PRACTICE INFORMATION BOOKLET

1 ANCORA MEDICAL PRACTICE 291 ASHBY ROAD, SCUNTHORPE, DN16 2AB & 20 DETUYLL STREET, SCUNTHORPE, DN15 7LS PRACTICE INFORMATION BOOKLET SURGERY CONTACT NUMBERS: 291 ASHBY ROAD, SCUNTHORPE TELEPHONE: 01724 842244 FAX: 01724 282570 20 DETUYLL STREET, SCUNTHORPE TELEPHONE: 01724 747280 FAX: 01724 278338 Website: www.ancoramedicalpractice.nhs.uk Email: nl.b81026@nhs.net

2 Contents Introduction - 3 Practice Director - 3 The Partners - 4 Salaried GPs - 4 Doctor s clinic Times Ashby Road - 5 Doctor s Clinic Times Detuyll Street - 6 Practice Staff - 7 Services provided - 9 Surgery Information - 12 Minor Ailments Scheme - 18 Care Quality Commission - 19 RCGP Practice Accreditation - 19 Attached to the surgery - 20 Self-treatment of Common illnesses and accidents - 21 General Medical Services - 25

3 Welcome to Ancora Medical Practice This publication is designed to help you make best use of the services provided by the Practice and to allow the provision of these services to be accessed as smoothly as possible. We aim to provide a full range of primary care services. We are a team of ten doctors and associated trained staff all working for your care and interests. We are happy to receive comments and suggestions, preferably written, on any aspect of the service we currently provide or any additional service you may feel would be useful. Our Patient Promise We promise to treat everyone as an individual, with no discrimination. Our patients will be treated as people not just a medical condition. This means we plan care, which emphasises the patient s individual needs, dignity and strict confidentiality. The care given will be research based and delivered with the highest standards. Advice, support and information will be available in order to help our patients make the right choices. Surgery Opening Times Monday to Friday: 8.00am to 6.30pm Practice Director Christine Buckley BA (Hons) Health Studies FMAAT Dip HSM. The Practice Director has overall responsibility for the management of the practice. She would be happy to hear your views and suggestions about the service offered by the practice.

4 The Partners Dr Girgis Abdel Shahid Henalla (Male) MB, BCh. Registered as a Medical Practitioner in 1975 at Cairo. Dr Eugene Paul Mary Ryan (Male) MB, BCh, DCH. Registered as a Medical Practitioner in 1983 at Dublin. Dr Patricia McCormack (Female) MB, BCh, DRCOG. Registered as a Medical Practitioner in 1982 at Belfast. Dr James Taylor (Male) MBBS, DFFP. Registered as a Medical Practitioner in 1981 at London. Dr Krishna Pandeya (Male) MBBS, MS, FRCS, MRCGP, DIP Palliative Care. Registered as a Medical Practitioner in 1980 at Patna, India. Dr Deepa Mary Joy (Female) MBBS, MRCP, MRCGP. Registered as a Medical Practitioner in 1996 in India. Dr Mubark M A Jajja (Male) MBBS, MRCS, MRCGP. Registered as a Medical Practitioner in Pakistan. Dr Tehmina Mubarika (Female) B.Sc, MBBS, DRCOG, DFFP. Registered as a medical practioner in Pakistan. Salaried GPs: Dr Martin G Clausen (Male) MRCOG. Practitioner in 1994 in Berlin. Registered as a Medical Dr Aliza Siddiqui (Female) MBBS 2008, MRCGP 2013, DIP Palliative Care

5 Doctor s Clinic Times (Ashby Road Surgery) DOCTOR MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY AM 08.30-11.30 Henalla PM 14.30-15.30 15.30-18.00 AM 08.30-11.30 Ryan PM 14.30-17.00 15.30-18.00 AM 10.00-13.00 McCormack PM 14.30-17.30 14.30-17.30 AM 08.30-11.30 08.30-11.30 08.30-11.30 Taylor PM 14.30-17.00 15.00-17.30 AM 08.30-11.30 Pandeya PM 15.00-17.30 15.00-17.30 15.00-17.30 AM 08.30-11.30 08.30-11.30 08.30-11.30 Joy PM 14.30-17.00 14.30-17.00 AM 09.00-12.00 09.00-12.00 Jajja PM 14.30-17.00 14.30-17.00 AM 08.30-11.30 08.30-11.30 08.30-11.30 Mubarika PM 15.00-17.30 AM 08.20-12.30 Clausen PM 14.30-17.50 AM 08.30-11.30 08.30-11.30 08.30-11.30 Siddiqui PM 14.30-17.00 14.30-17.00 Nurse Clincs (Ashby Road) NURSE MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY AM 08.20-12.30 *08.30-12.50 08.20-12.30 Sue Antcliffe PM 13.00-18.20 13.00-17.50 AM *08.30-12.20 09.00-12.30 Kerry Barnby PM *14.00-17.50 13.00-14.50 AM 08.30-12.20 09.00-12.30 Julie East PM 13.00-17.50 13.00-15.20 AM 08.30-12.30 08.30-12.20 Sharon Arnold PM 13.00-17.20 *Please note that clinics labelled with a * alternates surgery sites every other week. *As a patient of Ancora Medical Practice, you may see any doctor at either surgery site. * The times stated are subject to change.

6 Doctor s Clinic Times (Detuyll Street Surgery) DOCTOR MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY AM 08.30-11.30 08.30-09.50 Henalla Ryan McCormack Taylor Pandeya Joy Jajja Mubarika Clausen Siddiqui PM 15.30-18.00 AM 08.30-11.30 08.30-11.30 PM 14.30-17.00 AM PM AM 08.30-11.30 PM 15.00-17.30 15.00-17.30 AM 08.30-11.30 08.30-11.30 08.30-11.30 PM 14.30-17.00 AM PM 14.30-17.00 AM 09.00-12.00 09.00-12.00 PM 14.30-17.00 14.30-17.00 AM 08.30-11.30 PM 15.00-17.30 14.30-17.00 14.30-17.00 AM 08.20-12.30 08.20-12.30 08.20-12.30 PM 14.30-17.50 14.30-17.50 14.30-17.50 AM 08.30-11.30 PM 14.30-17.00 14.30-17.00 Nurse Clincs (Detuyll Street) NURSE MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY AM *08.30-12.50 Sue Antcliffe PM AM 08.30-12.30 09.30-14.00 *08.30-12.20 Kerry Barnby PM 13.00-16.50 *14.00-17.50 AM 09.00-12.30 09.00-12.30 Julie East PM 13.00-15.50 13.00-15.50 Sharon Arnold AM 08.30-12.30 PM 13.00-17.20 *Please note that clinics labelled with a * alternates surgery sites every other week.

7 *As a patient of Ancora Medical Practice, you may see any doctor at either surgery site. * The times stated are subject to change. Reception and Administration Practice Staff There are 40 reception and admin staff across both surgeries. They are trained to assist you in making appointments to see the Doctor, undertake repeat prescriptions and to offer help and assistance at all times. The administration team includes staff with responsibility for requesting reports from other agencies and the updates of information on the computer. It is a legal requirement that confidentiality of patient records is maintained at the highest level by all staff. There are two part-time secretaries who are based at Ashby Road but work for both surgeries. Nursing Team Within our surgery team we have 1 Nurse Practitioner, 3 Practice Nurses, and to assist the nursing team 7 Health Care Assistants NURSE PRACTITIONERS: Sue Antcliffe: RGN, BSc (Hons) Health Professional Studies, A33 Autonomous Nurse Practitioner, Independent Nurse Prescriber, Diploma in Primary Care Diabetes Management, ENB A51, ENB 903 Family Planning. The Nurse Practitioner specialises in the management of chronic disease care e.g. Diabetes, Heart Disease, and Asthma. She also runs Acute Minor Illness Clinics. Within these clinics patients with acute minor infections or illness can be seen by the Nurse Practitioner instead of a GP. Clinics are run most days; please ask the reception staff if you are unsure about whom you need to see. PRACTICE NURSES: Kerry Barnby: RN, Diploma in Nursing Studies, ENB 998 Teaching & Assessing in Clinical Practice, Family Planning Diploma, Diploma in Diabetes, Diploma in Asthma, Spirometry Certificated. Julie East: RN, Diploma in Nursing Studies, Family Planning Diploma, Asthma Diploma, COPD Diploma, Diabetes. Sharon Arnold: SRN, BSc (Hons), ENB998 Teaching & Assessing in Clinical Practice, School Nursing Certificate, ENB901 Family Planning Certificate, ENB D01 Health Promotion Certificate, ENB A29 Learning Through Reflection

8 on Experience, ENB 870 An Understanding and Application of Research, U10 Working with Children & Families, Cytology screening. All of the nurses within the practice have wide experience and receive regular update training. Our Practice Nurses are available on an appointment system at both surgeries Monday to Friday. The work our nurses are available for includes: Blood pressure check Smoking Advice Diet and Weight Advice Blood tests Cervical cytology (smears) Contraceptive advice Breast awareness and self examination teaching Ear syringing Travel vaccinations and advice Child vaccinations Suture removal Wound management Assisting with surgical procedures Cryotherapy ECG s Disease Management: Asthma, Diabetes, Ischaemic Heart Disease, COPD, Thyroid problems. The receptionists are available to assist you with booking an appointment with the appropriate nurse. Our nurses are supported by our 7 Health Care Assistants (HCA): Andrea Fawcett Alice Hewitt Emma Hill Shirley Hulley Joanne Laurens Emma Bradley Robin Lynam These HCA support the nurses in the baby clinics and run their own phlebotomy clinics (blood tests). They can perform blood pressure checks, weight and height checks, smoking cessation and ECG s. We also offer all new patients health screens that are performed by the HCA.

9 Services Provided Health Promotion Clinics For diabetic, asthma, COPD, hypertensive and coronary artery diseases, sufferers are reviewed regularly either by the practice nurse or doctor. The practice adheres to a policy of an active lifestyle and you may well receive advice about cigarette and alcohol consumption. Health Clinics Baby Clinics are held at Ashby Road Surgery on Mondays from 1.00pm to 2.30pm and at the Detuyll Street Surgery on Tuesdays from 1.00pm to 2.30pm. Immunisations and the 8 week surveillance are carried out within these clinics. Immunisations These are given by the Practice Nurse. 8 Weeks: Diphtheria, Hib, Pertussis, Polio, Tetnus, Rotavirus (oral), Pneumococcal. 12 Weeks: Diphtheria, Hib, Pertussis, Polio, Tetnus, Rotavirus (oral), Meningitis C. 16 Weeks: Diphtheria, Hib, Pertussis, Polio, Tetnus, Rotavirus (oral), Pneumococcal. 12-13 Months: Hib, Meningitis C, MMR, Pneumococcal. 36-40 Months: Diphtheria, Pertussis, Tetnus, Polio, MMR. Tetanus Injection: Every Ten Years Travel Vaccinations: For travel abroad, ask at reception for a travel assessment form. Please submit your travel assessment form at least 6 weeks before travelling. It may be found on our website or from reception. Flu Vaccine: Every Year Starting October

10 Hepatitis B Vaccine: For high risk patients. Yellow Fever: Detuyll Street Surgery is a designated Centre. Family Planning Services We provide all family planning services during surgery hours, including diaphragm, coil, implanon and injectable contraceptives. These are carried out by the Doctors or Practice Nurse if you prefer. Midwives The Town Team are a group of midwives who will care for you antenatally, during labour and at home during the postnatal period. Your first contact with a midwife from the team will be at your booking appointment which will be held at Henderson Avenue Sure Start centre, details of this will be sent to you through the post once your pregnancy has been confirmed. Throughout your pregnancy you will have regular antenatal checks by your midwife. You will also be invited to attend parent craft sessions held by the team. If you have any questions, worries or concerns, you can contact a member of the Town Team at any time by phoning Burringham Road on 01724 247962 or West Street on 01724 747268. Cervical Smears Women between the ages of 20-65 years are recommended to have regular cervical smears every 3-5 years, to check that the neck of the womb is healthy and that there are no signs of changes that could develop into cancer. The examination is simple and not painful. These are carried out by the Doctors or Practice Nurse. A proportion of smears are recalled for repeats sooner than would be envisaged. This is often due to there being insufficient material on the smear to allow a diagnosis to be made and not because there is any abnormality identified. Minor Surgeries Minor surgery is carried out by the doctors, usually during the morning surgery hours with the help of the Practice Nurse. Vasectomies are carried out at Ashby Road Surgery, performed by Dr Henalla. Private Medical Examinations (Not covered by the NHS)

11 A fee is payable upon making an appointment with the receptionist. Private medicals including insurance, HGV and PSV medicals are carried out at specific times and are not covered by the NHS. Medicals and other non-nhs work will incur a charge. Chaperones You are entitled to ask or arrange for a chaperone to be present during intimate examinations. You may either choose to ask a friend or relative to be present or ask the Practice to provide a trained chaperone. Please ask in advance if you wish the Practice to provide a chaperone. If the Practice is unable to provide a chaperone at the time of your examination, you may be asked to re-book your appointment for a time when one is available. Flu Vaccination An influenza vaccination is particularly recommended for patients with heart, lung or kidney disease, diabetes and residents of nursing and rest homes. Please contact the reception staff in early October for details of the vaccination dates. If you are housebound, a home visit by the practice nurse will be arranged to administer this vaccination. Private Health Services to Patients not entitled to NHS Care Individuals visiting the UK from abroad may not be entitled to NHS Care unless reciprocal agreements exist between their country of residence and the UK. For further information please visit the Department of Health website or ask at reception. If not entitled to NHS Care, the following costs should be paid by the patient before being seen by the GP. The individual should then subsequently obtain a reimbursement from their insurance company if appropriate. Price Appointment with GP (10 minute consultation) 40 Private prescription (per item)* 20 * Additional charges liable to the Pharmacy also apply when subsequently collecting any medication

12 Routine Screening Services There are certain screening procedures that are triggered by age, gender or underlying conditions. For these, the patient will be contacted automatically:- Aneurysm Screening Men aged 65 Bowel Cancer Screening Men and Women aged 60-69, every 2 years* Breast screening Women aged 50 70 (first one before age 53) Cervical Cancer Screening (Smear Test) Women 25-50 every 3 years and 51-65 years every 5 years* Chlamydia Recommended for sexually active patients under 25 (this does not need to involve an examination and can be checked with a test you do yourself) www.chlamydiascreening.nhs.uk Retinal Screening All diabetics 12yrs or over More information can be found on www.cancerscreening.nhs.uk

13 Surgery Information Appointments All appointments with a doctor are of 10-minute duration. Each GP has 18 slots in a morning session and 15 in the afternoon. The first 5 appointments of each clinic may be pre-booked up to 3 months in advance. The remainder of the slots are called same-day appointments and can only be booked in that session. All same day appointments are released and can be booked from 08.00am that day. There is an emergency surgery on Friday afternoons. For urgent problems, please explain the situation to the receptionist and she will do her best to get the help you need. Urgent cases will be seen the same day. Our receptionist will try to arrange for you to see the doctor of your choice, but in an emergency it may be necessary for you to see the first doctor available. To book an appointment, contact our reception via telephone or in person. Appointments can also be booked via our online services. If you are not registered for our online services you can request this service via our reception. Please cancel any appointments you cannot attend, otherwise you may prevent other patients from getting an appointment. Please help us by being punctual. Please do not bring other patients with you and expect the doctor to see more than one patient when only one appointment has been allocated. Remember one appointment - one patient. Home Visits Home visits are for patients who are too ill or frail to attend surgeries. If there is any doubt, the doctor will discuss the problem and advise. Please try to request home visits by 11.00am. It helps to judge the urgency if you can describe the symptoms. Our receptionists have been specifically trained, so do expect to be asked.

14 Night and Weekend Emergencies NHS 111 If you need medical help fast but it s not a life-threatening situation, you can now call the new NHS 111 number. When you call 111, a trained adviser will ask you questions to find out what s wrong, give you medical advice and direct you to someone who can help you, like an out-of-hour doctor or a community nurse. If the adviser thinks your condition is more serious, they will direct you to hospital or send an ambulance. If you don t speak English, tell the adviser what language you want to speak and they will get you an interpreter. You can call 111 any time of the day. The call is free, from landlines and mobiles. You should only call 999 in an emergency for example, when someone s life is at risk or someone is seriously injured or critically ill. Call 111 if you need medical help fast, but it s not life-threatening for example, if you: think you need to go to hospital don t know who to call for medical help don t have a GP to call need medical advice or reassurance about what to do next For health needs that are not urgent, you should call your GP. If a health professional has given you a number to call for a particular condition, you should continue to use that number.

15 Repeat Prescriptions If your doctor is in agreement, you may obtain repeat prescriptions by written requests over the counter, by post (including a stamped addressed envelope), fax or our online services via our website www.ancoramedicalpractice.nhs.uk. Please ask the receptionist for further details or to request to become a registered user of our online services. We run a computerised repeat prescription system. This provides an attached slip containing all prescribed medicines authorized for repeat prescribing by your doctor. Ordering a repeat prescription is greatly simplified by submitting information contained on this slip. Your doctor will have authorised a certain number of repeat prescriptions. When these have been issued, your doctor will assess your need. Further repeat prescriptions may be authorised by the doctor or you may be asked to attend the surgery for a review of your condition. Please allow 2 working days for your repeat prescription request. Online Services The practice offers a range of online services to our patients. These include repeat prescription ordering, change of details, new patient registration and the booking and cancelling of appointments. This service is safe and secure and if you would like to access our online services please ask for a username and password from one of our receptionists. (ID will be required) Telephone Advice If you need advice from your doctor, the most convenient time is between 11.30am and 12.00pm. Do not expect to speak to a doctor before that time. You may be asked to ring back at a certain time to speak to a doctor especially in the afternoon. Receptionists have been asked not to disturb the doctor with non-urgent calls during surgery hours at the doctor can only deal with one problem at a time. Confidentiality and Test Results You may telephone for the result of a test providing the doctor has seen the result and has agreed to it being given over the telephone. Enquiries about results are best directed between 2.00pm 4.00pm. In order to maintain confidentiality you must ring for your own results and the receptionist will

16 need to ensure that the results are only given to the person named on the results slip, or to the parents of patients under 16 years of age. No information will be passed to another person. Confidentiality and Access to Patient Information All patient information is considered to be confidential and we comply fully with the Data Protection Act to keep your confidential data safe and secure. All employees have access to this information in relation to their role and have signed a confidentiality agreement. Relevant information may be shared within the multi-disciplinary health care team at the practice and with other health care professionals to whom a patient is referred. Those individuals have a professional and contractual duty of confidentiality. Confidential and identifiable information relating to patients will not be disclosed to other individuals without their explicit consent, unless ordered to do so by court order or where it is in the public interest to do so to prevent harm. The Data Protection Act and The Access to Health Records Act allow a patient to find out what information is held in their health records and those of someone who has died in some circumstances. A patient wishing to see health records should make a written request to the Practice. Where entitled to receive a copy, it should be noted that a charge will be made. Your Electronic Patient Record and Sharing of information Ancora Medical Practice uses a unique computer system called SystmOne that allows the sharing of full electronic records across different NHS healthcare services. When you register with Ancora Medical Practice, clinicians at other organisations that care for you (e.g. out of hours and physiotherapy) and use SystmOne will be able to see the information recorded here. For example, a district nurse that visits you would be able to see the data entered by your GP. If you are not happy for your records to be shared, please let us know. Expected Behaviour Policy The Practice is committed to producing a high quality of care to our patients. The relationship between the patients and those working in the surgery is an important issue and is a two-way process. Therefore, in order to protect both the staff and other patients, we respectfully point out that the following inappropriate behaviour will not be tolerated: swearing, threatening or abusive behaviour, drunkenness, verbal / physical abuse.

17 Such behaviour has a marked effect on staff and other patients, and therefore, where such behaviour is observed, we reserve the right to withdraw from treating the patient and ensuring removal of those involved from the premises. Fitness For Work Certificates PERIODS OF SICKNESS 1-3 DAYS: You do not need a certificate. PERIODS OF SICKNESS 4-6 DAYS: Your employer may require you to complete a self-certification form SC2 which is available from your employer or the DSS. PERIODS OF SICKNESS LONGER THAN 6 DAYS: You will need to see the doctor for him/her to issue a sickness certificate and for any subsequent renewal of that certificate. The only exceptions to this may be after hospital inpatient or outpatient attendance or for long-term sickness. The law states that you do not need to obtain a certificate from your doctor for illnesses between 1-6 days. If your employer insists that you obtain one, this service is not covered by the NHS and a charge will be made. Change of Name, Address and Telephone Number Please let us know as soon as possible of any changes to your name, address and telephone number. If you move out of the Practice area, it will be necessary to register with another doctor. Disabled Patients At both surgeries, reserved car parking space for the disabled is marked near the front door. Wheelchair access to the building is via a ramp at the front entrance. Patient services are provided at ground level. A disabled patient WC is provided near the front entrance. Ashby Road has 4 disabled spaces at the front of the building, with other disabled spaces at the rear of the building. If access proves difficult to any of our patients we would be happy to consider any suggestion for improvement. Teaching We are a teaching practice, with 2 designated GP trainers who oversee the training of a GP Registrar. These are fully qualified doctors who are different stages of their GP training. They hold their own clinics which are overseen by one of the regular GP s. One aspect of a role as a training practice is to make video recording of consultations. These are only done with a patient written consent and you are

18 quite at liberty to refuse. The recordings are only for the individuals training purposes and their use is strictly controlled. FY2 Doctors / Medical Students The practice is involved with the training of FY2 doctors. These are fully qualified doctors who are in their 2 nd year after medical school. They run their own clinics which are overseen by a regular GP. Throughout the year, we have medical students from Hull-York medical school with us as part of their studies. They observe general practice consultations and hold shared clinics with a regular GP. Patient Participation Group If you are a patient of Ancora Medical Practice and would like to be involved within the practice and would like to be apart of the patient participation group then please email Elaine.godley@nhs.net. A full group meeting is held every 3 months within the practice. New Patients We currently have an open list and welcome requests for registration with the practice from patients living or moving to the practice area (see map). You are registered with the Practice rather than with an individual GP and may see any of the doctors. You are able to express a preference of practitioner and whilst the Practice will try to comply, it might not always be possible. You can register by presenting your medical card or completing a form GMS1 available from reception. You will be asked to complete a questionnaire and you will be invited to attend for a simple health check. Please bring a urine sample with you. If you move out of the area, we regret that you must register with another practice.

19 Complaints Procedure We are always happy to improve our services to patients and the way we deliver them. If you have any comments or suggestions we would be pleased to receive them. Should you have cause to complain we have a proper complaints procedure and would be pleased to assist you in making use of this, leaflets explaining this are available throughout the waiting area and from reception. Please write to the Practice Director, Christine Buckley if you have cause to complain. Minor Ailments Scheme All local pharmacists take part in this scheme. Pharmacists can give advice and recommend over the counter medications for minor ailments without the need for you to visit your doctor, e.g. Coughs, conjunctivitis, cystitis, diarrhoea, insect bites and stings, sore throats, warts and verruca s, and many more. If you receive free NHS prescriptions you will receive the over-thecounter medication free. You need to register with your local pharmacist to take part in this scheme.

20 *If you wish to advertise in this booklet please email nl.b81026@nhs.net* Care Quality Commission (CQC) The practice registered under the Care Quality commission on 1 st April 2013. Inspectors of the CQC could visit the practice at any time in order to inspect us and the services we offer to our patients are meeting the National Standards. RCGP PA The practice was awarded the Royal College of General Practitioner s Practice Accreditation award in November 2012. The award is valid for 3 Years. The Practice Accreditation award has been developed in partnership with the University of Manchester, and in collaboration with the General Medical Council, Royal College of Nursing, Care Quality Commission, Department of Health, NHS Confederation Primary Care Trusts and Patient Groups. The standards reflect key aspects of primary care, particularly the organisational systems and processes that ensure delivery of safe and quality care, facilitate on going team development and recognise the contribution to quality improvement that can be made by the whole practice team. Practice Accreditation is a quality standard aimed and tailored specifically for General Practice.

21 Attached To the surgery District Nurses Your District Nurse is qualified to degree level and will lead the District Nursing Team to deliver evidence-based practice care to patients in the community. The nurse works closely with your GP and other agencies, to ensure high standard of care. The District Nursing Service is available to provide care for patients who are housebound and cannot access any other means of health care. Contact telephone number is: 01724331102 (24 hours a day, 7 days a week) Health Visitors The role of your Health Visitor is to improve Public Health by working with individuals, families and communities. In this surgery, the main focus of our work is families with children from birth to 5 years. Development Assessment / Health Promotion is offered to all children at age 8 weeks, 7-9 months, 24 months and 3½ years-appointments arranged with parents. We offer individual or family appointments at surgery, home or community location, according to the wishes and needs of the patients. We liaise closely with Midwives, School Nurses, Sure Start, Education, Social Services, Housing and Voluntary Services. We are actively involved supporting the substance misuse programme within the practice.

22 Self Treatment of Common Illnesses and Accidents Many common aches and pains can be simply treated at home without the need to consult a doctor. Back Pain Back pain causes 13 million working days to be lost in Britain each year. The spine being made of 24 fragile bones and associated cartilage and tendons supports the whole weight of the upper body and, therefore, it is understandable that it sometimes goes wrong. Because of the complex nature of the spine it is advisable to consult your doctor if back pain persists for more than a few days. If, as is usual, the pain has been caused by abuse i.e. lifting too heavy weights etc, be sensible and take things easy. Take care to sit as upright as possible with a support for the small of the back. Take aspirin or Paracetamol which will not only relieve the pain but will help to relieve inflammation. Your doctor may well prescribe stronger drugs, heat treatment, gentle exercise or some kind of supportive corset. Burns Apply large quantities of cold water to the affected area as soon as possible and maintain this until the pain subsides. This may take as long as 15 minutes! If the skin is unbroken but blistered, apply a loose, dry dressing. If the burn is larger than 4 or 5 inches in diameter or if the skin is broken, consult your doctor as soon as possible. Colds Even in this day and age there is still no magic cure for the common cold. Go to bed, take plenty of drinks. If you have a headache or are feverish, take aspirin or Paracetamol. Do not bother to take antibiotics you may have in the house these will have no effect! Chickenpox On the first day a rash appears as small red patches about 3-4mm across. Within a few hours of these developing, small blisters appear in the centre of these patches. During the next three or four days further patches will appear

23 and the earlier ones will turn crusty and fall off. Oily calamine lotion may be applied to soothe the often severe itching. Cool baths may also help. The most infectious period is from two or three days before the rash appears and up to five days after this date. Children may return to school as soon as the last crusts have dropped off. Minor Cuts and Grazes Wash the wound thoroughly with water and a little soap. To stop bleeding apply a clean handkerchief or dressing firmly to the wound for about five minutes. Cover with a clean dry dressing. Diarrhoea In adults diarrhoea is usually caused by a virus infection and is therefore unable to be treated directly. The symptoms can usually be eased by the traditional kaolin and morphine mixture or by medicines containing codeine. Holiday diarrhoea is often due to bacteria. Again, kaolin and morphine can be taken. In both the above cases, consult your doctor if the symptoms persist for more than a few days. Diarrhoea in very young children and babies needs careful attention. Most babies have loose bowel action during their first six months due to their predominantly liquid diet. Sudden bouts of unusually watery diarrhoea should be treated by taking the baby off solids and feeding it a cooled solution of boiled water with a teaspoon of sugar and a pinch of salt to the pint. If the symptoms persist for more than 24 hours, or are accompanied by vomiting or weakness, consult your doctor. Gastroenteritis Gastroenteritis describes a group of diseases affecting the stomach or part of the intestine. Symptoms are often diarrhoea, sickness and stomach ache. Due to the lining of the stomach likely to be inflamed, medicines are often immediately vomited up. Large quantities of water, orange juice, or thin soup should be taken to counter the effects of dehydration. Consult your doctor if vomiting persists for more than a day. German Measles (Rubella) The rash appears during the first day and usually covers the body, arms and legs in small pink patches about 2-4mm across and doesn t itch. No other symptoms are usually present apart from occasional aching joints. It is

24 infectious from two days before the rash appears, until the rash disappears in about four or five days from that date. The only danger is to unborn babies and, therefore, it is important that all contacts are informed in order that anyone who may be pregnant can contact their doctor. Immunisation can prevent this disease. Head Lice These creatures, contrary to popular belief, prefer clean hair and are, therefore, not a sign of poor personal hygiene. Medicated head lotion can be obtained from the chemist without prescription. Insect Bites and Stings Antihistamine tablets can be obtained from the chemist without prescription and will usually relieve most symptoms. Note: Bee stings should be scraped away rather than plucked in order to avoid squeezing the contents of the venom sac into the wound. Measles The rash is blotchy and red and appears on the face and body around the fourth day of illness. It is at its most infectious from two or three days before the rash appears until eight or ten days after that date. Immunisation can prevent this disease. Mumps Symptoms are swelling of the glands in front of one ear often followed, after a couple of days, by swelling in front of the other ear. It is infectious from two or three days before the swelling appears until eight or ten days after that date. If the pain is severe you should contact your doctor. Immunisation can prevent this disease. Nosebleeds Sit in a chair (leaning forward with your mouth open) and pinch your nose just below the bone for approximately ten minutes, by which time the bleeding should have stopped. Avoid hot drinks or hot food for 24 hours. If symptoms persist, consult your doctor. Sprains Firstly apply a cold compress, containing ice if possible, for 15 to 30 minutes to reduce the swelling. Apply, firmly, a crepe bandage and give the sprain plenty of rest until all discomfort has subsided. Further strain will inevitably lead to further swelling and a longer recovery period.

25 Stomach Ache Most attacks are not serious and are usually caused by indigestion or wind. A hot water bottle will often relieve the symptoms and, in the case of indigestion, a teaspoon of bicarbonate of soda in half a glass of water will help. If the pain lasts for longer than eight hours or increases in intensity you should consult your doctor. Sunburn Treat as for other burns with cold water to remove the heat. Calamine lotion will relieve the irritation whilst paracetamol will also help. Children are particularly susceptible to sunburn and great care should be taken to avoid overexposure to the harmful effects of the sun.

26 General Medical Services Details We provide services to patients under the Primary Care Services arrangements. Details of General Medical Services in this area may be obtained from: NHS North Lincolnshire CCG Health Place Wrawby Road Brigg North Lincolnshire DN20 8GS Telephone: 01652 251000