Helping patients with ECZEMA to get the best out of the NHS

This web-site is about helping you to understand how you can get the best out of the practice and other resources. Terms highlighted in RED are key words that you should find in your own medical record. Staff are highlighted in BLUE. Equipment is highlighted in GREEN.

You may ask why?
The most recent patient survey has shown that patients want to be able to see the clinician sooner (ie less than 2 weeks) and on time (ie not have to wait an hour for a scheduled appointment) and feel that all their concerns have been met. It has been independently confirmed that the practice already offers more appointments than the average to its patients.

So how can we meet the demand?
Being prepared for the consultation greatly helps as does recognising the length of the appointment slot and helping the clinician to stay within the time limit. 

You may ask how?
There are some simple steps that are essential for you to understand that will help you on your journey of discovery for your health and well-being:

1. What condition do you suffer with? 
   Eczema refers to dry skin often found inside your elbow or on the back of your knees but can also affect other parts of your body as well.
2. What does that condition mean?
   Here are some links to websites with useful information on eczema that you may wish to see:
   • NHS Choices
   • A summary of Eczema information sheet
   • National Eczema Society : (click on About Eczema to see Frequenty Asked Questions
3. What help is available for you to use?
   This condition is primarily managed by the nurses and doctors. They can check how your eczema is going and whether you are using sufficient emollients and creams and using other medications to control the condition. There are also Specialist Dermatology Nurses based in Hyde who can also see you if your eczema or your child’s eczema is particularly problematic.
4. What does the condition mean for you?
   You need to know what all the different treatments are that your doctor has prescribed and how much to use of each. Often patients and their families get used to itching all the time and having disturbed sleep. It is important that you find out what you should do especially if you are not sure. We can only help you if you tell us so. This information should be in your GP-held record for you to see.
5. What needs to happen now and in the future?
   The typical patient with eczema which is well controlled needs the following:
   • Make sure all your emollients, bath oils, and anti-histamines are on repeat prescriptions are so that you can order them as soon as you need to.
   • If a cream or ointment does not suit you then you must see a doctor to have it changed. You need to be in control of your treatment otherwise the condition will control you.
   • Medication Review twice a year usually with the nurse unless you are told otherwise
6. What can you do to help?
   As this is a new way of working, it is worth discussing this with the nurse to see how this can be done the first time you decide to take control.
   • Get access to your GP-held record. Without knowing what is in your records and what you need to do, it will be very hard to know what to do when and with who. This is an essential first step for anybody with any condition or who wants the best from the practice.
   • You need to know what the different medications are. In particular if you are prescribed any steroid cream then it should be the lowest strength and applied wth the correct amount for the least amount of time necessary. Your doctor can help you to understand this as well as the websites above.
   • Look at the web page – pre-consultation care – and go through it prior to your review with the clinician. This can help us to understand your needs better and what you want out of the consultation. If there are no specific issues AND all the tests are normal and you are well-controlled, it may even be possible to conduct the medication review over the telephone. This must be with the agreement of the clinician and if you are happy with this. We think many people may benefit from this but we do not want to prevent anybody from coming to the surgery of they so wish. Understanding your needs is key to a successful outcome of the medication review. See the above mentioned websites to help you to understand what your needs are. Initially you may need the clinician to help you understand how to look at the websites and what they mean for you.
7. How are we doing?
   The Quality Outcomes Framework was set up so that practices can look at how successful they are in delivering services to their practice population and also give an opportunity to see how we compare with others around the country. This data is readily available from here (www.qof.ic.nhs.uk/search.asp). Overall we got 996 points out of a maximum of 1000 last year indicating that we are a very high performing practice across the board which is reassuring for you and us. Whilst eczema is not part of the Quality and Outcomes Framework, we are still keen to provide an excellent service for our patients. It is hard to compare experiences especially as everybody’s eczema is a unique experience. However we would welcome any thoughts you may have on how we can see how we are doing and perhaps even how we might be able to compare with other practices too.
8. How can you help us do even better and help other patients too? 
   This is very important. In your journey of discovery about your health, you may come across odd things that do not make sense about the way the practice runs and you may have a better suggestion. Or you may come across something new that we have not considered that helps you even more. Tell us about it next time you see a clinician or preferably write it down and hand it in or send it as a comment to the Patient Participation Group (PPG) so that they can bring it up with the practice the next time we meet up. Even better, why don’t you join the PPG and become an active member. We are always on the look out for new members and new ideas.

Instead of having to come to the surgery lots of times a year to get high dose steroid creams that could be harmful to your skin long term, once you have understood what eczema is and what advice your doctor or nurse are giving you by reading your GP-held electronic health record, you may find that your skin improves greatly, whilst you are using less steroid cream and sleeping better as a result of not itching as much. If your child is the patient then not only does he or she or sleep better but so do you and of course spend less time at the surgery.

Most importantly, by working together and understanding each other’s needs better, we can help you to get the best out of the practice and the wider NHS.