Covid Clinics - A Carnival Atmosphere in an otherwise bleak week!

Written by: M Fletcher

I know my colleagues may not share this sentiment, but I LOVE working weekend Covid and Flu clinics. Have I had a bit too much coffee? Or too little sleep? Have I finally succumbed to the pressure of working in Primary Care in 2022 and cracked? Nope, I really do mean it. Covid Clinics have been a recent highlight at an otherwise bleak moment in time for the NHS.

All I seem to read are negative and worrying articles about GPs only working part time, or how long it takes to see a doctor, or nurse strikes or drug shortages…it’s all a bit doom and gloom and I personally am tired of hearing nothing but GP bashing from patients, the public in general and the media. And that brings me to the subject of weekend Covid/Flu clinics.

Every day with out fail I deal with someone grumbling about the practice – it could be a patient wanting to complain, a staff member feeling overworked and pressured, or a PCN level meeting where, you guessed it, everyone has something to whinge about. It’s a difficult time in GP land right now, and we must find some balance, because if we allow the negativity to penetrate us as managers it will inevitably filter down through the ranks and everyone will be walking around with a face like a slapped backside.

This is why weekend covid clinics are such a positive in my mind. We don’t work a full day, and all we do is vaccinate. Clinicians only jab, they don’t answer any clinical questions or have time to just look at this thing on my back, and patients understand the appointment is just a quick in and out. We open reception but make it very clear that all we are doing on a weekend is running the clinic; no appointment booking, no queries, just vaccinating.

There are patients who I have seen grumbling at the desk on a weekday, who appear happy as Larry on a Saturday morning, they joke and have a giggle with the team and even thank us when they leave.

During the last clinic I laughed until my eyes watered when a patient, having overheard a conversation I was having with a receptionist about Halloween, said goodbye and imitated a zombie as he walked past. It was really, genuinely funny, and the patient (who I would estimate to be in his late 70s) was clearly happy at having made us all chuckle. It was fun – a genuinely fun morning working with a few colleagues and providing a service that, on the whole, our patients really appreciate.

Every single one of them left with a smile and a thank you, and I left work not begrudging the fact that I had lost the majority of my Saturday but feeling as though we had done something worthwhile and positive for our patients.

For reception staff in particular, who take so much flack it is a lovely experience, and they appreciate every positive comment and every word of gratitude.

Last year, during a Saturday covid clinic in early November, we realised that the radio wasn’t working properly. Faced with a choice of a free CD listing the most popular hits by Elgar or several festive albums, we decided to get in the Christmas spirit early, and we watched as patients queuing for their vaccines started dancing along to the tunes. It was like the scene in the Full Monty, for anyone who remembers that fabulous film.

For whatever reason, there is always a sense of fun at these clinics, a feeling that on these days patients leave their grumbles behind, and likewise staff get to come in and concentrate on one job and one job only, the task of protecting our patients and even better, doing it with a smile. We make sure that staff get a proper break mid way through the clinic, we order in bacon butties and I make sure that the one member of staff who is a secret smoker gets to go and pick them up so she can fit in a crafty fag break. We make sure everyone has a brew when they need one, and that we all leave on time allowing everyone to enjoy the rest of their weekend.

We are very good at organising and running flu clinics in general practice, and I used to love standing in the atrium of our surgery watching the snake of people moving through the building when we used to do walk in afternoons. It was a very impressive sight seeing hundreds of people being vaccinated like clockwork, walking in one door, joining a queue, being called for a vaccine and then leaving via the back. Once Covid hit we had to rethink the way that the clinics ran, considering social distancing and the time it would take to talk patients through the questions on pinnacle etc. but we have gotten very good at this too.

Our clinics now run like a military operation. We get everything (with the exception of the vaccine) ready the day before, the morning of the clinic we arrive, dole out the stock, make everyone a brew and once we’re all drawn up and ready to go, the doors open. It is a slick operation that has developed over the last couple of years, and I’m so proud of our team for continuing to give up their weekends to protect our patients. I’m even prouder of what these clinics have become; a fun way for the team to earn a bit of extra money and to receive the positive and grateful feedback from patients that they so deserve.

I hope that it is the same for my colleagues across the country, and that you too feel the positivity radiating from patients who, because of you, will feel protected this winter.

Covid is something we will just have to live with; for us in GP land organising vaccine programmes creates a lot of work and a lot of stress. But for those few hours, where all you can do is vaccinate, it doesn’t feel so bad. In years to come, we will be proud of our contribution, but for now, I’ll settle for dancing to Christmas music with the patients we serve, and occasionally seeing a man nearing 80 years old pretending to be a zombie as he wishes me all the best for the rest of my weekend.

Managing and reducing stress

Written by: Georgia Dossis

Stress serves the purpose of reacting and avoiding danger, which is great but too much can have a negative effect on you. Life is full of major and minor challenges and it’s completely normal to sometimes feel inundated with these issues.

According to Champion Health, one in 14 UK adults feel stressed daily and I guarantee if you ask your neighbour, your work colleague, a friend, or a family how they are, at least one of them will use the word ‘stress’ in their response.

Below are some suggestions on how to relieve and control symptoms when everything is getting a little bit too much:

-          Leave work at work. With the most common cause of stress being work related, I think one of the most important things is to leave work at work. I’m aware that not all job roles have this perk, but where you can you most definitely should leave work at the office. You psychologically associate your surrounding with your feelings. If you’re taking your work home you’re more likely to feel stress in your home and find it more difficult to switch off when you need to.

-          Be active. I can guarantee that this is the first thing you hear when you say that you’re stressed, and it often is the first question too “are you getting any exercise?” but they aren’t wrong. Exercise increases endorphins, which numbs pain receptors, allowing you to feel better and happier. Even if it’s a walk around your estate, getting movement in will reduce your stresses.

-          Take some time for you. Work holidays are given to be used. It would be unhealthy to work every single day of the year, no matter how much someone loves their job. Taking time off to catch up on you is not a bad thing. You can use this to get some of the life admin that you put off during the week done, take a holiday or even take a day to put your feet up.

-          Getting organised. By getting organised, you instantly feel better about the tasks that you need to do. Creating a to do list helps by having everything out of your mind, alongside being able to visually see what you’ve got to do.

-          Breathing and meditating. There are hundreds of apps and thousands of YouTube tutorials that can help with this. By focusing your attention on breathing it clears your mind of all the tangled thoughts. Meditating not only strengthens areas of your brain responsible for learning, attention and memory but also helps calm down your sympathetic nervous system. This improves your heart rate by slowing it down and causes you to feel more relaxed.

-          Activities. Whether it be apple picking, going shopping or using an adult colouring book, doing something you enjoy will allow you to take your mind away from what you’re focussing on that’s causing you stress. Colouring or reading for example help relax the fear centre of your brain which is what cause you to become calm.

-          Keep a journal. Journalling can allow you a safe space to express how you feel without fear of judgement. Here you don’t have to worry about grammar, punctuation, or spelling, just write whatever comes to mind.

-          Healthy Diet. There’s nothing more tempting when your stressed to eat badly, which is normal, and variety is good. But a healthy diet is key to keeping your body regulated and happy. We’ve all heard the term ‘hangry’, eating good healthy foods will help eliminate the ‘angry’ part.

Although stress is unavoidable it is definitely controllable, you just need to find what is right for you. Keeping stress at a manageable level is key to your overall well-being.

The IT man cometh

Written by: D. Nedry

I don’t know about anyone else, but I am getting more and more frustrated with the IT ‘support’ provided to our practice.

I can never get hold of anyone when I need to, if I desperately need something for the practice like a replacement for a 15 year old printer I am told that there are none available and when I need an engineer to come to the building they seem to be as rare as hens teeth. And yet, for no immediately obvious reason, they keep turning up at the practice unannounced to replace equipment that seems to be in perfect working order.

I’m not sure if this is something local or a problem across the country, but decisions about IT budgets and spending seem entirely illogical to me. But then, it’s not my business to know how those budgets are allocated and to be frank, I have enough to think about without pondering this techno-puzzle but what drives me absolutely round the bend are the things that we, or I must do to enable this bizarre cherry picking of IT needs.

For example, last week I had to check every single monitor in the practice for a particular model number and screen size, and that is no mean feat. We have a lot of rooms and a lot of computers, and the part about it I couldn’t fathom, was why I was doing it at 7pm on a Monday night? Why was I frantically rushing to get this done when it really wasn’t a top priority task for my practice?

I realised that actually I was making a rod for my own back by agreeing to do it in the first place. At 7pm on a Monday I should be at home with my family (probably with a glass of wine), not running around with a clipboard and a set of keys dashing past the cleaners to get in and out of rooms. So, I’ve decided on a new approach.

If something is so important that IT absolutely positively need it doing ASAP/yesterday, then quite frankly they can come and do it themselves. From this point on, I’m just refusing to jump to IT’s schedule because actually, I think that getting on with my own day job is more important to patients than replacing an old monitor that works just fine!

I am sure I will make some enemies in the IT department, but with everything else we have to juggle at present, I don’t really care. I care about my practice, my team and our patients, and if IT don’t like it, they can stick it up their modem.

I think we should all adopt this attitude and make our IT departments work for us.

And so today, when I received another email from IT asking me to look for a piece of equipment at our practice, I asked them why they don’t have a record of where their equipment is allocated, and why they couldn’t send someone out to look for it themselves instead of wasting my time and the time of the practice team.

There was silence for a while…but eventually I had this reply…

‘We’ll be on site tomorrow’

It’s a little win sure, but it’s saved me a bit of time today and surely in these ever changing, completely bonkers times we need all the little wins we can get.

Why we should be composting

Written by: Georgia Dossis

By now you’ll have seen all the headlines and David Attenborough documentaries that hit us with the hard truths about becoming carbon neutral before 2030. There are so many ways to do this, whether it be using green energy to power your house, recycling, cutting down on your journeys in the car or even driving an electric vehicle, the list is endless.

But one really easy way in which we can reduce our carbon footprint is composting.

Composting is the natural process of recycling organic matter, such as food waste, teabags, leaves and food peelings.

What we don’t think about is that when you throw food waste away it ends up in landfills. Every 100 pounds of food waste that goes into landfills produces 8.3 pounds of methane, which in turn releases methane into the atmosphere trapping in heat and contributing to global warming.

This makes up for 8% of greenhouse gas emissions. It’s said that if every household in the UK composted their food waste rather than throwing it away it would have the same effect on greenhouse gases as planting 640,000 trees.

I won’t lie when I hear composting, I hear green thumb, gardener, or farmer. But you can do this in every environment whether you have a big garden, small garden, farm, yard or flat. Little kitchen compost bins are easily attainable and easy to use to turn your food to mulch and if you don’t have an arboretum to use this on, you can share it with neighbor’s or local farms through app’s like ShareWaste, which find people around you that you can give your compost to so that they can use it for fertilizer.

Whether you keep the little bin in the kitchen or outside is completely at your discretion but for such an easy way to reduce your carbon footprint, it’s definitely worth thinking about!

A Crummy Guide to CQC's New Guidelines

Written by: Georgia Dossis

In a bid to make the process easier for surgeries as well as fit into new guidelines, CQC have decided to change part of their framework on how they will begin assessing care providers going forward.

So far, they’ve explained that their five statements Safe, Caring, Responsive, Effective, and Well-led (SCREW) domains are staying, along with their four-point rating scale (Outstanding, Good, Require Improvement and Adequate).

However, they will replace their Key Lines of Enquiry, prompts and rating characteristics with new ‘quality statements’ to reduce duplicates in the four-assessment area’s and make it essentially easier for providers to follow.

To make their judgement consistent, their new framework includes the below six categories for the evidence that they will collect:

• people’s experiences
• feedback from staff and leaders
• observations of care
• feedback from partners
• processes
• outcomes of care.

The way that they will use their new framework, is that they will continue to use inspections via site visits so that they can get evidence to assess quality, use a range of information to assess providers flexibly and frequently (this is not tied to a previous rating) and produce shorter and simpler reports showing the most up to date assessment.

Which going forward means that providers can be clearer on what is expected of them from the assessments, the reports will be simpler to read and all in all will result in better quality patient care.