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Practice Updates

Please read the following Practice Updates which are published monthly in the East Bergholt Parish Magazine. These monthly updates enable the Practice to let our patients know what has been going on across our two sites. 

Pete Keeble

Practice Manager

Constable Country Medical Practice – Practice Update August 2017


Dementia is a condition that can have a devastating impact on patients, their family and friends. However, the earlier it is identified, the more likely it is that the patient will retain a good quality of life and their dignity.

The practice has one of the lowest levels of dementia diagnosis across Suffolk. Although we would like to think this really is that case, we suspect the truth is that many patients suffering from dementia have not been formally diagnosed and are therefore are not receiving the support and care they need. If you suspect a friend or family member may be suffering from dementia, please persuade them to make an appointment with a GP. A quick assessment at the practice may suggest dementia, in which case they will be referred to the Hospital for a comprehensive assessment, or their symptoms may be attributable to another cause.

For more information on dementia, visit or

Dr Fayez Ayache

After over 30 years as a GP at the practice Dr Ayache, our senior GP Partner, has decided to retire. He has been a steadying influence on the practice and been crucial in steering us through difficult times over the last few years. Dr Ayache has earned the respect of not just patients and staff, but the health community in general across Suffolk and further afield. As an ENT specialist GP he has worked in the community at Hadleigh as well as at Ipswich Hospital. However, his biggest challenge has been supporting those in desperate need as a result of conflict in his country of birth, Syria. He has been frequently interviewed by the media and has been a key supporter of a charity set up to help Syrian refugees. He will continue this work when he leaves the practice at the end of December. Dr Ayache has endeavoured to give all his patients the best care possible and would like to thank them all for their kindness and support over the years.

Annual Flu Clinics

We are starting to prepare for our annual flu clinics. This year we will be administering a quadrivalent influenza vaccine to patients over 18. Previously, the  majority  of  seasonal  influenza  vaccines  were  trivalent  meaning  that  they  protect  against  three  of the four main flu virus strains. If the strain not covered turns out to be predominant then the vaccine is less effective. The new quadrivalent vaccine protects against all four strains and so will be effective irrespective of which strains are predominant in any one year. The vaccine is administered exactly the same as in previous years so patients will not experience any difference. The practice sources the quadrivalent vaccine from Sanofi Pasteur, one of the largest and most respected vaccine manufacturers in the world.

Our aim is to vaccinate as many patients as possible and start the vaccination programme as soon as we take delivery of the vaccines. This year we will be holding additional flu clinics at the end of October, though we urge all eligible patients to attend our main flu clinics on the following dates.

East Bergholt Medical Centre:

Tuesday 26th September, 2.00pm to 7.00pm (Patients aged 18 year and over)

Capel St Mary Surgery:

Thursday 5th October, 2.00pm to 7.00pm (Children and Adults)

Additional flu clinics will be held on the following dates:

East Bergholt Medical Centre:

Thursday 26th October, 3.00pm to 6.00pm (Children and Adults)

Capel St Mary Surgery:

Tuesday 31st October, 3.00pm to 6.00pm (Children and Adults) 

The clinics will run on the same basis as previously: all eligible patients will receive a letter by mid-September inviting them to attend on one of the above days. Patients may attend any clinic, irrespective of where they live, and no appointment is needed.

Training Days

 Just a reminder that the practice will be closed from 1pm on the following dates for staff training:

7th September 2017 (Thurs)

4th October 2017 (Wed)

16th November 2017 (Thurs)

 On these afternoons the doors will be closed so please ensure any prescriptions are picked up well beforehand. If you phone the practice the recorded message will ask you to ring 111 for medical assistance if your problem cannot wait until the next day.

Constable Country Medical Practice – Practice Update July 2017

Patient Confidentiality

The practice takes patient confidentiality very seriously but our staff are often faced with situations where they are asked to compromise this confidentiality. I thought it would be useful remind patients of a few guidelines.

Unless it is clearly in the patient’s best interest to do otherwise, we can only discuss patient information with someone other than the patient themselves if we have written consent from the patient. Even the fact that a patient has an appointment at the practice is confidential, as they may not wish family or friends to know. We therefore cannot confirm that a patient has an appointment, discuss their medication or any other aspect of their care without their permission. It is acceptable for a patient to give verbal consent on the phone, and then pass the phone to a friend or relative to discuss their problem. It is also acceptable for someone to book an appointment for a patient, or cancel it, as this does not require us to divulge any information.

 We may leave a general message on a landline answer phone to contact us, but will not be specific about the reason. Where we have a mobile number of a patient we will assume they have consented for us to send text messages confirming appointments or conveying test results or other information, unless they have informed us otherwise. Please ensure we have an up to date mobile number.

 Two specific problem situations are often encountered. First, elderly or disabled patients may have difficulty in communicating or lack mobility and need someone to act on their behalf. A letter of consent enabling practice staff to discuss issues on their behalf really helps. The letter could specify, for example, that just appointments and medication should be discussed, rather than specific details about conditions.

 The other situation is parents discussing their children’s records. This is not a straightforward area. When parents are separated or divorced they may still have parental responsibility and so be entitled to fully discuss their child’s health. For children under 16, parents do not have an automatic right to access their child’s record and discuss their medical issues. Here, “Gillick competency” applies.

Lord Scarman, in his judgment of the Gillick case in the House of Lords (Gillick v West Norfolk, 1985) commented generally on parents’ versus children’s rights as follows: "parental right yields to the child’s right to make his own decisions when he reaches a sufficient understanding and intelligence to be capable of making up his own mind on the matter requiring decision."

This means that we may decline to share children’s medical information with their parents if it is judged by a practice healthcare professional that it is not in their best interest to do so. Teenagers should also confirm that we have their own mobile number, rather than one of their parents, recorded for them.

Constable Country Medical Practice – Practice Update June 2017

Phone System Upgrade

We will be further upgrading our telephone system over the summer. Patients will no longer experience a busy tone when all lines are engaged but will be informed of their position in a queue. This information will be updated as you progress through the queue. At peak times we have up to 7 receptionist answering calls, so even if there are a number of patients already in the queue, your waiting time should not be too long.

Whatever time you ring during day you will be able to speak to a doctor if you need to, unless demand is exceptionally high. If all our face-to-face appointments have already been booked, a doctor will phone you back to discuss your problem and if you need to be seen in person they will arrange for you to be seen that same day.

Patient Information Screens

We have purchased new computers to run the patient information screens at East Bergholt and Capel which should now be more reliable. They convey useful information provided by the NHS and also details of how we operate the practice and how best to access the services we offer.

Medical Receptionists

Our medical receptionist can help with a wide range of issues. Increasingly, we are training them to ensure they are equipped to help patients and signpost to a variety of support services. If you have a medical problem, it helps if you disclose it to them so they can ensure you are seen by the right practice clinician (GP, Nurse Practitioner, Practice Nurse or Health Care Assistant). Pharmacists and osteopaths can help for many conditions, and there are many support services available which offer expert advice to help patients with issues such as bereavement, dementia etc. Our reception team can provide information on these services.  

National Diabetes Audit

The practice is participating in the National Diabetes Audit. This is an NHS initiative which aims to determine how the Clinical Commissioning Group and practices across Suffolk can improve the effectiveness of treatment for patients with diabetes. This involves sharing patient information with NHS England, though strict confidentiality and security rules will apply. Please inform the practice if you do not want your information to be shared for this purpose.

Constable Country Medical Practice – Practice Update April 2017

GP+ Service

Suffolk GP Federation provides out-of-hours services on behalf of the majority of practices in Suffolk. It operates from a number of sites, the nearest to the practice being Stowmarket (Stow Health), Ipswich (Riverside) and Felixstowe (Felixstowe General Hospital). Typically, services are offered from 18:30 to 21:00 during the week and through the day on Saturday and Sunday. 15 minute GP and Nurse Practitioner appointments are available but can only be booked by the practice or other healthcare organisations. At the time of booking, patients will need to provide their consent to share their medical notes with the clinician they see. This service is proving to be very popular as it relieves pressure on the practice on busy days and also provides patients with alternative options for addressing a medical problem. You may be offered an appointment with GP+ or you can ask the receptionist for current availability.

 Nurse Practitioners

 I’m delighted to announce that we have an additional Nurse Practitioner joining the practice. June will be joining us at the end of April. She is an experienced Nurse Practitioner who also specialises in the treatment of diabetes. Our two Nurse Practitioners, June and Sarah, are able to address a wide range of medical conditions. On contacting the practice our reception team can advise patients whether it is appropriate for them to be seen a Nurse Practitioners or if they need to see a GP. 

Repeat Prescriptions

 Please note that it may take the practice up to 72 hours to process a repeat prescription. When issued they can be sent immediately to the patient’s nominated pharmacy but it may take up to 72 hours for the pharmacy to have your medication ready for collection, depending on workload and the availability of the items required. In the majority of cases your prescription will be processed and ready for collection much sooner, but please allow ample time by ensuring the practice receives repeat prescription slips a week in advance of when the items are required.


The Practice has wheelchairs available at both Capel and East Bergholt to assist patients with mobility problems getting in and out of the practice. Unfortunately, one of the chairs at East Bergholt has broken and is not repairable. If you have a wheelchair you no longer need, and it is not on loan from the NHS, the practice could make very good use of it.


Constable Country Medical Practice – Practice Update March 2017 

Demand Over Public Holidays

Demand over Christmas and New Year was very high and we experienced a backlog in processing prescriptions for a couple of days immediately after the New Year. Pharmacies are also very busy over public holidays. We are sorry if patients experienced delays in receiving their medication.

 In order to minimise delays over the Easter period, please submit requests for repeat medication well in advance. Repeat medication can be requested online if you have a SystmOne online account. Please contact the reception team if you would like to register for an account.

 High Demand and Storm Doris

 Storm Doris caused major disruption across Suffolk on Thursday 23rd February. The East Bergholt surgery lost power for over 4 hours. We relocated clinicians to Capel and diverted or rearranged patients who had appointments at East Bergholt. The loss of power meant that we lost access to patient records, our phone system for both sites went down, vaccines in our fridges went over their permissible temperature range, and we had to close the East Bergholt premises at about 16:45 as it was too dark to work safely.

 Many patients were affected by the disruption, not only on the day but also for the following week or so when appointments were rescheduled and whilst vaccines were unavailable due to the loss of power to our fridges. Thank you to all patients affected for your understanding.

 The last significant power loss at East Bergholt was in 2013, though outages do occur on a regular basis, usually for just a few minutes. Following a full review of events we have decided to purchase an emergency generator and necessary cabling to ensure that in the event of future significant power failures at the East Bergholt or Capel premises, we are able to continue to keep our phone system operational and attend to patients who need urgent care. Hopefully these events will be few and far between.

Constable Country Medical Practice – Practice Update January 2017

 Managing Demand over the Winter Period

Demand on the NHS as a whole is at its highest during the winter months. This puts pressure on all our staff and so it is even more important at this time of the year that we deal with patient problems as efficiently as possible. Please help us by following the guidelines below:

  • Tell the receptionist the nature of your problem. They can ensure you see the right clinician (GP, Nurse Practitioner, Practice Nurse) and you may not need to come into the practice if it can be dealt with over the telephone. If you need to see a GP, they will be aware of your problem before you see them which helps them prepare for you consultation. Of course, if your problem is personal and you would rather not disclose it, then that is fine.
  • If you need a home visit, please let us know as soon as possible. The doctor will phone you before leaving the practice to ensure they need to see you and they can help with the problem. Home visits can take up to an hour in total so if you can attend to practice please do so.
  • Order repeat medication well in advance and nominate a pharmacy. Many prescriptions can be sent electronically to a pharmacy of your choice. However, it can take up to 3 days for the practice to process you prescription as the doctor will need check that it is safe to issue it.
  • The clinicians at the practice are not equipped to deal with every problem. If you have a serious acute problem you should attend A&E or dial 999 for emergency assistance as contacting the surgery may delay treatment being provided to you. Serious problems include broken bones, severe allergic reactions, breathing difficulties, severe chest pain, severe burns, seizures, very ill children, severe bleeding, poisoning, foreign body in your eye/ear. This list is not exhaustive and the practice may advise you to attend A&E if it is in your best interest to do so.

Constable Country Medical Practice – Practice Update December 2016

Happy New Year!

On behalf of all practice staff, I hope you had an enjoyable Christmas break and wish you a very happy 2017!

 With the New Year we must expect cold and icy weather. Please be careful on icy paths as a simple fall may mean a trip to A&E. Please also make full use of your pharmacy. Your local pharmacist can offer advice on a range of minor problems and often provide effective over-the-counter medication. They will tell you if they believe you should be seen by a GP.

 Please also look out for your neighbours. The elderly can be particularly vulnerable at this time of year. As well as slips in icy conditions, they may be cold or suffering from coughs and colds. Please keep an eye on them.

 Allied Health Professional Suffolk

 I’m pleased to announce that Allied Health Professionals Suffolk (AHPS) will hold clinics at the East Bergholt Medical Centre on Thursday’s from 12th January 2017. AHPS hold a number of musculoskeletal outpatient physiotherapy clinics around Suffolk. They see patients with a wide variety of conditions including those affecting muscles, bones and joints.  The physiotherapist will assess each condition and agree with patients the most appropriate management of that condition which may include manual therapy, electrotherapy, acupuncture, work related ergonomics advice, and posture advice. Patients can self-refer to this NHS service. For more details please visit the AHP website at or ring 03330 433966.

Flu, Pneumococcal and Shingles Vaccinations

We still have plenty of flu and pneumococcal vaccinations available. All eligible patients should have received a letter at the end of September. If you wish to make an appointment for a vaccination, or are uncertain whether you are eligible, our reception team can advise you.

 We have also written to patients who are eligible for a shingles vaccination. Patients are eligible if they are aged 70, 71, 72, 73 or 79 on 1st September 2016. This is a one-off vaccination and can be booked with one of our practices nurses.

 Electronic Prescription Service (EPS)

 The practice switched over to the Electronic Prescription Service (EPS) on 22nd November. We are now able to send electronic prescriptions for most (but not all) medication to the majority of pharmacies. You must have nominated a pharmacy for your prescription to be processed electronically. You can inform either the pharmacy or the practice, and change your nominated pharmacy at any time.

Constable Country Medical Practice – Practice Update November 2016 

Flu, Pneumococcal and Shingles Vaccinations

We held Flu clinics at East Bergholt on 11th October and Capel on 20th October. We vaccinated over 2,137 patients over the two days which was higher than last year. Representatives from the Patient Participation Group helped to direct patients and generally both days went well with a steady flow through each afternoon. Thank you to all patients for making the day so successful and for your kind donations to Age UK and EACH.

 Patients who are eligible for free NHS flu or pneumococcal vaccinations but were unable to attend one of our flu days can now book an appointment at one of our weekly mini clinics.

 Due to supply issues we were not able to vaccinate patients eligible for the pneumococcal vaccination at our first flu day, though we did have supplies for the second one at Capel. We have now have ample supplies. Note that patients were informed by letter if they are eligible the pneumococcal vaccination.

In November the practice will be writing to patients who are eligible for shingles vaccinations. These can then be booked with one of our nurses.

Constable Country Medical Practice – Practice Update September 2016 

Helping the Practice to Help You

Pressures on the NHS are reported on daily in the media; overspend, hospital closures, A&E waiting times etc. Your GP practice is a critical component of the NHS and increasing demand and pressure on funding affects us as well. We have finite resources so therefore need to work as efficiently as possible. As we head into autumn we know that demand will increase. We continually work to improve the efficiency the practice and you can help us by bearing in mind following guidelines:


  1. If you require repeat medication, let us know well in advance and allow 3 working days before collection.
  2. Nominate a pharmacy so that from November your prescriptions can be sent quickly and electronically to a pharmacy of your choice.
  3. Use your pharmacist. They can offer excellent advice and provide over-the-counter medication which your GP cannot prescribe. If your pharmacist believes you need to see a GP they will tell you.
  4. Use NHS Choices. The website contains extensive help on a wide range of medical conditions and offers advice on what you can do to help yourself and when you need to seek help from a GP.
  5. Tell our receptionist the nature of you problem. They may be able to resolve it without you having to come to the practice (e.g. medication issues) and they can advise on the most appropriate clinician to see (GP, Nurse Practitioner, Nurse, Pharmacist etc.). Remember that we will never turn a patient away who needs to speak to a doctor. If our on-the-day appointments are fully booked, one of our doctors will phone you back to discuss your problem and see you in person if necessary.
  6. Phone later in the day if you need test results. If a result is abnormal and or action is required then you will be contacted by the practice. We don’t contact patients when no further action is required.
  7. Please bear with us! Some days are very busy, especially Mondays and Fridays. If you can’t get through on the phone then try later. You will always be able to speak to a doctor if necessary.

Constable Country Medical Practice – Practice Update August 2016

Repeat Prescription Requests

The practice processes hundreds of prescriptions every week. To ensure patients are safely prescribed the medication they need, every item needs to be checked by a doctor before it is authorised. Please allow up to 72 working hours (3 working days) for prescriptions to be processed by the surgery before collection. Your chosen pharmacy may then take 24 hours or more to dispense the items, depending on availability. You can drop repeat slips into the practice or to your nominated pharmacy if it is close to the practice, though pharmacies in Essex are unable to accept repeat slips. You can also request repeat medication via SystmOnline Web access or phone app if you have registered for an account. However, requests cannot be accepted over the phone.

 Medication Following Hospital Discharge

When a Hospital discharges a patient they should be given a minimum of 14 days medication if any is required. The consultant will send the practice a letter requesting our doctors prescribe any further medication. However, the patient will need to contact the practice if they need a prescription to be issued. Patients’ circumstances can change and this system ensures that medication is not dispensed unnecessarily.

 Electronic Prescription Service (EPS)

In November the practice will be implementing the Electronic Prescription Service (EPS). This is a national system which is now being rolled-out across Suffolk. The aim of the EPS is to reduce reliance on printed prescriptions. With the exception of prescriptions for some special types medication, the majority of prescriptions will be signed and sent electronically to a pharmacy of the patient’s choice. This will speed up the process and provide a clear audit trail of where the prescription is at any point in time.

In order for the system to work, patients should nominate a pharmacy for their prescription to be sent to. You can inform either the pharmacy of your choice or the practice. You can change your nominated pharmacy at any time and if you need to pick up a paper prescription you can still do so. However, patients who are on repeat medication will benefit the most as potential delays will be minimised. Note that you will still have to submit your repeat slip, which will be issued by the pharmacy, with the items you require ticked and the practice will still require up to 72 hours to process your request.

There are many other benefits to EPS including nominating a pharmacy elsewhere in the UK when you are on holiday, or a pharmacy near where you work. Prescriptions are sent as soon as the doctor has authorised them, minimising delay for urgent medication needs.


Breast Feeding Facilities

If mothers would like somewhere private to feed their baby, please ask a receptionist who will be happy to find a suitable room.

Constable Country Medical Practice – Practice Update July 2016


Patient Participation Group and Patient Feedback

Over the last year there have been many changes at the practice. In addition to changes in the partnership and other staff, we have also changed our appointment system. Some changes take a while to have an impact on how the practice is perceived as some patients only occasionally have a need to visit the practice. However, we hope that our policy of always offering a same day face-to-face or telephone appointment is reassuring and patients understand they can contact us at any time of the day if they need access to a clinician.

 We want to continue to improve the service we offer and our interaction with patients is key to helping us understand what works well and where we can improve. I thought it may be useful to summarise how you can improve your interaction with the practice:

 Most importantly, please ensure we have up to date contact details for you, including home and mobile telephone numbers and email address. You can update these via our website (click on ‘update contact details’ on the home page) or by filling in a form available from reception. This will enable us to send appointment confirmations, notifications of test results and other important information we feel you should be aware of. Note that your details are strictly confidential and will only be used for practice purposes.

 We are further developing our website to ensure that information you need is available. It contains PPG minutes and contact details, news items including regular practice updates, information on our appointment system, and the facilities to register as a new patient and provide feedback. Our aim is to improve the website over the coming months to ensure it contains up to date and useful information. We will also be introducing a twitter feed to inform patients of incidents, such as power cuts, or events such as flu clinics.

 The PPG has been operating for over a year now and we are lucky to have such an active PPG. We meet monthly and discuss the day to day operation of the practice, new developments and any problems which come to their attention. The PPG are also proactive in helping the practice address wider health issues. They recently organised a very successful presentation on diabetes by Dr Gerry Rayman, and will be organising further events in the year ahead. Their contact details can be found on the website and they welcome feedback on how the practice is performing.

 The PPG have provided feedback cards for patient use and collection boxes at Capel and EB, and these are reviewed regularly. We also have Friends and Family Test feedback cards available, and patients can provide feedback via our website and on NHS Choices. We welcome all feedback, though we hope patients will tell us when they have had a good experience, not just when they have experienced a problem.

Constable Country Medical Practice – Practice Update June 2016


Staff Changes

I’m delighted to announce that Dr Ewa El Graoui will be joining the practice on 13th June as a GP Partner. We will then have four GP Partners and are advertising to fill our outstanding vacancies for an additional doctor and a Nurse Practitioner. Many practices are struggling to recruit doctors, as there is a national shortage of GPs, and our practice is no exception. In the meantime, we will continue to use a number of excellent doctors on a locum basis, including Dr Johal, Dr Le Roux, and Dr Kunche. Dr Ewa’s arrival will help us to improve continuity of care to patients. Dr Omar left the practice at the end of March and will be moving to a different part of the UK. Until that time he will continue to oversee our four GP registrars.

 Practice workload and operations

 We operate a very busy practice with demand steadily increasing in line with national trends. In order to cope with demand, and work within NHS funding constraints, the practice needs to operate in a way which offers the best service possible, with the finite resources at our disposal. I thought it worthwhile clarifying a few issues which patients have bought to my attention.

We feel that our new appointment system offers excellent access for patients. Some practices insist that all appointments are initially via telephone with a doctor, and others refuse to offer appointments when they are full. We do neither. We have some pre-bookable appointments, the majority are then available for booking on the day, and when they are full we operate an overflow list where we will never turn a patient away. Patients on the overflow list will initially speak with a doctor over the phone and then be seen in person if necessary. Although this does not work for everyone we feel this is an excellent compromise; patients will always be able to speak to a doctor whenever they contact us.

As long as we have your mobile number, the practice will send you a text message confirming your appointment. Please note that Constable Country Medical Practice refers to the East Bergholt site and Capel St Mary to the Capel site. For technical reasons we are unable to change ‘Constable Country Medical Practice’ for ‘East Bergholt’ but are exploring the possibility of doing this.

Our doctors have 10 minutes for a face-to-face appointment, as specified by NHS England. However, when patients attend with serious or multiple problems, consultations can take longer. Doctors may also have to see additional urgent cases or make an urgent visit to a patient’s home. Please be patient, but if the doctor is overrunning and you cannot wait then let the receptionist know.

Along with all other practices in Suffolk, we are working with the Clinical Commissioning Group (CCG) to reduce NHS prescribing costs. A pharmacist from the CCG helps us to identify patients who could be switched to identical, but non-branded medication which is often considerably cheaper. The pharmacist will then write to the patient informing them of the change. All medication changes are approved by our doctors before they are made, and if the patient experiences any problems, e.g. because of a different coating, the doctors are happy to discuss with the patient and switch back if necessary.

Finally, just a word about test results and medication. Our doctors review hundreds of test results and letters every week (often hundreds a day!). If a patient has been referred for a test the practice will inform them if further action is required. We will not contact patients if no action is required though patients can contact the practice to find out their result. With regard to medication, when medication is requested by a consultant following discharge from hospital, the doctors will enter the medication on to the patients record. However, the prescription will generally only be printed out, signed and ready for collected when requested by the patient. This is because the hospital is obliged to provide 14 days medication following discharge and the patient may not require further medication depending on the nature of their problem and speed of recovery.


Constable Country Medical Practice – Practice Update February 2016


Managing Winter Demand and Prescribing

This is one of the busiest times of the year for the practice and on some days demand can be extremely high. Since last September we have operated a triage system. When all our doctor appointments are full, and you feel you need to speak with a doctor, you will be placed on a list for the doctor to phone you back and either address your problem over the phone or ask you to attend an appointment later in the day. Each day, one doctor has responsibility for contacting patients added to the list.

 Some days, this list has extended to over 40 patients and the nominated doctor for that day will contact them all in addition to their morning surgery and dealing with the clinical administration work (test results and letters from the hospital relating to patients they have referred).

Many of the problems patients present with can be addressed by our excellent Nurse Practitioners and our Minor Illness Nurse. Many of their appointments are pre-bookable as well. These include problems such as cough/colds, rashes, headache, earache, minor injuries, conjunctivitis etc. Our reception team can advise on whether our nurses can treat you.

Also, pharmacists can provide sound advice on many conditions and treatments are often available over the counter without prescription. Please note that the Clinical Commissioning Group (CCG) have issued guidelines for our clinicians not to prescribe treatments which are available over the counter. Paracetamol, for example, is available very cheaply in supermarkets but cost the NHS is significantly greater if it is prescribed.

The CCG have recently issued guidelines on prescribing gluten free products. These can no longer be prescribed for patients over 18 years old, and only in limited quantities for patients under 18.

Our clinicians have also been asked to reduce antibiotic prescribing. This is because many viruses are becoming more resistant to antibiotics and very few new antibiotics have been discovered over the last 20 year or so. This means that if they continue to be prescribed at high rates then there is a very real danger that the antibiotics currently available cease to become effective. Our clinicians will, of course, prescribe the medication they believe is most appropriate to treat a problem.

 Christmas Gifts

Thank you to all patients who handed presents to the practice over the Christmas period. All these gifts were distributed to all doctors and other members of staff. Last year was very challenging for us and we were all very grateful, and moved, to receive so many gifts of appreciation.

Constable Country Medical Practice – Practice Update January 2016


Practice Rated as ‘Good’ by Care Quality Commission (CQC)

The Practice was inspected by the CQC on 2nd November 2015. This was a follow-up to their last inspection on 10th March 2015. Six inspectors spent the day at both East Bergholt and Capel St Mary sites. They spoke to patients, staff and members of the new Patient Participation Group (PPG). They also requested evidence that the practice was meeting its contractual and regulatory obligations, including infection control, staff training, prescribing, patient confidentiality etc.


After the inspection in March, the practice quickly put in place an improvement plan, which it agreed with the CQC and Clinical Commissioning Group (CCG). Over the following 8 months, all staff have worked exceptionally hard to implement the plan. We have made many internal changes which aren’t immediately evident to patients, such as the way we review and learn from events that happen. We have also made changes which have had a direct impact on patients, including the formation of our new PPG, and a fundamental change to our appointment system. Judging by comments left on the NHS Choices website and comment cards in our waiting areas, the changes we have made have had a very positive impact on the quality of care we provide to patients.


This was recognised by the CQC and we are delighted that they have rated the practice as ‘Good’ overall, and ‘Good’ for every area they assessed. The report is very positive and all issues highlighted in the March 2015 report have been addressed. The CQC were particularly impressed with how we had engaged with our patients to understand how they wanted us to improve the service we offer. This includes the open evening we held in June 2015, which ultimately resulted in the formation of our new PPG, and the engagement with Healthwatch to survey patients and understand their needs.


Being rated as a ‘Good’ practice is a great achievement which we are all very proud of, and we would like to thank all patients who have supported us through the last 8 months. The environment in which we operate remains challenging and with increasing pressure on the NHS we cannot be complacent. We intend to continue to work with patients and other organisations to understand how we can deliver high-quality primary care health services as efficiently and effectively as possible.


The full CQC report can be viewed at We issued a press release on 24th December which can be viewed on our website at We also welcome comments on the service we offer including any ideas on how we can improve it further. Feedback can be left via our website or using the Friends and Family Test or PPG comment cards available in the waiting areas.

Practice Feedback

We have been monitoring patient feedback over the last few months since we started to address the concerns highlighted by the CQC in April. We are delighted to have received generally positive feedback on the changes we have made so far. On 7th September we launched a new appointment system and this appears to be working well. We have committed to never turn a patient away, though they may need to speak to a doctor or nurse practitioner on the phone and then be seen if person if necessary.


We have taken notices down from doctors’ doors stating that only one problem is to be discussed per 10 minute consultation and our doctors will aim to spend the time necessary to fully address a patient problem. Of course they do operate under time constraints and appointments are nominally 10 minutes long, so if you think you need longer then please let the receptionist know and they can book a double appointment. However, feedback is positive and suggests patients feel they are being listened to and treated appropriately. We have also been working with all staff to ensure that the overall experience when patients need to contact the practice is professional and helpful, and again your feedback is generally very positive.


We value feedback, both positive and negative, so please complete either the Friends and Family Test or PPG comment cards available in waiting areas, or leave a comment on the NHS Choices website. Clearly we should be alerted when problems arise but we also want to hear about positive experiences as this provides confirmation that the changes we are making are having the desired effect.

Ring Back

Please don’t use the ring back facility as this will not work with our phone system. When all our phone lines are engaged you may get a ‘press 5 for ring back’ message from your phone provider. This will only work if you are calling a residential number and will generally not work if you are calling a business number. The BT network cannot differentiate between residential and business numbers so may still offer you a ring back option even if it is not available. This isn’t a fault with our phone system.

Restricted Prescribing list


Last year in Ipswich and East Suffolk, over £1m was spent on prescribing paracetamol, which can readily be obtained from pharmacies without prescription. The Clinical Commissioning Group is advising all practices to limit prescribing medication which can be obtained without prescription, often at low cost, from pharmacies and supermarkets. Such medicines include analgesics, emollients and antihistamines. There are always exceptions but please don’t be offended if your GP or nurse asks you to purchase medication yourself.


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