The Nuffield Practice

What is social prescribing?

Lots of things can make us feel unwell. Some of these are medical problems that need medical treatment, others are more about the dificulties we all face, at times, in our day-to-day lives. 

Social prescribers work with people 18+ and can support you to connect to all the different non-medical services, support, activities and opportunities that exist locally and in your community. They work with you to find support that is tailored to your needs, and which could improve your health and wellbeing, helping you live life to the full. 

Oxfordshire Mind is here to support your mental health and overall wellbeing. 

New Age UK Oxfordshire physical activity classes at Witney Corn Exchange. Next Course of Stay Strong and Steady in Chipping Norton starting early January

• Stay Strong and Steady– a free 12 week Falls Prevention Exercise and Information course
• Strength and Balance Exercise Class
• Class details and referral information below – We welcome new referrals for Chipping Norton Falls prevention course
• Referral Form and promotion leaflets/posters attached.

Carers Oxfordshire is a free service that offers information, advice and support to unpaid adult carers of someone living in Oxfordshire. 

If you are 18 or older and another adult, child or both, relies on you for help to do everyday things, support is available for you.

The support we provide is personalised, enabling you to identify your own needs and make choices about how and when you are supported.

We know that your health and wellbeing are important, so whatever your situation, we want to make caring easier for you.

You can visit the Carers Oxfordshire website HERE 

 Eligible groups this Autumn 

• adults aged 65 years and over
• residents in a care home for older adults
• individuals aged 6 months to 64 years in a clinical risk group (as defined in tables 3 or 4 in the COVID-19 chapter of the Green Book)
• frontline NHS and social care workers, and those working in care homes for older people

The eligibility is the same across the 4 nations of the UK (England, Scotland, Wales and Northern Ireland).

We all know how tough it can be to stay on top of our health, especially during times of stress. It's easy to overdo it and lose track of our drinking habits. But don't worry, DrinkCoach has got you covered.

With DrinkCoach's quick and confidential test, you can easily keep track of your drinking and get personalised advice online. Because at the end of the day, it’s about making responsible choices and taking care of ourselves.

So don't wait any longer, take two minutes out of your day and find out your score today drinkcoach.org.uk/oxfordshire-alcohol-test

CQC Report - 15th March 2024 

Our view of the service

The Nuffield Practice is a NHS GP practice which provides primary care services to patients in Witney. We carried out an announced assessment of one quality statement, Equity of Access, under the key question of Responsive on 25 March 2024. We carried out the assessment as part of our work to understand how practices are working to try to meet peoples demands for access and to better understand the experiences of people who use services and providers. Overall, the practice is rated as good overall and the key question responsive continues to be rated as providing a good service. We recognise the work that GP practices have been engaged in to continue to provide safe, quality care to the people they serve. We know colleagues are doing this while demand for general practice remains exceptionally high, with more appointments being provided than ever. In this challenging context, access to general practice remains a concern for people. These assessments of the quality statement Equity in Access in the Responsive key question includes looking at what practices are doing innovatively to improve patient access to primary care and sharing this information to drive improvement. Leaders understood the challenges to patient access and used patient feedback and other information to monitor and improve access in a way that met patient needs.

People's experience of this service

Feedback from patients regarding access at the practice was positive as demonstrated from data from the national GP Patient Survey, NHS Friends and Family Test (FFT) and via Give Feedback on Care through the CQC website. A representative from the Patient Participation Group (PPG) reported positive access to services for patients and the practice worked closely with the PPG to continue to identify where they could make improvements.

National guidance expects long-term involvement of specialists in reviewing these patients and their medical treatment, but this does not currently happen in Oxfordshire.

Therefore, in line with county-wide safety recommendations, the practice has taken the difficult decision that any requests from specialists, both NHS and private, to prescribe ADHD medications to adult patients, will be declined. Also, we will no longer be able to supply ADHD medicines safely to adult patients who have obtained these medicines from the practice in the past. We will be making this clear to providers of ADHD services, at the point we refer patients for a diagnostic assessment.

Care of adults already receiving ADHD treatments remains under careful review. Patients may be able to access the care they need outside of the NHS, for instance by seeking a referral to a private provider from their NHS GP or NHS specialist. As your NHS GP, we will not enter into “shared care” arrangements with private providers.

The practice feels strongly that patients should not be left without the care they need, due to a lack of comprehensive NHS funding, and our local representatives have raised this issue with local funding and decision-making groups. By taking this stand with other Oxfordshire GP practices we hope that a safe service will be funded. 

If you also wish to raise this issue, please contact the “planned care team” at BOB ICB, This email address is being protected from spambots. You need JavaScript enabled to view it., and/or your MP.

We understand that some of our patients may have been unable to view certain documents (e.g. letters from the hospital) when using online services due to a software problem.

We sincerely apologise for any inconvenience this may have caused.

We are pleased to inform you that this issue has been resolved; any new documents added to your electronic GP health records will be visible and it may take up to a month for older, affected documents to become visible.  

Your GP team will have been able to access the letters, so your care will not have been affected during this time. 

FEAR OF FLYING

Patients come to us, asking us to prescribe diazepam for fear of flying. There are a number of very good reasons why prescribing this drug is not recommended.

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 4 hours.

3) Whilst most people find benzodiazepines like diazepam sedating, a small number have paradoxical agitation and increased 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 treating phobia. Your doctor would be 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 a number of 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. We have listed a number of these below.

Easy Jet    http://www.fearlessflyer.easyjet.com

British Airways     http://www.flyingwithconfidence.com/courses/venues/glasgow 

 Virgin     https://www.flyingwithoutfear.co.uk/fear-of-flying-courses/adult-course/ 

What is changing:

There will be an ability now to pre-book appointments with GP in the future: both phone and face to face.

You no longer need to phone up on a specific day that your GP is in.

Online “e-consults” will be available Monday - Thursday from 18:30 to 21:00, and on a Sunday from 16:30 - 21:00.

We are being more transparent with our patients about our capacity for GP appointments, and aligning our work patterns with the BMA’s statement on safe working in General Practice. (https://www.bma.org.uk/advice-and-support/gp-practices/managing-workload/safe-working-in-general-practice)

Individual GPs are also spreading their capacity throughout the week.

Why is this changing:

Prior to the COVID-19 pandemic we changed our appointment system by having all requests for GP appointments to be triaged first (usually by telephone). This was in response to patient complaints that the wait for appointment was too long. By triaging appointments and dealing with as much as we could remotely, we increased our throughput of consultations with patients receiving GP care far quicker than before. As it happens, the nature of the COVID-19 pandemic prompted GP practices nationally to adopt a similar system for differing reasons.

However, the need to phone was frustrating for patients and the volume of work was exhausting for our GP staff.

Most of our GPs work 10-12 hours a day a week, mostly 3 days a week or more, with additional hours working from home when not at the surgery doing important work which is not directly patient facing but vital for patient care. This works out at around what most people would regard as “full time” over the course of a week.  On a typical day in our old system any one GP may have 30 to 60 patient contacts (mainly by phone). This is more than the BMA’s recommendations on safe working intensity for GPs. We have three to five GPs in on any one day. 

What is not changing:

There will still be an element of telephone or online triage, especially for on the day capacity and to manage demand for appointments generally. The central problem has not changed: the demand for GP time is beyond the capacity we have to provide GP appointments. It is therefore envisaged that the wait for appointments booked in advance will run to several weeks.

We continue to encourage patients to self care were possible and seek alternatives to GP appointments where more appropriate.

Our GP mostly continue to work the equivalent of full time (approximately 37.5 hrs a week) over 3 or more days a week.

What we are continuing to do:

We are continuing to monitor how our appointment system works, and are seeking to expand our clinical workforce. Frustratingly, there is a recruitment and retention problem nationally with GPs. We are also seeking to expand our workforce to support our existing GP according to government's additional roles initiative as part of working in a Primary Care Network (PCN). 

This practice is supporting vital health and care planning and research by sharing your data with NHS Digital. For more information about this see the GP Practice Privacy Notice at:

NHS Digital's own website.

Note that consent to have your data shared in this way is automatic unless you opt out. 

What Data is Shared

Data may be shared from the GP medical records about:

•  any living patient registered at a GP practice in England when the collection started - this includes children and adults
•  any patient who died after 1 July 2021, and was previously registered at a GP practice in England when the data collection start

NHS Digital will not collect patients’ names or addresses. Any other data that could directly identify patients (such as NHS Number, date of birth, full postcode) is replaced with unique codes which are produced by de-identification software before the data is shared with NHS Digital.

This process is called pseudonymisation and means that patients will not be identified directly in the data. NHS Digital will be able to use the software to convert the unique codes back to data that could directly identify patients in certain circumstances, and where there is a valid legal reason.

To Opt out Of Data Sharing

If you would prefer that your identifiable patient data is only shared for your own health care purposes, you can opt-out by registering a Type 1 Opt-out or a National Data Opt-out, or both.

These opt-outs are different and they are explained in more detail in below. Your individual care will not be affected if you opt-out using either option (or both).

A Type 1 opt out has to be registered by your Practice; please let us know if you want to register a type 1 opt out.

A National Opt out can be done without contacting your practice, at https://www.nhs.uk/your-nhs-data-matters/

Type 1 Opt-out (opting out of NHS Digital collecting your data)

NHSD will not collect data from GP practices about patients who have registered a Type 1 Opt-out with their practice. More information about Type 1 Opt-outs is in the GP Data for Planning and Research Transparency Notice, including a form that you can complete and send to your GP practice.

The collection started on 1 July 2021 so if you do not want your data to be shared with NHS Digital, please register your Type 1 Opt-out with your GP practice.

If you register a Type 1 Opt-out after this collection has started, no more of your data will be shared with NHSD. They will however still hold the patient data which was shared before you registered the Type 1 Opt-out.
If you do not want NHS Digital to share your identifiable patient data with anyone else for purposes beyond your own care, then you can also register a National Data Opt-out.

 You can download a blank form here which you can then send to us by post or email.

National Data Opt-out (opting out of NHS Digital sharing your data with other organizations)

NHSD will collect data from GP medical records about patients who have registered a National Data Opt-out. The National Data Opt-out applies to identifiable patient data about your health, which is called confidential patient information.

NHS Digital won’t share any confidential patient information about you - this includes GP data, or other information, such as hospital data - with other organisations, unless there is an exemption to this.

To find out more information and how to register a National Data Opt-Out, please read NHSD GP Data for Planning and Research Transparency Notice.

If you’re a patient at our practice you can now use the new NHS App, a simple and secure way to access a range of NHS services on your smartphone or tablet.

You can use the NHS App to check your symptoms and get instant advice, book appointments, order repeat prescriptions, view your GP medical record and more.

You will also have evidence of your covid vaccinations on the App; useful for when you have to travel abroad.

If you already use any of the Patient Access providers, you can continue to use them. You can use the NHS App as well.

For more information go to www.nhs.uk/nhsapp

We have been part of the scheme for 3 years.

A map showing premises signed up to the scheme throughout West Oxfordshire can be found on the  WODC website.

https://www.safeplaces.org.uk/search/?query=West%20Oxfordshire%20District%2C%20UK&exact

For more information on the scheme, please see:

https://www.westoxon.gov.uk/communities-and-leisure/community-safety/safe-places/
https://www.facebook.com/SafePlacesOxfordshire/?ref=hl

There is also an App which you can download here:

https://www.safeplaces.org.uk

Community Connect

Medicine that doesn't come in a tube or bottle!

Community Connect, a new Social Prescribing service which helps with people’s health and well-being, is now available at the Nuffield surgery. It links people with community activities to improve mental and physical wellbeing and reduce loneliness.

Social Prescribing is a way in which people living with long term conditions can get access to a variety of support services they need. Issues like help with getting a job, housing, debt management and social contact. Help with these things is often available through local authorities, charities and local community organisations.

Social Prescribing means that the individual can build their support links by working with a Community Navigator who does know, or who has expertise in finding out, what is available.  Following a referral from the GP, together with the Community Navigator, the individual can discuss their problems and identify the support that they need to manage their own health more effectively and meet their own personal goals.

Get in touch: This email address is being protected from spambots. You need JavaScript enabled to view it.

Find out more at: https://www.canosn.org.uk/Pages/Category/community-connect