Antenatal (Tuesdays 9.00am to 4.00pm) 

This clinic is run by the midwives.  If you become pregnant, you will be given a 'booking appointment' at which the midwife will ask you a few questions and carry out some general health checks.   You will be seen regularly throughout your pregnancy either at the practice or at the local hospital, or both.

Asthma / COPD

With several hundred patients with asthma and /or Chronic Obstructive Pulmonary Disease registered with the practice, we offer a special service.  Our nurses are trained in the management of asthma, including childhood asthma and emergencies.  Apart from visits to your doctor when you have particular problems, we encourage all patients with a diagnosis of asthma or COPD to attend our nurse-run clinics on a regular basis.

Baby Clinics (Wednesdays 1.00 - 3.00pm) 

Our Health Visitors run Baby Clinics to give advice on feeding problems and general health matters, and to check weight and height from birth to 4 years.  Regular checks on development and immunisation for the under fives are carried out at this clinic by the doctor, health visitor and practice nurse.  The practice runs a comprehensive infant and pre-school immunisation programme in liaison with the health visitor.  Parents are automatically informed when their child is due for the next injection.

Blood Pressure Checks

Your blood pressure is taken for various reasons, routinely in the 'healthy' every five years, six monthly for those patients whose blood pressure is well controlled by medication, more frequently when blood pressure is raised and medication being considered.

Cervical Smears

All women between the ages of 25 and 64 are eligible for a free cervical screening test every three to five years.  A cervical smear appointment with one of our practice nurses can be arranged through our receptionists.

Ear Care

Wax is a natural ear lubricant – however some people produce excess wax and may need it removed.  Ear syringing or irrigation is not the only method of removing wax.  When you attend the nurse will decide the most appropriate way to remove the wax from your ear.

Family Planning

We offer confidential contraceptive and family planning advice and services during normal surgery hours.  Pre-conception advice is also available.  For women, the first consultation should be with the doctor.  Six monthly 'pill checks' can be made with our practice nurses who also do injectable contraception (depo) after the first consultation.   All other methods of contraception should be accessed at a Family Planning Clinic (Graingerville tel: 0191 2195239).   For patients wishing to use condoms, they are freely available on request at the reception desk or at nurse appointments if preferred.

IHD Checks

Ischaemic Heart Disease checks are for patients who have previously had a heart attack, cardiac surgery or stroke.  We encourage all patients with a diagnosis of IHD to attend for review at regular intervals to reduce the risk of further heart attack or stroke. This is done by monitoring kidney, liver and thyroid function, cholesterol, blood glucose and anaemia status (by blood test).  Routinely checking urine.  Recording blood pressure, smoking status, alcohol intake, weight, diet, exercise and advise appropriate adjustments to lifestyle.

Mental Health

We have a team of Counsellors and Mental Health Workers as well as a Community Psychiatric nurse (CPN) who are fully trained to discuss mental health issues and personal problems - your GP will refer you to them if they deem it necessary.

Smoking Cessation

There are lots of types of Nicotine Replacement Therapy (NRT) products available and they are all effective.  In appointments our practice nurses can offer prescriptions for nicotine patches, nicotine gum, the microtab, the lozenge and the inhalator.

Travel Vaccinations 

Travel vaccinations are all carried out by our practice nurses.  Appropriate Malaria advice is also given at consultation.  Ideally you should attend eight weeks before travel to ensure that if a course of vaccine is required your body has time to develop that immunity before your travel date.

Weight / Diet Advice

Our practice nurses can give advice, leaflets, support and monitor weight loss on a monthly basis.  In certain circumstances medication may be given to aid weight loss.

Wound Care / Dressings

Wound care, dressing changes and stitch or staple removal are all carried out by our practice nurses.

Private Services

The doctors are available to carry out examinations and prepare reports.

Please ask if you are not sure what services can be provided and how much they will cost.  The services listed below are examples of what are NOT covered under the NHS and you may be asked to pay a fee.

• Life Insurance examinations
• Pre-employment medicals
• HGV licence medical
• PSV licence medical
• Taxi licence medical
• Insurance verification
• Holiday cancellation forms
• Identity confirmation documents i.e. passport applications
• Other medical for non-NHS bodies

These services are not offered in our routine services - please inform reception that you require a private service when booking your appointment (all private services are subject to strict conditions).

Travel Vaccinations

If you require any vaccinations relating to foreign travel you need to make an appointment with the practice nurse to discuss your travel arrangements. This will include which countries and areas within countries that you are visiting to determine what vaccinations are required.

There is further information about countries and vaccinations required on the links below

Europe & Russia	North America
Central America	South America
Caribbean	Africa
Middle East	Central Asia
East Asia	Australasia and Pacific

It is important to make this initial appointment as early as possible - at least 6 weeks before you travel - as a second appointment will be required with the practice nurse to actually receive the vaccinations. These vaccines have to be ordered as they are not a stock vaccine. Your second appointment needs to be at least 2 weeks before you travel to allow the vaccines to work.

Most travel vaccines are ordered on a private prescription and these incur a charge over and above the normal prescription charge. This is because travel vaccination is not included in the services provided by the NHS and therefore is a chargeable service.

If you are travelling to Europe a very useful booklet has been published with advice and guidance to help you get the most out of your holiday. To visit please click:- http://ec.europa.eu/publications/booklets/eu_glance/86/en.pdf (this is a large document and may take a minute or two to view)

Been Off Work?

You do not require a doctor's sickness certificate for any illness lasting seven days or less. Your employer may however require you to complete a self-certification form (SC2) which is available from your employer or on the HMRC website.

Evidence that you are sick

If you are sick for more than seven days, your employer can ask you to give them some form of medical evidence to support payment of SSP (statutory sick pay).

It is up to your employer to decide whether you are incapable of work. A medical certificate, now called a 'Statement of Fitness for Work’ (see below) from your doctor is strong evidence that you are sick and would normally be accepted, unless there is evidence to prove otherwise.

You could also provide evidence from someone who is not a medical practitioner, e.g. a dentist. Your employer will decide whether or not this evidence is acceptable. If your employer has any doubts, they may still ask for a medical certificate from your GP.

Statement of Fitness for Work - ’Fit Note'

The 'fit note' was introduced on 6 April 2010. With your employer's support, the note will help you return to work sooner by providing more information about the effects of your illness or injury.

For more information see the DirectGov website (where this information was sourced)

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