Chronic Disease Reviews

Our doctors strongly encourage all of our patients with a chronic disease(s) / long term condition to attend for their reviews.  This is in the best interests of long term health and to help try to minimise the effect a chronic condition has on your life.

Chronic Disease Reviews By Doctors

Our doctors carry out the following reviews, which you will be invited to attend for:-

• Dementia
• Epilepsy
• Heart Failure
• Learning Disabilities
• Mental Health
• Rheumatoid Arthritis

Chronic Disease Reviews By Practice Nurses

Our experienced practice nurses carry out the following reviews, which you will be invited to attend for:-

• Asthma
• Chronic Obstructive Pulmonary Disease (COPD)
• Diabetes
• Stroke / TIA
• Chronic Kidney Disease (CKD)
• Heart Failure
• Chronic Heart Disease (CHD)

Treatment Services

Doctor & Practice Nurse Services

• Minor Surgery
• Contraception Insertions and/or Removals
• Implant Insertions and/or Removals
• Pessary Ring Insertion and/or Removals

Practice Nurse Treatment Services 

• Cervical Smears
• Contraceptive Injections
• Doppler Tests
• Memory Tests (by invitation only)
• Swabs
• Travel Advice & Vaccinations (please see separate tab above for more information)
• Vaccinations/Immunisations (including baby imms - please see separate tab above for more information)

Practice Nurse / Healthcare Assistant Treatment Services

• Ambulatory/ Home Blood Pressure Monitoring
• Carer Health Checks
• Dressings / Wound Management
• Ear Syringing (pre-syringing advice leaflet available from reception desk)
• ECG's
• HIV Tests
• New Patient Health Checks (16yrs+)
• NHS Health Checks
• Obese Health Checks
• Ring Pessary Insertion and Removal
• Smoking Cessation (please see separate tab above for more information)
• Wound Checks

Midwife Services

The practice have midwives who provide antenatal services (for patients who are 16 weeks+ pregnant) at both Bedwell Medical Centre and Roebuck Surgery each week, as detailed below:-

Bedwell Medical Centre

• Monday - pm

Roebuck Surgery

• Monday - pm

Smoking Cessation - Stop Smoking Service

Giving up smoking is one of the most important things any smoker can do for the future of their health and wellbeing.

We run stop smoking clinics every day (Monday - Friday), please contact Reception, at either surgery, to book your appointment for free stop smoking advice today.

Our stop smoking advisors are fully trained to provide you with the necessary support you will need to stop smoking.

The health benefits of stopping smoking over a period of time:-

Children's Immunisations

Please check the following points before bringing your child to the surgery:

1. Is your child taking steroid treatment?
2. Does the child's parent, brother or sister suffer from epilepsy? Epilepsy in more distant relatives is not considered a problem.
3. Is your child suffering from any feverish illness? Don't worry about a runny nose without a fever.
4. Does your child suffer from any disease affecting their immune system?
5. Does your child suffer from a severe reaction to eggs?
6. Has your child suffered from a reaction to any previous immunisation injection?
7. Has your child got a high temperature now?

If the answer to any of the questions above is yes then tell your doctor.

Your child is at greater risk from contracting the disease than they are from suffering a reaction to the immunisation.

When Should Children be Immunised?

Children's immunisations are performed by the nurse. Simply make an appointment in the usual way, telling the receptionist it is for an immunisation injection.

Please click here for the current NHS vaccination schedule.

Travel Advice and Vaccinations 

We are unable to provide travel advice, please contact a Travel Clinic or you can look up your own information. An informative site to check is: 

https://travelhealthpro.org.uk/ 

The following travel vaccines are available free on the NHS from your GP surgery: 

Polio (given as a combined diphtheria/tetanus/polio jab) 

Typhoid 

Hepatitis A 

Cholera 

These vaccines are free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.  

If you require one of these vaccinations, please contact our Reception Team to book your appointment. Please contact us 6-8 weeks prior to travel as there may be a wait for your appointment. 

For more information, please visit: 

https://www.nhs.uk/conditions/travel-vaccinations/ 

Malaria Advice: 

https://www.nhs.uk/conditions/malaria/ 

Non-NHS Services

Some services provided are not covered under our contract with the NHS and therefore attract charges. Examples include the following:

• Medicals for pre-employment, sports and driving requirements (HGV, PSV etc.)

• Insurance claim forms

• Prescriptions for taking medication abroad

• Private sick notes

• Vaccination certificates 

The fees charged are based on the British Medical Association (BMA) suggested scales and our reception staff will be happy to advise you about them along with appointment availability. 

Please allow plenty of time for these types of requests to be completed. It can take up to 30 days to respond to, 60 days if deemed excessive. 

Please note, on the advice from the Passport Office, the doctors are no longer able to countersign paperwork for passports.  The doctors are also not able to complete Power of Attorney forms or Mental Capacity Forms. These will need to be completed by Specialists in that field.

NOTE: 

Please be aware that the GP has the right to refuse any non-NHS service requests.

We are often asked to prescribe sedative drugs, such as diazepam (Valium), for fear of flying. We have recently agreed a practice policy that we will no longer prescribe these drugs for fear of flying. There are a number of good reasons why prescribing of drugs such as diazepam is not safe or recommended:-

1. The use of any sort of CNS depressant causes longer reaction times & slowed thinking, which during a flight will put the passenger at significant risk of not being able to act in a manner which could save their life in the event of a safety critical.
2. The use of any sort of CNS depressant has potential to increase the risk of DVT - these drugs can induce non-REM sleep which tends to be of a type where the person does not move in their sleep, and therefore increases the possibility of sitting without moving for more than 4 hrs (the amount of time which has been shown to increase the risk of developing DVT whether in an aeroplane or elsewhere).
3. The sedating effects have the possibility of causing some respiratory depression, resulting in a drop in 02 sats. Normal sats for a healthy person at 8000ft are around 90%, so with the 2 effects added together, this may become significant.
4. A paradoxical increase in aggression may be reported by patients taking benzodiazepines & therefore has potential to put other occupants of the aircraft at risk.
5. Reduced inhibitions may put other occupants of the aircraft at risk, or more significant consequences
6. Benzo use added to alcohol consumption causes an increase in the risk posed by many of the points above, & many (nervous) flyers will consume alcohol in the terminal before boarding & during their flight, despite any advice that you may give to do otherwise.
7. Benzodiazepines are contraindicated in phobic states.
8. For some countries it is illegal to import these drugs, eg in the Middle East, and so the passenger will need to use a different strategy for the homeward bound journey and / or any subsequent legs of the journey.
9. Standard GP indemnity does not cover you for treatment initiated outside the UK, so you would only be covered for doses to be taken on journeys starting in the UK.
10. NICE guidelines suggest that medication should not be used for mild & self-limiting mental health disorders; in more significant anxiety related states - benzodiazepines, sedating antihistamines or antipsychotics should not be prescribed; Benzodiazepines are only advised for the short term use for a crisis in generalised anxiety disorder, ie acute anxiety emergencies & if this is the case, they would not be fit to fly anyway (potential risk to being able to allow completion of the flight without diversion) & fear of flying in isolation is not generalised anxiety disorder.
11. Risk of addiction from inappropriate benzo use.
12. Possible risk of early dementia in benzo users.

We recognise that fear of flying is real and frightening and we don’t underestimate the impact it can have. We recommend tackling this properly by using self-help resources or considering one of the ‘Fear of Flying’ course run by many airlines. We do not recommend any specific course but you may find the following links useful.

1. Easy Jet www.fearlessflyer.easyjet.com Tel 0203 8131644
2. British Airways www.flyingwithconfidence.com  Tel 01252 793250
3. Virgin www.flyingwithoutfear.co.uk  Tel 01423 714900
4. https://thefearofflying.com/programs/fly-and-be-calm/

Flight anxiety does not come under the remit of General Medical Services as defined in the GP contract and so we are not obliged to prescribe for this. 

Patients who still wish to take benzodiazepines for flight anxiety are advised to consult with a private GP or travel clinic. 

It is important to declare all medical conditions and medications you take to your travel insurer. If not, there is a risk of nullifying any insurance policy you may have.