Clinics

Antenatal Clinics Dr on call in attendance Midwives Tuesday at 2.00pm Wednesday at 2.00pm Child Health Clinic Health visitor, GP and nurse Times on application Asthma Clinic Debbie Cunningham Times on application Diabetic Clinic Alyson Plumb Times on application Well Woman Clinic All practice nurses   Healthy Heart Clinic All practice nurses   Travel Clinic including Yellow Fever All practice nurses   Blood Sample Alyson Plumb Emma Abbot Monday to Friday 8.30am - 10.30am

Other Clinics

All Adults

Immunisation
We encourage all adults to be immunised against tetanus (this means 10-yearly boosters).

Health Promotion
We are participating in a government scheme to reduce the incidence of vascular disease (angina, heart attacks and strokes) nationwide. Our nurses offer a three-yearly screening and advice service to all patients aged 16 to 74. In order to make this service as convenient as possible to you and to maximise the uptake of the scheme, you may find the nurses offering this service to you when you attend the surgery for other reasons. We hope you will take advantage of this opportunity to focus on your long-term health.

Private Medical Examinations
We are able to undertake a range of medical examinations covering your health and fitness. These include mortgage and insurance medicals, HGV, PSV, elderly drivers’, diving and pre-employment medicals and others. Medicals required under the Health and Safety and COSHH regulations are also available. Details are available from reception.

Women

We offer a range of services which are specific to women. If you think one of the following might apply to you, book in to see your doctor and discuss it.

Family Planning (Men Included!)
All the doctors are trained and experienced in advising on all aspects of contraception. In addition we are able to offer contraceptive coil insertions, cap fittings, injectable contraceptives and referrals for sterilisations. Vasectomies can be carried out by one of the partners.

Pre-conception
We strongly encourage women planning a pregnancy to consult their doctor in advance of conception for advice and screening for rubella susceptibility and advice with regard to folic acid (vitamin) supplements (we recommend 400mcg daily). Timely intervention can significantly reduce some of the medical risks of pregnancy to both mother and baby. Bring your partner if you wish!

Pregnant Women
Pregnancy is an exciting time and we are here to help ensure that you end up with the very best possible outcome. We work closely with the district midwives who are based at Stroud Maternity Hospital. For most women we are able to provide a comprehensive service throughout pregnancy, including during delivery. This means that you may not need to attend hospital outpatients at all. Most of our patients have few if any antenatal problems and choose to have their babies under our supervision at Stroud Maternity Hospital.

Postnatal Care
Care and advice for you and your new baby will be given mostly by your district midwife. We may also visit you and through us help is available 24 hours a day should the need arise. Your doctor would like to see you six weeks after delivery for a postnatal check. This will be arranged by your midwife.

Cervical Cytology (Smear Tests)
We strongly encourage all women who have ever been sexually active to have regular cervical smears from the age of 20. This helps us detect problems which might, if left untreated, lead to cervical cancer. The programme nationwide has been successful in saving the lives of thousands of young women, who often have young families. We are fully committed to supporting it.

Well Woman Clinic
An appointment for this clinic will enable you to have a checkup and discuss appropriate problems with the practice nurse. All health education topics may be covered, including healthy living, the menopause, cervical cytology, the NHS breast screening programme and so on.

Menopause (‘The Change’)
This is a difficult time of life for a lot of women and even now many suffer unnecessarily from its effects. Safe and simple treatments are readily available. Please consult the doctor for the treatment best suited for your needs.

The Very Young

We work with your district midwife and your health visitor to offer you a full postnatal and early childhood screening and immunisation programme.

Your New Baby
The new arrival should be checked by a doctor at birth and screened for blood disorders by the district midwife on day three (thyroid function and phenylketonuria). We recommend vitamin K to safely help prevent bleeding disorders. Regular weighing and measuring enables us to see that your baby is growing well, and development checks at home and in the child health clinic should help ensure that, should any problems arise, they are picked up promptly when they may be best dealt with. We encourage breast feeding whenever possible as this, amongst other things, will help your baby to fight the infections they will be faced with. Please also ask for our comprehensive leaflet - "Having a baby" - available from the midwife, Mrs Sheila Bladder.

Children's Immunisations
It is most important that your child is properly immunised. The practice runs a comprehensive infant and pre-school immunisation programme in liaison with the health visitor. Parents are automatically informed when their child is due for the next injection. The schedule of vaccination is:-

Age		Immunisation
2 months		1st triple (diphtheria, tetanus, pertussis), polio, HIB
3 months		2nd triple, polio and HIB
4 months		3rd triple, polio and HIB
15 months		MMR (measles, mumps and rubella)
4 to 5 years		Pre-school booster: diphtheria, tetanus and polio
15 - 18 years		Tetanus and polio booster

Cot Death Prevention
We strongly advise you to encourage your baby to sleep on their back. Babies should not get overheated, especially at night. Avoid over-dressing them; do not use a duvet or quilt until they are a year old. A well ventilated bedroom free of cigarette smoke is also important, as is avoiding unnecessary medication.

The Over 75s
Many of you will probably be seeing your GP from time to time with medical problems and so will know your doctor well. In line with government rules, we offer those who wish it an annual check by a doctor or nurse, in the surgery or at home. This is entirely voluntary and you may take up the offer if you wish.

Asthmatics
With several hundred of you registered with the practice, we offer a special service. All our nurses are trained in the management of asthma, including childhood asthma and emergencies. Debbie Cunningham is our specialist asthma nurse. Apart from visits to your doctor when you have particular problems, we encourage all asthmatics on regular medications to attend our nurse-run asthma clinics on a regular basis. Research shows that hospital admissions, time off work and deaths from asthma are considerably reduced if asthmatics are regular attenders at an asthma clinic. Please make the effort to come if you are invited - we think you will find it worthwhile!

Diabetics
Diabetes is for life. If it affects you, you will live longer and with fewer medical problems if you are regularly seen, not just by your doctor but also in the nurse-run diabetic clinic. It is here that we can focus just on your diabetes and help you to achieve the best possible control of your blood sugar levels. We can also screen you regularly for the best early signs of the complications which sometimes develop. Early treatment means a much better outcome. The nurse will keep your own doctor informed and bring any problems to their attention. Alyson Plumb is our specialist diabetes nurse.

Influenza Vaccination
Influenza vaccination is available and actively encouraged for patients in ‘at risk’ groups. These are:

• Aged 65 and over
• Heart disease
• Diabetes
• Chronic chest disease/breathing problems (including asthma)
• People who live in nursing or residential homes
• Kidney disease
• Immuno-suppressed - usually caused by:
  - spleen removed
  - on high dose steroid treatment
  - chemotherapy
  - HIV infection
  - carers of people in any of the above categories

Flu vaccination is available during October and November each year. Please ask at reception or telephone to make an appointment.

Pneumococcal vaccination is also available at any time for patients in recognised risk groups. Please ask at reception.

Minor Surgical Procedures

We undertake a range of minor operative procedures in the surgery’s treatment room, including the removal of skin lesions and foreign bodies, joint injections, contraceptive coil insertions and so on. Ask your doctor if you have something you would like looked at with a view to removal!

Endometrial Biopsy and Sigmoidoscopy

Certain investigative procedures are available in house. Dr Kirby performs endometrial biopsies and Dr Gerald performs Sigmoidoscopies when necessary.

Travellers And Holidaymakers

Our nurses will help you to have a safe trip by providing you with routine advice on travel immunisations and other health-related travel issues. If at all possible, please attend for advice at least a month, and preferably six weeks, before departure.

REMEMBER: GOOD ADVICE CAN SAVE LIVES.

Before You Go
Well before travelling abroad, check with your travel agent or the tourist office/embassy of the country you intend to visit on any special precautions you may need to take. Many countries require more than one immunisation. At least two months before departure, discuss any vaccination requirements with your doctor or the practice nurse. Pack a small first aid kit containing adhesive dressings, insect repellent, antiseptic cream and water purification tablets.
HIV travellers’ kits are available from the practice.

Eating And Drinking
Attention to water and food quality is crucial, especially in less developed countries. Factory bottled water is usually less likely to carry infections than tap water. Water sterilisation tablets can be helpful - particularly at altitude where water cannot be sterilised by boiling it. Fruit and vegetables should be washed in clean water. Meat and egg quality may be poor and therefore these should be well cooked and NOT eaten ‘rare’.
Food should NOT be re-frozen or re-heated.

Sun Protection Sun exposure causing sunburn puts you at risk of skin cancers in later life, some of which are very difficult to treat. Prevention is better than cure. Appropriate clothing and headgear is the best protection, but if you must tan your body, aim to do it slowly and be sure to use suncreams of sufficiently high protection against UVA and UVB. Note that these are considerably more expensive than standard products, many of which only protect against UVA. In hot climates drink plenty of non-alcoholic drinks. If you are not passing water regularly, you are not drinking enough.

Mosquito Bite Prevention

• By day: Use repellents which contain agents such as diethyl tolbutamide on exposed skin or on appropriate garments.
• After sunset: Wear clothing which covers you fully when out of doors.
• Overnight: Sleep in appropriately screened rooms and use a knock down spray to kill mosquitoes which have accidentally found their way in. If this is not possible, use mosquito netting around the bed. Tuck it in under the mattress before nightfall. Nets work best if impregnated with a permethrin-based spray every six months. Also use an electric pyrethroid vapouriser or burn a mosquito coil.

Insect Bites
Topical antihistamines can help. Seek medical advice if they become infected.

Traveller’s Diarrhoea
Anti-diarrhoeal medications should in general be avoided unless there is a pressing reason taking you out of reach of loos - they may cause the illness to be prolonged! There are few diarrhoeal illnesses which need specific medical intervention.

Diarrhoea And Vomiting
This is unpleasant but generally short-lived. Avoiding dehydration is the mainstay of treatment. Even if still vomiting, ensure you take frequent sips of clean, non-fizzy, clear fluids such as squashes and plain water. Most episodes settle spontaneously. Consult a doctor if vomiting is prolonged.

Cuts And Bruises
Cleanse the wound and apply fresh clean dressings daily. Avoid repeated or prolonged salt water immersion. Consult a doctor if infection is suspected.

Deep Vein Thrombosis (DVT)
Thrombosis can occur on long haul flights. Exercise during the flight is the best protection. Special socks are available from chemists.

Sexually Transmitted Diseases
These are very common in some countries. Condoms offer some protection.

Health Insurance
Ensure that you have adequate health insurance when abroad.

On Your Return
If you fall ill, don’t forget to tell your doctor that you have travelled abroad. If you have received treatment abroad, tell your own doctor on your return. When donating blood, tell the transfusion staff which countries you have visited.