This is the on-line version of our practice leaflet and contains information about:

PRACTICE AREA & LOCATION
The practice is centred on Ross-on-Wye and covers an area of approximately five miles radius from the surgery as shown shaded.

CAR PARKING
There is a dropping off point by the entrance, and there are two spaces for people with valid disabled stickers at the rear of the surgery. Ample parking is available in the main hospital car park for use whilst you are attending the surgery. However, Herefordshire Primary Care Trust, who own the hospital, have experienced significant problems with people parking inappropriately, and as a result CLAMPING IS IN OPERATION.

HOW TO REGISTER
Registration can be achieved either on production of your Medical Card, or on completion of the appropriate forms, which are available from Reception. You may be asked to produce evidence of identity and residency, e.g. a passport and household bill. We are unable to register patients (including temporary residents) beyond our practice area.

DOCTORS
Dr Philip Frank Clayton (male) BSc MB BS(London) 1986 FRCGP

Dr Nichola Benedicte Janis (female) MB BS(London) 1987

Dr Simon Benedict Lennane (male) BM (Southampton) 1993 DGM DRCOG MRCGP

Dr Lisa Jane Price (female) MB BCh (Cardiff) 1998 DRCOG MRCGP

Dr Paul Fraser Downie (male) BSc MBChB (Leicester) 2002 DFFP DRCOG MRCGP

Dr Richard John Cook (male) MA BM BCh(Oxford) 1974 MRCGP

Dr Georgina Claire Hobbs (female) MBChB (Sheffield) 2001 DCH DFFP DRCOG MRCGP

GP REGISTRARS
We are an approved training practice and from time to time we may have one or more GP Registrars. They have had at least three years of hospital experience as fully qualified doctors, and are attached to the practice for 6 or 12 months. We also have doctors in the 'second foundation year' of their training programme following qualification, for 4 months at a time, to enable them to gain experience of general practice.

PRACTICE NURSES

Mrs Elizabeth Ellis RGN

Mrs Cate Lamport BSc RGN

Our Practice Nurses perform a range of treatment room procedures. They also run various specialist clinics, for example for asthma and diabetes.

HEALTH CARE ASSISTANTS
Mrs Lynn Latham

Miss Louise Jones

Our Healthcare Assistants perform a number of procedures, such as ECGs, and also undertake blood tests.

MANAGING PARTNER
Ms Shirley Hallett DMS MSc(Econ) MBA MIHM
Responsible for the overall management of the practice. The person to contact if you have suggestions or ideas, and also if you have a complaint.

PATIENT SERVICES MANAGER
Mrs Dianne Coleman DMS
Responsible for the reception, administration and facilities teams and ensuring our patients receive the best possible service.

RECEPTIONISTS AND ADMINISTRATIVE STAFF
We have a team of full and part-time receptionists who help patients make appointments, answer queries, take home visit details, etc. Behind the scenes we have a number of staff who are involved in providing secretarial, audit and data processing services - tasks that ensure we provide the best possible care for our patients.

ATTACHED STAFF
District Nurses - Our District Nursing Team is based at the surgery and may be contacted on 01989 767023 (answer phone). The team provide expert care for those patients who are housebound.

Health Visitors - The Health Visiting Team are based at the Community Hospital and may be contacted on 01989 562100. Health Visitors are closely involved with preventative healthcare, particularly of children, and also run stop smoking clinics.

Midwifes - The Midwives are based at Hereford County Hospital Maternity Department and may be contacted on 01432 364070. They are involved with the antenatal care of all expectant mothers, and hold antenatal clinics in the surgery. They also visit mothers and babies at home after delivery.

Counsellor - A counsellor works in the practice one day per week (Tuesdays). Referrals to the counselling service are made by the doctors.

TELEPHONING THE SURGERY - 01989 563646
Our receptionists are on duty to take telephone calls from 8.00am to 6.00pm

APPOINTMENTS
Our surgery and clinic times are by appointment only, and may be booked up to six weeks in advance. Please book in advance if possible, or say if you need an urgent appointment. Appointments may be booked in person, on the telephone, or via our website www.altonstreet.nhs.uk (standard appointments only).

Our standard appointments are 10 minutes. There are some 5 minute appointments at the end of surgeries, but you should be aware that these are only 5 minutes, and only for urgent problems.

When you request an appointment, and the 10 minute slots are full for that surgery, you will be offered the alternatives of a later surgery, an appointment with a different doctor, or a 5 minute appointment if one is available. Please help us by only taking the short appointment if the problem is one that needs to be seen quickly - and remember that we are unlikely to be able to deal with several problems during that consultation.

As always, if you no longer need, or cannot attend, a booked appointment, please let us know as soon as possible so that we may offer the appointment to another patient. A lot of appointments are wasted by people who book, but then fail to turn up.

Appointments may be booked directly with the Practice Nurses, Health Care Assistants and attached Midwives - you do not necessarily need to see a doctor first, but do bear in mind that certain tests and investigations, e.g. blood tests, will need to be 'ordered' by a doctor.

TELEPHONE APPOINTMENTS
If you feel you do not require an appointment, but would like to speak to a doctor for advice, please ask the receptionist for a telephone appointment. You will be given a time when the doctor will endeavour to ring you back, although this may not always be possible and may be at a later time.

SURGERY TIMES

Please note all surgeries are by appointment
* These appointments are primarily for patients unable to attend during our normal working hours, and appointments can only be booked in advance. During these times telephone calls will continue to be answered by the out-of-hours service, and access to the surgery is for booked patients only.

HOME VISITS
To request a visit during normal hours please telephone between 8.30am and 10.30am if possible, so that we can plan the day's calls. Home visits will normally only be carried out for patients who, in the reasonable opinion of the doctor, have a medical condition such that it would be inappropriate to expect them to attend the surgery.

EMERGENCIES
During surgery hours ring the usual practice number and tell the receptionist the nature of the emergency. The duty doctor will be contacted as soon as possible, or it may be suggested you should call the ambulance service.

REPEAT PRESCRIPTIONS
If possible these should be requested in writing, via email, or online - www.altonstreet.nhs.uk (ask for a leaflet). We ask you to request these 24 hours in advance: really urgent repeat prescriptions can be done the same day. We can send your prescription to the chemist of your choice if you wish.

EMERGENCY CONTRACEPTION
Please contact the surgery to be seen within 72 hours of the need arising.

TEST RESULTS
To obtain the results of tests and investigations, please telephone personally after 2.00 pm. Some results require further clarification, and you may be asked to telephone again, speak to the doctor, or make an appointment.

DISABLED PATIENTS
Disabled patients can be brought by car to the 'pull-in' adjacent to the main doors of the surgery. However, you are asked to then remove your car to the main parking area. Parking spaces for the disabled are for the use of patients with a disabled sticker only. The car can be brought to the door again when the patient is ready to leave. General access is easy within the building.

CLINICS

SEEING A DOCTOR
Expressing a preference
You may express a preference to receive services from a particular doctor or nurse, either generally or in relation to a particular condition. If you wish to do this, please write to the Managing Partner, who will ensure that your preference(s) will be recorded in your records. We will endeavour to comply with your request, but there may be occasions when we may not be able to do so.

Requesting a consultation
If you are over age 75 years, you may request an annual consultation with a doctor or healthcare professional. Similarly if you are aged between 16 and 74 years, and have not seen a doctor or healthcare professional in the preceding three years, you may also request a consultation.

CONTACTING A DOCTOR OUT-OF-HOURS
Out-of-hours (OOH) refers to those times of the day and night when the surgery is not open - from 6.00pm until 8.00am Monday to Thursday, and 6.00pm Friday to 8.00am Monday.

If you need to contact a doctor OOH for matters which cannot wait until the next normal surgery, all you need to do is phone the Herefordshire Primary Care Out-of-Hours Service on 0330 123 9309. The call will then be automatically passed to someone to take details, and one of several things may then happen:

• If it is very urgent, an ambulance may be called
• For many problems, advice on the 'phone will be all that is needed, and this will be available
• If you need to actually see a doctor, a time will be arranged for you to attend a Primary Care Centre (PCC) either locally or in Hereford
• Sometimes a home visit may be required for those too ill to go to a PCC - in this case a visit will be arranged.

The minor injury unit at Ross Community Hospital is available for accidents and injuries. If the nurses there are unable to deal with the problem you could be asked to attend the OOH centre at Hereford, be transferred to the County Hospital in Hereford, or seen by a doctor locally if that is appropriate.

NHS DIRECT
By telephone:
NHS Direct provides a confidential 24-hour helpline staffed by expert nurses. By calling 0845 4647you can obtain advice at any time of the day or night, wherever you are in England

On the internet:
www.nhsdirect.nhs.uk provides a gateway to health information on the internet. This includes a health encyclopaedia, self help guides, and a local information database of primary medical services such as GP practices, dental practices, optometrists, pharmacies and hospitals.

Further details of local services can also be obtained from Herefordshire Primary Care Trust, Vaughan Building, Ruckhall Lane, Belmont, Hereford, HR2 9RP. Telephone: 01432 344344.

MEDICAL STUDENTS
We do sometimes have attached medical students with the practice. At these times a notice is placed in the waiting room - if you prefer to see the doctor alone, simply tell the receptionist or the doctor.

CONFIDENTIALITY
Every effort is made to protect the confidentiality of each patient, and staff may refuse to release information, particularly on the telephone or to a relative. This may occasionally appear unreasonable, but it is hoped it will be recognised as in the best interests of the patient.

PATIENT INFORMATION
We ask for information about you so that you can receive the best possible care and treatment. We keep this information, together with details of your care, to ensure that your doctor or nurse has accurate and up to date information when you need to see them.

There are times when we have to pass on information about you to other people such as hospitals, social services, or Herefordshire Primary Care Trust (formerly the Health Authority). This is always done confidentially, or by removing your identifying details when they are not essential. Everyone working for the NHS has a legal duty to maintain the highest level of confidentiality relating to patient information.

All information remains confidential, but you are free to refuse to give permission for us to pass on your details. Your care will not be affected in any way. If you wish to refuse permission, please inform us and your record will be marked accordingly.

CARERS
Do you look after someone who is ill, frail, disabled or mentally ill? If so, you are a carer. We are interested in identifying unpaid carers, especially those people who may be caring without help or support. We know that carers are often "hidden" looking after a family member or helping a friend or neighbour with day-to-day tasks and may not see themselves as a carer.

We believe carers should receive appropriate support, so if you are a carer, let us know by completing a Carer's Identification and Referral Form which is available in reception.

PRACTICE CHARTER STANDARDS
Our responsibility to you

Names: People involved in your care will give you their names and ensure that you know how to contact them. The surgery will be well signposted and names will be indicated on the surgery doors.

Waiting Time: We run an appointment system, and in most cases you will be given a time at which the doctor or nurse hopes to be able to see you. You should not have to wait more than 30 minutes after this time without receiving an explanation for the delay.

Access: We are committed to providing excellent access to our patient services and to providing the opportunity to:

• Register with the practice and access services without fear of discrimination
• Consult with a Practice Nurse / Health Care Assistant within one working day
• Consult with a GP within two working days
• Request an assessment the same day if the patient determines this is clinically indicated
• Directly book appointments with the Practice Nurses, Health Care Assistants, and attached Midwives
• Book appointments more than two working days in advance
• See a practitioner of the your choice, normally within seven working days
• Request a home visit

Telephone: We will try to answer the phone promptly and ensure there are sufficient staff to do this. You should be able to speak to a doctor by telephone, but it is likely that the doctor will be asked to call you back.

Respect: Patients will be treated as individuals and partners in their healthcare, irrespective of their ethnic origin or religious and cultural beliefs.

Information: We will give you full information about the services we offer. Every effort will be made to ensure you receive the information which directly affects your health and the care being offered.

Health Records: These will be kept confidential at all times, and you have the right to see them, subject to limitations in the law.

Your responsibility to us

• Please let us know if you change your name, address or telephone number
• Please do everything you can to keep appointments, or let us know if you cannot, or no longer need the appointment
• Please ask for home visits by the doctor only when the patient is too ill to visit the surgery

SUGGESTIONS & COMPLAINTS
We welcome suggestions, and wish to know of any matters of particular concern. Please give your suggestions to any member of our team.

If you feel you need to complain, we operate a practice complaints procedure as part of the NHS system for dealing with complaints, and our system meets national criteria. The Managing Partner and Patient Services Manager are able to provide further information, and a copy of our complaints leaflet, giving details of the procedure, is available in the waiting room or from reception.

VIOLENCE & AGGRESSION
We have adopted a policy of zero-tolerance towards violence and abuse. Any person who acts in a violent or abusive manner to any other person, whilst on practice premises or on a home visit, will be removed from the practice list.

PATIENT PARTICIPATION GROUP
The practice is keen to involve patients in decisions about the running and direction of the practice, and to provide ideas and feedback from a patient's perspective. We have conducted a patient survey for three years now, and we actively use the feedback that we receive to instigate improvements in the service we provide. However, we wanted to take this further and have formed a patient participation group to provide a link between the practice and our patients.

The group meets quarterly, and if you have an issue you think it would be useful to draw to our attention, you may contact the practice direct, but may prefer to contact one of our patient members. We are extremely grateful to them for agreeing to make their contact details available. They all have lives to lead and we ask that you only contact them by telephone between the times shown where these are specified.

The group have been instrumental in organising a series of patient education events. These are on various topics and those that have taken place already have proved very successful. Look out for information on forthcoming events.