HOW CAN WE SEE A DOCTOR?
Special report on medical centre
“I've seen staff in tears because of their desire to support all their patients … they are trying to do two jobs and have stretched resources and a lack of support”
PATIENTS are concerned that Wokingham Medical Centre is failing to meet its duty of care obligations.
Hordes of residents have contacted Wokingham.Today, concerned that the centre is struggling to help its 22,000 registered patients.
It has already been flagged as needing improvement by the Care Quality Commission.
These include one resident who lost out on a room at university after a £79 doctor's note was not sent on, and another who may lose their license if they are not signed off as fit to drive.
But a volunteer at the surgery told Wokingham.Today staff have been in floods of tears due to the situation.
The medical centre has declined to comment.
Lorna Shipton, who has type one diabetes, said if there was another surgery within walking distance, she would “switch in a flash”.
When she joined the medical centre in 2019, an error was made on her repeat prescription for insulin.
“It took three months to resolve it,” she said. “I was running out.”
Now, she is three months away from her driving licence expiring, because a doctor has yet to complete the fit note.
While her licence expired in September, Ms Shipton is fast approaching the extension expiry date.
“[The DVLA] wrote to my doctor on October 6, 2020, requesting he complete the medical report, but as yet have heard nothing back,” she said.
“I have called the surgery twice and have been told the request from the DVLA is sitting on his desk and there is nothing they can do.
“I have 14 weeks until this extension expires, and at that time I will be unable to legally drive.”
Ms Shipton said when she last phoned the surgery, she was told her named GP was busy giving vaccines.
“I thought they had a whole army of volunteers for that,” she said. “If he has time to do vaccinations, surely he should do patient forms.”
She also said as part of her diabetes treatment, she should have a HbA1c blood test conducted every three to six months to monitor her glucose levels.
“I had my last check in July 2019,” she said. “I haven’t had any notification for another.
“Patients with diabetes are not getting the care they need.”
She added: “The service provided by Wokingham Medical Centre has been impacted by covid without a doubt, but these issues started prior to the pandemic, and things have only got worse.”
Sharon Holmes, whose name has been changed for her privacy, said her son lost out on specialist accommodation at his chosen university, after the centre did not send the medical note in time.
After paying £79 in February for a doctor’s note detailing her son’s extensive allergies, Ms Holmes said she was told it would be sent to Nottingham Trent University within two weeks.
“It’s been two months, and we’ve had no reply at all,” Ms Holmes said. “On March 12, they told us it would be two weeks. We've emailed, and phoned, and we can’t get through.
“All of the medical rooms at Nottingham Trent have now gone, and we’re sitting here worrying whether or not we can get a room that meets my son’s needs.”
Ms Holmes said if an alternative cannot be found, her son will have to live at home, and look for a place at the University of Reading.
“People say money talks, but in this case it hasn’t. We’ve paid for something and not received it.”
She believes if the medical centre was better at talking to patients, many of the issues would be resolved.
“If the communication was there, people might understand a bit more,” she said. “As a community we want it to work well — we could even fundraise to support them.
“But it’s not being addressed and the surgery continues to get worse.”
Benjamin McClure, from Wokingham, said he was referred by the NHS 111 service for an urgent, same-day face-toface appointment with a GP.
He said NHS phoneline advisers were concerned that his swollen elbow could develop sepsis.
After calling the medical centre repeatedly to confirm his appointment, Mr McClure said he was unable to get through. Instead he visited the site, worried about the urgent need to see a doctor.
He said on arrival, the building was dark inside, with no cars parked in the doctor’s bays, and shutters drawn across the entrance.
“Besides the receptionist, the clinic looked completely empty,” he said.
“She was a bit like a robot, and said ‘sorry, we are not seeing anyone face-to-face due to Covid-19’ and just repeated that.”
Concerned that NHS 111 sent an urgent message to the clinic for a referral, Mr McClure said he phoned the national service again while stood in the car park.
“I reported the matter to NHS 111, who told me the clinic is not meeting its duty-of-care obligations,” he said.
Fearing the urgency of his situation, Mr McClure reached out to a private doctor who prescribed two rounds of antibiotics the same day to resolve the infection.
He said he “gave up” calling
Wokingham Medical Centre, and never heard from them to confirm his emergency appointment.
Volunteering on the ground
Lindsey Reece-Smith has been volunteering at Wokingham Medical Centre for a few months in various roles.
She told Wokingham. Today staff in GP surgeries across the country are tired and are desperately trying to support their patients.
“They have to have staff on the phones many days of the week trying to get patients supported and booked into clinics,” she said. “One of the many challenges is the number of patients who don't answer their phones when you ring them. Also the number who phone asking when the next clinic is or what is happening about the vaccine roll out.
“The reality is that there has been little guarantee or control of when vaccines arrive and some deliveries have turned up almost unannounced.”
She said staff at the medical centre have been crying due to the pressures of the situation.
“I've seen staff in tears because of their desire to support all their patients and the reality is that they are trying to do two jobs and have stretched resources and a lack of support,” she said.
This is due to balancing the demands of the vaccination programme and day-to-day patient needs.
“The latest government information is often announced on the BBC in the evening and surgeries are supposed to be putting it into operation the following day,” Ms Reece-Smith said.
“I have a whole new respect for GP surgeries and what they have to do day in, day out. They often get no thanks and only criticism.”
Instead, she encouraged residents to celebrate the surgery.
Lesley Jameson, whose name has been changed, told
Wokingham.Today it is “complete rubbish” for the medical centre to say the “service decline” is due to the pandemic.
“We need to understand why it's so bad,” she said. “There don’t seem to be other surgeries struggling in the same way.
“The problem is all with the admin side.
“I went to the surgery to book an appointment, and the person at reception said they haven’t got the facilities to make appointments at the surgery.
The only way to do it is by calling. That seems ridiculous.”
Ms Jameson, who requires blood tests every four weeks due to complex medical conditions, said without regular tests, the impact could be fatal.
“I was standing there at reception, and I told them, ‘If I don’t get this, I could end up in a coma and die’. I explained I needed regular tests and couldn’t get through on the phone — this is a real risk to patient life.”
Sir John’s concerns
On Monday, Sir John Redwood, MP for Wokingham spoke to Matt Hancock, secretary of state for health and social care, about the issue.
“I asked that GP surgeries should have a phone and internet booking system which allows a patient to get an online or face to face consultation as appropriate,” he said.
“I have been getting complaints where a surgery requires someone to ring at a single specified time each day to see if they can get an appointment that day.
“In the worst cases there is great difficulty in getting through at all.
“NHS surgery services should allow forward booking with good phone access as many good practices already offer.”
Sir John believes this is a national issue, and was told senior NHS management is working on the problem. He also suggested a minimum standard across NHS England.
Impact of the vaccine roll-out
Kevin Morgan, who is registered at Wokingham Medical Centre, said he fears that access to primary care has declined as the centre’s GPs were administering vaccines.
“I have seen medical staff from local surgeries at the Bradbury Centre giving injections during times that they maybe should have been giving primary care,” he said.
“The reason this makes me very annoyed is that in response to calls from the Government last year to join the Covid Army, I spent more than five months retraining as a vaccinator.”
Mr Morgan trained through NHS Professionals, an organisation that has been responsible for recruiting the community as vaccinators.
“This involved a massively complex process of online training, security clearances and face-to-face training, for which I had to go to
Southampton at my own cost, before I qualified at the end of April,” Mr Morgan said.
“Since this time I have not been able to book a single session as the system just shows no availability until the end of this year.” Mr Morgan said he was left fuming after escorting an elderly neighbour to Wokingham Medical Centre for her second vaccination last week.
“The queue was up Rose Street past the Bradbury Centre,” he said. “I spoke to a gentleman doing inoculations in the car park and I mentioned to him about my training.
“He said they are so short of staff they could only open three positions in the medical centre and said ‘we could do with you here now’.”
Mr Morgan said he fears the country has trained an “army” of vaccinators, and is instead “taking frontline medical staff to do the job”.
Cllr Charles Margetts, executive member for health at Wokingham Borough Council, said the Government has just created a new contract that requires GPs to meet all of their obligations alongside the vaccination programme.
“The new programme places a requirement on GPs to fulfill all their other obligations if they take the contract.”
He said this could result in some surgeries in the borough choosing not to take up the second contract, with vaccinations being moved to pharmacies so that GPs can care for other patient needs.
However this would only impact people who have yet to have any doses.
At the same time, Cllr Margetts said the vaccination programme is shifting from short-term, immediate response, to a medium- to longterm strategy, focussing on mass vaccination centres instead.
Part of this plan involves moving the mass vaccination centre at Madejski Stadium to another nearby location.
“I expect the demand for people who have been trained as vaccinators will increase from this point,” the councillor said. Jane Frances, whose name has been changed, said she fears her 93-year-old mother will see the quality of service decline.
“My Mother does not have a computer or a mobile phone where she can use apps and video conferencing,” she said.
“When I took [her] for her vaccinations, we had a form to read and a questionnaire to fill out which noted that the medical centre wanted to make changes so that they didn’t have to see people face-to-face as often.”
She is worried older people in Wokingham will struggle to access the same services with this change.
“The elderly must have had an awful time trying to get help during the pandemic with doctors holding them all at arms length or just not communicating,” she added.
Ms Holmes said her parents who live near to the surgery have struggled to get an appointment via telephone.
Instead, they have sometimes walked to the surgery to try to speak to someone.
“It’s hard for the elderly to cope,” she said.
Ms Frances said she is also concerned that with the digital changes, the Wokingham Medical Centre website has not been updated, and contact information removed.
“It has only noted the first round of covid vaccinations which were in January and has not been updated since,” she said. “There used to be emails you could contact staff with … these have disappeared.”
Nick Durman, from Healthwatch Wokingham, said they will be monitoring the issue closely.
“We are aware that nationally there is an issue of how GP services and other Health Services restart and reset following an unprecedented year,” he said. “We will be monitoring this closely and feeding back the experiences of patients and where appropriate highlight issues with the Care Quality Commission and Healthwatch England.”
A spokesperson for the Royal Berkshire NHS Foundation Trust & Berkshire West CCG said the surgery has been open throughout the pandemic and has been seeing patients faceto-face “when appropriate” following a telephone or online consultation.
They added: “We apologise if anybody is having difficulty speaking to somebody at the practice, the surgery is receiving a higher number of phone calls than usual which their reception team is working hard to answer as quickly as possible." Ms Holmes said she would consider moving to another surgery, and was concerned about the number of patients registered there.
“Something has to change,” she said. “As a town, we haven’t got the infrastructure to support all of these people.”
Wokingham Medical Centre has 13 registered doctors for its 22,764 patients.
Research has shown that taking on more than 2,000 patients per GP can result in a decline in care.
In England, the average GP has 2,253 patients, and Wokingham Medical Centre fares better than average, with 1,751 patients per GP.
Across the borough, Swallowfield Medical Practice has the highest patient-todoctor ratio, with one GP for every 2,366 patients.
This is followed by Woodley Centre Surgery which has 2,176 patients per doctor, Finchampstead Surgery which has 2,102 patients per doctor, and Loddon Vale Practice, which has 2,101 patients per doctor. Wargrave Surgery has the fewest patients per doctor, with 1,045 people per GP. What is your experience? Email jwarren@wokingham.today to share your story
Wokingham Medical Centre, NHS 111 and NHS Professionals were contacted for comment but declined, in favour of the CCG.
“The person at reception said they haven’t got the facilities to make appointments at the surgery”