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Summer Newsletter 09 - Summer 09


                                                                                          Opening Times

                            SWINE FLU                                                     Monday—Friday


    HOW DOES SWINE FLU SPREAD?                                                              CLINICS
 Flu viruses are made up of tiny particles that can be spread through the droplets that      Diabetes
              come out of your nose and mouth when you cough or sneeze.
When you cough or sneeze without covering your nose and mouth with a tissue, those         Monday am
            droplets can spread and others will be at risk of breathing them in.           Tuesday am
 If you cough or sneeze into your hand, those droplets and the germs in them are then
                                                                                          Wednesday pm
easily spread from your hand to any hard surfaces that you touch, and they can live on
     those surfaces for some time. Everyday items such as door handles, computer           Respiratory
  keyboards, mobile and ordinary phones and the TV remote control are all common
                                                                                           Tuesday am
                         surfaces where flu viruses can be found.
  If other people touch these surfaces and then touch their faces, the germs can enter     Tuesday pm
    their systems and they can become infected. That’s how all cold and flu viruses,
                                                                                           Thursday pm
                including swine flu, are passed on from person to person.
WHAT CAN I DO TO PROTECT MYSELF AND OTHERS                                                 Monday pm
                AGAINST FLU?
                                                                                           Thursday am
  The best thing you can do to protect yourself is to follow good hygiene practices.          CHD
 These will help to slow the spread of the virus and will be the single most effective
           thing you can do to protect yourself and others from infection.                 Thursday am
 When you cough or sneeze it is especially important to follow the rules of good            Friday am
                      hygiene to prevent the spread of germs:
                               Always carry tissues.                                       Phlebotomy
    Use clean tissues to cover your mouth and nose when you cough and sneeze.
                            Bin the tissues after one use.                                   Monday
         Wash your hands with soap and hot water or a sanitiser gel often.                     To
                      There’s a simple way to remember this:
                                                                                            Friday am
                      CATCH IT, BIN IT, KILL IT.
                                                                                           Tuesday pm
Some of the symptoms are the sudden onset of fever, cough or shortness of breath. Other symptoms can in-
   clude headache, sore throat, tiredness, aching muscles, chills, sneezing, runny nose or loss of appetite.

     If you or one of your family think they have swine flu, and are over one with no underlying illness,

     ring The National Pandemic Flu Service on 0800 1 513 100 or use

 If they are under one or have an underlying illness PLEASE RING THE SURGERY and a health profes-
                                           sional will contact you


How Patients Can Contact Out of Hours
              Services                                              Waiting room computer
When the Practice is closed, the local out of hours service     When you use the computer in the waiting
organised by Western Cheshire Primary Care Trust are            room to sign in for an appointment if you
  responsible for your care. This service is for urgent        have two appointments you will need to sign
       problems in the evenings and weekends.
                                                                               in TWICE
If you have a problem that cannot wait until the surgery is
  open again, telephone 01244 343300 where you will be
  put through to a receptionist who will take your details.
 These details will be passed onto a medical professional
                      for assessment.
                       NHS Direct
If you need some advice why not try the national service
                     NHS Direct                                              Home Visits
                Telephone No: 0845 4647
                                                                 If you require a home visit, please ring
                                               before 10:30 am
      Booking Appointments

We are currently booking appointments 2 weeks in advance and for the following day.
We operate a triage clinic for emergencies on the day run by either one or two doctors and a nurse practitioner
The Rota Team continue to monitor the appointment system with a view to improving the
service we offer our patients. We intend to carry out a survey to measure telephone calls and
requests at reception from patients to help us understand more fully your needs.
To book an appointment at City Walls Medical Centre: Please telephone the day before you require the
appointment i.e. telephone on Monday to book for Tuesday.
To book an appointment at Saughall Medical Centre: Telephone at 8:00am on the day you wish to be seen.
We strongly advise that if you wish to see a particular doctor that you do book ahead as we cannot guarantee
you being able to see the doctor of your choice when booking the day before

         Extended Opening Hours at St Martins Clinic in Chester

                       Did you know about extended open hours at St Martin’s Clinic?
                If you are registered at City Walls Medical Centre, you can now book a routine
                                    appointment outside our opening hours

                                    These appointments are available at :-
                                          St Martin’s Clinic, Chester

                 These additional routine appointments are available at the following times :-
                                      Monday to Friday 6.30pm to 8pm
                                           Saturday 10am to 12 pm

              You can book a routine appointment up to two weeks ahead by ringing City Walls
Medical Centre and we will make your appointment or by phoning St Martins Clinic direct on 01244 364700,
                                Monday to Friday between 8am and 6pm
                Book an appointment on the                                            CHOOSE
                          internet !!                                     & BOOK SYSTEM
                 Order prescriptions on the                   The Choose and Book System is very popular with
                                                               our patients who have been referred through this
                          internet !!                                              system.
   Please ask at reception for details of this exciting      This means that when your doctor wishes to refer
                                                             you for further care you will be able to visit the
         facility at City Walls Medical Centre               hospital of your choice. The doctor will then give
                                                             you a unique booking number and password and a
          http\\                 number to ring to book your appointment with the
                                                             With this new system you will be able to book a
                                                             hospital appointment on a date to suit yourself.

PLEASE could you let us know as soon as possible if you are unable to make an appointment which you have

                                        You are a Carer if……………….
        You look after a friend, relative or partner with an illness or disability or who is elderly or frail

 You may provide physical help, emotional support, personal care, help with medication or practical support
           such as shopping, providing support/transport to appointments, washing or cleaning

                 You can be of any age, either gender and from any background or community

                                 Please take a look at our carers board by the lift

           Take a leaflet and if required you can speak to Amanda Ward who is our carers link at
           City Walls Medical Centre or Jane Anderton our carers link at Saughall Medical Centre

Help and support is out there for you, you have an important role. We are here to direct you to the best support

             Please fill out the carers leaflet (ask at the reception ask if there are none on display

                     We will do our best to get you the support and help when you need it
 We would like to congratulate Alison Bradshaw
on her new position as Secretary, Jane Anderton as
    the new Branch Manager at Saughall and
   Lisa Nield as our new Medical Summariser
                                                     We would all like to send our congratulations to Kirstie
                                                      (one of our receptionists) & Domingo on the birth of
                                                                their twin sons , Aaron & Ethan

                              We would like to welcome the following new members of

                             staff, Karen, Amanda and Tawny our new receptionists

                         Collecting Prescriptions from Pharmacies
Did you know that you can ask your local pharmacy to order your prescription and all you have to do is either
                collect it from your pharmacy or the pharmacy will deliver it to your house

                           Please contact your local pharmacy for further advice.

       Holiday Injections
 If you require holiday vaccinations please ring the surgery at least two months ahead as you
           will need to have your injections at least six week prior to your holiday.
                                       Beating Cervical Cancer
                                              HPV Injections
 The vaccine protects against the two types of the virus, types 16 & 18 that cause most cases (Over 70%) of
                                               cervical cancer

  It does not protect you against all cervical cancers so it is essential that you have cervical screening (tests)
                                  when you are older (25 and over in England)

      By having the vaccination you will reduce your risk of getting cervical cancer when you are older

 Human papilloma virus immunisation will now be offered to all girls in year 10 and 11 (Girls born between
 1st September 1993 and 31st August 1995). You should have received a written invite if you were born be-
              tween these dates. If you have not please contact the surgery as soon as possible

Girls born between 1st September 1991 and 31st August 1993 were invited last year to attend, however if you
 did not receive an invite or declined at the time but now wish to take up the offer, please contact the surgery
                                       for an appointment with the nurse.

        If you require any further information , please contact the nurses at City Walls Medical Centre

   We are offering free Chlamydia screening to all under 25s ( and anyone else who may be interested).

Please feel free to discuss this at your appointment or see the poster with City Walls Medical Centre for more

                          Training Days
                       The surgery will be closed
                                                                       Car Parking Problems
                      12 noon and 5pm for training
                                                             Our car park at the surgery has been causing some
                                purposes                      problems for patients who are having difficulty
                                                            parking. We would like to recommend that patients
                         on the following dates:             use the multi storey car park located beneath The
                         Thursday 13th August                                Crown Plaza Hotel

                      Wednesday 16th September               Please note that traffic wardens patrol outside the
                                                            car park at various times of the day so please do not
                         Thursday 22nd October                            park outside on the road.
                               Patient Forum Meeting

This practice would like to inform you that we carried out a questionnaire about the service we provide to
patients in the Autumn, and discussed the result at the patient forum in December. It is important that we aim
for the national targets and achieve them without letting other services suffer.
The principal concern raised was with continuity of care. It can be difficult for patients to see the same doctor
because of doctors working part time and having other responsibilities including emergency work. However
our policy is for people see the same doctor whenever possible, and that can be done by booking appointments
up to two weeks in advance. When this is not possible or someone’s problem becomes more urgent, an
appointment with an alternative doctor will be made available. We would like to reassure you that this doctor
will have full access to the notes from their usual doctor or nurse or hospital consultant.
Availability of appointments remains an issue because demand will always outstrip our ability supply in these
areas. However the appointment system has been tailored to accommodate people’s requirements in providing
booking in advance, booking the day before and also booking on the day for emergencies. The demand and
provision of telephone appointments is increasing. Internet booking frees up receptionist to answer the phone.
Car parking is also limited so we would continue to encourage people to use public transport, pedal power or
Many other initiatives are occurring within the practice and over the past year include ‘Xpert Patient
Education’ courses and Insulin initiation for patients with Diabetes. We have increased diagnosis of patients
with Diabetes and Chronic Kidney Disease. Pulmonary rehabilitation referrals for patients with lung disease,
and management of patients with this is occurring more at the practice and in the community. Blood tests are
by appointment which helps car parking and reduces waiting room congestion. Our morning emergency
clinics are run by a nursing and doctor team, we have more medical students training here and offer later
appointments than in the past. We have passed a Data Quality and Information Governance inspection and
regularly have training on a wide range of topics.
Waiting times in surgery, phoning the practice, nurse clinics, repeat prescriptions and the touch screen check
in were among other issues discussed. Many of the points raised could be answered by communicating
information to patients differently. Currently we use the practice newsletter, the website, the practice leaflet
and the notice boards to show information. We have been considering using television screens to display more
                          YOU MAY NOT ALWAYS NEED TO SEE A DOCTOR
What is a Nurse Practitioner?
A Nurse practitioner is a nurse who in addition to 3 years of general nurse training has also trained for a
further 3 years to degree level (BSc). In addition, a Nurse Practitioner may have further specialist
qualifications in areas such as Diabetes, Asthma, Heart Disease, Family Planning etc. Training for this role
involved patient assessment, physical examination and diagnostic skills. A Nurse Practitioner is also able to
Nurse Practitioners normally manage patients with minor illness as outlined below. However, on occasion, a
minor illness can turn out to be something more serious requiring the attention of a GP. In this case, the Nurse
Practitioner will refer you to see a GP after ordering the necessary investigations or organize an appointment
as soon as possible depending on the urgency of the problem.

What kind of problems does the Nurse Practitioner manage ?
Nurse Practitioners can deal with most problems but due to the nature of the clinic it should be reserved for
patients who are feeling unwell and have booked “on the day”. Chronic conditions are better managed in
different clinics.
A few examples of what can be managed are:
Sore Throat/Tonsillitis
Ear infections/pain
Hay fever
Urinary tract infections (cystitis)
Rashes/skin problems
Emergency Contraception
                               HOW OFTEN SHOULD I VISIT THE SURGERY?
We are often asked this question by patients who have long standing medical conditions, or who are on regular
medication. We hope you will find the following guide helpful and allow you to make best use of our services.
When first diagnosed, or when starting new medication, your doctor or nurse will tell you how often to attend.
The following applies only to those who have stable conditions.
Blood test information
The phlebotomist is available at City Walls between 08:30am and 12.15pm Monday to Friday, please book an
appointment with the receptionists. If you wish to see the phlebotomist at Saughall please phone Saughall to book an
appointment. It would be helpful when booking appointments if you can tell the receptionist which test you require.
(NB. Please phone reception one week after your test for your results, between 2pm and 4pm).
You may be requested to fast before your blood test. If so you may eat until 9.00pm the day before, after that you may
only have sips of water until your test. Take any medicines as usual. Fasting samples are for cholesterol and blood
glucose tests.
High blood pressure (hypertension)
Once a year you should have a routine fasting blood test. Please bring a urine sample with you.
1-3 weeks later you should visit the Practice Nurse for a check up and to discuss the blood test results. You should have
another blood pressure check every 6 months (that is half way between your full annual checks). There is no need to
have your blood pressure checked more frequently, unless you are requested to do so. The Practice Nurse may ask you
to see your doctor if any problems are identified.
Heart disease or stroke
This includes a diagnosis of ischemic heart disease, angina, a heart attack in the past, heart failure, stroke or TIA
(transient ischemic episode).
Once a year you should request a routine fasting blood test. Please bring a urine sample with you. One to three weeks
later you should make an appointment to visit the Practice Nurse for a check up and to discuss the blood test results.
Once a year you should request a routine fasting blood test. Please bring a urine sample with you. One to three weeks
later you should make an appointment to visit the Practice Nurse for a check up and to discuss the blood test results.
You should also ensure that you have an annual eye test with an Optometrist approved to provide a Diabetes screening
test. You should have another (HbA1C) blood test and blood pressure check with urine test after 6 months (that is half
way between your full annual checks).
You should visit the Practice Nurse once a year for a check up and to check your medication.
Thyroid Disease
If you are taking Thyroxine tablets you should have a routine test every year. If the dose of medication is changed, you
should have extra tests after 6 to 12 weeks.

Lipid or cholesterol lowering drugs or Diuretics (water tablets)
If taking these medicines you may already be having tests as part of the checks described above, e.g. for heart
disease or diabetes, if not, you will need to have a blood test once a year. This will always be a fasting

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