Patient Advisory Notice: Patients at potential risk - Manse Gardens Amenity Housing, Strachur

**UPDATE: Trust Housing, who are responsible for Manse Gardens, responded yesterday to the concerns Strachur Medical Practice has raised by sending a legal letter threatening a defamation action unless we retract our concerns.  We take our responsibilities to patient safety very seriously and I have passed my concerns over what we consider an inappropriate response to the Chair of the Board of Trust Housing.  We are currently building a list of people willing to be witnesses should the need arise for a defence of 'veritas' (truth) and 'fair comment' (honestly held opinionl, based on those facts, which are in the public interest). **

Dalnacraig, Strachur PA27 8BX

8th May 2019 1400hrs


Patients at potential risk – Manse Gardens Amenity Housing, Strachur

Strachur Medical Practice has seen a significant rise in the number of patients attending the practice complaining of mental health problems they perceive as caused by, or exacerbated by, the current situation in Manse Gardens amenity housing complex, Strachur.

Initial investigation has raised concerns about a sharp increase in the number of residents allocated to the remote facility with complex problems, a reduction in warden support for the facility, and an exodus of low-disability residents who previously provided a balance of support for residents with greater disability.

Strachur medical practice is therefore issuing a public medical advisory that patients may be at risk in Manse Gardens due to system-related issues at the facility.

Strachur medical practice is advising patients not to accept offers of accommodation at the facility pending further investigation and resolution of any safety issues identified. 

If any patients currently resident at the facility require additional support, or require medical support for their application to move to amenity accommodation elsewhere, or if anyone has concerns about the safety of a resident at the facility, please contact Strachur Medical Practice on 01369 860224.

Dr Robert Coull
MB ChB, BSc Med Sci, Dip IMC RCS Ed.
GMC# 4041625

Appointment Times

Planning your day around a visit to see the doctor?
Remember you are seeing the Duty Doctor, so appointment times are only a rough guide.  The clinic is really a pseudo-walk-in clinic: it's normal to wait up to an hour after your stated appointment time to be seen, and you could then spend an hour or longer being seen.  So please allow up to two hours for your visit and bring a good book.  We have a comfy sofa, a coffee machine, and free WiFi for a reason!

Strachur Medical Practice is a single-handed practice, so patients will always see the Duty Doctor.  This is an important difference from larger practices.

Every GP practice has at least one Duty Doctor each day.  The Duty Doctor's job is to deal with the large number of urgent issues that come up during the day.

For example (in no particular order):
  • urgent abnormal results being called in by the laboratory
  • urgent calls from specialists about patients they are concerned about
  • calls from social work
  • calls from the Community Mental Health Team about a patient
  • District Nurses attending the practice who need to speak to the doctor urgently about a patient
  • Home Carers who need urgent assistance with a house-bound patient and will only be in the house for a few minutes
  • patients needing urgent telephone advice
  • patients who need to be seen the same day but there are no appointments left
  • medical emergencies
  • patients who are suicidal or in acute distress
  • patients who attend the clinic without an appointment needing urgent medical care
  • ambulance calls
  • police calls
  • calls to and from the NHS IT desk about computer issues
  • patients who have run out of medication
  • problems in the dispensary - national shortages of certain medications being a near-daily issue
  • problems with patients who are being seen by a Practice Nurse
Several of these problems will come up on any given day, but we can never predict exactly what or when.  In a multi-doctor practice the Duty Doctor(s) can deal with these things while the other doctors get on with seeing patients who have appointments without too much distraction.  (Even those GPs often run late, but that's a story for another day.)

Traditionally, single handed GPs did not have appointments because they were always the Duty Doctor.   All clinics were Walk In Clinics: patients turned up at the start of the clinic (usually coming early to get ahead of the queue) and they were then seen generally in order of arrival.  Patients will wait anywhere from 1 to 4 hours to be seen in a Walk In Clinic.

To try and reduce the waiting times for patients, most single-handed practices now have 'appointment times' to stagger when patients arrive and reduce their waits.  However, this is not the same as an appointment in a multi-doctor practice, because the patients are still seeing a Duty Doctor.  So it is, in reality, a pseudo-appointment system designed to stagger the arrival of patients to what - at times - can resemble a tiny, under-staffed. emergency department.  As such, patients will still wait to be seen - sometimes there will be no wait, sometimes the wait will be over an hour.  However, most patients will be seen within one hour, which is a big improvement over the 1 to 4 hour waits of a standard Walk-In Clinic.

Because waiting times of up to an hour are normal, staff may not offer an explanation and the doctor is unlikely to be apologetic about the wait.  This can understandably cause irritation, or even upset, to patients who are not used to the system and who misunderstand the 'appointment time' to mean that they will be seen at that specific time.

Patients can also be caught out by how long their appointment takes.  You have been booked for a '15 minute' time slot, but of course that might end up being 30 minutes with the doctor if your case is more complex than your realised, and/or you might need to wait to see the nurse or health care assistant, and then you might need to wait for test results, medications from the dispensary, or to see the doctor again before leaving.  This can mean an hour - or longer in some cases - between when the doctor first sees you and when you leave the clinic.

We still run some walk-in clinics.  These are useful at certain times for patients who can't wait for the next routine clinic: for example, over Christmas and New Year. Walk In clinics will have a 'start time' when patients can begin to queue.  This is not the same as the time the doctor starts to see patients: which will usually be thirty to sixty minutes after patients can start to queue.  There is also a cut-off time for patients arriving for the clinic.  This is to stop everyone turning up in the last hour of the clinic which would mean staff working hours beyond closing time, which would be unfair to the staff and dangerous for patients.  Patients arriving after that cut-off time (which might be before the clinic actually starts) will only be seen if clinically justified.   Walk In Clinics are designed to 'separate the wheat from the chaff' at times of high demand when routine matters should be postponed.  Patients will self-select: patients with routine needs are unlikely to be willing to wait several hours to be seen, which ensures that patients with urgent problems have access to the doctor.

So, when planning your visit to our surgery, remember that you will be seeing the Duty Doctor, your appointment time is only a rough guide, and that the doctor and staff will consider a waiting time of less than an hour to be seen as routine.  Please allow at least two hours for your appointment - one hour waiting time, and one hour for the medical services to be completed - and be prepared to reschedule if the Duty Doctor is particularly over-run on the day of your visit.