Care Navigation - Hereford Medical Group

Here you will find both local health information, NHS content and a selection of tools for health checks.

Self-Help Information

NHS Healthy Steps

10 Common Ailments

Age Well

Blood Pressure

Contraception

Diabetes

Fear of Flying

Tablets For Fear Of Flying – Why We Don’t Prescribe Them

Patients will sometimes ask our Doctors and Nurses to prescribe Diazepam, or similar drugs like Lorazepam, Temazepam or Clonazepam, to help with fear of flying, or to aid sleep during flights.

This isn’t something that is recommended for the following reasons:

For these reasons, Hereford Medical Group will no longer be providing Diazepam or similar drugs for flight anxiety, including for patients who may have had this prescribed in the past.

Instead please try one of these aviation industry-recommended flight anxiety courses:

Fly and Be Calm™
- Fly And Be Calm™ is an instant download and comes with a money back guarantee (Guarantee does not apply to app versions).6 MP3 tracks which include instructions, the fear removal tool and two hypnotic tracks. The least expensive option, takes very little time, works on the root cause of your problem. If you are not 100% happy you can get a full refund.
Easy Jet – Fearless Flyer
British Airways – Flying with Confidence
Virgin Atlantic – Flying without Fear
Anxiety UK – Fear of Flying

Gender Health

Health Information Video Library

Ingrowing Toenail Surgery Information

Before you come in for the procedure:

Please make sure your feet are freshly washed in preparation!

Wear (or bring) loose-fitting footwear or slippers to wear afterwards as you will have a bulky dressing on your toe.

We strongly advise you to have someone to take you home after the procedure and not drive yourself – you have a legal responsibility to remain in control of your vehicle at all times, and this may be impaired by local anaesthetic effects on your foot. Your vehicle insurance is likely to be affected, meaning if you had an accident you may not be covered.

Make sure that you tell the clinician about any relevant medical problems, drugs and allergies – particularly if you have been started on new medicines recently in hospital for example (eg blood thinners such as rivaroxaban, apixaban, edoxaban, warfarin)

After the surgery:

For the rest of the day of the procedure, rest as much as possible with feet at waist height, use a cushion under your knees to keep your legs slightly bent in order to prevent muscle tension in the back of your legs.

Prepare that your mobility may be reduced for a few days as you may have some soreness, and the dressing on your toe/foot will impact what you can wear on your feet.

Do Not Remove The Surgical Dressing – Slight bleeding is normal.

In case of significant bleeding apply additional dressings on top and elevate the foot, apply pressure if necessary and seek medical attention if the bleeding does not settle.

Please also seek medical attention if you have increasing pain, swelling or redness in the days following your procedure or if you feel unwell.

For post-op pain, take paracetamol based painkillers (not aspirin based)
Do not wear footwear that is too tight and may put pressure on the foot and toes

You will be given a dressing appointment for us to review and redress your toe several days after the procedure.

Please soak your whole foot in warm water for 5 minutes – but leave the dressing on – before you come in for this appointment as this will make the removal of the original surgical dressing easier and more comfortable.

Long Term Conditions

What we do

As your GP surgery we play a significant role in managing your long-term condition. We believe in working with you and specialists in the community to provide holistic, personal, and high-quality care.

Long term conditions or chronic diseases are conditions for which there is currently no cure, and that are managed with drugs and other treatments.

All patients with a long-term condition should have an annual review (or ‘health MOT’). The first part of this is with a health care assistant or a nurse. At this appointment we will take a blood sample, check your blood pressure, and update other health data.

A GP will review your results, looking at your medical history and medications, and consider how together we could improve your health/management of your LTC. This may include health advice, medication changes or referrals to a community service.

Your second contact with us will be to share and discuss the GP’s recommendations with you. This appointment will also be with a healthcare assistant or a nurse. If you have more than one long term condition, we aim to make this second appointment with a nurse or GP.

Coronavirus

Due to coronavirus we had to pause our bringing patient’s in for their annual review. We restarted bringing in patients in May but with minimal contact so to minimise risk. This includes wearing personal protective equipment (PPE), increasing ventilation in the room (so keeping the door open) and keeping the appointment as short as possible.
To keep the appointment short and minimise contact we ask that you complete the ‘Long Term Conditions’ health questionnaire prior to your first appointment.

Minimising risk of coronavirus must be balanced with the risk of not looking after your health, therefore we strongly encourage you to attend if we ask.

Long Term Conditions Health Information

MMR Vaccine

Patient Information on the NHS Steroid Card

Why have I been given this card?

This is a new NHS card. You have been given it because you are currently taking steroids long-term, or at a high dose. Steroids can decrease the ability of your body to deal with stress, trauma, and surgery.

By ‘long-term’ we mean that you are have either been taking steroids every day for at least the last four weeks, or you may be taking regular, shorter courses of steroids.

Steroids can come as tablets, liquids, inhalers, nasal sprays, creams, injections, or rectal applications, and you may be taking steroids in more than one of these ways.

Why is it called an ‘emergency’ card?

It is important that any healthcare professional who may treat you in the future knows you are on long-term steroids and this card will help them give you the right treatment if you ever get sick and have to go into hospital for emergency treatment, or need an operation. It has been introduced because we now know much more about the best way to treat people in the hospital setting who are taking long-term steroids.

I have finished my steroid course, but I have still been given this card – do I need it?

It can take about a year after taking long term or high dose steroids before the ability of your body to deal with stress and illness returns to normal. During this time, you will still need to carry this card.

What do I need to do?

You must fill in the card with your own details. Keep it safe in your purse or wallet. Have it ready to show to any healthcare professional you see. If you ever need to call 999 or 111 then you should follow the advice on the back of the card.

Please let your family know that you carry an NHS Steroid Emergency Card. This is very important if you need emergency treatment, as they can tell the emergency services for you.

The weblink and QR code printed on the card will take any health teams involved in your care straight to further clinical information.

I already have a ‘blue’ steroid treatment card – do I need to keep that, too?

Yes, you will need to keep both for now as they have separate purposes. The blue card tells you to not stop taking your steroids suddenly, whilst the new card will help to ensure you receive the correct treatment if you ever get sick. In the future the two cards may be combined into one.

If you have a ‘medic alert’ bracelet or necklace you should also make sure you wear it and keep any other emergency cards you may have.

Where can I get another card from if I lose this one?

New or replacement NHS Steroid Emergency Cards can be obtained from your GP practice, community pharmacy or hospital or can be downloaded here. You can have more than one card if you would like to store them in different places. However, please make sure the details on both cards are the same.

Where can I get more information?

Call your surgery on: 01432 272 175 and ask to speak to a member of the pharmacy team.

Pain Relief and Pain Management

Respiratory

Our Advanced Respiratory Nurse Practitioner, Kerry, has put together a really useful list of websites and resources to help patients that have respiratory conditions. Take a look below, you can click on the icons to be taken directly to that website:

British Lung Foundation

This is an excellent website for our patients, families and health care professionals to access. There is a patient helpline number and lots of information about all different types of lung conditions. Information can be read on line, printed or ordered, some items do have a cost as this is a charity based project. It has information about dealing with breathlessness, Covid-19 and emotional stress and this is always kept up to date. It also has some useful exercise links to keep us active which is so important if you have COPD
Exercise video

Children

Difficulty breathing and wheeze

Asthma UK

This is an excellent website for people that specifically have asthma – young and old. It has lots of information about how the lungs work, what asthma is, what makes it worse and really useful links to check how good your inhaler technique is.
Inhaler video
A really important part of managing asthma is your personal asthma action plan, this can be printed from the Asthma UK site to discuss with your asthma nurse. Most patients will have discussed this as their annual review

RightBreathe

This is another website that is really helpful when trying to understand how to take your inhaler or what medications are in it

Allergy UK

Allergy UK is a website for people that suffer with allergy symptoms, it contains lots of information regarding triggers and symptoms and how to manage things like hayfever, rhinitis and even anaphylaxis

Sarcoidosis UK

This site is really useful and supportive for people who have been diagnosed with sarcoidosis. It contains lots of accurate and up to date information

Action for Pulmonary Fibrosis

Pulmonary fibrosis is a condition that affects the lung tissue and is very different to Asthma or Chronic Obstructive Pulmonary Disease (COPD). There is lots of incorrect information on the internet regarding this condition. This website was created by patients who felt they needed the support for this condition, it has lots of accurate advice about the condition, how it is diagnosed and how to live well with it

Roy Castle Foundation

Lung cancer is an increasing lung disease and Roy Castle set up this foundation many years ago to support people and families living with it. It has lots of information and advice about the condition, what you may go through and how to manage the condition

Anxiety UK

It is very common for people with respiratory symptoms to become anxious, which can worsen the symptoms and make coping harder. This is a really useful resource to keep control of anxiety and has lovely techniques to manage the situations when they occur

Association of Chartered Physiotherapists in Respiratory Care

This website is from the Association of Chartered Physiotherapists in Respiratory Care. This website has really good links to breathing exercises we encourage for symptoms of breathlessness, keeping breathing under control and helping get sputum shifted easily.

Social Prescribing Service

Spirometry Test

Information and Pre-Appointment Preparation for Your Spirometry Test

If you have been asked to arrange a Spirometry test it is important to take a few minutes to read through the following information and instructions to ensure that a reliable test is taken and an accurate diagnosis can be made.

The Test

The purpose of the test is to determine how well your lungs are working by measuring the amount of air that you are able to breathe in and out, and the total amount of air you are able to exhale in one breath.

During the test you’ll be seated and a soft clip will be placed on your nose to stop air escaping from it. The tester will then explain what you need to do, and you may be asked to have a few practise attempts first.

When you are ready for the test you will be instructed to:

Inhale fully, so your lungs are completely filled with air
Close your lips tightly around the mouthpiece
Exhale as quickly and forcefully as you can, making sure you empty your lungs fully

This will normally need to be repeated at least 3 times to ensure a reliable result. Sometimes, the test may need to be repeated around 15 minutes after taking some inhaled bronchodilator medicine as this can show if you have a lung condition that responds to these medicines.

Overall, your appointment should take approximately 20 to 40 minutes. You’ll be able to go home soon after the tests have finished and return to your normal activities.

Preparation

Before your Spirometry test please avoid:

Vigorous exercise 2 hours before
Eating a large meal 2 hours before
Drinking alcohol 4 hours before
Smoking a cigarette 24 hours before
Wearing tight clothing as that may restrict your breathing during the test
Regarding your inhalers you will receive a letter prior to your appointment with instructions of when you can use them. Please follow these instructions otherwise your results won’t be reliable and we will need to rebook your appointment to have another test

Please contact the surgery if you have experienced any of the following:

Recent chest infection, or taken any antibiotics, in the last 6 weeks
Taken any oral steroids in the last 6 weeks (inhalers and ointments are fine to use)
Recent head, eye, chest or stomach surgery in the last 3 months
Attended A&E in the last 2-3 days
Chest pain on the day of your test
High blood pressure

Any of these can make carrying out the test unsafe for you, so please contact us so we can rearrange your appointment and provide it to another patient.

We will send you a checklist for you to bring along to the appointment, can you please fill out as much as you can just before your appointment starts and bring it along to the appointment. Your clinician will be able to help with any sections you aren’t sure about.

We would like for you to submit 7 days’ worth of blood pressure readings before your appointment so we can assess if it is appropriate to continue with the spirometry test. Please follow to link to submit these readings: Blood Pressure Review

If you find it difficult to manage without your inhaler please use it and make a note of the time. Informing the clinician, who will undertake your test, of any inhaler use will allow for more accurate interpretation of the test.

All other medication should be taken as normally directed by your doctor or nurse.

If you have had a spirometry test in the last 12 months, please contact the surgery to confirm if the test is still necessary.

If you are unable to attend your appointment please contact the surgery as soon as possible so we can offer it to another patient.

If you have any further concerns following this information please contact the surgery to discuss these concerns.

Your Cholesterol

Health Checks

NHS Health Check

Quit Smoking

Drink less