General practice has been in a crisis for many years. This is down to decades of neglect from successive governments which is now putting patient safety at risk.

As GPs we want our patients to know – we’re on your side.

We want to be there for you and your family when you need us. But this is getting harder and harder…

This announcement contains important information about the pressures General Practice is facing across the UK which may mean that access to GP services and wait times may deteriorate in the coming months.

If you want your GP to be there for you and your family, you can help us. Take a look at the campaign video at the bottom of this page and write to your MP demanding that NHS GP services receive the funding urgently needed NOW to stabilise General Practice.

Don’t let your GP services go the way of NHS Dentistry!

GP Surgeries are under EXTREME pressure.

• GPs carry out 400 million annual appointments
• October 2022  36.1 million appointments delivered nationally
• October 2023  37.2 million appointments delivered nationally
• OVER A MILLION EXTRA APPOINTMENTS PER MONTH ARE BEING DELIVERED
• 90% of NHS contact is in primary care (delivered on less than 8% of the NHS budget)
• 7.7m suffering patients on hospital waiting lists are placing huge extra demand on primary care
• GP Surgery Staff are burning out with increased levels sickness and early retirement

Numbers of registered patients are rising.

• There are over 6 million more patients on the books and a growing elderly population

But chronic underfunding means 1,300 GP surgeries have closed since 2013.

60 GP Surgeries closed last year alone.

The number of qualified NHS GPs has fallen by 1,877 since 2015.Each full-time equivalent GP is now responsible for an average of 2,295 patients!

NHS GP Surgeries perform over 90% of patient contacts in the NHS on less that 8% of the NHS Budget. The government plans to reduce this further to 6%.

This will ring the death knell for YOUR local GP services.

On 28th March 2024, the results of a BMA GP referendum were published:

Over 99% of GPs voted against the government and its third consecutive IMPOSED contract on GP surgeries.

How YOU can help save YOUR GP Surgery

✍️ Write to your MP (all nations), MSP (Scotland), and/or MS (Wales) – email templates and guidance linked.

🤳 Share this website with your friends and to your social media – post directly to X/Twitter here, or find a template post for other social media here.

🔁 Encourage your friends and neighbours to do the same by sharing these materials.

Follow the campaign on Twitter @RebuildGP

On 31st January this year a new service run by community pharmacists was launched. The service, called Pharmacy First, enables community pharmacists to support general practice by providing treatment of patients without prescription for 7 specific conditions:

• Uncomplicated urinary tract infections (in women aged 16 to 64)
• Shingles
• Impetigo
• Infected insect bites
• Sinusitis
• Sore throat
• Acute otitis media (ear infection) 

Please note age ranges apply to all these conditions. 

Patients with any of the above requesting advice or treatment from the practice using the online service will be triaged by the duty GP in the usual way, and if appropriate can now be referred for a face to face consultation with a community pharmacist.

The community pharmacist will perform a clinical assessment, including examination if necessary, in a private consulting room and then:

• provide treatment
• provide advice about self care and the use of over-the-counter (otc) medicines
• refer to another health professional- this may be the GP.

‘Walk-in’ patients are able to self-refer for a Pharmacy First consultation with a community pharmacist provided they meet the clinical criteria for one of the seven specific conditions above.

The practice continues to encourage patients to seek advice from their community pharmacist (before approaching their GP) about other common ailments, which even if self-limiting bmay benefit from otc symptomatic treatment.

In March we were very sad to say farewell to Dr Georgina Washbrook, one of our salaried GPs. She has moved to work in a practice that is more convenient for her home and family. 

Having completed his globetrotting we're delighted to welcome back Dr Andrew Marriott as our new salaried GP. Since completing his GP training at the practice a few years ago Andrew has worked with us on and off as a locum so is well known to many patients. He'll be working three days a week in the practice.

It has been a long, soggy winter, but spring has finally sprung, and hopefully the cold and flu season is coming to an end.

COVID-19 is still around but is a milder illness for most patients, and therefore less of a concern to many. We need to consider COVID-19 as a cause of upper respiratory symptoms, but self-testing is no longer practical for most patients as test kits are unavailable or out of date.

It is important we continue to protect our patients, and staff. If staff members test positive for COVID-19 they are still required to isolate which has a massive impact on our ability to deliver healthcare for the community. We therefore request that if you test positive for COVID-19 or suspect you may have COVID-19, please let us know before visiting the Health Centre and wear a mask to reduce spread. 

One of the many things the pandemic taught us was the effectiveness of face masks in preventing the spread of all respiratory infections. If you have a cough or cold, whether COVID-19 or otherwise, wearing a face covering will help protect others from catching your infection. You should also wear a face mask if you feel at risk, due to increased vulnerability or proximity to anyone with respiratory symptoms.

Common sense and respect for others is all we ask. 

If you are exempt from paying for your prescription, or if you have purchased a prepayment certificate, it is necessary that you sign the back of your prescription form, indicating why you are exempt. 

There has always been an obligation for staff to check exemption status, but occasionally this is overlooked.  Signing is necessary to reduce the number of fraudulent exemption claims. Within the Dispensary we have asked our reception staff to ensure all patients who are exempt, including those with a prepayment certificate, sign the back of their prescription form. Unless they do this they must pay the prescription fee.

• When you sign the back of a prescription form, you are confirming free entitlement to NHS prescriptions. If this is not true, signing the form is an act of fraud and you will be liable to a fine of £100 to the Prescription Pricing Authority, plus the outstanding cost of any unpaid prescription fees.
• If you do not sign the back of the prescription form, you will have to pay a prescription fee.

Please be aware that when you pay a prescription fee the money is passed on to the NHS. It is not retained by the practice, but we are required to ensure the correct fees are collected. However, if we fail to charge a prescription fee when this is due, the practice is held responsible for this payment, and the NHS deducts the fee from practice income. Obviously, this is not something the practice can afford, and for this reason you may be asked to show current proof of exemption, even if you have shown this before.

If you are unable to provide proof of exemption when you collect your medication, we will hold it for seven days until you can return with the necessary evidence. If you need your medication urgently, you have the option of paying the prescription fee or taking your prescription elsewhere. Provided you return with 48 hours with proof of exemption your prescription fees will be refunded.  

If you think you should be entitled to free prescriptions check on line at Free prescriptions booklet (V3) 09.2018.pdf (nhsbsa.nhs.uk)

If you would like to know if you could save money by purchasing a prepayment certificate visit Save money with a prescription prepayment certificate (PPC) - NHS (www.nhs.uk)

The practice now uses an online triage service for all requests for appointments with our medical team (GPs, Advanced Nurse Practitioners and Paramedics) or for advice about medical issues. This can be accessed using the AccuRx online request form.

The phone lines continue to be very busy so please use the online form whenever possible.

Because of the success of the triage service we have downgraded our reliance on emails and these are no longer monitored on a regular basis. Emails should not be used to request an appointment or medication as we cannot guarantee a response within a safe timescale.

Emails should now be used only for non-urgent administrative purposes. 

The practice uses the Electronic Prescription Service (EPS). This is an NHS service that allows your prescriptions to be sent to a pharmacy or dispenser of your choice. They will be signed, sent and processed digitally, without having to be handled by you.

What does EPS mean for you?

• If you use a pharmacy to collect your medication you can order online or via your pharmacy and you will not have to visit the Health Centre to collect your prescription; it will be sent electronically to the place you choose, saving you time.
• If you have stable chronic health condition you can set up a regular prescription order, so that the only time you need to visit the Health Centre is when you need to see a GP or nurse.
• You can choose to collect your medicines from any pharmacy or dispensing service in England. If you are on regular medication, it will always be quicker for you to nominate a pharmacy so that your prescriptions can be sent there to be dispensed before you collect your medication, but you can nominate a pharmacy local to where you work or shop, or choose to use an online pharmacy.
• Your GP will use EPS every time you require a prescription, no matter how often this is. Your prescription will be sent to the secure NHS database, where it will remain until you ask a pharmacy to dispense it.
• The software required to download prescription information from the NHS database is only available to pharmacies at present. If you are a dispensing patient will continue to benefit from a one-stop dispensing service that enables you to order and collect your medication without having to handle your prescription.

How do you use EPS?

• When a prescription is generated by a doctor using EPS it is given a unique code which is sent electronically to the NHS database, known as the NHS 'spine'. EPS allows you to obtain your prescriptions from any pharmacy in England. You can choose to have your prescriptions sent automatically to a preferred pharmacy each time – this is known as your "nominated" pharmacy.
• If you have nominated a pharmacy the prescription code will automatically be sent there to enable the pharmacy to start the dispensing process and provide your medication as quickly and efficiently as possible, without the need for paper prescriptions or tokens. 
• If you have not yet nominated a pharmacy you can still use EPS. Your prescription will be sent electronically to the NHS 'spine' where it will remain until you ask any pharmacy in England, including an online pharmacy, to retrieve the information in order to dispense your medication.
• To use a pharmacy that you have not nominated you will need to provide them with details to confirm your identity so they can securely retrieve your prescription details from the NHS spine. This will be your name, date of birth and NHS number. You can find your NHS number on your medical card, your prescription reorder form, and it is available on the NHS App which you can also use to order your prescription online and find health information. 
• Once your prescription code has been sent to your nominated pharmacy, or if have asked a pharmacy to download your prescription code from the NHS spine by a pharmacy you cannot go to any other pharmacy for the same prescription until it has been 'released' back to the spine by the pharmacy.
• You no longer need a paper prescription or token to obtain your medication from a pharmacy, and for this reason, and to help save resources for the planet, the practice no longer issues paper tokens other than in exceptional circumstances.
• You can only use EPS to obtain your medication from any pharmacy in England. If you want to use a pharmacy in Scotland, Wales, or Northern Ireland you will still require a paper prescription. Paper prescriptions will therefore only be issued very special circumstances, and not on demand. 
• I the unlikely event that a pharmacy is unable to locate your prescripton on the NHS spine using your name, DOB and NHS number a unique code can be provided which the pharmacy may use. In exceptional circumstances it may be necessary to issued a paper 'token' which includes all the information on your electronic prescription including your unique code for use by the pharmacy.
• The software for EPS is currently not available for use with practice dispensaries. We will therefore continue to issue paper prescriptions for patients using the Dispensary until this situation is updated, but for all other patients paper prescriptions will only be issued in special circumstances
• Click NHS App to read more and download the App.

How do I add or change my nomination?

• Ask any pharmacy or dispensing appliance contractor that offers EPS, or staff at the Health Centre, to add your nomination for you. You may have already nominated your usual pharmacy, possibly without realising it, and this will be recorded in your GP medical records.
• If you want to change or cancel your nomination speak to any pharmacist or our practice staff. Tell them before your next prescription is due or your prescription may be sent to the wrong place.
• Once your prescription has been sent to the NHS spine you can ask any pharmacy to retrieve the information in order to dispense your medication. If you this isn't your nominated pharmacy you will need to provide the pharmacy with details to confirm your identity - this will be your name, date of birth and NHS number. You no longer need a paper prescription or token to obtain your medication from a pharmacy, and for this reason, and to help save resources for the planet, the practice will no longer be issuing paper tokens.You can find your NHS number on your medical card, your prescription reorder form, and it is available on the NHS App which you can also use to order your prescription online and find health information. Click NHS App to read more and download the App
• We will continue to issue paper prescriptions for patients using the Dispensary until software is available, but otherwise paper prescriptions will only be issued in special circumstances

Is EPS reliable, secure and confidential?

• Yes. Your electronic prescription will be seen by the same people in GP practices, pharmacies and NHS prescription payment and fraud agencies that see your paper prescription now.
• Sometimes dispensers may see that you have nominated another dispenser. For example, if you forget who you have nominated and ask them to check or, if you have nominated more than one dispenser.

Dispensing patients

• All patients living in Goostrey, and anyone who lives elsewhere but more than one mile from a pharmacy is permitted under NHS rules to obtain their medication from the Dispensary within the Health Centre.
• As a dispensing patient you are not required to nominate a pharmacy, as your prescription will automatically be sent to the dispensary. In fact, EPS will not make any difference to your current prescription service as this is already effectively ‘paperless.’ Although paper prescriptions will continue to be generated and processed within the dispensary, all medication will be dispensed without the need for you to handle your prescription.

Prescription team

Prescriptions for all patients will continue to be generated by our prescription team within the Dispensary. Prior to EPS being available it has been necessary to collect a paper prescription from the Dispensary, resulting at times in a long wait and frustration. Now that all prescriptions are sent electronically to your chosen pharmacy or dispenser the footfall within the Dispensary should be greatly reduced. In this way, EPS will enable us to improve the service we are provide to all patients using the Dispensary.

Ordering your prescription

EPS will ensure your prescriptions are sent electronically to the pharmacy or dispenser of your choice, but there is no change to how you order your prescriptions:

• Order your repeat prescription online using patient access, accessible via the practice website or the NHS App.
• Use your current repeat prescription slip or complete a request form, available in the foyer or at the dispensary.
• Place your request form in the collection box in the health centre, post it to the surgery.
• Send an email to:hchcscripts@nhs.net or hchcdispensary@nhs.net if a dispensary patient

Your electronic prescription is available for a pharmacy to download from the NHS database as soon as it has been generated. However, please check with your nominated pharmacy how long they require before collection. If you are a dispensing patient, please try to allow us one week to dispense your medication, and extra days if affected by Bank Holidays.

EPS is reliable, secure, and confidential. Your electronic prescription will be seen by the same people in GP practices, pharmacies and NHS prescription payment and fraud agencies that see your paper prescription now.

For more information talk to your community pharmacist, staff at the Health Centre, or you can read more about EPS on the NHS website and watch a video about EPS using this link to YouTube.

The practice now uses an online triage service for all requests for appointments with our medical team (GPs, Advanced Nurse Practitioners and Paramedics) or for advice about medical issues. This can be accessed using the AccuRx online request form.

Faced with an increase in the number of COVID-19 infections, plus other respiratory infections, it is important we try to keep unnecessary visits to the Health Centre to a minimum. 

Medication enquiries, sick note requests and other administrative queries will be also be directed to use the AccuRx online request form It is important that all requests are processed using the triage system, so even if you don't have access to the internet you may phone reception in the usual way and a member of the team will complete the request form for you.

The service will be used for both routine and urgent appointment requests and all will be triaged on the same day by a member of the clinical team. The online system will be available to use from 8am to 3.30pm Monday to Friday. For urgent issues after 3.30pm it will be necessary to phone reception so that a member of the team can take the details of your request and pass these to the triaging clinician. They will decide if further action is required that day or whether it can safely wait to the following day.

When your request has been triaged you may be given a face to face or telephone appointment. This may be with a GP or an advanced prescribing nurse practitioner, but it may be more appropriate for your problem to be dealt with by another health care professional, such as  a paramedic, pharmacist, physiotherapis, mental health worker or another member of the team. Although you may feel you need a certain type of appointment, the actual decision will only be made by the triaging doctor. The reception staff are unable to bypass this system so please do not demand your appointment request is dealt with in any other way. 

We appreciate that new systems can seem daunting at first, and there will inevitably be some who reflect on the 'good old days'. Unfortunately the previous system was unable to deal with increasing demand, and we have been forced to look for a better way of working that improves access for all our patients. Triage is not entirely new to the practice. We first trialled it during the pandemic to help us to manage patients remotely, and accompanied by developments in software it was very successful. Unfortunately, it was also heavy on practice resources, and as we emerged from the pandemic we faced not only an increase in demand but also a reduced workforce. This meant we struggled to maintain the service and eventually had to take the difficult decision to suspend the service in December. Since then we have increased our staffing levels, and learned from other practices to ensure we are able to manage demand. We know total triage works very well in other areas of East Cheshire, including Wilmslow and Macclesfield, and with everyone's support we are confident it will work in Holmes Chapel.

If you require their assistance to complete the online triage form or have any queries about how it works our reception staff are there to help you. If you can, it will be quicker for you to complete the online form yourself, or someone else does this on your behalf. This will also ensure our phone lines are less busy for those who truly cannot do it themselves. Our reception staff are not able to bypass the system so please do not ask them to do so.

Please be kind to our reception team who are our ‘front line’. We understand that being a patient can be frustrating, and we apologise if we cannot always provide the service you want, but there are always reasons for this. Please do not take this out on our staff, as inevitably the problem is not of their making.  We are grateful for any patient feedback, particularly if this allows us to improve our service, but please be aware, we have advised all staff to follow our zero tolerance policy when faced with inappropriate behaviour or abuse of any kind. 

We hope that reverting to an online system will reduce the demand on our phone lines, but inevitably there will be peak times when it is difficult to contact the practice by phone. Use the online service whenever possible. Please do not attempt to contact the practice for an appointment via email - this is for administrative purposes only and therefore is not monitored to a level that allows us to respond to email queries about medical problems or requests for appointments within a safe time frame.

To access online triage please click the AccuRx online request form.

Download the NHS App, or open the NHS website in a web browser, to set up and log in to your NHS account. Owned and run by the NHS, your NHS account is a simple and secure way to access a range of NHS services online.

• get your NHS COVID Pass – view and download your COVID Pass for travel abroad
• get advice about coronavirus – get information about coronavirus and find out what to do if you think you have it
• order repeat prescriptions - see your available medicines, request a new repeat prescription and choose a pharmacy for your prescriptions to be sent to
• book appointments - search for, book and cancel appointments at your GP surgery, and see details of your upcoming and past appointments
• get health advice - search trusted NHS information and advice on hundreds of conditions and treatments. You can also answer questions to get instant advice or medical help near you
• view your health record - securely access your GP health record, to see information like your allergies and your current and past medicines. If your GP has given you access to your detailed medical record, you can also see information like test results and details of your consultations
• register your organ donation decision - choose to donate some or all of your organs and check your registered decision
• find out how the NHS uses your data - choose if data from your health records is shared for research and planning
• view your NHS number - find out what your NHS number is

The practice welcomes feedback. The positive kind is great for staff morale, and who doesn’t enjoy a pat on the back for a job well done? However, other kinds of feedback are possibly even more important to us, as it helps us improve the service we provide. We want our patients to always have a first-class experience and we need them to ensure this is the case at all times. Although it can be uncomfortable, we need to hear when we get things wrong. We always reflect on how we do things in response to genuine comments and polite feedback, but we can only do this when patients approach the practice on a personal basis, detailing the specific issues they have experienced. 

Social media allows disgruntled patients to express themselves and their posts may act as a catalyst to generate further comments. Unfortunately the ensuing discussion is inevitably one-sided and is rarely constructive in a way that helps the practice move forward, but apart from feeling slightly bruised the practice is not generally damaged. The same cannot be said about personal comments directed against individual members of staff. 

Online abuse of Health Centre staff

We recognise the importance of social media. The practice uses Facebook and other social media to disseminate information quickly and effectively to a large number of patients. We welcome feedback via any means, particularly constructive feedback if this helps us improve our service. Genuine grievances made by the proper channels will always be investigated. Unfortunately, comments are sometimes made on social media about the practice which are personal and abusive, to which we are unable to respond, and the practice has even received anonymous letters that can only be described as hate male. This will not be tolerated. 

For those who continue:

We are caring professionals who come to work to help people - we do not come to work to be abused.