Willow Tree Family Doctors News Blog

When we visit patients at home we often find piles of old unused medicines, inhalers and other items. Not only does this present a hazard but it is a huge drain on the increasingly scarce  NHS resources. It is estimated that every year around £300m is wasted in unused medicines.  This would for instance pay for   11,778  MORE community nurses   or  80,906  MORE hip replacements   or  19,799  MORE drug treatment courses for breast cancer   or  300,000  MORE drug treatment courses for Alzheimer's   or  312,175  MORE cataract operations, so it is a major problem. How does it happen? Often with repeat prescriptions the whole lot is ordered each time, meaning over-stocking occurs, or when new medicines are started sometimes the old ones continue to be ordered. Sometimes  patients don't like to take the prescribed medicines or have side effects and stop them but are afraid to tell the doctor. Other times d...

It has been a long journey but we’ve finally made it: Willow Tree Family Doctors was approved as a Training Practice earlier today by Health Education England - North West London . This means that later this year we will hopefully be able to welcome Foundation 2 (F2) doctors to our wonderful team. The Foundation Programme is a  two-year training programme which forms the bridge between medical school and specialist/general practice training. Drs Dodhia and Mehrali , who have overseen the process, were also approved as trainers. F2 doctors remain under clinical supervision (as do all doctors in training) but take on increasing responsibility for patient care. In particular they begin to make management decisions as part of their progress towards independent practice. We believe that achieving and maintaining training practice status enhances the quality of the medical care that we provide at the practice. It also enables patients to see a wider range of clinicians whil...

Sustainability and transformation plans (STPs) have just been submitted by  NHS organisations in different parts of the country outlining the future of health and care services in their area. Ours involves the whole of North West London and involves the NHS services and the Local Authorities planning ways in which they hope to come together to deliver health and care in a more intelligent and integrated way, bridging the gap between social care and health services.  One of the principle themes now is cooperation rather than competition, which has  driven the way we work over the last 4 years (in, some would say, a very destructive and dysfunctional way). The other themes are, of course, diminishing resources - both money and people - and rising and changing patterns of demand and how to provide good quality care under these circumstances.  There will be a lot of re-balancing budgets and reshaping the types of services offered. There is simply no possibility of ca...

If you want urgent (unplanned) medical help where do you turn to – your GP, A&E,   a Walk In Centre , an Urgent Care Centre,   Minor Injuries Unit, or Out of Hours GP service, ring 999 or 111 ? In hours and Out of Hours the choices are rather different. This multiplicity of choices and the different options in each area makes for a very confusing picture and it is no wonder people often go to less appropriate places. There is a lot of duplication and very poor communication so that you have to repeat your story and there no access to your complete medical record held at your GP practice and the information about your urgent care contact may not filter back to the GP or other people involved in your ongoing care. You may be seen by a doctor or a nurse or another type of professional. And the cost is high; attendance at A&E is rising inexorably and you’ll have seen the headlines showing that the system is breaking and unsustainable in its present form. We ne...

Information Processing We in Brent CCG are part of the  North West London Collaboration of Clinical Commissioning Groups which is engaged on a huge project to integrate health and social care across the 8 boroughs of North West London ( Whole Systems Integration Pilot ).  A fundamental part of this is to link the information systems so if you are seen in A&E, General Practice, Hospital Outpatients, Community clinic, wherever, that appropriate levels of information flow across to enable safe, efficient care. Some of this information also needs to tell Social Services what you need to have in place when you are discharged from hospital, the Ambulance crew to understand your essential medical history in an emergency, the Palliative Care team to help give the most appropriate care and all the Community teams to coordinate their care properly. Surprisingly, most of the IT systems do not speak to each other and so there is duplicati...

It's that time of the year when all children get ill with coughs, colds and other viral infections often accompanied by fevers, vomiting and rashes and they can feel really miserable and distressed.  As adults we've all been through these infections and  as a result  our immune systems now give us resistance, so even if we get ill we usually don't feel so bad. And we can understand and know we'll feel better in a few days but a young child doesn't know this. When we see a sick child with a high fever it can be extremely worrying for a parent to know if it is part of a more serious illness and what should be done to make your child better. The NHS 111 service has produced a very useful booklet to help:                                                When should I worry? Signs of potentially more serious illness: Your child is drowsy or irritable . (...

There is a multiplicity of services in this increasingly fragmented NHS. Where do you go when you're ill?  With A&E waiting times typically of several hours and likely to get worse this winter, it seems many choose that option. But is it the best? If you you haven't had an accident and it's not an emergency (chest pain, collapse, loss of consciousness etc) then probably not.  Many people visiting A&E are making the wrong choice and are delaying the care of more urgent cases. Should they instead have chosen a walk-in centre, urgent care centre, GP out of hours service, visited a pharmacist or checked what to do on-line? So, how to choose, if you're not sure?  A good starting point is to ring NHS 111  which has a directory of all local services. If it's not urgent and they are busy, you may have to wait a while until someone calls you back. You will be asked about your problem and a computer will help the adviser to decide ...