We are receiving queries from patients asking for medication that they have been advised to get from their GP surgery.
Please note, it is the hospitals responsibility to provide patients with any new medication that is required on discharge for the first 28 days. It is not the GP Surgery responsibility.
The hospital is also responsible for organising any tests, including blood tests, when the hospital requires the results.
The NHSE guidance can be found here
The Primary Care Network policy is shown below
PRIMARY – SECONDARY CARE INTERFACE – BILLERICAY PCN
- PATIENTS SEEN IN OUTPATIENT CLINIC (VIRTUAL OR F2F)
If any new medication is initiated, it is the responsibility of the secondary care clinician to prescribe the first 28 days supply.
Secondary care retains responsibility for doing any monitoring that may be required within the first 4 weeks of initiation, which includes pre-screening and monitoring.
Any investigations (including bloods) required as part of the outpatient review should be arranged by the hospital clinician, and they are responsible for communicating the results to the patient in a safe timescale.
- PATIENTS DISCHARGED FROM HOSPITAL
28 days’ supply of all medication should be given to patients on discharge. Any monitoring requirements in the first 4 weeks after discharge should be organised by the hospital, including managing the results.
Any investigation requested during admission by hospital clinicians is their responsibility to follow up and they should not be asking GPs to chase investigation results in the discharge letter.
If patients require blood tests or injections to be given by community teams within the first 4 weeks after discharge, then these referrals should be arranged by the hospital team before discharge.
A&E doctors should refer patients to RACPC. Only the stroke team can refer to TIA clinic.
- FIT NOTES (Med 3)
Both surgical and medical teams are responsible for issuing Med3 certificates in outpatient clinic, and at the time of discharge, for the total duration of sickness that they may anticipate, not limited to a two-week period.
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Prescribing for patients travelling abroad
Malaria prophylaxis
- Antimalarials are not available at NHS expense for malaria prophylaxis and most medicines for prophylaxis against malaria are available over-the-counter at community pharmacies.
- If a prescription only medicine is required for prophylaxis, this will be prescribed privately and the practice may charge for providing the private prescription.
Non-NHS travel vaccinations
The following travel vaccines are not available at NHS expense when exclusively given for travel purposes:
- Japanese encephalitis
- Tick-borne encephalitis
- Meningitis ACWY (quadrivalent meningococcal meningitis vaccine; A, C, Y and W135)
- Rabies
- Tuberculosis
- Yellow fever
- Hepatitis B
- Combined hepatitis A and B vaccine is not supported for prescribing on the NHS for travel purposes within Mid and South Essex ICB. Patients requiring both vaccines for travel purposes should be offered hepatitis A vaccine as an NHS service and hepatitis B vaccine separately as a private service.
Prescribing ‘just in case’ travel medication
Prescriptions for medication which is requested solely in anticipation of an ailment whilst outside of the UK, but for which treatment is not required at the time of prescribing should not be prescribed on the NHS. This includes items to treat ailments such as travel sickness, jet lag, or diarrhoea. It also includes postponement of menstruation whilst abroad. These remedies can be either purchased over-the-counter; or if prescription only they should be treated as a private service and the practice may charge for the provision of a private prescription.
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IMPORTANT PATIENT NOTICE
Appointment with the most appropriate clinician
With a growing population and the shortage of qualified General Practitioners it is no longer possible to see a doctor for every medical condition that you may have seen a doctor for in the past.
As part of the new way of working within Primary Care the receptionists will be triaging every patient who requests an appointment to ensure that the patient is seen by the most appropriate clinician.
Reception staff are trained and empowered by the partners to triage all appointment requests.
The practice offers a range of clinicians who are more appropriate than a doctor to treat certain medical conditions.
Advanced Nurse Practitioner
Practice Nurse
Health Care Assistant
First Contact Mental Health
First Contact Physiotherapists
Social Prescriber
Pharmacist
GP Assistant
By booking an appointment with one of these clinicians frees up the doctor’s time to consult with the frail and chronic sick patients.
The receptionists are doing their best to help you and to signpost you to the most appropriate clinician.
The partners will not accept anyone being rude or demanding towards any member of staff. The practice operates an NHS Zero tolerance policy.
If you decide to decline the appointment that you have been offered, then you do have the option of sending in an eConsult via the practice website for a member of the clinical team to triage.
They will then signpost you to the most appropriate clinician.
Thank you for your assistance.
The Partners
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Carer Peer Support Group
The Billericay Medical Practice Patient Participation Group invite all Carers to join the Carer Support Group.
Structured Medication Reviews
As part of the Billericay Primary Care Network, (All Billericay GP Surgeries) pharmacists who are attached to the PCN have been asked to perform Structured Medication Reviews on behalf of our patients.
These reviews will be performed by a qualified Pharmacist.
You may therefore receive a call from either Beata or Wole inviting you to book an appointment for a Structured Medication Review with one of the pharmacist.
If you receive a call then please ensure that they clearly state that they are calling on behalf of the practice to book a Structured Medication review.
The Structured Medication Reviews are to review your medication only.
If you have any concerns on who has contacted you regarding this service or would like further guidance then please contact the surgery.
Sedative Prescribing for Flying or for Procedures (Diazepam)
Billericay Medical Practice does NOT prescript sedatives for fear of flying or for procedures such as MRI or CT scans. This policy decision has been made by the GP Partners and is adhered to by all prescribes working in the practice. The reasons for this can be found below:
1) Diazepam is a sedative, which means it makes you sleepy and more relaxed. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and those around you.
2) Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than four hours.
3) Whilst most people find benzodiazepines like diazepam sedating, a small number have paradoxical agitation and in aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law.
4) According to the prescribing guidelines doctors follow (BNF) Benzodiazepines are contraindicated (not allowed) in phobia. Your doctor is taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.
5) Diazepam and similar drugs are illegal in several countries. They may be confiscated, or you may find yourself in trouble with the police.
6) Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing, you may fail this having taken diazepam.
We appreciate that fear of flying is very real and very frightening. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines and we have listed a number of these below.
Easy Jet www.feariessflyer.easviet.com Tel 0203 8131644 British Airways www.flyingwithconfidence.com Tel 01252 793250 Virgin www.flyingwithoutfear.co,uk Tel 01423 714900
If you require a sedative for a procedure, then you should discuss this with the clinician or hospital who will be performing the procedure
Issuing of Prescriptions
After careful consideration, as from August 2022 the partners have decided to revert back and to issue prescriptions for 56 days, rather than the current 28 days.
This means that your prescription will be changed back to 56 days when it is next due to be re-authorised.
Saturday Morning Extended Hours Clinic
This is to inform you that from October 2022 we will no longer be providing an extended hours service on a Saturday morning at the practice
The funding for the extended hours service has been moved from individual surgeries and is now held centrally by the Billericay Primary Care Network.
All the surgeries in Billericay will continue to offer an extended hours service, but this will be run centrally by one provider out of one site.
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Integrated Care Systems (ICS)
The Health and Care Act 2022 has been given Royal Assent and will place Integrated Care Systems )(ICS) on a statutory footing from 1 July 2022.
Integrated Care Systems (ICS) are partnerships of health and care organisations that come together to plan and deliver joined up services and to improve the health of the people who live and work in their area.
Our ICS will be made up of two parts – Integrated Care Board (ICB) and Integrated Care Partnership (ICP) . The Mid and South Essex Integrated Care Board will be known as NHS Mid and South Essex
Our ICB will replace the five CCGs (Basildon and Brentwood, Thurrock, Mid Essex, Southend and Castlepoint & Rochford)
The Integrated Care Partnership will be a committee of the ICS jointly established between NHS and Local Authorities
There are four Alliances (place-based partnerships) across Mid and South Essex. These are Basildon and Brentwood, Mid Essex, South East and Thurrock. Alliances will work in partnership with local communities to improve local population health.
Chronic Kidney Disease
The practice is working with Healthy.io ( commissioned by the Basildon and Brentwood Clinical Commissioning Group) to provide and early detection service for Chronic Kidney Disease. If you are eligible for the service then you will be contacted by SMS or letter inviting you to take part in the screening service.
Your GP Practice team and how they are continuing to care for you and your family
Dear Patients
I am writing this letter in response to the understandable concerns of some patients about access to their GP, and to other members of the primary care team, following negative newspaper reports and unhelpful comments from some officials and politicians who should know better. General practice, including your GP practice in Essex, has remained open throughout the Covid pandemic and continues to provide the best possible care to patients despite the obvious strains on the NHS and our colleagues in Social care.
Appointments are now delivered either face to face, or by telephone or online, and “triage” or sorting of patient needs and requirements is now routine in order to provide the most suitable response in terms of effective and timely access to the correct clinician. You will have noticed an increasing range of professionals within your practice and its wider team, as this is intended to improve your access to care and to relieve pressure on your GP.
A few numbers to illustrate the problems faced by your practice:
- Nationally, 10% more GP appointments were delivered in the last year compared with two years ago, even though general practice is not an emergency service.
- 5 million appointments were delivered in general practice in May 2021, as well as 8.5 million vaccination appointments. (General practice has delivered around 70% of the successful national vaccination programme)
This illustrates the increasing demand on the service, and at a time when GP numbers are generally falling, meaning more patients than ever are trying to see each GP.
Many of you have been affected in different ways by Covid including Essex GPs and their staff. Though it may take years for the NHS to recover, practices will continue to provide services to our patients and at the same time are preparing for a challenging autumn and winter. The South Essex Local Medical Committee is aware of this additional strain and will continue to support practices to care for you and your family.
I ask that you work with your practice to maximise the care they can give both to you and your fellow citizens, and to remember that we are all in this together.
Best wishes
Dr Brian Balmer
Chief Executive, North and South Essex Local Medical Committees
Telephones
Our phone lines are busiest between 8 am and 9 am and then again at 2pm to 3pm. During these times you could experience up to a 20 minute wait. If you are not ringing for an on the day/emergency appointment you may find it easier to ring later in the day.
Kind regards - The Partners
Ear Syringing
Ear syringing is not carried out at this Practice
Please read the Ear Wax Patient Guide for information on how to care for your ears.
Ear irrigation is a non-funded service and is not part of the doctors NHS contract. Recommendation from the Basildon and Brentwood Clinical Commissioning Group is for patients in the first instance to use over the counter remedies
CCG commission services for Primary Care can be contacted on 01268 594350.
Latest News...
ACCESS TO INFORMATION IN YOUR PATIENT RECORD
From the 31st March 2016 the Practice will be providing an additional service through the on-line system. This service will allow registered users to see information that is coded in their medical records. Many of you have already signed up for access to the service for booking your appointments on-line and for ordering prescriptions on-line but to access this coded information you will be required to come into the surgery to re-register. This is because we do need to ensure that you are made fully aware of the service and the obligations of the practice and yourselves. You will be given a patient information leaflet in regard to the new service and, in turn, we will have to check your records to ensure that there is no sensitive material contained therein, prior to facilitating your registration. If you would like access to coded information or are new to the on-line service and wish to access everything, please call into Reception, WITH PHOTOGRAPHIC IDENTIFICATION, and speak to one of the Reception Team. Further information on this new wave of online services can be found on the NHS Choices website at http://www.nhs.uk/pages/home.aspx then search for Billericay Medical Practice, Billericay.
As part of our review of the on-line system we are going to be changing the age for enabling parents/guardians to access the service on behalf of their children. Currently, if you have access for one of your children this will be removed once they reach their 16th Birthday and the young person in your family will be notified accordingly. The new age will be 13 years.