Community services that patients can self refer to.

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

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.

We administer the full range of travel vaccinations and advice.

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.
• Meningitis A&C or ACWY, Hepatitis B, and Rabies vaccinations are chargeable (see fees for private services). 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.

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

Are you eligible for a free flu vaccination on the NHS?

Find out if you are eligible through this short video

Did you know you can refer yourself for some local services, without seeing a GP? Please see below some organisations in your area:

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MENTAL HEALTH

To refer yourself for counselling with Brent Talking Therapies Services, please complete the Brent Referral form here. You can also call 020 8206 3924.

Brent Mental Health Emergency Crisis Number: 0800 0234 650 (open 24 hours a day)

Self-Help Booklets

A list of useful apps that can help with mental health: general wellbeing, depression and anxiety, eating disorders and younger people

Samaritans (for anyone, any time for any reason): 116 123

Childline (under 25 years old and their relatives): 0800 1111

Silverline (for over 50 years of age): 0800 470 8090

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RELATIONSHIPS

Bereavement:

Cruse Bereavement Care 0808 808 1677

The Good Grief Trust

Child Bereavement UK (9am-5pm): 0800 0288840

Child Death Helpline: 0800 282 986 / 0808 800 6019

Survivors of Bereavement by Suicide (9-9 daily): 0300 111 5065

Miscarriage Association: 01924 200799

Tommy’s Miscarriage Support (M-F: 9-5): 0800 0147 800

Relationship Support:

Relate

Domestic Violence:

National Domestic Violence Helpline: 0808 2000 247

Advance (Brent): 07398 545 898 / 020 8741 7008

Drug and Alcohol Help:

Local Services

Alcoholics Anonymous: 0800 9177 650

NHS Live Well

Gambler’s Anonymous

Gamcare (gambling problems): 0808 8020 133

Narcotics Anonymous: 0300 888 1212

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PREGNANCY

Planning a Pregnancy:

Tommy’s advice

NHS Advice

Already Pregnant:

NHS Pregnancy Guide

Due Date Calculator

Referral for Antenatal Care at Northwick Park Hospital

Appointment Information for Northwick Park

Emma’s Diary

Unplanned Pregnancy:

NUPRAS: 0333 004 6666

Marie Stopes: 0345 300 8090

BPAS: 03457 30 40 30

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SEXUAL HEALTH

Local Sexual Health Clinics in both the community and hospitals. These clinics can test and advise on sexually transmitted infections and give advice and start some contraceptives.

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LIFESTYLE ADVICE

Smoking Cessation:

Smokefree

Smoking Cessation Clinics

Smoking Cessation Treatments

NHS Advice for Obesity and Overweight

Find local weight loss support groups

Healthy Eating

Healthy Eating in Diabetes

Exercise

Getting started with running

Park Run (weekly 5km fun runs)

Exercise for those with Cancer

Exercise for those with COPD

Exercise for those with Dementia

Exercise for those with falls and frailty

Exercise for those with Rheumatological Diseases

Exercises for those with Ischaemic Heart Disease / Angina

Exercise for those with Diabetes

Brent Physiotherapy Self Referral Service: 0203 795 3429

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.

CERTIFICATES AND FORMS	FEE
Private Letter / TWIMC	From £10
Private Sick Certificate	£15
Private Prescription for Travel	£10
Freedom from Infection Certificate	£25
Accident Insurance Form	From £50
Private Health Insurance Form	From £50
Housing Letter (payable in advance)	TBC
Children Letter for Ballet / Stage etc.	£10
Fitness to Fly Letter	£69(full report)£18 (pre-existing medical condition)
Cancellation Holiday Form / Letter	£45
Fitness to Exercise Certificate	£20
Overseas Pension Form	£20
Power of Attorney Form	£50 per form
Power of Attorney Form (Home Visit)	TBC
School Health Report	£60 (report, no examination)
School Health Report (Ofsted)	£85
Letter for taking Meds on Plane	£18
Passport Form / Photograph	GPs no longer permitted to sign British Passports
Firearms / Shotgun Licence	£40

MEDICAL EXAMINATIONS AND REPORTS	FEE
HGV	£90
All Taxi Medicals and Bus Medicals	£90
Pre-employment Medical (Including elderly driver fitness to drive)	£80

TRAVEL VACCINATIONS	FEE
Hepatitis B (course of three injections)	£25 per injection
Meningitis ACWY	£40
Rabies (course of three injections)	£55 per injection
Please note we offer these services to registered patients only.You may be asked to pay in advance for the service you are requesting. We accept all major debit/credit cards or cash as payment.Prices correct as of 2/10/2020.

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

• The Pregnancy Care Planner
• NHS Choices – Antenatal Care

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

• NHS Choices – Planning a Pregnancy
• NHS Choices – The Facts about 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.

Neo-natal Checks

Some newborn babies are released from hospital without a detailed examination. If this is the case, our GPs are happy to perform the relevant checks, either in the surgery, or in comfort of your own home, depending on which is easier for you.

In most cases, the Practice will contact new mums to arrange for this to happen, on rare occasions where we are unaware of the birth, please feel free to give us a call and arrange an appointment or visit.

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

• NHS Choices – Birth to 5 years old guide
• NHS – Breastfeeding Guide
• Netmums – Information and support

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 Choices – Before you try to get pregnant 
• NHS Choices – Pregnancy Care Planner
• NHS Choices – See how your baby will develop
• NHS Choices Tool – Work out your due date

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.

Male Pattern Baldness

Male-pattern baldness is the most common type of hair loss, affecting 6.5 million men in the UK.

It generally starts with a little thinning of the hair, followed by wider hair loss, allowing more of the scalp to become visible.

For a few men, this process starts as early as the late teens. By the age of 60, most men have some degree of hair loss.

Some men aren’t troubled by this at all. Others, however, suffer great emotional distress associated with a lack of self-esteem and, in some cases, depression.

Useful links

• NHS Choices – Hair Loss Treatments

Prostate Cancer

PROSTATE CANCER IS THE MOST COMMON CANCER IN MEN IN THE UK, WITH OVER 40,000 NEW CASES DIAGNOSED EVERY YEAR.

Prostate cancer usually develops slowly, so there may be no signs you have it for many years.

Symptoms often only become apparent when your prostate is large enough to affect the urethra (the tube that carries urine from the bladder to the penis).

When this happens, you may notice things like an increased need to urinate, straining while urinating and a feeling your bladder has not fully emptied.

However, these signs do not mean you have prostate cancer. It is more likely they are caused by something else, such as benign prostatic hyperplasia (also known as BPH or prostate enlargement).

What is the prostate?

The prostate is a small gland in the pelvis found only in men. About the size of a Satsuma, it is located between the penis and the bladder. It surrounds the urethra, the tube that carries urine from the bladder to the penis.

The main function of the prostate is to help in the production of semen. It produces a thick white fluid that is mixed with the sperm produced by the testicles, to create semen.

Testicular Cancer

Although still rare compared to other cancers, testicular cancer is the most common cancer in men aged between 15-45 years with around 2,200-2,300 men being diagnosed each year. It is more common in Caucasian males.

If found at an early stage a cure rate of 98% is usually possible and even when testicular cancer has spread to other areas of the body cure can still be achieved. In fact according to recent research overall 96% of men diagnosed with any stage testicular cancer will be alive 10 years after treatment.

It is important to visit your GP as soon as you notice any lump or swelling on your testicle. Your GP will examine your testicles to help determine whether or not the lump is cancerous.

Symptoms

The earliest warning signs of testicular cancer usually include the following:

• A change in size or shape of a testicle.
• Swelling or thickening of a testicle.
• A firm, smooth, initially painless, slow-growing lump or hardness in a testicle.
• A feeling of testicular heaviness.

Useful links

• Orchid – Fighting Male Cancer
• Your Privates – Testicular Cancer Awareness
• NHS Choices – Testicular Cancer

Chronic Heart Disease

The most common symptoms of coronary heart disease (CHD) are chest pains (angina) and a heart attack.

You can also experience other symptoms, such as palpitations and unusual breathlessness. In some cases, people may not show any symptoms before they are diagnosed.

Angina

If your coronary arteries become partially blocked, it can cause chest pain (angina). This can be a mild, uncomfortable feeling similar to indigestion.

However, a severe angina attack can cause a painful feeling of heaviness or tightness, usually within the centre of the chest, which may then spread to the arms, neck, jaw, back or stomach.

Angina attacks are often triggered by physical activity or stressful situations. Although symptoms of Angina usually pass within 10 minutes, you can alleviate the symptoms by resting or using a nitrate tablet or spray.

Heart attacks

If your arteries become completely blocked, it can cause a heart attack (myocardial infarction). Heart attacks can cause permanent damage to the heart muscle and, if not treated straight away, can be fatal.

If you think you are having a heart attack, dial 999 for immediate medical assistance.

Although symptoms can vary, the discomfort or pain of a heart attack is usually similar to that of angina but often more severe. During a heart attack you may also experience the following symptoms:

• Sweating
• Light-headedness
• Nausea
• Breathlessness

The symptoms of a heart attack can be similar to indigestion. For example, they may include a feeling of heaviness in your chest, a stomach ache or heartburn. However, these symptoms can also be accompanied by a pain that affects the arms (particularly the left arm), the neck and the jaw.

A heart attack can happen at any time, including while you are resting. If heart pains last longer than 15 minutes, it may be the start of a heart attack.

Unlike angina, the symptoms of a heart attack are not usually relieved using a nitrate tablet or spray.

In some cases, you may have a heart attack without any symptoms, called a silent myocardial infarction. This is more common in people with diabetes.

Heart failure

Heart failure can also occur in people with CHD when the heart becomes too weak to pump blood around the body, which can cause fluid to build up in the lungs that makes it increasingly difficult to breathe.

Heart failure can happen suddenly (acute heart failure) or gradually over time (chronic heart failure).

Useful links

• British Heart Foundation – Angina
• British Heart Foundation – Cardiovascular Disease
• British Heart Foundation – Heart Attack

Diabetes

Diabetes is a long-term condition caused by too much glucose, a type of sugar, in the blood. It is also known as diabetes mellitus.

There are two main types of diabetes, which are explained below:

• Type I diabetes
• Type II diabetes

Normally, the amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas. The pancreas is a gland behind the stomach. When food is digested and enters your bloodstream, insulin moves any glucose out of the blood and into cells, where it is broken down to produce energy.

However, in people with diabetes, the body is unable to break down glucose into energy. This is because there is either not enough insulin to move the glucose, or because the insulin that is there does not work properly.

Our specialist diabetes team will provide you with support, regular reviews and the day-to-day care of your needs.

All Diabetic patients are entitled to an annual review. The Practice will normally contact you if yours is due. The review takes place in two parts – a data collection appointment and where appropriate, a follow up care plan appointment. If you feel you have been missed, or require a more urgent review, then please contact the Practice to arrange an appointment.

At the initial data collection appointment, your blood pressure, weight, urine, feet and well-being will be checked. It is necessary for you to bring an early morning urine sample with you. Following your initial appointment, a care plan booklet will be sent to you and if necessary, an appointment with your GP or one of our specialist nurses will be arranged.

For more information please visit the websites below:

Useful links

• Diabetes UK

Hypertension

Hypertension relates to High Blood Pressure.

High blood pressure often causes no symptoms, or immediate problems, but it is a major risk factor for developing a serious cardiovascular disease (conditions that affect the functioning of the heart and the circulation of blood around the body), such as a stroke or heart disease.

Useful links

• NHS Choices – High Blood Pressure Explained
• Blood Pressure Association
• British Heart Foundation
• British Hypertension Society

Respiratory

Our respiratory clinics are primarily intended for patients with Asthma and COPD.

Asthma is caused by inflammation of the airways. These are the small tubes, called bronchi, which carry air in and out of the lungs. If you have asthma, the bronchi will be inflamed and more sensitive than normal. Our practice nurses have specialist asthma qualifications. During their clinics they monitor your overall condition, offer advice, answer any queries and ensure your treatment is effective.

Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have trouble breathing in and out. This is referred to as airflow obstruction. Breathing difficulties are caused by long-term damage to the lungs, usually because of smoking.

Asthma and COPD Clinics

We hold clinics to diagnose and to help patients to manage their asthma or COPD.

We like to see all our patients who have been diagnosed with these conditions at least once a year, depending on the severity of your condition, we may invite you to come to the clinic more often in order to ensure we give you the care you require.

Useful links

• NHS Choices – Asthma
• The British Lung Foundation
• Asthma UK
• NHS Choices – COPD

Boost your immunity this Winter

Learn more about flu jab videos

Flu jab for adults:

Dr Steeden talks through all the things you need to stay well this winter – Flu and Covid-19 booster vaccinations and NHS Services.

Flu jab and long term conditions:

Children: 

Other Languages:

Arabic

Dr Bashir (GP) flu jab for adults: https://www.youtube.com/watch?v=ET_q764ctGA

Dr Bashir (GP) nasal flu spray for children: https://www.youtube.com/watch?v=H-3N1LLGR3Q

Somali

Salma (Practice nurse) nasal flu spray for children: https://www.youtube.com/watch?v=B2XOznQLEKI

Polish

Marta (care coordinator) flu jab for adults: https://www.youtube.com/watch?v=CflkMU3p2b0

Marta (care coordinator) nasal flu spray for children: https://www.youtube.com/watch?v=GlgkWbD57eM

Leaflet “Protecting your child against flu” German, Hindi, Gujarati, Chinese, Italian, Polish,  Romani, Romanian, Somali, Tamil, Tagalog, Turkish and Urdu

https://www.gov.uk/government/publications/flu-vaccination-leaflets-and-posters