Clinics & Services

The Practice is part of a shared-care scheme with Barnsley Alcohol and Drug Advisory Service, to treat patients with substance misuse problems at the surgery.

For more information visit:
www.patient.co.uk/health/Alcohol-and-Liver-Disease.htm
www.patient.co.uk/health/Alcoholism-and-Problem-Drinking.htm

Ante-natal Clinics: Wednesday 1.00pm - 3.00pm

Once your pregnancy has been confirmed by a clinician you will be contacted by one of our midwives who will make you an appointment for the start of your antenatal care.

Under normal circumstances you will be asked to attend a clinic at:
10 weeks
16 weeks
18-20 weeks
25 weeks
28 weeks
31 weeks
34 weeks
36 weeks
38 weeks
40 weeks
41 weeks – for women who have not given birth by 41 weeks

For more information visit:
www.patient.co.uk/health/Pregnancy-Routine-Screening-Tests.htm

Wednesday 8.30am - 10.30am

Welcome to our anti-coagulation clinic - a Practice Nurse led clinic by Paula Davis and Joan Kelly with support from Dr M. A. Ashton.

It is estimated that about 950,000 people in the UK take Warfarin, representing 1.5% of the general practice population. Recommendations made within the national service framework for coronary heart disease have increased clinical awareness of the implications of Warfarin therapy for preventing stroke in people with atrial fibrillation. This is predicted to increase five-fold in the future, putting further strain on a secondary care sector that is already operating to full capacity.

Advances in technology have made point of care (POC) devices for measuring international normalized ratio (INR) adaptable for use in primary care. POC testing services offer accurate and instant results at greater convenience to the patient who does not have to visit a hospital for blood tests. There is also increasing evidence that primary care clinics can achieve high standards of anti-coagulation management.

The surgery operates a 'near-patient testing' system (NPT) using a specialized machine called a CoaguChek S. The CoaguChek S machine measures how well your blood clots. A finger tip blood drop is used instead of a venous (needle) sample. This method is well researched, simple and accurate. It has benefits for you the patient. For example:

• greater continuity of care
• saves time
• less travelling
• less waiting for test
• less waiting for result
• less waiting for new dose
• less interference with work and social life
• any changes in general health/medication can be identified immediately

We use a computerised system developed to help with the monitoring of patients taking Warfarin. Your new INR result is documented using the decision support software which confirms the correct new dose and suggests the next follow up date. The system keeps detailed records of your treatment and this is also stored in your electronic medical record.

All this enables the nurse/doctor to maintain efficient, safe and effective anti-coagulation therapy.

All patients with Asthma will be invited to see our Practice Nurse specialising in Asthma on a regular basis. You will be offered either an initial 30 minute appointment or two 15 minute appointments within 2 months of your diagnosis. You will be asked to attend appointments until we have your Asthma under control, after which you will be recalled on an annual basis for review.

It is very important you attend these appointments, even if you are feeling well, so we can monitor your medication and compliance.

At your initial assessment we will:

• Explain about the clinic and its objectives
• Measure and record your height
• Measure and record PEFR and predicted PEFR
• Carry out reversibility testing
• Illustrate how to use the different inhaler devices
• Explain how your medication works
• Supply you with appropriate literature on Asthma
• Supply you with a peak flow meter and diary (children only)
• Give you a follow up appointment
• Record findings in your medical record using a dedicated template

At your follow up appointment we will:

• Check and discuss your symptoms control
• Check your inhaler technique and compliance
• Check your PEFR
• Discuss treatment and devise a self management plan
• Record findings in your medical record using a dedicated template
• Arrange follow up appointment
• Provide appropriate information leaflets to help manage unexpected acute attacks
• Offer annual flu vaccination if you are on step 2

For more information visit:
www.patient.co.uk/health/Asthma.htm

Atrial Fibrillation is an irregular heart beat which if left untreated can lead to an increased risk of having a stroke.

All our patients with Atrial Fibrillation will be invited at least annually to see our Practice Nurse specialising in Atrial Fibrillation. You will receive a letter asking you to make an appointment for a blood test to be taken by one of our Health Care Assistants. You will then need to make an appointment at least one week later to see the Nurse.

It is very important you attend these appointments, even if you are feeling well, so we can monitor your condition.

At your initial assessment an Electrocardiogram (ECG) will be taken to monitor your heart rate and your blood results reviewed and discussed with you.

Then we will:

• Explain about the clinic and its objectives
• Discuss your condition and any concerns
• Monitor your blood pressure and pulse
• Discuss and symptoms i.e. breathlessness, palpitations, ankle swelling
• Discuss lifestyle issues i.e. smoking, alcohol, drinking, diet, exercise
• Discuss your medication, any side effects etc
• Measure and record height, weight and BMI
• Refer to other Health Care Professionals if required i.e. GP/Dietician
• Inform you of next follow up appointment
• Provide patient information leaflets where necessary
• Record all your information on a dedicated template in your medical record

For more information visit:
www.patient.co.uk/health/Atrial-Fibrillation.htm

This service is staffed by NHS Nurses linked to our GPs and supports people with long term health conditions including patients with breathing problems, diabetes, coronary heart disease, stroke/TIA, heart failure and high blood pressure. They can provide support and direct individual patients through a number of services and resources to help you to remain in control of your health and care needs. This can be through providing information and advice about local services such as self help groups, support groups, social services and the voluntary sector, helping you to make appropriate choices to improve your general health. For more information call and speak to a care navigator on 0800 612 1976 Monday to Friday 9 am to 5pm.

Are you a carer? If so, please complete the carer form available here.
As a carer you are entitled to a free flu vaccination and a yearly health check.
For further support see the Barnsley Carers Service.

Once you get to the age of 25, you will be invited for your cervical smear test and this will be done every 3 years. Smear tests are carried out until you get to the age of 65.

Please see this link for details on the smear test and what happens at the appointment Cervical screening - NHS (www.nhs.uk)

Cervical screening is important, and we encourage all women to have them done once they receive their invitation. However, we recognise that some women do not want to have this done, so please complete the form below and we will decline you from cervical screening, however, you can change your mind at any time and book in for a smear test.

Informed Consent for withdrawal from the Cervical Screening Programme.docx

We offer a full programme of childhood immunisations. Full details are available from your Health Visitor.

For more information visit:
www.patient.co.uk/health/Childhood-Immunisation.htm

CHD clinics: Tuesday afternoons.

We offer appointments to all our patients who have had heart problems, to make sure that they are receiving the most appropriate care. Paula Davis, Practice Nurse looks after all our patients with Chronic Heart Disease and you will be asked to attend her clinics for reviews.

For more information visit:
www.patient.co.uk/health/Angina.htm
www.patient.co.uk/health/Myocardial-Infarction-(Heart-Attack).htm

Chronic kidney disease (CKD) means that your kidneys are not working as well as they once did. Various conditions can cause CKD. Severity can vary but most cases are: mild or moderate, occur in older people, do not cause symptoms and do not progress to kidney failure. People with any stage of CKD have an increased risk of developing heart disease or a stroke. This is why it is important to detect even mild CKD, as treatment may not only slow down the progression of the disease, but also reduces the risk of developing heart disease or stroke.

Sometimes you may have a blood sample taken for other reasons and these may show some deterioration in your kidney function. If this happens we may send for you to have further blood samples taken and ask some simple questions to find the cause of this.

For more information visit:
www.patient.co.uk/health/Chronic-Kidney-Disease.htm

The Practice Nurse is able to do contraceptive pill checks.

For more information please visit:
patient.info/sexual-health/contraception-methods

These appointments run on patient initiated times to provide ease of attendance. Your appointment will be with one of our Practice Nurses, Carole Byron, who is a specialist in this field.

For more information visit:
www.patient.co.uk/health/Chronic-Obstructive-Pulmonary-Disease.htm

Diabetic Clinics: Various times and days throughout each week.

It is important for diabetic patients to have regular check-ups to make sure they are receiving the most appropriate care. You will be sent a reminder when your review is due.

For more information visit:
www.patient.co.uk/health/Diabetes-Type-1.htm
www.patient.co.uk/health/Diabetes-Type-2.htm

Both Nurses and Healthcare Assistants are proficient in dealing with dressings and suture removal.

Our Nurses have appointments available for ear syringing. You must make an initial appointment with a GP to confirm this procedure is essential before making your appointment with the Nurse.

Free and confidential advice on legal, medical and domestic issues.

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Heart failure occurs when the heart is damaged and unable to pump as effectively as it should. The main symptoms are breathlessness, fatigue and flue retention.

All our patients with Heart Failure will be invited at least annually to see our Practice Nurse specialising in Heart Failure. It is very important you attend these appointments, even if you are feeling well, so we can monitor your condition.

Initially you will be invited to have an Electrocardiogram (ECG) and a blood test with one of our Health Care Assistants. You will then need to book an appointment to see the nurse at least one week later.

Then we will:

• Discuss your condition and any concerns
• Discuss medications and any side effects
• Discuss your blood results
• Monitor your blood pressure and pulse
• Monitor for signs of increasing symptoms of breathlessness, ankle swelling
• Discuss lifestyle issues such as exercise, nutrition, smoking, alcohol, sexual issues
• Monitor height, weight and BMI and discuss
• Educate re self-monitoring i.e. weight and daily fluid intake
• Offer annual flu vaccinations and a one off pneumococcal
• Discuss any help required at home i.e. District Nurses, Social Services
• Refer to other Health Care Professionals if required i.e. GP/Heart Failure Nurse Specialist
• Inform you of your next follow up appointment
• Provide patient information leaflets where necessary

For more information visit:
www.patient.co.uk/health/Heart-Failure.htm

Your specialist will have informed us if you have agreed to be a part of the Primary Care based service for monitoring your methotrexate prescribing. Before using this service we will need to have received a copy of your signed agreement form after which time we will inform your specialist that we are happy to take over your prescribing and monitoring of your blood tests.

There are procedures we have to take in the Practice to ensure your safety when prescribing and we ask that you help us to help you by following the procedure we have in place.

• You will need to supply your Blue Book every time you request a prescription for Methotrexate.
• This will be checked and updated with any changes of medication and blood results.
• Regular monitoring of your bloods is very important and we need to ensure blood tests are done every 3 months before we can issue you with a prescription.
• You will be responsible for making an appointment with our Health Care Assistants for your blood tests to be done - please make sure you do this before the 3 month period is up otherwise we will not be able to give you your prescription.
• When you collect your prescription your Blue Book will be returned to you.
• You will need to take your Blue Book with your to your regular Pharmacist as they will need to see sight of it before dispensing your methotrexate.
• Your doctor will see you on an annual basis for a full medication review.

For more information visit:
www.patient.co.uk/medicine/Methotrexate.htm

Know Your Score!

The practice offers an NHS Health Check to patients between 40 and 74 every 5 years to identify your own personal score. Your score will give you a percentage of the likelihood of developing a heart condition or diabetes. Depending upon the result we can offer support and advice where needed to reduce your risk.

If you are 75 or over you should be seen annually, either by your doctor, the practice nurse or a district nurse. This can be arranged by the surgery or if that's not possible a home visit can be arranged.

Our Health Care Assistants are fully trained to take blood samples.

For more information visit:
www.patient.co.uk/health/Blood-Test-General.htm

Our Mental Health Workers see patients with mental health problems, such as mild depression, anxiety or bereavement. You can be referred to this service by your GP.

We offer the seasonal flu and pneumonia vaccine to all patients in at risks groups. These patients include:

• People aged 65 years and over
• All those aged 6 months or over in a clinical risk group
  
  • Chronic respiratory disease
  • Asthma that requires continuous or repeated use of inhaled or systemic steroids or with previous exacerbations requiring hospital admission
  • Chronic heart disease
  • Chronic renal disease
  • Chronic liver disease
  • Chronic neurological disease
  • Diabetes
  • Immunosuppression
• All pregnant women
• People living in long-stay residential care homes or other long-stay care facilities where there is a risk of high morbidity and morality
• Those who are in receipt of a carer's allowance, or those who are the main carer, or the carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill
• Frontline health and social care workers
  (Employers must arrange for health care workers' vaccination. Health care workers should not generally by vaccinated by GPs.)

Appointments will be available from September onwards.

For more information visit:
www.patient.co.uk/health/Influenza-Immunisation.htm

Our nurses are trained to support & encourage you to stop smoking.

For more information visit:
www.patient.co.uk/health/Smoking-The-Facts.htm
www.patient.co.uk/health/Smoking-Tips-to-Help-you-Stop.htm
www.patient.co.uk/health/Smoking-and-Others.htm
www.patient.co.uk/health/Smoking-and-Pregnancy.htm

A stroke or CVA occurs when the blood supply to the brain is slowed down or stopped. There are two causes for this, either blood clotting or bleeding within the brain. A TIA is a mini-stroke that most patients recover from but can lead to more severe strokes or health problems.

The main symptom of a stroke or TIA are:

• slurred speech
• facial weakness
• arm weakness

These symptoms should never be ignored, even if not all present.

All our patients that have experienced a stroke or TIA will be invited annually to see our Practice Nurse specialising in stroke care. It is very important that you attend these appointments, even if you are feeling well, so we can monitor your condition.

Your initial invite will be for you to attend for Electrocardiogram (ECG) and blood tests. You will then need to book an appointment to see the nurse at least one week later.

During this consultation we will:

• Discuss your condition and any concerns
• Discuss medications and any side effects
• Review your blood results
• Monitor blood pressure and pulse
• Discuss lifestyle issues such as exercise, nutrition, smoking and alcohol consumption
• Monitor height, weight and BMI
• Educate re self-monitoring diet and exercise etc
• Offer annual flu vaccinations and one off pneumococcal
• Discuss any help required at home e.g. District Nurses, Social Services
• Refer to other Health Care Professionals if required i.e. GP, Stroke Nurse Specialist, rapid access clinics
• Inform you of your next follow up appointment
• Provide patient information leaflets

For more information visit:
www.patient.co.uk/health/Stroke.htm

All our Practice Nurses offer travel advice and an immunisation service. They offer help with:

• Vaccinations
• Preventing malaria (using tablets and avoiding bites)
• Looking after your skin (sunburn and heat rash)

Travel Vaccines

We will now only be giving the NHS vaccinations to patients who are travelling - this includes Hep A, Typhoid & Tetanus.

If you are travelling somewhere that needs more than the above then you will need to visit a Travel Clinic/Pharmacy that does give those vaccines.

We also advise that you have the vaccinations done 6 weeks before travel - please bare in mind that our Nurse appointments at the moment are quite busy.

Please visit https://travelhealthpro.org.uk before travel to see what the recommended vaccinations are.

If you require more detailed travel advice we suggest you look at these websites:

www.doh.gov.uk
www.travelhealth.co.uk

Alternatively you can pick up an information booklet from the Post Office with an E111 form (European Union Travel Insurance Form).

Please be aware that most travel immunisation and advice is covered by the NHS. Most anti-malaria tablets can be bought directly from your pharmacy. There are some, however, that we have to prescribe for you on a non-NHS prescription. The pharmacy will ask you to pay for the cost of the tablets and the practice will charge a fee of £10.00.

You will receive a letter from child health regarding any child vaccinations that are required. You will then attend our clinics run by our nurses on a Tuesday between 2pm-4pm or a Thursday between 10.30am and 12.30pm. Please ensure that you bring your child's red book with you. If you are unable to make these days, then please contact reception and they will book you in. If you require a doctor's input, then you will need to make a separate appointment for this.

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