Primary Care Networks
Park Parade Surgery is part of the Mowbray Square Primary Care Network which is made up of East Parade Surgery, The Spa Surgery and us, and totals 30,000 patients.
Finance
All GP practices are required to declare the mean earnings (ie. average pay) for GPs working to deliver NHS services to patients at each practice.
However it should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice, and should not be used to form any judgement about GP earnings, nor to make any comparison with any other practice.
The average pay for GPs working in Park Parade Surgery in the last financial year [2023] was £40,589.75 before tax and National Insurance. This is for 1 full time GP and 7 part time GPs who worked in the practice for more than six months.
Named GP
From June 2015 all patients registered with the practice will have been given a named accountable GP. This is a contractual requirement but patients are entitled to choose to see any GP or nurse in the practice. A named accountable GP takes responsibility for the co-ordination of all appropriate services for their patients and ensures they are delivered. If you wish to know who your named GP is you can ask a member of the reception team.
What happens when you are referred to a specialist?
Information for patients who have been referred for specialist care.
Are you drinking enough?
Check the colour of your urine against this colour chart (PDF, 378KB) to see if you’re drinking enough fluids throughout the day.
Minor Eye Service
Harrogate and Rural District Clinical Commissioning Group (HaRDCCG) have commissioned a Minor Eye Conditions Service which can be accessed at 20 Optician Practices across the Harrogate and Rural District.
Patients may contact the service directly and make an appointment if they are concerned about minor eye problems. The service can see patients within 24 hours if urgent or within a few days if routine; they will also refer on to the Hospital Eye Service if required.
For further details download this information leaflet (PDF, 161KB)
Ear Care
Ear care advice here.
Online Support Site for People with Type 1 Diabetes
It can be hard for those newly diagnosed with Type 1 diabetes to know which websites to trust, so NHS England has made it easier by collecting all the useful NHS-trusted links in one place on the nhs.uk website. The new pages will help people with Type 1 diabetes to gain the knowledge and confidence to manage their condition. The site has been developed with NHS Digital, Diabetes UK and people living with Type 1 diabetes.
The site provides links to practical help on injecting insulin and checking blood glucose levels – as well as useful advice around living with the condition.
Healthcare professionals are being encouraged to refer newly diagnosed patients, their parents and carers to the site as a one stop shop for Type 1 diabetes support. See the new pages at www.nhs.uk/conditions/type-1-diabetes
Cosmetic Procedures
www.nhs.uk/conditions/cosmetic-procedures/cosmetic-procedure-right-for-me
North Yorkshire Care & Support Services Directory
Looking for advice, information and all types of care services in North Yorkshire? View the North Yorkshire Care Services Directory.
Children and Families: Early Help programme
Get more information about the Children and Families Service: Early Help and what’s available in your local areas.
https://www.northyorks.gov.uk/children-and-families/early-help
List of Private Physiotherapists in Harrogate
Nuffield Health Fitness and Wellbeing
tel 01423 810858
www.nuffieldhealth.com/physiotherapy/harrogate
Harrogate Physiotherapy Practice
tel 01423 544004
www.harrogatephysiotherapypractice.co.uk
Elizabeth Webster Physiotherapy
tel 01423 884162
CB Physio
tel 07837 791590
cbphysio.co.uk
Pure Physio
tel 01423 525150
www.pure-physio.co.uk
Gary Fleming Practice
tel 07891 447226
thegaryflemingpractice.co.uk
FitBack Physiotherapy
tel 01423 608080
www.fitback.co.uk
myPhysio
tel 01423 543187
www.myphysioharrogate.co.uk
OneWellness Physio
tel 01423 568212
Family Chiropractic and Physiotherapy
tel 01423 701777
family-chiropractors.co.uk/physiotherapy
Physio Action (David Lloyd)
tel 0113 2687578
www.physioaction.com
ADHD/Autism Referrals
Adults
Over the last few years, we have seen increased patients wanting an assessment for ADHD or Autism. Services are experiencing potentially long waiting times due to the demands on their services.
If after a GP assessment, a patient requires a referral for assessment of ADHD or Autism, there are 2 main choices:
An NHS assessment using our local provider, or
Elect for a ‘Right to Choose’ referral (see separate section).
OPTION 1: NHS assessment using our local provider
The current local NHS referral pathway, put in place by our local ICB (Humber and North Yorkshire Health and Care Partnership), has 2 pathways to access an assessment. If you meet certain criteria (as per below), you may be referred directly for an assessment at ‘The Retreat’ (who run the Tuke Centre in York) for assessment by the GP. Please note, these criteria are very strict. If accepted, there remains long waiting times for assessment.
Referral Criteria for local direct referral (a lack of diagnosis affects the following):
- Affects court decision, employment (family breakdown, custody hearing, armed forces),
- Adjustments needed to access health care (hospital operations / procedures),
- Immediate urgent impact on care (loss of housing, employment tribunal, financial loss)
For patients not meeting the set criteria for direct referral (see above), it requires patients to complete a self-assessment tool online (The ‘Do IT Profiler’), to assess eligibility. Patients will receive online practical advice, and you will be given the option of remaining on a waiting list, which is managed by the ICB.
OPTION 2: Right to Choose referral
See this section for this information.
NEXT STEPS
Please read the following tabs below to decide what referral pathway you want:
Right to Choose
Shared care prescribing for ADHD medication (if wanting an ADHD assessment)
Once you have decided which referral pathway you would like to explore, please send an eConsult to the practice so we can assess your case further. Within this eConsult, you need to provide details on the reasons for your suspected diagnosis, the impact it is having, what you hope to achieve and which referral pathway you would like to follow.
Right To Choose
We are aware that NHS services for ADHD/Autism assessment, diagnosis and treatment are limited, with extensive waiting times. An increasing number of patients are therefore choosing to access private providers, sometimes under the NHS ‘Right to Choose’ rules.
Our ICB has recently updated their advice on making Right to Choose referrals. The Do-IT Profiler no longer must be completed for these. We can confirm that if the provider has a contract with NHS England for the required service, then you can go ahead and arrange an appointment, or we can refer you, when this is clinically appropriate. No prior commissioner approval is required, provided the service is led by a named consultant or named healthcare professional.
Please be aware that the ‘Right to Choose’ pathway will ONLY fund a diagnostic assessment. They will not fund prescribing or review appointments.
For the avoidance of doubt please read the following:
Investigations / health checks / monitoring
We are not able to perform any investigations, physical health checks or ongoing monitoring on behalf of a private provider (whether or not you were referred under the ‘Right to Choose’), as this is their responsibility, even if they operate a remote access tele-health service.
Shared care prescribing
Please be aware that the practice will not be able to do any shared care prescribing with a private provider. If medication is recommended, you would need to be referred to the NHS provider to review and advise if they able to support the decision.
NEXT STEPS:
If you choose to have ‘right to choose’ referral, you will need to organise this yourself. We are not legally allowed to recommend specific companies. You will need to consider what sort of service /assessment that company offers.
Once chosen, you will need to go on their website/ contact the company to find out what their referral process is. Some will accept self-referral, some need the practice to complete a referral form.
We will still need information regarding the reasons for a referral and symptoms, so we can assess this further. Some companies require you to complete scoring questionnaires – these will need sending to the practice as well. If you need us to refer, please send an eConsult with all the required information / scoring questionnaires.
Shared Care Prescribing for ADHD medication
Medication for ADHD can only be initiated by a specialist and must continue to be supervised long term by a specialist. Most of the medications used are legally classified as Controlled Drugs, which means that only a 28-day prescription can be issued at a time.
What if I am seen under the NHS?
If you are assessed under the NHS pathway at The Retreat Clinic in York, they may initiate you on medication, if considered appropriate. Once a patient has been on a stable dose of medication for at least 3 months, we will usually take over ongoing prescribing from The Retreat, under a ‘Shared Care Agreement’. Patients remain under the care of the specialist and will be required to have ongoing reviews (usually annually and additional interim reviews if deemed necessary due to change of symptoms, side effects, or other medication queries). We will only be able to continue prescribing if you keep up-to-date with the required physical monitoring and reviews.
What if I am seen privately or as a ‘Right to choose’ referral?
We will NOT enter into a ‘Shared Care Agreement’ with a private provider. This means that if you choose to initiate medication in the private sector (even if this was through a ‘Right to Choose’ referral), you will be required to continue to fund this long term, whilst you remain under their care, with periodic reviews by that provider. Please ensure that the private provider has a copy of this information, if you go ahead with your assessment, so that they are fully informed.
Please remember that a ‘Right to choose’ referral only covers NHS funding for the assessment but not any prescribing or monitoring.
Can I transfer to the NHS for my prescriptions?
If in the future, you wish to transfer your care to the NHS, we can refer you to the local NHS commissioned service (The Retreat Clinic at The Tuke Centre in York), at your request, so long as you provide the following information, and they agree to enter a shared care arrangement with us.
Please be aware that The NHS service will assess what you have been prescribed and ensure it fits with national guidance. It is not guaranteed they will support all drugs initiated by a private specialist.
Please be aware that the practice will not be able to do any shared care prescribing with a private provider. If medication is recommended, you would need to be referred to the NHS provider to review and advise if they able to support the decision. If a patient has already been started and stabilised on the medication, we can usually obtain shared care prescribing with the NHS relatively quickly. Unfortunately, if no medication has been started, there are significant waits for an assessment to be done.
Referrals for Medication monitoring and Shared Care at the The Retreat in York (NHS)
In order for The Retreat to share care with us on the NHS, you must provide us with all of the following:
Your original ADHD diagnostic report.
A full medication and prescribing history from your current specialist.
The most recent clinic letter from your last review with them, with details of your most up-to-date physical monitoring.
Once we have received this, we can make a shared care referral to The Retreat. Depending on the source of your diagnosis, it is possible that The Retreat would not recognise this and would not agree to take over prescribing on the NHS. If all the necessary information is received by The Retreat, then they will sign a shared care agreement, and return this back to us.
Once we have received this, we will be able to take over the prescribing of your medication on a monthly prescription. It is currently taking many months, up to a year, to receive this shared care agreement from The Retreat. Until we have received approval for shared care from them, you will be required to continue to obtain your prescriptions from your original provider. We will only be able to continue prescribing your medication if you keep up to date with the required physical monitoring and reviews.
Children
Autism assessments are carried out through a dedicated team at Harrogate District Hospital. ADHD assessments are carried out by a different team, based at CAMHS (part of TEWV NHS Trust). There are self-referral processes for both assessments, which would then be triaged by the relevant service.
There are lengthy waits for these appointments. 32 months is quoted at the time of writing this (Sept 23) on the HDFT website for an autism assessment.
Some parents may choose to approach private providers for assessment, diagnosis and management of Autism and ADHD. The Practice operates the same policy for children and adults, as outlined above. We are unable to provide investigations, physical health checks or ongoing monitoring on behalf of the provider, this is their responsibility, even if they operate a remote access tele-health service.
Prescribing for Children
As with adults, medication for children with ADHD can only be initiated by a specialist and must continue to be supervised long term by a specialist. Most of the medications used are legally classified as Controlled Drugs, which means that only a 28-day prescription can be issued at a time.
Once a child is stable on medication (for at least 3 months), we will usually enter a ‘Shared Care’ arrangement with the NHS team at CAMHs (or HDFT), so that we take over the prescribing. The child will remain under the care of the specialist and will be required to attend regular review appointments.
We will not enter into a shared care agreement with a private provider, so if you choose to fund the initiation of medication in the private sector, you will be required to do so long term.