Contraception

Emergency Contraception

If you’ve forgotten to take your pill, your condom split or you’ve had unprotected sex in the last 72 hours then you may need emergency contraception, and the sooner you take it the better.

Emergency contraception is available free from Contraception and Sexual Health Services, some GPs (family doctors) and most pharmacies (chemists), even if you’re under 16.

If you’ve had unprotected sex or your condom failed, it is also really important to consider your risk for sexually transmitted infections and to think about your long-term contraception needs. Please phone the surgery to book an emergency appointment.

If you miss the 72 hours it is still possible to have an emergency coil fitted up to 5 days after unprotected sex. You can have an emergency coil fitted for free at your local sexual health clinic.

SHL.UK

SHL.UK offers regular and emergency contraception to people over the age of 16 who live in Lambeth, Southwark, Kensington and Chelsea, Hammersmith and Fulham, Westminster, Lewisham, Ealing, Harrow, Hackney, City of London, Brent, Kingston, Barnet, Islington, Camden, and Bexley (if you live in Bexley you can use the contraception services, however, please note this is currently a pilot).

It’s for people who want to start using contraception or continue their current method.

Use this link below to access this service.

Women’s Health

Breast Screening

The National Breast Screening Programme was introduced in 1988 as an early detection service for breast cancer. It states that all women who are aged between 50 – 70 years of age will be routinely invited for free breast screening every three years. The programme is very successful and currently saves around 1,400 lives per year.

Breast screening aims to find breast cancer at an early stage, often before there are any symptoms. To do this, an x-ray is taken of each breast (mammogram). Early detection may often mean simpler and more successful treatment. When women are invited for their mammogram depends on which GP they are registered with, not when their birthday is.

The screening office runs a rolling programme which invites women by area. The requirement is that all women will receive their first invitation before their 53rd birthday, but ideally when they are 50. If you are under 50 and concerned about any aspect of breast care, please contact the surgery to make an appointment with your GP.

Cervical screening test

Cervical screening, or smear test, is a method of detecting abnormal (pre-cancerous) cells in the cervix in order to prevent cervical cancer. The cervix is the entrance to the womb from the vagina. Cervical screening is recommended every three years for women aged 25 to 49 and every five years for women aged 50 to 64 or more frequently if smear results indicates abnormal changes.

Cervical screening is not a test for cancer; it is a test to check the health of the cells of the cervix. Most women’s test results show that everything is normal, but for 1 in 20 women the test will show some abnormal changes in the cells of the cervix.

Most of these changes will not lead to cervical cancer and the cells may go back to normal on their own. However, in some cases, the abnormal cells need to be treated to prevent them becoming cancerous.

Our nurses are qualified to carry out cervical screening and tests in the form of cervical smears. In order to have a cervical smear the patient must have received a letter requesting that they have a cervical smear and the appointment must please be made for when the patient is not menstruating.

These appointments typically take around 10 minutes. For any further information or to book an appointment, please call the surgery.

Useful links

NHS Choices – Cervical Screening

Cervical screening – the facts

Non-urgent advice: What is cervical screening?

Cervical screening is not a test for diagnosing cervical cancer. It is a test to check the health of the cervix, which is the lower part of the womb (often called the neck of the womb).

For many women the test results show that everything is fine.

But for around one in 20 women, the test shows changes in cells that can be caused by many things.

Most of these changes will not lead to cervical cancer.

Cervical screening is also introducing testing for the human papillomavirus (HPV). Certain types of HPV can cause abnormal changes in the cervix.

Non-urgent advice: What is HPV?

The human papillomavirus (HPV) is a very common infection and most women get it at some time in their life. There are many types of HPV, and some types can cause abnormalities in the cervix. In some cases these abnormalities may, if left untreated, go on to develop into cervical cancer. Not all abnormalities develop into cancer however, and in many cases HPV clears up by itself.

HPV is easily transmitted during intimate sexual contact between partners. This includes intimate contact between men and women, and between partners of the same sex. The virus shows no symptoms. This means you or a partner could have had the virus for many months or years from a previous relationship, without knowing it.

Non-urgent advice: Why are women offered cervical screening?

Cervical cancer can often be prevented. The signs that it may develop can be spotted early on so it can be stopped before it even gets started.

Around 750 women die of cervical cancer in England each year. However many of those who develop it have not been screened regularly. Not going for cervical screening is one of the biggest risk factors for developing cervical cancer.

Non-urgent advice: Should all women have the test?

We offer the test to all women aged between 25 and 64 but cervical cancer is more common if you:

smoke;

first had sex at an early age;

have had several sexual partners or have had a sexual partner who has had several other partners; or

take immunosuppressant drugs (for example, after an organ transplant).

If you have passed the menopause, you still need to be tested to check that your cervix is healthy. Ask your doctor for advice if you:

have had a hysterectomy;

are over 65;

have never had sex with a man or woman; or

you are not sure whether you still need to be tested.

Non-urgent advice: What is the NHS Cervical Screening Programme?

The programme makes sure that if you are aged between 25 and 64, you will automatically receive an invitation. We will get your name from your doctor’s list. This means it is important that your doctor always has your correct name and address.

After your first cervical screen, you will receive invitations every three years between the ages of 25 and 49. You will then be invited every five years between the ages of 50 and 64.

Non-urgent advice: Who will carry out my test?

A doctor or nurse will carry out your test. If you would prefer to see a female member of staff, or would like someone with you, please ask when you make your appointment.

Non-urgent advice: Will I have to undress?

We will ask you to undress from the waist down, but if you wear a full skirt you will not have to remove it.

Non-urgent advice: What happens during the test?

The doctor or nurse will ask you to lie down on a couch. They will then gently put a small instrument, called a speculum, into your vagina to hold it open.

Then, they will wipe a small brush-like device over the cervix to pick up some cells.

They will put these cells into a small container of liquid, and send it away for the cells to be transferred onto a slide and examined under a microscope.

The test takes just a few minutes.

Non-urgent advice: What about HPV testing?

We are starting to introduce HPV testing as part of the cervical screening programme. It will take a while for this to happen everywhere in England. HPV can cause abnormal changes in the cervix. If your screening result shows borderline cell changes or mild abnormalities (known as mild or low-grade dyskaryosis), an HPV test may be carried out on the sample of your cells taken during screening. This will help us decide if you need any further investigation, or if you can simply go back to routine screening in three or five years’ time (depending on your age).

The nurse taking your cervical screening sample will be able to tell you whether HPV testing has started where you live.

Non-urgent advice: When should I have my screening?

You should not be tested during your period so try to make sure you get an appointment before or after your period is due. The best time is in the middle of your cycle.

Non-urgent advice: Can I have sex before the test?

If you use a spermicide, a barrier method of contraception, or a lubricant jelly, you should not use these for 24 hours before the test as the chemicals they contain may affect the test.

Non-urgent advice: When do I get my results?

When you have the test, the doctor or nurse will tell you how, where and approximately when you will get your results. Make sure you have received this information before you leave the surgery or clinic.

Non-urgent advice: What about my HPV results?

If you have a screening result showing borderline cell changes or mild abnormalities, then your screening sample may be tested for HPV. This won’t happen for everyone yet, as HPV testing is only just being introduced in England. If your sample is tested for HPV, then you will get this result at the same time as your screening result.

Non-urgent advice: How reliable is cervical screening?

Early detection and treatment can prevent around 75% of cancers developing but, like other screening tests, it is not perfect.

It may not always detect early cell changes that may lead to cancer. Abnormal cells on your slide may not be recognised because:

sometimes they do not look much different from normal cells;

there may be very few abnormal cells on the slide; or

the person reading your slide may miss the abnormality (this happens occasionally, no matter how experienced the reader is). About one in 20 tests have to be taken again because:

you may have an infection which needs treating before a clear slide can be made;

the cervical cells on your slide may have been hidden by blood or mucus;

there may not have been enough cervical cells on your slide to give an accurate assessment;

your sample may not have been properly prepared; or

the slide may have been broken.

Screening isn’t used to investigate cervical symptoms. If you have any unusual symptoms, such as bleeding after sex or between periods, you should see your doctor as soon as possible.

Non-urgent advice: What does it mean if I am called back for another screening test?

This usually means that your sample did not show up clearly, so we need to take another one. This is called an ‘inadequate result’.

On the other hand, screening may have found some small changes in the cells of the cervix. If abnormal changes (known as dyskaryosis) are detected, you will have what is called an ‘abnormal result’. If you have borderline or mild changes found at screening, you may be asked to come back again after six months for a repeat test. This is routine for any woman with borderline or mild changes if their screening sample hasn’t been tested for HPV. Your results letter will let you know if you need to come back for another screening test.

For more information about an abnormal screening result, you can read our leaflet ‘what your abnormal result means’, available at www.cancerscreening.nhs.uk/cervical/ publications/abnormal-result-means.html

Non-urgent advice: Can anything be done about abnormal changes?

Yes. Your doctor or nurse will explain what needs to be done. They may simply ask you to come back for more cervical screening tests, because the abnormal cells may return to normal by themselves.

However, they may ask you to go to hospital for a closer examination which is called ‘colposcopy’.

For more information about colposcopy, you can read our cancer screening programme leaflet ‘The colposcopy examination’.

Treatment, if it is needed, is a minor procedure and is usually done in an outpatient clinic. This means you will not have to stay overnight.

Non-urgent advice: Can cervical screening prevent cancer?

Yes. Regular cervical screening is the best way to detect changes to the cervix before cancer develops. Early detection and treatment can prevent cancer developing in around 75% of cases. Screening can also find cervical cancer early on, when treatment is more likely to be effective.

Non-urgent advice: What happens to my screening sample once it has been looked at?

The laboratory that looks at your sample will keep it for at least 10 years. They can then compare your latest result with the ones you have had before. This is to make sure that you get any treatment you may need. They may review all screening records, including your sample, as part of our aim to offer a quality service and to help increase the expertise of specialist staff. This means that staff who work elsewhere in the health service will need to see your records.

When a review shows that you should have been cared for differently, we will contact you. We will offer you information about the review of your case if you want to know it.

For more details about the records we keep, you can contact NHS Direct on 0845 4647.

Summary

To help you decide whether or not to come for cervical screening, the main benefits and difficulties of cervical screening are explained below.

Cervical screening reduces the risk of developing cervical cancer.
Due to cervical screening, cervical cancer is now an uncommon disease in this country.
Cervical cancer rates have halved since the 1980s, largely due to most women regularly having cervical screening.

In around one in 20 tests, the cells cannot be seen properly under the microscope and the test must be taken again.
The test can show minor abnormalities in cervical cells which would have cleared up on their own, and women would never have known about them if they had not been for screening. It is not yet clear which minor abnormalities will develop into cancer and which will not. Many women worry when a minor abnormality is found.
Cervical screening does not pick up every abnormality of the cervix.
Regular cervical screening can prevent around 75% of cervical cancers developing, but it does not prevent every case.
Some women find having the test an unpleasant experience.
Research suggests that up to 4,500 lives will be saved each year in England by cervical screening.

More information and support

If you have any questions about the service, you can:

Ask your GP
Contact a local health clinic
Visit our website at cancerscreening.nhs.uk; or
Call NHS Direct on 0845 46 47, or visit www.nhs.uk

The text of this document may be reproduced without formal permission or charge for personal or inhouse use.

If you require further copies of this publication quote 2900406/

Cervical Screening and contact: DH Publications Orderline

Email: dh@prolog.uk.com

Tel: 0300 123 1002

Fax: 01623 724524

Textphone: 0300 123 1003 (8am to 6pm Monday to Friday)

To read the information provided in your own language, please click one of the links below.

Vaccinations

We administer the full range of travel vaccinations and advice. We are an authorised Yellow Fever centre.

Please see link to a short video YouTube channel promoting uptake of immunisations that has been produced by Solutions for Health and the communications team.

For current vaccination recommendations and comprehensive travel advice, check the free NHS site Fit for Travel.

It is recommended you make an appointment to see the Practice Nurse at least 6 weeks before travelling. This gives a chance to have all the vaccines you need. If you are travelling at short notice, we can administer an accelerated programme though this is not so satisfactory. When booking your appointment, tell the receptionist you are coming for travel jabs.

People working abroad, especially aid workers, may require extra immunisations.

If you originally come from the country you are visiting, it is likely your immunity will have worn off so it is important to be vaccinated.

Diphtheria/Tetanus, Polio, Typhoid, and Hepatitis vaccinations are all available free of charge.
Yellow Fever, Meningitis A&C or ACWY, Hepatitis B, and Rabies vaccinations are chargeable. Certificates are included.
The Japanese B Encephalitis vaccine is only available privately from Masta.
Dip/Tet and Polio may require a booster every 10 years for travellers to certain areas
Heptatitis A requires a booster vaccine 6-12 months after the first with boosters every 10 years.
Hepatitis B requires a booster 5 years after the initial course of 3 injections. Typhoid lasts 3 years.
Yellow fever lasts 10 years

Don’t forget to take malaria tablets – these are not available on the NHS and need to be bought from a pharmacy. Some require a private prescription, some not. Our nurse will tell you which combination you’ll need – there may be seasonal changes. Though vitally important, the tablets do not offer complete protection so also take mosquito protection measures (mosquito netting, repellents, long sleeves, sprays and vapouriser, all of which help to some extent). All children will require protection; reduced dose vaccines and malaria prevention are available.

Flu Immunisation

Seasonal flu is a highly infectious illness caused by a flu virus.

The virus infects your lungs and upper airways, causing a sudden high temperature and general aches and pains.

You could also lose your appetite, feel nauseous and have a dry cough. Symptoms can last for up to a week.

We offer ‘at risk’ groups the flu vaccine at a certain time each year to protect you against the flu virus.

You may be invited for a flu jab if you are:

over 65 years of age
pregnant

or have:

a serious heart or chest complaint, including asthma
serious kidney disease
diabetes
lowered immunity due to disease or treatment such as steroid medication or cancer treatment
if you have ever had a stroke
If you have any queries please contact the surgery.

For more information please visit the websites below:

Useful links

NHS Choices – Flu and the Flu Vaccine

Weight Loss

If you would like to know more about weight and diet advice, we offer a weight management clinic giving you advice on how to lose weight and stay healthy.

A range of options are available to support people with weight loss. To understand which of them may be the best fit for you please arrange an appointment with your GP who will be happy to discuss them with you.

One suitable option may be our Health Trainers who offer 1:1 sessions for people wanting to improve their health and change their behaviour. They can support individuals with healthy eating, weight management and getting physically active.

Many doctors now believe that when it comes to your health, your waist measurement is important.

While knowing your body mass index (BMI) is a good way to decide if you’re overweight, it doesn’t tell the whole story.

BMI is a measure of how healthy your weight is for your height. You can work out what your BMI is by using the NHS Choices BMI healthy weight calculator.

If you have a high BMI, you’re likely to be carrying extra fat. But your health could be at greater risk depending on where you store that fat.

Having a large amount of tummy fat (compared to fat around your bottom or thighs) makes you more likely to develop diabetes and heart problems.

A healthy waist circumference for men is less than 94cm (37 inches), and for women it’s less than 80cm (32 inches).

Losing weight and keeping it off isn’t easy, but it has many benefits. You may only need to make small changes to your lifestyle to maintain a healthy weight.

If you’d like to find out more about how you can lose weight in a healthy way please book an appointment with one of our nurses.

For more general information about weight loss, please see the websites below:

Useful links

Smoking Cessation

If you’re trying to give up smoking, we can help. Studies show that your chances of success will be greatly improved if you get advice and support from health care professionals to help you stop smoking and if you don’t pay for your prescriptions then giving up is free.

The services we offer from the Practice can:
Boost your willpower to stop smoking
Concentrate your efforts by getting advice from someone who knows your medical background
Help you feel that you’re not doing it alone
Help you to cope when you are tempted to smoke
Monitor improvements to your health so that you can see the benefits

Please call the surgery to arrange an appointment with our smoking cessation advisers.

Useful links

Sexual Health

A range of sexual health services are offered at the surgery including:

Contraception and contraception advice
Emergency contraception and emergency contraception advice
Testing and treatment for sexually transmitted infections (STIs), such as syphilis, gonorrhoea and genital warts
Chlamydia screening is available from the surgery. Simply ask at reception for a kit. It is a completely confidential service where you can send a urine sample in the envelope provided and receive the results easily.
Testing and counselling for HIV and AIDS

If you need advice and support with a sexual health matter or you think you have a problem you would like to discuss, please call the surgery to make an appointment with your GP.

Sexual health services are freely available for everyone.

For more information please visit the websites below:

Useful links

Sickness Certificates

The NHS provides sickness certification only after seven continuous days of illness. If you need a sick note to cover this period of sickness you should complete a Self Certification (SC2) form which is available from your employer or on the HMRC website.

Please visit the Direct Gov website for full information about fitness for work following a period of sickness.

After this period a NHS certificate may be issued but you will need to contact the surgery as it may be necessary to discuss your request with your GP.

You do not need to see your GP again to be ‘signed back to work’.

Private Services List and Fees

We offer a number of Non-NHS services to our patients or in other words there are a number of services that are run from these premises that are offered on a Private basis. They are not part of the NHS, so fees are usually payable. Please contact the practice for prices.

CERTIFICATES AND FORMS

Private Letter / TWIMC

Private Sick Certificate

Private Prescription for Travel

Freedom from Infection Certificate

Sickness / Accident Insurance Form

Lighter Life Forms

Housing Letter (payable in advance)

Children Letter for Ballet / Stage etc.

Fitness to Fly Letter

Cancellation Holiday Form / Letter

Fitness to Exercise Certificate

Overseas Pension Form

Power of Attorney Form

Power of Attorney Form (Home Visit)

School Health Report

School Health Report (Ofsted)

Letter for taking Meds on Plane

Passport Form / Photograph

Firearms / Shotgun Licence

MEDICAL EXAMINATIONS AND REPORTS

HGV

All Taxi Medicals and Bus Medicals

Pre-employment Medical
(Including elderly driver fitness to drive)

TRAVEL VACCINATIONS

Hepatitis B

Yellow Fever

Polio Certificate

Rabies (three injections)

Japanese Encephalitis (Adult – Two Injections)

Japanese Encephalitis (Child – Two Injections)

Tickbourne Encephalitis (Adult – Two Injections, 1 year cover)

Tickbourne Encephalitis (Child – Three Injections, 1 Year Cover)

Meningitis

MMR (Over 16s)

Family Planning

Antenatal care

Antenatal care is the care and help you receive from health professionals during the course of your pregnancy. It is important you take good care of your own health and that of your unborn baby during pregnancy.

As soon as you find out you are pregnant, you should get in touch with us to find out more information on the services and support that are available to you.

Useful links

Family Planning

Our family planning clinics offer free, confidential advice and information about contraception and sexual health.

We provide a range of services including:

Confidential advice about contraception
The combined oral contraceptive pill
The Progestogen-only pill
Progestogen injections
Limited supplies of free condoms
Free emergency contraception
Confidential advice about STIs
Cervical screening
Unplanned pregnancy advice
Free pregnancy tests
Pre-conception advice and fertility awareness information
Fitting and checking of caps, diaphragms, and coils (intrauterine devices, or IUDs)

Please book an appointment (through reception or via our online services) with your GP to discuss any of the above in more detail.

For more information please visit the websites below:

Useful links

Postnatal Care

Postnatal care extends for between 6-8 weeks after the birth of your baby. During this period, routine checks are carried out by the health visitor and you and your baby’s recovery is monitored.

During your postnatal care you will find out about feeding, potty training, illnesses, safety and more. You will be able to ask your health visitor questions and request advice.

Useful links

Preconception Advice

If you are planning to have a baby or you need to know more information about how to look after yourself and your unborn baby, please book an appointment with your GP.

We can provide you with all the information you need to know to have a happy and healthy pregnancy.

Useful links

NHS Health Checks

Working together to improve your health

Everyone is at risk of developing heart disease, stroke, diabetes, kidney disease and some forms of dementia. The good news is that these conditions can often be prevented – even if you have a history of them in your family. Have your free NHS Health Check and you will be better prepared for the future and be able to take steps to maintain or improve your health.

Visit NHS Choices – Health Checks for further information.

Why do I need an NHS Health Check?

We know that your risk of developing heart disease, stroke, type 2 diabetes, kidney disease and dementia increases with age. There are also certain things that will put you at even greater risk. These are:

being overweight
being physically inactive
not eating healthily
smoking
drinking too much alcohol
high blood pressure
high cholesterol

Both men and women can develop these conditions, and having once could increase your risk of developing another in the future.

In the brain a blocked artery or a bleed can cause a stroke.
In the heart a blocked artery can cause a heart attack or angina.
The kidneys can be damaged by high blood pressure or diabetes, causing chronic kidney disease and increasing your risk of having a heart attack.
Being overweight and physically inactive can lead to type 2 diabetes.
If unrecognised or unmanaged, type 2 diabetes could increase your risk of further health problems, including heart disease, kidney disease and stroke.

What happens at the check?

This check is to assess your risk of developing heart disease, type 2 diabetes, kidney disease, and stroke.
The check will take about 20–30 minutes.
You’ll be asked some simple questions. For example, about your family history and choices which may put your health at risk
We’ll record your height, weight, age, sex, and ethnicity.
We’ll take your blood pressure.
We’ll do a simple blood test to check your cholesterol level.

What happens after the check?

We will discuss how you can reduce your risk and stay healthy
You’ll be taken through your results and told what they mean. Some people may be asked to return at a later date for their results.
You’ll be given personalised advice on how to lower your risk and maintain a healthy lifestyle.
Some people with raised blood pressure will have their kidneys checked through a blood test.
Some people may need to have another blood test to check for type 2 diabetes. Your health professional will be able to tell you more.
Treatment or medication may be prescribed to help you maintain your health.

Questions you may have

Why do I need this check? I feel fine!

The NHS Health Check helps to identify potential risks early. By having this check and following the advice of your health professional, you improve your chances of living a healthier life.

But don’t these conditions run in the family?

If you have a history of heart disease, stroke, type 2 diabetes, or kidney disease in your family then you may be more at risk. Taking action now can help you to prevent the onset of these conditions.

I know what I’m doing wrong. How can the doctor help me?

If you would like help, we will work with you to find ways to eat healthily, reach your healthy weight, be more active, cut down your drinking, or stop smoking.

If I am assessed as being at ‘low risk’, does this mean I won’t develop these conditions?

It is impossible to say that someone will or won’t go on to develop one of these conditions. But taking action now can help you lower your potential risk.

Will everyone has this check?

This check is part of a national scheme to help prevent the onset of these health problems. Everyone between the ages of 40 and 74 who has not been diagnosed with the conditions mentioned will be invited for a check once every five years. If you are outside the age range and concerned about your health, you should contact your GP.