Patients registered with the Freshbrook Surgery have seen the days they can see a doctor locally cut from five days a week to three.
The practice which is a branch of Ridge Green Surgery at Shaw Centre has been given permission to reduce opening hours on a temporary basis by the NHS England area team whilst a shortage of doctors applying to general practice positions is reviewed. See the reasons why doctor’s leave Swindon at the bottom of the page.
HealthWatch Swindon has been liaising with patients and NHS England and has been told that detailed discussions about the situation will take place by early August.
Several patients attended the West Swindon Forum on 14 July to express their concerns about the reduction in service, particularly to elderly residents of Elsie Hazel Court and Windmill Court close to the Freshbrook surgery, and also patients who live in two other sheltered dwellings in Freshbrook.
The two practices have a combined patient list of 10,100. Senior practice partner Dr Amit Dwivedi is encouraging patients who need to see a doctor to consider making an appointment at Ridge Green.
He gave an assurance that older people from Freshbrook who are unable to travel to Shaw, which requires two bus journeys, would be offered home visits.
Anybody who wants to express a view on the change of hours at Freshbrook Surgery can write to: Dr. Dwivedi, Ridge Green Medical Practice, Ramleaze Drive, Shaw, Swindon, Wiltshire SN5 5PX Email: email@example.com
The letter sent to Freshbrook Surgery patients advising them of the changes in practice hours from Friday 1 August
We write to inform you of temporary changes to the service provided at Freshbrook Surgery and ask for your help in the ongoing success and support of Freshbrook surgery and its service.
This letter contains important information.Please share with all affected registered patients in your household.
The key points are summarised for quick reference at the end of the letter.
Freshbrook Surgery merged with Ridge Green Medical Centre (on Ramleaze Drive, Shaw Village Centre, SN5 5PX) in May 2008. From this date all patients were registered under Ridge Green Medical Centre, however the Freshbrook surgery remained staffed and run as it always was for the convenience of patients.
Current challenge and position
The practice has recently seen the departure of Dr Rachel Blunt and other doctors reducing their working hours. This has created vacancies within the team and has affected the staffing levels across both practices. We are of course urgently recruiting for this position and in the meantime using locum staff wherever possible.
However, due to a number of pressures the availability of doctors to support the work at Freshbrook has also significantly decreased. We therefore urgently had to review how to utilise its staff across the two sites so that a safe, quality service can be maintained.
One of the key problems has been that many patients at Freshbrook Surgery have quite complex medical needs, which with modern medicine and protocols require much more involved care than ever before. Senior experienced staff such as Dr Dwivedi need to be available at both sites to provide support and help to existing and any future doctors working at Freshbrook and Ridge Green.
In order to help address this problem an extraordinary practice meeting with the Patient Group was held at Freshbrook Surgery on the 4 June 2014. This was attended by the Patient Participation Group with additional local Freshbrook patient representatives who depend on Freshbrook Services. This was an initial meeting to establish a working proposal.
The staffing situation was discussed at length and a number of options reviewed. Due to the overwhelming support of the Freshbrook Practice and our continued service to its patients, the option to close this surgery was not what the practice and Dr Dwivedi wanted to do.
Therefore, a temporary option was for Freshbrook to remain open on Monday, Wednesday and Friday only, with Ridge Green Surgery open throughout the week for telephone advice and appointments when the surgery is closed. This solution allows for Dr Dwivedi to be available for support at both sites and provide safe levels of cover with remaining staff, while ensuring patient services continue without too much disruption.
What Permission has been given?
To enable the practice to do this, the practice has received special permission from NHS England to change the opening days of Freshbrook Surgery to Monday, Wednesday and Friday initially for four months allowing the practice time to recruit to the vacancy within the team. Over the coming weeks we will be engaging patients and friends of Freshbrook and support groups to give their views on long term solutions and check how the temporary arrangements are working, with the help of NHS England.
We will need to apply these changes with effect from 1 August 2014.
What this means for you as a patient :
Freshbrook Surgery will continue to be open as normal on Monday, Wednesday and Friday (all day). Patients will be able to book appointments for either Freshbrook or Ridge Green clinics. If you need to telephone the practice on a Tuesday and Thursday your call will be diverted automatically to the Ridge Green Practice, the practice staff will take all your calls and be able to book appointments for either surgery and deal with your requirements. The practice has undertaken considerable training with the staff and put in place arrangements to ensure there will be minimum disruption to patient care and treatment .
Freshbrook Opening Times (01793 870494)
As of 1 August 2014 the opening times for our usual services and clinics at Freshbrook will be:
Monday 8.30am -6pm (closed 1-2 pm)
Tuesday – Closed
Wednesday 8.30am -6pm (closed 1-2 pm)
Thursday – Closed
Friday 8.30am -6pm (closed 1-2 pm)
Tuesday and Thursdays – please call the usual number for appointments and advice – appointments
will be at Ridge Green, Shaw.
Ridge Green Medical Centre, Shaw SN5 5PX (01793 874894)
will be open Monday to Friday 8.30am to12.30pm and 2pm to 6pm and open to all patients for doctors appointments, advice and medical services such as antenatal, immunisations, nurse clinics, blood tests, travel vaccines, minor illness and urgent appointment advice.
Minor Illness and Urgent Appointments
A Nurse Telephone Triage line will be open for patients to call Monday to Friday. Please use it to discuss requests for urgent appointments and advice on simple illnesses with our nursing team. You can get urgent advice and appointments throughout the week, please dial:
Mon-Fri 8.30am-10am 874386
Mon-Fri 1.30pm-2.45 pm 874386
If patients need to book an urgent appointment when Freshbrook Surgery is closed, patients can telephone the usual number which will be routed through to Ridge Green Surgery in practice hours and an appointment offered at Ridge Green Surgery where available. Housebound patients may be offered a home visit just as before.
If a patient needs an urgent or ‘soon’ appointment and is immobile or housebound the patient will be visited at home in the usual way.
Routine appointments will be made in the usual way across both sites. Patients will be able to book appointments for Ridge Green clinics throughout the week and Mondays, Wednesdays and Fridays for
In addition there is a visiting service in Swindon already running supported by Swindon NHS that can help if our doctor cannot come to you that day. They are qualified GPs employed for this purpose by Swindon NHS and who report back to us afterwards. We will always try and ensure a familiar doctor sees you if we can.
Out of Hours
Please call NHS 111 for urgent medical advice in the evenings and weekends outside of core working
hours (ie after 6.30 pm in the evening and before 8am in the morning Monday to Friday or any time at
Contacting the Practice
For patients there will be no change in contacting the surgery – when the Freshbrook Practice is closed on a Tuesday and Thursday the telephone lines will automatically be transferred to the Ridge Green Practice who will answer all your queries, medication and information requests.
This letter will be sent to all patients and notification will be displayed in both surgeries. We will of course
keep all patients up to date of how the new arrangements are working.
In the appendix below we have put the answers to some questions we have already anticipated from
If you wish to contact us further you can contact us on 01793 874894 and ask for the practice manager
or Dr Dwivedi.
Please note this is a temporary measure whilst we try and fill the vacancy and seek the views of our
patients over the coming months. We welcome your feedback on your concerns and you will have
opportunity to discuss the issues at our meetings which will be advertised on the www.ridgegreen.org.uk
website over the coming weeks and at both surgeries. Please alert us to any issues as and when they
arise and we will do our best to address them swiftly.
Dr Amit Dwivedi
Ridge Green Medical Centre and Freshbrook Surgery
The Freshbrook Surgery
Freshbrook Village Centre
• Use Ridge Green and Freshbrook surgery as one and the same. You will be able to make appointments and get medical help at both sites now.
• Remember that Freshbrook will no longer be open on Tuesdays and Thursdays from August 1. Please use Ridge Green only on those days.
• You can continue to use the 870494 number every day to talk to a receptionist (calls will automatically be diverted as needed).
• Do use the Nurse on our “Triage Line” for discussing and booking urgent problems on 874386 open twice a day 8.30-10am and 1.30-2.45 pm.
• If you are housebound and need an urgent appointment then call either the usual reception number or 874386 (Triage Line) to let us know.
• Please ensure your contact details are correct. Please sign up for the text messaging service if you have a mobile phone. Please request prescriptions through our electronic requesting service (SystmOnline) – you will need to sign up in person at either surgery to make use of this convenient prescription requesting service.
What do I do if I can’t be seen at Ridge Green or it’s too far for me to travel ?
Ridge Green is only 1.5 miles away from Freshbrook in Shaw, West Swindon. However some of you may find it difficult to get there but please do remember that you will be able book appointments at Freshbrook just as before though you may only be seen on Mondays, Wednesday or Fridays.
What do I do on Tuesdays and Thursdays in an emergency?
Please call our triage line 874386 to speak to a nurse who will be able organise help for you. You can also call the usual reception number and request help that way. Immobile or housebound patients who cannot get to Ridge Green will be visited at home if they need to be seen that day. In addition there is a visiting service in Swindon already running supported by Swindon NHS that can help if our doctor cannot come to you that day. They are qualified GPs employed for this purpose by the Swindon NHS and who report back to us afterwards. We will always try and ensure a familiar doctor sees you if we can.
What do I do if I need an appointment for a pressing and urgent medical problem?
You can of course contact the surgery in the normal way or we also have a nurse available to discuss your medical problem and she will either give advice, a routine appointment or an urgent same day appointment depending on the medical need (Tel 874386). If it is medically necessary, then she will ensure your problem is dealt with that day at Ridge Green Medical Centre or Freshbrook Surgery. This “triage” telephone service is open daily from 8.30-10am and 1.30-2.45pm. It has been running for over 10 years at Ridge Green and has been very successful.
Some facts about Freshbrook and General Practice that might be helpful:
• We have invested much of our time and money to help make Freshbrook a success. Over £80,000 has been spent on modernising the premises at Freshbrook in the last few years. Only £16,000 was reimbursed by the NHS, the rest being funded by the practice owners.
• Another £15-20,000 will be spent for repairs and further internal renovation this year (including over £10,000 to replace the crumbling side wall, new signage and replacement flooring for all clinical areas). This will again be funded by the owners.
• We have invested in IT and telephone infrastructure with new clinical systems (SystmOne) that allow seamless use of medical records across both Ridge Green and Freshbrook. This means we can review your medical care instantly. It also means we can offer online appointments, prescription renewals and vast array of clinical tools at our fingertips to help improve our medical care for you. We have also invested in new IP based phone system this year at a cost of over £17,000 with multiple benefits to our patients over our old system – again funded purely by the practice (funding by NHS England was declined).
• Freshbrook has invested time and effort into working with the Community Matron service which has considerably helped with reducing unnecessary trips to A+E and has avoided hundreds of admissions over the last 3 years.
• We are also taking part in the case management program. This is a nationally agreed format which aims to improve proactive management of care for high intensity or complex patients with multiple care needs. We will be contacting individual patients about this in the next few weeks too.
• General Practice in this country is widely admired through out the world and is seen to deliver high quality services, available to all, irrespective of their ability to pay, cost effective and trusted by patients.
• In 2004 there were 240,000,000 consultations with GPs and this rose to 340,000,000 in 2013, which means about 1,000,000 patients, consult with a GP each day.
Why are there problems with recruiting doctors?
The problems in recruitment and retention of doctors seems to be caused by lots of things. Doctors working with much higher workloads and on their own (unable to work in a team). They are working under substantial increase in stress of providing the services required of them from escalating “targets” and complexity of medicine made worse by supervision and support issues.
In Swindon only a few doctors have indicated they will stay in the area after qualifying this year. Practices have long relied on “locum doctors” or short term doctors to provide stop gap cover. We have found that this year this has dwindled with long gaps where there are very few doctors available to cover annual leave or sickness.
You would hope that demand for appointments remains steady. Instead the opposite has happened, demand has gone up dramatically over the last few years (40% more appointments requested nationally). Added to this the number of patients not cancelling unwanted appointments has also gone up to nearly 200 per month at our clinics alone, further putting pressure on remaining appointments.
Anne Snelgrove, Labour’s Parliamentary Candidate for South Swindon, will be outside Freshbrook GPs Surgery with patients who are unhappy about the changes to its opening hours on Friday 1 August at 12noon