1. Dates of changes to services at Bootle Surgery Closed for all services Mon 2 nd May – Bank Holiday, **Open Tuesday 3 rd May** Friday 6 th May Tuesday 10 th May Friday 13 th May Tuesday 17 th May Friday 20 th May Tuesday 24 th May Friday 27 th May Mon 30 th May – Bank Holiday **Open Tue 31 st May** Fri 3 rd Jun

2. Bootle Surgery - Changes to Services Thank you again for your patience and understanding since moving to 3 days services. Although we have new Dispensers and Receptionists in training we still believe that keeping on 3 days is safest. We have also been hit by the sickness bug in our team over the last month and this demonstrates that if we had moved back to 5 days, we wouldn’t have sufficient capacity in the team to cover. To avoid confusion and disruption, we feel it best to keep 3 day services at Bootle until a whole practice staffing review can take place. NHSE are fully aware and supportive of this decision. This is in a climate of increasing demand for services and recruitment pressures locally and nationally. We are now part of a rural and small practice ‘task group’ in Cumbria who are all experiencing the same difficulties. Thank you again to those patients who have registered to use our online services to book appointments and order medication. Please do ask for help to set this up as this is a big help to us. Whilst we continue to review our staffing for both sites and to avoid fatigue and prevent illness in the team; we will remain open until 1.30pm on Monday, Wednesday and Thursday, unless there is a Bank Holiday. This is to allow staff a reasonable break and travel time before continuing to work at Seascale. The situation remains that if you need to speak to a GP on the day when Bootle is closed, the Doctors at Seascale will call you back to help. For urgent, ‘on the day’ clinical needs you will be offered an appointment at Seascale. Visiting for housebound or seriously ill patients will not be affected.

3. Bootle Surgery - Changes to Services (cont ) Drs Carhart and Sowton will continue to carry out the majority of telephone consultations from Seascale with Bootle patients and allocate appointments as required (as they currently do already from Bootle). Dr Blyth will attend at least fortnightly so that you have a choice of a female GP. Appointments for Clinics continue on Thu afternoon and Barbara Fell now has some afternoon Nurse Practitioner slots if you prefer an afternoon appointment. When Bootle surgery is closed in an afternoon, please telephone 01229 718711 in the morning before we close to place your medication order. This gives us more time to ensure delivery. Alternatively, please order online using Patient Access. We experience a high demand for medication orders on Mon and will still attempt to turnaround your repeat orders within 48hrs from request but please order with at least one week of medication so that you don’t run out. We may have delivery problems that we cannot foresee. We will continue to consider all options and will review the situation on an ongoing basis and would ask you to keep checking our website for updates. www.seascalehc.co.uk. Our next Patient group meeting is on 27 th Apr 2016, if have any issues that you would like considered or can contribute any suggestions whist we continue to experience difficulties, please do let us know.www.seascalehc.co.uk Please accept our apologies and bear with us during this difficult time for staff. Regards, Drs Illsley, Carhart, Sowton, Osayi and Blyth 25 th April 2016