Chronic Illnesses

There is a growing epidemic of chronic disease within the UK, related to smoking, unhealthy diets, physical activity & other risk factors. Although it is important to try to avoid having them in the first instance (Primary Prevention), it also important to monitor or try and prevent affected patients from getting worse (Secondary Prevention) so they can live longer. Diabetes, depending on its complexity may require GP-only or Hospital based management. Other gastro-enterological, dermatological or rheumatologically conditions requiring specialised drugs are managed by the hospital, but can have blood monitoring at a GP surgery.

 Diabetic appointments

Either nurse or doctor-led clinics

Diabetes is a particularly important condition as poor control can result in the condition causing kidney failure, blindness, heart attacks, stroke and gangrene. You will be contacted on an annual basis with an invitation to attend for review. 

Respiratory Clinic

Asthma and COPD

The Respiratory Clinics are run by our own nurses with a Special Interest in Respiratory Care. They keep their knowledge updated by regular reading and attending courses. The practice possesses its own Spirometer, to expertly assess Lung Function and assist in the diagnosis and management of the conditions. Asthma and COPD are the two main respiratory conditions monitored. Long term Oxygen therapy however is managed and initiated by Hospital Chest Clinic and their own team of specialist-nurses.  This again is by invitation and you will be contacted annually. 

INR Clinic (Anticoagulation)

The aim of the clinics is to detect any changes that may affect your health so correct treatment can be applied at an early stage. Monitoring includes yearly weight & urine check, blood pressure and discussions on diet, smoking and exercise. INR Clinics are held daily (except Friday) to monitor patients taking the anti-coagulant drug Warfarin. Warfarin is used to ‘thin’ blood in patients with an irregular heart rate, heart abnormalities or clotting disorders causing a thrombosis or a stroke.

DMARD Monitoring

DMARD’s are specialised drugs issued by Hospital gastroenterologist, rheumatologists or dermatologists for particular conditions. Due to their potential toxicity, they require regular blood tests to monitor and detect any adverse changes caused by them.

Health Promotion

We encourage all our patients to share responsibility for their health, both in preventing disease and in treating existing diseases. Many of the most serious diseases can be prevented by a healthy lifestyle and without the need of drugs. Our experienced nurses are able to offer advice on weight management and dietary advice, incorporating lifestyle aims on exercise, alcohol awareness and smoking cessation. 

Baby clinic

Child Surveillance

Child Health Clinics are for the assessment of well children, checking their appropriate development, weight and immunisation schedule. Please do not ask for an ill child to be seen in this clinic, if you are concerned your child may be ill you will need to see a GP.  Baby Clinic is run by our Health Visitors on a Tuesday morning.  On hold at present (Health Visitor 01633 492455)

Family Planning

Incorporating the contraceptive Implant clinic

All our doctors are able to provide contraceptive advice and initiate treatment at a routine surgery. Ongoing follow-up and re-issue together with administering of contraceptive ‘injection’ or ‘implant’, can be undertaken by our trained nurses. Long-acting reversible contraception methods are more reliable and easier to use than traditional contraceptive pills. Emergency Contraception within 72 hours, can be obtained from pharmacies without a prescription. We also fit IUD coils and this can be arranged with Dr J Evans.

Cervical Smears

Only after a Health Authority invite to attend

A cervical screening test (otherwise known as a smear test) is a method of detecting abnormal cells on the cervix. The cervix is the entrance to the womb from the vagina. It’s a test to check the health of the cells of the cervix. The aim of the testing program is to reduce the number of women who develop cancer by detecting any early abnormal changes. All women over 25 years will be invited by the Health Authority every 3 years until the are 50 years old Thereafter they are re-called every 5 years until aged 65 years, when the recall stops. The Health Authority will advise when you are due and will refuse a test taken too soon.

Antenatal Clinic

Managed by Community Midwives, but held at our Surgery

Antenatal Care begins since your pregnancy has reached 8 weeks, at which point you are advised to contact reception to make an appointment with your designated midwife. Antenatal care will be undertaken mostly by the midwife, but you are also able to see your GP if there are any problems or your care may be transferred to hospital antenatal clinic should the requirement arise. The midwife will contact you directly to arrange any date and times of attendance at her clinics held at St Julians Medical Centre but her clinics are run on a Tuesday and Wednesday afternoons.   It is recommended that for most women intending to become pregnant and also up to the 12th week of pregnancy, to take Folic acid 400 microgram supplements daily, to prevent the risk of spina bifida.

Services offered at the Surgery

• Phlebotomy
• New Patient Checks
• Diabetic checks
• Baby Clinic - On Hold (Health Visitor 01633 492455)
• Coronary Heart Disease (CHD)
• Respiratory Clinic (Asthma/COPD)
• Anticoagulant Clinic
• Antenatal Clinic - Tuesday, Wednesday held between 13:00 – 14:45.
• Minor Operations - Minor procedures are undertaken by and at the discretion of the GP. They are by appointment only.

Family Planning advice 

We offer a range of contraceptive services including IUD insertion.

Ear Syringing

This is carried out by our practice nurses. 

Cervical Screening 

Cervical smears are undertaken by our nurses by appointment only.

Child Psychologist 

A psychologist specialising in child and youth problems is available. Referral is made through your GP.

Practice Counsellor 

Mrs Leah Pilling, Primary Care Mental Health Practitioner and Mr Ray Jones, Accredited Counsellor MBACP, are available to give counselling and advice one day a week at the Practice. Referral to them is made through your GP.

Drug Misuse Service

Held on Wednesday and Friday mornings.

Dietician 

A dietician is available to give advice twice a month at the Practice. Referral is made through your GP.

Citizens Advice Bureau 

A case worker is available for consultation at the Practice for one session a week. The case worker can give assistance with problems relating to benefits, debt, housing, employment and relationship problems. Referral is through your GP or other healthcare professional.

Community Mental Health Service 

A Community Mental Health Service is available at the Practice once a month. Referral is through your GP.

Podiatry 

Referral to this service is through your GP.

District Nurses 

Direct telephone number: 01633 851943.

Health Visitors 

Direct telephone number: 01633 492455

The health visitors are available to discuss, give information and guidance on a range of topics to promote family health and wellbeing. This includes emotional health, postnatal depression, relationship difficulties, bereavement, child development difficult behaviour, feeding, sleeping, minor illness and injury reduction.

Community Midwives 

Direct telephone number for advice: 01633 436806
Antenatal clinic held on Tuesday, and Wednesday by appointment.

Immunisations & Vaccinations

The Flu vaccine is seasonal and only provides cover for the administered year. It thus has to repeated annually, and supplied to specific target groups. The pneumococcal vaccine is available all year round to target groups. It is very important to ensure the recommended full course of immunisations throughout childhood to ensure adequate protection against harmful infectious diseases. We can offer some Travel related vaccines but we are NOT a Yellow Fever approved centre. 

Influenza

Flu is Seasonal (September to March)

Flu and Pneumococcal vaccines are routinely given by the nurses, and those in the at risk category will be sent an invitation letter. They are provided to patients over 65 years, and those over 6 months of age with chronic diseases such as asthma, diabetes, heart disease, kidney/liver disease or cancer and if you are pregnant.

Pneumococcal is available all year

Pneumococcal vaccinations are available all-year round, and again offered to patients over 65 years and those with chronic diseases. The vaccine is available as a nasal spray for 2-3 year olds and children in reception class or school years 1,2,3 and 4 and at risk under 18 year olds.. If you are outside of these criteria, you may still be able to obtain a flu vaccine directly through your community pharmacist for a fee.

Child Immunisation

Strongly Recommended

Many childhood diseases have been virtually eradicated in the UK due to the availability of vaccinations. It is thus very important that all children are fully immunised. The majority of vaccinations up to the age of 5 years are performed at the surgery following a reminder sent to the parents by the Health Board. Vaccines for Diptheria, Tetanus, Whooping cough, polio, Haemophilus, Rotavirus, Meningitis B&C and Pneumococcus are staggered at various times from 8 weeks to 4 years of age. Further vaccines for HPV in girls (12-13yrs) and the 3 in 1 booster with meningitis vaccine at 14 yrs to all, are usually administered at school.  But can be accessed via GP surgery For a detailed schedule of recommended vaccinations please click HERE

Travel Vaccinations - Please note we no longer administer MenACWY, Private Hep B and Yellow Fever.  Please see link below for Yellow fever vaccinations

https://nathnacyfzone.org.uk/search-centres

Travel

Immunisation for Foreign Travel 

As well as providing comprehensive advice regarding overseas travel, our practice nurses are able to provide some immunisation cover. Travel immunisations are by appointment only, please call to ensure we provide the immunisation you require. Please allow sufficient time, ideally 6-8 weeks before your intended date of travel to make an appointment in order for them to take effect. More information can be found on the above tab.

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

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

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

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

Some travel vaccines are ordered on a private prescription and these incur a charge. This is because not all travel vaccinations are included in the services provided by the NHS.

Anti-Malarial medication

is not a replacement for adequate Mosquito Bite Avoidance 

It is usually recommended you take anti-malarial medication when travelling to areas where there is a risk of of Malaria. The tablets can reduce your risk by about 90%. The type of medication required is dependent on exactly where you are going (check http://www.wales.nhs.uk/healthtopics/travelhealth), relevant family & your medical history, allergies, medication you are currently taking, previous experiences with anti-malarials, age and whether your pregnant. You will be able to obtain with an adequate amount of required medication over-the- counter from your community Pharmacy. Unfortunately certain drugs may require a private prescription from your GP (he will advise you if this is necessary). All anti-malarial medication is chargeable (and not on NHS). For further information on types of anti-malarial medication please check this website.

Holiday Health

Do not forget adequate Travel Insurance

It is a wise precaution to pack some essential items in case of illness on holiday. Do choose medicines according to your needs and the country you are intending to visit. Remember to also pack your regular prescription medicines ( and ensure you order adequate supply in good time). You may also wish to consider the following: • Paracetamol, Travel sickness tablets, Plasters and a small crepe bandage. • Rehydration solutions (such as Dioralyte) and anti-diarrhoeal (such as Imodium) • High-factor Sunscreen • Anti-malarial tablets (if indicated), Insect Repellent, Water purification tablets. • Sun-hats for yourself and children • Condoms / other contraceptives.

Travelling in Europe

If you are travelling to Europe the EU has published useful information for travellers on the European website.

Non-NHS Services

Some services provided are not covered under our contract with the NHS and therefore attract charges. Examples include the following:

• Medicals for pre-employment, sports and driving requirements (HGV, PSV etc.)
• Insurance claim forms
• Prescriptions for taking medication abroad
• Private sick notes
• Vaccination certificates
• Private letters

The fees charged are based on the British Medical Association (BMA) suggested scales and our reception staff will be happy to advise you about them along with appointment availability.

NHS services are provided free of charge to our patients under our General Medical Services contract and the NHS covers the cost of provision. Additional services are not available under the NHS and are not paid by NHS funding. The provision of such services are a cost to the GP, to cover staff, heating, lighting and facilities. Time spent by GP’s completing private reports and undertaking private medical examinations are generally done outside of normal contracted working hours as an extra commitment to GP workload. The fees charged for non-NHS services go towards covering costs of running and investing in our Practice to provide the wide range of services patients require.

Professional Medical Examinations

HGV/PSV, Taxi, Boatman, Powerboat, DVLA, Insurance medicals

Paperwork is completed through questioning but will require an extensive physical examination to confirm satisfactory fitness.  It may be worth undertaking a review with an optician prior to the examination. Taxi drivers are locally required to satisfy the DVLA group 2 entitlement for fitness to  drive. This is the same stringent requirement as pertains to HGV drivers. Please bring any paperwork, glasses (if required) and medication to the examination. Be  aware you may be requested to provide a Urine specimen on arrival. Appointments are available usually on a Tuesday afternoon after routine surgery ends.

Medical Reports

for Institutions (insurance, employer) or Patients (e.g. supportive)

We complete various medical reports including but not limited to insurance, occupational, disability and housing reports.  Patients may also request private sick notes, personal insurance forms, holiday  cancellation forms, fitness to travel certificates, supportive letters and some private  prescriptions. All are chargeable. When a doctor simply signs a certificate or minor report of confirmation, the Doctor needs to check the patient’s entire medical record to ensure that  they are confirming to be providing accurate information. A doctor will not be able to complete forms the same day, so please ensure reasonable  notice is given. We aim to complete reports within a 28 day time frame, essential NHS workload naturally  takes priority and can cause delay. 

Non-NHS Chargeable Fees

a full list of fees is available from Reception.

All payments are requested to be in CASH in the correct amount (as change is limited). We are not VAT registered. 

Training Practice-GP Trainee

We have been approved as a training practice and a fully qualified doctor, known as a GP Trainee, will be employed by the practice for six to twelve months at a time during which time their training will be supervised by one of the partners. You may be offered appointments with the GP Trainee.

Medical Students

We have 5th year medical students visiting the practice who sit in with the doctors in surgery and also attend pre-arranged home visits. Such experience is a very valuable part of undergraduate training.

You will be informed beforehand if there are medical students present. If you do not wish students to be present during your consultation you will be seen alone. We appreciate your help.