Nearly half of all adults wrongly believe that antibiotics can kill viruses

Nearly half of all adults wrongly believe that antibiotics can kill viruses.

The 2017 Healthy Ireland Survey of 7,500 people has revealed that accurate understanding is lowest among those aged 75 and older.

  • 92% indicate that they are happy to trust their GP’s advice in relation to antibiotics.
  • 67% correctly disagree that antibiotics can work on most coughs and colds, however this declines to 61% of those aged 65 to 74 and 55% of those aged 75 and older.
  • 90% are aware that if taken too frequently, antibiotics may not work in the future.
  • 95% correctly agree that a course of antibiotics should always be completed, and

85% correctly disagree that once you start to feel better you should stop taking the antibiotic.

Of the total survey of 39% were prescribed antibiotics in the last year, 33% were men and 44% for women. Medical card holders were more likely to be prescribed antibiotics (46%) while non-medical card holders were 33%.

To link to the Healthy Ireland survey 2017 click here.

To see the HSE video and advice on antibiotics click here

 

Northdoc gets top audit marks

“D Doc was best out of 15 co-ops in terms leadership and teamwork”
Irish Medical times Report..
Northdoc, which runs the D Doc out-of-hours (OOH) co-op covering the majority of north Dublin city and county, has outperformed other UK and Irish OOH services in a new audit carried out by the Medical Protection Society (MPS).
MPS found that Northdoc Medical Services was the best out of 15 co-ops stress tested in terms leadership and teamwork, and was in the top quartile for other categories such as communications, resources and training.

Dr Mel Bates – Medical Director – Northdoc

It is understood at least three of the 15 OOH services involved in the voluntary risk audits were Irish co-ops.
MPS said Northdoc had shown “exceptional leadership and unique vision” in clinical oversight of the D Doc service, highlighting the co-op’s ‘SAFE’ (Supported, Appraised, Familiar, Excellence) guidelines for GPs introduced last year.
The indemnifier’s report noted that the clinical notes assessment system implemented and managed by Board members Dr Kate McSweeney and Dr Vivienne Wallace appeared to have had a “positive impact on members, as confirmed by GPs we interviewed during our visit”.
MPS also noted that Northdoc was the first company in Ireland to achieve the International Social Enterprise Mark for its commitment and contribution to the homeless and socially deprived population of north Dublin.. read more

 

Under sixes will impact capacity during clinical winter – especially as holiday season approaches

Under sixes will impact capacity during clinical winter – especially as holiday season approaches.

Presentations in the D-Doc out of hours service for children under six has increased by 25 % year on year to the end of October 2016. However, this does not really demonstrate the effect the under six presentations have, especially during holiday weekends are indeed Christmas and New Year.   The October bank holiday was 38 % ahead on Under Six presentations when compared with 2014 before the scheme was introduced.

Last January there was a lot of media coverage regarding the effects the under sixes were having throughout the health service. Paul Cullen, reporting in the Irish Times said that hospitals had seen a sharp increase in referrals since the introduction of free GP care for under sixes. In Cork emergency medicine consultant Dr Chris Luke said that he had seen a substantial increase in attendances among young children since the scheme was introduced and also said that local GPs in the south had seen up to a 60% increase in young children attending local GP Co-op’s.

In D-Doc in North Dublin, under sixes now represents about 1/3 of all presentations in out of hours. If trends continue, there will be considerable pressure on both A & E and the North Dublin D-Doc GP out of hours service.

Dr Mel Bates, medical director, said that “A 25% increase over the full year to date would indicate that we may expect another spike over the Christmas period. We will be under severe pressure to manage. We have, as ever, more doctors in place during the busy holiday period but we have a finite source or GPs and appointments, and capacity is likely to be reached. That will bring a real challenge both to ourselves and our colleagues in A&E.”

 

 

 

 

 

Patient survey shows D Doc as being an expected and essential part of GP care to North Dublin Patients

Patient survey shows D Doc as being an expected and essential part of GP care to North Dublin Patients

Now in its 10th year of operation the D-Doc service continues to score well with patients in the latest Northdoc survey. Patients were surveyed about their experience throughout the patient journey in D-Doc, from the call answering stage, through nurse triage, and on to the experience they had in the centres and with GPs.

98% of respondents said that the calls were answered promptly, found the call takers courteous, the triage nurses helpful, and rated our centre nurses and staff as excellent. Satisfaction with GP consultations was high.

There is a significant evidence that the service is being used on a regular basis by patients. Only 22% of patients use the service just once in a 12 month period, 40% had use of twice or three times, and 38% indicated that they used the service four times more in one 12 month period.

When asked how they would rate the service on D-Doc overall there was a 95% satisfaction rating scoring good or excellent.

When asked “how would you rate the doctor consultation in terms of findings and treatment” there was a 90% satisfaction rating scoring good or excellent.

Waiting times in D-Doc were relatively short – with 92% of patients saying they were seen in under 30 minutes with the remaining 8% been seen in less than one hour.

The results show that there is a definite trend towards treating the service as a ‘convenience’ rather than just for the “urgent” out of hours GP care it was originally set up for. shutterstock_132413564(1)D Doc stats have shown a year on year increase in attendances with particular pressure at holiday weekends and over the Christmas and New Year period. The survey  was conducted in March and include patients seen during preceeding busier winter months.

 

 

Minister, Consultant, and GPs Agree free service needs proper resources before expansion of under Six GP scheme.

“Political decisions have real world implications very very quickly” – A & E consultant Dr Chris Luke

D Doc saw a 58% increase in under six consultations in January.

Minister for Health Leo Varadkar said on RTE Tuesday that “you have to have the capacity in the system” in order to expand the free GP care to all age groups.  The minister said that currently the system would be short “about 500 GPs” to provide such a service. On the same programme Dr Chris Luke, consultant in emergency medicine said that has been a significant increase in the number of under sixes attending A & E’s across the country. Dr Luke said that “inevitably there is going to be competition of resources…you can’t look after two patients at the same time, you can look after the toddler or the eighty  year old on the trolley, you can’t look at both simultaneously”. Dr Luke said “Political decisions have real world implications very very quickly”

Dr Gary Stack, Medical Director of South Doc which covers the largest geographical area covering cork and Kerry said that they have experienced a huge increase in demand with a 46% increase in October. “There is less time in which to see patients and there are increased waiting times which can adversely affect the outcome for the patient who needs more urgent care”.

Dr Mel Bates, Medical director for D Doc which covers North Dublin said of the new demand created by free GP care to under sixes. “I don’t think anyone expected it to become as big as is has become”. Dr Bates referring to the minister’s comments said he “welcomed the fact that they are reflecting on the extra workload that had occurred”. Dr Bates said D Doc saw a 58% increase in under six consultations in January. Here is what the minister and Dr Bates had to say…

D Doc/ Northdoc inaugural annual B-B-Q Social a great success!

Thanks to everyone who came along to the first of many (we hope!) D Doc/ Northdoc annual B-B-Q social events.

Our special thanks to Na Fianna GAA Club for hosting the event.

Here are some of the many photos taken on the day by our intrepid photographer Dr Mel Bates!

We had two great prizes – Family membership for one year to Tayto Park – won by Dr Aliya Rahim.

And one year’s family membership to Dublin Zoo won by Niamh O’Neill.

A big thanks to all the D Doc and Northdoc staff   and GPs who came along – and of course our best wishes to all those who were busy in D Doc on the day keeping the flag flying!

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HSE ‘has no more money’ for D Doc – Private memorandum to Northdoc members

 “The HSE have taken the approach that D Doc needs to be assessed from a cost only perspective and seems to have gone away from any social or patient focused values the service provides“

“This is not the time to unpick and unravel one of the best primary care services in the country.”

At the Northdoc AGM earlier in the year we explained that Northdoc’s income continued to decline from the effects of FEMPI cuts and unrealistic funding from the HSE. We also said that we were working closely with the HSE in an effort to resolve the funding issue. Since we started the Northdoc/ HSE partnership we have had many challenges. We worked together and we worked through them. The single biggest challenge over the last few years has been the funding.

The HSE has until now shared the same value we have of the service, and has, until now, underpinned that value by filling the funding gap where it was needed. The HSE has always recognised the Northdoc input, not just in terms of supplying an important component of the service (GPs) but they have always valued our overall commitment to D Doc, ensuring that the service provides a GP service to North Dublin patients that is second to none in terms of medical standards and patient safety. In Northdoc our values have not changed and neither has our commitment to providing an excellent GP out of hour’s service to the people of North Dublin.

The HSE appears to have changed its partnership approach to the funding problems. Loss of institutional memory of the quality of the service compared to what existed before D-Doc has resulted in a foot dragging approach to the funding problems that have been well flagged for years.  In recent talks they have explained that any cost savings their end might take ‘years’ to introduce and instead have insisted on focusing, yet again,  on what further cost savings Northdoc can provide.  The Board of Northdoc are clear that there is no further room for this in the company  when we have lost 140,000 euros for the first time last year and are on track to lose 180,000 in 2015.

Set up as not for profit company, Northdoc has, since the service commenced, ensured that all  fees (including those from private patients) go back into the company to underpin the service.  Last year, one million two hundred thousand euro of private funds were used together with STC payments and a small HSE grant to provide the service.

Despite Northdoc cutting pay to GPs and service efficiencies being introduced ,Northdoc continued to provide excellent service (average waiting times during hospital crises at Christmas was 45 minutes in D doc).  90% of North Dublin GPs were on duty at critical times. Northdoc has the endorsement of MPS UK  and a 95%  satisfaction ratings from patients (April 2015). Despite this level of service the HSE continue to focus almost exclusively on the money they pay to Northdoc.

D Doc average waiting times of 45 min during peak demand compares favorably with  A & E

D Doc average waiting times of 45 min during peak demand compares favorably with A & E

At our latest meeting with the HSE they said they were looking at all  of the service. They said that they would be looking at “the need” for maintaining five centres across North Dublin and they queried whether it was necessary to continue the current  excellent waiting times  for patients. 

The HSE have taken the approach that D Doc needs to be assessed from a cost only perspective and seems to have gone away from any social or patient focused values the service provides. In recent talks they have explained that any cost savings their end might take ‘years’ to introduce and instead have insisted on focusing on what cost savings Northdoc can provide instead.

The HSE maintain they have no money for further funding and  are saying we should look to a diminished service as the answer. We need to address this and we need to be united and firm in our response. The Northdoc/ D Doc model of care has evolved over the last eight years and all that is good about it is as a result of the hard work put in by GPs and their colleagues in D Doc at the front line of the service. This is not the time to unpick and unravel one of the best primary care services in the country.

If the HSE continue to undervalue and under-fund the service then it simply cannot continue and Northdoc will need to operate an alternative in line with current funding. This will mean the end of the D doc model as it has developed.

The board of Northdoc will in the coming weeks await the response of our final submission to the HSE management. Unless there is a commitment from them to adequately fund the service we will hold a meeting of all members to discuss our options. This meeting is currently scheduled for May 25th.

For more details and background please click here Northdoc GP Update from northdoc May 08th 2015

This is a private communication from Northdoc Medical Services board to members of the company. Do not distribute in whole or in part or any attachments.

Copyright Northdoc Medical Services Ltd 2015.

D Doc Urgent GP out of hour’s service copes well during busy holiday period.

D Doc, like all other health services, saw a surge in activity over the holiday season. During this peak period from Christmas Eve and New Year’s Day the service received over 3000 calls. Over 80,000 call were received by the service in 2014.
Dr Mel Bates Medical Director for D doc said “Christmas and New Years are the most challenging time of the service. We had over 100 individual GPs on duty during this time and they saw over 2500 patients. 70% of the GPs on duty were local north Dublin GPs with the remainder sessions filled by our regular sessional GPs.
Our five centres were extremely busy, especially at Swords, Coolock and Hartstown, but with the help HSE D Doc staff; Receptionists, nurses, and drivers, we managed to provide a safe and good service for patients. Average waiting times from appointments to consultation time were good with 87% seen within 45 minutes and the figure for those seen in less than one hour is 96%.The average waiting time was 27 minutes.home-image
The appointments based system we use means that people can wait in their own homes rather than waiting rooms until their appointment time, and while they could wait up to 4 hours for a routine appointment, we would schedule more urgent cases to be see more quickly.
At lot of planning goes into this achieving this performance. We work with the HSE management and Clinical Nurse Managers as far back as September and of course we have to recruit the local doctors to make themselves available during the holiday period.
We expect levels of activity to remain high over the next two months and would advise people to plan to see their own GP in the first instance before considering D Doc. This way the service will be better available for those people needing urgent GP care during the coming winter months.”

Ebola Virus

In response to concerns about the spread ob the Ebola virus the HSE have issued a FREQUENTLY ASKED QUESTIONS guide which you can access here.  Should are concerned about having been exposed to the virus you can call us on 1850224477

If you are a GP and a member of Northdoc log in to the doctors section here.

 

 

 

 

 

 

 

New Northdoc website supports GP in Out of Hours setting

The new Northdoc website is designed to provide support for GPs in the D Doc Out of Hours setting.

The information is as simple as “Things to remember on your D Doc” shift to guidelines on more complex areas such as Mental Health issues, drug seeking behaviour, paediatrics and Anti-biotic prescribing. There is a section on Special Patient Groups such as the Traveling Community,, Victims of assault, child abuse, pregnancy related issues, unaccompanied children and much more.

The site provides a handy A to Z of its content and a search option by subject.

Links to useful GP sites, poisons information, Medical council, ICGP, Statutory forms (Mental Health). HSE, MIMS, Univadis, Dermet, and GP notebook.

There are useful section in “Avoiding complaints”, “Informational outcomes” and a host of similar headings.

The site was designed for it to be easy to give on the job feedback to Northdoc via an on online feedback form that generates emails directly to the CEO and Medical Director. There is also easy access to the Northdoc roster website.

There is a public version of the site as well which gives basic information about the service but does not allow access to the GP area of the site.