News

Steroid Treatment Cards - Inhalers

(25 Aug 2022)

The British National Formulary (BNF) now recommends that when patients use a high dose steroid inhaler to control their asthma or COPD, a small amount of the steroid may be absorbed into the blood stream.

When this happens, the body may reduce its own production of corticosteroid. This is the body's main stress hormone so it is particularly important during periods of injury or illness.

Then, if a patient stops their high dose steroid inhaler suddenly, e.g. if they suffer an injury or illness, there is a small chance of the body not having enough corticosteroid to cope with the injury or illness.

As a result of this recommendation, we have been advised to provide all patients taking a high dose steroid inhaler with a Steroid Treatment Card (please see the photograph above), which they should carry with them at all times.

Please click here to see which steroid inhaler doses count as a high dose. Your community pharmacist can help you identify if you should carry a Steroid Treatment Card & they can provide you with one if necessary.

Some challenges for The Corner Surgery in adopting this guidance are:

Our computer system does not allow us to identify all patients using high dose steroid inhalers automatically;
A patient's dose of inhaled steroid often changes over time - indeed some patients are advised to increase & reduce the dose themselves in response to their symptoms - so our computer records may not be accurate;
We do not have an accurate record of patients who have already been provided with a Steroid Treatment Card.

Therefore, we will be identifying patients opportunistically during their asthma or COPD annual reviews & by using computer searches, & directing patients/ carers to this webpage for further information.

If you prefer to carry a Steroid Treatment Card irrespective of whether your steroid inhaler dose is high or not, that is absolutely fine - they are available to collect at your community pharmacy & at the Surgery.

We recognise that this change in national guidance may cause some patients to worry but we must stress that any risk from stopping a high dose steroid inhaler is theoretical & very small.

By comparison, steroid inhalers have been used safely for many years and they are a vital treatment for many patients with asthma or COPD - the benefits are huge so please do not stop one without taking medical advice.

If you have any questions about this matter, please discuss it with our practice nurse at your next asthma or COPD review. It may be safe for some patients to wean their steroid inhaler dose if they have a particular concern.

Update on Face Coverings

(08 Jun 2022)

On 1st June 2022, NHS England & NHS Improvement updated its guidance on the wearing of face coverings in GP surgeries & throughout the NHS.

We have discussed this with our colleagues at The Marshside Surgery & following a risk assessment, we have agreed the following changes:

Patients, staff & visitors should continue to wear face masks within our consultation rooms, apart from when one member of staff is in the room alone, subject to any genuine medical exemptions.
Patients, staff & visitors will not be required to wear face masks routinely in other areas of the building unless it is their personal preference.
Patients with acute respiratory symptoms or other symptoms of potential Covid-19 infection should continue to wear a face mask at all times whilst in the building, including in our non-clinical areas. This will be identified by our reception team when booking appointments & text message reminders may be used for prebooked appointments. These patients will also be asked to sit away from other patients in our waiting room.
When assessing a patient with acute respiratory symptoms or other symptoms of potential Covid-19 infection, the assessor is responsible for cleaning the surfaces in their room using Clinell Universal wipes, opening the window to improve ventilation or using another consultation room, if appropriate.
We will review these decisions if the infection prevention & control guidance is changed again, or if we subsequently identify that any of our staff are extremely clinically vulnerable to Covid-19.

Please click here to read our full risk assessment & the relevant NHS England guidance. Thank you to all our patients for their continued support with this matter.

Dr Woodcock Leaving

(24 May 2022)

On Friday 27th May 2022, Dr Stephanie Woodcock is leaving the Partnership of The Corner Surgery. Dr Woodcock has been a much loved & highly respected member of the team for 10 years & we know that she will be greatly missed by staff & patients alike. She has prepared the following statement for our patients:

“It is with heavy heart that I have made the very difficult decision to leave the Partnership of The Corner Surgery. Over the past few years the increasing demands placed on GPs from the NHS, Government and the media have made it very difficult for me to be the doctor, employer and colleague that I aspire to be. I would like to thank all the patients, staff and the partners at the practice, for their support and kindness to me over the past 10 years. I am very sad to be leaving the surgery but it is time to start the next chapter of my life.”

For over 6 months, The Corner Surgery has been working hard to try to recruit GPs to replace Dr Finn, who left the surgery earlier this year, & Dr Woodcock. Unfortunately, despite placing advertisements both locally & nationally, we have been unable to recruit any additional regular GPs.

Therefore, from June 2022, Drs Mulla & Smith will be the two remaining Partners of The Corner Surgery. This has required a change to our clinical model whereby each day, alongside their own patient consultations, they will be supervising & supporting a variety of other clinicians & trainees.

In July, another Advanced Nurse Practitioner will be joining the team; from August, we will start hosting junior doctors at the practice; & from September, we should have a female GP in post again. During this transition period, we have engaged some locum clinicians to help protect our appointment capacity.

If your named, allocated GP was Dr Woodcock this has now been changed to Dr Smith. However, please note that our GPs do not hold specific patient lists so you may consult with any GP at the surgery depending on their day-to-day availability.

Drs Mulla & Smith & the staff of The Corner Surgery would like to thank our patients in anticipation of their understanding during these changes. GP recruitment & retention has reached a crisis point so we are supporting the national campaign to help Rebuild General Practice: https://rebuildgp.co.uk

Access to Appointments

(09 Apr 2022)

The demand for appointments, investigations & procedures throughout the NHS is far outstripping the supply. Whilst the Covid-19 pandemic has not helped with this issue, the main causes existed before the pandemic: fewer hospital beds, limited resources, a staff retention crisis & an ageing population. The Corner Surgery is working hard to support our patients during this time. However, we recognise that sometimes, patients are having to contact us more than once to arrange an appointment, & that patients can wait a long time in the caller queue for their call to be answered. We are truly sorry for this inconvenience.

Patients often ask us why when the waiting room appears empty, we are not able to offer more appointments. Our appointment system is now designed to avoid too many patients being in the waiting room at any one time, to improve infection prevention & control. Many of our patients now choose to have a telephone consultation rather than a face-to-face consultation; particularly for ongoing problems. Also, clinical appointments are just the tip of the iceberg of activity that takes place in General Practice - please see this webpage for some other examples:

The Iceberg of General Practice

Nevertheless, 90% of clinical contacts within the NHS occur within General Practice, for just 8% of the total NHS budget in England. The Corner Surgery is providing access to more clinical appointments than ever before, & more than the number of appointments that we are expected to provide. At the moment, many of these appointments are spent supporting patients who are waiting for a hospital appointment, investigation or procedure, including requests for us to try to expedite these. Therefore, in the North Mersey region, GPs & hospital specialists have developed the following policy, to help ensure GP surgery appointments are being used appropriately:

For patients who have not had a first hospital appointment yet:
- All patients on the waiting list are prioritised according to the severity of their condition.
- Your GP may be able to write a letter requesting that your appointment is brought forward but only if your medical condition has worsened.
- If you think your symptoms have worsened, please contact your GP surgery.
- Your GP cannot write a letter just to move your appointment forward.
For patients who are awaiting a hospital follow up appointment, investigation or procedure:
- All patients on the waiting list are prioritised according to the severity of their condition.
- Your consultant team are responsible for reviewing you if your medical condition has worsened.
- If you think you need an earlier appointment, please contact your consultant’s secretary.
- The consultant team may bring your appointment forward if they feel it is necessary.

Thank you very much for supporting us to ensure our clinical appointments are used as effectively as possible.

Sefton Self Care Medicines Policy

(01 Nov 2020)

The Corner Surgery has been asked to promote the Sefton Self Care Medicines Policy to our patients:

Sefton Medicines Self Care Policy

This Policy is a list of over-the-counter medicines that are no longer recommended to be routinely prescribed by GPs, nurses or pharmacists. There are some exceptions included in the policy and our more vulnerable patients are reminded to use the Care at the Chemist service:

Care at the Chemist Service Details

The Care at the Chemist service ensures that patients who do not normally pay for their prescriptions have quick, easy and free access to medicines for range of minor illnesses and ailments without the need for a doctor’s appointment. Please watch the following video for details of the services provided at local pharmacies:

Many unnecessary visits to the GP or to the A&E department can be avoided through self care. When it comes to treating minor ailments and illnesses, it is important to examine your options. By simply visiting your local pharmacist and having a well stocked medicine cabinet, many conditions can be better managed at home.

Embracing self care is all about the little things people can do every day to live well and be healthy. Being active, eating well, stopping smoking, limiting alcohol to recommended levels, and learning when to treat common ailments without the need for a doctor’s appointment are all ways to embrace self care.

The Corner Surgery is now expected to adhere to the Sefton Medicines Self Care Policy (indeed, this has been included as a performance indicator in our contract with the NHS) so we thank you in anticipation of your support with this requirement.