The Penrose Scroll - Edition 5

Author

Kelda Manser-Smith
May 21, 2025

Welcome to the fifth edition of The Penrose Scroll.

You might notice some polls throughout this edition… please take a couple of seconds to respond so we know what’s working and what’s not! 📈

Latest News

DNAs are creeping up 😱

When we first reported about DNAs last quarter, the total rate of DNAs for all of our surgeries was 8%. Sadly, these numbers are creeping up, with the total rate of DNAs for the month of April 2025 at 9.2%.

Below are the rates for each surgery…

Effecting the biggest change over this time period (from 9.0% to 7.8%, to end the quarter at 8.4%) - Knights Hill Surgery.

They came close to being top dog, but in the end, it was NG that pulled the DNA out of the hat! Given the results from our last report, KH and NG are the top two contenders for the second time. However this time NG exacted their revenge, knocking KH off its joint top spot with LMC. What are you doing right, NG?

So sorry, LMC! Staying level for three months has put you in third place…time for a new strategy!

DNAs are costly, so if anyone has a proven way to reduce them, share, please… or at least try to drive your surgery to the lowest rate and beat your colleagues! We’ll see how you fare next quarter.

Face mask use from September 2025

It’s important that all of our team follows infection prevention and control procedures, to protect yourself, your colleagues, and our patients from the preventable spread of disease. As such, from September 2025 it will be mandatory for all of our frontline staff to wear a mask when interacting with patients.

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The LTC year in review: prioritising fundamental care

😞 The bad news

We did not provide the best quality care to all our long-term conditions (LTCs) patients in 2024-25.

🙂 The good news

We can make it better! We recognise the extraordinary effort that our teams put in to patient care. However, there is an urgent need to align expectations and delivery of care more robustly, to give our patients the best quality care. Let’s take a look at how we can aim higher…

🤔 So, what’s the plan, Stan?

Our primary goal is to ensure that all patients with long-term conditions receive comprehensive and proactive care, at every appointment, without placing unnecessary strain on capacity. To that end, we have developed some ‘proactive care’ actions:

  • Leads will be more proactive, supporting their team members in attaining highest standards of clinical care, consistently. This support includes improving time management and reviewing performance so that they can identify and fill any information or training gaps that may exist.

  • All clinicians are asked to view our patients holistically. Address any underlying or outstanding care needs within each consultation. If time is a constraint, advise patients to book a follow-up appointment with the appropriate team member.

  • Monthly targets will be implemented immediately to work toward the full completion of Proactive Care actions by January 31, 2026.

🔦 There are tools to help you get there…

  • The pink box is there to help clinicians deliver truly fundamental care - it is a visual post-it note; a remembrall; whatever form of reminder that works… but it exists to alert the clinician that the patient needs some care, there and then.

  • Templates are a vital tool in reducing documentation errors and standardising care. And the best part about them…we really do want UX feedback! Please do let us know what works and doesn’t, so that we can up the game here, too.

  • Improving coding precision = improving the overall patient experience. To maximise coding accuracy, monthly reports will identify coding usage patterns, so that we can provide tailored feedback and training to all staff as necessary.

Delivering real time quality care isn't only looking at the problem with which you've just been presented. The patient in front of you is complex; a whole system of functions that needs attending to fundamentally. As a clinician, you are in the unique position of being able to do just that. And we can all support each other to achieve this universal goal.

A special thanks goes to all the Leads and Louis Williams for wrapping up the QOF year. Data was gathered, numbers were crunched and reports were made…Louis and the Leads (sounds like a band?) did a great job of getting it all together, in tempo! Thank you for your hard work. 🎸

Learning & Development Updates

Upcoming PLT dates…

Lambeth

10 June 2025

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10 September 2025

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9 October 2025

Lewisham

26 June 2025

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11 September 2025

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20 November 2025

Southwark

19 June 2025

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17 July 2025

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21 August 2025

Blue Stream Academy

Blue Stream completion is still inching up… let’s keep the momentum going. 🏃

Upcoming training events

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Lunch & learn webinars

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If training falls within your normal working hours, please first agree with your Lead that you are able to attend, then submit a training request to our L&D Coordinator - the form is also on the Portal Homepage! 

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 - new CPD-certified online learning added from RISE Leadership Programme, Clean Air Academy and GatewayC

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What’s new in the Penrose Portal?

Ask Aunty Portal…

Aunty Portal has taken a holiday this month - she’s decided she needs a break from all those pages!

However, before she left, she did say that a new page has been added to the Portal, so do check it out…

…and updates for Samples, Reporting Patient Deaths, ECGs and Cervical Smears pages.

Significant Events Heads Up

“I am still learning.” — Michelangelo (aged 87)

Below are recent Significant Events (SEs) and the lessons learned and/or procedures modified, to reduce the risk of them happening again… live and learn.

1️⃣ Blood sample collection missed

Event: Blood Samples placed in a different area and not seen in time for last courier collection

Blood samples were placed on a trolley behind reception for collection by the courier. As this is not the usual location for leaving them, the receptionist did not see the samples, so when the last courier collection took place, they were not handed over. The oversight was not realised until around 17:00, well after the last collection and just before the weekend.

No harm occurred, but consider the following points:

  • many patient samples could have been lost - imagine the wasted time and patient frustration if they had to be recalled to get a new sample.

  • to ensure that the samples went on the day, an additional fee was charged to the surgery for the extra collection.

  • on the eve of a bank holiday weekend, someone had to wait in the surgery until the courier could come back to get the samples.

✨ Learning point ✨

Samples must be collected in a timely manner, as it is not best practice to store samples in the fridge overnight, and they certainly cannot be stored over a weekend.

Reception and Nursing staff should always clearly communicate locations and times of sample bag placement and collections.

Reception Leads are now expected to physically check, daily, that at the time of final sample collection to ensure it has gone. If it hasn’t, it gives plenty of time to rectify the situation.

See Portal page for more information: Samples

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2️⃣ Incorrect reporting of patient death

Event: Medical Certificate of Cause of Death (MCCD) written without referring to the Medical Examiner (ME).

Call handlers were informed of a death but failed to notify the Lead Receptionist and the site Care Coordinator (who was off sick). The Lead Care Coordinator wasn't informed either.

The GP erroneously told the Welcome team they only needed to write the MCCD. This led to the MCCD being written without a referral from the ME and so delayed the process for the family, who required an urgent faith burial.

The situation only came to light when the Welcome team asked where to send the MCCD, not realising it needed ME review.

✨ Learning point ✨

Call Handlers → need to be aware of who is on duty when a call comes in regarding the death of a patient. They must inform these people, urgently, in this situation: Site Reception Lead, Site Care Coordinator and Lead Care Coordinator.

GPs → do not write the MCCD before the referral is done to ME or without conversation with the Care Coordinator team.

See Portal page for more information: Reporting Patient Deaths

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3️⃣ Errors recording dates of urine dips

Event: Several urine dips added to previous day's duty list, so not actioned at the appropriate time.

On two separate occasions, two different members of the HCA/Nursing teams added several urine dips to the duty doctor list for the wrong day.

One lab result came through workflow 5 days after it should have, and was picked up by a GP. Harm was not done in this case, but there was a delay in treatment for the patient. Thankfully, no urgent action was indicated in any of the other cases.

✨ Learning point ✨

Accuracy in records is key to patient safety and must be taken seriously.

Staff must double check dates for things added to the duty list at least twice: at the time of writing and again at the end of adding information, to ensure that data is on the correct list.

Staff should document things as close to the time of doing the task as possible; the longer it is left, the more room there is for error.

N.B. The Nursing team will be running a refresher session on duty list use and documentation, so everyone is clear on protocol and maintains consistency going forward.

See Portal page for more information: UTI Process & Urine Dips

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Beyond First Impressions

Dutch double doctor docks in Deptford…

Esther Blenke

Esther is a GP at Kingfisher & Surrey Docks. She is actually a dual doctor - ENT and GP, who enjoys splitting her time between the two.

After qualifying in the Netherlands, Esther made her way to London, taking a long Northern route through Northern Ireland, Scotland and the North of England (she must be okay with cold weather!). Why London, you might ask? Well, to start a Medical Doctorate in Aeronautics at Imperial College, of course! We are intrigued…

What's inspiring you in life right now? 

Beauty always inspires me. I absolutely love making spaces look beautiful at home and at work. I’m always on the lookout for vintage pieces with which to adorn our flat. We are always running out of space...

Sweet or savoury? 

Savoury, say cheeeese!

What’s your favourite board game? 

The Game of the Goose, or Ganzenbord, as it is called in the Netherlands; a simple game that can be enjoyed by children of all ages, even 53.

Where would we find you this weekend? 

On Fridays, we often host dinner for friends at home. On Saturdays, I read the Weekend Edition of the Financial Times and some magazines over a leisurely breakfast before heading to somewhere like Brockley Market or Bermondsey Spa Terminus. Firm favourites are the Käse Swiss, where they only sell Swiss and Dutch cheese, and the Ham & Cheese Company, where they sell everything else. For fruit and veg we pop over to Brothers Fruit and Veg on Lordship Lane. In the evenings, we might pop into town to see friends or go the theatre.

What’s your guilty pleasure? 

By definition, pleasures should not be guilty, but ok: that glass (or two) of red wine on a Friday night might just do it.

What’s your favourite underground line and why? 

I like the Jubilee and “Ginger” Lines as they get me home. I have a soft spot for the District and Circle Lines as these remind me of Kensington where I lived for many years.

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

I had no idea that I was dyslexic until I was advised to seek an assessment as a GP trainee. I suppose dyslexia wasn’t well known when I was young. While at Medical School I failed most exams at least two or three times, missing out by 0.25 points. I persevered, as giving up does not quite exist in my book, but I often despaired .... Finding out I am dyslexic was a revelation: so many things suddenly fell into place.

If you were not a GP, what would you be doing? 

I would love to be an interior designer, creating beautiful and interesting homes.

Well, Esther, Penrose Health are glad that you changed tack from Aeronautics to ENT and GP - otherwise, we would never have had the pleasure of getting to know such an energetic person who gives so much to our patients. And what a testament to your tenacity - persevering through medical school with undiagnosed dyslexia - what a role model for resilience! As Nelson Mandela once said, “Do not judge me by my success, judge me by how many times I fell down and got back up again.”

And as for interior design?…Your determination suggests that it would be more like Grand Designs for you! And not as an alternative, but just one more feather to your career cap - Kevin McCloud, watch out!

Next time…we’ll be asking a pharmacist to ‘say cheese’!

The Shout Out 📢 

Penrose Health would like to welcome…

Tanvi Deshpande to the Care Coordinator Team - Addison and the folks at Deptford are delighted to have you on board! 🚢

…and give a big Penrose shout out to…

Sophie Murdoch, who consistently goes above and beyond to support our patients, demonstrating an unwavering commitment to their care. Calm, empathetic, and exceptionally attentive to detail, she brings together all the qualities that make her truly outstanding in her role. A valued member of the KFSD team, she is held in high regard by both the welcome team and clinicians alike, who deeply appreciate the dedication and compassion she brings to every aspect of her work.

…and…

Stacey James, who has been absolutely amazing — she is incredibly knowledgeable, gives great advice, and recently went above and beyond, helping to organise drinks last month in LB with the reception team. Stacey is always willing to help and happy to answer any questions. Her support and positive attitude really make a difference to all.

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.

We see you…

Mindfulness (or mind-less-mess!)

Staff well-being is a key tenet of the Penrose Health ethos. In order for you to perform at your best, you need to feel ‘at your best’. Doing something that takes you to an oasis of calm can work wonders for your physical and mental health. So, we’re sharing some local activities and services that could help you reach that Zen inner peace. ☮️

Brockley Max is a nine-day community arts festival, taking place 31st May - 8th June. It celebrates local talent and occurs in different venues across Brockley, Ladywell, Crofton Park and Honor Oak. For more info and festival programme, visit their website: What is Brockley Max? – Brockley Max

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If you know of any activities or services available to our teams, let us know here so we can share it with everyone else!

And finally, did you know that... 

Blue light card holders can get 20% off food for a table of up to 4 at any Honest Burgers restaurant for eat-in? See their website for particulars: Blue Light Discount | Honest Burgers

And if you don’t already have one, Penrose Health will reimburse you when you purchase a blue light card. See our page Blue Light Card for details.

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If you know of any discounts local to your surgery, let us know here so we can share it with the rest of the team!