The Penrose Scroll - Edition 10

December 03, 2025

Welcome to the latest edition of our Penrose Health newsletter – The Penrose Scroll. If you have any suggestions for the next edition, please let us know here! 👈

Latest News

Christmas Party 🎄 

Penrose have planned a cracking party for Christmas festivities, so please don’t miss the boat…be sure to RSVP soon, as space is limited and we need to ensure enough food and drink (and 🛟!) for all.

The party boat will have lights, laughter and festive cheer with a DJ and dance floor, so don your deck-dancing shoes, your best sparkly-clothes and prepare for an evening of fun on the high seas 🏴‍☠️…well, the Thames, actually.

🗓️ Date: 12 December

🕖 Time: from 7pm

🛳️ Meeting Place: Bankside Pier

The image below shows the docking times for the boat - the time shown is the time the boat is open to boarding. You have 15 minutes from that time to jump on board and not miss it! Just to be crystal clear - Greenwich Pier 20:15 = boat docked and open. At 20:30, doors close and boat sails - be on it!

Reach out to SMI 🫂

Mental health issues are difficult at any time of year, but Christmas time can be particularly stressful and lonely for those with serious mental illnesses (SMI). To support our SMI patients during the harsh winter season, it is really important to ensure that they are looked after all year round.

Some sobering stats about our ability to connect with them:

  • Contact rate by phone: 57%

  • DNA rate: 33.7%

  • Response rate to text: 0.45% - less than one percent 😱!

As you can see, our SMI patients are notoriously difficult to contact, so we need to focus on making every contact with them count. This is where you come in…

When contacted in any way by SMI patients → check the QOF box, look at notes, and strongly encourage them to come in for reviews.

🎁 The best present we can give them is ensuring that they receive the best care possible.

DNA year in review…

As we all know, DNAs are bad. Let’s check in on our total 2025 stats and see where we are as we approach year end.

All of these numbers are above the national average (which is reported to be anywhere from 5-7%). So let’s examine some reasons for DNAs and explore ways of reducing them.

Who is most likely to DNA?

Although no specific profile of a DNA patient exists, data suggests patients who are most likely to miss GP appointments are:

  • those with a serious mental illness

  • young adults aged 16‐30 years

  • from low socioeconomic backgrounds

  • aged over 90 years

Further, patients with a serious mental illness or from areas of high socioeconomic deprivation are more likely to miss multiple GP appointments.

The impact of missing an appointment is more profound than just inconvenience or preventing someone else from using that slot, particularly when it comes to patient with SMI or long term conditions. Data indicates that:

These patients are at significantly greater risk of all‐cause mortality, which increases in a dose‐dependent manner in response to the number of appointments missed…patients with long‐term mental health conditions who miss more than two appointments each year have been shown to have a greater than eightfold increase in risk of all‐cause mortality compared with those who missed no appointments…

Given the data above, GP practices around the country have been donning their thinking caps to find ways of addressing some of these issues.

What are some ideas for reducing DNAs?

  • Always ensure that we have the correct contact details for every patient.

  • For patients who require carers → ensure that the carer can make the appointment.

  • Be aware of your vulnerable patients and those most likely to DNA → ensure that they are verbally reminded, either the day before or on the day of their appointment.

Below is an interesting observation from a report made by the accounting firm, BDO, A practical guide to reducing DNA rates in healthcare settings:

People generally prefer to live up to their commitments, especially those that are owned and require their active rather than passive involvement. Social psychologist Robert Cialdini cites the example of Chicago restaurateur Gorden Sinclair who asked his staff to make one small change when taking reservations over the phone. Rather than asking customers to “please call us if you need to change or cancel your booking” staff were instructed to say, “Would you be willing to call us if you have to change or cancel your booking?” and then pause and wait for the customer to answer ‘Yes’. This small change led to a notable drop in no-shows.

BDO advised using this similar technique with patients → when booking an appointment, ask the patient “if they would be willing to call if they have to cancel,” then pause to allow them to respond, and finally, ask them to repeat back the date and time of their appointment. BDO reported that this intervention alone led to a 6.7% reduction in DNAs.

Have you got any suggestions for reducing DNAs? If so, please let us know in our feedback form and we can include them in our next issue - let’s all help each other bring these numbers down, and promote excellent patient care.

Admin angst alleviation arrives as Anima!

Managing backlog is like weeding - no matter how many you pull up, within a few days, they’re back, crushing your green soul! Clinical documents accrue on a daily basis, and having a backlog can feel a lot like that. It makes taking annual leave impossible - what field of docs will be growing while you are away, ready, upon your return, to rain on your recently revived sunny beach disposition? (😱)

To reduce the backlog accrued by the influx of clinical documents from external services, and to allow our admin team to take their well-earned holidays without worry, we have procured a document processing software called Anima.

After trialling a couple of options, Anima was found to be the most robust, flexible and accurate system for streamlining the coding of documents. In fact, Anima was more accurate and at least three times faster than manual coding, thus vanquishing the menacing backlog and yielding true, up to date patient EMIS records.

This new system also auto-generates document summaries and saves them to EMIS notes, making it easier for clinical admin to quickly identify the purpose of the document, and for clinicians to note a document’s relevancy to a consultation.

Rollout of Anima has been staggard as follows:

  1. Nightingale - 14th November

  2. Kingfisher - 24th November

  3. LMC - 28th November

  4. Penrose - 1st December

  5. Deptford - 10th December

  6. Knight’s Hill - 10th December

Although training is being done in clinical meetings a week prior to ‘go live’ dates, anyone requiring individual support or further tuition can Teams message our fabulous project officer, Anna Latham, who is leading on this software.

Job referrals & internal vacancies 👇️ 

Our HR team want you! Or, actually, they want your connections…

Referral scheme

We offer a referral scheme - £200 when you refer someone for a job here and they pass probation. Just email a CV to Adam Breen with contact details and he will take it from there – they don’t even need to apply online!

Know any experienced Practice Nurses?

We’re offering a Black Friday Double Bubble offer for experienced practice nurses – if you refer an experienced practice nurse up until 20 December, you’ll get £400 instead of £200. More info here: https://penroseportal.co.uk/company-handbook/referral-program

Internal career development

Don't forget, we also support your career development, and you should always feel free to apply to a role we’re advertising if you meet the essential criteria – make sure you flag your application to your manager and Adam Breen so we can tag it as an internal application!

Here are a few roles we’ve opened over the last few days that might be interesting:

You can find more information and all our open roles on our jobsite: Jobs at Penrose Health | Penrose Health Careers.

Learning & Development Updates

Don’t forget, you can find out all about L&D at Penrose Health, including how to make a training request, on our Portal page: Learning & Development!

Upcoming PLT dates…

Lambeth

20 January

Lewisham

16 December

Southwark

18 December

Upcoming training events

👈️

Past events & online learning

And finally, you can check out these past training events and online learning modules whenever you have the time…

South East London Cancer Alliance (SELCA) - Webinar series

CHILDS Framework - Past webinar recordings

CESEL Education - Training recordings

Guy’s Cancer Academy - Online learning events

Penrose Academy - Learning libraries

👈️

What’s new in the Penrose Portal?

Ask Aunty Portal…

Another quiet month on the question front for Aunty Portal!

But we’re not winding down for Christmas just yet - there are lots of new pages and big updates on the Portal this month. Here are some highlights:

Significant Events Heads Up

“A mistake is only an error. It becomes a mistake when you fail to correct it.” — John Lennon

1️⃣ Prescription exemption form rejected due to lack of information

Event: A prescription exemption form required additional address details before the GP could sign it. It was sent off-site without the correct information.

✨ Learning points ✨

  • Reception team are responsible for ensuring that fully completed and signed forms are processed correctly.

  • Copies of completed and signed forms should be scanned and saved to the patient’s EMIS record before sending or returning to the patient.

See Portal page for more information: Exemption Certificates

👈️ 

2️⃣ Call handler quoted wrong price to patient for a form

Event: When the patient called chasing for a BUPA Insurance Form, process and time frame she was quoted £60 = vat by a call handler, whereas the actual price for processing it is £201.80, which was sent via email to the patient.

✨ Learning points ✨

  • Call handlers may inform the patient that there may be a fee for a request. However, call handlers should never quote prices for any form of report → this is the role of Clinical Admin, because the fee varies, depending on the type of report requested.

See Portal page for more information: Handling Medical Reports Requests

👈️ 

3️⃣ Patient took double dose of sertraline

Event: Patient was reviewed in September 2025, and sertraline dose increased from 50mg to 100mg. The patient was not aware that the strength of tablet had increased, so took two tablets of 100mg for an extended period of time. When she notified the surgery that she was running out of tablets much sooner than she should have, pharmacy team investigated promptly and discovered the error.

✨ Learning points ✨

  • When changing medications in any way, it is vital that this information is communicated clearly to the patient and that their understanding of the change is accurate.

  • This also demonstrates the importance of checks and balances - the early request was queried by the pharmacy team, which led to the revelation of the issue.

4️⃣ Patient’s dose of losartan not increased due to delay in actioning hospital letter

Event: A patient's dose of Losartan was meant to have been increased post hospital admittance, as per the discharge summary. There was a 2 month delay in actioning the letter, thus impeding effective treatment for an acutely unwell patient.

✨ Learning points ✨

Backlogs should not be allowed to develop:

  • effective, monitored workflows should prevent delays,

  • staff must clear workflows in a timely manner,

  • line managers must monitor and address cases where staff are not clearing their allocations.

5️⃣ Patient registered as ‘regular’ when actually in UK temporarily

Event: A patient was registered as a regular patient, then afterwards it was discovered that they were only here visiting a friend, with no intention to remain.

✨ Learning points ✨

This is a tricky one - the patient registered online, so it was impossible to know the reason he was in the UK when registering. Also, under the Safe Surgeries initiative, to ensure equity of access for all, we cannot delve too deeply into residential status and nationality.

However, the initiative does allow for offering the patient “the option to register as a temporary resident if they will be residing in the practice area for more than 24 hours but less than three months.” Posing this as a question may present an acceptable way to discern regular and temporary patients if the person is registering in the surgery. As for online registrations - well, we just have to do our best.

See Portal page for more information: Registrations

👈️ 

Beyond First Impressions

Confident, comedic, class clown comes clean…

Krishna Gnanaseelan

LMC’s PA, Krishna, considers humour a life skill and clearly uses it generously. Known for his quick wit, sharp timing and an uncanny ability to make people laugh when it’s most needed, he is always up for an adventure, though his definition of this is wide-ranging: from a spontaneous trip to ordering something new on a menu.

His philosophy is simple, “laugh often, choose joy where possible, and surround yourself with people who make the chaos worthwhile”.

Let’s find out more about this audacious ray of sunshine…

What's inspiring you in life right now? 

My inspiration right now are my students. I am fortunate to be able to teach both medical and physician associate students. Both professions are going through a hard time with job security in limbo. Despite this and the uncertainty the students still manage to keep going and have a positive outlook within the future careers. Teaching them and seeing them thrive is rewarding and inspirational.

Sweet or savoury? 

I am very much a savory person but don’t mind the occasional sweet tooth.

What’s your favourite board game? 

Monopoly was a staple in my household when growing up. Fighting for pieces and keeping a close eye on whoever is the banker in case a bill or two goes missing!

What’s your guilty pleasure? 

My passion for automotive vehicles whether this be cars or motorbikes. I have been a motor enthusiast and had a passion for not just driving but also working on vehicles myself whenever I can.

Where would we find you this weekend? 

You will find me partying with my friends and colleagues during a cold and wet autumn.

What’s your favourite underground line and why? 

Elizabeth line – when it was first introduced, the space, the air conditioning was almost all new and exciting. Gone the days of being crammed into a small tube with minimal ventilation!

What’s one thing you had to learn the hard way? 

Life is not what others tell you but it is what you choose to make of it. Growing up you hear and see others doing certain things and you wonder if it will be the same for you. You start putting expectations on yourself or even others will too, soon you realise that you are becoming your worst enemy by putting out hurdles only to get somewhere where you truly did not want to be. Follow your own dreams and not that of others!

If you were not in your current job role, what would you be doing? 

If I wasn’t teaching or working clinically then I would choose to go into the automotive industry – whether it be running my own mechanic shop, body work, selling and buying vehicles.

Automotive Industry? Body work? We’re really glad to have you here at Penrose, performing a different sort of ‘body work’ as a PA! Whether it is a mechanical machine or the human body, it’s clearly in your DNA to make things work as best they can, and to encourage that vocation in others, too. And, as a future world traveller, I am sure you will bring your enthusiasm and good to all ‘corners of the globe’.

The Shout Out 📢 

A huge shout out to Emma Tobin for her call handling excellence. She asks all the triage prompt questions, follows suggested outcomes and logs tickets appropriately. Beyond ticking all these technical boxes, she also excels at explaining concepts like external services to patients. However, most importantly, she handles all patients with a hefty dose of compassion, deftly diffusing tense situations…so much so that by the end of the call, patients are grateful for her help. Bravo to you Emma - model Call Handler.

We think all of our employees are invaluable, but if you think a member of your team deserves a shout-out for something special they’ve done or achieved, let us know here.