Ear Syringing at The Hall Practice will no longer be available from 1st May 2018
Regrettably due to the increased demands on our service we are no longer able to offer an ear syringing service. We have continued to offer this service for as long as we could without receiving any funding to do so but unfortunately the Partners have had to come to the difficult decision to prioritise the services for which we are contracted by NHS England. This procedure is not included in our GMS contract. We apologise for any inconvenience this may cause but we are sure you will appreciate that we need appointments for things that are specified within the 'core contract of services that we have to provide'.
If you would like information about ear wax and products available over the counter please read our Ear Care Guidance.
Another option available to you is to find a private provider such as:
- Chalfont Hearing Centre, 01494 765144
- Aston Hearing, 01494 733840
- Help in Hearing, 0345 222 0579
- Rickmansworth Earwax Removal Clinic, 0800 1337 987
Disclaimer: The Hall Practice takes no responsibility for services given by other private providers.
View your medical record online from the 22nd March 2016
For more information and details on how to register go to the Online Services page.
Some infections could become untreatable
"Surgeries that handed out the fewest pills do not have higher rates of serious illnesses," the Daily Mail reports.
A new study looked at the impact of prescribing patterns of antibiotics by GPs. The researchers were particularly interested in seeing what happened in practices where GP's did not usually prescribe antibiotics for what are known as self-limiting respiratory tract infections (RTIs).
RTIs include coughs, colds, and throat and chest infections that normally get better by themselves. Using antibiotics to treat these types of infection is not recommended as it can contribute to the growing problem of antibiotic resistance.
Researchers wanted to look at two main outcomes:
- whether a reduction in antibiotic prescribing would lead to an increase in RTI rates
- whether a reduction in antibiotic prescribing would lead to an increase in potentially serious RTIs, or a serious complication of an RTI, such as meningitis
Researchers assessed prescribing patterns and RTI incidence rates in more than 4 million patients across 630 GP practices in the UK. They found that reduced prescribing did not necessarily put patients at any greater risk of RTIs, or serious complications, except for a very small increase in pneumonia (0.4% yearly).
The researchers hope that findings from this study will help raise awareness about the importance to public health of only using antibiotics when necessary.
Giving a patient antibiotics for a cold or cough, just to reassure them, rather than meeting a clear clinical need, should be a thing of the past.
Where did the story come from?
The study was carried out by researchers from King's College London, the University of Southampton, University of Bristol and The Health Centre, Oxford. It was funded by the UK National Institute for Health Research Health Technology Assessment programme initiative on antimicrobial drug resistance.
The study was published in the peer-reviewed British Medical Journal (BMJ) on an open-access basis, so is free to read online.
The Daily Mail's coverage of this study was generally accurate, giving a balanced report on the study and its potential implications.
What kind of research was this?
This was a cohort study which aimed to determine whether the incidence of some diseases was higher in general practices that prescribe fewer antibiotics for self-limiting respiratory tract infections (RTIs).
Cohort studies are able to suggest a potential link between exposure and outcome but, on their own, can't confirm cause and effect. It is possible that other factors influenced the incidence of respiratory diseases observed in this study.
What did the research involve?
The researchers used data from the UK Clinical Practice Research Datalink (CPRD), which contains records from about 7% of general practices nationwide. The database is considered to be broadly representative of the UK population.
Data from 2005-2014 was analysed which allowed for a cohort of 4.5 million registered patients. The study evaluated the number of first episodes of the following respiratory tract infections:
- pneumonia – infection of the lungs
- empyema – pockets of pus that collect inside the body; often between the outside of lungs and the chest cavity
- peritonsillar abscesses (quinsy) – a serious tonsil infection
- mastoiditis – a serious ear infection
- bacterial meningitis – a serious infection of the of the protective membranes that surround the brain and spinal cord
- intercranial abscesses – serious infections that occur in or around the brain
The researchers also evaluated the rates of RTI consultations and antibiotic prescribing per 1,000 patients, and the proportion of RTI consultations with antibiotics prescribed. This data was used to investigate the association between antibiotic prescribing rate and antibiotic prescribing proportion with rates of infective complications.
What were the basic results?
Overall, from 2005-2014 the results showed that reductions in the rate of antibiotics prescribed were not necessarily linked to any greater risk of respiratory infection apart from pneumonia.
- The RTI consultation rate continued in its long-term decline; it decreased from 256 to 220 per 100,000 in men and from 351 to 307 per 100,000 in women.
- The antibiotic prescribing rate for RTIs also declined from 128 to 106 per 100,000 in men, and from 184 to 155 per 100,000 in women.
- The proportion of RTI consultations with antibiotics prescribed declined from 53.9% to 50.5% in men, and from 54.5% to 51.5% in women.
- Over the same period, declining rates of incidence were observed for peritonsillar abscesses (1% yearly), mastoiditis (4.6%) and meningitis (5.3%).
- Pneumonia showed an increase of 0.4% yearly, and no clear change was observed for empyema and intracranial abscesses.
How did the researchers interpret the results?
The researchers concluded: "Antibiotic prescribing for RTIs might expect a slight increase in the incidence of treatable pneumonia and peritonsillar abscess. No increase is likely in mastoiditis, empyema, bacterial meningitis, intracranial abscess, or Lemierre's syndrome.
"Even a substantial reduction in antibiotic prescribing was predicted to be associated with only a small increase in numbers of cases observed overall, but caution might be required in subgroups at higher risk of pneumonia."
This cohort study aimed to determine whether the incidence of some diseases was higher in general practices that prescribe fewer antibiotics for self-limiting respiratory tract infections (RTIs).
It found that alongside reductions in the rate of antibiotics prescribed, rates of incidence for peritonsillar abscesses, mastoiditis and meningitis declined. Pneumonia showed a slight increase and no clear change was observed for empyema and intracranial abscesses.
The study had a good sample size, and represented the UK population well in terms of age and sex. However, there are a few points to note:
- As the researchers acknowledged, the study observed outcomes from a population perspective and therefore was unable to deal with variations in prescription at the individual doctor or patient level.
- This study only looked at data collected from GP surgeries, and prescription and infection incidence rates may be higher in emergency departments or out-of-hours practices which this study was not able to capture.
- Finally, due to its study design, these findings can't confirm cause and effect. It is possible that unmeasured confounders influenced the reported associations.
The researchers hope these findings will potentially be used in the context of wider communication strategies to promote and support the appropriate use of antibiotics by GPs.
Patients can also help by not pressuring GPs for antibiotics "just in case" they may need them.
Read more about how we can all help combat the threat of antibiotic resistance.
Friends and Family Test
Many thanks to all our patients who have completed our Friends and Family Test over the past couple of months (both online and by completing a survey at the practice) - you can see an overview of the results by clicking on "Friends and Family Results" on the right hand side.
We are currently reviewing the hundreds of responses and will be publishing a full response from all the team very shortly.
May we take this opportunity to thank all our patients for their views and opinions - we have been staggered by the positive response we have received.
FRIENDS AND FAMILY TEST - PLEASE COMPLETE ONLINE - CLICK LINK ON THE RIGHT HAND SIDE TO TAKE PART
IT/ELECTRONIC PATIENT RECORDS "STATEMENT OF INTENT"
FOR THE HALL PRACTICE
New contractual requirements came into force from 1st April 2015 requiring that GP practices should make available a statement of intent in relation to the following IT developments:-
- Referral Management
- Electronic Appointment Booking
- On line Booking of repeat prescriptions
- Summary Care Record
- GP2GP transfers
- Patient Access to records.
Please find below details of The Hall Practice stance with regards to these developments:-
1. Referral management
All practices must include the NHS Number as the primary identifier in all NHS clinical correspondence issued by the practice.
2. Electronic appointment booking
Practices are required to promote and offer the facility for all patients, who wish to, to book, view, amend, cancel and print appointments online.
We currently offer the facility for booking and cancelling appointments on- line. Please visit www.calcotmedicalcentre-hallpractice.co.uk to register for on line services or come into the practice.
3. Online booking of repeat prescriptions
Practices are required to promote and offer the facility for all patients, who wish to, to order online, view and print a list of their repeat prescriptions for necessary drugs, medicines or appliances.
We currently offer the facility for ordering repeat prescriptions on-line. Please go to 'Prescriptions' to register for Patient Access, the on line service.
4. Interoperable records/Summary Care Record.
Practices are required to enable successful automated uploads of any changes to a patient’s summary information, at least on a daily basis to the Summary Care record.
Having your Summary Care Record available will help anyone treating you without your full medical record. They will have access to information about any medication you may be taking and any drugs that you have a recorded allergy or sensitivity to.
The Hall Practice is already live with SCR. However, if you do not want your medical records to be available in this way then you will need to let us know so that we can update your record. You can do this via the ‘opt out form’ or on our website.
Please visit http://systems.hscic.gov.uk/scr for more information.
5. GP2GP record transfers
There is a contractual requirement to utilise the GP2GP facility for the transfer of patient records between practices, when a patient registers or de-registers.
It is very important that you are registered with a doctor at all times. If you leave your GP and register with a new GP, your medical records will be removed from your previous doctor and forwarded on to your new GP via NHS England. It can take several weeks for your paper records to reach your new surgery. With GP to GP record transfers, your electronic record is transferred to your new practice much sooner.
The Hall Practice confirms that GP2GP transfers are already active and we send and receive patient records via this system.
Please visit http://systems.hscic.gov.uk/gp2gp for more information.
6. Patient access to their GP record
Practices are required by 31st March 2016 to promote and offer the facility for patients to view online, export or print the detailed information from their medical record. I.e. information held in coded form.
Please visit http://www.england.nhs.uk/ourwork/pe/patient-online/po-public/ for more information
Information to support patients accessing online services
Patients will be able to access online services by visiting our website or by accessing the online services pages for the practices clinical system (see below).
EMIS Practices – (This is not currently active but we are working with our system supplier and it is our intention to have this facility available to patients by 31st March 2016)
Patient online access web site - https://patient.emisaccess.co.uk
User information page & how to guides http://patient.uservoice.com/knowledgebase
To use Patient Access, you can go to your GP practice to request a user name and password or you can register for this service online and book one appointment. Your identity needs to be verified when you attend the online booked appointment before you will be given full access to your clinical record. ID required: any photo ID and utility bill with your name and address visible.
How to give feedback to the practice about online services
To give feedback about the online services you can:
- Use the practice website to send an e-mail via ‘Contact us”
- Leave comments with the receptionist.
- Write a letter to the practice:
Mrs Cathy Slattery
The Hall Practice
Calcot Medical Centre
Chalfont St Peter