When a patient contacts the surgery, it is important that we make sure they are signposted to the most appropriate person in the team for their presenting complaint/condition/issue. It is a common misconception that patients always need to see a GP, yet the most appropriate person is not always the GP. We have a wide primary healthcare team with staff members specializing in different areas. These are outlined below:-
Registrars
We are a training practice and often have GP registrars working at the practice. They are able to see patients and are closely supervised by their GP mentor.
Nursing Team
Our nursing team is led by our Lead Nurse Annie Cornell. She is responsible for the services offered by the team and the skill mix of the team (this essentially means who can do what). The nurses are better placed than the GPs to see patients with long term conditions such as diabetes, asthma and COPD. They are also able to combine annual health checks into fewer appointments so that patients do not have to make as many visits to the surgery. Our nursing team also sees patients for cervical smears, immunisations, complex dressings, and contraception including coil and Implanon fittings.
As part of the nursing team we also have HCAs (Healthcare Assistants). HCAs are not registered nurses but can carry out a number of ‘procedures’ to support the nursing team as well as being responsible for a number of other areas such as BPs, foot checks, injections, dressings, blood tests, ECGs, urine samples and things such as stocks and supplies/ordering.
A recent addition to the team as been the GPAs (General Practice Assistants). At Crown this includes reception/admin team members who have been trained up in specific clinical areas such as phlebotomy, ECGs, Blood Pressures. This means we can provide additional appointments for patients.
Primary Care Practitioners
We have two ex-paramedics who have been trained to predominantly deal with acute on the day issues. However, they are also able to see patients with more routine minor problems. We have a number of on the day slots available with them so that patients can be seen and assessed quickly with their acute problems as well as more routine slots for conditions that do not require immediate attention.
Pharmacist / Pharmacy technician
We have a pharmacist team consisting of Paulo Alberto, Clinical Pharmacist and Chelsea Howlett. Paulo can see and prescribe for people with a range of conditions such hypertension, depression, pain management, heart failure migraine and acne. He can counsel patients regarding new medications, queries about side effects and conduct annual medication reviews. Chelsea can help with people wishing to start statin medication or reduce antidepressant medications. She can also help with queries relating to hospital discharge medications.
Musculo-skeletal (MSK) First Contact Practitioner (FCP)
We have two MSK Practitioners (Philip Johnson and Stuart Wareham) who work with us. They are First Contact Physiotherapists (FCPs) who offer timely access to specialist musculoskeletal services. They are able to offer expert diagnosis and management of injuries such as shoulder pain, sciatica and joint pains including osteoarthritis, and act to bridge the gap between primary and secondary care clinics such as Orthopaedics and Physiotherapy Outpatients. They can offer advanced practice input such as injection therapy and are trained to recognise the signs of non-musculoskeletal medical conditions that require alternative pathways, allowing them to pick up cases at first contact within the practice.
Mental health workers
Fiona Miller
Fiona is a highly experienced mental health nurse who offer telephone appointments. These appointments are longer than typical GP appointments giving patients time to explore their mental health difficulties more fully. She sees people with anxiety, depression and OCD. She also has an interest in ADHD and can help people explore whether they wish to pursue a diagnosis of ADHD. Fiona does not see people who are already under the care of the Community Mental Health Team.
Emily Kane
Emily is an experienced mental health nurse for children and has a wealth of knowledge about local support available to children and families. She sees children and their families with issues such as anxiety, low mood, self-harm, concerns around food and sleep. Emily does not see children who are currently under CAMHS.
Pharmacy First
Local pharmacists are able to deal with a number of minor illnesses / conditions and our reception team is able to signpost patients to this service using a clinical triage program called “assess to refer”. The reception will ask some questions regarding your symptoms to check your condition is suitable to be seen by this service.
Medical Students
We host 3rd, 4th and 5th year medical students from Bristol University.
Patients may be offered appointments with our medical students, who usually consult in pairs, and a fully qualified GP will review your case before you leave the surgery.
Proactive Care Team
This is a team of highly skilled OTs, nurses and care co-ordinators who support people to maintain their independence. GPs may refer to this team or they may contact patients who they feel would benefit from their input.
Neighbourhood health coaching team
The neighbourhood health coaching team can support you to achieve your goals such as weight loss, stopping smoking or increasing exercise.
Use of technology / Apps
There are several useful apps and websites that we direct our patients to. The following do not need a GP referral. Patients who are registered with a GP in Somerset can access them directly.
NHS website for England - NHS
Somerset cancer self-referral - Cancer services - Somerset NHS Foundation Trust
Patients with a breast lump or bleeding after the menopause can self-refer using this link.
Patient Tailored Care for MSK pain and Women's Pelvic Health
The Get u better app is a physiotherapy-based app which can be accessed for musculoskeletal conditions and Women’s health.
For Mental Health we recommend:
Self-referral to talking therapies:
https://www.somersetft.nhs.uk/somerset-talking-therapies/
For anxiety
https://selfhelp.cntw.nhs.uk/organisation/somerset-nhs-foundation-trust/self-help-guides/anxiety
MINDLINE
24/7 emotional support line 01823 276892 there for you anytime you need to talk
Insomnia
https://selfhelp.cntw.nhs.uk/organisation/somerset-nhs-foundation-trust/self-help-guides/sleeping-problems
Mental health Crisis
For help in a mental health crisis, call MINDLINE 24/7 on 01823 276892 or book a Crisis Safe Space slot
Crisis Safe Space is an out-of-hours service provided by Mind in Somerset. Instead of going to A&E or making an urgent doctor’s appointment, you can arrange a one-to-one session with Crisis Safe Space team who will listen and able to help you. To book a space go to https://openmentalhealth.org.uk/crisis-safe-space/