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GP Appointment Waiting Times

I recently tried to make an appointment with my GP surgery, concerning a problem I have had for a few weeks. It is uncomfortable, but not urgent. I went online to register to make an appointment, but you are required to register for online access in the surgery! I duly went to the surgery to obtain the required form, and, whilst there, make an appointment. I was told that if the appointment was not urgent they had no appointments currently available. Ring tomorrow morning and they will be releasing appointments for four weeks’ time!

I rang next morning and after waiting ages to get through was told at 8.52am that the appointments for four weeks’ time had already gone!

Feeling cross and a bit frustrated, I decided to see if this was a national problem.

The BBC has carried out an analysis looking at the difference in the availability of appointments in GP surgeries across the UK. They found that in one area, Swale in Kent, there is only one GP for every 3,300 patients, while in Rushcliffe in Nottinghamshire it is just under 1 for every 1,200, a threefold difference. The average GP's caseload is 1,734.

The Chairwoman of The Royal College of General Practitioners (RCGP) Dr Helen Stokes-Lampard said that the ten year NHS plan recently announced by the government did not address the current urgent problems. The numbers suggested there were areas of the country that were struggling to get the GPS they need and thus a greater delay in allocating appointments.

Dr Stokes-Lampard said she believed the health service in England is 6,000 doctors short of what it needs, meaning that it was 'not safe' in some places.

There are no official recommendations for how many patients a GP should have. Surely this needs to change? It is also not just a simple matter of numbers, as it also depends on the 'type’ of patient. For example older patients, children and those with chronic illnesses such as diabetes statistically take up more time.

Measures are being taken to tackle the problem, such as opening up more training places. The RCGP would like more incentives to encourage GPs to work in unpopular areas or those perceived to be more difficult.

Have waits for GP appointments got longer?

NHS Digital published figures showing that while 40% of patients were seen on the day they booked, just under a fifth waited longer than a fortnight for a routine appointment with a GP or practice nurse. As well as my own experience, this is born out by conversations with friends and colleagues, who report that unless they state the problem is urgent a two-three week wait is common.

This delay could have a serious effect as patients do not always know the significance of their symptoms i.e. if they are serious or not. There is a risk that longer waits may be causing harm as well as the stress of living with symptoms, the cause of which may be unknown.

How is this affecting Shropshire?

NHS Digital reports that over 20,000 people in Shropshire are waiting three weeks or more to see a GP. The waiting times have worsened in comparison with November 2017. However two out of five patients were able to see a GP the same day.

Rachel Power, Chief Executive of the Patients Association, a charity supporting the rights and experiences of patients, said, ' it was a symptom of an NHS running at boiling point all year round.'

As for me, I went to my GP again in person and manged to get a cancellation in three weeks’ time. Let’s hope it’s nothing serious!

Limits on Tribunal Awards and Statutory Payments to Increase from April 2019

Employment Tribunal compensation limits will increase on 6 April 2019.

The maximum amount of a week's pay, used to calculate statutory redundancy payments and various awards including the basic and additional awards for unfair dismissal and awards relating to a failure to provide employees with minimum required written particulars of employment, will rise from £508 to £525.

The cap will rise

As a reminder, where a week’s pay would otherwise be below the maximum limit, in accordance with current case law, employer pension contributions are required to be taken into account when calculating the weekly pay figure.

The maximum compensatory award that applies in most cases of unfair dismissal is an amount equal to the employee’s gross basic annual pay, subject to a cap. This cap will rise from £83,682 to £86,444.

As a reminder, there is no maximum compensatory award where the unfair dismissal relates to the making of a protected disclosure (“whistleblowing”) or the carrying out of certain health and safety activities.

The above increases will apply in relation to dismissals where the effective date of dismissal falls on or after 6 April.

Date of dismissal

Bear in mind that the effective date of dismissal for statutory purposes will be later than the actual date of dismissal in the event that an employee is dismissed with less than the statutory minimum notice, but has not committed gross misconduct or another fundamental breach of the employment contract. Statutory minimum notice is nil until an employee has been employed for a month, then a week until they have been employed for two years, and then is a week for each complete year of service up to a maximum of twelve weeks.

Therefore, for example, if an employee with five or more years’ service was dismissed without notice by reason of redundancy on 4 March and paid in lieu of their entitlement to notice, as the effective date of termination for statutory purposes will fall after 5 April, the cap of £525 will apply to their weekly pay when determining their entitlement to statutory redundancy pay.

However, if the employee had been employed for, say, just four years, the cap of £508 would still apply. This would be the case even if their contractual entitlement to notice would have taken the employment beyond 5 April, had they not been paid in lieu.

Working Full Time and Studying for a Law Degree

If someone had said to me, five years from now you will complete your law degree whilst holding down a full time job and bringing up three young children with my husband, I would have laughed and said no chance. I honestly did not expect to get through the first year let alone five years.

It turns out however, with a fully supportive husband and employer I am now thankfully at the end and on course to obtain a high 2:2. On 1 March, I actually found out I gained a 2:1, I am over the moon to have achieved this and not to have taken any resits!

Good background

Having worked for Neil Lorimer, the head of the personal injury department, since 2010, working on high level injury claims where clients have suffered serious multiple injuries including brain injury, spinal injury and amputees, this has given me a good background on aspects needed in a good lawyer.

Since 2016 I have worked for Debbie Humphries as her legal assistant. This has furthered my knowledge and experience in dealing with clients, barristers and experts. Each case is unique and requires clear communication with clients to enable them to understand the legal process they are going through, and also with barristers and experts where organising conferences or instructions.

My role consists of duties such as obtaining and collating documents for a claimants claim such as medical records, police reports and other relevant documents. I also meet with witnesses and prepare witness statements, as well as preparing draft instructions to counsel and experts together with collating the relevant documents for them. These tasks require me to consider the facts of each case, setting out a descriptive background detailing the issues to be considered. All of these duties have given me experience to pull from when completing assignments and exams, as I have been able to put myself in the shoes of a lawyer advising clients.

Along with other aspects of my role I have found that being a full time worker in a law firm, whilst studying a law degree, has been invaluable. Each and every one of my work colleagues have been pestered for their views on whatever subject I happen to have been studying at the time. Similarly every trainee solicitor passing through the department, when completing the seat with personal injury, has been helpful in giving their advice on both subjects I was studying and also on training contracts and, more importantly, the interviews for a training contract. They all have my undoubted thanks.

Plan and organise time

Working whilst studying a law degree has taught me to plan and organise my time. Remembering to allow time to be with my family and time to relax, but also planning in study time around exams to coincide with work.

I would thoroughly advise anyone thinking of studying whilst working, it can be done! If you are lucky enough to be working in a law firm whilst studying, use this to your advantage and speak with your colleagues, you will find that many of them are more than happy to help and advise. Lanyon Bowdler has been instrumental in aiding me to achieve my goal and have given me the flexibility to work and study whilst also having the balance with family life.

2019 Advances in Medicine

Many of you will have seen in the news recently that quadruple amputee Corinne Hutton underwent a double hand transplant on 7 January 2019. This news got me thinking about developments in medicine and also about raising awareness of important medical issues.

It has been reported that Corinne suffered acute pneumonia and sepsis in 2013 and nearly lost her life as a result. Initially she was given a 5% chance of survival. Professor Andrew Hart, Consultant Hand and Plastic Surgeon, reportedly performed the surgery to remove her hands and lower legs in 2013 and her life was saved. Professor Hart was reportedly also involved in the 12 hour hand transplant operation she underwent this year at Leeds General Infirmary.

Since her amputations in 2013, it is reported that Corinne has tirelessly campaigned to help raise awareness of organ and limb donation and she even set up a charity called Finding Your Feet. She now devotes her life to the charity supporting amputees throughout the UK.

Ballroom dancing lessons

In addition to founding this charity, Corinne’s motivation saw her become the first female quadruple amputee to reach the summit of Mount Kilimanjaro, she has climbed Ben Nevis in Scotland, she has abseiled, cycled around the Isle of Arran, took up skiing and ballroom dancing lessons. She has even raised awareness by posing nude, whilst being painted with organs and tissue that are apparently transplantable, to raise awareness.

Her charity has reportedly raised more than £700,000 through fundraising and donations.

Able to move her fingers

Over the years since 2013, doctors had been working to find suitable hands which were a match for Corinne in terms of blood group, skin tone and size. These were finally found and the transplant has now gone ahead. Corinne posted a video from her hospital bed shortly after the operation stating that she could already move her fingers.

Five double hand transplants

Whilst it may seem incredible that such surgery can be carried out, Corinne is not the first. In actual fact the doctor who led the team who performed Corinne’s transplant has already performed five previous double hand transplants in the UK, the first of which was undertaken in 2016. And it must also be recognised that this positive outcome for Corinne would not have been possible without someone selflessly making a decision to be a donor after a tragedy. Corinne has reported through her charity that she will be forever grateful to this unknown family.

Wonderful medical treatment

This story just goes to show how medical treatment really can be incredible and I, for one, enjoyed reading the stories about Corinne and the wonderful medical treatment it appears she has received. This is an uplifting story in a world where many media reports relate to difficulties with healthcare services, and things that have gone so sadly wrong causing people to suffer harm as a result.

It also, I think, raises the importance of prompt treatment when a patient suffers pneumonia and sepsis. In Corinne’s case, her life was saved by treatment for a condition that could, so easily have resulted in her death. She has gone on to achieve many things and raise lots of awareness which is very important.

Driver Wrongly Penalised for Speeding in Telford

I was recently asked to represent X. He had received through the post a NIP (Notice of Intended Prosecution) alleging he had been speeding on the A442 Trench Lock Interchange junction.

As is not uncommon, he was offered a fixed penalty fine and three penalty points on his licence if he accepted the misdemeanour, and consequently he paid up.

However, X, an experienced driver with over 20 years no claims bonus felt that something was not quite right. He contacted me for advice.

Fortunately, X had dashcam footage of the incident.

I spoke to an expert who generated a brief report confirming what we all suspected – X was innocent and that the vehicle seen overtaking him at speed was the person who should have received the NIP.

Upon receipt of this evidence, together with a letter from me, the police withdrew the case against X who was obviously delighted.

X has given me permission to share his story and the dashcam footage, as it is possible other people may have incorrectly been prosecuted for ‘speeding’ at the same junction in Telford and simply paid up as the easier option, when in fact they were innocent.

It also raises possible questions regarding the calibration of that particular camera and other speed cameras in the West Mercia catchment area.

If anybody would like any advice regarding this particular issue or indeed any other motoring law matters, then please get in touch with me, on 07776 184489

Horatio's Garden

Spending time in a beautiful garden is a way many of us love to relax - but how often do we take this for granted? For patients with a spinal cord injury, being able to get out into the garden might seem a far off dream. However, Horatio’s Garden is an inspirational charity which has been set up to create and care for beautiful accessible gardens in Spinal Injury Centres around the country.

Last November, I was thrilled to be able to attend the ground breaking ceremony marking the beginning of work on a garden at The Midlands Centre for Spinal Injuries at the Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry.

Patients who have sustained spinal injuries usually need to spend many months in hospital so that they can receive necessary treatment and therapy, and start the rehabilitation process. This can involve prolonged periods of time on bed rest, which must be hugely frustrating and at times claustrophobic. Having the opportunity to go outside again and enjoy the fresh air and wonder of nature is a life affirming experience. Providing accessible gardens gives a fantastic opportunity for patients to rest and relax, to socialise with family, friends and other patients, and to take part in general rehabilitation activities.

I heard about the inspiration behind Horatio’s Garden charity earlier last year when David Chapple, a Spinal Surgeon at Salisbury Hospital, spoke about Horatio’s Garden at our Spinal Injury Conference at The Midlands Centre for Spinal Injures. Horatio’s Garden is named after David’s son, Horatio, who was a volunteer at the Spinal Treatment Centre in Salisbury in his school holidays and who, along with his dad, came up with the idea for a garden at that centre. Tragically Horatio was killed at the age of 17, but based on patient research, which Horatio had carried out, the plans for the first Horatio’s Garden were drawn up. Horatio had even got himself taken around the site in a bed and wheelchair so that he could get the patient’s perspective on what was needed.

Beautiful accessible gardens have now ben created in the Spinal Injuries Centres in Salisbury, Glasgow and Stoke Mandeville, with work now underway for gardens in Oswestry and London. The Oswestry garden is being designed by the award winning Garden Designer, Bunny Guinness (of Gardeners’ Question Time fame). I’m looking forward to seeing the garden develop and am sure it will make a massive difference to the lives and rehabilitation of patients, both physically and mentally.

For more information about how to support this fantastic charity - as a friend, by making a donation or fundraising, by volunteering in one of the gardens, or even just doing some shopping in their online shop – then please check out their website at www.horatiosgarden.org.uk.

Management is More than Just a Job Title

An issue I frequently come across is where an employee, due to creditable performance in their current role, is promoted into a management position without full consideration as to whether this is the best decision for the business or the individual. Has the business considered, for example, alternative ways to reward good service or what, if any, support and guidance will be provided to the employee to enable them to succeed in their new role?

If an employee is successful at their current role, it does not necessarily follow that they will be successful in a management role. If you are seeking to reward good performance and retain your best performing staff, promotion is only one option and it may not always be the most suitable. Rather than encouraging loyalty and retention of your most valued staff members, promoting an employee into management without adequate training or assessment of their suitability for such a position could have the opposite effect.

There are many other ways to reward loyal and good service, and these need not necessarily cost the business additional money.

We can provide bespoke training

If you are minded to promote any particular employee into a management role, I advise that consideration is given to providing them with management training to equip them with the tools required to succeed and to deliver the best for your business. Similarly, you may have managers in post now to whom you do not feel able to delegate certain tasks. If that is the case, you are not fully utilising them and you should consider providing them with suitable training in order to correct this, and free up more senior managers and directors to focus their time and attention on other areas of the business.

We can provide bespoke training, either at your place of work or at one of our offices, for managers, and would-be managers, on a wide range of topics to help them to reach their full potential, such as in relation to identifying and addressing performance or attendance issues, promoting good mental health, handling grievances and whistleblowing, dealing with indiscipline, and anti-bullying and harassment strategies. We can also provide advice and guidance on alternative methods of rewarding good performance and retaining key staff.

Retainer services

In addition, we offer retainer services which, for a fixed fee, would give your managers access to employment law and HR advice and guidance from qualified local solicitors in relation to day to day, and not so day to day, issues that they encounter. This can include the drafting of relevant documents and letters as and when needed, giving you the confidence to allow managers to deal with matters, safe in the knowledge that they have the benefit of specialist advice at their fingertips. And added to this, because employees often chance their arm with claims even when managers have done everything by the book (and because even the best trained managers sometimes make mistakes, or otherwise employment tribunals can make unpredictable decisions) is the availability of the safety net of insurance against employment tribunal claims, settlements and awards.

Please call us to discuss your options in more detail.

New Year's Resolutions & My Goals

As we recover from the overindulgence of Christmas contemplating our New Year's resolutions I thought I would share my goals for the year ahead.

None of what I want to achieve in 2019 seems particularly out of the ordinary; be healthier; give more to charity, put my affairs in order. The same as many others I am sure.

But today is officially known as ‘Quitters day’ according to Strava the social media platform who using data collected in 2017 found that the second Friday in January was the day when motivation started to falter. It went on to say that setting an achievable goal and a target date was the key to keeping people motivated. Of all those who entered a race in 2017 92% of them were still active 10 months later.

Some of my fitness goals over the years have perhaps been a little too ambitious for example in the same year I got married, I also crashed out of the London Marathon with a damaged knee. What suddenly struck me about that date was the realisation I hadn’t reviewed my Will since then and I now have two children so that has to be the first thing on the list to sort.

Whilst 2018 saw me improve my fitness by learning to swim and loose over a 10kg in weight. This year I have joined a cycling club with a view to combining all three disciplines and complete my first Triathlon for charity.

Whilst I can't promise to make you more healthy in 2019, If you like the sounds of getting your affairs in order and perhaps giving more to charity, then perhaps setting yourself the simple goal of booking an appointment to discuss making a Lasting Power of Attorney and reviewing your Will is an achievable goal and something I can help with.

Ex-Police Officer Avoids Losing Driving Licence

I read with interest the case of former police officer Adrian Pearce who was sentenced at Basingstoke Magistrates‘ Court on Thursday 3 January by a District Judge.

The case has received widespread coverage in the national press and on social media for the court not disqualifying Pearce for committing a drink driving offence. On closer inspection, whilst an extremely foolish thing to do, there is no evidence of Pearce actually driving, only that he intended to drive having returned on the train from a Christmas party.

Had he not intended to drive, then he would have had a defence in law to the allegation he faced. As there is no evidence of Pearce driving or attempting to drive then a mandatory disqualification does not necessarily follow.

Instead, he pleaded guilty to and was sentenced for being drunk in charge of a motor vehicle.

The Sentencing Guidelines that all courts follow make it clear that for a breath reading of 61, as in this instance, a disqualification is only discretionary. The District Judge, having heard the personal mitigation and the impact a driving ban would have on Pearce’s future employability, quite properly exercised his discretion.

It is not a case of Pearce being treated more leniently because he was a police officer, as I have seen suggested. Each sentencing court should deal with a particular case on its own merits as has happened in this instance.

If the courts are not afforded discretion, then we are heading down a slippery slope……what next?....a mobile phone app for the public to decide on sentence?!

A&E at Christmas

It is well known that Christmas is one of the busiest times of year for Accident and Emergency Departments (A&E) and there are no signs of this changing any time soon. Figures published by NHS England show that 2,003,964 people attended A&E in December 2017 in England.This was an increase compared to December 2016 when there were 1,944,568 attendances and December 2015 when there were 1,867,652 attendances.

It is also well known that NHS staff are under enormous pressure to meet targets and to see all attendees within a four hour window.

This combination can be a recipe for disaster and it is therefore not surprising that there is an increased risk of medical errors happening during this time.

People can be very understanding during the festive season and for this reason many people do not take action in response to these errors, often as they do not want to get anyone into trouble, particularly as the doctor or nurse concerned has given up their Christmas to care for others. However, clinical negligence cases are not about getting anyone into trouble, and whilst their main aim is to obtain compensation for the injured person, there is a wider goal and that is to encourage the NHS to learn from their mistakes and to prevent the same thing from happening again to someone else. Often, the mistakes happen because there just weren’t enough staff (for whatever reason) to cope with the number of patients. Consultations are therefore rushed, staff are distracted and they take their eye off the ball.

Focus of the NHS

However, rather than taking adequate steps to ensure there are sufficient staffing levels to meet the needs of an increased number of patients, the NHS remains focused on encouraging people not to attend A&E except in an emergency.

What is an emergency?

Unfortunately, it is not always clear from this campaign what an “emergency” is and therefore a lot of genuinely sick people risk their lives by not seeking medical attention when they genuinely need it for fear of being branded a nuisance or wasting valuable time.

The dictionary definition of “medical emergency” is ‘a serious and unexpected situation involving illness or injury and requiring immediate action’. According to the NHS, this can include loss of consciousness, an acute confused state, fits that aren’t stopping, chest pain/breathing difficulties, severe bleeding that cannot be stopped, severe allergic reaction, severe burns or scalds.

Seek help!

Anyone who has any of these symptoms should not hesitate to go to their closest A&E as these people are not who the campaign targets.

The campaign targets people who do not fall into the definition of emergency.

In 2014, Cannock Chase Clinical Commissioning Group published ‘the 12 A&E Visits of Christmas’ in a bid to highlight the kinds of things staff are being asked to contend with including broken fingernails and bad hair extensions (you can’t make it up, the full list can be viewed here https://www.cannockchaseccg.nhs.uk/news-events/96-nhs-releases-12-a-e-visits-of-christmas-in-bid-to-deter-unnecessary-visits). As always though, if you are in doubt, dial 111 for advice.

The NHS campaign has been ongoing for a number of years now but the number of people attending hospital isn’t going down and therefore the risk of mistakes remains high. It therefore remains imperative that there are sufficient staffing levels to deal with this.

Therefore, if you’re unfortunate enough to need to attend A&E this Christmas and even more unfortunate enough that something goes wrong, do not hesitate to contact our clinical negligence team for advice. Our hope is that we can work together to encourage positive change from within the NHS to reduce the risk of future mistakes alongside the NHS’ own campaign.

Drug Driving

Two stories have caught the eye in the national press over the last few days involving drug driving.

The first story is the criminal investigation into alleged manipulation of data in respect of toxicology tests carried out at Randox laboratory in Manchester.

At present it is believed that the majority of affected samples relate to drug driving offences but it may extend to more serious offences too.

Having recently successfully represented a client in having their conviction overturned, it will be interesting to see how many more people have had their lives turned upside down as a result of what has allegedly happened.

People convicted based on these tests will have received a minimum mandatory driving disqualification of 12 months. This in turn may have cost them their employment and impacted upon other areas in their life.

Those wrongly convicted will no doubt be pursuing civil claims for damages, and it will be interesting to see how this is quantified in due course

In the second story, a study between June to July shows that an average of 37 motorists were testing positive for banned substances on a daily basis.

That number is likely to increase as police forces increase drink and drug drive testing at this time of year.

The rise is being put down to the introduction of new drug testing saliva roadside testing kits, which allow police to identify illicit substances within minutes.

For any advice on motoring law or if you feel you may have been wrongly convicted, please contact us on 0800 652 3371.

Hope House & Ty Gobaith

Following on from my recent blog regarding my visit to Ty Gobaith, I have now run the Conwy Half Marathon, taken part in the Lantern Walk and attended a number of other events to support this amazing charity which provides such an incredible service which benefits our clients.

Conwy Half Marathon

When I first signed up to this I did not realise just how difficult it would be. My colleague Edward Nutting who is a partner based in our Conwy meeting rooms also signed up. Neither of us are runners, so training began. The training itself was hard work but at the same time we had a goal to achieve. We were fundraising using Just Giving and traditional sponsorship forms and the support we have been given by family, friends, colleagues and clients kept us going.

On the day I was very nervous, all those thoughts such as ‘what if I need the bathroom’, ‘what if I fall over’, ‘what if I can’t finish’ were swimming in my head. On arrival at the start line I was delighted to see the amount of people there in support of all of the runners. The first part was not that bad but we then arrived at the Great Orme. The uphill was extremely difficult and it was freezing and windy. Every bend I turned I prayed for the down hill but the up hill seemed to last forever. The other runners were wonderful people and we all supported each other. I was very aware that I was slow in comparison to many others but the group of runners I was near were fantastic. The relief I felt when I saw the down hill and could just let gravity take my poor legs was immense.

My knee decided to give way with three miles to go and it was incredibly painful, but I was determined to finish. Unfortunately this meant me having to walk for two of those miles. There was a huge crowd of supporters on the last mile and they were all so kind even though they did not know me. I managed to run the final stretch and was so relieved to see the finish line.

It took me a few weeks to recover and my knee is still not back to normal but I am so pleased that I did it. I thought of all the children throughout the race and particularly our clients. Edward and I managed to raise over £1,500 between us and that makes it all worth while.

Hope House Lantern Walk

The Lantern Walk took place in The Quarry, Shrewsbury and I recommend it to anyone who would like to support the charity. It was an incredibly moving event with staff members from Hope House singing at the start.

The Lantern Walk is an opportunity for family members and supporters to remember all of the children who have passed away. It was a gentle walk designed so that all ages and abilities could take part. There were an array of lanterns and other lights and Hope House kindly brought along lanterns for those who did not already have one to use. It was a truly lovely event and I will certainly take part again next year.

Christmas Events

Hope House and Ty Gobaith have a number of activities over the festive period. I attended a Christmas Bazaar with an array of stalls to get you in the Christmas spirit recently. I have also attended their festive lunch which is a great way to speak with other supporters and families.

I would definitely recommend looking on the events page of the Hope House website as there is so much that you can be involved in and it all goes to a wonderful cause.

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