Citizens Advice

We are pleased to be able to restart our Citizens Advice clinic in the surgery on alternating Wednesday mornings, from January 2022.

Please see our clinics page for more information.

Appletree Update – Oct 2021

We are acutely aware that patients are currently frustrated with trying to get an appointment with a GP. We thought we would try and explain some of the issues that we are currently facing.

Currently we have approximately 11,100 patients and we offer around 700 appointments per week with a clinician, i.e. a doctor, Nurse Practitioner or Pharmacist. We offer a further 300 appointments with a practice nurse/HCA. Each day the demands for appointments far exceeds the number of appointments we can offer, so we need to manage these appointments carefully.

We are reviewing the number of face-to-face appointments vs telephone appointments that we offer on a weekly basis. However, patient/practice staff safety, as well as a clinical need, means that patient preference cannot always be offered.

Why aren’t you offering more face-to-face appointments?

There are many reasons why we are currently restricting the number of face-to-face appointments we offer:

  1. We are trying to reduce risk. Many patients who telephone the surgery have a cough or fever etc. which are possible indicators of Covid-19. Cases of Covid-19 are currently high, and we need to protect vulnerable patients visiting the surgery as well as staff members. We have been following NHS England guidance to telephone triage patients first, which enables us to reduce this risk. If, having spoken to a patient, a clinician feels that it is appropriate to see you face-to-face, they will book you in accordingly. Also, many problems can be dealt with effectively over the telephone.
  2. We have a finite number of appointments and by telephone triaging, we can prioritise patients accordingly, ensuring those with the most urgent clinical need can still be seen face-to-face if clinically necessary.
  3. We have made available a number of pre-bookable face-to-face routine appointments for patients to book directly without the need for telephone triage. This is due to some ailments automatically requiring an examination, so receptionist can advise if they feel this appropriate.
  4. Although isolation guidance has been relaxed for most of society, healthcare workers are still following strict isolation procedures. This means that if a member of staff has someone in their household who tests positive for Covid-19, that member of staff must work from home for up to 10 days. If this is a clinician, this has an impact on the number of patients that can be seen face-to-face.
  5. This has a knock-on effect for reception staff who are not only trying to answer incoming calls but are also rearranging pre-booked appointments, often at short notice. To reduce this additional workload, the booking of future routine appointments is restricted to ensure unnecessary rearranging.
  6. GP surgeries are required to ensure strict infection control procedures are followed. Consulting and treatment rooms need to be deep cleaned up to twice daily and all surfaces wiped down in between each patient as well as a change of PPE. This all takes additional time and resources.
  7. We do also have to remember that many patients prefer a telephone call rather than a face-to-face appointment as they are often at work or it fits in with their lifestyle.

Why are the telephone lines so busy?

We recognise that the phone lines are extremely busy, which demonstrates how much pressure the receptionists are currently under. Please be patient and kind; they are working tremendously hard and they are working to the instructions of the GPs.

Some of the reasons why the phones are busy are:

  • Patient enquiries regarding covid-19 vaccinations and the covid-passport. Each day we receive many calls relating to when patients will receive vaccine appointments or how to access the NHS app.
  • Additional enquiries regarding hospital waiting lists due to delays in operations. These patients are requiring additional GP help, care and appointments.
  • Every time the news/papers/social media report any sort of health-related story, patients ring their GP surgeries for advice and guidance. Over the last 18 months there has been a lot of media regarding the pandemic, which subsequently increases telephone traffic. For example:
    • Patients needing a covid passport to travel.
    • Covid Booster vaccination eligibility
    • The relaxing of isolation guidance
    • Do I need a PCR test?
  • There has been a national blood bottle shortage. Patients have been contacting the surgery asking if their blood test is urgent or when they can get a blood test appointment. Many appointments have been cancelled as a result; all of this requires receptionist time.
  • Many calls to the surgery are generally taking longer to deal with. There is an unprecedented demand for appointments and it takes time explaining the reasons why there are no appointments left that day, or that you will need to ring back at 8am the following day. Prior to booking an appointment, receptionists are also required to ask covid-19 related questions.

The phone lines are under regular review and we have recently increased the number of lines into the practice to help meet demand. We have also moved over to the Medicines Order line (MOL) for repeat prescription requests. This will hopefully reduce the amount of phone calls coming into the practice.

Why don’t you get more staff?

If only it was that easy:

Clinical staff
The setting up of the vaccination hub at the beginning of this year is having a massive impact on our staffing levels. Whilst we have been very fortunate to secure a large number of volunteers, along with the 3 other surgeries involved, we have had to supply our share of GPs, Nurses and administration staff to help deliver the vaccination programme. This will continue through to Christmas as we administer the flu and covid-19 booster vaccines. If clinicians are working at the hub, this obviously has an impact on the number of appointments we can offer at the surgery.
We have desperately tried to get some locum cover to help ease the pressure, but unfortunately, there is a national shortage of GPs. We have managed to secure one locum GP for half a day per week until Christmas. We have also secured a second locum GP for one day per week during November and December. Although this is still a shortfall of what we require, it goes a little way in bolstering the appointment availability.

Reception Staff
The role of a receptionist is a complex one. It takes approximately 8 weeks of intensive training to become a receptionist, and a further 6 months before they feel confident enough to be able to deal with the majority of queries that come in on any given day, so recruiting temporary staff is not an option.

Over the last year, we have increased the number of receptionists answering the telephone at any one time. We have employed a couple of members of staff to help out with ringing patients who do not have a mobile phone (and therefore no text facility) to invite them for the flu/covid/booster vaccines. We have also recently employed an apprentice to help support the reception team.

How you can help us!

I hope that this goes some way to explaining the challenging circumstances our staff are currently facing. Please show respect to all staff and treat them with kindness. Although it might look like our waiting room has very few patients sitting in it, this is to protect you and your loved ones. Whether it is our clinical staff, our receptionists or our administration team, we are all working extremely hard and we are all incredibly proud to be working for the NHS.

Thank you

DVLA and ‘fit to drive’ support

Please see our support page for information on DVLA ‘fit to drive’ requests

Ordering repeat prescriptions – Medicines Ordering Line

From October 6th Appletree will be changing the way we accept repeat medication requests.

What does this mean for you?

The surgery will no longer be accepting telephone calls for repeat prescriptions or queries. Instead you will call a dedicated Medicines Ordering Line:

 0115 855 0260

who with your consent, will have access to your medication and process your request or query directly through to the GP.

Please see further information on our Ordering Repeat Prescriptions page.

Support Your Surgery

GPs and their teams have faced an extremely challenging time during the COVID-19 pandemic. The restrictions have meant that face-to-face contact with patients has been limited in order to keep practice staff and patients safe.

The British Medical Association Support Your Surgery campaign provides GP practices with the tools to both manage expectations and to provide patients with the reality of issues facing general practice.

Alongside this, they have launched a petition calling on the UK Government to provide the urgent resourcing needed to increase the number of GPs in England.

See the full information and sign the petition here

BMA Support Your Surgery

Covid-19 Booster & Flu Vaccines


Covid booster and Flu Vaccinations clinics have now been organised and invitations are being sent to patients who are due their booster now. These vaccinations (one in each arm) will be given at the same appointment.  The covid booster cannot be given until 6 months after you received your second covid vaccine.   You are likely to be offered a full dose of the Pfizer/BioNTech vaccine (or, less likely, a half dose of the Moderna vaccine).  This follows scientific evidence showing that both of these vaccines provide a strong booster response, regardless of which vaccine you initially had.

We are currently working to staff these clinics, so please bear with us.  We will be contacting eligible patients either by text, phone or letter inviting you to book an appointment a the Babington Vaccination Hub.

If you are a Carer or Health and Social Care Worker and it is more than 6 months since your 2nd dose of Covid vaccine and you are eligible for a booster you can let us know using this link

Eligible Under 18’s are the exception and will be offered the Nasal Flu vaccination at the Duffield Surgery.  Again, invitations will be sent by text, phone or letter.

Face Masks – July 21

Despite lockdown restrictions lifting in the community from 19 July, measures will remain unchanged in healthcare settings, including your GP practice. Please continue to help us to help you by wearing a face covering when entering our buildings, washing your hands using the facilities provided and maintaining social distancing.

Restrictions remain and inside all our premises and you still need to wear a mask, wash your hands and follow social distancing. Our practice has put in place comprehensive measures for staff and patients for the wearing of face masks and face coverings whilst at our surgery. All patients and visitors should continue to wear a face covering on entrance to our buildings and throughout the duration of their visit.

The face coverings can be a scarf, homemade face mask or one that has been purchased. The measures continue to be an important part, alongside social distancing, of reducing the spread of Covid-19 and to keep our patients and communities safe.

We do understand that it can be frustrating, but we do know that when patients come to see us they are often sick and vulnerable, so we feel it would be wrong to not take these small precautions that can protect people.

Mask Exemptions for Airline Passengers in Relation to COVID-19

We are aware that some airlines are asking for medical evidence to support mask exemptions for passengers.

Government guidance clearly states that there is no requirement to have written evidence for an exemption for face covering rules and that people do not need to ask for proof from a doctor.

NHS Digital – update

The data held in the GP medical records of patients is used every day to support health and care planning and research in England, helping to find better treatments and improve patient outcomes for everyone. 

For more information about how data is used, and how to opt out if you choose to, please see our page General Practice Data for Planning and Research (GPDPR).

Vaccine Passport

From 17 May 2021, people in England who have been fully vaccinated against COVID-19 can demonstrate their vaccination status for international travel. A full course is currently two doses of any approved vaccine. Vaccine status will be available from: 

  • the NHS App which you can download from app stores 
  • the NHS website (from 17 May 2021)

It may take more than a week for your identity to be checked and verified so you can use these services.

If you cannot access these online services, and you have had two vaccines, you can request a paper letter from the NHS by calling 119. Only call 119 if you had your second dose more than five working days ago. It may take seven working days for the letter to arrive.

This practice is not able to provide you with a letter that shows your COVID-19 vaccination status.

When you’re planning your travel, check the latest information on demonstrating your COVID-19 status when travelling abroad on the website. Make sure there is time to get  proof of your vaccination status before you leave.

NHS App to be used as Covid-19 passport from May 17