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PLEASE REMEMBER WE REQUIRE AT LEAST 6 TO 8 WEEKS NOTICE PRIOR TO YOU TRAVELLING

If you are thinking of travelling abroad please read our advice below. For those intending to go back packing or with a complicated itinerary, please contact the surgery several months in advance. 

Our Nurses can provide comprehensive travel health advice and arrange for appropriate vaccinations. We strongly advise you to check your requirements at least six to eight weeks before travel, as sometimes a course of up to three vaccinations needs to be given over the course of several weeks.

It is your responsibility to ascertain which vaccinations (and, if relevant, anti-malaria tablets) you need, and also to inform yourself fully of recommended travel safe precautions. To do this, you should visit here and read the information relevant to the country you are visiting.  Those intending to go back-packing or with a complicated itinerary should ideally contact the surgery several months in advance.

Please fill in our Travel Assessment form outlined below and one of our team will respond to you within 7-10 working days recommending the vaccinations you require for your trip.  Please be advised this is a private Travel Vaccination Clinic.  If you are a registered patient at The Grange Surgery the NHS eligible vaccines will not be charged, but you will be charged for any that are not available on the NHS and will need to be paid for in advance of appointments.  Please click here for up to date prices.

For all advice on travel care including general health and malaria click here to read our Travel Advice Leaflet.  If you prefer please collect a leaflet from our reception team.

Yellow Fever Vaccine

Yellow fever is a potentially life threatening viral illness that is found in tropical areas of Africa and South and Central America. In the UK you can only obtain the yellow fever vaccination from a designated Yellow Fever Clinic. If you require yellow fever we are registered centre.

Further information for yellow fever vaccine please click here.

Further Travel Information

The following websites will give you additional travel advice

Travel Health for information of vaccinations available on NHS

Gov.uk for specific country travel advice

EHIC to apply for your free European Health Insurance Card

People with learning disabilities are recognised as a group who can sometimes have poorer physical and mental health than others. To try and address this issue, we offer an annual health check to all our patients with learning disabilities. These are carried out within the surgery by our team of nurses.

They will complete a health questionnaire at the appointment. Please feel free to bring along a chaperone. 

During the appointment the information you have provided in the health questionnaire will be discussed as well as lifestyle issues such as diet, exercise, smoking and alcohol consumption. We will check your height, weight and blood pressure. We will check you are up to date with any screening that is due, such as cervical cytology (smear test) and breast screening. We may need to take a blood sample from you. Please also bring a fresh sample of urine to this appointment with you. This appointment will take approximately 30 minutes. 

If you wish to discuss your contraceptive options or start a new type of contraception – please make an appointment with a GP.

We offer a full range of contraceptive options including long-acting reversible methods (LARCs) which can be fitted at the surgery.  These includes Contraceptive Implants and Coils in addtion to Depo-Provera injections.

Please see the individual sections below for more information about each method of contraception offered:

Emergency Contraception

There are two methods of emergency contraception:

A special pill known as emergency hormonal contraception (or the ‘morning after pill’) that works within 3 days after sex (but it works better the sooner you take it).

The emergency IUD (also known as the coil), which can be used up to 5 days after sex and is the most effective.  If you are under 25 you can get free emergency contraception pills from the following places:

Where can I get emergency contraception from?

• Young people’s sexual health clinics
• Your own doctor
• NHS Walk-In Centres

You can get the emergency IUD (coil) from most young people’s sexual health clinics but you should ring first to check that a doctor or nurse trained to fit one is available.  If you are considering starting the contraceptive pill you should see your GP to discuss your options and ensure that the type of pill chosen is the safest and most appropriate for you to take. This will involve discussing your past medical history and that of your family. We will also need to weigh you, ask questions about your lifestyle and measure your blood pressure. 

The IUD/IUS (‘The Coil’)

There are 2 types of contraceptive intra-uterine devices: one is made of copper and the other is made from plastic impregnated with a synthetic form of the hormone progesterone (The Mirena Coil).  If you are considering either of these as a form of contraception, please make an initial appointment with a GP to discuss.

The Doctor may ask you if you want to have swabs taken to exclude any genital tract infections before fitting the contraceptive device. We need to be certain there is no risk of you already being pregnant before we can fit the device. This means you that need to either already be using a reliable method of contraception or have abstained from any sexual intercourse for the previous 3 weeks and have had a negative pregnancy test.

The contraceptive device is fitted inside the uterus . The GP will perform an internal examination first to find the position and size of your uterus. Fitting the device can take 30 minutes. It can be uncomfortable and can cause some light bleeding so it’s a good idea to bring a sanitary pad to wear afterwards. We usually advise women to take 400mgs Ibuprofen (if you are able to safely take anti-inflammatory medications) before you attend your coil fitting appointment.

We ask you to attend for an appointment with our nursing team around 6 weeks after having the device fitted. This is so they can check it remains in the right place and that any concerns you have can be addressed.

For further detailed information about intra-uterine contraceptive devices (coils), please click here:

http://www.fpa.org.uk/helpandadvice/contraception

Contraceptive Implant (NEXPLANON)

If you are considering the implant as a form of contraception, please make a telephone appointment with a GP to discuss.  Insertion of the implant is performed by Dr Mileham. This is done under local anaesthetic and is not usually uncomfortable. It is removed using a similar procedure after 3 years.

It is really important that we are sure you are not already pregnant before the implant is fitted. For this reason, we need you either to be already using a reliable method of contraception or to have had no sexual intercourse in the previous 3 weeks and have had a negative pregnancy test.

For further detailed information about the contraceptive implant, please click here:

http://www.fpa.org.uk/helpandadvice/contraception

If you have ever had a stroke or transient ischaemic attack (TIA), the nursing team would like to review you on an annual basis to ensure that your risk of developing further cerebrovascular problems is reduced as much as possible. This check will involve discussing your diet, exercise, smoking history and alcohol intake. We will weigh you, check your blood pressure and take blood to check your kidney function, glucose levels, and cholesterol levels. We also ask you to bring a fresh sample of urine to this clinic with you.

Further information can be found about strokes/TIAs at http://www.stroke.org.uk/

If you have ever had a heart attack or been diagnosed with a heart problem, including angina or valve problems, the nursing team would like to see you on an annual basis to review your treatment and lifestyle choices.  This clinic takes around 20 minutes and we will discuss your diet, exercise level, alcohol intake and smoking history. We will provide appropriate advice if changes are advised to reduce your risk of developing future problems. We will also measure your height and weight, blood pressure and take blood to check your kidney function, glucose levels, and cholesterol. We ask you to bring a fresh urine sample with you to this clinic. We may ask you to have an ECG if you have not had one recently.

Please tell the receptionists if you require a heart disease clinic appointment so that they can allocate the right amount of time.

Further information about heart disease can be found at http://www.bhf.org.uk

If you are already taking medication to control your blood pressure we need to monitor your condition on an annual basis. This is to ensure that your blood pressure remains at an acceptable level (blood pressure tends to rise naturally as we age) and review your medication. We will also reinforce any lifestyle changes that may benefit you and perform some blood tests to ensure that your kidneys are working effectively. Due to the blood tests needed, we usually offer these appointments in the morning clinics only. Our nursing team, or one of the health care assistants can see you for these annual checks.

Please also bring in a fresh urine sample to this appointment.

Please tell the receptionists if you require a Hypertension check so that they can allocate the right amount of time.

If your blood pressure is not well controlled on your current medication the nurse will liaise with your GP.  Further treatment options will be discussed with you as well as giving advice on lifestyle factors, prescribe any medication needed and arrange to review you if necessary.

Further information about blood pressure can be found at

 http://www.patient.co.uk/health/High-Blood-Pressure-(Hypertension).htm

If you have asthma the nursing team would like to see you on an annual basis to monitor your condition. They can advise you on managing your condition and review your treatments with the aim of you being completely symptom-free. Please tell the receptionist if you wish to book an asthma review and they will allocate the appropriate amount of time. Please bring the inhalers you use to the appointment with you.

Asthma is a common condition that causes coughing, wheezing, tightness of the chest and breathlessness. Most people with asthma who take the appropriate treatment can live normal lives, but left untreated, asthma can cause permanent damage to the airways.

The usual symptoms of asthma are

• coughing
• wheezing
• shortness of breath

Not everyone will get all of these symptoms. Some people experience them from time to time; a few people may experience these symptoms all the time.

There isn’t a cure for asthma. However, treatments are available to help manage your symptoms. Your treatment plan will be individual to you, combining medicines and asthma management in a way that works best for you.

Medicines are only part of your treatment for asthma. You will also need to deal with the things that make it worse. Keep a diary to record anything that triggers your asthma – this can help you to discover a pattern. Using a peak flow meter to monitor your lung function can also help. If you have repeatedly low readings in a certain situation (for example, at the end of a working day, after exercise or after contact with an animal) this may indicate the trigger.

Further detailed information about asthma is available at http://www.asthma.org.uk

If you have been diagnosed with COPD (chronic obstructive pulmonary disease) you will be asked to attend for a review with one of our nurses once a year.  The clinic will involve a test of your breathing, called a spirometry test, where you will be asked to fully empty your lungs of air into a machine a few times for measurements to be taken.  We will also discuss your treatment and assess your inhaler technique.  Prior to the appointment you MUST NOT eat a substantial meal, take vigorous exercise, smoke or drink alcohol.  It is important however that you DO take your inhalers as normal and bring them with you to the clinic.  If you have a chest infection which has required antibiotics in the 6 weeks prior to your appointment, then you will have to rearrange it.  The appointment should take approximately 30 minutes but you should give yourself plenty of time as you do not want to be out of breath for the test.

More information can be found about COPD at:

http://www.lunguk.org/you-and-your-lungs/conditions-and-diseases/copd.htm

If you have either Type 1 or Type 2 diabetes and are not being seen by a hospital consultant regarding your diabetes management, we need to see you at least annually at the surgery for a diabetes clinic. Please make an appointment with our nursing team for this. It will take approximately 30 minutes to complete.  During this clinic, lifestyle issues such as diet, weight, exercise, smoking and alcohol intake will be discussed and advice given if necessary. We will weigh you, check your blood pressure, and take blood to see how well your diabetes is being controlled. We also send blood to measure your kidney function, cholesterol levels and check on your thyroid function. We also need to send a fresh specimen of urine, so please bring this with you to the clinic if you can.  We will check to ensure that you are having your annual retinopathy checks (checks to the vessels in the back of your eyes). We will also check your feet to ensure that the sensation is intact and you have a good blood supply to them. We can refer you on to a foot specialist (podiatrist) if any issues are uncovered.

When the results of your tests are back, your GP will decide if we need to do more to help you manage your condition. You may be asked to make an appointment to see the practice nurse who will explain the results of the tests and discuss what may be done to improve your diabetes control and reduce the risk of developing future diabetic complications.

Further information about diabetes can be found at http://www.diabetes.co.uk/.