DOCTORS SURGERIES IN 2020

THE DOCTORS SURGERIES TODAY 2020

There is something amiss at our Doctors surgeries as we enter the Third Decade of the 21st Century.
Doctors are overworked and cannot cope with the number of patients which they have on their books.
Demand from patients exceeds the supply of Doctors. Many surgeries have to cope with 7,000 people with every aches and pains imaginable and more Patients are in the Elderly group with lots of illnesses. There is a major gap in the NHS service and at  Doctors Surgeries level.
My previous article - Future Strategy of the NHS - suggests some solutions.
So, what is happening at a typical Doctors surgery today ?

My surgery lists quite a number of Doctors serving the Practise. However, many of them are Part Timers. Some leave the Practise to have children.
The Receptionists at the Practise cannot give you an appointment until they know, what days a Doctor is coming on duty.
So, they say, telephone at 8am tomorrow and we will see what appointments we have available.
The next morning at 8am, you telephone the surgery.
The automated telephone system then says.........
“ You are number 10 in the queue.”
How can that be ?

When you eventually speak to a human, you may be lucky to get an appointment. But, it may not be a Doctor you know.
Some time ago, the Government decreed that all patients will in future have a dedicated Doctor. I was given one but I saw the Doctor once. Every other time, I saw a range of different Doctors.
If you try to get an appointment some other time you are looking at at least 3 weeks.
So, as far as the surgery is concerned, you can suffer another 3 weeks and if you are referred to the local hospital, you can wait another 3 months. To be fair, if the Patient has say suspect Skin Cancer, you will get an appointment in 2 weeks.

Then, there is a very irritating action. The Receptionist tries to triage you....Please explain your problem ? Oh, I will get the Doctor to telephone you this afternoon. You ask...When ?
Reply....Any time ? Normally the Doctor will telephone you after 4.40pm so why cannot you be told...He will telephone you after 5pm. No waiting an afternoon for a call. Many older people do not have Mobile phones or computers.
What Doctor you ask ? I do not know at the moment is the reply.

Many of the illnesses can be diagnosed by a good Doctor within 5 minutes. Surely if a patient has suffered for example, with a blocked nose, and the patient who had suffered over the Christmas period, should be able to be seen by a Doctor before the situation gets worse.
Another example of the overburdened Doctors today, is when the Receptionists say “ Is it an emergency ?”
This is a technique for putting patients off wanting a quick and early appointment. How do they know if it is an emergency?  I am talking about medium level illnesses. It is not the job of the Receptionist to ask the Patient if it is an emergency.
If you say No it is not an emergency, they will offer you an appointment in 3 weeks time. Then, the Doctor might have to refer you to a hospital....another wait in most cases.

It is interesting to observe the attitude of some Doctors.
Most have a caring approach, appear kind and professional.
Others look at you as if you were a number on an NHS form.
Please can we have some nice smiles now and again.I have noticed that it is the younger Doctors who have the right attitude. The older ones look worn out and cannot bother to smile anymore. Time to retire ?

There are too many mistakes being made on prescriptions.
Doctors fail to cross check what is ordered leaving patients short of vital medicines. The Pharmacist then gets the blame. Recently, it has happened to me. Tablets have not been sent. Prescriptions have been lost. Medicines have been sen to the wrong Pharmacy.

There is room for improvements in the non hospital check ups.
If you telephone the 111 service, you will be dealt with by a person reading from a script. You will be asked many questions and after sometime, you might be told, go to Minor injuries at your local hospital. You have waisted valuable time.
So, you go to Minor Injuries and spend the next 4 hours in the waiting room. This appears to be an acceptable time by the NHS standards. It is not my standard of patient service.

Is all this poor service due to lack of money ?
To a certain extent, the answer is Yes.
However, I am convinced that there is room for improvement at our local Doctors surgeries.
Some areas that need investigation are -

1- We need more full time Doctors and Nurses.
2- Better Administration procedures.
3- Dedicated Doctors as announced by the Government.
4- Use of FaceTime video contact between Doctor and Patient.
5- Less triaging by Surgery Receptionists. More Patient oriented rather than Doctor orientation.
6- More specialist equipment for on the spot diagnostic usage.
In my surgery, only one Doctor is qualified to use Nitrous Oxide for a patient with sun damage.
7- Computer systems are old and slow.
8- More involvement of Pharmacists in early response treatment for many illnesses.
9-Penalties for non attendances at Appointments.
10- More Trainee Nurses to attend part time at Surgeries to deal with mundane minor duties - for example Blood Tests, Temperatures, Minor injuries needing dressings, Blood Pressure where no machine exists and so on. Trainee Nurses at University normally would welcome to participate with on the job experience.

I suggest an Internal Research Scale from 1 to 10 ......10 being Very Good and 1 being Very Bad.
However, there is room for improvement in patient care in the third decade of the 21st Century.

We cannot blame our dedicated Doctors and Nurses.

Doctors Surgeries procedures need an overhaul. Service levels seem to be on the decline.

But, who can do this ?  Can the Practise Manager take on this task ?
Can a Practise Panel be established ?

Someone must do the review. Or, just ignore the problems.

NEW MUSICAL

RIA CONCHITA - THE MUSICAL

Music and Lyrics
By
Raymond Williams

THE STORYLINE - SYNOPSIS

This is a modern musical set in Scene One in the small fishing village Puerto Logo,near Havana Cuba.
The storyline is how Melissa Brown became Ria Conchita, her new showbiz  name when she moved from her home in Puero Logo to take up a singing job at a night club in Miami Florida famed for its vibrant Cuban music.
Whilst in Miami she meets an English businessman and they full in love. However, when the businessman returns to London, they lose contact. Ria is concentrating on her career in Miami and the businessman on his fading investments on the London Stock Exchange.
Ria’s career continues to blossom. She in invited to star at the World famous Bougainville Club in Paris. She becomes a great success.Success bring for her a suite at Le George V Hotel on the Champs Elysee Paris.
The Businessman is visiting Paris when he goes to a famous Jazz Club on the left bank. Whilst there, he hears that the talk of the town is a Cuban girl named Ria Conchita, starring at Le Bourgainville Club Paris.
The next evening, he visits the Bougainville Club and watches as Ria sings and dances. Their eyes meet. After her cabaret act, Ria visits the table of her long lost lover.
They agree to meet at the Pont Neuf bridge the next day.
In the meantime, back in her hotel, Ria hears the sad news that her Father had died in Puerto Logo. She is distraught.
However, she still goes to Pont Neuf as agreed the next day.
The businessman is held up on traffic. At the last moment Ria sees him in the distance. They meet up and they pledge never to lose contact again. Their love is still alive.
Ria returns home for the funeral of her Father.
A few months later, Ria meets up with her lover in London.
He has had a bad time losing heavily on the stock market but now, things were looking up.
They decide to get married. The wedding is fixed for Puerto Logo. It is a dazzling affair.
The Finale is very vibrant with Cuban dancers, dazzling costumes, Lido style feathers, repeat of many songs in the show. Rumba music and dance routines.
A very happy Finale leaving the audience with the feel good factor.

MUSICAL SCORE

Golden lights
Melissa
Cry over You
Cry over you Dance track
Everytime
Everytime Dance track
Much too soon
Paris Organ grinder
Back where we belong
Tout le monde
In your Hands
Wild Flowers Concerto
Now and Ever

COSTUMES

Parisian Lido style
Cuban Multi colour style
Business suites in London
Golden style dresses
Cuban dresses and white suites in Puerto Logo

CHOREOGRAPHY

Cuban rumba dance routines
Gospel Choir in black dresses
Father of Ria solo dance
Ria dance routines
Wedding carnival group dancing
The finale embrace.

SCENES

Puerto Logo Home Cuba
Miami night Club
Bourgainville Nigh Club Paris
Jazz Club left bank Paris
Hotel room Paris
Funeral Puerto Logo Cuba
Head Office of Crimpton Associates
Pont Neuf Bridge
Wedding Puerto Logo Cuba

NOTE
Ria Jones has the full outline script and a CD of most of the songs.

Choice of Starr playing lead role of Ria Conchita is
RIA JONES

PROMOTION THEME

“ RIA PLAYS RIA “

RAYMOND WILLIAMS MA MPhil MBA DIPM
EUREKYS
Music & Journalism










Reply, Reply all or Forward
Send









RIA CONCHITA - THE MUSICAL

Music and Lyrics
By
Raymond Williams

THE STORYLINE - SYNOPSIS

This is a modern musical set in Scene One in the small fishing village Puerto Logo,near Havana Cuba.
The storyline is how Melissa Brown became Ria Conchita, her new showbiz  name when she moved from her home in Puero Logo to take up a singing job at a night club in Miami Florida famed for its vibrant Cuban music.
Whilst in Miami she meets an English businessman and they full in love. However, when the businessman returns to London, they lose contact. Ria is concentrating on her career in Miami and the businessman on his fading investments on the London Stock Exchange.
Ria’s career continues to blossom. She in invited to star at the World famous Bougainville Club in Paris. She becomes a great success.Success bring for her a suite at Le George V Hotel on the Champs Elysee Paris.
The Businessman is visiting Paris when he goes to a famous Jazz Club on the left bank. Whilst there, he hears that the talk of the town is a Cuban girl named Ria Conchita, starring at Le Bourgainville Club Paris.
The next evening, he visits the Bougainville Club and watches as Ria sings and dances. Their eyes meet. After her cabaret act, Ria visits the table of her long lost lover.
They agree to meet at the Pont Neuf bridge the next day.
In the meantime, back in her hotel, Ria hears the sad news that her Father had died in Puerto Logo. She is distraught.
However, she still goes to Pont Neuf as agreed the next day.
The businessman is held up on traffic. At the last moment Ria sees him in the distance. They meet up and they pledge never to lose contact again. Their love is still alive.
Ria returns home for the funeral of her Father.
A few months later, Ria meets up with her lover in London.
He has had a bad time losing heavily on the stock market but now, things were looking up.
They decide to get married. The wedding is fixed for Puerto Logo. It is a dazzling affair.
The Finale is very vibrant with Cuban dancers, dazzling costumes, Lido style feathers, repeat of many songs in the show. Rumba music and dance routines.
A very happy Finale leaving the audience with the feel good factor.

MUSICAL SCORE

Golden lights
Melissa
Cry over You
Cry over you Dance track
Everytime
Everytime Dance track
Much too soon
Paris Organ grinder
Tout le monde
In your Hands
Wild Flowers Concerto
Now and Ever

COSTUMES

Parisian Lido style
Cuban Multi colour style
Business suites in London
Golden style dresses
Cuban dresses and white suites in Puerto Logo

CHOREOGRAPHY

Cuban rumba dance routines
Gospel Choir in black dresses
Father of Ria solo dance
Ria dance routines
Wedding carnival group dancing
The finale embrace.

SCENES

Puerto Logo Home Cuba
Miami night Club
Bourgainville Nigh Club Paris
Jazz Club left bank Paris
Hotel room Paris
Funeral Puerto Logo Cuba
Head Office of Crimpton Associates
Pont Neuf Bridge
Wedding Puerto Logo Cuba

NOTE
Ria Jones has the full outline script and a CD of most of the songs.

Choice of Starr playing lead role of Ria Conchita is
RIA JONES

PROMOTION THEME

“ RIA PLAYS RIA “

RAYMOND WILLIAMS MA MPhil MBA DIPM
EUREKYS
Music & Journalism










Reply, Reply all or Forward
Send


























12

CLIMATE CHANGE

CLIMATE CHANGE CAUSES

Here is one more theory about Climate Change for you to think about.

Facts first 

1- The Polar Ice Caps are melting and causing sea levels to rise putting millions of people at risk

2 - Most of the scientific world says that it is Carbon Dioxide gasses that are causing World temperatures to rise. It is the fault of Mankind.

3 - Climate change is the biggest threat to The Earth ever.

New Possible Causes of climate change

1 - The Earth has had Ice Periods and Hot Periods on average every 10,000 years.

2 - At one time in the past, the United Kingdon had a tropical climate. Evidence of this has been traced, for example, in the Vale of Oxford. Tropical plant deposits have been found there.

3 - In the distant past, Earth has had Ice Ages as well.  Glaciated ladscapes are evidence of this today.

New Theory 

The main cause of Climate Change is due to the Earth changing orbit in relation to the Sun.
This causes the Polar Ice Caps to melt. So, the Earth is in Stage One of a new Hot Age - which Mankind cannot prevent. In the past, the change in Orbit of Earth with the Sun has caused frequent periods of Hot and Cold climates.
This change in the position of the Earth in realtion  to the Sun means more Solar Radiation and Sun Flares reaching the Earth.

Cabon Dioxide fumes created by Mankind do not help and contributes to the acceleration of the new Hot Age - but in a very small way. It is the Mechansim of the Universe and the Solar Galaxy that is the main cause of the Climate Changes that we are experiencing today.

Future Action

 Scientits must pay more attention to the rotational position of Earth in relation to any rotational changes in the orbit of the Sun. Solar Heat reaching Earth nedds to be closely monitored. This can be monitored by NASA and other World Space Agencies.

Conclusion

If the Climate of Earth has changed before when there werer no cars, no aeroplanes, no ships, No Human activities - perhaps we are at the beginning of a new 10,000 years Sun Cycle of a Hot Climate which is happening again. Manking cannot stop Climate Change.

Ask yourself this question .....What were the causes of the 10,000 years cycles of Cold and Hot Climates in the past of Earth ?

Can the Scientists disprove this Theory of Sun / Earth relationship as the cause today of Climate Change ?

THINK ABOUT THIS !