It is very important that our team has the oppurtunity to meet together for training purposes. The practice will therefore be closed for staff training at 13:00 on Tuesday 5th November for the rest of the day, re-opening on Wednesday 6th November at 08:00. (Patients with pre-booked appointments after 18:30 should attend as planned.)

This time is important as it provides protected time for our team to meet together to discuss practice issues, including our triage service, and reflect on feedback from patients to help us improve the service we provide.

The online triage service will be switched off from 12:30 on the day of practice training and remain off until the following morning. During the planned closure any urgent phone calls will be dealt with by NHS 111. If you require emergency care please phone 999 as at any other time. The surgery will re-open at 08:00 on Wednesday 6th November.

Please ensure any prescriptions required on the day are collected before 1pm.

Autumn is upon us once again and the practice is preparing for an increase in seasonal viral respiratory infections. Most are relatively mild, causing mainly nuisance symptoms affecting the upper part of the respiratory tract. They are self-limiting, and the only treatment required is for symptom control. The viruses that cause them are not treatable with antibiotics. More troublesome symptoms are caused by influenza and COVID-19 infections, and these have the potential to cause serious illness, particularly in more vulnerable patients. 

It is important we continue to protect our patients, and staff. If staff members test positive for COVID-19 they are still required to isolate which has a massive impact on our ability to deliver healthcare for the community. We therefore request that if you test positive for COVID-19 or suspect you may have COVID-19, please let us know before visiting the Health Centre and wear a mask to reduce spread. 

One of the many things the pandemic taught us was the effectiveness of face masks in preventing the spread of all respiratory infections. If you have a cough or cold, whether flu, COVID-19 or otherwise, wearing a face covering will help protect others from catching your infection. You should also wear a face mask if you feel at risk, due to increased vulnerability or proximity to anyone with respiratory symptoms.

Common sense and respect for others is all we ask. 

Under current legislation the NHS ceases to have responsibility for the medical care of patients when they leave the UK.  

For patients who inform us they will be out of the country for less than 3 months, the NHS will provide sufficient medicines from their repeat prescription to cover the period abroad. However, this is at the discretion of the GP. There is no obligation to prescribe in this situation, and medications may not be prescribed if they require frequent monitoring or if there are safety concerns. For periods longer than than 3 months, patients need to find an alternative supply of their medication.

GPs are not required by their terms of service to provide ‘just in case’ prescriptions for the treatment of a condition that is not present and may arise while the patient is abroad or as a result of travel. This includes:

• ‘just in case’ medications for treating travel related illnesses e.g. travel sickness, diarrhoea, and requests for medication due to travel abroad
• postponement of menstruation
• travel sickness
• treatment of jet lag

These situations are not covered by the NHS. The GP is not obliged to provide a prescription but if they feel it is clinically appropriate, and the medication can be self-administered safely without medical assessment, a private prescription may be issued at a cost of £20. This does not include the cost of the medication.

In line with prescribing guidance, the practice no longer issues prescriptions for fear of flying or to aid sleep during flights. 

See the Prescriptions page for more information.

In March the British Medical Association (BMA) held a ballot asking GPs to support action against the erosion of funding for general practice that over the past few years has had a negative affect on patient care and staff morale.

• In the last 5 years GP practices have lost funding worth over £660 million.
• We're not allowed to use the poor funding we have to recruit more GPs or more practice nurses. 
• GPs and our team are losing morale. 
• No matter how many hours we work, we still can't see all the patients that need our care

The result of the ballot was an overwhelming ‘yes’ to taking action and as a direct consequence all practices in the country are taking collective action, to protect patient care, before it is too late.
 This is not industrial action, and it is not about GP pay - it is to about bringing pressure on the government to invest more resources in primary care and amend the GP contract so that we can employ enough doctors, nurses and staff to provide sufficient appointments and work safely.


If general practice received a fairer share of NHS funding we could:

• Train and hire more GPs
• Deliver the services you require
• Make it easier to get the appointments you need

At Holmes Chapel we have done our very best to provide extra capacity to deal with increasing demand, making the most efficient use of our clinical staff and available resources. Our triage service ensures we see patients appropriately, and timely, and as a result we deal with far more than the recommended number of patient contacts for each clinician. It is exhausting work, and it is not sustainable.

Our practice therefore supports the nationwide campaign to improve funding in primary care so that surgeries can move forwards with sufficient staffing and capacity to provide the quality of care we all want for ourselves and all patients.
 We hope that the issues will be resolved swiftly, and that general practice can have a brighter future as a result.

From Monday 19th August 2024, as part of a number of actions designed to bring pressure on the government, we will limit the daily patient contacts to the recommended safe level of 25 per clinician per day. Alternative health providers are available, including local pharmacies, urgent care settings and NHS 111, and once our daily maximum safe capacity has been reached patients will be diverted to these services. 

We ask for your continued support of the practice and the BMA in our efforts to improve GP services and patient care. For more information visit the GPs Are On Your Side or watch the video A message for patients in England/BMA.

General Practice has been broken. Help us fix it.

General practice is broken, the result of decades of neglect from successive governments. As GPs we want our patients to know – we’re on your side. We want to be there for you and your family when you need us. But this is getting harder and harder…

If you want your GP to be there for you and your family, you can help us. Take a look at the campaign video at the bottom of this page and write to your MP demanding that NHS GP services receive the funding urgently needed now to stabilise General Practice.

GP Surgeries are under extreme pressure.

• GPs carry out 400 million annual appointments, and the number is increasing - over the last 12 months this number has increased by one million extra appointments every month
• NHS GP Surgeries perform over 90% of patient contacts in the NHS but receive less that 8% of the NHS Budget. 
• 7.7m suffering patients on hospital waiting lists are placing huge extra demand on primary care
• GP Surgery Staff are burning out with increased levels sickness and early retirement
• demand for appointments is increasing, with more patients being registered, and a growing elderly population

Due to chronic underfunding 1,300 GP surgeries have closed since 2013, with 60 GP Surgeries closures in the last 12 months. 

The number of qualified NHS GPs has fallen by 1,877 since 2015. Each full-time equivalent GP is now responsible for an average of 2,295 patients

In the BMA GP referendum on 28th March 2024, over 99% of GPs voted against the government and its third consecutive imposed contract on GP surgeries. 

Help save General Practice and your GP Surgery

✍️ Write to your MP (all nations), – email templates and guidance linked.

🤳 Share this website with your friends and to your social media – post directly to X/Twitter here, or find a template post for other social media here.

🔁 Encourage your friends and neighbours to do the same by sharing these materials.

Follow the campaign on Twitter @RebuildGP

On 31st January this year a new service run by community pharmacists was launched. The service, called Pharmacy First, enables community pharmacists to support general practice by providing treatment of patients without prescription for 7 specific conditions:

• Uncomplicated urinary tract infections (in women aged 16 to 64)
• Shingles
• Impetigo
• Infected insect bites
• Sinusitis
• Sore throat
• Acute otitis media (ear infection) 

Please note age ranges apply to all these conditions. 

Patients with any of the above requesting advice or treatment from the practice using the online service will be triaged by the duty GP in the usual way, and if appropriate can now be referred for a face to face consultation with a community pharmacist.

The community pharmacist will perform a clinical assessment, including examination if necessary, in a private consulting room and then:

• provide treatment
• provide advice about self care and the use of over-the-counter (otc) medicines
• refer to another health professional- this may be the GP.

‘Walk-in’ patients are able to self-refer for a Pharmacy First consultation with a community pharmacist provided they meet the clinical criteria for one of the seven specific conditions above.

The practice continues to encourage patients to seek advice from their community pharmacist (before approaching their GP) about other common ailments, which even if self-limiting bmay benefit from otc symptomatic treatment.

If you are exempt from paying for your prescription, or if you have purchased a prepayment certificate, it is necessary that you sign the back of your prescription form, indicating why you are exempt. 

There has always been an obligation for staff to check exemption status, but occasionally this is overlooked.  Signing is necessary to reduce the number of fraudulent exemption claims. Within the Dispensary we have asked our reception staff to ensure all patients who are exempt, including those with a prepayment certificate, sign the back of their prescription form. Unless they do this they must pay the prescription fee.

• When you sign the back of a prescription form, you are confirming free entitlement to NHS prescriptions. If this is not true, signing the form is an act of fraud and you will be liable to a fine of £100 to the Prescription Pricing Authority, plus the outstanding cost of any unpaid prescription fees.
• If you do not sign the back of the prescription form, you will have to pay a prescription fee.

Please be aware that when you pay a prescription fee the money is passed on to the NHS. It is not retained by the practice, but we are required to ensure the correct fees are collected. However, if we fail to charge a prescription fee when this is due, the practice is held responsible for this payment, and the NHS deducts the fee from practice income. Obviously, this is not something the practice can afford, and for this reason you may be asked to show current proof of exemption, even if you have shown this before.

If you are unable to provide proof of exemption when you collect your medication, we will hold it for seven days until you can return with the necessary evidence. If you need your medication urgently, you have the option of paying the prescription fee or taking your prescription elsewhere. Provided you return with 48 hours with proof of exemption your prescription fees will be refunded.  

If you think you should be entitled to free prescriptions check on line at Free prescriptions booklet (V3) 09.2018.pdf (nhsbsa.nhs.uk)

If you would like to know if you could save money by purchasing a prepayment certificate visit Save money with a prescription prepayment certificate (PPC) - NHS (www.nhs.uk)

The practice now uses an online triage service for all requests for appointments with our medical team (GPs, Advanced Nurse Practitioners and Paramedics) or for advice about medical issues. This can be accessed using the AccuRx online request form.

The phone lines continue to be very busy so please use the online form whenever possible.

Because of the success of the triage service we have downgraded our reliance on emails and these are no longer monitored on a regular basis. Emails should not be used to request an appointment or medication as we cannot guarantee a response within a safe timescale.

Emails should now be used only for non-urgent administrative purposes. 

The practice uses the Electronic Prescription Service (EPS). This is an NHS service that allows your prescriptions to be sent to a pharmacy or dispenser of your choice. They will be signed, sent and processed digitally, without having to be handled by you.

What does EPS mean for you?

• If you use a pharmacy to collect your medication you can order online or via your pharmacy and you will not have to visit the Health Centre to collect your prescription; it will be sent electronically to the place you choose, saving you time.
• If you have stable chronic health condition you can set up a regular prescription order, so that the only time you need to visit the Health Centre is when you need to see a GP or nurse.
• You can choose to collect your medicines from any pharmacy or dispensing service in England. If you are on regular medication, it will always be quicker for you to nominate a pharmacy so that your prescriptions can be sent there to be dispensed before you collect your medication, but you can nominate a pharmacy local to where you work or shop, or choose to use an online pharmacy.
• Your GP will use EPS every time you require a prescription, no matter how often this is. Your prescription will be sent to the secure NHS database, where it will remain until you ask a pharmacy to dispense it.
• The software required to download prescription information from the NHS database is only available to pharmacies at present. If you are a dispensing patient will continue to benefit from a one-stop dispensing service that enables you to order and collect your medication without having to handle your prescription.

How do you use EPS?

• When a prescription is generated by a doctor using EPS it is given a unique code which is sent electronically to the NHS database, known as the NHS 'spine'. EPS allows you to obtain your prescriptions from any pharmacy in England. You can choose to have your prescriptions sent automatically to a preferred pharmacy each time – this is known as your "nominated" pharmacy.
• If you have nominated a pharmacy the prescription code will automatically be sent there to enable the pharmacy to start the dispensing process and provide your medication as quickly and efficiently as possible, without the need for paper prescriptions or tokens. 
• If you have not yet nominated a pharmacy you can still use EPS. Your prescription will be sent electronically to the NHS 'spine' where it will remain until you ask any pharmacy in England, including an online pharmacy, to retrieve the information in order to dispense your medication.
• To use a pharmacy that you have not nominated you will need to provide them with details to confirm your identity so they can securely retrieve your prescription details from the NHS spine. This will be your name, date of birth and NHS number. You can find your NHS number on your medical card, your prescription reorder form, and it is available on the NHS App which you can also use to order your prescription online and find health information. 
• Once your prescription code has been sent to your nominated pharmacy, or if have asked a pharmacy to download your prescription code from the NHS spine by a pharmacy you cannot go to any other pharmacy for the same prescription until it has been 'released' back to the spine by the pharmacy.
• You no longer need a paper prescription or token to obtain your medication from a pharmacy, and for this reason, and to help save resources for the planet, the practice no longer issues paper tokens other than in exceptional circumstances.
• You can only use EPS to obtain your medication from any pharmacy in England. If you want to use a pharmacy in Scotland, Wales, or Northern Ireland you will still require a paper prescription. Paper prescriptions will therefore only be issued very special circumstances, and not on demand. 
• I the unlikely event that a pharmacy is unable to locate your prescripton on the NHS spine using your name, DOB and NHS number a unique code can be provided which the pharmacy may use. In exceptional circumstances it may be necessary to issued a paper 'token' which includes all the information on your electronic prescription including your unique code for use by the pharmacy.
• The software for EPS is currently not available for use with practice dispensaries. We will therefore continue to issue paper prescriptions for patients using the Dispensary until this situation is updated, but for all other patients paper prescriptions will only be issued in special circumstances
• Click NHS App to read more and download the App.

How do I add or change my nomination?

• Ask any pharmacy or dispensing appliance contractor that offers EPS, or staff at the Health Centre, to add your nomination for you. You may have already nominated your usual pharmacy, possibly without realising it, and this will be recorded in your GP medical records.
• If you want to change or cancel your nomination speak to any pharmacist or our practice staff. Tell them before your next prescription is due or your prescription may be sent to the wrong place.
• Once your prescription has been sent to the NHS spine you can ask any pharmacy to retrieve the information in order to dispense your medication. If you this isn't your nominated pharmacy you will need to provide the pharmacy with details to confirm your identity - this will be your name, date of birth and NHS number. You no longer need a paper prescription or token to obtain your medication from a pharmacy, and for this reason, and to help save resources for the planet, the practice will no longer be issuing paper tokens.You can find your NHS number on your medical card, your prescription reorder form, and it is available on the NHS App which you can also use to order your prescription online and find health information. Click NHS App to read more and download the App
• We will continue to issue paper prescriptions for patients using the Dispensary until software is available, but otherwise paper prescriptions will only be issued in special circumstances

Is EPS reliable, secure and confidential?

• Yes. Your electronic prescription will be seen by the same people in GP practices, pharmacies and NHS prescription payment and fraud agencies that see your paper prescription now.
• Sometimes dispensers may see that you have nominated another dispenser. For example, if you forget who you have nominated and ask them to check or, if you have nominated more than one dispenser.

Dispensing patients

• All patients living in Goostrey, and anyone who lives elsewhere but more than one mile from a pharmacy is permitted under NHS rules to obtain their medication from the Dispensary within the Health Centre.
• As a dispensing patient you are not required to nominate a pharmacy, as your prescription will automatically be sent to the dispensary. In fact, EPS will not make any difference to your current prescription service as this is already effectively ‘paperless.’ Although paper prescriptions will continue to be generated and processed within the dispensary, all medication will be dispensed without the need for you to handle your prescription.

Prescription team

Prescriptions for all patients will continue to be generated by our prescription team within the Dispensary. Prior to EPS being available it has been necessary to collect a paper prescription from the Dispensary, resulting at times in a long wait and frustration. Now that all prescriptions are sent electronically to your chosen pharmacy or dispenser the footfall within the Dispensary should be greatly reduced. In this way, EPS will enable us to improve the service we are provide to all patients using the Dispensary.

Ordering your prescription

EPS will ensure your prescriptions are sent electronically to the pharmacy or dispenser of your choice, but there is no change to how you order your prescriptions:

• Order your repeat prescription online using patient access, accessible via the practice website or the NHS App.
• Use your current repeat prescription slip or complete a request form, available in the foyer or at the dispensary.
• Place your request form in the collection box in the health centre, post it to the surgery.
• Send an email to:hchcscripts@nhs.net or hchcdispensary@nhs.net if a dispensary patient

Your electronic prescription is available for a pharmacy to download from the NHS database as soon as it has been generated. However, please check with your nominated pharmacy how long they require before collection. If you are a dispensing patient, please try to allow us one week to dispense your medication, and extra days if affected by Bank Holidays.

EPS is reliable, secure, and confidential. Your electronic prescription will be seen by the same people in GP practices, pharmacies and NHS prescription payment and fraud agencies that see your paper prescription now.

For more information talk to your community pharmacist, staff at the Health Centre, or you can read more about EPS on the NHS website and watch a video about EPS using this link to YouTube.

The practice now uses an online triage service for all requests for appointments with our medical team (GPs, Advanced Nurse Practitioners and Paramedics) or for advice about medical issues. This can be accessed using the AccuRx online request form.

Faced with an increase in the number of COVID-19 infections, plus other respiratory infections, it is important we try to keep unnecessary visits to the Health Centre to a minimum. 

Medication enquiries, sick note requests and other administrative queries will be also be directed to use the AccuRx online request form It is important that all requests are processed using the triage system, so even if you don't have access to the internet you may phone reception in the usual way and a member of the team will complete the request form for you.

The service will be used for both routine and urgent appointment requests and all will be triaged on the same day by a member of the clinical team. The online system will be available to use from 8am to 3.30pm Monday to Friday. For urgent issues after 3.30pm it will be necessary to phone reception so that a member of the team can take the details of your request and pass these to the triaging clinician. They will decide if further action is required that day or whether it can safely wait to the following day.

When your request has been triaged you may be given a face to face or telephone appointment. This may be with a GP or an advanced prescribing nurse practitioner, but it may be more appropriate for your problem to be dealt with by another health care professional, such as  a paramedic, pharmacist, physiotherapis, mental health worker or another member of the team. Although you may feel you need a certain type of appointment, the actual decision will only be made by the triaging doctor. The reception staff are unable to bypass this system so please do not demand your appointment request is dealt with in any other way. 

We appreciate that new systems can seem daunting at first, and there will inevitably be some who reflect on the 'good old days'. Unfortunately the previous system was unable to deal with increasing demand, and we have been forced to look for a better way of working that improves access for all our patients. Triage is not entirely new to the practice. We first trialled it during the pandemic to help us to manage patients remotely, and accompanied by developments in software it was very successful. Unfortunately, it was also heavy on practice resources, and as we emerged from the pandemic we faced not only an increase in demand but also a reduced workforce. This meant we struggled to maintain the service and eventually had to take the difficult decision to suspend the service in December. Since then we have increased our staffing levels, and learned from other practices to ensure we are able to manage demand. We know total triage works very well in other areas of East Cheshire, including Wilmslow and Macclesfield, and with everyone's support we are confident it will work in Holmes Chapel.

If you require their assistance to complete the online triage form or have any queries about how it works our reception staff are there to help you. If you can, it will be quicker for you to complete the online form yourself, or someone else does this on your behalf. This will also ensure our phone lines are less busy for those who truly cannot do it themselves. Our reception staff are not able to bypass the system so please do not ask them to do so.

Please be kind to our reception team who are our ‘front line’. We understand that being a patient can be frustrating, and we apologise if we cannot always provide the service you want, but there are always reasons for this. Please do not take this out on our staff, as inevitably the problem is not of their making.  We are grateful for any patient feedback, particularly if this allows us to improve our service, but please be aware, we have advised all staff to follow our zero tolerance policy when faced with inappropriate behaviour or abuse of any kind. 

We hope that reverting to an online system will reduce the demand on our phone lines, but inevitably there will be peak times when it is difficult to contact the practice by phone. Use the online service whenever possible. Please do not attempt to contact the practice for an appointment via email - this is for administrative purposes only and therefore is not monitored to a level that allows us to respond to email queries about medical problems or requests for appointments within a safe time frame.

To access online triage please click the AccuRx online request form.

Download the NHS App, or open the NHS website in a web browser, to set up and log in to your NHS account. Owned and run by the NHS, your NHS account is a simple and secure way to access a range of NHS services online.

• get your NHS COVID Pass – view and download your COVID Pass for travel abroad
• get advice about coronavirus – get information about coronavirus and find out what to do if you think you have it
• order repeat prescriptions - see your available medicines, request a new repeat prescription and choose a pharmacy for your prescriptions to be sent to
• book appointments - search for, book and cancel appointments at your GP surgery, and see details of your upcoming and past appointments
• get health advice - search trusted NHS information and advice on hundreds of conditions and treatments. You can also answer questions to get instant advice or medical help near you
• view your health record - securely access your GP health record, to see information like your allergies and your current and past medicines. If your GP has given you access to your detailed medical record, you can also see information like test results and details of your consultations
• register your organ donation decision - choose to donate some or all of your organs and check your registered decision
• find out how the NHS uses your data - choose if data from your health records is shared for research and planning
• view your NHS number - find out what your NHS number is

The practice welcomes feedback. The positive kind is great for staff morale, and who doesn’t enjoy a pat on the back for a job well done? However, other kinds of feedback are possibly even more important to us, as it helps us improve the service we provide. We want our patients to always have a first-class experience and we need them to ensure this is the case at all times. Although it can be uncomfortable, we need to hear when we get things wrong. We always reflect on how we do things in response to genuine comments and polite feedback, but we can only do this when patients approach the practice on a personal basis, detailing the specific issues they have experienced. 

Social media allows disgruntled patients to express themselves and their posts may act as a catalyst to generate further comments. Unfortunately the ensuing discussion is inevitably one-sided and is rarely constructive in a way that helps the practice move forward, but apart from feeling slightly bruised the practice is not generally damaged. The same cannot be said about personal comments directed against individual members of staff. 

Online abuse of Health Centre staff

We recognise the importance of social media. The practice uses Facebook and other social media to disseminate information quickly and effectively to a large number of patients. We welcome feedback via any means, particularly constructive feedback if this helps us improve our service. Genuine grievances made by the proper channels will always be investigated. Unfortunately, comments are sometimes made on social media about the practice which are personal and abusive, to which we are unable to respond, and the practice has even received anonymous letters that can only be described as hate male. This will not be tolerated. 

For those who continue:

We are caring professionals who come to work to help people - we do not come to work to be abused.