Health chief faces your questions

THE Chronicle is putting Oldham’s leading figures in the hot seat, giving local people the chance to ask the questions that really matter to them.

This time the spotlight falls on departing NHS Oldham chief executive Gail Richards who has been at the helm of Oldham’s primary care trust but has now joined a national team that will develop how GPs take control of health spending.

The reins have been handed to Shauna Dixon, who swaps her role as executive director of clinical leadership for interim chief executive.

Here, Marina Berry concludes the questions on behalf of readers.


Q IS it true that people over 65 are given less care than younger people? It is certainly true that some GPs are reluctant to admit there may be a cause which needs investigation for an old lady complaining of constipation.

A OUR rule is to make sure care is equitable. In no way should it be affected by a person’s age.

A woman presenting with a change in her bowels would warrant an assessment as to the likely cause. Constipation can be a presenting symptom of bowel cancer but it is common and is often due to other causes such as medication.

To help decide whether more invasive investigations are needed a GP will ask a number of questions, carry out a comprehensive examination and possibly some blood tests.

If symptoms persist or if there are any abnormal findings then prompt referral is recommended.

There is no policy to avoid referring anyone presenting with worrying symptoms and signs, and the threshold to consider referring actually gets lower with age as the risk of bowel cancer rises with age.

The NHS continues to try to improve the early identification and treatment of any cancer and an example of this has been the launch over the last two years of the national bowel cancer screening programme. Early evaluation of this programme is demonstrating improvements and expanding screening across a greater age range is being considered.

A IT is important that a GPs time is spent on patients who really do need to see a GP, rather than those who may be able to see a nurse.

This is why reception staff may inquire about the reason for calling, so they can ensure that people are offered the right appointment.

However it is also true that a patient should not feel forced to disclose the reason they need to see someone if they would rather not.

AA Guidance from NICE (National Institute for Clinical Excellence), advises that patients with a lower limb plaster cast should be considered for medication after an individual review to determine their risk of developing a blood clot.

More information about assessing the risks is available at http://www. nice.org.uk/nicemedia/live/12695/47195/47195.pdf in section 1.1 and details about medication is in section 4.3 on page 39.




Q WHY do receptionists at some GP surgeries insist on asking personal and delicate details before offering an appointment, at the expense of patient confidentiality?





A IT is important that a GPs time is spent on patients who really do need to see a GP, rather than those who may be able to see a nurse.

This is why reception staff may inquire about the reason for calling, so they can ensure that people are offered the right appointment.

However it is also true that a patient should not feel forced to disclose the reason they need to see someone if they would rather not.


Q THE chances of getting a same-day appointment to see a GP for an urgent matter are slim if you work and cannot telephone before 9am — why?

AMost GP practices do try to offer some urgent appointments on the same day and many GPs also now offer some evening and weekend appointments to make it more convenient for people who are working. However the guidelines state that patients should be able to book an appointment with a GP within 48 hours. If people cannot get a satisfactory appointment the Urgent Care Centre in Oldham town centre does offer a walk-in facility from 7am to 11pm.


Q WHY are people allowed to smoke in the Royal Oldham Hospital grounds, particularly at the entrance, which is just below the respiratory ward? And why are staff in uniform allowed to smoke, eat and drink in near by bus shelters?

A THE issue of smoking at the hospital entrance is currently being tackled by Pennine Acute Trust, which runs the hospital.

It is creating a specific area away from the entrance where patients and members of the public can smoke.

Further information has been provided by Pennine Acute Trust that a £20,000 scheme to create designated shelters for patients and visitors to the Royal Oldham to smoke in will not now go ahead due to the current financial situation.

It will enforce its no smoking policy with security and site staff advising patients and the public not to smoke outside the hospital entrance, which is considered not only a fire risk, but unsightly and unpleasant for people to have to walk through a cloud of smoke to get to the entrance.

The trust has pledged to use posters to educate people about its no-smoking policy and the health dangers of smoking.

And it says it has a no-smoking policy both in the hospital and within the grounds for staff, which staff adhere to.




This is an edited version of the questions put to Gail Richards in tonight’s Oldham Chronicle. See the full feature with a subscription to the online E-Chron, or in tonight’s printed edition.