C ombs F ord S urgery

1. Combs Ford Surgery Patient Information Screen September 2017

2. Did Not Attends Due to an increase in the number of missed appointments it has become necessary to implement the following policy: Patients who fail to attend twice in fairly close proximity will receive a letter. If a patient continues to miss appointments, without contacting the surgery, they may be removed from the practice list and may be required to find an alternative doctor. The decision to remove will be taken on a case by case basis and at the discretion of the partners.

3. Cancelling an Appointment If you cannot attend your appointment for any reason, please let us know as soon as possible, even if it’s only 30 minutes notice, we still may be able to offer the appointment to someone else. Thank you for your co-operation

4. Checking In Screen If checking in, please use the checking in touch screen. It asks 3 questions: • Month of birth • Day of birth – please select the actual date, not two separate numerals • First letter of your surname This will help to eliminate queues and get you checked in quicker.

5. Lost Hours This is a total of 317 appointments missed in 3 months. A total of 89 hours of appointments lost in 3 months. If you are unable to attend an appointment, please let reception know as soon as possible, so we can then offer the appointment to another patient. We have recently had a rise in patients not attending appointments. In the past three months, this is how many appointments were missed and how many hours were lost: March = 124 appointments = over 32 hours April = 84 appointments = over 25 hours May = 109 appointments = over 32 hours

6. Dispensary Dispensary opening hours: 08:00-18:30 We are able to take phone calls between the hours of: 10:30-12:00 and 14:30-16:00 We ask patients to allow 3-4 days for prescriptions to arrive before medication is collected

7. FLU Day We are holding a walk-in Flu day On Saturday 23rd September Between 08:15 – 12:30 Please let reception know if you will be attending. If you are unsure if you are eligible, please ask a member of reception to check for you

8. Restricted Medication The Ipswich and East Suffolk CCG are restricting certain medications from being prescribed as they are available to buy on the high street. These include: • Paracetamol • Hay fever tablets • Emollient preparation creams

9. Additional GP Appointments – NHS GP+ Service: weekends, evenings and bank holidays

10. Suffolk GP + This is an NHS service for- • People with a routine need to see a local doctor • People who find it difficult to attend weekday appointments

11. Suffolk GP + Appointments made via the practice, NHS 111 or out of hours service Ipswich GP+Bury GP+ Riverside Clinic Northgate St Landseer Road Bury St Edmunds IP3 0AZ IP33 1AE Stowmarket GP+ Stowhealth Victoria Road IP14 1NL

12. Smoking Cessation Want help quitting but don’t know where to turn? Visit www.NHS.uk to find smoking cessation services available to you.

13. Care Quality Commission CQC Report We have now received our final report from the Care Quality Commission (CQC). We are very pleased to hear we were rated as GOOD in every category. The report can be found in the waiting room or you can read the report online on the website below: http://www.cqc.org.uk/location/1-547756653

14. Online Blood Test Booking You can now book your next blood appointment online for the following: • West Suffolk Hospital and • Sudbury Health Centre If you are unable to book online please call 0333 103 2220  Call Centre bookings available from 8am to 8pm Mon to Fri.  Walk In patient access remains available too.

15. Self Referral Service For Physiotherapy • Online and telephone access Contact them on 01473 770066, or visit www.ahpsuffolk.co.uk/referral • NHS funded • Initial contact within 1 week • Treatment is given according to individuals needs • Contact us directly or via your GP

16. Telephone Appointments If you have a telephone appointment, please be aware that when the GP/Nurse Practitioner calls you, it will be from a withheld number.

17. Contact Telephone Number If you have changed your contact details, please inform reception, or complete a change of contact details card found in the reception area. It is important that we have the correct, up to date contact details for you, in case you request a telephone consultation. Also we may need to contact you with test results, and we also send text confirmations and reminders about appointments

18. Contact Details – TEENAGERS! As you are getting older and taking more responsibility for yourself you may want us to have your personal contact details instead. To check or change your contact details, please speak to reception. Please check that we have the correct contact details for you on our system. We may have the telephone number of your home address and/or your parent’s mobile number.

19. Change Of Address If you have moved house, please ask at reception for a change of address form. It is important we have your up to date address for any correspondence, and in case you require a home visit. If you have moved away from the Stowmarket area, you will need to register with a local surgery.

20. Online Booking To register for online services you will need to bring TWO forms of identification to reception. We require one photo ID (e.g. Driving licence or Passport) AND One address ID (e.g. Utility bill, Bank statement) Once registered you will be able to order repeat prescriptions and book appointments online.

21. Appointments How we book our appointments: • We have on the day appointments • We have appointments available 1 or 2 days in advance • We also book appointments in days or weeks in advance • We also release our appointments for online booking, Please visit www.combsfordsurgery.org.uk and follow links to book appointment (You will need to register for an online login and password)

22. Right Person, Right Time, Right Place Denise Farrow Nurse Practitioner Andrew Toogood Emergency Care Practitioner Our Nurse Practitioner (Denise Farrow) and Emergency Care Practitioner (Andrew Toogood) are available to see you for a number of problems. They are likely to be able to see you on the day you call.

23. Right Person, Right Time, Right Place Denise Farrow Nurse Practitioner Andrew Toogood Emergency Care Practitioner Denise and Andrew have direct access to a doctor at the practice, can arrange for a prescription if necessary and can refer you directly to a consultant or specialist if required. Talk to our reception team about making an appointment.

24. Right Person, Right Time, Right Place Your local pharmacist can give you lots of advice on the best way to treat problems such as colds, coughs, minor burns, diarrhoea, sprains, bumps and bruises.

25. Courtesy and Politeness Our reception staff strive to remain polite and courteous under often difficult circumstances. The doctors expect their patients to do the same Rude or abusive behaviour will not be tolerated and could result in immediate removal from our list.

26. Self Certification Information How long can you self certify? Employees must give their employer a doctor’s ‘fit note’ (previously called a sick note) if they’re off for more than 7 days in a row (including non-working days). Hospital doctors or GP’s provide them. If you are off for less than 7 days, you will need to complete a self certificate, you can download a self certificate form from www.gov.uk/government/publications/statutory-sick-pay-employees-statement-of-sickness-sc2

27. Waiting Times Please be a patient patient – in future it may be you requiring a longer appointment with the doctor

28. Hay Fever Hay fever symptoms vary in severity and may be worse some years, depending on the weather conditions and pollen count. The time of year your symptoms start will depend on the types of pollen you're allergic to. The symptoms of hay fever include: • frequent sneezing • runny or blocked nose • itchy, red or watery eyes (allergic conjunctivitis) • an itchy throat, mouth, nose and ears • cough, caused by postnasal drip (mucus dripping down the throat from the back of the nose)

29. Hay Fever Less commonly, you may also experience: • the loss of your sense of smell (anosmia) • facial pain (caused by blocked sinuses) • headaches • earache • tiredness and fatigue Even though your hay fever symptoms may be mild, they can interfere with your sleep and your daily activities at school or work.

30. Hay Fever When to seek medical advice Most cases of hay fever can be treated using over-the-counter medication. Your local pharmacist can advise you on treatments for you or your children. You usually only need to see your GP if: • you can't control your symptoms with over-the-counter medications, or you have troublesome side effects caused by the medication • you're experiencing persistent complications of hay fever, such as worsening of asthma or repeated episodes of sinusitis • the pattern of your symptoms is unusual, such as occurring during the winter or only at your workplace (it's likely that another substance other than pollen is responsible, and further testing will be needed to confirm this)

31. Stings and Bites Insect bites and stings are common and usually only cause minor irritation. However, some stings can be painful and trigger a serious allergic reaction. • In the UK, insects that bite include midges, mosquitoes, fleas, bedbugs and, although not strictly insects, spiders, mites and ticks, which are arachnids. Insects that sting include bees, wasps and hornets. • An insect bites you by making a hole in your skin to feed. Most insects sting as a defence by injecting venom into your skin.

32. Stings and Bites • Dial 999 and ask for an ambulance if you experience any of these symptoms after a bite or sting: • wheezing or difficulty breathing • nausea, vomiting or diarrhoea • a fast heart rate • dizziness or feeling faint • difficulty swallowing (dysphagia) • confusion, anxiety or agitation When to seek medical help See your GP if you've been bitten or stung and there's a lot of swelling and blistering or if there's pus, which indicates an infection.

33. Stings and Bites Try not to scratch the affected area to avoid infection. If you're in pain or the area is swollen, take painkillers such as paracetamol or ibuprofen. If you have a more serious reaction, your GP may prescribe other medication or refer you to an allergy clinic for immunotherapy (desensitisation). Treating insect bites and stings Most bites and stings are treated by: • washing the affected area with soap and water • placing a cold compress (a flannel or cloth soaked in cold water) over the area to reduce swelling

34. Skin Cancer Skin cancer is the most common form of cancer in the UK, and rates continue to rise. At least 100,000 new cases are now diagnosed each year, and the disease kills over 2,500 people each year in the UK - that's seven people every day. Whilst we are getting better at understanding how skin cancer works, we still have a long way to go. On average, someone who dies from skin cancer typically loses 20 years of their life, and rates of malignant melanoma are rising faster than any other type of common cancer.

35. Whilst we are getting better at understanding how skin cancer works, we still have a long way to go. On average, someone who dies from skin cancer typically loses 20 years of their life, and rates of malignant melanoma are rising faster than any other type of common cancer. Skin Cancer Skin cancer is the most common form of cancer in the UK, and rates continue to rise. At least 100,000 new cases are now diagnosed each year, and the disease kills over 2,500 people each year in the UK - that's seven people every day.

36. Skin Cancer - Protecting Yourself Clothing Clothing should always be your first line of defence against damage from the sun, with sunscreen being used in addition to clothes, including a hat, t-shirt and UV protective sunglasses.

37. Skin Cancer - Protecting Yourself Find the right sunscreenUse a sunscreen of SPF30 (SPF stands for ‘Sun Protection Factor’) and refers to the level of protection against UVB radiation, linked to skin cancer. Look for a four or ideally five star UVA rating on the bottle which will help protect from UVA radiation, associated with skin ageing. You may also find that the UVA rating is represented by the letters ‘UVA’ inside a circle. Keep babies and toddlers should be kept out of direct sunlight

38. Skin Cancer - Protecting Yourself Get your timing rightSkin needs time to absorb sunscreen, so apply generously about 20 to 30 minutes before going out. Reapply frequently at least every two hours, as it can come off when sweating or through rubbing.

39. Skin Cancer - Protecting Yourself Seek shelter!The sun tends to be strongest in the middle of the day, so find some shade typically between 11am and 3pm, especially if you are very fair skinned. Just 10 minutes of strong sunshine is all it takes to burn pale skin.

40. Heat Stroke This usually happens during a heat wave or in a hot climate, but can also occur when you're doing very strenuous physical exercise. • Heat exhaustion is where you become very hot and start to lose water or salt from your body, which leads to the symptoms listed below and generally feeling unwell. • If heat exhaustion isn't spotted and treated early on, there's a risk it could lead to heatstroke. • Heatstroke is where the body is no longer able to cool itself and a person's body temperature becomes dangerously high (sunstroke is when this is caused by prolonged exposure to direct sunlight). • Heatstroke is less common, but more serious. It can put a strain on the brain, heart, lungs, liver and kidneys, and can be life-threatening.

41. Heat Stroke • Signs and symptoms Heat exhaustion or heatstroke can develop quickly over a few minutes, or gradually over several hours or days.  Signs of heat exhaustion can include: • tiredness and weakness • feeling faint or dizzy • a decrease in blood pressure • a headache • muscle cramps • feeling and being sick • heavy sweating • intense thirst • a fast pulse • urinating less often and having much darker urine than usual 

42. Heat Stroke If left untreated, more severe symptoms of heatstroke can develop, including confusion, disorientation, seizures (fits) and a loss of consciousness.

43. Heat Stroke – What To Do. If you notice that someone has signs of heat exhaustion, you should: • get them to lie down in a cool place – such as a room with air conditioning or somewhere in the shade • cool their skin –use whatever you have available, such as a cool, wet sponge or flannel, cold packs around the neck and armpits, or wrap them in a cool, wet sheet If the person is unconscious, you should follow the steps above and place the person in the recovery position until help arrives. If they have a seizure, move nearby objects out of the way to prevent injury. • remove any unnecessary clothing to expose as much of their skin as possible • fan their skin while it's moist – this will help the water to evaporate, which will help their skin cool down • get them to drink fluids – this should ideally be water, fruit juice or a rehydration drink, such as a sports drink

44. Holiday Vaccinations We offer NHS holiday jabs at the surgery, the jabs we give here are as follows: • Diphtheria tetanus polio • Hepatitis A • Typhoid • Cholera If you require additional non NHS holiday jabs you will need to make an appointment at the travel clinic.

45. Dehydration Dehydration occurs when your body loses more fluid than you take in. When the normal water content of your body is reduced, it upsets the balance of minerals (salts and sugar) in your body, which affects the way it functions. Water makes up over two-thirds of the healthy human body. It lubricates the joints and eyes, aids digestion, flushes out waste and toxins, and keeps the skin healthy.

46. Dehydration A baby may be dehydrated if they: have a sunken soft spot (fontanelle) on their head have few or no tears when they cry have fewer wet nappies are drowsy Some of the early warning signs of dehydration include: • feeling thirsty and lightheaded • a dry mouth • tiredness • having dark coloured, strong-smelling urine • passing urine less often than usual

47. Dehydration Who is at risk from dehydration? Anyone can become dehydrated, but certain groups are particularly at risk. These include: • people with a long-term health condition – such as diabetes or alcoholism • athletes – they can lose a large amount of body fluid through sweat when exercising for long periods • babies and infants – they have a low body weight and are sensitive to even small amounts of fluid loss • older people – they may be less aware that they are becoming dehydrated and need to keep drinking fluids

48. Dehydration Contact your GP, out-of-hours service or NHS 111 straight away if you have any of the following symptoms: • extreme thirst • feeling unusually tired (lethargic) or confused • not passing urine for eight hours • rapid heartbeat • dizziness when you stand up that doesn't go away after a few seconds When to see your GP See your GP if your symptoms continue, despite drinking plenty of fluids, or if you think your baby or toddler is dehydrated. If your GP suspects dehydration, you may have a blood test or a urine test to check the balance of salts (sodium and potassium) in your body.

49. Dehydration You should also contact your GP if your baby has had six or more episodes of diarrhoea in the past 24 hours, or if they have vomited three times or more in the past 24 hours. 

50. Your doctors and nurses say… “Your local pharmacist can give you lots of advice on the best way to treat problems such as colds, coughs, minor burns, diarrhoea, sprains, bumps and bruises.”