this month’s talk – the link to this and previous sessions can be found on our YouTube channel.

Find out more in our April 2024 feedback report