Surgery clinics

Diabetes is a long-term condition caused by too much glucose, a type of sugar, in the blood. It is also known as diabetes mellitus.

There are two main types of diabetes, which are explained below:

• Type I diabetes
• Type II diabetes

Normally, the amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas. The pancreas is a gland behind the stomach. When food is digested and enters your bloodstream, insulin moves any glucose out of the blood and into cells, where it is broken down to produce energy.

However, in people with diabetes, the body is unable to break down glucose into energy. This is because there is either not enough insulin to move the glucose, or because the insulin that is there does not work properly.

Our specialist diabetes team will provide you with support, regular reviews and the day-to-day care of your needs.

All Diabetic patients are entitled to an annual review. The Practice will normally contact you if yours is due. The review takes place in two parts – a data collection appointment and where appropriate, a follow up care plan appointment. If you feel you have been missed, or require a more urgent review, then please contact the Practice to arrange an appointment.

At the initial data collection appointment, your blood pressure, weight, urine, feet and well-being will be checked. It is necessary for you to bring an early morning urine sample with you. Following your initial appointment, a care plan booklet will be sent to you and if necessary, an appointment with your GP or one of our specialist nurses will be arranged.

For more information please visit the websites below:

• Diabetes UK

The most common symptoms of coronary heart disease (CHD) are chest pains (angina) and a heart attack.

You can also experience other symptoms, such as palpitations and unusual breathlessness. In some cases, people may not show any symptoms before they are diagnosed.

Angina

If your coronary arteries become partially blocked, it can cause chest pain (angina). This can be a mild, uncomfortable feeling similar to indigestion. However, a severe angina attack can cause a painful feeling of heaviness or tightness, usually within the centre of the chest, which may then spread to the arms, neck, jaw, back or stomach.

Angina attacks are often triggered by physical activity or stressful situations. Although symptoms of Angina usually pass within 10 minutes, you can alleviate the symptoms by resting or using a nitrate tablet or spray.

Heart attacks

If your arteries become completely blocked, it can cause a heart attack (myocardial infarction).

Heart attacks can cause permanent damage to the heart muscle and, if not treated straight away, can be fatal.

If you think you are having a heart attack, dial 999 for immediate medical assistance.

Although symptoms can vary, the discomfort or pain of a heart attack is usually similar to that of angina but often more severe. During a heart attack you may also experience the following symptoms:

• sweating
• lightheadedness
• nausea
• breathlessness

The symptoms of a heart attack can be similar to indigestion. For example, they may include a feeling of heaviness in your chest, a stomach ache or heartburn. However, these symptoms can also be accompanied by a pain that affects the arms (particularly the left arm), the neck and the jaw.

A heart attack can happen at any time, including while you are resting. If heart pains last longer than 15 minutes, it may be the start of a heart attack.

Unlike angina, the symptoms of a heart attack are not usually relieved using a nitrate tablet or spray.

In some cases, you may have a heart attack without any symptoms, called a silent myocardial infarction. This is more common in people with diabetes.

Heart failure

Heart failure can also occur in people with CHD when the heart becomes too weak to pump blood around the body, which can cause fluid to build up in the lungs that makes it increasingly difficult to breathe.

Heart failure can happen suddenly (acute heart failure) or gradually over time (chronic heart failure).

Want to know more?

• British Heart Foundation: angina
• British Heart Foundation: cardiovascular disease
• British Heart Foundation: heart attack

Our respiratory clinics are primarily intended for patients with Asthma and COPD.

Asthma is caused by inflammation of the airways. These are the small tubes, called bronchi, which carry air in and out of the lungs. If you have asthma, the bronchi will be inflamed and more sensitive than normal. Our practice nurses have specialist asthma qualifications. During their clinics they monitor your overall condition, offer advice, answer any queries and ensure your treatment is effective.

Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have trouble breathing in and out. This is referred to as airflow obstruction. Breathing difficulties are caused by long-term damage to the lungs, usually because of smoking.

Asthma and COPD clinics

We hold clinics to diagnose and to help patients to manage their asthma or COPD.

We like to see all our patients who have been diagnosed with these conditions at least once a year, depending on the severity of your condition, we may invite you to come to the clinic more often in order to ensure we give you the care you require.

• NHS – Asthma in adults, the symptoms, diagnosis and treatment.
• Asthma UK
• Action Asthma
• NHS COPD

Hypertension relates to high blood pressure.

High blood pressure often causes no symptoms, or immediate problems, but it is a major risk factor for developing a serious cardiovascular disease (conditions that affect the functioning of the heart and the circulation of blood around the body), such as a stroke or heart disease.

Download and complete our home blood pressure record sheet (PDF) and return to the practice.

High Blood Pressure Explained – NHS

Blood Pressure Association

British Heart Foundation

British Hypertension Society

High blood pressure has no symptoms, but if it’s not treated it can damage the kidneys, heart and brain.

Warfarin is a drug which can prevent life threatening conditions. However, it can be dangerous if people taking it are not monitored regularly and advised which dose to take. Recent changes have been made to the way we prescribe it.

When a patient requests a prescription for warfarin, the doctor must check that the necessary monitoring has been carried out. We can no longer prescribe warfarin “as directed” and the specific dose must be stated on the prescription.

Nurse led Warfarin clinics

We run nurse led warfarin clinics for patients who are already classed as being stable on the drug.

Hay fever is a common allergic condition.

Symptoms of hay fever include:

• sneezing
• a runny nose
• itchy eyes

The symptoms of hay fever are caused when a person has an allergic reaction to pollen.

Pollen is a fine powder released by plants as part of their reproductive cycle. Pollen contains proteins that can cause the nose, eyes, throat and sinuses (small air-filled cavities behind your cheekbones and forehead) to become swollen, irritated and inflamed.

There is currently no cure for hay fever but most people are able to relieve symptoms with treatment. Treatment options for hay fever include antihistamines, which can help prevent an allergic reaction from happening and corticosteroids (steroids), which help reduce levels of inflammation and swelling. Many hayfever symptoms can be controlled with over-the-counter medication at your pharmacist.

Helpful ways to reduce your exposure to pollen:

• Check the BBC Pollen Forecast. The pollen forecasts can help hay fever sufferers to plan their activities and medication.  If the forecast is high, think about keeping indoors, with the windows shut.
• Reduce the time you spend outdoor during the peak time of 7am to 10am and 4pm to 7pm when the pollen is at its highest level.
• If you have been outside you might find it useful to change and wash your clothes and wash exposed areas, including your hair.
• Keep up-to-date with your symptoms and maybe based on previous years’ experiences, consider taking medicines slightly ahead of the peak pollen season.

• NHS – Living with Hay Fever – Your questions answered.
• Patient.info – Includes information on symptoms, avoidance methods and overview of treatment options
• Asthma Org – looking at causes and ways of controlling and treating hay fever.

If you’re trying to give up smoking, we can help. Studies show that your chances of success will be greatly improved if you get advice and support from health care professionals to help you stop smoking and if you don’t pay for your prescriptions then giving up is free.

The services we offer from the practice can:

• Boost your willpower to stop smoking
• Concentrate your efforts by getting advice from someone who knows your medical background
• Help you feel that you’re not doing it alone
• Help you to cope when you are tempted to smoke
• Monitor improvements to your health so that you can see the benefits

Please call the surgery to arrange an appointment with our smoking cessation advisers.

For more information about quitting smoking visit:

• Smoking Cessation – NHS Site – if you smoke, giving up is probably the greatest single step you can take to improve your health.
• Quit Org. – Quit is the independent charity whose aim is to save lives by helping smokers to stop.

A range of sexual health services are offered at the surgery including:

• Contraception and contraception advice
• Emergency contraception and emergency contraception advice
• Testing and treatment for sexually transmitted infections (STIs), such as chlamydia, syphilis, gonorrhoea and genital warts
• Testing and counselling for HIV and AIDS

If you need advice and support with a sexual health matter or you think you have a problem you would like to discuss, please call the surgery to make an appointment with your GP.

Sexual health services are freely available for everyone.

For more information please visit the websites below:

Family Planning Association: Sexual Health Advice

British Pregnancy Advisory Service

Sexual Health Topics – NHS

If you would like to know more about weight and diet advice, we offer a weight management clinic giving you advice on how to lose weight and stay healthy.

A range of options are available to support people with weight loss. To understand which of them may be the best fit for you please arrange an appointment with your GP who will be happy to discuss them with you.

One suitable option may be our health trainers who offer 1:1 sessions for people wanting to improve their health and change their behaviour. They can support individuals with healthy eating, weight management and getting physically active.

Many doctors now believe that when it comes to your health, your waist measurement is important.

While knowing your body mass index (BMI) is a good way to decide if you’re overweight, it doesn’t tell the whole story.

BMI is a measure of how healthy your weight is for your height. You can work out what your BMI is by using the NHS BMI healthy weight calculator.

If you have a high BMI, you’re likely to be carrying extra fat. But your health could be at greater risk depending on where you store that fat.

Having a large amount of tummy fat (compared to fat around your bottom or thighs) makes you more likely to develop diabetes and heart problems.

A healthy waist circumference for men is less than 94cm (37 inches), and for women it’s less than 80cm (32 inches).

Losing weight and keeping it off isn’t easy, but it has many benefits. You may only need to make small changes to your lifestyle to maintain a healthy weight.

If you’d like to find out more about how you can lose weight in a healthy way please book an appointment with one of our nurses.

For more general information about weight loss, please see the websites below:

Check your BMI – NHS

8 tips for healthy eating – NHS

NHS Advice on drinking recommends that men should not regularly drink more than 3-4 units of alcohol a day and women should not regularly drink more than 2-3 units a day, “regularly” means drinking every day or most days of the week.

The Alcohol Interventions Team (AIT) offers support, information, advice and signposting to individuals who drink above “safe” levels of alcohol for whatever reason. To book an initial appointment, please call 023 9284 1753.

Alternatively, please fill out an alcohol review form available from reception and return it to the surgery. The surgery will arrange any necessary appointments based on the information that you provide.

Chlamydia screening is available from the surgery.

Simply ask at reception for a kit. It is a completely confidential service where you can send a urine sample in the envelope provided and receive the results easily.

Mental health is about how we think, feel and behave. One in four people in the UK have a mental health problem at some point in their lives, which affects their daily life, relationships or physical health.

Mental health disorders take many different forms and affect people in different ways. Schizophrenia, depression and personality disorders are all examples of mental health problems. Diseases such as Alzheimer’s and dementia generally develop in old age, whereas eating disorders are more common in young people.

You can subscribe to wellbeing podcasts on the Mental Health Foundation website.

The website of the Mental Health Foundation outlines the charity’s work in research, policy, service development and service user involvement. The site offers information and publications to download on research, good practice in services and on mental health problems and key issues.

• Alzheimer’s Society Comprehensive information for people with all forms of dementia. Alzheimer’s Society is a membership organisation, which works to improve the quality of life of people affected by dementia in England, Wales and Northern Ireland.
• Mental Health Foundation Founded in 1949, the Mental Health Foundation is a leading UK charity that provides information, carries out research, campaigns and works to improve services for anyone affected by mental health problems, whatever their age and wherever they live.

While it is commonly believed that depression only effects adults, around 10% of children in Great Britain aged between 5 and 16 have a recognisable mental disorder; with about 4% of children suffering from an emotional disorder such as anxiety or depression.

The problem for many is that depression is difficult to spot and often regarded as teenage mood swings. However, if your child is appearing to have an extreme emotional response to a life event or has lost interest in activities which previously interested them they may be suffering from an emotional disorder.

If you are worried about your child’s mental health please visit your GP, who will be able to offer a range of support to help both you and your child. There are a range of talking therapies which are highly effective in dealing with both short term and long term depression, for more information on these therapies please view the NHS Talking Therapy Guide.

While it is commonly believed that depression only effects adults, around 10% of children in Great Britain aged between 5 and 16 have a recognisable mental disorder; with about 4% of children suffering from an emotional disorder such as anxiety or depression.

The problem for many is that depression is difficult to spot and often regarded as teenage mood swings. However, if your child is appearing to have an extreme emotional response to a life event or has lost interest in activities which previously interested them they may be suffering from an emotional disorder.

If you are worried about your child’s mental health please visit your GP, who will be able to offer a range of support to help both you and your child. There are a range of talking therapies which are highly effective in dealing with both short term and long term depression, for more information on these therapies please view the NHS Talking Therapy Guide.

Barnardo’s Mental health Support for children and adolescents

Mind- Mental Health Charity

Sane – Mental Health Support

Rethink Mental Illness

A range of sexual health services are offered at the surgery including:

• Contraception and contraception advice
• Emergency contraception and emergency contraception advice
• Testing and treatment for sexually transmitted infections (STIs), such as chlamydia, syphilis, gonorrhoea and genital warts
• Testing and counselling for HIV and AIDS

If you need advice and support with a sexual health matter or you think you have a problem you would like to discuss, please call the surgery to make an appointment with your GP.

Sexual health services are freely available for everyone.

For more information please visit the websites below:

Family Planning Association: Sexual Health Advice

British Pregnancy Advisory Service

Sexual Health Topics – NHS

Cervical screening, or smear test, is a method of detecting abnormal (pre-cancerous) cells in the cervix in order to prevent cervical cancer. The cervix is the entrance to the womb from the vagina. Cervical screening is recommended every three years for women aged 25 to 49 and every five years for women aged 50 to 64 or more frequently if smear results indicates abnormal changes.

Cervical screening is not a test for cancer; it is a test to check the health of the cells of the cervix. Most women’s test results show that everything is normal, but for 1 in 20 women the test will show some abnormal changes in the cells of the cervix.

Most of these changes will not lead to cervical cancer and the cells may go back to normal on their own. However, in some cases, the abnormal cells need to be treated to prevent them becoming cancerous.

Our nurses are qualified to carry out cervical screening and tests in the form of cervical smears. In order to have a cervical smear the patient must have received a letter requesting that they have a cervical smear and the appointment must please be made for when the patient is not menstruating.

These appointments typically take around 10 minutes. For any further information or to book an appointment, please call the surgery.

Cervical screening – NHS

The national breast screening programme was introduced in 1988 as an early detection service for breast cancer. It states that all women who are aged between 50 – 70 years of age will be routinely invited for free breast screening every three years. The programme is very successful and currently saves around 1,400 lives per year.

Breast screening aims to find breast cancer at an early stage, often before there are any symptoms. To do this, an x-ray is taken of each breast (mammogram). Early detection may often mean simpler and more successful treatment. When women are invited for their mammogram depends on which GP they are registered with, not when their birthday is.

The screening office runs a rolling programme which invites women by area. The requirement is that all women will receive their first invitation before their 53rd birthday, but ideally when they are 50.  If you are under 50 and concerned about any aspect of breast care, please contact the surgery to make an appointment to be referred by your GP.

If you’ve forgotten to take your pill, your condom split or you’ve had unprotected sex in the last 72 hours then you may need emergency contraception, and the sooner you take it the better.

Emergency contraception is available free from contraception and sexual health services, some GPs (family doctors) and most pharmacies, even if you’re under 16.

If you’ve had unprotected sex or your condom failed, it is also really important to consider your risk for sexually transmitted infections and to think about your long-term contraception needs. Please phone the surgery to book an emergency appointment.

If you miss the 72 hours it is still possible to have an emergency coil fitted up to 5 days after unprotected sex. You can have an emergency coil fitted for free at your local sexual health clinic.

Although still rare compared to other cancers, testicular cancer is the most common cancer in men aged between 15-45 years with around 2,200-2,300 men being diagnosed each year. It is more common in Caucasian males.

If found at an early stage a cure rate of 98% is usually possible and even when testicular cancer has spread to other areas of the body cure can still be achieved. In fact according to recent research overall 96% of men diagnosed with any stage testicular cancer will be alive 10 years after treatment.

It is important to visit your GP as soon as you notice any lump or swelling on your testicle. Your GP will examine your testicles to help determine whether or not the lump is cancerous.

Symptoms

The earliest warning signs of testicular cancer usually include the following:

• A change in size or shape of a testicle.
• Swelling or thickening of a testicle.
• A firm, smooth, initially painless, slow-growing lump or hardness in a testicle.
• A feeling of testicular heaviness.

• Orchid – Fighting Male Cancer
• Your Privates – Testicular Cancer Awareness

Bowel cancer is a term used to describe cancer in the colon, rectum or the small bowel.

The symptoms of bowel cancer can include:

• Bleeding from the back passage (rectum) or blood in your stools
• A change in normal bowel habits to diarrhoea or looser stools, lasting longer than 4 to 6 weeks
• A lump that your doctor can feel in your back passage or abdomen (more commonly on the right side)
• A feeling of needing to strain in your back passage (as if you needed to pass a bowel motion)
• Losing weight
• Pain in your abdomen or back passage
• A lower than normal level of red blood cells (anaemia)

Because bowel tumours can bleed, cancer of the bowel often causes a shortage of red blood cells. This is called anaemia and may cause tiredness and sometimes breathlessness.

Bowel cancer screening

How do I get a screening kit?

If you are aged 60-69 years, you will be sent your screening invitation automatically through the post. All you need to do is make sure that your GP has your correct address.

‘People aged 70 years and over or under the age of 60, who wish to be screened, should request a kit. Simply call the free helpline on 0800 707 60 60.’

Macmillan cancer support

Have questions about cancer? Visit www.macmillan.org.uk or call 0808 808 000 free (Monday to Friday, 9am to 8pm).

If you would like to know more about weight and diet advice, we offer a weight management clinic giving you advice on how to lose weight and stay healthy.

A range of options are available to support people with weight loss. To understand which of them may be the best fit for you please arrange an appointment with your GP who will be happy to discuss them with you.

One suitable option may be our health trainers who offer 1:1 sessions for people wanting to improve their health and change their behaviour. They can support individuals with healthy eating, weight management and getting physically active.

Many doctors now believe that when it comes to your health, your waist measurement is important.

While knowing your body mass index (BMI) is a good way to decide if you’re overweight, it doesn’t tell the whole story.

BMI is a measure of how healthy your weight is for your height. You can work out what your BMI is by using the NHS BMI healthy weight calculator.

If you have a high BMI, you’re likely to be carrying extra fat. But your health could be at greater risk depending on where you store that fat.

Having a large amount of tummy fat (compared to fat around your bottom or thighs) makes you more likely to develop diabetes and heart problems.

A healthy waist circumference for men is less than 94cm (37 inches), and for women it’s less than 80cm (32 inches).

Losing weight and keeping it off isn’t easy, but it has many benefits. You may only need to make small changes to your lifestyle to maintain a healthy weight.

If you’d like to find out more about how you can lose weight in a healthy way please book an appointment with one of our nurses.

For more general information about weight loss, please see the websites below:

Check your BMI – NHS

8 tips for healthy eating – NHS

A range of sexual health services are offered at the surgery including:

• Contraception and contraception advice
• Emergency contraception and emergency contraception advice
• Testing and treatment for sexually transmitted infections (STIs), such as chlamydia, syphilis, gonorrhoea and genital warts
• Testing and counselling for HIV and AIDS

If you need advice and support with a sexual health matter or you think you have a problem you would like to discuss, please call the surgery to make an appointment with your GP.

Sexual health services are freely available for everyone.

For more information please visit the websites below:

Family Planning Association: Sexual Health Advice

British Pregnancy Advisory Service

Sexual Health Topics – NHS

Prostate cancer is the most common cancer in men in the UK, with over 40,000 new cases diagnosed every year.

Prostate cancer usually develops slowly, so there may be no signs you have it for many years.

Symptoms often only become apparent when your prostate is large enough to affect the urethra (the tube that carries urine from the bladder to the penis).

When this happens, you may notice things like an increased need to urinate, straining while urinating and a feeling your bladder has not fully emptied.

However, these signs do not mean you have prostate cancer. It is more likely they are caused by something else, such as benign prostatic hyperplasia (also known as BPH or prostate enlargement).

What is the prostate?

The prostate is a small gland in the pelvis found only in men. About the size of a Satsuma, it is located between the penis and the bladder. It surrounds the urethra, the tube that carries urine from the bladder to the penis.

The main function of the prostate is to help in the production of semen. It produces a thick white fluid that is mixed with the sperm produced by the testicles, to create semen.

Our family planning clinics offer free, confidential advice and information about contraception and sexual health.

We provide a range of services including:

• Confidential advice about contraception
• The combined oral contraceptive pill
• The Progestogen-only pill
• Progestogen injections
• Limited supplies of free condoms
• Free emergency contraception
• Confidential advice about STIs
• Cervical screening
• Unplanned pregnancy advice
• Free pregnancy tests
• Pre-conception advice and fertility awareness information
• Fitting and checking of caps, diaphragms, and coils (intrauterine devices, or IUDs)

Please book an appointment (through reception or via our online services) with your GP to discuss any of the above in more detail.

For more information please visit the websites below:

• Planning a Pregnancy – NHS
• Cervical Screening – NHS

If you are planning to have a baby or you need to know more information about how to look after yourself and your unborn baby, please book an appointment with your GP.

We can provide you with all the information you need to know to have a happy and healthy pregnancy.

Before you try to get pregnant – NHS

Everything you need to know about pregnancy – NHS

Pregnancy Care Planner – NHS

Work out your due date – NHS calculator tool

Antenatal care is the care and help you receive from health professionals during the course of your pregnancy. It is important you take good care of your own health and that of your unborn baby during pregnancy.

As soon as you find out you are pregnant, you should get in touch with us to find out more information on the services and support that are available to you.

For more information, please visit the following websites.

Pregnancy week-by-week – NHS

The Pregnancy Care Planner

Antenatal Care – Lifestyle Advice

Some newborn babies are released from hospital without a detailed examination. If this is the case, our GPs are happy to perform the relevant checks, either in the surgery, or in comfort of your own home, depending on which is easier for you.

In most cases, the surgery will contact new mums to arrange for this to happen, on rare occasions where we are unaware of the birth, please feel free to give us a call and arrange an appointment or visit.

Postnatal care extends for between 6-8 weeks after the birth of your baby. During this period, routine checks are carried out by the health visitor and you and your baby’s recovery is monitored.

During your postnatal care you will find out about feeding, potty training, illnesses, safety and more. You will be able to ask your health visitor questions and request advice.

Birth to 5 years old guide – NHS

Breastfeeding Guide – NHS

Information and support – NetMums

Support for new mum’s – NCT

One of the most important things that a parent can do for their child is to make sure that they have all their routine childhood vaccinations. It’s the most effective way of keeping them protected against infectious diseases.

Ideally, children should have their jabs at the right age to protect them as early as possible and minimise the risk of infection.

Find out which jabs your child needs, when they need them, and what the benefits of each jab are.

Please call the surgery to make an appointment.

For more information please visit the websites below:

Vaccinations for you and your family – NHS

In order to assist us to make a full assessment of the potential risks to your health from your planned travel, we would ask that you make a Travel Clinic appointment with our Practice Nurse. Ideally, this appointment should be made around the time of booking your holiday, at least 6 weeks before you travel.

At your appointment we may ask the following questions to help us plan for your trip:-

• When are you departing and for how long?
• Where are you going, including the destinations within a country?
• Where are you staying, e.g. backpacking, camping, hotels?
• Are you planning to undertake any high risk activities?
• Have you taken out travel insurance and have you informed the company of any existing medical condition?
• If female and of child bearing age, is there any possibility you could be pregnant, or are you planning a pregnancy?
• Do you have any medical conditions, or a history of significant medical illness? (these can influence the choice of malaria tablets we recommend)

Please fill out our travel risk assessment before your appointment.

It would help us greatly if you had some awareness of the travel problems that you may be at risk from on your trip before you come for your appointment.

Please look at the following website, to read the information for the county you are visiting www.fitfortravel.nhs.uk

Other useful websites to look at are:

• www.fco.gov.uk
• www.nathnac.org

Seasonal flu is a highly infectious illness caused by a flu virus.

The virus infects your lungs and upper airways, causing a sudden high temperature and general aches and pains.

You could also lose your appetite, feel nauseous and have a dry cough. Symptoms can last for up to a week.

We offer ‘at risk’ groups the flu vaccine at a certain time each year to protect you against the flu virus.

You may be invited for a flu jab if you are:

• over 65 years of age
• pregnant

or have:

• a serious heart or chest complaint, including asthma
• serious kidney disease
• diabetes
• lowered immunity due to disease or treatment such as steroid medication or cancer treatment
• if you have ever had a stroke

If you have any queries please contact the surgery.

For more information please visit the websites below:

Flu and the Flu Vaccine – NHS

The pneumococcal vaccine (or ‘pneumo jab’ or pneumonia vaccine as it’s also known) protects against pneumococcal infections.

Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia, septicaemia (a kind of blood poisoning) and meningitis.

Read more about why the pneumococcal vaccination is needed.

Who should have the pneumococcal vaccine?

A pneumococcal infection can affect anyone. However, some people need the pneumococcal vaccination because they are at higher risk of complications. These include:

• all children under the age of two
• adults aged 65 or over
• children and adults with certain long-term health conditions, such as a serious heart or kidney condition

Read more about who should have the pneumo jab.

How often is the pneumococcal vaccine given?

Babies receive the pneumococcal vaccine as three separate injections, at 2 months, 4 months and 12-13 months.

People over-65 only need a single pneumococcal vaccination which will protect for life. It is not given annually like the flu jab.

People with a long term health condition may need just a single one-off pneumococcal vaccination or five-yearly vaccination depending on their underlying health problem.

Certain small surgical operations can be performed at the surgery. With minor surgery the recovery time is usually short and you will be back to your usual activities fairly quickly (depending on your procedure).

Before attending for minor surgery you will need to see a doctor for the diagnosis and then you will be given an appointment to attend for your procedure.

Working together to improve your health

Everyone is at risk of developing heart disease, stroke, diabetes, kidney disease and some forms of dementia. The good news is that these conditions can often be prevented – even if you have a history of them in your family. Have your free NHS health check and you will be better prepared for the future and be able to take steps to maintain or improve your health.

Why do I need an NHS health check?

We know that your risk of developing heart disease, stroke, type 2 diabetes, kidney disease and dementia increases with age. There are also certain things that will put you at even greater risk. These are:

• being overweight
• being physically inactive
• not eating healthily
• smoking
• drinking too much alcohol
• high blood pressure
• high cholesterol

Both men and women can develop these conditions, and having once could increase your risk of developing another in the future.

• In the brain a blocked artery or a bleed can cause a stroke.
• In the heart a blocked artery can cause a heart attack or angina.
• The kidneys can be damaged by high blood pressure or diabetes, causing chronic kidney disease and increasing your risk of having a heart attack.
• Being overweight and physically inactive can lead to type 2 diabetes.
• If unrecognised or unmanaged, type 2 diabetes could increase your risk of further health problems, including heart disease, kidney disease and stroke.

What happens at the check?

• This check is to assess your risk of developing heart disease, type 2 diabetes, kidney disease, and stroke.
• The check will take about 20–30 minutes.
• You’ll be asked some simple questions. For example, about your family history and choices which may put your health at risk.
• We’ll record your height, weight, age, sex, and ethnicity.
• We’ll take your blood pressure.
• We’ll do a simple blood test to check your cholesterol level.

What happens after the check?

• We will discuss how you can reduce your risk and stay healthy.
• You’ll be taken through your results and told what they mean. Some people may be asked to return at a later date for their results.
• You’ll be given personalised advice on how to lower your risk and maintain a healthy lifestyle.
• Some people with raised blood pressure will have their kidneys checked through a blood test.
• Some people may need to have another blood test to check for type 2 diabetes. Your health professional will be able to tell you more.
• Treatment or medication may be prescribed to help you maintain your health.

Questions you may have

Why do I need this check? I feel fine!

• The NHS health check helps to identify potential risks early. By having this check and following the advice of your health professional, you improve your chances of living a healthier life.

But don’t these conditions run in the family?

• If you have a history of heart disease, stroke, type 2 diabetes, or kidney disease in your family then you may be more at risk. Taking action now can help you to prevent the onset of these conditions.

I know what I’m doing wrong. How can the doctor help me?

• If you would like help, we will work with you to find ways to eat healthily, reach your healthy weight, be more active, cut down your drinking, or stop smoking.

If I am assessed as being at ‘low risk’, does this mean I won’t develop these conditions?

• It is impossible to say that someone will or won’t go on to develop one of these conditions. But taking action now can help you lower your potential risk.

Will everyone have this check?

• This check is part of a national scheme to help prevent the onset of these health problems. Everyone between the ages of 40 and 74 who has not been diagnosed with the conditions mentioned will be invited for a check once every five years. If you are outside the age range and concerned about your health, you should contact your GP.

What is non-NHS work and why is there a fee?

The National Health Service provides most health care to most people free of charge, but there are exceptions: prescription charges have existed since 1951 and there are a number of other services for which fees are charged.

Sometimes the charge is because the service is not covered by the NHS, for example, providing copies of health records or producing medical reports for insurance companies, solicitors or employers.

The Government’s contract with GPs covers medical services to NHS patients but not non-NHS work. It is important to understand that many GPs are not employed by the NHS; they are self-employed and they have to cover their costs – staff, buildings, heating, lighting, etc. – in the same way as any small business.

In recent years, however, more and more organisations have been involving doctors in a whole range of non-medical work. Sometimes the only reason that GPs are asked is because they are in a position of trust in the community, or because an insurance company or employer wants to ensure that information provided to them is true and accurate.

Examples of non-NHS services for which GPs can charge their own NHS patients

• accident/sickness certificates for insurance purposes
• school fee and holiday insurance certificates
• reports for health clubs to certify that patients are fit to exercise
• private prescriptions for travel purposes

Examples of non-NHS services for which GPs can charge other institutions

• life assurance and income protection reports for insurance companies
• reports for the Department for Work and Pensions (DWP) in connection with
• disability living allowance and attendance allowance
• medical reports for local authorities in connection with adoption and fostering
• copies of records for solicitors

Do GPs have to do non-NHS work for their patients?

With certain limited exceptions, for example a GP confirming that one of their patients is not fit for jury service, GPs do not have to carry out non-NHS work on behalf of their patients. Whilst GPs will always attempt to assist their patients with the completion of forms, they are not required to do such non-NHS work.

Is it true that the BMA sets fees for non-NHS work?

The British Medical Association (BMA) suggest fees that GPs may charge their patients for non-NHS work (ie work not covered under their contract with the NHS) in order to help GPs set their own professional fees. However, the fees suggested by them are intended for guidance only; they are not recommendations and a doctor is not obliged to charge the rates they suggest.

Why does it sometimes take my GP a long time to complete my form?

Time spent completing forms and preparing reports takes the GP away from the medical care of his or her patients. Most GPs have a very heavy workload and paperwork takes up an increasing amount of their time. Our GPs do non-NHS work out of NHS time at evenings or weekends so that NHS patient care does suffer.

I only need the doctor’s signature – what is the problem?

When a doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true. In order to complete even the simplest of forms, therefore, the doctor might have to check the patient’s ENTIRE medical record. Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council (the doctors’ regulatory body) or even the Police.

If you are a new patient we may not have your medical records so the doctor must wait for these before completing the form.

What will I be charged?

It is recommended that GPs tell patients in advance if they will be charged, and what the fee will be. It is up to individual doctors to decide how much they will charge. The surgery has a lists of fees based on these suggested fees which is available on request.

What can I do to help?

• Not all documents need a signature by a doctor, for example passport applications. You can ask another person in a position of trust to sign such documents free of charge. Read the information that comes with these types of forms carefully before requesting your GP to complete them.
• If you have several forms requiring completion, present them all at once and ask your GP if he or she is prepared to complete them at the same time to speed up the process.
• Do not expect your GP to process forms overnight: urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this may cost more. Usually non-NHS work will take 2 weeks.

You may require a doctor’s letter for various reasons eg fitness to travel or confirmation of medical conditions. Please contact reception to make your request which will be dealt with in the most appropriate way.

If you are pregnant and require a doctor’s letter as proof of ‘permission to travel’ please be aware that many airlines require your doctor’s letter to be signed within 48 hours of international travel.

Please note that you will not be provided with a doctor’s ‘permission to travel’ letter if you are due in less than 30 days or if your pregnancy is considered high-risk.