Noticeboard

IMPORTANT UPDATED INFORMATION

We are updating our website regarding some of the changes that we have had to put in place since the coronavirus (COVID-19) outbreak, along with some useful advice and resources. As we are sure you appreciate, this is a rapidly changing situation and whilst we endeavour to keep this site under review, we cannot guarantee that any web links will always be up to date. If new government announcements are made, please follow that advice as it emerges.

Courtyard Surgery would like to thank all of our patients for their continued support and cooperation during these unprecedented times.

Is the surgery open?

Yes! We are open and we have been working really hard to make sure that we have everything in place to be able to continue to give you high quality medical care both now and if the situation with COVID-19 escalates over the coming weeks.

 

But! We are not operating in the usual way, so PLEASE DO NOT WALK INTO THE SURGERY TO ASK FOR APPOINTMENTS AS WE ARE ONLY MAKING APPOINTMENTS OVER THE PHONE. Please see the information below that outlines the reasons why we have changed our systems and how they operate.

We would like to reassure you that in the currently unlikely event that the surgery would need to close at any point in the future (for example due to staff shortages), we work closely with a number of neighbouring practices and together we will continue to provide medical care for you and your families.

How should I access healthcare?

If you have a new continuous cough and/or high temperature (37.8 degrees or above) then you advised to self-isolate at home. YOU SHOULD NOT GO TO A GP, PHARMACY OR HOSPITAL.  You should only call 999 if you are seriously unwell and feel it is a medical emergency.

The following NHS website is regularly updated with the latest advice:

https://www.nhs.uk/conditions/coronavirus-covid-19/

It also provides information about self-isolation, including practical advice and recommendations about how long this should last.

If you need to seek medical advice initially then please use 111 online:

https://111.nhs.uk/covid-19

If you have any other medical related problem that requires advice please consider approaching this in the usual way whilst remembering social distancing measures:

Seek advice online from 111 https://111.nhs.uk

Phone 111

Phone pharmacy if appropriate

Phone GP surgery if required

Livi

See a GP by video with LIVI. Even at the weekend.

Patients of Courtyard Surgery can now see an NHS GP by video using LIVI.

Get medical advice, prescriptions and referrals on the same day – even at weekends.  LIVI offers appointments between 7am - 10pm Monday to Friday and 8am - 4pm on weekends.

The service is provided free on the NHS.

You can download the LIVI app to your mobile phone or tablet, at the App Store or Google Play. Or visit the Livi website for more information.

LIVI GPs are all GMC-registered NHS GPS, who (with your consent) will be able to access your medical records and give you a considered, in-depth diagnosis based on your medical history.


To be able to access this service, you will need to have appropriate record sharing consents in place - you can contact the surgery on 01403 330320 or email your consent to sharing to HSCCG.courtyard.admin@nhs.net (please note this email address has limited monitoring, so must not be used for any urgent clinical or medication needs).  

Can I get a test for COVID-19 (coronavirus) at the surgery?

No. Testing is not currently available in the community other than in very specific circumstances (and this service is not run by GP surgeries).

How do I contact the surgery and how will the surgery contact me?

The surgery has temporarily suspended all pre-booked and online appointments for you to see a GP.  We have changed these appointments to telephone triage. This means that if you wish to make an appointment to see a GP you will need to telephone the surgery first and speak to a member of the reception team. Please do not come into the surgery to make an appointment.

If the surgery needs to contact you, it is likely that we will use our text messaging service more frequently over the coming weeks, as this is an instant way to keep in touch with you. If we telephone you from the surgery it may appear as an unknown number on your phone, so please ensure that if you are expecting a call make sure you have your phone with you at all times.

Why has the surgery changed the appointment system and access?

You will have heard of the need for everyone to be socially distancing themselves from others and this advice is especially important in doctors’ surgeries. With COVID-19 now circulating in the community, patients coming to the surgery have the potential to spread the virus to staff who can then go on to infect others, some of whom will be very vulnerable to infections. In addition, we could very quickly see large numbers of staff self-isolating leading to real gaps in service provision. We hope you can, therefore, understand why we don’t want you coming to the surgery unless it is absolutely necessary, however if you do need to visit us we will make it as safe as possible for you to do so.

We will try to deal with as many queries as possible over the phone or in some cases, via video consultation. You will be advised of the process for this if required. Some routine work, such as chronic disease reviews, may need to be postponed, but some of our usual work will continue. We are looking to do this without you needing to come into the surgery wherever practical. A good example of this would be ordering repeat prescriptions, please see below for more details.

Of course, some patients may have to come to the surgery during the next few weeks, either for routine care which cannot be postponed, for example childhood immunisations and dressings others will need to be seen with more urgent illnesses. We have processes already in place to ensure that our staff knows who does need to be seen and what work can be deferred. These decisions have been made by doctors, nurses and other members of our clinical team, so please do not hold the reception staff accountable for this.

What will happen if I do need to come to the surgery and why?

 If you do need to come to the surgery we have systems in place to prioritise your safety and the safety of our staff. Firstly, we aim to keep anyone who has any possible symptoms or signs of any general infection away from others and therefore we have a special appointment system in place for these patients. They will be seen at the local COVID-19 HUB and not at the surgery.

We also want to ensure that we enable other patients to follow social distancing guidelines even within the surgery. For that reason we ask that you aim to keep 2 metres distance from others in the waiting room wherever practical. This is particularly important for those in the ‘at risk’ groups and they will be given additional advice accordingly. We have a special appointment system to protect these potentially vulnerable patients as much as possible.

As you might imagine, these processes are evolving all the time, so please listen carefully to the instructions you are given by a member of staff if you are given an appointment.

Our staff may need to wear protective equipment during the consultation, such as gloves, a gown and a facemask. Please do not be alarmed by this. If bringing a child it may be helpful to warn them of this in advance.

When attending the surgery please limit the number people where possible.

 On arrival at the surgery you will find the doors are closed, please knock on the door and a member of the reception team will communicate with you from a window. If you have an appointment with a Doctor or Nurse you will be given a mask to wear and asked to wait outside and the Doctor or Nurse will come and collect you when they have put on their PPE.

Repeat Medication requests

How to order:

If you already order your prescriptions online then please continue to do so in the usual way. If you do not already use electronic prescribing it is quick and easy to set up via the following link https://www.nhs.uk/using-the-nhs/nhs-services/the-nhs-app/ If you are unsure how to do this then please ask a relative to do this for you. This is the safest and most efficient way to get your prescriptions to you.

If this is not possible then please contact the surgery, for further advice.

Please allow 3 full working days for us to process your prescription requests at this time.

What to order:

Please be aware that the current medical advice for those people with any long-term conditions is to continue taking your usual prescribed medication unless advised to stop by a health professional. In line with government guidelines, we respectfully ask that you DO NOT REQUEST EXTRA QUANTITIES OF YOUR MEDICATION at this time. We will continue to process prescriptions promptly.

Request for medical certificates

There have been some recent changes to the medical certificate and benefits systems to ease pressures for both users and service providers during these busy times. Please see link to latest government advice regarding current guidance for all claimants during COVID-19 outbreak:

https://www.gov.uk/government/news/coronavirus-support-for-employees-benefit-claimants-and-businesses

Remember that you can always self-certify for up to 7 days for any reason. 

During the COVID-19 outbreak, 111 are providing an easy online service to obtain certificates for if you are isolating relating to either personal illness from coronavirus or following advice to protect others. The online certificates can be issued for longer than 7 days. Please note that we have been advised that self-isolation is regarded as illness for employment purposes. This service has been created to avoid unnecessary administrative work for surgeries during this extremely busy period and therefore this will be the only way to obtain certification for isolation at the present time.

 https://111.nhs.uk/isolation-note/

If you need a medical certificate for any other reason (beyond 7 days duration) then you will need to telephone the surgery, to request it. It is likely that you will be emailed the certificate, so please have your email address to hand.

Request for non-NHS work for example insurance reports

We will be very unlikely to be able to process these types of requests at this time due to volume of workload and prioritising patient care. This is the position we have been advised to take by local bodies. Please consider whether this request can be postponed if at all possible.

Working together to provide high quality medical care

We want you to know that we are here for you. We know that if we all work together as a team of patients and staff then we will be able to continue to look after you to the best of our ability.


  • Flu clinic update 2020 - we apologise for any patients still waiting to hear from us regarding their annual flu vaccination. We have experienced delays in our vaccine deliveries.

    We will be inviting eligible patients who have not yet heard from the surgery to book an appointment very shortly as our vaccines are delivered.

    If you haven't already, why not sign up for SMS text messaging (Text Messaging Consent) so that we can contact you via text message.   

    Please note that, if you are aged between 50 and 64 and not in a clinical at risk group, the earliest you will be offered a flu vaccination is November, providing there is sufficient vaccine. No appointments will be offered for people in this age group until then. This is to ensure that those who are most at risk are vaccinated first. If you are aged 50 to 64 and are in a clinical ‘at risk’ group which is eligible for the flu vaccination, for example you have a health condition which puts you at risk from the flu, you will be invited earlier. 


Livi - new video consultation service - visit LIVI for more information


EMERADE Fact Sheet for patients October 2019 - see Medication Information


Sepsis Awareness - visit Sepsis Awareness


New Registrars at Courtyard Surgery

We are pleased to welcome Dr Hitesh Gadhia and Dr Saif Ali  as our new placement ST3 GP Registrars, they started training at Courtyard Surgery in August 2019. Dr Gadhia will be with us for 6 months and Dr Ali for 12 months.  Both will have the support of the full clinical and administrative team whilst at the surgery. 

Courtyard Surgery has been approved as a Training practice for GP registrars from the Mid Sussex GP Training Scheme.


Important Announcement

Following our announcement in 2017 regarding Riverside Surgery moving premises to Courtyard Surgery, this is no longer taking place and Riverside will be remaining at their current premises on Worthing Road.

As such, Courtyard Surgery will no longer be joining with Riverside Surgery. Although this is a change in the original plans, we have, as part of future proofing, 7 new rooms that will be for our patients. 

We are continuing all of the services that we currently offer and will be employing more doctors and other health care professionals to make the most of the additional capacity and strengthen our clinical team.

With more rooms and staff available, we anticipate improving our services with the capacity and ability to look after our patients.

We would like to thank you for your patience.


New Physician Associate at Courtyard Surgery

We are delighted to be welcoming a new healthcare professional to our primary care (GP) team.

Shannon Rosine is a US trained Physician Associate (PA) with considerable clinical experience, working in both emergency departments and a health centre linked with a correctional facility. Shannon is also a Teaching Fellow in Physician Associate Studies at Brighton and Sussex Medical School, training PAs for the future.

For more information, visit Latest News on our website.


Physiotherapy Self-Referral for Patients
Did you know you can now refer yourself to physiotherapy at Horsham Hospital for musculoskeletal conditions? Please refer yourself by clicking here to access the referral form or alternatively pick up a paper form from the surgery reception.

Horsham Hospital Blood Service
Please click here to see change in opening times for the above blood test service from 01 June 2017. Click here for more information on the changes.

Latest News

IMPORTANT UPDATED INFORMATION

We are updating our website regarding some of the changes that we have had to put in place since the coronavirus (COVID-19) outbreak, along with some useful advice and resources. As we are sure you appreciate, this is a rapidly changing situation and whilst we endeavour to keep this site under review, we cannot guarantee that any web links will always be up to date. If new government announcements are made, please follow that advice as it emerges.

 Courtyard Surgery would like to thank all of our patients for their continued support and cooperation during these unprecedented times.

Is the surgery open?

Yes! We are open and we have been working really hard to make sure that we have everything in place to be able to continue to give you high quality medical care both now and if the situation with COVID-19 escalates over the coming weeks.

But! We are not operating in the usual way.  Please see the information below that outlines the reasons why we have changed our systems and how they operate.

We would like to reassure you that in the currently unlikely event that the surgery would need to close at any point in the future (for example due to staff shortages), we work closely with a number of neighbouring practices and together we will continue to provide medical care for you and your families.

How should I access healthcare?

If you have a new continuous cough and/or high temperature (37.8 degrees or above) then you advised to self-isolate at home. YOU SHOULD NOT GO TO A GP, PHARMACY OR HOSPITAL.  You should only call 999 if you are seriously unwell and feel it is a medical emergency.

The following NHS website is regularly updated with the latest advice:

https://www.nhs.uk/conditions/coronavirus-covid-19/

It also provides information about self-isolation, including practical advice and recommendations about how long this should last.

If you need to seek medical advice initially then please use 111 online:

https://111.nhs.uk/covid-19

If you have any other medical related problem that requires advice please consider approaching this in the usual way whilst remembering social distancing measures:

Seek advice online from 111 https://111.nhs.uk

Phone 111

Phone pharmacy if appropriate

Phone GP surgery if required

Please use all services responsibly and appropriately

Livi logo

See a GP by video with LIVI. Even at the weekend.

Patients of Courtyard Surgery can now see an NHS GP by video using LIVI.

Get medical advice, prescriptions and referrals on the same day – even at weekends.  LIVI offers appointments between 7am - 10pm Monday to Friday and 8am - 4pm on weekends.

The service is provided free on the NHS.

You can download the LIVI app to your mobile phone or tablet, at the App Store or Google Play. Or visit the Livi website for more information.

LIVI GPs are all GMC-registered NHS GPS, who (with your consent) will be able to access your medical records and give you a considered, in-depth diagnosis based on your medical history.


To be able to access this service, you will need to have appropriate record sharing consents in place - you can contact the surgery on 01403 330320 or email your consent to sharing to HSCCG.courtyard.admin@nhs.net (please note this email address has limited monitoring, so must not be used for any urgent clinical or medication needs).  

Can I get a test for COVID-19 (coronavirus) at the surgery?

No. Testing is not currently available in the community other than in very specific circumstances (and this service is not run by GP surgeries).

How do I contact the surgery and how will the surgery contact me?

The surgery has temporarily suspended all pre-booked and online appointments for you to see a GP.  We have changed these appointments to telephone triage. This means that if you wish to make an appointment to see a GP you will need to telephone the surgery first and speak to a member of the reception team.  

If the surgery needs to contact you, it is likely that we will use our text messaging service more frequently over the coming weeks, as this is an instant way to keep in touch with you. If we telephone you from the surgery it may appear as an unknown number on your phone, so please ensure that if you are expecting a call make sure you have your phone with you at all times.

Why has the surgery changed the appointment system and access?

You will have heard of the need for everyone to be socially distancing themselves from others and this advice is especially important in doctors’ surgeries. With COVID-19 now circulating in the community, patients coming to the surgery have the potential to spread the virus to staff who can then go on to infect others, some of whom will be very vulnerable to infections. In addition, we could very quickly see large numbers of staff self-isolating leading to real gaps in service provision. We hope you can, therefore, understand why we don’t want you coming to the surgery unless it is absolutely necessary, however if you do need to visit us we will make it as safe as possible for you to do so.

We will try to deal with as many queries as possible over the phone or in some cases, via video consultation. You will be advised of the process for this if required. Some routine work, such as chronic disease reviews, may need to be postponed, but some of our usual work will continue. We are looking to do this without you needing to come into the surgery wherever practical. A good example of this would be ordering repeat prescriptions, please see below for more details.

Of course, some patients may have to come to the surgery during the next few weeks, either for routine care which cannot be postponed, for example childhood immunisations and dressings others will need to be seen with more urgent illnesses. We have processes already in place to ensure that our staff knows who does need to be seen and what work can be deferred. These decisions have been made by doctors, nurses and other members of our clinical team, so please do not hold the reception staff accountable for this.

What will happen if I do need to come to the surgery and why?

If you do need to come to the surgery we have systems in place to prioritise your safety and the safety of our staff. Firstly, we aim to keep anyone who has any possible symptoms or signs of any general infection away from others and therefore we have a special appointment system in place for these patients. They will be seen at the local COVID-19 HUB and not at the surgery.

We also want to ensure that we enable other patients to follow social distancing guidelines even within the surgery. For that reason we ask that you aim to keep 2 metres distance from others in the waiting room wherever practical. This is particularly important for those in the ‘at risk’ groups and they will be given additional advice accordingly. We have a special appointment system to protect these potentially vulnerable patients as much as possible.

As you might imagine, these processes are evolving all the time, so please listen carefully to the instructions you are given by a member of the staff if you are given an appointment.

Our staff may need to wear protective equipment during the consultation, such as gloves, a gown and a facemask. Please do not be alarmed by this. If bringing a child it may be helpful to warn them of this in advance.

When attending the surgery please limit the number people where possible

Repeat Medication requests

How to order:

If you already order your prescriptions online then please continue to do so in the usual way. If you do not already use electronic prescribing it is quick and easy to set up via the following link https://www.nhs.uk/using-the-nhs/nhs-services/the-nhs-app/ If you are unsure how to do this then please ask a relative to do this for you. This is the safest and most efficient way to get your prescriptions to you.

If this is not possible then please contact the surgery, for further advice.

Please allow 3 full working days for us to process your prescription requests at this time.

What to order:

Please be aware that the current medical advice for those people with any long-term conditions is to continue taking your usual prescribed medication unless advised to stop by a health professional. In line with government guidelines, we respectfully ask that you DO NOT REQUEST EXTRA QUANTITIES OF YOUR MEDICATION at this time. We will continue to process prescriptions promptly.

Request for medical certificates

There have been some recent changes to the medical certificate and benefits systems to ease pressures for both users and service providers during these busy times. Please see link to latest government advice regarding current guidance for all claimants during COVID-19 outbreak:

https://www.gov.uk/government/news/coronavirus-support-for-employees-benefit-claimants-and-businesses

Remember that you can always self-certify for up to 7 days for any reason. 

During the COVID-19 outbreak, 111 are providing an easy online service to obtain certificates for if you are isolating relating to either personal illness from coronavirus or following advice to protect others. The online certificates can be issued for longer than 7 days. Please note that we have been advised that self-isolation is regarded as illness for employment purposes. This service has been created to avoid unnecessary administrative work for surgeries during this extremely busy period and therefore this will be the only way to obtain certification for isolation at the present time.

 https://111.nhs.uk/isolation-note/

If you need a medical certificate for any other reason (beyond 7 days duration) then you will need to telephone the surgery, to request it. It is likely that you will be emailed the certificate, so please have your email address to hand.

Request for non-NHS work for example insurance reports

We will be very unlikely to be able to process these types of requests at this time due to volume of workload and prioritising patient care. This is the position we have been advised to take by local bodies. Please consider whether this request can be postponed if at all possible.

Working together to provide high quality medical care

We want you to know that we are here for you. We know that if we all work together as a team of patients and staff then we will be able to continue to look after you to the best of our ability.


Flu clinic update 2020 - we apologise for any patients still waiting to hear from us regarding their annual flu vaccination. We have experienced delays in our vaccine deliveries.

We will be inviting eligible patients who have not yet heard from the surgery to book an appointment very shortly as our vaccines are delivered.

If you haven't already, why not sign up for SMS text messaging (Text Messaging Consent) so that we can contact you via text message.   

Please note that, if you are aged between 50 and 64 and not in a clinical at risk group, the earliest you will be offered a flu vaccination is November, providing there is sufficient vaccine. No appointments will be offered for people in this age group until then. This is to ensure that those who are most at risk are vaccinated first. If you are aged 50 to 64 and are in a clinical ‘at risk’ group which is eligible for the flu vaccination, for example you have a health condition which puts you at risk from the flu, you will be invited earlier. 


Patients who previously had Dr Mark Chopin as their named doctor have now been reallocated across the GPs at the surgery. If you would like to know your named GP, please just ask a member of our reception team. Thank you.


Flu Clinics 2019

Book your jab today!

You should book your flu vaccination if you:

  • Aged 18-64 and have a chronic disease - please see NHS.UK Flu information to see if you are eligible
  • Are aged over 65
  • Are  pregnant
  • Are a Carer
  • Are in close contact with someone who is immunocompromised 

Please call the surgery today on 01403 330320 to book an appointment in one of our clinics

We will provide further information regarding vaccines for patients aged under 18 later into the month.


DR MARK CHOPIN  - RETIRING

It is with great sadness that we announce from the end of June 2019 Dr Mark Chopin will be retiring as Partner and GP from Courtyard Surgery.

We would like to thank him for the past 25 years he has practiced at Courtyard looking after Horsham patients, and he will be greatly missed by us all.

We wish Dr Chopin all the best for the future and to have a long and enjoyable retirement.


Extended Access Service

From October 2018 the Government’s plan to provide patient access to see a GP from 8am – 8pm 7 days a week has been put in place.

This extended access service provides patients with evening and weekend appointments with a GP – either at their own practice or a nearby Practice Hub which has been commissioned by our local CCG.

These appointments are pre-bookable through your own surgery for Horsham patients between 4.00 pm  - 8.00 pm and are held within Hosting Hubs at Courtyard, Park and Village (Southwater) surgeries. Weekend appointments to see a GP will be available within surgeries held at Crawley Urgent Treatment Centre (UTC). You will be seen by various Locum GPs and must be willing to consent to the sharing of your medical records within the HUBs.


New  GP Registrars at Courtyard Surgery

We are pleased to welcome Dr Alice Tyler (ST3) and Dr Jenny Almeida(ST2), to the practice.  Dr Tyler will be here for 8 months until August 2019 as she completes her GP training and will work under the supervision of Dr Brydie.  Dr Almeida  joins the practice for 4 months from April 2019 as part of her GP training, working under the supervision of Dr Greenwood.  Both will have the support of the full clinical and administrative team whilst at the surgery. 


Congratulations to Dr Mark Chopin, who celebrated 25 years as a GP Partner at Courtyard Surgery on 1st November 2018!


Pharmacy Managed Prescriptions Changes

We are no longer accepting Pharmacy Managed Prescriptions. It is estimated that over-ordering, stock piling and not using medication, costs the local NHS around £2.5 million per year. To help reduce these costs the local CCG have put in place these changes. This means that the Pharmacy will no longer be able to order patients repeat prescriptions on their behalf and will need to be requested by the patients themselves. Patients can sign up to our Online Services to order their repeat prescriptions requests.

This will not effect how your medicine and equipment is delivered or received. The Electronic Prescription Service(EPS) will allow you to nominate a pharmacy or supplier to dispense your prescription for collection or delivery.


New GP at Courtyard Surgery

We are delighted to welcome Dr Sheena McCullough to the Courtyard Surgery team from July 2018.  Dr McCullough will be working four days a week.  Welcome Sheena!

For patients who previously had Dr McGuire or Dr Barrows as their usual GP - this has now been changed to Dr Jo Skipp or Dr Sheena McCullough respectively.  If you have any queries, please let us know.


Dementia Awareness Week

Sussex Police are promoting the Herbert Protocol. This is a national scheme which is adopted by a number of police forces across the UK to encourage carers or next of kin to compile and keep useful information, which could aid the police in the search for a vulnerable missing person. The Herbert Protocol form can be filled in by a family member, carer or close friend of those affected by dementia and asks for vital information about the vulnerable person. Questions include: previous addresses, medical history, regular routines, favourite places, physical health and current medical conditions.

Below is the link for further information and the form.

https://www.sussex.police.uk/advice/protect-yourself-and-others/missing-persons/herbert-protocol/


New Physician Associate at Courtyard Surgery

We are delighted to be welcoming a new healthcare professional to our primary care (GP) team.

Shannon Rosine is a US trained Physician Associate (PA) with considerable clinical experience, working in both emergency departments and a health centre linked with a correctional facility. Shannon is also a Teaching Fellow in Physician Associate Studies at Brighton and Sussex Medical School, training PAs for the future.

Physician Associates (PAs) are medically trained, generalist healthcare professionals, who work alongside doctors and provide medical care as an integral part of the multidisciplinary team. PAs are dependent practitioners working with a dedicated medical supervisor, but are able to work autonomously with appropriate support.

Shannon will work alongside the GPs, practice nurses and HCAs to help with delivering healthcare to our population, under GP supervision and guidance at all times.

We are also a training practice for PA students from the PA course at Brighton and Sussex Medical School.


Measles Poster for patients

Measles leaflet for patients


Courtyard Surgery currently has two Physician Associate students on placement at the surgery please see attached leaflet for further information.


Courtyard Surgery has been approved as a training practice for GP registrars. For more information, please follow the following link: Information on training practice


Alcohol Wellbeing Programme (for one-to-one and face-to-face interventions) is no longer available due to a reduction in their grant allocation.

From 01 February 2017, Horsham District Council will no longer be providing the Stop Smoking service from Courtyard Surgery. Patients requiring this service can be seen at their local participating pharmacy.


 GP net earnings 2018/2019

All GP practices are required to declare the mean earnings (e.g. average pay) for GPs working to deliver NHS services to patients at each practice.

Average pay of practitioners working at the Albion Medical Group = £81,590

Number of Full-time G.Ps = 3    Part-time G.Ps = 4

Number of locums who worked six months or more in the financial year 2018/19 = 0

The average pay figure is before payment of Income tax, National Insurance, Employee pension costs and is net of practice expenses. The average pay above is based on provisional accounting data and will be updated in due course once the figures have been agreed.

 

Health News from the BBC and the NHS

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