Tonge Fold Newsletter January 2025
Tonge Fold Health Centre Autumn/Winter Newsletter 2024
Welcome to our newsletter. We hope it will update you on what is happening at your GP practice.
You will no doubt be aware from the news, media and your own experiences that the NHS continues to be under great pressure with longer waiting times than any of us would want. This affects hospital, clinic and A&E (secondary care) times and GP (primary care) referrals to them. We understand that longer waiting times to be seen in clinic or for treatment is frustrating and can be a concern that conditions will worsen whilst on waiting lists. Throughout these difficulties, our staff continue to try to provide stable and consistent care for you.
Staff News
Doctors
Dr Jane Lowe (known as Dr Jane) retired from GP practice on 30/9/24. She joined Dr K Lowe and Dr M Steele at the surgery when it was still at 39 Bradford Street, before the practice moved to Tonge Fold Health Centre in February 1982.
She has worked tirelessly for the patients in the practice, for over 40 years. She will be very greatly missed in the practice, by all of our staff. We know that very many patients will also miss Dr Lowe.
Despite the challenges in the NHS at present, we hope to maintain her strong values.
We wish her well in the future.
Our current doctors are: Dr Scott (M) Dr Rothwell (F) Dr McLoughlin (F) Dr Durbar (M) Dr Acomb (F) and Dr Faulkner (M). Dr Faulkner provides specialist clinics only, for minor operations, joint injections and Contraceptive Implants.
Our Doctors have now become a Training Practice for GPs in training. The trainees will have been working as a doctor for at least 3 years in a mix of hospital and GP jobs but who have decided to follow a career in GP. As with all the doctors here, they will provide routine and urgent appointments for you. These doctors are with the practice for either 6 months or 1 year.
Dr Durbar has also been training Medical Students, the doctors of the future. The practice received a Silver Award for this, in 2024, so a big thank-you to all our patients who have included them in their GP consultations, it really helps the medical student connect their learning to the real world. We hope that it will encourage some of them to think about becoming GPs in the future.
Reception, Administration Secretarial and Support Staff
We are very pleased to welcome Carla and Rebecca to our Reception staff this year, many of you will have already met or spoken with them. It takes time to learn the role of a GP receptionist and we appreciate your understanding whilst they are learning. We ae happy to receive feedback, whether good, or when things have gone not so well.
We have our longstanding staff in reception Ann, Gail, Lisa, Linda, Laura and Tracey and the team continues to be led by Elaine Leatham, our Practice Manager.
Kath and Carol continue as our Practice Nurses, supported by additional Practice Nurses from time to time, many of you will have also met Megan.
Recently, Carol has had to step back from her clinics, but we hope that she will be able to return in the future
Shahina and Sandra continue as our Healthcare Assistants, supporting the practice Team with a wide range of skills. Lisa also provides a phlebotomy service (taking blood samples) for the practice.
In General Practice, we now have the support of additional specialist staff.
Our Health Improvement Practitioner, often called HIP for short, is especially involved with NHS Health Checks and review of patients at risk of developing diabetes, heart attacks and strokes. She also reviews conditions such as high cholesterol and weight management.
Our Musculo-Skeletal Practitioner (usually shortened to MSK) is now available for specialist advice about joints, muscles, and back problems. Appointments can be booked directly through the Practice Reception. They are able to diagnose your problem, arrange X-rays and scans, provide physiotherapy, treatment and refer to the specialist if needed. We have had Byron in this role and he will be being replaced by James, in January 2025. Some patients will already have met James.
Our Mental Health Practitioner, Damon, is available for advice about mental health concerns, including stress, anxiety and depression. Appointments can be booked directly through the Practice Reception.
Our Practice pharmacist, Ahmed, is involved in reviewing complicated medications or medication supply/queries. He is also able to undertake reviews of specific medications and conditions .This role is separate from the Local and Independent High Street Pharmacies.
Our Paramedic is available for acute appointments and works as part of the Team supporting with vaccinations, health checks for certain groups, to promote good health.
A big than-you to Roland our caretaker and the Cleaning Staff who support him.
Appointments
NHS England have introduced the Pharmacy First Scheme to support GP care. Some of you may have already had experience of this. For common conditions such as urinary infections, insect bites, sore throats and coughs, NHS England wants you to be seen by pharmacists, in local pharmacies, who have had extra training to treat these conditions. This is to avoid you having to wait for a GP appointment, and to ensure that the right patients see the GP.
Some opticians also now provide an urgent Eye assessment, as an alternative to seeing a GP, this is for urgent eye problems other than routine sight tests. This makes use of the specialist equipment which these opticians have and also the optician’s ability to directly refer to the eye specialists, where needed.
Our reception staff will try to help you find the earliest, most suitable appointment if there is an alternative to a GP appointment. This is one of the reasons that our Reception staff ask you about your symptoms, the other reasons being that we need to be sure how urgent your condition is and whether you need to go directly or quickly to the hospital, eg for a suspected heart attack or stroke, or if there has been an injury which may need A&E input/Xray at the hospital.
GP appointments
Since the Covid19 Pandemic, and for the future, GPs at Tonge Fold Health Centre have offered a mixture of appointment types eg Face to Face appointments or Telephone appointments or initial telephone appointment consultations followed by a Face to face review. Appointments can be booked ahead or urgently on the day.
Telephone appointments followed by face to face, when needed, have enabled the doctors to meet the increase in demand for appointments that has arisen over the last three years.
We understand that one type of appointment does not suit everyone.
It is important to recognise some patients prefer and need a face to face appointment with a GP, whilst for other patients they may prefer not to come to the surgery, perhaps due to work commitments or not wanting to mix with other people indoors.
We apologise if appointments do run late as we recognise this is frustrating for all concerned.
The waiting room is used by patients attending appointments for the GP, Practice Nurse, Health Care Assistant, Health Improvement Practitioner, MSK, Mental Health Practitioner and for blood sample taking. This increases the numbers of patients in the surgery at any one time, particularly if appointments are unexpectedly running late or if patients have arrived early for an appointment.
We hope this helps you to understand how we are trying to keep the surgery a safe place for you all and to minimise your waiting time at the surgery. However we understand that this may sometimes be frustrating, it is not meant to be.
Please remember to cancel your appointment if you no longer need it so that we can offer the appointment to someone else.
To be sure of an urgent appointment for that day, you need to contact the surgery as early as possible, and before 10:30, so that we can arrange this.
Primary Care Network (PCN) and Extended Out of Hours Service
All GP practices in England are now required to be part of a PCN. It is through the PCN that we have access to the Pharmacist, MSK and Mental Health Practitioners, as already mentioned. Our practice is part of the Breightmet and Little Lever Primary Care Network.
Through our PCN, patients can access appointments in the evening and at weekends. The appointments are booked through our own Reception, but are based at one area of Tonge Fold Health Centre. You may be offered an appointment there with another GP, Nurse or MSK from the network and can book some appointments for eg blood tests.
Vaccinations .
Vaccinations are very important for children and adults to maintain your health, avoid serious illness and to avoid hospital admissions. Some conditions such as Measles and Whooping Cough that had become uncommon due to high vaccination uptake, have now come back in localised outbreaks where vaccination rates have fallen.
Please consider booking your Flu jab at the doctors if you are 65 years of age by 31/3/25 or older and if you are under 65years with certain conditions. It is advised also during pregnancy. There is a separate vaccine for children of school age or aged 2 or 3 years old.
Your Covid booster vaccination will be delivered by one of the Community Pharmacy or Hubs, for example the Health Hive, in the Market Place. For housebound patients, these are delivered by the Bolton GP Federation, who should contact you directly. The booster is offered to eligible groups.
Shingles vaccine – 2 doses of this vaccine are recommended if you are 65 years or older or from age 50 years if you have a weakened immune system.
Pneumoccocal vaccine is a one-off vaccine recommended for adults aged 65 years and over or adults younger than 65 years old with certain conditions such as lung or kidney diseases. It is also part of the childhood vaccination programme.
RSV vaccine (Respiratory Syncytial Vaccine) is advised during pregnancy and for adults aged 75 to 79 years of age. This has become available this year, as it was found that the RSV virus was a major reason for older people and very young children, being admitted to hospital with breathing problems. This is a one-off vaccine.
Whooping Cough vaccine (Pertussis) is an important part of children`s Immunisation programme and is recommended during pregnancy to protect your young baby. This will usually be given to you by the midwives. If there is a problem with this, please contact the surgery and we will try to help.
If you think that you may be eligible for these vaccines, please contact the reception, who will endeavour to help.
Health Checks
These are important to identify any problems early and to make sure you remain as well as possible.
If you have conditions requiring annual review and monitoring with the Practice Nurse, such as Asthma, COPD, angina, have had a heart attack or stroke in the past, have high blood pressure, diabetes, or dementia, please book your review each year in the month as below:
| Birth Month | Recall Review Month |
| April and October | April |
| May and November | May |
| June and December | June |
| July and January | July |
| August and February | August |
| September and March | September |
Patient Participation Group
If you are interested in joining our Patient Participation Group, or would like to find out about this, please contact our Practice Manager.
Thanks
We would like to thank our incredible cleaning staff and caretaker Roland, for all their hard work, it is much appreciated and very essential for us all. We would also like to thank all our Reception Team and clerical staff for their hard work, particularly at times when circumstances are difficult.
Finally, a big thank-you to all our patients for your patience, and understanding. You are important to us and we value good relationships with you.
Reflections on changes in General Practice at Dr J Lowe`s retirement
Dr Kenneth Lowe joined Dr Cowan in General Practice at 39 Bradford Street before the NHS started in 1948. He always thought the NHS was so important, as before that patients had to pay for their treatment and this could be very difficult. Dr Michael Steele joined Dr K Lowe, after Dr Cowan retired. Many people did not have a car then or their own telephone so he used to receive requests for home visits from Lizzie at the Post Office/shop at Darcy Lever. Patients could leave their request with her and she would phone it through to the surgery, or the doctors would call there to collect the requests each day. They were on call 24hrs 7 days per week between them, and covered maternity services as well as dispensing medication from the surgery.
When I joined Drs Lowe and Steele at the Practice, there was only one Receptionist, no computers and the surgeries were all Open Access (walk-in), no appointments were needed. You just arrived at the surgery during the times 8.30-9.30am and 4-6pm and waited your turn to see the next Doctor who was free. Whilst this meant you did not need an appointment to be seen, it did mean patients had to wait longer at the surgery, and in busy periods this could sometime be 3hrs. If an Emergency, eg Heart attack arrived at the surgery, the waiting time would be longer as the Emergency would have to be dealt with first. This is not really an option now for children at school or busy people at work or retired.
We moved to Tonge Fold Health Centre as it was a purpose built building with more room, car parking and disabled access. Initially another GP practice, Dr Brimms, Nagle and Docker also moved into the Centre, alongside Community/ District Nurses, Health Visitors and a dental clinic.
After the retirement of Dr Steele, Dr PN Kulkarni joined the practice, then Dr GS Faulkner joined at the retirement of Dr Kenneth Lowe in 1988.
Dr J Lowe, Dr PN Kulkarni and Dr GS Faulkner worked together at Tonge Fold Health centre for many years, supported by the Practice Manager, Receptionists and Secretary. Kath Kerry joined as Practice Nurse with the introduction of the role of Practice Nurse into GP surgeries. Early Health Prevention became more important to try and keep everyone healthy, alongside our GP work.
We changed the appointment system to pre-booked appointments in the evening and Open Access (no appointments needed) in the morning, all face to face at the surgery.
Later still, as more people had cars and phones, more people were at work so the Practice changed to all surgeries being pre-booked appointments but urgent appointments were seen after the morning surgery.
Flu epidemics arrived annually any time between October and March as Flu vaccination was not as organised or taken up by many patients as an option at that time. Vaccination has become an important part of Health Prevention, for children and adults, as serious illness from eg Measles, Mumps, Whooping Cough and Pneumonia or Meningitis were concerning before vaccinations were developed and available.
Health and Illness advice, other than from GP, was largely accessed through books or Family/Friends but with the advent of the Internet, this changed to allow wider access to information and knowledge, allowing patients able to manage their own Health Care.
Ambulance staff have become more specialised as Paramedics in their role, and the benefits of rapid access to hospital for heart attacks and strokes is understood.
Drs Scott and Rothwell joined the Practice after Dr Kulkarni retired, and Dr McLoughlin joined soon after. Nurse Carol joined the Practice and Sandra as Health Care Assistant.
The GP Practice has now expanded to a Team involving Paramedic, Mental Health practitioner, Musculoskeletal Practitioner, Paramedic, Pharmacist and Secretarial/Reception staff have increased in number as the role of a GP has changed to cover acute and chronic illness, prevention and monitoring alongside its continuing role in diagnosis and treatment.
Covid 19 had a significant change on all our lives and affecting us individually in different ways. In GP consultations were of necessity telephone based or using video consults or electronic use of photographs to aid diagnosis rather than face to face appointments. Telephone consultations were already being used as an option, alongside Face to face appointments, before Covid, but since then their use has been increased as we realised that this option was important to people and it allowed us to cope with increased demand for appointments, that could not be met by all in person clinics. However no one type of appointment, or access to getting an appointment suits everyone, so a variety has been maintained.