‘Right Clinician, Right Time, Right Place’ – Who Do I See?

See A-Z topics below for how to best access help for common medical problems including useful phone numbers and websites.

Please have a look at the advice provided before contacting the practice as you may not require an appointment to get the help you need. Please also make use of the NHS website and local pharmacies for self care advice for treatment for minor illness and ailments.

To contact us for assistance you can:

Submit an E consult. You will receive a response by the end of the next working day (often the same day). Depending on the nature of the issue, you will be contacted by the same day triage team or given an appointment with your GP or another member of the team.

Book a routine GP appointment via reception. We encourage you to consult with your registered or ‘named’ GP wherever possible for continuity of care and to build the doctor – patient relationship. We aim to be able to offer you a routine GP appointment within 2 weeks.

If you have an urgent problem that requires same day attention, contact reception for the same day emergency triage line. Please be aware that only clinically urgent issues will be dealt with by the triage team and you may be redirected to a more suitable service or appointment type. The triage team consists of a GP and a team of Advanced Nurse Practitioners (ANPs). You will be asked to provide the reason for the appointment and must be available to take a call back at any time. If you require a face to face appointment you will be expected to attend the same day. We do not provide a walk in and wait service.

For ongoing/longer term problems then please book in to discuss with your registered GP in a routine appointment.

There are only a set number of emergency appointments each day so please do not abuse this service. For patient safety, once all the available appointments for the day have been taken, you will be re-directed to an alternative service such as NHS 111.

Abdominal Pain

Acne

ACR Test

ADHD

Anger

Anxiety

Asthma

Alcohol Advice

Allergies

Andover PCN

Who do I see?

The PCN team

Advice:

Since the NHS was created in 1948, the population has grown and people are living longer. Many people are living with long term conditions such as diabetes and heart disease or suffer with mental health issues and may need to access their local health services more often.

To meet these needs, GP practices are working together with community, mental health, social care, pharmacy, hospital and voluntary services in their local areas in groups of practices known as primary care networks (PCNs).

PCNs build on existing primary care services and enable greater provision of proactive, personalised, coordinated and more integrated health and social care for people close to home. Clinicians describe this as a change from reactively providing appointments to proactively caring for the people and communities they serve.

Each of the 1,250 PCNs across England are based on GP registered patient lists, typically serving natural communities of between 30,000 to 50,000 people (with some flexibility). They are small enough to provide the personal care valued by both people and GPs, but large enough to have impact and economies of scale through better collaboration between GP practices and others in the local health and social care system.

Primary Care Networks Animation – YouTube

Andover Primary Care Network is a collaborative project involving the following GP Surgeries:

Adelaide Medical Centre
Andover Health Centre Medical Practice
Charlton Hill Surgery
Shepherds Spring Medical Centre
St Mary’s Surgery

If you are a patient at one of these surgeries then you can benefit from the services provided by Andover Primary Care Network.

Check out their website for services they provide including: social prescribing, mental health support services, support for carers and veterans, cancer care and more. You can reach out to them directly or via the AMC team.

Andover Primary Care Network – A primary healthcare organisation committed to quality care and health improvement in the community (andoverpcn.co.uk)

Athlete’s Foot

Atrial Fibrillation

Audiology (Hearing Issues)

Autism

Back Pain

Bedwetting

Behavioural Concerns in Children

Bereavement Support

Blocked ears (wax)

Blood Pressure Monitoring

Who do I see?
Monitor at home

Use the surgery ‘Health POD’ (ask at reception)

See HCA or Practice Nurse

Advice:

Blood pressure is recorded with 2 numbers. The systolic pressure (higher number) is the force at which your heart pumps blood around your body. The diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels between heartbeats when blood is pumped around your heart.

They’re both measured in millimetres of mercury (mmHg).

As a general guide:

high blood pressure (or hypertension) is considered to be from 140/90 or more if your reading was taken at a pharmacy, GP surgery or clinic (or an average of 135/85 if it was taken at home)
if you’re over the age of 80, high blood pressure is considered to be from 150/90 or more if your reading was taken at a pharmacy, GP surgery or clinic (or an average of 145/85 if it was taken at home)
The ideal blood pressure is usually considered to be between 90/60 and 120/80.

Keeping an eye on your blood pressure is a sensible thing to do. It is simple and easy to do at home if you have access to a home monitor or can be checked in our surgery health POD – no need for an appointment, just ask at reception.

Blood pressure checks can also be performed at most local pharmacies. If the results are high, a discussion with a pharmacist or a GP at the surgery would be needed for further assessment.

High blood pressure (hypertension) – NHS (www.nhs.uk)

If you already have a diagnosis of high blood pressure (hypertension) you will be invited for an annual review in the month of your birth to make sure things are well controlled.

We will want to know an up to date blood pressure reading and you will also usually require a blood test and a urine test (ACR). We will contact you when your review is due. If your blood pressure is above the target then you may be given lifestyle advice or changes to your treatment may be required.

NG136 Patient decision aid on how do I control my blood pressure? Lifestyle options and choice of medicines (nice.org.uk)

Having a blood pressure monitor at home is a great way to keep an eye on things if you are in a position to be able to purchase one. We would recommend one that goes round your arm rather than your wrist.

If you have a home blood pressure monitor then you will be able to submit home readings for your review if you prefer. You can submit them here: Consult Online from Home – Adelaide Medical Centre (webgp.com)

Please do not drop/send in home readings unless you have been asked to do so for your review. If you are worried your blood pressure is high then please speak to reception to arrange an appointment.

Blood pressure monitors: All you need to know (bhf.org.uk)

Blood Pressure UK

How to check your blood pressure:

Sit in a chair comfortably upright with your arm supported on a table beside you, with both feet on the ground. Put the cuff on your upper arm (5cm above your elbow) resting on the table, the cuff should be roughly at the level of your heart. Press the on/start button on the BP monitor and take two readings at least 1 minute apart.

Take readings twice a day for a total of 7 days, please then return your readings (and the BP monitor if borrowed) to the surgery. We can provide you with a paper diary sheet to complete or send you a link to submit electronically.

Blood Tests

Blue Badge Forms

Boils

Bowel Cancer Screening Programme

Breathlessness

Breast Pain (also known as Mastalgia)

Breast Lump

Breastfeeding Advice

Breast Cancer Screening

Bruised Ribs

B12 Deficiency

Burns

Cancer (diagnosis, support and treatment)

Can My Child Go To School?

Carers Support

Cervical Smear

Chest Pain

Cellulitis

Chest Infections

Child Development Concerns

Coils or Implants

Colds

Cows Milk Protein Allergy

Conjunctivitis

Colonoscopy

Constipation

Contraception and Family Planning

Cystitis

Chronic Heart Disease

Chronic Kidney Disease

Chronic Pain

Cold Sores

Cough

Dementia / Memory Problems

Dementia Support

Depot Injection (Contraception)

Diabetes Monitoring

Diet / Lifestyle Changes

Domestic Violence Support

Driving

Dressings

Drug Addiction

Dental Problems

Delaying Periods

Depression

Diarrhoea

Dizziness

Dyslexia

DWP: GP letters for Personal Independence Payment (PIP) and Employment and Support Allowance

Ear Care / Ear Wax

Eating Disorders

Early Pregnancy Referrals

Emergency Contraception

Earache

Eczema

Eye Problems

Fatty Liver Disease

Flu Vaccine

Fear Of Flying

Who do I see?
Self help

Counselling services accessible online

Advice:

Patients sometimes ask us to prescribe diazepam for fear of flying. There are a number of reasons why prescribing this drug is not recommended.

1) Diazepam is a sedative, which means it makes you sleepy and more relaxed. If there is an emergency during the flight it may impact your ability to concentrate, follow instructions and respond to the situation. This could have serious safety consequences for you and those around you.

2) Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung. Blood clots are very dangerous and can prove fatal. This risk is even greater if your flight is greater than 4 hours.

3) Whilst most people find medications like diazepam sedating, a small number of people report agitation and increased aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers and could also get you into trouble with the airline/law.

4) According to the prescribing guidelines doctors follow, medications such as diazepam are contraindicated (not allowed) in treating phobias. Your doctor would be taking a significant legal risk by prescribing against the guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.

5) Diazepam and similar drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police on arrival if you are carrying them.

6) Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing you may fail this having taken diazepam.

We appreciate that fear of flying is very real and very frightening. Some airlines runs courses designed to try and help with this issue.

Fear of flying course | Fearless Flyer (easyjet.com)

flyingwithoutfear | Virgin Flying Without Fear

Fever

Fibromyalgia

Who do I see?
Routine GP Appointment

Online support services

Advice:

Fibromyalgia is a long-term condition that causes pain all over the body. Anyone can develop fibromyalgia, but it’s more common in women than men.

The condition typically develops between the ages of 25 and 55, but people of any age can get it, including children and older people.

The exact cause of fibromyalgia is unknown, but it’s thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system (the brain, spinal cord and nerves) processes pain messages carried around the body.

It’s also suggested that some people are more likely to develop fibromyalgia because of genes inherited from their parents.

In many cases, the condition appears to be triggered by things that are physical or emotional like an injury, an infection or stress.

As well as widespread pain, other symptoms may include, increased sensitivity to pain, muscle stiffness, difficulty getting to sleep or staying asleep, headaches, which can make you feel very tired (fatigue), problems with mental processes (known as “fibro-fog”), such as difficulty concentrating or remembering things, feelings of frustration, worry or low mood and IBS symptoms.

The symptoms of fibromyalgia are variable, they can sometimes suddenly improve or get worse depending on various factors.

Although there’s currently no cure for fibromyalgia, there are treatments to help relieve some of the symptoms and make the condition easier to live with.

Treatment tends to be a combination of:

– lifestyle changes, such as exercise programmes and relaxation techniques
– talking therapies, such as cognitive behavioural therapy (CBT) and acceptance and commitment therapy (ACT)
– medicine, such as antidepressants

In particular, exercise has a number of important benefits for people with fibromyalgia, including helping to reduce pain.

If you are concerned you have symptoms that could be caused by Fibromyalgia then arrange to speak to the GP. There are no diagnostic tests and the symptoms can be similar to other conditions so it is what we call a ‘diagnosis of exclusion’, only made once other conditions have been excluded.

Support:

If you have fibromyalgia, support groups can provide an important network for talking to others living with the condition.

Fibromyalgia Action UK is a charity that offers information and support to people with fibromyalgia.

If you have any questions about fibromyalgia, call the charity’s helpline on 0300 999 3333.

Fibromyalgia Action UK also has a number of regional co-ordinators who can put you in touch with a support group near you.

Another organisation you may find useful is UK Fibromyalgia.

Flippin’ Fibromyalgia – Flippin’ Pain (flippinpain.co.uk)

Fungal Skin Infections

Fertility Concerns

Who do I see?
Routine GP appointment

Advice:

Most couples (around 84%) will get pregnant within a year if they have regular sex and don’t use contraception. Having regular sex means having sex every 2 to 3 days throughout the month. This figure rises to 92% after 2 years.

If you’re trying to get pregnant it’s important to take folic acid daily, eat a healthy diet, and drink no more than 1 or 2 units of alcohol once or twice a week. This will help your baby develop healthily.

Fertility problems affect 1 in 7 couples in the UK, these can be caused by a variety of issues which may affect either person or both. In 25% of couples, fertility problems can’t be explained.

Risk factors for infertility include smoking, obesity, occupational risks, excessive alcohol consumption, and drug use. Female fertility declines with age; the effect of age on male fertility is less clear.

Trying to get pregnant – NHS (www.nhs.uk)

Infertility – NHS (www.nhs.uk)

Investigations for infertility are not usually recommended until the couple has been unable to conceive after 1 year of regular unprotected sex. However, investigations should be offered earlier than 1 year to couples who have been identified as less likely to conceive or if the woman is aged 36 years and older.

Before a referral can be made, both partners will need to have further tests completed, these can be arranged by the GP. For men this is a sperm sample and for women this requires 2 blood tests, an ultrasound scan and STI screening.

You will then be referred to the specialist fertility clinic who will be able to discuss options with you based on your test results and individual circumstances.

Fertility treatments include:

Medication for lack of regular ovulation
Surgical procedures such as treatment for endometriosis, repair of fallopian tubes, or removal of scarring (adhesions) within the womb or abdominal cavity
Assisted conception such as intrauterine insemination or IVF

In Hampshire you are only eligible for NHS funded IVF if you are under 35, have been trying to conceive for one year and have not fallen pregnant and have not had IVF before. Both partners must not have any previous children. For same sex couples or single people you need to have had 12 failed insemination cycles, of which 6 need to be in a clinic using intra-uterine insemination OR a diagnosed fertility problem.

The person having IVF must have a BMI between 19-29.9 and both partners must be non smokers for at least 6 months.

Flu

Fungal Nail Infections

Forms, certificates and medicals

Genital Infections including Herpes (GUM Clinic)

Gender Identity Concerns

Haemorrhoids

Hay Fever

High Blood Pressure (Hypertension)

Head Lice

HRT

Who do I see?
Routine GP Appointment

Practice Nurse for your annual review

Advice:

Hormone replacement therapy (HRT) is a treatment to relieve symptoms of the menopause. It replaces the hormone oestrogen which your body naturally stops producing as you go through menopause, the average age for this in the UK is 51.

This can cause a variety of symptoms (see Menopause section) which can be very debilitating. HRT can help to reduce these symptoms for lots of women. You are able to start HRT during peri menopause (before your periods have stopped).

There are a number of considerations to take into account when considering HRT.

Do you need any tests prior to starting? Usually no testing is required to diagnose menopausal symptoms. A blood test is often suggested if you are under 45 (termed ‘early menopause’) and would definitely be recommended if you are under 40 (termed ‘premature ovarian insufficiency’ or POI).
What are the risks of taking HRT? As with all medications there are some risks to using HRT but there are also many benefits. Please see attached links for further details. Some of the most important risks to consider are related to breast cancer and blood clots.
What type of HRT will you need? HRT can be oestrogen only or combined HRT (oestrogen and progesterone). Oestrogen only HRT is for women who have had a hysterectomy (surgery to remove their womb), or are using an intrauterine system (IUS) such as a Mirena coil. This type of HRT does not contain progesterone (which is otherwise needed to protect the lining of the womb). Combined HRT can be used cyclically or continuously, this depends on whether you are still having periods or not. Cyclical HRT will give a monthly bleed and continuous HRT gives no bleed. Continuous HRT is recommended once you have not had a period for 1 year.
How do I use HRT? Oestrogen can be given as a gel, patch, spray or tablet. Progesterone can be included in a combination patch, taken as a tablet, used vaginally or via an IUS (coil).
How long can I take HRT for? HRT can be taken for as long as you require it, provided the risks do not outweigh the benefits, there is no maximum length of time it can be taken for.

General info:

Treatment – Rock My Menopause

Hormone replacement therapy (HRT) – NHS (www.nhs.uk)

My Menopause Centre | HRT (Hormone Replacement Therapy) Explained

Layout 1 (balance-menopause.com)

HRT-types-and-doses.pdf (balance-menopause.com)

Info on risks:

HRT: Benefits and risks – Women’s Health Concern (womens-health-concern.org)

01-WHC-FACTSHEET-BreastCancer-NOV2020-C.pdf (womens-health-concern.org)

HRT-Myths-Uncovered.pdf (pcwhf.co.uk)

WHC-UnderstandingRisksofBreastCancer-MARCH2017.pdf (womens-health-concern.org)

Practical info:

Layout 1 (balance-menopause.com)

Balance – What to expect when you start HRT (balance-menopause.com)

Some women are unable to use HRT due to other medical conditions. There are also some non hormonal treatments that can help.

RMM_Alternatives-to-HRT.pdf (rockmymenopause.com)

Vaginal Oestrogen (‘Local HRT’):

The menopause can cause problems with vaginal dryness and irritation. For this particular symptom, ‘local’ HRT can be applied directly to the affected area as a cream or a pessary. This can be used along side systemic HRT (patches/tablets etc) or on it’s own.

Vaginal-dryness.pdf (balance-menopause.com)

There is a wealth of information on the menopause and HRT available via the following sites.

Balance – Menopause library

Get Informed – Rock My Menopause

My Menopause Centre | Information & Advice from Menopause Experts

WHC factsheets and other helpful resources – Women’s Health Concern (womens-health-concern.org)

Prescriptions:

With your first prescription we generally provide 3 months to get you started and see if your chosen regime suits you. At the 3 month mark we would ask that you arrange a review with our nursing team. Once you are happy with your dose you will need an annual review with a blood pressure/BMI check, this is to ensure it is still safe for you to receive HRT.

No matter how many prescriptions you have in a year, you should only pay a flat rate due to the ‘HRT Pre Payment Certificate’. Please see below.

NHS Hormone Replacement Therapy Prescription Prepayment Certificate (HRT PPC) | NHSBSA

Handy Hints:

Trouble with patch residue? Try Apeel spray, Zoff or Peeleasy products available online.

Patches not sticking well? Try a squirt of a steroid nasal spray beneath your patch (!) (available OTC from the pharmacist)

Thinking about stopping HRT?

There is no fixed time that you can/should use HRT for. We recommend always considering the risks vs the benefits when deciding how long to continue for.

However, there are some medical conditions that would mean you need to stop using HRT or change the way in which you use it. Breast, ovarian and womb cancers being some of the most significant. It is also recommended that you stop HRT 6 weeks before having any major surgery, this is due to the increased risk of a blood (DVT or PE) in the post operative period.

Stopping HRT – London Menopause Clinic

Stopping HRT : Menopause Matters

Holiday Cancellation Certificate

Head Injuries

Headaches

Hospital Appointments (Outpatients)

Hospital Transport

Homelessness

Housing – letter of support

Indigestion

Insect Bites

Insurance Reports

Infected Wounds

Long Covid

Low Carb Advice

Lyme Disease

Medication Queries and Reviews

Menopause

Who do I see?
Routine GP Appointment

Advice:

Menopause is the medical term for the natural time in life when your periods stop, this usually occurs between 45 and 55 years of age and happens due to a decline in oestrogen levels (a hormone produced by the ovaries). The ‘peri menopause’ is the stage leading up to this, usually a few years before your periods fully stop where you might start experiencing other symptoms.

In the UK, the average age for a woman to reach the menopause is 51. Menopause is only diagnosed once you have not had a period for 1 year, a ‘retrospective’ diagnosis. You can then be termed ‘post menopausal’ or having been through the menopause.

Menopause is usually a clinical diagnosis meaning that no blood tests are required, it can be diagnosed based on symptoms alone.

Some patients will have an ‘early’ (before 45) or a ‘premature’ menopause (before 40) and some patients will go through surgical menopause if they have had their ovaries removed with a hysterectomy or other type of surgery.

These links explain things in more detail:

My Menopause Centre | Understanding the Menopause

Layout 1 (balance-menopause.com)

Menopause and me (balance-menopause.com)

Menopause – NHS (www.nhs.uk)

Menopause can cause a wide variety of symptoms including hot flushes, mood swings, fatigue, urinary symptoms, memory loss, insomnia, joint pains, hair loss, brain fog, anxiety, reduced libido, itchy skin, headaches and many more.

3 out of 4 women will experience symptoms with 1 in 4 women describing these as severe. The symptoms can start several years before your periods stop and can last for a number of years. This questionnaire can help you to understand the symptoms better.

Menopause Symptoms Questionnaire (balance-menopause.com)

Lifestyle changes can help with symptoms, for example maintaining a healthy weight, exercising regularly, reducing caffeine and alcohol and eating a healthy diet. There are also a variety of supplements available over the counter that can help support with menopausal symptoms.

Many women also wish to consider HRT to help with menopausal symptoms (see HRT section of this webpage) or one of the non hormonal medications which are also available.

There is lots of support and information online:

The menopause – Women’s Health Concern (womens-health-concern.org)

15-WHC-FACTSHEET-The-Menopause-NOV2022-B.pdf (womens-health-concern.org)

WHC factsheets and other helpful resources – Women’s Health Concern (womens-health-concern.org)

Balance – Menopause library

The Menopause Charity – Menopause Facts, Advice and Support

Menopause Matters, menopausal symptoms, remedies, advice

menopausesupport.co.uk – Supporting You Through Change

Menopause and Me|Official Website

Rock My Menopause – Menopause Information

Specific to ‘POI’ (menopause under 40):

Premature Ovarian Insufficiency or ‘POI’, also known as premature menopause, affects up to 1 in 100 women and this is when your periods stop before the age of 40.

It means your ovaries are not working well and the lack of hormones cause many associated troublesome symptoms and health conditions if left untreated. It is important to replace the hormones that your body is no longer producing until the age of natural menopause at the earliest i.e. 51yrs old. There are no increased risks related to HRT before age of natural menopause, as you are replacing the hormones that your body would otherwise produce.

Charity for Women with POI | The Daisy Network

Surgical Menopause:

Surgical menopause, i.e. your ovaries have been removed surgically, then you should replace the hormones that your body is no longer producing until the time a natural menopause would occur at the earliest – i.e. 51yrs. There are no increased risks related to HRT as you are replacing the hormones that your body would otherwise produce.

Embracing The Change: Emotional Wellbeing for Menopause.

This free course will explore how Cognitive Behavioural Therapy (CBT) can help to reduce unpleasant symptoms of menopause such as night sweats, hot flushes, sleep problems, anxiety, and depressive symptoms. It gives you evidence-based tools and techniques to help manage some of the most common symptoms of peri menopause and the menopause. Although we can’t completely eradicate these natural symptoms, we can start to feel empowered to take control back of our body and mind and make some positive changes.

NHS Talking Therapies Hampshire Wellbeing Classes (italk.org.uk)

Medical Reports

Mental Health Crisis (see also Suicidal Thoughts section)

Mental Health Support For Young People

Minor Injuries

Moles

Mouth Problems

Musculoskeletal Problems

Neck Pain

New Baby

Nail Concerns

Nappy rash

NHS App

Nosebleeds

Occupational Therapy

Online Services

Passport Forms

Proactive Care Team

Panic Attacks

Period Problems

Pharmacy Services

Who do I see?
Community Pharmacy

Advice:
Pharmacists are experts in medicines who are expertly trained and can help you with minor health concerns.

As qualified healthcare professionals, they can offer clinical advice and over-the-counter medicines for a range of minor illnesses, such as coughs, colds, sore throats, tummy trouble and aches and pains.

If symptoms suggest it’s something more serious, pharmacists have the right training to make sure you get the help you need. For example they will tell you if you need to see a GP, nurse or other healthcare professional. Many pharmacies are open until late and at weekends and you do not need an appointment.

Pharmacists can also answer your questions on prescription and over-the-counter medicines.

The New Medicine Service is available at pharmacies to give you extra help and advice if you’re just starting on a new medicine for one of the following conditions: asthma, chronic obstructive pulmonary disease (COPD), type 2 diabetes, high blood pressure, people who have been given a new blood-thinning medicine and more.

New Medicine Service (NMS) – NHS (www.nhs.uk)

All pharmacies also provide the following services:

dispensing of NHS prescriptions
access to the repeat prescription service (with agreement from your GP)
an emergency supply of medicine, subject to the decision of the pharmacist (you may need to pay for an emergency supply)
non-prescription medicines like paracetamol
disposal of unwanted or out-of-date medicines
advice on treating minor health concerns and healthy living

Pharmacy technicians can help with things like:

inhaler technique
how to take a medicine safely
helping you understand the correct dose of a new medicine and how often you need to take it
Pharmacists can give treatment advice about a range of common conditions and minor injuries, such as aches and pains, sore throat, coughs, colds/flu, earache, cystitis, skin rashes, teething and red eyes.
Through the NHS Minor Ailment Scheme, a pharmacist will be able to offer advice and some medicines for a minor illness without you having to book an appointment to see a GP. Medicines can be supplied free of charge to the customer if they are exempt from NHS prescription charges.
Medication Shortages:
Unfortunately these days more and more medications are affected by stock issues, this is outside of our control. Speak to your regular chemist to see if they can order in for you or if they know somewhere else locally they may stock your product. Boots run a stock checker on their website.
Boots pharmacy | Online Prescription stock checker
This online site may also be able to help.
Hard To Find Medicines | Hive Pharmacy

Pharmacy First Scheme

Pregnancy

Pre Diabetes (Borderline Diabetes)

Pneumoccocal Vaccine

Pre and Postnatal Depression

PSA Testing / Prostate Cancer

Who do I see?

Request a PSA test via E Consult

Discuss results with GP if abnormal or if you have symptoms

Advice:

Prostate cancer is the most common cancer in men – 1 in 8 men – and there may be no symptoms in the early stages.

A PSA test is a blood test that can help to detect prostate cancer. The test is not always accurate and this is why there is no official screening programme for prostate cancer.
Routine PSA screening is a controversial subject. PSA tests are unreliable and can suggest prostate cancer when no cancer exists (called a false positive result).

If the result is raised, most men are now offered an MRI scan before a biopsy to help avoid unnecessary tests, but some men with a raised PSA may end up having invasive and sometimes painful biopsies for no reason.

Unfortunately also around 1 in 7 men with prostate cancer have normal PSA levels (a false negative result), so cases may be missed.
The PSA test can find aggressive prostate cancer needing treatment but it can also find slow growing cancer that may never cause symptoms or shorten life.

Although screening has been shown to reduce a man’s chance of dying from prostate cancer, it would also mean many men receiving treatment unnecessarily. As a result there is currently no prostate screening programme in the UK but since 2016 asymptomatic men aged 50 years or older have been able to discuss having a PSA test with their GP as per the prostate cancer risk management programme.

If you are over 50 you are welcome to have a PSA blood test.

We would recommend reading the information below via the links to help you decide if you wish to go ahead.

If you’re having a PSA test, you should not have:

ejaculated in the past 48 hours
exercised heavily in the past 48 hours
a urinary infection
had a prostate biopsy in the past 6 weeks as each of these may give an inaccurate PSA reading.

More info here:

Prostate cancer – Should I have a PSA test? – NHS (www.nhs.uk)

Prostate cancer – PSA testing – NHS (www.nhs.uk)

PSA testing and prostate cancer: advice for men without symptoms of prostate disease aged 50 and over (publishing.service.gov.uk)

If you would like to speak to a Prostate Cancer nurse specialist you can contact them here: 0800 074 8383

Prostate Cancer UK’s Specialist Nurses | Prostate Cancer UK

There are a number of things that can increase your risk of having prostate cancer, the main ones being age, being of black or mixed black ethnicity and having a father or brother with prostate cancer. You can check your prostate cancer risk here: Check your risk in 30 seconds | Prostate Cancer UK

Prostate Problems

Rectal Bleeding

Rashes

Relationship Problems

Removal of Stitches

Sedation for Scans

Sick Note (Fit Note)

Who do I see?
Please ensure you self certify for first 7 days, then please submit your request via an E consult

If you are unable to do this then please speak to reception

Advice:
Sick notes mean that you are medically unfit for any type of work and should be completed by the person or team who has been in charge of your care. This is not always the GP. We can only issue a fit note if we have been involved in your care or have supporting documentation.

A fit note can be backdated if required, please provide the required dates and as much information as you can.

Please note – requests for fit notes are not appropriate for same day / emergency triage calls, please follow the process above.

Self Certify
For the first 7 consecutive days of absence, you do not need a note and should self certify. You can obtain this form from your employer or by visiting the HMRC website.

Taking sick leave – GOV.UK (www.gov.uk)

Employee’s statement of sickness to claim Statutory Sick Pay – GOV.UK (www.gov.uk)

If you have been discharged from hospital, your hospital team will issue any fit notes for the period of your recovery. Please contact the ward staff or the Consultant’s secretary (even after discharge). If you run into any difficulties please reference this guidance or speak to the ‘PALS’ department, this is part of their duty of care to you as their patient.

Statement of fitness for work: a guide for hospital doctors – GOV.UK (www.gov.uk)

Schools should not request a GP letter to confirm absence, this can be written by a parent or guardian.

Private Certificates
If you or your employer require further information concerning your period(s) of illness, then your doctor may require to issue you with a letter. Please note that a charge may apply for this service. Please check with our reception desk.

There are no notes to say that you are fit and well to return to work, this is for you and your employer to decide together. The absence of a fit note to state that you are unable to work is enough to support your return.

Sore Throat

Sleep Problems

Sleep Apnoea

Stings

Stopping Antidepressants

Sunburn

Support Services

Shingles Vaccine

Sinusitis

Smoking Cessation

Sore Penis

Social Prescribing Service

Sprains

Styes

Statin Medication

Who do I see?

Routine GP appointment

As part of your annual long term condition review

Advice:

Statin medication is a type of drug treatment used to lower cholesterol, for some patients this is recommended to help protect you from conditions such as stroke and heart attack (also termed cardiovascular disease).

If you have a known diagnosis of cardiovascular disease (stroke, TIA, previous heart attack, coronary artery disease or angina) or chronic kidney disease then statin medication is recommended. Statins are also usually recommended to patients with diabetes.

Statins – NHS (www.nhs.uk)

Statins are a type of medication used to lower the level of cholesterol in the blood and protect the insides of the artery walls. | BHF

If you not do have cardiovascular disease, kidney disease or diabetes, then in order to determine who would benefit from statin medication we calculate something called your ‘cardiovascular risk score.’ The Q risk score is based on a number of variables including age, blood pressure, BMI, smoking status and cholesterol readings.

QRISK will categorise patients into low (<10%), moderate (10-20%) or high (>20%) risk groups. It is important to note that based on age alone once men reach 65 and women reach 70 you will automatically fall into a moderate risk group even if your blood pressure, weight, cholesterol etc are within the normal ranges!

The QRISK score is usually done as part of your annual medication or long term condition review.

If your score is above 10% then medical guidelines would advise that we alert you to this finding and have a discussion about lifestyle changes and statin medication with you.

It is important to note that lifestyle measures such as losing weight, increasing our activity levels and reducing alcohol intake are the most effective ways in which to reduce our risk of cardiovascular disease but for some patients statin medication will also have an important role.

Cardiovascular Risk Score (QRISK2) Patient Information Leaflet – Winchmore Hill Practice

The Q Intervention tool can tell you your QRISK score (risk of developing cardiovascular disease in the next ten years) and also your QDiabetes score (risk of developing diabetes in the next ten years). It also allows you to see the how this risk changes with different interventions such as losing weight or starting statin medication.

QIntervention

How do I lower my cholesterol? we answer 5 of your most common questions – BHF

Suicidal Thoughts (see also Mental Health Crisis section)

Termination of Pregnancy

Threadworms

Tiredness and Fatigue

Urinary Incontinence

Urine Infections

Verrucae

Vomiting

What To Do When Someone Dies At Home

Travel Advice and Vaccinations

Who do I see?
Practice Nurse

Online resources

Advice:

Some airlines are advising travellers who are bringing medication in their hand luggage that they should bring a letter from their medical practitioner confirming the type of medication and what it is for.

This is incorrect, if a passenger packs their medication in their hold luggage, they do not require any of their medical information.

If a passenger seeks to carry their essential medication in their cabin luggage, and the form of the medication contravenes aviation regulations e.g., the use of sharps, liquids more than 100ml or oxygen cylinders, they require the passenger to produce confirmation from their healthcare practitioner that the medication is necessary to be carried as it may be required on board.

We can offer you a private letter for this or patients can also provide proof of medical conditions and medication by showing airlines their medical records on the NHS App, by accessing their online medical record, or by getting a copy of their medical summary from their practice.

If a person is going to be abroad for over 3 months then all they are entitled to at NHS expense is a sufficient
supply of regular medications to get to the destination and find an alternative supply of that medication. The NHS accepts responsibility for supplying ongoing medication for temporary periods abroad of up to three months. This applies for both holidays and working abroad.

If a person is going to be abroad for more than three months, then only a sufficient supply of his/her regular medication should be provided to enable them to get to the destination and find an alternative supply. The patient should be advised to register with a local doctor for continuing medication, which they may need to pay for; the patient should check if the medicines required are available in the country being visited.

GP practice are not responsible for finding a doctor or ensuring medication supplies are available at the travel destination. The patient is responsible for finding and registering with a local doctor and for confirming a regular supply of their medication.

NHS prescriptions must never be obtained by relatives or friends on behalf of patients who are currently abroad.

Patients should check on arrangements for obtaining prescribed medicines in the country they intend to visit
before leaving the UK.

Can I take my medicine abroad? – NHS (www.nhs.uk)

For vaccinations, please submit a travel form at least 6 weeks or more before travelling. Have a look at your destination on the NaTHNaC website to find out which vaccinations you will need.

Travel vaccinations – NHS (www.nhs.uk)

NaTHNaC – Country List (travelhealthpro.org.uk)

Home – Fit for Travel

Tetanus Injection

Thrush (Vaginal)

Thrush (Oral)

Vaginal Discharge

Vasectomy

Veterans

Vitamin B12 Injection

Warfarin Monitoring

Weight Loss Support

Who do I see?
Online Resources

Social Prescribing service

Specialist Referral

Advice:

There is so much advice available on different methods for weight loss it can be hard to know where to turn. Ultimately, it is about finding a method that is safe, effective and fits with your lifestyle. Maintaining a healthy weight is one of the best things you can do to help keep healthy for the future.

Support for losing weight on the NHS is split into tiers.

Tier 1 means using free, accessible support and information to start your weight loss journey. Things like weight loss apps, advice from a nurse, social prescriber or pharmacist, NHS online support etc.

Lose weight – Better Health – NHS (www.nhs.uk)

NHS England » The NHS Digital Weight Management Programme

WEIGHT LOSS HACK: Eat MORE and LOSE Weight! (youtube.com) (10 part YouTube series from a GP)

The Andover PCN Social Prescribing team can support with weight loss and can be contacted by visiting the Health Hub in the Chantry Centre or here Andover Primary Care Network – A primary healthcare organisation committed to quality care and health improvement in the community (andoverpcn.co.uk)

Tier 2 services are delivered by local community weight management services, that provide community based diet, nutrition, lifestyle and behaviour change advice, normally in a group setting environment, services such as Weight Watchers or Slimming World. Normally people can only access these services for a limited time period (often only 12 weeks). Our local provider is ‘Gloji’ and we can refer you to this service or a 12 week weight loss programme if you complete the form here: Weight Management – Adelaide Medical Centre

Home – Gloji Hampshire

Tier 2 services also include accessing discounted gym memberships (see below).

Tier 3 services are provided by a clinician led multidisciplinary team usually including a specialist Consultant or GP, specialist nurse, specialist dietitian, psychologist, psychiatrist, and physiotherapist. These are specialist weight management clinics that provide non-surgical, intensive medical management.

Our local service is called The Weigh Ahead and requires you to complete a referral form and have a blood test prior. There are strict inclusion criteria and you must have completed Tier 1 and Tier 2 before being able to apply. Over a six-month programme the team will provide you with the tools and support you need to lose weight and lead a healthier lifestyle for the long-term. Through a programme that is tailored specifically to your needs, “The Weigh Ahead” aims to help you lose at least 5-10% of your excess body weight to achieve improved health outcomes.

You must be 16 or over

You must have a BMI of 35 or over and one or more weight related medical problem OR a BMI over 40

You must have completed Tier 1 and Tier 2 interventions

You only get one opportunity to be referred

The Weigh Ahead (spirehealthcare.com)

If you meet the criteria and would like a referral you can collect a from from the receptionist.

There are some medications that can help with weight loss. The one that we can prescribe is called Orlistat.

Orlistat (Weight Loss Medicine) | Patient

The NHS has also begun licencing weight loss injections but these are currently not available for us to prescribe, this will likely change over the coming months. These are only currently available in the private sector.

Tier 4 services provide bariatric surgery and are only accessible after completion of the Tier 3 programme. A new referral is required and can be made 6 months after completion of the Tier 3.

Increasing activity levels will also help with weight loss:

home | Andover parkrun | Andover parkrun

Andover Leisure Centre | Gym & Pool | Places Leisure – Places Leisure – discounted memberships are available if you meet certain criteria, reception can help with this, no appointment needed but you need to fill in an application form.

I Can Therapy Centre – Power Assisted Exercise Facility in Andover