Social Prescribing

Social Prescribing and what you can do to help yourself

Social prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services. Social prescribing, sometimes referred to as community referral, is a means of enabling GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services. Recognising that people’s health is determined primarily by a range of social, economic and environmental factors, social prescribing seeks to address people’s needs in a holistic way. It also aims to support individuals to take greater control of their own health. (Taken from the Kings Fund description of Social Prescribing)

We always advocate that patients and carers should have full access to their GP electronic health records to gain a better understanding of their healthcare needs alongside social prescribing so that you can get the best from what the community offers as well as getting the best from the practice. Over 8000 patients now have full access to their electronic health records in the practice and this is growing. 

The practice website is a great resource for trusted information about what is available in the practice for you and your family as well as in the local community and wore widely across Greater Manchester and the UK. Please look at the resources here and contact the practice if you need further help. Many of the resources available here can be accessed without needing to see the GP or nurse. Please go ahead, look at what is available here and if you need help contact them directly! You don’t always need a doctor to give you permission to find out more for yourself! 

Here are other resources on what is self care too that you may find helpful and things you can do to help yourself! Don’t forget there is Time to Talk, a drop in session also on the 3rd Tuesday of every month or you can contact the Patient Participation Group htmcppg@gmail.com to find out more.

Diversity Matters North West Ltd. (diversitymattersnw.org.uk)
Haughton Green Centre (tameside.gov.uk)

Learn about your health

Register now with Bangla support as well for anybody who would like to learn more about your own health and getting the best from the services around you. This is a service delivered in partnership with Haughton Thornley Patient Participation Group and Diversity Matters Northwest

Action Together

  • Lack of social contact / loneliness
  • Over-reliance of medical appointments
  • Low mood
  • Low self esteem / loss of confidence
  • Bereavement
  • Unpaid carer

Learn more about Action Together

Ask your GP to refer you to our Social Prescriber Bernie Connor who can come and visit you at home and see what may help you most

Active Tameside / Live Well Tameside

  • Increase activity through tailored programmes and ongoing support for 12 months
  • Improvements to blood pressure, weight loss, heart and lung health
  • 57% feel fitter; 41% have better sense of wellbeing; 31% feel more confident, 29% lost weight; 22% made new friends; 20% reduced pain; 9% less reliant on medication
  • 70% adherence rate
  • Free or discounted sessions available
  • Make sure you can log into your electronic health record so that you can share your medication list (or have a copy of all your medications if not online). We always recommend you should have access to your records if possible

Can self refer to 0161 366 4860 but may need to get confirmation from GP that activity is appropriate. Please check with GP if you would like to be referred and think you may qualify

Age UK (for over 50s)

  • Benefits advice – pensions, council tax support, budgeting
  • Falls service – “Best Foot Forward”
  • Carer’s support
  • Bereavement
  • Social activities
  • Help with shopping or getting out and about
  • Dementia groups 

Self referral to Age UK, 131 Katherine Street, Ashton-under-Lyne 0161 308 5000 info@ageuktameside.com More details at www.ageuk.org/tameside

Be Well Tameside

  • Social isolation / loneliness / low level anxiety
  • Smoking cessation
  • Alcohol interventions
  • Weight management (group or individual programmes)
  • Being more active
  • Improving sleep
  • Feeling better about yourself 

Self Refer: 0161 716 2000 or bewelltameside@nhs.net

Initial telephone consultation / triage with Julie Havern at her Wednesday clinic at Donneybrook surgery

Being There

  • Support for those with a life limiting illness
  • Befriending
  • Transport to hospital
  • Social activities

Self refer to Suzanne Roberts 0161 217 1373 or tameside@beingthere.org.uk

Bowel Cancer Screening (for over 60’s)

  • 98% of people will survive if this cancer is found early

Learn more about the Greater Manchester Bowel Screening programme 

GPs & our Cancer Champions are happy to deal with any questions you may have

Cancer Warriors

  • Support for those living with a cancer diagnosis
  • Practical help with day to day demands and treatments
  • Based in Stalybridge

Self refer: 07533 915061

Dementia Support

  • Dedicated support workers for Hyde Neighbourhood
  • Must have dementia diagnosis

Ask your GP to refer you for further support available via Alzheimer’s Society

Diversity Matters North-West

  • Peer mentoring for Bengali & Pakistani women
  • Volunteering opportunities
  • Training for women to improve employment chances
  • Health, social and exercise activities
  • Help to access record online
  • Men’s badminton
  • Regular coffee mornings / lunches etc
  • Bengali, Urdu & Punjabi speakers

Tel: 0161 368 3268 Mon – Thur 9am – 5pm; Fri 10am – 4pm

Macmillan Cancer Support

  • Support and advice including welfare rights & benefits
  • Online community
  • Financial support for families and patients
  • Office at Tameside Hospital – drop in
  • Practical help
  • Volunteering opportunities

Self refer: drop in at Tameside Hospital or ring David Banks 0161 922 5644

Safe & Well

  • Part of Greater Manchester Fire Service
  • Home visits for smoke alarm fitting, home security, fire safety, home safety
  • Can refer direct to Social Services and other local services
  • Make pro-active visits to whole neighbourhoods
  • Can provide risk reduction equipment

Self refer 0800 555 815 or contact@manchesterfire.gov.uk

Slimmin’ Without Women

  • Men’s health & wellbeing
  • To tackle men’s obesity in a male only environment
  • Weigh in / share hints & tips
  • Optional activity sessions

At The Grafton Centre, Grafton Street, Hyde SK14 2AX

    Starts 28/6/18, then every Thursday 4pm – 6pm

Or at Best Foot Forward Studio, AGE UK Tameside, 131 Katherine Street, Aston-under-Lyne OL6 7AW

    Starts 27/6/18, then every Wednesday 2pm – 4pm 

Self refer to 07919 917612 or info@slimmingwithoutwomen.com

www.slimmingwithoutwomen.com

Facebook: SWWCIC Twitter: @SWWCIC

Tameside Pulmonary Fibrosis Support Group

  • Support for patients and families living with pulmonary fibrosis
  • ·Regular group meetings for friendship / support

Self refer: Clive Green 07533 802620 or greenandbearit@tiscali.co.uk

Ischaemic Heart Disease Care

Information for those affected by heart and circulatory diseases | BHF
Cardiac Risk in the Young – Young Sudden Cardiac Death – Cardiac Risk in the Young (c-r-y.org.uk)

Helping patients with ISCHAEMIC HEART DISEASE (heart disease) to get the best out of the NHS.

You may ask why?

The most recent patient survey has shown that patients want to be able to see the clinician sooner (i.e less than 2 weeks) and on time (i.e not have to wait an hour for a scheduled appointment) and feel that all their concerns have been met. It has been independently confirmed that the practice already offers more appointments than the average to its patients. 

So how can we meet the demand?

Being prepared for the consultation greatly helps as does recognising the length of the appointment slot and helping the clinician to stay within the time limit.  

What condition do you suffer with?

The term Ischaemic Heart Disease denotes anybody that suffers with angina or has had a heart attack (myocardial infarction) or has had angioplasty or even coronary artery bypass surgery. It is sometimes also referred to as Coronary Heart Disease. Even if you do not suffer any symptoms now, if you have had any of the above then you suffer with Ischaemic Heart Disease and should find this term in your GP-held record. 

What does that condition mean?

Here are some links for heart disease that you may wish to see: 

What help is available for you to use?

This condition is primarily managed by the nurses unless you are suffering with symptoms. They can check your blood pressure readings, order tests and review them, check any problems you may be encountering and do a medication review for you. They can also advise on things you may wish to consider and discuss things that you may have learned during your journey of discovery. The health care assistants can check your height and weight and do any blood tests you may need as well as check your urine sample. Doctors can see patients whose symptoms are not getting under control or if you are having difficulties due to possible side effects. There is a blood pressure machine in the waiting room for you to check your blood pressure whenever you come to the practice. 

What does the condition mean for you?

You need to know what your target blood pressure and target cholesterol (less than 5 mmol /l) and LDL (less than 3 mmol/l) should be and what other risk factors you have that need to be managed eg whether you smoke or not or if you are obese or whether you suffer with diabetes or raised cholesterol. You also need to know what is expected of you in the course of a year even if your blood pressure and symptoms are well-controlled. Finally you can monitor your own blood pressure, weight and smoking status and blood tests and urine test as a way of seeing how you are doing. This information should be in your GP-held record for you to see. 

What needs to happen now and in the future?

The typical patient with ischaemic heart disease which is well controlled needs the following: 

  • Fasting blood tests and urinalysis once a year with the healthcare assistant– checking their kidney function (Sodium, Potassium, Urea, Creatinine and eGFR), Liver function tests, lipid profile (Cholesterol, HDL, LDL, triglycerides) , diabetes status (glucose) and urinalysis (dip stick urine checking for protein and blood) 
  • Blood Pressure reading at least twice a year 6 months apart. You can do this on your own! This is the minimum needed but you are encouraged to do this more often by using the practice blood pressure machine in the waiting room or buying a blood pressure machine yourself so that you can monitor it at home / work yourself. The local pharmacies all sell reasonably priced blood pressure machines and can give you more details about them. 
  • Medication Review twice a year usually with the nurse unless you are told otherwise

What can you do to help?

As this is a new way of working, it is worth discussing this with the nurse to see how this can be done the first time you decide to take control. 

  • Get access to your GP-held record. Without knowing what is in your records and what you need to do, it will be very hard to know what to do when and with who. This is an essential first step for anybody with any condition or who wants the best from the practice. 
  • Ideally we want you to book in with the healthcare assistant for fasting blood tests and urine test if you have not had them done for 12 months or prior to your next medication review. At the same time, ask to book in with the nurse a week later. The nurse will check your records and book you in for you. (This is because the nurse needs to check who is the most appropriate person to do the medication review dependent on what else you may also suffer with). 
  • Remember to ask for a yellow topped urine bottle from the receptionist which you can bring with you when you have your blood tests. You can do this when you turn up to the surgery and are waiting for the healthcare assistant or bring it with you. 
  • Bring your blood pressure readings with you to show to the nurse or doctor if you have been checking them at home. 
  • Record your blood pressure twice a day for a week and then take an average of your readings. Write your readings down and bring them with you when you see the nurse / doctor. 
  • You can download a form here for you to use.
  • Look at the web page – pre-consultation care – and go through it prior to your review with the clinician. This can help us to understand your needs better and what you want out of the consultation. If there are no specific issues AND all the tests are normal and you are well-controlled, it may even be possible to conduct the medication review over the telephone. This must be with the agreement of the clinician and if you are happy with this. We think many people may benefit from this but we do not want to prevent anybody from coming to the surgery of they so wish.. Understanding your needs is key to a successful outcome of the medication review. See the above mentioned websites to help you to understand what your needs are. Initially you may need the clinician to help you understand how to look at the websites and what they mean for you.

How are we doing?

The Quality Outcomes Framework was set up so that practices can look at how successful they are in delivering services to their practice population and also give an opportunity to see how we compare with others around the country. This data is readily available from here (http://qof.hscic.gov.uk/search/index.asp) our postcode is SK14 1JY. Overall we got 1000 points out of a maximum of 1000 last year indicating that we are a very high performing practice across the board which is reassuring for you and us. But you can help us do even better because there are still things  that are missing. Perhaps you could look at your own record and check if we have done everything for you that we should and ask why not if you find a discrepancy. It’s in your interests to get the best treatment and that’s why we want you to check you are getting it!

How can you help us do even better and help other patients too?

This is very important. In your journey of discovery about your health, you may come across odd things that do not make sense about the way the practice runs and you may have a better suggestion. Or you may come across something new that we have not considered that helps you even more. Tell us about it next time you see a clinician or preferably write it down and hand it in or send it as a comment to the Patient Participation Group (PPG) so that they can bring it up with the practice the next time we meet up. Even better, why don’t you join the PPG and become an active member. We are always on the look out for new members and new ideas. 

Instead of having to come to the surgery 5 times a year to check your blood pressure (x2), check blood tests and urine test (x1) and get your results of the blood tests and have a medication review (x2 if you are lucky – x4 if this is not done at the same time), you may find that you only need to come once for the blood tests and urine test and the other things could be done over the telephone as long as everything is normal. That frees up 4 appointments that others could use! This means more appointments available for patients that are more focused for your needs within the time allocated.

By working together and understanding each other’s needs better, we can help you to get the best out of the practice and the wider NHS.

Immunisations

girl getting vaccine

It’s official – vaccines are amongst the safest medicines available! Vaccines save lives – read here about why vaccinations are important and the safest way to protect yourself and your loved ones. Listen to Dr Rupa Shah talk about Vaccines – are they safe for my child reinforcing how important vaccines are.

Learn about vaccines here

NHS Choices: The NHS Vaccine schedule and all you need to know about each of the vaccines

Learn about different vaccines available on the NHS here

Immunisation tips for parents

Haughton Thornley Medical Centres strongly recommends all people to have their vaccinations as soon as they are due. The tables below show the variety of vaccines people need at different stages in your life. It is important you understand why you need them, what you are protecting yourself and your loved ones from and that the decisions you make not only impact on you but also all those around you too. If you have any concerns then please raise them with your doctor or nurse. 

We also recommend you should have access to your records so that you can check your immunisation history and share it with others if asked to do so. This is particularly useful for people who may be at risk of life-threatening conditions. Remember people outside the GP practice are unable to see this information and rely on your memory or for you to share this information with them. This is particularly important when you are seen in the Out of Hours, walk in centres, A&E or even when calling 111. Please scroll down to the bottom of this page for screenshots of the test patient to see what the information looks like. 

See the schedule of what is needed below – click on the table to download a PDF version which may be easier for you to read too. 

Immunisation against infectious disease: the green book front cover and contents page. The green book has the latest information on vaccines and vaccination procedures for all the vaccine preventable infectious diseases that may occur in the UK. First published in 2006 as Immunisation against infectious disease, this publication is now available as individual chapters via the Immunisation section of the GOV.UK website and not in printed form. These chapters are updated as necessary to reflect the current policies and procedures as advised by the Joint Committee on Vaccination and Immunisation.

Table taken from patient.co.uk where you can find more information.

MMR (measles, mumps and rubella) vaccine – NHS (www.nhs.uk)

View your Immunisation History and check you and your loved ones are up to date!

Click here if you would like to sign up for access to your records now and you are a patient of Haughton Thornley Medical Centres. You will need to complete the Records Access and Understanding safety checklist questionnaire

Eczema care

Helping patients with ECZEMA to get the best out of the NHS.

What condition do you suffer with?

Eczema refers to dry skin often found inside your elbow or on the back of your knees but can also affect other parts of your body as well.

What does that condition mean?

Here are some links to websites with useful information on eczema that you may wish to see:

What help is available for you to use?

This condition is primarily managed by the nurses and doctors. They can check how your eczema is going and whether you are using sufficient emollients and creams and using other medications to control the condition. There are also Specialist Dermatology Nurses based in Hyde who can also see you if your eczema or your child’s eczema is particularly problematic.

What does the condition mean for you?

You need to know what all the different treatments are that your doctor has prescribed and how much to use of each. Often patients and their families get used to itching all the time and having disturbed sleep. It is important that you find out what you should do especially if you are not sure. We can only help you if you tell us so. This information should be in your GP-held record for you to see.

What needs to happen now and in the future?

The typical patient with eczema which is well controlled needs the following:

  • Make sure all your emollients, bath oils, and anti-histamines are on repeat prescriptions are so that you can order them as soon as you need to.
  • If a cream or ointment does not suit you then you must see a doctor to have it changed. You need to be in control of your treatment otherwise the condition will control you.
  • Medication Review twice a year usually with the nurse unless you are told otherwise

What can you do to help?

As this is a new way of working, it is worth discussing this with the nurse to see how this can be done the first time you decide to take control.

  • Get access to your GP-held record. Without knowing what is in your records and what you need to do, it will be very hard to know what to do when and with who. This is an essential first step for anybody with any condition or who wants the best from the practice.
  • You need to know what the different medications are. In particular if you are prescribed any steroid cream then it should be the lowest strength and applied with the correct amount for the least amount of time necessary. Your doctor can help you to understand this as well as the websites above.
  • Look at the web page – pre-consultation care – and go through it prior to your review with the clinician. This can help us to understand your needs better and what you want out of the consultation. If there are no specific issues AND all the tests are normal and you are well-controlled, it may even be possible to conduct the medication review over the telephone. This must be with the agreement of the clinician and if you are happy with this. We think many people may benefit from this but we do not want to prevent anybody from coming to the surgery of they so wish. Understanding your needs is key to a successful outcome of the medication review. See the above mentioned websites to help you to understand what your needs are. Initially you may need the clinician to help you understand how to look at the websites and what they mean for you

Instead of having to come to the surgery lots of times a year to get high dose steroid creams that could be harmful to your skin long term, once you have understood what eczema is and what advice your doctor or nurse are giving you by reading your GP-held electronic health record, you may find that your skin improves greatly, whilst you are using less steroid cream and sleeping better as a result of not itching as much. If your child is the patient then not only does he or she or sleep better but so do you and of course spend less time at the surgery.

Most importantly, by working together and understanding each other’s needs better, we can help you to get the best out of the practice and the wider NHS.

New-born Baby Care

Congratulations on your new-born baby. It is a very exciting time but can also be scary for parents who are unsure what to do next or what challenges. So here are some simple tips for you and your baby to get the best from the practice.

Hopefully you already have full access to your own GP electronic health record and can see what your doctor or nurse has written about you. If you have registered your baby then why not also register for you to be able to see their electronic health records too. You can then also see what their doctor or nurse has written about them. For many babies, the first consultation can often be the 8 week baby check-up as part of your baby’s health and development reviews when they also get their first immunisations too. Why not register your baby so that you can see what the doctor or nurse have written and also check what immunisations they have had. If you have not yet done so then please complete the Record Access and Understanding Safety checklist questionnaire . You will need to have registered yourself on Patient Access and use this to get proxy access so that you can use your passwords to access their records with (if you have parental responsibility).

Worried about your child (aged 3 months and over)?
National :: Healthier Together (what0-18.nhs.uk)
FOR PARENTS A SPECIAL COVID-19 MESSAGE
From Bump to Breastfeeding | Best Beginnings

Your new baby

When your baby arrives, you can find advice on baby care, including:

Plus:

Feeding, teething and tantrums

Netmums

Healthy Eating in Pregnancy

Want to share your pregnancy and baby experiences?

Connect with others who can offer practical and emotional support about any pregnancy and baby issues on the HealthUnlocked NCT forum.

Best Beginnings
WHEN SHOULD I WORRY? – Your guide to Coughs, Colds, Earache & Sore Throat
Netmums: The UK’s Most Inclusive Parenting Community
Baby Buddy 2.0 | Join Us (babybuddyapp.co.uk)
Get help to buy food and milk (Healthy Start)
Babies: The First Year Archives – Infant & Toddler Forum (infantandtoddlerforum.org)
APNI – Association for Post-Natal Illness | Post Natal Depression

Click on the links below to learn more

Pregnancy Care

This guide includes all you need to know about trying for a baby, pregnancy, labour and birth.

Pregnancy – NHS

Pregnancy – NHS (www.nhs.uk)
Calculate your Expected Date of Delivery
Vitamins, minerals and supplements in pregnancy – NHS (www.nhs.uk)
Pregnancy and coronavirus (COVID-19) – NHS (www.nhs.uk)
Antenatal care – uncomplicated pregnancy | Health topics A to Z | CKS | NICE
Where to give birth – Which?
Best Beginnings
Netmums: The UK’s Most Inclusive Parenting Community
APNI – Association for Post-Natal Illness | Post Natal Depression

Medicines in pregnancy

Most medicines taken during pregnancy cross the placenta and reach the baby.

Before taking any medicine when you’re pregnant, including painkillers, check with your pharmacist, midwife or GP that it’s suitable.

When deciding whether to take a medicine during pregnancy, it’s important to find out about the possible effects of that medicine on your baby.

This is the case both for medicines prescribed by a doctor and for medicines you buy from a pharmacy or shop.

Learn more here from NHS Choices

We invite all pregnant women to get full access to their GP electronic health record so that they can monitor their healthcare needs and also learn how to use the NHS app before their baby is born. It will help you as your baby grows

DR Amir Hannan
pregnant woman in blue dress holding blister pack
BUMPS – Medicines in Pregnancy

Evidence-based safety information about medication, vaccine, chemical and radiological exposures in pregnancy

Helping our patients who are PREGNANT to get the best from the practice, the NHS and other resources you might find useful.

You may ask why? 

The most recent patient survey has shown that patients want to be able to see the clinician sooner (i.e less than 2 weeks) and on time (i.e not have to wait an hour for a scheduled appointment) and feel that all their concerns have been met. It has been independently confirmed that the practice already offers more appointments than the average to its patients.

So how can we meet the demand? 

Being prepared for the consultation greatly helps as does recognising the length of the appointment slot and helping the clinician to stay within the time limit.  

What do you need to see in your record? 

Pregnancy is not a condition but a normal part of life. So this page is to help you and your fetus get the best start in life. Ideally this means that you read these pages even before you decide to try for a baby as there are many things you can and should do before you even start to try to conceive. At this stage, your GP-held electronic health record should say Trying to conceive. Once you do find yourself pregnant, your GP-held electronic health record should say Patient Pregnant. If you are not sure whether you want to continue with the pregnancy then you must ring 0161-367-8800. You do not need to wait to see the doctor or the midwife to access this service. 

What does that mean?

Here are some links for pregnancy that you may wish to see: 

What help is available for you to use? 

Pregnancy is primarily managed by the midwives under a shared care scheme with the doctors in the practice. 

  • The pharmacist knows exactly what medication or over the counter remedies are safe and what is not. Ask if you are not sure. 
  • The websites listed above will give you lots of information to help you get to a flying start and help you to ask the questions that matter to you when you see your midwife or doctor. (Please let us know if you find other resources that our patients could benefit from). 

What does pregancy mean for you? 

This is easier said than done. Every pregnancy and every baby is very unique. Even before you try to conceive it is important that you modify your lifestyle and check what you can and should take and what you should not. If you are on prescription medication or taking over the counter remedies including certain painkillers or perhaps herbal remedies then it is important to check whether it is safe to take these when you are pregnant. Often you and your partner will go through a multitude of emotions and experiences as soon as you find out that you are pregnant. Sometimes you may be confused and want to speak to a trained professional who can understand your needs better especially if you do not think you are ready for a baby just yet. You need to know that you do have time to make decisions and there are always choices and help available for you to make them. 

What needs to happen now and in the future? 

The typical pregnant person needs the following: 

  • Whilst most people wish to carry on with the pregnancy, some people may not. It is important to try to clarify this. 
  • Regular appointments with the midwife in the practice with some in the hospital at appropriate times. Your midwife will keep you informed. 
  • During the appointments, your midwife will do routine blood pressure checks, urine tests and check for any ongoing issues or new problems as and when they arise. 

What can you do to help? 

As this is a new way of working, it is worth discussing this with the midwife to see how this can be 

  • Get access to your GP-held record. Without knowing what is in your records and what you need to do, it will be very hard to know what to do when and with who. This is an essential first step for anybody with any condition or who wants the best from the practice. 
  • Bring your blood pressure readings with you to show to the nurse or doctor if you have been checking them at home.
  • Look at the web page – pre-consultation care – and go through it prior to your review with the clinician. This can help us to understand your needs better and what you want out of the consultation. 

Obesity Care

There are lots and lots of theories on how to lose weight and claims on the best way to do this. Here we try to provide advice on what is available locally to help you and what you can do for yourself too!

How obese you are is currently determined by your Body Mass Index. You may find this in your medical record or you can calculate it based on your height and weight. Adults with a BMI of 25-29.9 are classed as overweight. BMI over 30 are obese. BMI over 35 are very obese and BMI over 40 are morbidly obese.

You can calculate your BMI

Here are some useful links for further information on obesity and what can be done about it

NHS Choices: Obesity

NHS Choice: Lose weight

Patient.co.uk (Obesity and overweight in adults)

Patient.co.uk (Obesity and overweight in children)

See Be Well Tameside and get 1:1 support to help motivate you to lose weight

Article in the Washington Post – Take off that FitBit. Exercise alone won’t make you lose weight by Dr Aseem Malhotra.

What we SHOULD be eating every day (according to the Government) | Daily Mail Online

Your doctor or nurse can help you to devise a personalised plan that can help you

You can get 1:1 training and support to lose weight via Be Well Tameside. This is how you can also access further care potentially leading to weight losing surgery as well.

Personal Trainer from Active Tameside

Ask questions from other people via HealthUnlocked Blog

Many patients do not realise they are overweight or obese because so many people suffer with it without realising it. You need to know your Body Mass Index and Waist Circumference. Often obesity can be associated with other complications including diabetes, cardiovascular disease, osteoarthritis, depression, stroke, abnormal liver tests, gall bladder disease, sleep apnoea, certain certain cancers and hypertension. Many of these things can be reversed or their impact reduced by reducing your weight. Assuming there is no specific underlying medical cause, your weight is ultimately dependent on the types and quantity of food you eat and the amount of exercise you do.

It is important to monitor your weight. Agree goals with your doctor or nurse which have SMART objectives (Specifiic, Measurable, Achievable, Realistic and Timely). That way you can see how well your strategies are working and whether they need to be reviewed or not. If you are over 40 then you should have an NHS Health Check done every 5 years. That will give you a baseline to start from. Then see if you can make small changes in your lifestyle that you are able to adopt. Your doctor or nurse will be able to inform you about what else you need to do over the coming year if you have other related conditions that also need to be managed.

Screenshot
You can use the My GM Care app to record your weight and set your Goal enabling your clinicians looking after you to also see this

Make a plan to help lose weight

  • Agree a care plan with your doctor or nurse which includes regular monitoring of your weight
  • Agree small changes in your weight that you hope to achieve over the next few weeks and how you hope to achieve them.
  • Agree changes in your diet and exercise that you hope to achieve. Making small changes rather than wholesale change is more likely to succeed in the long run.
  • Make a note of your weight so that you can see what is happening over time.
  • Make notes on what is helping you and also what is hindering you. These are personal to you but which will provide insights now and in the future on how to make the necessary changes for you to succeed.
  • Do not be disappointed if you do not get the expected reduction in weight as you hoped for,
  • See if you can get your family and friends to join you. They will help to motivate you too and we all need a little help (even if you are the one motivating them too!)
  • Have a lot of fun and be happy. Imagine how much your weight would be if you did not do what you are doing now!

Hypertension Care

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

High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes.

Around a third of adults in the UK have high blood pressure, although many will not realise it.

The only way to find out if your blood pressure is high is to have your blood pressure checked.

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.

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

As a general guide:

  • high blood pressure is considered to be 135/85 mmHg or higher (or 145/85 mmHg or higher if you’re over the age of 80) when measured at home
  • ideal blood pressure is usually considered to be between 90/60mmHg and 120/80mmHg

Blood pressure readings between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you do not take steps to keep your blood pressure under control.

Everyone’s blood pressure will be slightly different. What’s considered low or high for you may be normal for someone else.

Listen to Dr Hannan talk about checking your blood pressure and how to measure it

You can record your own blood pressure readings using the “My GM Care app” Download it for FREE now

How to measure your blood pressure at home.
Click here to learn everything you need to know to check your blood pressure safely

Blood Pressure UK

Learn more about the

Do you need to check your blood pressure?

If you are at risk of developing high blood pressure or already have high blood pressure and take medication for this or take medication that could cause your blood pressure to rise or have diabetes, heart disease, had a stroke, have chronic kidney disease, suffer with headaches then it is important that you monitor your blood pressure. Many people would usually come to the GP practice to check their blood pressure. However, you may wish to consider buying a blood pressure machine so that you can safely monitor your blood pressure and pulse too in the comfort of your own home and also measure it over a week. It also means other family members and friends can also use it to check their own blood pressure too.

The price of blood pressure machines has dropped and you can buy a good one from about £19.99. If you plan to buy one, please ensure it is clinically validated.

Ideally you should check your blood pressure 3 times,waiting 1 minute after checking your blood pressure each time and then noting down the lowest readings of the 3.

Repeat this again twice a day for a week

Take an average of the top readings and the bottom readings so that you have an average blood pressure reading over the week.

This gives us a better understanding of what your blood pressure is like

If your blood pressure is very high (more than 180/120) then you should get in touch with the surgery sooner or call 111

Helping patients with HYPERTENSION (High Blood Pressure) to get the best from your doctor and the NHS.

What does Essential Hypertension mean?

95% of patients with high blood pressure suffer with Essential Hypertension which means “high blood pressure of unknown cause”. A few patients develop Hypertension for another cause which you can find in your GP-held electronic health record.

Further links to understand hypertension and how to lower it

Here are some links for hypertension that you may wish to see:

GM-Hypertension-Pathway-V9.2-FinalDownload

Who in the practice can help you ?

This condition is primarily managed by the nurses. They can check your blood pressure readings, order tests and review them, check any problems you may be encountering and do a medication review for you. They can also advise on things you may wish to consider and discuss things that you may have learned during your journey of discovery.

The health care assistants can check your height and weight and do any blood tests you may need as well as check your urine sample.

Doctors can see patients whose blood pressure is not getting under control or if you are having difficulties due to possible side effects.

There is a blood pressure machine in the waiting room for you to check your blood pressure whenever you come to the practice or you can monitor your blood pressure at home.

What else can you do to help?

You need to know what your target blood pressure should be and what other risk factors you have that need to be managed eg whether you smoke or not or if you are obese or whether you suffer with diabetes or raised cholesterol. You also need to know what is expected of you in the course of a year even if your blood pressure is well-controlled. You should monitor your own blood pressure, weight and mood at home and store your readings in the “My GM Care app“. You can also check you weight and smoking status, blood tests and urine test via your NHS app (or equivalent) to see what information we have about you and any advice your doctor or nurse has provided you. Use this web resource to get the best from the practice and learn what blood pressure means too.

What needs to happen now and in the future?

The typical patient with hypertension which is well controlled needs the following:

  • Fasting blood tests and urinalysis once a year with the healthcare assistant– checking their kidney function (Sodium, Potassium, Urea, Creatinine and eGFR), Liver function tests, lipid profile (Cholesterol, HDL, LDL, triglycerides) , diabetes status (glucose) and urinalysis (dip stick urine checking for protein and blood)
  • Blood Pressure reading at least twice a year 6 months apart. You can do this on your own! This is the minimum needed but you are encouraged to do this more often by using the practice blood pressure machine in the waiting room or buying a blood pressure machine yourself so that you can monitor it at home / work yourself. The local pharmacies all sell reasonably priced blood pressure machines and can give you more details about them. You can store your readings on the “My GM Care app“
  • Your smoking status updated
  • Medication Review twice a year usually with the nurse unless you are told otherwise

What can you do to help?

  • As this is a new way of working, it is worth discussing this with the nurse to see how this can be done the first time you decide to take control.
  • Get access to your GP-held record via the NHS app or equivalent. Without knowing what is in your records and what you need to do, it will be very hard to know what to do when and with who. This is an essential first step for anybody with any condition or who wants the best from the practice.
  • Ideally we want you to book in with the healthcare assistant for fasting blood tests and urine test if you have not had them done for 12 months or prior to your next medication review. At the same time, ask to book in with the nurse a week later. The nurse will check your records and book you in for you. (This is because the nurse needs to check who is the most appropriate person to do the medication review dependent on what else you may also suffer with).
  • Remember to ask for a yellow topped urine bottle from the receptionist which you can bring with you when you have your blood tests. You can do this when you turn up to the surgery and are waiting for the healthcare assistant or bring it with you.
  • We calculate your risk of having a heart attack in the next 10 years by using the QRisk score (www.qrisk.org) . This takes account of your age, post-code, sex, diabetes, status, smoking status, blood pressure and Cholesterol: HDL ratio. If the risk is greater than 20% then you will need to start a statin therapy (eg simvastatin) as well as dietary advice to help lower your cholesterol level. You can see your QRisk in the values section of your GP-held electronic health record. For patients with just hypertension (ie not diabetes or ischaemic heart disease), we use this score as a way of determining whether you need to be on a statin or not. Click here for further details about statins.
  • Show your blood pressure readings via the “My GM Care app” or ask your doctor or nurse to check themselves the readings if you have been checking them at home. They can view the readings via the GM Care record that they have access to also.

Heart Failure Care

Heart failure means that your heart is not able to pump blood around the body properly. It usually occurs because the heart has become too weak or stiff. 

Common symptoms of heart failure include fluids retention (swelling of the ankles or legs), breathlessness (especially when lying flat) and extreme tiredness

It does not mean that it is about to stop. However symptoms can be controlled for many years.

Who can help you manage your heart failure?

  • Your practice nurse will usually be your key clinician who monitors your health annually
  • Your GP can help too if your symptoms are worsening or you are not responding as well to treatment
  • You may need to be referred to a cardiologist or other specialist if symptoms continue to worsen

What can you do to help yourself?

  • We recommend all patients with heart failure should have full access to their electronic health records. This allows you to read what your doctor or nurse has advised and also to share this if you like with others including your family and also if you ever need to be seen by other health care or other professionals whom you trust eg Out of Hours, A&E or if you ever get admitted into hospital. Remember only you can have full access to your electronic health records and hence only you can share this with others if you wish to with those whom you trust. 56% of patients with heart failure could do this (correct on 27th January 2019). Here are the latest figures for now. 
  • It is important NOT to smoke and to improve your lifestyle by eating a healthy diet and exercising regularly. Contact Be Well Tameside or ask your doctor or nurse if you would like help
  • Make sure you take your medication regularly and on time. Online services can really help by ensuring you order your prescriptions on time regularly. The Evergreen Life app also allows you to set notifications on your smartphone to remind you when it is time to take your medication and you can even record when you have taken it to remind yourself in case you are unsure! 
  • Learn about Heart Failure
  • Know your numbers! You should know what your usual blood pressure, pulse and weight is.
  • Buy a blood pressure machine so that you can monitor your blood pressure and pulse at home. Clinically validated blood pressures can cost from £19.99 if you shop around. Your pharmacist may be able to help you find the right machine based on your needs
  • Learn how to check your blood pressure including
  • Monitor your weight. Get digital scales if you can so that you can accurately weigh yourself using the same scales and in the same conditions each time. A change in weight may suggest you are retaining fluids or losing too much and may give an early warning something is not right.
  • Ensure you have blood tests and your urine checked at least once a year – you can monitor your blood tests by looking at your electronic health records and checking when they were last done and whether it is well-controlled or not. (Your nurse or doctor can advise you on what the normal values should be for you. Watch this video to learn more about understanding your blood test results).
    • Kidney function (Urea, Creatinine, eGFR)
    • Lipid profile (Total cholesterol, HDL, LDL, triglycerides)
    • Diabetes status (HbA1c)
    • Liver function tests 
  • Check for anxiety and depression. Patients can often begin to feel anxious or depressed. We can all have an “off day” occasionally but if you find you are constantly feeling low or anxious then please speak to your doctor or nurse
  • Make sure you have your flu jab.
  • Make sure you are taking the right medication and are on the right dose. Most patients with heart failure should be prescribed and ACE Inhibitor as well as a Beta-Blocker:
    • an ACE Inhibitor or Angiotensin II antagonist. This should ideally start at a low dose and gradually increased to the maximum tolerated dose (without your blood pressure falling too low or getting side effects such as a persistent cough with the ACE Inhibitor). Ask your doctor or nurse if you are on the maximum tolerated dose 
    • Beta-blockers. This should ideally start at a low dose and gradually increased to the maximum tolerated dose (without your blood pressure falling too low) Ask your doctor or nurse if you are on the maximum tolerated dose 
    • Loop Diuretics otherwise known as “water tablets”
    • Mineralocorticoid / Aldosterone receptor antagonists eg spironolactone / eplerenone
    • Others eg digoxin, anticoagulant therapy or ivabradine
    • Consider if you should be on an anti-platelet drug eg aspirin or clopidogrel
    • Consider if you should be on a statin  

Pumping Marvellous

Click here to download the Heart Failure Toolkit 
Listen to Nick Hartshorne-Evans from Pumping Marvellous talk about Heart Failure and his own experience
Your daily guide to living with Heart Failure
Full Marvellous Guide to Heart Failure

Diabetes Care

If you have recently been diagnosed with diabetes or would like to know more about diabetes and what you can do to help yourself  then please see the information below. Click on Type 1 diabetes, Type 2 Diabetes or  Diabetes and Me for general information from Diabetes UK. Please see below for more specific information about how we as a practice are supporting you and what is available locally as well. 

What is diabetes?

Type 1 diabetes

About 8% of people with diabetes in the UK have type 1 

What is type 1 diabetes?

Insulin and diabetes. Some positives of type 1 diabetes. My child has type 1 diabetes. Coping with type 1 diabetes. Not sure where to start with type 1 diabetes – try the Learning Zone today

Type 2 Diabetes

About 90% of people with diabetes in the UK have type 2 diabetes.

Newly diagnosed with type 2 diabetes? What is type 2 diabetes? I have type 2 diabetes – what can I eat? Some people can reverse type 2 diabetes – want to find out more? How do I treat my diabetes?

Sandeep has been supported by others since his type 2 diagnosis in 2015. Not sure where to start with type 2 diabetes – try the learning zone today

Learn more about how to best manage type 2 diabetes here

Diabetes and Me

Your relationship with diabetes is personal, so your experience on the Diabetes UK website should be too. That’s why they have created Diabetes and Me, so you can save useful information, your favourite recipes and anything else you’re interested in.

Blood glucose testing

Watch this video which shows how to test your blood glucose levels if you have been given the GlucoMen Areo – How to test with the GlucoMen Areo blood glucose meter

You will need to know what type of diabetes you have. If you are unsure then please log into your electronic health record and see what is in your Problems List where it should state whether you have type 1 diabetes or type 2 (or diet controlled diabetes or non-Insulin dependent diabetes). Please note some patients with type 2 diabetes may be treated with insulin and occasionally patients with type 2 diabetes may become type 1. If you are unsure what type of diabetes you have, please speak to your doctor or nurse.

1. Get access to your GP electronic health record so that you can see what your doctor or nurse has written in your notes about you and understand your healthcare needs better


2. Your practice nurse will usually be able to help you with your diabetes monitoring and management. You can book an appointment with the nurse by going online. 


3. Make sure you know what medications you are taking, when to them as well as why. Also know how to order your repeat prescriptions so that you never run out or forget. Ordering prescriptions online is the best way to do this, We have a clinical pharmacist who can help you with your medications too if you are struggling. 


4. There are 15 important checks and balances you should have at least once a year. Make sure you do not miss any.


5. Check your blood test results and learn to understand them. The NHS app shows your results and also graphs them for you so that you can easily see the trend as well (if your HbA1c is going up or down for example). 


6. Use the NHS app to read what your doctor, nurse or pharamcist have advised . You can also monitor your blood pressure, weight and mood via the My GM Care app too. 

7. Join the NHS Diabetes Prevention Programme to get onto a nine-month, evidence-based lifestyle change programme for FREE

8. Your lifestyle is very important. Do a Healthpledge today – designed by our own Patient Participation Group to help improve it now. 


9. Read the Pioppi Diet and reduce your risks of diabetes as well as cardiovascular risk and obesity too! 


10. You may also wish to join the Low Carbohydrate Programme. Try for free for 1 week. Costs £14.99 per month or £69.99 per year (price correct on 29.12.2019)

Patients with diabetes often think they need to check their blood glucose levels at home regularly. This is usually not the case for patients with type 2 diabetes unless you are on insulin or medication that may cause you to have a hypo- see here for those who need to check their blood glucose levels. If you are unsure then please ask to speak to a doctor or nurse.

Diabetes UK

Learn about Living with Diabetes from Diabetes UK including dealing with illness, travel, insurance, your child and diabetes, employment, driving, sex, pregnancy, help with giving up smoking & emotional issues

Diabetes UK – Know diabetes. Fight diabetes. | Diabetes UK
Diabetes UK – 15 healthcare essentials
The care you should receive
Management of Type 2 diabetes

Summary of Main Messages from latest Type 2 Diabetes guidance

Work with your doctor or nurse to identify targets for you to reach
Ideally Blood Pressure should be less than 140/90 in clinic (average home BP monitoring should be less than 135/85) or 130/80 if patient has kidney, eye damage or stroke. If aged more than 80 then aim for Blood pressure less than 150/90. See Diabetes and Blood Pressure
Lifestyle changes are beneficial in helping to control diabetes and limit complications
Going on structured education courses are key to gaining a better understanding of how to manage. Sign up on-line for the My DESMOND course or contact the surgery so we can book you on the local DEMSOND course based at Tameside hospital for a face to face meeting.
Having a low GI diet helps improve your diabetes control
Patients without cardiovascular disease do not need antiplatelet therapy (aspirin or clopidogrel)
Ideally aim for HbA1c less than 48 mmol/mol (6.5%) with lifestyle change / medication
If HbA1c rises above 7.5% then aim to bring down to less than 53 mmol/mol (7.0%) with further medication and individualised care
Self managing of blood glucose is important if you are on medications which may cause you to suffer with hypoglycaemia – this is particularly important if you drive or use heavy machinery 
For more information, see Clinical Knowledge Summaries – Management adult type 2 diabetes
NICE guidance
NICE guidance

When exercising their judgement, professionals and practitioners are expected to take this (NICE) guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian

Helping patients with DIABETES to get the best out of the NHS

This web-site is about helping you to understand how you can get the best out of the practice and other resources.

You may ask why?

The most recent patient survey has shown that patients want to be able to see the clinician sooner (ie less than 2 weeks) and on time (i.e not have to wait an hour for a scheduled appointment) and feel that all their concerns have been met. It has been independently confirmed that the practice already offers more appointments than the average to its patients.

So how can we meet the demand? 

Being prepared for the consultation greatly helps as does recognising the length of the appointment slot and helping the clinician to stay within the time limit.

You may ask how?

There are some simple steps that are essential for you to understand that will help you on your journey of discovery for your health and well-being:

What condition do you suffer with? 

Diabetes is often described as Type 1 Diabetes Mellitus or Insulin Dependent Diabetes or Type 2 Diabetes Mellitus or Non-Insulin Dependent Diabetes. This latter category includes patients that may be diet-controlled or those who are taking anti-diabetic tablets. It is important for you to know which type of diabetes you have as this affects your management significantly. You should find this term in your GP-held record. 

Click here to learn more about Prediabetes, Impaired Glucose Tolerance and Impaired Fasting Glucose

What does Diabetes Mellitus mean? 

Here are some links and resources for diabetes that you may wish to see: 

Annual review for diabetes
Welcome to Type 1 Whiteboard
Trevor and the Perks of Diabetes
The Women’s CHAI Project
https://youtu.be/C9XnBIToUc4
Chapatti and Chat cookbook for diabetes

Chapatti & Chat – Food made with love

Download the free book “Chapatti & Chat – Food made with love” developed with the support of Oldham Council to help raise awareness and creatively educate in the prevention of diabetes in adults from South Asian communities.

Read / Download Chapatti & Chat – Food made with love

What help is available for you to use?

This condition is primarily managed by the nurses. They can check your blood glucose readings that you may be testing at home, blood pressure readings, order tests and review them, check any problems you may be encountering and do a medication review for you. They can also advise on things you may wish to consider and discuss things that you may have learned during your journey of discovery. They can also check that you have had your annual retinal screening and feet checks done

The health care assistants can check your height and weight and do any blood tests you may need as well as check your urine sample.

Doctors can see patients whose control remains poor or if you are developing further complications that need careful management or if you are having difficulties due to possible side effects. 

Specialist Diabetic Nurses look after those patients who have particular poor control or those who are being started on insulin therapy. You can learn more about the Diabetes and Vascular service by clicking here.

Pharmacists, podiatrists and opticians also have a wealth of experience and knowledge on the management of diabetes and can give you further tips and helpful advice

There is a blood pressure machine in the waiting room for you to check your blood pressure whenever you come to the practice.

There is also a telephone support line to provide urgent Diabetes advice and telephone support as detailed below

Monday to Friday 8am till 10pm

Weekend and Bank Holidays 9am till 1pm

Telephone advice line 0161-366-2354

What does the condition mean for you?

You need to know what your target blood pressure (140/80 or 130/70 if you have other complications too) and target cholesterol (less than 5 mmol /l or less than 4 mmol/l ideally) and LDL (less than 3 mmol/l or less than 2mmol/l ideally) and HbA1c (less than 7.5% or less than 6.5% ideally) should be and what other risk factors you have that need to be managed eg whether you smoke or not or if you are obese or whether you suffer with ischaemic heart disease or kidney disease. You also need to know what is expected of you in the course of a year even if your blood pressure and symptoms are well-controlled. Finally you can monitor your own blood pressure, weight and smoking status and blood tests and urine test as a way of seeing how you are doing. This information should be in your GP-held record for you to see.

What needs to happen now and in the future?

The typical patient with diabetes which is well controlled needs the following:

  1. Fasting blood tests and urinalysis once a year with the healthcare assistant– checking you are not anaemic (Haemoglobin), kidney function (Sodium, Potassium, Urea, Creatinine and eGFR), Liver function tests (ALT, AST, albumin), a measure of how your blood sugars have been on average over the previous 3 months (HbA1c),  lipid profile (Cholesterol, HDL, LDL, triglycerides). Thyroid function tests (Thyroxine, TSH) and urinalysis (dip stick urine checking for protein and blood) as well as microalbuminuria
  2. Blood Pressure reading at least twice a year 6 months apart. You can do this on your own! This is the minimum needed but you are encouraged to do this more often by using the practice blood pressure machine in the waiting room or buying a blood pressure machine yourself so that you can monitor it at home / work yourself. The local pharmacies all sell reasonably priced blood pressure machines and can give you more details about them.
  3. Medication Review every 6 months usually with the nurse if you have good control or every 3 months if you have poor control

What can you do to help?

As this is a new way of working, it is worth discussing this with the nurse to see how this can be done the first time you decide to take control.

  1. Get access to your GP-held record. Without knowing what is in your records and what you need to do, it will be very hard to know what to do when and with who. This is an essential first step for anybody with any condition or who wants the best from the practice.
  2. Ideally we want you to book in with the healthcare assistant for fasting blood tests and urine test if you have not had them done for 6 months or prior to your next medication review. At the same time, ask to book in with the nurse a week later. The nurse will check your records and book you in for you. (This is because the nurse needs to check who is the most appropriate person to do the medication review dependent on what else you may also suffer with).
  3. Remember to ask for a yellow topped urine bottle from the receptionist which you can bring with you when you have your blood tests. You can do this when you turn up to the surgery and are waiting for the healthcare assistant or bring it with you. This needs to be checked once a year for microalbuminuria
  4. Bring your blood pressure readings and weight with you to show to the nurse or doctor if you have been checking them at home.
  5. Record your blood pressure twice a day for a week and then take an average of your readings. Ideally you could download a form from here and bring them when you see the doctor or nurse. 
  6. Also make a note of when you had your retinal screening done and had your feet checked by the podiatrist.
  7. Look at the web page – pre-consultation care – and go through it prior to your review with the clinician. This can help us to understand your needs better and what you want out of the consultation. If there are no specific issues AND all the tests are normal and you are well-controlled, it may even be possible to conduct the medication review over the telephone. This must be with the agreement of the clinician and if you are happy with this. We think many people may benefit from this but we do not want to prevent anybody from coming to the surgery of they so wish.. Understanding your needs is key to a successful outcome of the medication review. See the above mentioned websites to help you to understand what your needs are. Initially you may need the clinician to help you understand how to look at the websites and what they mean for you.