Transcript - 

Hello, I'm Dr Lindsey Crockett, senior partner at Peninsula Practise, here to give you an update on Covid-related services.

Firstly, please may I ask anyone coming to the surgery to continue to wear face masks. This is for the benefit of our staff and your fellow patients, and helps prevent spread infection. We're seeing a lot of COVID affecting very many patients but also staff, and minimising the risks of this ensures that we can continue to provide a good service.

We're getting the vaccines delivered now, and in the next few weeks Covid clinics for the spring boosters, for those over 75 and others who are eligible, will be available. Our website will give details of when these clinics are. We're already vaccinating all our residents in our nursing and care homes, and by the end of next week, we will have completed all our eligible housebound patients.

Thank you for your patience and understanding that when we have significant staff sickness, due to mainly COVID, we do have to run an urgent only service. But in the main, we've been able to maintain a good normal service. If you do not agree, please do let us know by contacting our patient liaison lead, Sarah Fiddes, at our surgery. This way we can work together to improve our service wherever we can.

Thank you.

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Hello, I'm Dr Lindsey Crockett, GP partner for the Peninsula Practice. This is an update regarding our vaccine clinics and also around making an appointment.

All vaccine clinics are filling up and we're releasing further dates as they do. Please book if you're due your flu and we're also offering the COVID vaccine at the same time, if you'd like. We’re offering children's vaccination clinics as well and they are available during the half term week.

Invitations for vaccines are being sent by text for you to click on the links to book online. Alternatively, if this is difficult for you or if you're booking for a child, please call the surgery after 11:00am.

Regarding Therese Coffey’s announcement this week regarding her plan for patients, please know that if you need to see a GP the same day this has and always will be possible. Making appointments is very flexible these days and we offer same day appointments for urgent needs. You can also make an appointment several weeks in advance, and we also release additional appointments three days before. There are also appointments that our navigators, our care receptionists, can signpost you to which can also avoid delays in your care, such as our wellbeing and mental health teams, our social prescriber for non-medical needs, we also have same day physiotherapy, and many more available services. And all this information is on our website.

As always, please if you have any feedback or comments or ideas, we’re very keen to listen to what you would like, and do our best to provide an excellent service of care.

Many thanks.

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Hello, I’m Dr Lindsey Crockett, senior Partner at Peninsula Practice. This is a video update regarding our ongoing winter vaccine program; an invitation in the New Year to join us online for a menopause awareness presentation; and a plea regarding appointments booked but not attended.

Firstly, the vaccine program - this is going extremely well. We have given over 3,500 flu vaccinations and the same amount of covid vaccination to our eligible population. However, a quarter of eligible patients are yet to be vaccinated, and we are offering a clinic at Aldeburgh Surgery on Saturday 10th of December - please if you are one of those eligible and if you’d like your vaccination, book into this clinic.

We are seeing a significant rise in the number of Covid infections locally and also patients being admitted to hospital with flu are on the increase. With this in mind, we urge all patients to please wear masks, if you possibly can when you come to the surgery for face-to-face appointments. Covid, of course, affects our staff and we currently have staff off with the illness - we obviously want to be available to you to provide an excellent and safe service and mask wearing will help with that.

On a completely separate note, menopause awareness is something that’s been highlighted in the media and within the medical profession, and we at Peninsula would like to invite anyone who is interested in learning more about the menopause to join us for a presentation that I’ll be giving on the 5th of January from 7pm. If you’re interested, please call the Surgery after 11am to book yourself in and we will send you a link for that online zoom presentation in due course.

And lastly, this is an appeal to all our patients who need appointments. We have had a significant increase in the number of appointments that have not been attended once booked. This amounts to hours and hours of precious clinical time which could’ve been available to other patients that really need them. I would be most grateful if you could call us as soon as you know you’re not going be able to make your appointment and we could then release them. 

Thank you very much. Bye.

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[Presenter] That was the Health Secretary, the Conservative MP, MP for Suffolk Coastal, Thérèse Coffey, talking to BBC Breakfast’s Naga Munchetty within the last hour. But let's speak to Dr Lindsey Crockett from the Peninsula Practice covering Alderton and Aldeburgh. She's with me now.

[Presenter] Good morning to you.

[Dr Crockett] Good morning, Luke.

[Presenter] So, what do you make of Dr Coffey’s plans then this morning?

[Dr Crockett] Well, we all want the same thing, don't we? We all want, as patients, to have the right care at the right time. We need to see the right person, as well. Of course, Dr Coffey was describing how pharmacists might be upskilled and supported in providing an element of care, but there's a much wider health team than just GPs and I think putting the expectation and pressure, mentioning performance targets, on GPs as the caregivers only is not the only approach. And we have much wider members of the healthcare professional team and our voluntary groups in our communities that all can support wellbeing, health - physical and mental care.

[Presenter] Surely with the immense pressure that GPs are under at the moment, they don't need more targets, do they?

[Dr Crockett] We don't need more targets, but what we do need is the flexibility to be able to serve our patient population, and listen to our patients to find and understand, which we continuously do, understand their needs and provide for them. And we’re lucky at Peninsula, one of the top scoring standards for access and patient satisfaction; a recent survey told us that 99% of our patients were satisfied that their care needs were met, but that's not a sustainable standard with the staffing crisis and the winter we're about to enter. We need a lot of different approaches and particularly the flexibility to be able to spend any funds available in the way that we know our patients need.

[Presenter] What's your biggest fear, then, as a GP, with the ever growing population?

[Dr Crockett] The biggest fear is capacity, and wasted resources, as well. There's an enormous amount of work we can do, we're seeing senior, mature, experienced, wise GPs leaving, taking early retirement, or not becoming partners anymore, and becoming locums which doesn't sustain continuity of care. Relationships are so important in general practice, with our patients as people age and become more frail, we’re the best at identifying those needs and working with our teams and delegating to the right person to be able to support that patient’s stay, as well, and to live life, you know, fully before they die. And that's, you know, an integral part of general practice. But we also want to see our community supported, the national endeavour plans, I'm very keen to see the detail on that. Because there's an enormous power in our communities as well to support people from birth through ageing, to death.

[Presenter] And what about this new state-of-the-art phone system that they're talking about, that I've read about this morning for GP surgeries. I mean, how will that have an impact on, you know, people calling in at 8:00 o'clock in the morning, I mean are there other elements of the GP and patient experience that the Department of Health should be prioritising at the moment, rather than the phone system?

[Dr Crockett] Well, an example for my practice, and we’re a very rural, multi-site practice, last week I was in surgery and my phone lines went down four times during four separate consultations with our patients and I was told it was just an internet blip, it won't last long. That's enormously frustrating and difficult, and removes the time and continuity of that 10 minute consultation that we are allocated to be able to provide. So, if a whole lot of work is done on the digital offer and we also know that there are a number of patients who aren't able to access, you know, this sort of internet care, but that has a real place in medical provision of services, as well. A lot of thought, so I'm looking forward to the detail, really.

[Presenter] I bet. If you had five minutes for Thérèse Coffey, what would be your priority for her? What would you like her to deal with to start off, because she's got a huge challenge ahead of her, hasn't she?

[Dr Crockett] I would love to have five minutes or a whole session with Thérèse Coffey sitting in with me, in one of our surgeries, so that we could share the approach of her ABCD and look at the impact it has on primary care. But in various different locations; so, the needs of the rural population will be very different to the needs of an inner city practice, and hope that she will see some of the bureaucracy really gets in the way of us being able to provide that very patient-centred personalised care.

[Presenter] Will you be inviting her to your surgery?

[Dr Crockett] Already have.

[Presenter] Well keep us posted. We look forward to seeing whether she actually does join you. Thank you very much indeed for your time this morning Dr Lindsey Crockett there from the Peninsula Practice covering Alderton and Aldeburgh, giving us her thoughts on this statement that will be announced by the Health Secretary Thérèse Coffey a little later on today.

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[Presenter] This is quite alarming actually, an unpublished report by the Royal College of General Practitioners, which is being seen by the BBC, has found that more than 4 in 10 GPs in England are likely to leave the profession within the next five years. Now, the Royal College is warning that if those doctors do stop practicing, a service that, as we know, is already in crisis, could collapse altogether. The Department of Health say that a record-breaking number of GPs started training last year, but that takes time, doesn't it? And what could this mean for you, for me, for people who are vulnerable heading into winter and how easy is it for you at the moment to get a face to face appointment? I’d like to try and gauge this across the county this morning - if you’re listening to me, wherever you’re listening to me from, have you tried to get a face to face doctor's appointment in the last couple of days, the last couple of weeks and what happened? What were you told? 0800 141 2121. Let’s see what the situation is like in Suffolk. Have you tried to see a doctor face to face because you’re feeling a bit poorly? Were you knocked back, did you get one pretty quick?

Dr Lindsey Crockett is a GP at the Peninsula Practice covering Alderton and Aldeburgh, and joins us on the line now. Lindsey, good morning.

[Dr Crockett] Good morning, Wayne.

{Presenter] Now, we've covered this story an awful lot on the programme and I've a lot of it at first-hand experience here on the Wayne Bavin show team not being able to get to see a doctor and that's down to workload and that's down to the fact that it's just not enough of them. And then we get this information that 4 in 10 GPs are likely to leave within the next five years. That's going to be catastrophic, isn't it?

[Dr Crockett] It absolutely will be catastrophic. As you say, we're all feeling the absolute pressure and workload. I mean, you know, don't get me wrong, being a GP is a fantastic and rewarding career, and a great privilege, and what we all want to do is provide a safe and caring and effective service.

[Presenter] You will chat to other GPs - what would you think are the main reasons for this, why are people not wanting to stay in the profession?

[Dr Crockett] I think particularly when it comes to the more senior and experienced GPs, the responsibility with the lack of capacity to perform that and honour that responsibility is increasingly stressful and there are alternative job roles as a doctor elsewhere that people can approach without having to necessarily retire. But that is the main reason why we're losing GPs from the workforce. I mean if I can just give you an example, patients often asking, you know, why it's so difficult to see me and it's because there are so many other things that I have to do behind the scenes which directly impacts on patient care but as a senior GP and partner of the practice, I am taken away from those roles. For example, arranging investigations for patients, referring them on for further care, receiving letters from hospitals and ensuring that diagnoses are acted upon. The list is endless and additional to that, there is extra bureaucracy coming down the line where we again have to be taken away from patient direct care and look at the contractual obligations to fulfil.

[Presenter] What's gone wrong here? I remember when I was a teenager, not that long ago, 20 odd years, quite long I suppose, you could get a doctor's appointment the same day, you could get a doctor come out to your house if you were feeling that poorly. What's gone wrong?

[Dr Crockett] I think that the important thing to say is that should still be the case; so if a patient calls our surgery I would be very keen to know why they weren't able to get the appointment when they needed it. Now sometimes that takes an approach of understanding what is the need: if it's an urgent and necessary presentation of a clinical thing then that will be seen, you know, the patient will be seen that day and it might include a visit.

[Presenter] I know you can only speak from your practice, but I would disagree with that. I've run up my doctor a few times in the last couple of years and I get a receptionist asking me what my symptoms are and they’re judging whether or not I should see a doctor.

[Dr Crockett] Yeah, so this is where our receptionists are now being trained as navigators and they’re sign posting because of the GP workforce issues and that there aren't enough GPs for everybody to see. We are also recognising that actually the GP isn't the only person that a patient needs to see, and so we are asking our navigators nationwide to inquire the nature of the problem. That enables the patient to see the appropriate person at the right time, so nobody should be blocked from seeing or speaking to a GP at least, if they have a clinical need that they’re worried about and I think we need to do a lot of communication work between us and I'm really interested to hear what your listeners are saying as to the reasons because I think we really all need to understand how the system works. We certainly don't intend for our navigators or receptionist to clinically triage, that's not, that shouldn't be happening.

[Presenter] I think possibly that’s a conversation for another day. Let's get back to this report, this unpublished report that the BBC have looked at and read through. So, 4 in 10 GPs could leave the profession within the next five years. If that happens, Lindsey, what does that mean for patients?

[Dr Crockett] Well it means a very different NHS, I would say. I mean, I can't imagine managing with less clinicians than we already have. I mean, you absolutely need to have GPs but also the senior experienced GPs as well because things become very complicated especially as one ages and their needs are multiple and complex so I just can't imagine how the NHS service can sustain general practice if there are even less GPs than we have now.

[Presenter] If this report is right, it's 40% isn't it?

[Dr Crockett] Yes, it is.

[Presenter] That's nearly half of all our GPs. Now, the Department of Health are saying that there's a record-breaking number of GPs who started training last year. We don't have any figures on this, but how long does it take to become a good GP? Because surely once you come out of your training it's like driving a car, you kind of learn on the job once you get the qualification, once you pass your tests, if you will.

[Dr Crockett] Absolutely, I mean it takes 8 years as a minimum to become what we call a baby GP, you know just fresh out of having that training it is an 8 year course and that's eight years from year one of university, of course. And then, like you say, then you start to learn the ropes, then you had the wisdom to the experience and that can take years and years and years. So we're talking a long time ahead if we are even able to recruit new doctors that want to become GPs and of course once you become a qualified basic registered doctor that's when the choices come of what profession you want to join in the role of doctor and I can't imagine many people finding the GP role as an attractive career path at the moment.

[Presenter] And that was going to be my next question really, you know, how do you attract more people to it? It's not an attractive job role, it's in the press were talking about it every other day about the shortage. They did try to do something last week, the government, Therese Coffey, the health secretary did say that she would put some of that burden, that workload, will pass that onto pharmacists but as we chatted last week that's not going to work.

[Dr Crockett] Well, yeah, I mean there are some good initiatives to actually increase the workforce in different healthcare professional capacities, for example, as you mentioned pharmacists. But the pharmacists are only able to do so much and yet again it will come to the GP to make decisions and take the authority and the liability and the accountability that then takes a GP away from face to face patients, and you can see then the cycle, so the process. It's also the case that we really do need those other members of the workforce we have physios and just going back to when the patient rings and might want to see a doctor, if a navigator ascertains that patient for example has some back pain, they can actually see a physio the same day and this is the sort of approach that this extra work that Therese Coffey is talking about, can support general practice which translates to supporting our patients. But a lot of work needs to be done in understanding when it comes to that supervised accountability, the buck stops with the GP and the funding and the flexibility of the bureaucracy is not following at the moment.

[Presenter] Why do you think, Lindsey, that when you sign up to be a GP, that you have a certain duty of care to the public? So, GPs who are looking at leaving the profession, they are making the situation worse, or do you fully understand why they are?

[Dr Crockett] I think for years and years and years, GPs have tried really hard to understand, you know, if the bureaucracy is coming their way, how can we translate that into benefiting patient care. And I think if you get absolutely worn out and tired, and if you can't physically manage, mentally manage the responsibilities, probably shouldn't be in the profession. So, yes, I hear, you know, perhaps you're suggesting there's a duty of care to continue, but not if you're not feeling that you're, you know, safe and resourced, and able to meet the demands. Not if you're working regularly 50-60 hour weeks, not if when you're on holiday you’re continuously expected to respond to emails. Almost yesterday, you know, throughout the covid vaccine strategy, you know, we had to be answerable within minutes of some of the decisions that we had to make, and that was regardless of whether we were at work or not. Those sorts of things you can imagine will burn somebody out and wouldn't be the person I would choose to see with a condition that needed treating.

[Presenter] Look we're heading into winter, the flu virus we’re being told is going to come earlier this year, that there’s still covid knocking around, covid cases on the rise again, 4th booster jabs being given out as well. As we head into the winter, how's it looking in GP surgeries in Suffolk, Lindsey?

[Dr Crockett] Well I think we're fairly on top of things, as much as we can be, and, as you say, this additional work again comes to us to have to organise and manage. But we're very well versed in managing flu clinics and our practice has already gotten going with that: we’re  offering covid vaccines at the same time as flu for people who want them. So, we're doing our very very best, you know, with a very responsive alliance commissioning group as well to help us. But things do get in the way and it's often the bureaucracy and we really could do with more workforce but we particularly want our patients to understand, you know, that the best routes of getting to be seen by the right person, and will do as much as we possibly can to make that happen.

[Presenter] Can I ask how you feel? You don't have to answer, I understand it's difficult for you in your position, but do you see your future as being a GP or if somebody offered you another job in a couple of month’s time, would you seriously consider it?

[Dr Crockett] Honestly, I feel it's an absolute privilege to be working as a GP for the NHS. And every contact I have with a patient feels to me as a worthwhile thing to be doing, so I will carry on, I will find the energy and the strength, and I'm very fortunate to have a lot of that so far, I’m 54 and I'm not planning on going anywhere because my patients are what empower me in my own life

[Presenter] My goodness.

[Dr Crockett] An honest response from me.

[Presenter] We need those 4 in 10 that are leaving to be replaced by another Lindsey, I think, and they will be absolutely fine. Listen, Dr Lindsey Crockett, thank you so much for chatting.

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[Presenter] Around 1/4 of patients at Ipswich and Colchester hospitals have tested positive for the virus. One way pressure can be eased is through older people getting their covid booster vaccinations and Suffolk is leading the country in this delivery. Another key way is through providing people with information about staying healthy and promoting well-being. Guy Campbell has been to Aldeburgh to find out how one centre there is providing both of these services to help reduce the winter pressure on the NHS.

[Dr Crockett] Today we've got about 650 people booked in, which will take us up to over a third of our total eligible patients due to be vaccinated. We've got about 4000 patients, in all, to vaccinate and we will endeavour to do that in the next few weeks and complete.

[Reporter] Dr Lindsey Crockett is from the Peninsula Practice, she's at the Old Generator Station, a community centre which has for today become a covid and flu vaccination clinic.

[Dr Crockett] We are determined to do everything in our power to keep people as well as possible through this winter. We don't quite know what to expect together with the adversity with fuel costs etcetera, as well as, you know, no longer pandemic lockdown and covid is still very much in fact on the up at the moment. So, we're doing everything possible to keep people well.

[Reporter] We have the latest figures and says that the Suffolk and North East Essex areas are out-performing every other area in England in its delivery of the of the autumn booster vaccination - you must be delighted to hear that?

[Dr Crockett] Absolutely delighted to hear that. All of our patients individually are very special to us and we are very devoted. I have a fabulous team working with me and I know that colleagues in the area likewise, we have pulled our finger out, we have used all the staff available, sleeves up, heads down and we've been working hard. And our patients have been wonderful in being flexible to be able to come to the clinics that we provide.

[Reporter] Karen French is a social prescriber here to promote well-being and to help keep people out of hospital.

[Karen French] OK, so today I've talked about mostly about, frailty, about activities that can better balance, anything to do with making people much more active, talked about wellbeing, and referrals there, benefits is a huge thing, stop smoking. All those sorts of things today.

[Reporter] Vaccinations are so important we know, but there's more to it than that, isn’t there, when it when it comes to keeping older people safe during this time.

[Karen French] It’s the information they’ll give us to help them actually is what they'll share and often the referral will come across from the GPs with information but once we get talking to them, we do a discovery form, we find out that actually they’ve come over for weight loss but actually they’re depressed, they don't go out, they've got nobody to take them out, transport links are quite bad as we know, and they've got no friends at the moment neither -  they've lost all of that due to covid and actually covid is now frightening them from going out.

[Dr Crockett] We know that if somebody is struggling because of heating costs then they might not be keeping warm and that could lead to further illness and mental health difficulties and this is where a social prescriber can wrap around the patient and find out what matters to them, and provide them necessary sign posting or support.

[Derek] My name’s Derek, I’m a member of the patient participation group, and I’ve just been helping the practice in delivering the vaccinations today. So, we've got four cubicles being in service, and we've been able to get quite a good throughput of people. So, before lunch have done 300 and we've got another 300 to do, but actually the waiting time’s been amazingly good and often people don't even have time to sit down before they’re called to get the vaccination, so I think the feedback’s been very positive.

[Reporter] Vaccinations, be they very important, you've got a sort of a holistic approach to this, haven’t you?

[Dr Crockett] Yeah, absolutely, we know that people’s well-being includes their emotional and mental health, as well as their physical well-being and we want to offer support in all those ways. Now that doesn't just mean that a GP can be the centre of care for all those things. I think when it comes to self-care there's the immediate need, which I would call first aid, and that’s the mental as well as physical wellbeing. In terms of mental and emotional wellbeing it's important to check in with ourselves every so often; so we just reflect ‘how am I?’ and sometimes we can overthink and become quite negative and I think it's important to make sure that that doesn't gain power, and if it does then certainly, the resources that we can offer at the surgery and signpost people to the necessary services would be the right route.

[Presenter] And that was Dr Lindsey Crockett, GP at the Peninsula Practice covering Alderton to Aldeburgh, talking to our evening reporter Guy Campbell and we will have more on this a little bit later on in the programme.

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Hello, my name is Louise and I am a Lead Nurse at a GP surgery caring for patients with numerous conditions.

We know through many studies that air pollution does have an impact on people’s health. In the short term, exposure to high levels of pollution can exacerbate symptoms of people suffering from lung or heart conditions. Whilst longer term impacts can be associated with lung, heart and circulation disorders, it's important to understand that long term exposure to air pollution is not thought to be the sole cause of deaths, rather it is considered to be a contributory factor.

Air pollution is a local, national and international issue: we can all do our bit to tackle it. And there are simple things that we can do now to improve air quality. Things such as using the car less, walking short journeys, walking to the school and back on the school run, how about working from home one or two days a week if possible, or think about cycling to work if it's safe to do so.

We realise that many of us live in rural areas and need our cars for that very reason. But you can improve the effectiveness of your car by trying to stop it idling when it's stationary: just turn off the ignition. If you're burning wood in an open fire use a smokeless, well seasoned, quality fuel, as this will reduce the particulate emissions.

As a nurse, I was really interested to learn about the impact of Covid lockdowns on air quality: a survey by the British Lung Foundation showed that 1/4 of people with asthma noted an improvement in their symptoms.

Any improvement in air quality will have positive health consequences for everybody and there are simple steps to take that we can all do together now to make a real difference.

Thank you.