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Welcome to the Howe of Fife Medical Practice
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Non-urgent advice: NOTICES
DIGITAL INFORMED CONSENT - EMAIL OF PHOTO
WHY a photo? - Your Clinician would like to see a photo to help with your consultation; this will allow a more accurate diagnosis and plan to be made.
WHAT options - If you cannot provide a photo you can have a face-to-face consultation.
WHO will see it - The Clinician dealing with your care will be able to see this photo and it will be stored in your records. In future, other clinicians and administration staff (who are also bound by confidentiality) will be able to see this photo in your records should they need to access your records during the course of their work. The photo may be shared with other clinicians for your care, e.g. if referring you to another service.
HOW -
- Please email your photo to fife.f21101howeoffife@nhs.scot
- Subject Line: For the attention of Name of Clinician
- Body of Text: Patient Name & Surname and DOB (a brief description if required, i.e. Right Ankle)
The photo will only be used for direct care, unless you give us permission to use it for teaching or other purposes, e.g. writing an insurance report. The photo would also be provided if a court required your records in relation to legal proceedings. Please note that a photo from your phone to the Practice email is not a secure link and may expose you to cybercrime for which the Practice cannot be held responsible.
WHERE - The image will be stored in your GP records for as long as you have them in the United Kingdom and should be transferred if you move to another GP Practice.
ARE YOU CONSIDERING A PRIVATE OPERATION ABROAD?
Patients who make the decision to have surgery overseas do so at their own risk and may not be aware that the NHS has no contractual obligation to provide routine pre and post operative care on return.
All care required should be provided within the package of care sold by the overseas provider.
Links
Waiting Time Information
As NHS Fife recovers from the impact that Covid-19 had on a number of specialties, waiting times may be longer than usual. If you would like more information on waiting times in Fife, please visit the dedicated waiting times pages on NHS Inform:
The waiting times pages detail:
- typical waits in health board areas by speciality
- how many patients were admitted for treatment in the latest quarter
Find out more by visiting NHS Inform:
POSITIVE PREGNANCY TEST - WHAT NOW?
EARLY PREGNANCY CLINIC
https://www.nhsfife.org/earlypregnancy/
NHS service offers a 24 hour telephone triage service along with a face to face clinic for women who experience problems in early pregnancy.
ONLINE ELEARNING COURSE TO HELP PREVENT DIABETES
INFORMATION ON PREVENTING DIABETES
https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/prediabetes
SELF HELP GUIDE - CHECK YOUR SYMPTOMS
https://www.nhs24.scot/check-your-symptoms/
NEED HELP TO STOP SMOKING?
https://www.nhsinform.scot/care-support-and-rights/nhs-services/helplines/quit-your-way-scotland
Mental Health
If you are 18 and over, experiencing emotional distress affected by social circumstances; and/or persistent poor mental well being despite mental health problems being treated; and/or a long-term health condition where there is an adverse effect on mental wellbeing. Discuss this with your GP/ANP or Practice Mental Health Nurse as they may be able to refer you to the Link Life Fife Community Connectors Project
The Well
For anyone over 16 drop in centres and virtual appointments available
https://www.fifehealthandsocialcare.org/your-community/the-well
The Well can also be reached by calling 03451 551500
HELP FOR ADULTS AND OLDER PEOPLE
Repeat Prescription Collection Notice
THE POPULATION IN THE AREA IS GROWING AND DEMANDS ARE HIGHER CAUSING EXTRA STRAIN ON OUR PHARMACIES.
WE ARE STILL ABLE TO PROCESS YOUR PRESCRIPTION WITHIN 2 DAYS - PHARMACIES REQUEST THAT YOU NOW PLEASE NOW ALLOW UP TO 7 DAYS FROM ORDERING YOUR REPEAT PRESCRIPTION FROM THE SURGERY BEFORE COLLECTING FROM YOUR CHOSEN PHARMACY. IF YOUR REQUEST IS URGENT PLEASE LET GP ADMINISTRATION STAFF KNOW.
Thank you.
Right Care Right Place
Our administrative staff have been trained to ensure that they help you receive the right care in the right place at the right time. For this reason they will ask some questions when you call the practice to ensure that this is achieved. Please be reassured that they are bound by the same confidentiality standards as our clinicial staff. Thank you for your understanding and cooperation with this. Click here to use the NHS symptom checkers to assess your symptoms and find out what you should do next.
https://www.nhsinform.scot/
Why are your GP practices now unable to do everything they once were?
General Practice across the Country has been struggling for years. However it has now reached a critical situation with less money, less doctors and less staff to meet the growing needs of the Scottish population. So how did we get here?
In 2017, the Scottish Government recognised this and promised to introduce a new Contract, starting in 2018 and to be fully implemented within 3 years. At the time, the then Health Secretary Shona Robison MSP said “We equally recognised the fundamental challenges faced by general practice, not least growing workload and increasing risk”.
Unfortunately, for the first time in the history of the NHS, large parts of this contract have not been implemented. Even worse, when Health Boards haven’t been able to spend the money that they were given to employ additional pharmacists and other professionals to support General Practice, the money has had to be returned to Scottish Government rather than being able to be spent supporting your local practice.
Scottish Government promised transitional payments to Practices to recognise the non-delivery of this contract, but then withdrew that funding, even after some practices had already used the money for additional cover.
There have been many further challenges both local and National since then:
Many Practices in Fife are facing increasing bills for their building costs such as mortgages, rent payments and utility bills. Without any additional funding coming into practices, their financial situations will deteriorate and it’s likely this will lead to reduced staffing, with fewer appointments and longer waits to be seen.
All Practices in Fife are impacted by Scottish Government not funding an increase in compulsory pension contributions. This is only occurring in General Practice in Scotland; the English and Welsh Governments have already committed to paying this, and there is funding in place for all staff in hospitals. Therefore, these payments come out of the funding available to Practices to pay for administrative staff, nurses and doctors.
Many people don’t know that the funding for Practices comes through a National formula and doesn’t reflect how many times patients are seen. Practices are paid the same whether you are seen once or a hundred times per year. In 2017, the Scottish Government recognised that it wasn’t sufficient and promised to move towards a new funding model. This still hasn’t happened, and the funding uplifts have been substantially below inflation since then.
The average patient used to contact their Practice 3-4 times per year. This has increased to 6-7. The reasons for this are multiple and include an increasing elderly population, more people with illness (often multiple) and more available treatment options. The large growth in waiting lists has also had a big impact, with GP appointments being taken up with ongoing management whilst awaiting hospital investigations and procedures.
GPs are in demand. There are many roles and jobs that require the skills of a GP, so the GP that you see in your practice will likely be working “full time” hours across fewer, longer days with other days spent in these other roles or undertaking caring responsibilities for their families.
Part of the funding which comes from Government every year is earmarked for non-GP staff pay rises e.g. receptionists, nursing staff, practice managers. This has always matched what was given to staff working elsewhere in the NHS. For the first time last year, the Scottish Government decided to break this link, meaning practices had to fund the shortfall or risk losing staff.
The number of GPs in Scotland is falling. As part of the 2017 contract the Scottish Government promised that numbers would rise by 800, however when doctors in training are excluded from the figures, the numbers are actually reducing! Since 2013, the GP WTE (whole time equivalent) workforce has fallen by 5.35% - a fall of 196.7 whole time equivalent GPs. In that same time period, the number of practices has fallen by 9%, average practice list sizes have increased by 18% and the total patient population has increased by 7%. 42% of practices in Scotland report at least one GP vacancy. The number of GP partners has reduced by 14% between 2012 and 2022. In the last 20 years the ratio of GPs to hospital consultants has halved, despite many things which used to be done in hospital now commonly being done in practice, and this reflects the falling share of the NHS budget spent in General Practice.
In many areas, Practice buildings are too small and are outdated. Unfortunately, Scottish Government has now cancelled all funding for new builds, leaving many working out of buildings no longer fit for purpose. Scottish Government has also withdrawn sustainability loans, a scheme to reduce the risk for GPs who own their building. This leads to financial loss which again impacts on the services they can deliver.
With less staff and more work, better IT would help improve efficiency. Our IT is cumbersome and unreliable which often impacts on the care of our patients, increasing inefficiency and damaging staff morale. We are the only country in Britain still using paper prescriptions - this alone costs a huge amount of clinical, administrative and patient time.
In order to make systems better we need time to learn and develop. We used to receive regular half days to work with our teams on making practices better for everyone. The support for this was withdrawn by NHS24 and Scottish Government have done very little to reintroduce any form of reliable support, although our local health board have tried to reintroduce this recently.
Incredibly, despite all that we have just described, your Practice remains absolutely committed to provide the best service that it can.
However, if you’re not satisfied with the service you receive, look beyond the Practice and instead hold those with the power to improve matters to account. Scottish Government needs to do more to directly support General Practice, the bedrock of the NHS. Please contact your MSP. Their contact details can be found at Members of the Scottish Parliament (MSPs) | Scottish Parliament Website
Fife LMC
June 2024