Right Clinician, Right Time, Right Place – Who do I see?

Our clinical team is always expanding and we are pleased to be able to offer a variety of specialist services alongside our GP and nursing teams.

See below for how to access help for the following issues including useful phone numbers and websites. Please have a look at the advice provided before booking your appointment.

To get help you can:

Submit an E consult. You will receive a response within 36 hours, usually the same day. If needed, you will be booked with the triage team or given an appointment with your GP.

Book a routine GP appointment via reception.

Contact reception for the same day emergency triage line. Please be aware that only acute issues will be dealt with by the triage team and you may be redirected to a more suitable service or appointment type. If it is an ongoing or long term problem then please discuss with your registered GP.

Abdominal Pain

Who do I see?

Attend A+E if the pain is sudden or severe

Triage team for acute problems

Routine GP appointment for longer standing issues

Advice:

There are a variety of reasons for abdominal pain. The nature of the pain, the location and when it occurs help to give us an idea of what the cause may be. Blood tests and urine or stool samples may also be needed to help make the diagnosis.

The NHS website has more information about the different causes for abdominal pain. A pharmacist can help with common problems such as indigestion and constipation.

Stomach ache – NHS (www.nhs.uk)

For children:

Abdominal pain (tummy ache) :: Healthier Together (what0-18.nhs.uk)

ACR Test

Who do I see?
Reception

Advice:

ACR testing is an important part of diabetes care and checks the health of our kidneys. If you have been asked to provide an ACR test please drop off to reception.

This needs to be an early morning urine sample, in a white topped specimen pot and be clearly labelled with your name, DOB, time and date of your sample.

Urine albumin to creatinine ratio (ACR) – NHS (www.nhs.uk)

ADHD

Who do I see?
School / CAMHS

Routine GP appointment

Advice:

For concerns about ADHD in your child:

Attention Deficit Hyperactivity Disorder (ADHD) – CAMHS (hampshirecamhs.nhs.uk)

Discuss any concerns with your child’s school first as they may be able to provide additional support. You can self refer to the CAMHS service, the link to the referral form is half way down the page.

Should I make a referral? – CAMHS (hampshirecamhs.nhs.uk)

For help for adults:

ADHD UK | ADHD UK

ADHD – Online Consultations – Psychiatry-UK

Before speaking to the GP please undertake the following questionnaire so that we can understand the severity of your symptoms. To obtain a diagnosis you will need to be referred to a specialist team for an assessment. The waiting time for this can be lengthy, the right to choose website has estimated time scales for the different providers.

10852_elto_question_fhp2.PDF (add.org)

ASD and ADHD Service: Hampshire :: Surrey and Borders Partnership NHS Foundation Trust (sabp.nhs.uk)

Right to Choose | ADHD UK

Anxiety

Who do I see?
iTALK / Mind

Primary Care Mental Health Team

GP

Advice:

As part of our wider team we are lucky to have mental health practioners from the Primary Care Mental Health Team and from the charity Mind working with us. You can book an appointment directly via reception.

You can also self refer to iTALK and Mind for free support and counselling;

Call Mind on 0300 123 3393

italk, Hampshire’s NHS Talking Therapy Service

There is lots of help and support available online which you may like to take a look at before your appointment.

Anxiety – Every Mind Matters – NHS (www.nhs.uk)

Anxiety and panic attacks | Mind, the mental health charity – help for mental health problems

SilverCloud, free and easy to access online CBT (italk.org.uk)

Speak to the GP for advice on medication.

Treatment – Generalised anxiety disorder in adults – NHS (www.nhs.uk)

Asthma

Who do I see?
Attend A&E for any concerns over an acute asthma attack

When to go to A&E | Asthma UK

See the triage team for worsening asthma symptoms

See the asthma nurse or specialist pharmacist for routine care

As part of routine asthma care, you will be invited for an annual review with the asthma nurse or specialist pharmacist in the month of your birth. If you are having issues with your inhalers or feel your asthma control is slipping then please make an appointment with the nurse via reception.

Advice:

Asthma – NHS (www.nhs.uk)

Health advice | Asthma UK

Asthma UK run a helpline Monday to Friday 9am – 5pm

Helpline | Asthma UK

Alcohol Advice

Who do I see?
Inclusion Hampshire

Advice:

You can self refer to Inclusion Hampshire for support with drug and alcohol problems affecting you or a family member.
Please visit:

Home – Inclusion Hants

Alcohol.pdf (hampshirehospitals.nhs.uk)

Alcohol support – NHS (www.nhs.uk)

Alcoholics Anonymous Great Britain (alcoholics-anonymous.org.uk)

Speak to the GP routinely if you have concerns over any physical health symptoms related to excess alcohol intake.

Athlete’s Foot

Who do I see?
Self Care / Community Pharmacy

Advice:

Athlete’s foot is a common skin infection caused by a fungus. Treatment with an antifungal cream usually works well and is available without the need for a prescription.

Athlete’s foot – NHS (www.nhs.uk)

Athlete’s Foot | Symptoms, Treatment and Medication | How to avoid | Patient

Atrial Fibrillation

Who do I see?
GP for diagnosis

Practice nurse for annual review

Advice:

Atrial fibrillation is a heart condition that causes an irregular and often abnormally fast heart rate. Some people say it feels like their heart is fluttering or racing (known as palpitations). It is the most common heart rhythm disturbance and affects 1.4 million people in the UK. It becomes more common as we get older and affects more men than women.

Atrial fibrillation might come and go (called paroxysmal atrial fibrillation), but often it will be permanent. It’s not life-threatening, but it is considered serious because it could create blood clots in the heart that may lead to a stroke.

You should see the GP for a formal diagnosis but you can also detect it by feeling your pulse at your wrist. A normal heart rate is regular and usually between 60 and 100 beats a minute when you’re resting. If you have AF, your pulse will have no set pattern and the beats might have different strengths. 

You will need an ECG (heart tracing) to diagnosis it officially.

Treatment can be different depending on the individual situation. Most patients will be recommended to start blood thinning medication to reduce the risk of stroke. Warfarin used to be commonly used but now newer medications called ‘NOACs’ are advised.

Atrial fibrillation – NHS (www.nhs.uk)

Atrial fibrillation (AF) | British Heart Foundation (bhf.org.uk)

Novel anticoagulants – how they work – side effects | BHF

Audiology

Who do I see?
Self Referral

Advice:

if you have hearing aids and are having a problem with them then you can access assistance via audiology directly. More information is available on their website or on 01962 824437.

Audiology :: Hampshire Hospitals

Autism

Who do I see?
School for children

Routine GP appointment for adults

Advice:

Autism is a lifelong developmental disability which affects how people communicate and interact with the world. One in 100 people are on the autism spectrum and there are around 700,000 autistic adults and children in the UK. 

For concerns about autism in your child:

If your child is school age, speak to their teacher initially about help with accessing further support. Please be aware that referrals cannot be made until the age of 3.

If the concern is purely regarding autism, your child will be referred to the assessment service run by Pscion. The school are able to make this referral.

If there are co-existing concerns regarding mental health needs then the referral goes to CAMHS. This can be done via their website as a parent.

Signs of autism in children – NHS (www.nhs.uk)

Autistic Spectrum Condition (ASC) – CAMHS (hampshirecamhs.nhs.uk)

Children, Young People and Family Services (psicon.co.uk)

There are a number of support services available:

Support, advice and services for children with autism – Child Autism UK – releasing potential

Home | Autism Hampshire

For concerns about autism in adults:

Please book to speak to the GP routinely, it is helpful to make a list of symptoms or examples of situations that you struggle with. If you are able to, please complete the AQ10 questionnaire via the link below and make a note of your score. A referral to a specialist will be needed to obtain a formal diagnosis.

Adults (autism.org.uk)

Signs of autism in adults – NHS (www.nhs.uk)

Autism Spectrum Quotient (AQ) (psychology-tools.com)

ASD and ADHD Service: Hampshire :: Surrey and Borders Partnership NHS Foundation Trust (sabp.nhs.uk)

Back Pain

Who do I see?
You are able to book directly to see our First Contact Physiotherapy service at the surgery OR self refer to the Physiotherapy service run by Southern Health

More information is available here:

NHS England » First contact physiotherapists

Physiotherapy form :: Southern Health NHS Foundation Trust

The FCP team are able to assess, diagnose and refer you on for further tests or to see a specialist if this is required.

For acutely worsening symptoms or advice on pain relief speak to the triage team.

Advice:

Back pain – NHS (www.nhs.uk)

Home exercises are an important part of ongoing management and can be found online

Back pain | Causes, exercises, treatments | Versus Arthritis

Written information – STarT Back – (keele.ac.uk)

Back pain | The Chartered Society of Physiotherapy (csp.org.uk)

If you ever develop urinary incontinence, loss of sensation around your bottom or lose control of your bowels you must attend A+E immediately as your spinal cord may be compromised.

Bedwetting

Who do I see?
Health Visitor / School Nurse / ERIC website

Routine GP appointment if persisting problems

Advice:

Bedwetting is common and often runs in families. It can be upsetting, but most children and young people will grow out of it. Many children under the age of 5 wet the bed and it is considered to be normal until this age.

It can help to keep a diary and try to understand the pattern. Constipation can also cause bed wetting in younger children. It is recommended to encourage your child to empty their bladder during the day and before bed and avoid caffeine based drinks. It is important never to punish a child for bed wetting but to use positive reinforcement when things goes well.

For children over the age of 5 an ‘enuresis alarm’ is usually the first thing to try next. These cannot be prescribed on the NHS but can be bought online.

Helping your child stay dry | Pre-school | Health for Under 5s

Bedwetting | ERIC

Bedwetting alarms | ERIC

Behavioural Concerns (Children)

Who do I see?
Health Visitor / School Nurse / Parenting Support Service

Advice:

There is plenty of help and support available for children with behavioural difficulties but it can be hard to know how to access it. The health visiting and school nursing services are able to help with this along with the Hampshire Parenting Support Service.

Your Health Visiting Service – Hampshire | Health for Under5s

Hampshire Specialist Parenting Support Service | Barnardo’s (barnardos.org.uk)

Hampshire Parent and Carer Network (hpcn.org.uk)

Primary Behaviour Service (hants.gov.uk)

Parenting and Family Support – Family Lives (Parentline Plus)

Bereavement Support

Who do I see?

Online Support Services

GP if requiring further support

Advice:

Most people experience grief when they lose someone or something important to them. If these feelings are affecting your life, there are things you can try that may help at this difficult time.

Support is also available if you’re finding it hard to cope with stress, anxiety or depression.

Home – Cruse Bereavement Support

Coping with bereavement – Macmillan Cancer Support

Hope Again (specifically for young people)

Get help with grief after bereavement or loss – NHS (www.nhs.uk)

Sands | Stillbirth and neonatal death charity

Together, for every baby – Charity for Babies | Tommy’s (tommys.org)

Child Death Helpline – Home

The Compassionate Friends (tcf.org.uk)

Blocked ears (wax)

Who do I see?
Community Pharmacy

Advice:
A pharmacist can help with earwax build-up

They might recommend chemical drops to dissolve the earwax. The earwax should fall out on its own or dissolve after about a week.

Do not use drops if you have a hole in your eardrum (a perforated eardrum)

Non-urgent advice: Important Information

Do not use your fingers or any objects like cotton buds to remove earwax. This will push it in and make it worse.

Blood Pressure Monitoring

Who do I see?
HCA or Practice Nurse

Advice:
Blood pressure checks can also be performed at most local pharmacies. If the results are high, a discussion with a pharmacist or a GP would be needed for further assessment.

High blood pressure (hypertension) – NHS (www.nhs.uk)

If you already have a diagnosis of high blood pressure you will be invited to attend for an annual review in the month of your birth. This will usually also require a blood test and a urine test (ACR). We will contact you when your review is due.

Having a blood pressure monitor at home is a great way to keep an eye on things if you are in a position to be able to purchase one. We would recommend one that goes round your arm rather than your wrist.

If you have a home blood pressure monitor then you will be able to submit home readings for your review if you prefer. Please do not drop in home readings unless you have been asked to do so for your review. If you are worried your blood pressure is high then please speak to reception to arrange an appointment.

Blood pressure monitors: All you need to know (bhf.org.uk)

Blood Pressure UK

How to check your blood pressure:

Sit in a chair comfortably upright with your arm supported on a table beside you, with both feet on the ground. Put the cuff on your upper arm (5cm above your elbow) resting on the table, the cuff should be roughly at the level of your heart. Press the on/start button on the BP monitor and take two readings at least 1 minute apart.

Take readings twice a day for a total of 7 days, please then return your readings (and the BP monitor if borrowed) to the surgery. We can provide you with a paper diary sheet to complete or send you a link to submit electronically.

Blood Tests

Who do I see?

Phlebotomist

Advice:

Blood tests are available at the surgery on a Wednesday morning and can be booked via reception or online.

Blood tests are also available at Andover Hospital.

Phlebotomy (Blood Tests) :: Hampshire Hospitals

For children under 4 you will need to use Sophie’s Place at Winchester Hospital.

Sophie’s Place :: Hampshire Hospitals

Requests for blood tests MUST have been agreed by your doctor or other health care professional before booking your appointment.

If you have a long term / chronic condition requiring an annual blood test, you will be called for this in the month of your birth.

Blue Badge Forms

Who do I see?
Contact Hampshire County Council directly or apply online:

Blue Badge parking scheme | Hampshire County Council (hants.gov.uk)

Advice:

The Blue Badge Scheme is for people with severe mobility problems to allow them to park closer to where they need to go. The scheme is managed by local authorities who deal with applications and issue the badges.

GOV.UK has more details about the Blue Badge scheme, including information about applying for a Blue Badge.

Boils

Who do I see?
Community Pharmacy

Triage team

Advice:

A boil is a hard and painful lump that fills with pus. Most boils will go away on their own.

Speak to the GP if you keep getting them as you may require further tests to investigate the cause.

If you are worried about a significant infection then please speak to the triage team.

Boils – NHS (www.nhs.uk)

Bowel Cancer Screening Programme

Who do I see?
National Screening Programme

Advice:

Bowel cancer screening is offered every 2 years to men and women aged 60 to 74 via a home postal kit. People older than this can ask for a screening kit every 2 years by calling the free helpline on 0800 707 60 60.

You can also call this number if you have missed your test.

The NHS is starting to reduce the age range for bowel cancer screening from April 2021 meaning that screening in the future will start from the age of 50.

Bowel cancer screening – NHS (www.nhs.uk)

NHS bowel cancer screening: FIT kit instructions (English) – GOV.UK (www.gov.uk)

Breathlessness

Who do I see?
Attend A&E for sudden or severe symptoms

If an acute problem then speak to the triage team

Longer term problems can be discussed at a routine GP appointment

Advice:
Telephone 999 or 111 if symptoms are severe.
For less serious breathing issues such as COPD flare ups or chest infections speak to the triage GP or ANP.

There are numerous causes for longer lasting or chronic breathlessness. These can include problems with the heart and lungs so it is important to seek help. You will likely be asked to attend for a blood test and a chest XRAY.

Shortness of breath – NHS (www.nhs.uk)

Breast Pain (also known as Mastalgia)

Who do I see?
Routine GP appointment

Advice:

Breast pain is common and thankfully on its own, is not usually a sign of breast cancer. Pains can be cyclical or non cyclical but are often hormonal driven. There are many things you can try to help (see below) but speak to the GP if it is not settling down or there any other concerns.

Breast pain – NHS (www.nhs.uk)

bcc71_breast_pain_2018.pdf (breastcancernow.org)

Breast pain: Causes, types and treatments | Breast Cancer Now

Breastfeeding Advice

Who do I see?
Health Visitor

For concerns over mastitis speak to the triage team

Advice:

There is a wealth or information and support online.

All about breastfeeding | Baby | Health for Under 5s

Breastfeeding help and support – NHS (www.nhs.uk)

National Breastfeeding Helpline – Helpline

Finding Support – The Breastfeeding Network

The breastfeeding network also produces helpful guides on whether medications are safe to use whilst breastfeeding.

Drugs Factsheets – The Breastfeeding Network

Breast Cancer Screening

Who do I see?
Breast Screening Service

Advice:

Female patients aged between 50 and 71 will be invited for breast screening every 3 years. If you think you have been missed or you are over 71 you can request breast screening by contacting the service directly.

The number is 01962 824841.

When you’ll be invited for breast screening and who should go – NHS (www.nhs.uk)

Your_breast_screening_appointment_EASY_READ.pdf (hampshirehospitals.nhs.uk)

Checking your breasts at home for any changes should be undertaken regularly. There is lots of advice online about how to perform this.

How should I check my breasts? – NHS (www.nhs.uk)

Breast cancer – signs and symptoms | NHS – Bing video

Breast Cancer UK | Prevention Hub (breastcancerprevention.org.uk)

Bruised Ribs

Who do I see?
Community Pharmacist / Minor Injuries Unit

Advice:

Broken or bruised ribs are usually caused by a fall, a blow to the chest or severe coughing. Ribs cannot be easily splinted or supported like other bones, so they’re usually left to heal naturally. Having an XRAY for a broken rib is not routinely recommended unless there are other complications.

Broken or bruised ribs – NHS (www.nhs.uk)

B12 Deficiency

Who do I see?
Routine GP appointment

HCA or Practice Nurse For Injection

Advice:

Vitamin B12 is an essential part of making new cells in the body, such as new red blood cells which are made every day. Vitamin B12 is found in meat, fish, eggs and milk and a normal balanced diet usually contains enough vitamin B12. A lack of vitamin B12 can lead to anaemia and a number of other problems.

Causes can include poor dietary intake (mostly seen with vegan diets), certain medications and a condition called pernicious anaemia.

Symptoms of B12 deficiency can included tiredness, a sore mouth and tongue and pins and needles. Some patients with low B12 do not have any symptoms.

A deficiency can be detected by a simple blood test. You will also be checked for anaemia at the same time. Depending on your levels you may be recommended B12 injections or tablets and follow up testing will be required.

Vitamin B12 Deficiency and Pernicious Anaemia | Patient

Vitamin-B12-deficiency-Patient-factsheet-January-2021.pdf (westsuffolkccg.nhs.uk)

Vitamin B12 – Consumer (nih.gov)

Vitamins and minerals – B vitamins and folic acid – NHS (www.nhs.uk)

Burns

Who do I see?
Minor Injuries Unit / A+E

Advice:
If the burn is severe or deep, caused by a chemical or electrical burn or the burn is larger than the patient’s hand please attend A+E right away.

Andover Minor Injuries Unit can assist with minor burns. To arrange an appointment please call 111

Andover Minor Injuries Clinic :: Hampshire Hospitals

If you require ongoing dressing of a wound / care of your burn please book an appointment with the Practice Nurse.

Burns and scalds – NHS (www.nhs.uk)

Can My Child Go To School?

Who do I see?
Online Advice (see below)

Advice:

Individual schools and nurseries may have their own policies but we follow the NHS advice as below.

Do I need to keep my child off school A4 Draft 3 (hscni.net)

Should your child go to school/nursery today? :: Healthier Together (what0-18.nhs.uk)

Cervical Smear

Who do I see?
Practice Nurse

Advice:
Once you are invited, please book an appointment with the nurse on a day that you are not bleeding or on your period.

Cervical screening is very important and helps to pick up any potential problems at an early stage so please make sure you come along for your appointment when you are called.

Cervical screening – NHS (www.nhs.uk)

Cervical screening (smear test) | Jo’s Cervical Cancer Trust (jostrust.org.uk)

Chest Pain

Who do I see?

Call 999 / attend A&E for severe symptoms or with any symptoms that may suggest a heart attack

Triage team

Routine GP appointment

Advice:
Telephone 999 or 111 if symptoms are severe.

Symptoms of a heart attack can include sudden central chest pain, pain in the left arm, jaw and neck, nausea, anxiety, breathlessness and sweating.

If the chest pain is not severe, does not have the above features and is persisting please speak to the triage GP or ANP. If your pain is long standing please make a routine GP appointment.

There are numerous other causes for chest pains including indigestion, costochondritis, chest infections, muscular pains and more. The location, duration and nature of the pain can help us to determine the cause.

Chest pain – NHS (www.nhs.uk)

Symptoms of a heart attack – NHS (www.nhs.uk)

Cellulitis

Who do I see?
Triage team

Advice:
Cellulitis is a skin infection that’s treated with antibiotics. It makes your skin painful, hot and swollen. The area usually looks red, but this may be less obvious on brown or black skin. It can be serious if it’s not treated quickly.

For concerns about cellulitis please speak to the triage team.

Cellulitis – NHS (www.nhs.uk)

Chest Infections

Who do I see?
Self Care / Community Pharmacy

Triage team if persisting or you have underlying health problems

Advice:

Chest infections often follow colds or flu. It is not uncommon for a cough to last for 3 – 4 weeks.

Chest infections can be viral or bacterial, antibiotics are not helpful for viral chest infections and will therefore not always be recommended at your appointment.

Cough – NHS (www.nhs.uk)

Chest infection – NHS (www.nhs.uk)

NHS (hereforyouhampshire.nhs.uk)

Child Development Concerns

Who do I see?
Health Visitor

Advice:

Health visitors are qualified nurses or midwives who have undergone further specialist training. They can support with a variety of issues from birth up to 5 years of age. If you are worried about your child’s development they are the best people to speak to initially.

Your Health Visiting Service – Hampshire | Health for Under5s

Interactive Child Development Timeline | NHS GGC

Coils or Implants

Who do I see?
Practice Nurse or Sexual Health Clinic

Advice:
For new or replacement coils and implants you can book an appointment at the Andover GP Hub service via reception or use Andover Sexual Health Clinic.

Home | Sexual Health, hampshire, portsmouth, southampton (letstalkaboutit.nhs.uk)

Information about contraceptive implants.

Information about coils.

Colds

Who do I see?
Self Care / Community Pharmacy

Antibiotics are NOT needed for the common cold, as colds are caused by a virus.

A pharmacist will be able to help with cold and flu remedies.

Common cold – NHS (www.nhs.uk)

Colds, coughs and ear infections in children – NHS (www.nhs.uk)

Cows Milk Protein Allergy

Who do I see?
Health Visitor

Routine GP appointment

Advice:

Allergy to milk is the commonest food allergy in infants and young children and affects about 1 in 50 children. It usually starts when infants are first given cow’s milk or milk products (eg formula milk or a weaning food containing milk). About 20% of infants outgrow milk allergy by 1 year, and nearly all by 3 years.

Symptoms to look out for include rashes, diarrhoea, vomiting and failure to gain weight.

Cow’s Milk Allergy | Allergy UK | National Charity

What should I do if I think my baby is allergic or intolerant to cows’ milk? – NHS (www.nhs.uk)

Conjunctivitis

Who do I see?
Self Care / Community Pharmacy

Minor Eye Conditions Service if persistent

Triage team if patient under <28 days old

Advice:

Conjunctivitis is common and usually will resolve without any treatment. The pharmacist can help advise and provide antibiotic drops if needed.

If your symptoms are not settling down or you need further assistance contact the Minor Eye Conditions Service for an assessment.

Adults: Conjunctivitis – NHS (www.nhs.uk)

Children: Conjunctivitis :: Healthier Together (what0-18.nhs.uk)

Minor Eye Conditions Service (MECS) covers minor eye problems (primaryeyecare.co.uk)

Colonoscopy

Who do I see?

Hospital Team

Advice:

Having a colonoscopy can be a daunting experience but is usually very straightforward and takes around 30 – 45 minutes. You can usually go home the same morning or afternoon.

Colonoscopy – What happens on the day – NHS (www.nhs.uk)

Having_a_colonoscopy.pdf (hampshirehospitals.nhs.uk)

Information about the different types of bowel preparation medication is available under the Endoscopy section of the HHFT website.

Patient information leaflets :: Hampshire Hospitals

Constipation

Who do I see?
Self Care / Community Pharmacy

Triage team if not resolving

Advice:

Constipation is common and can be caused by a variety of reasons including diet, dehydration and some medications. A pharmacist can help and laxative medication can be obtained over the counter. If your symptoms are progressive or not resolved with simple measures then speak to the triage team.

Constipation – NHS (www.nhs.uk)

Constipation is also common in children, especially aged 2-3, the ERIC website has lots of information and a helpline on 0808 169 9949 for more advice. Keeping well hydrated is important.

Bowel problems | ERIC

Constipation :: Healthier Together (what0-18.nhs.uk)

Contraception and Family Planning

Who do I see?
GP / Practice Nurse

Advice:
Please book to speak to the GP for an initial assessment. Have a look at the links below so you are aware of your options.

If you are taking the contraceptive pill you will need an annual review with the practice nurse.

Please ensure your cervical smear test is up-to-date.

Your guide to contraception – Sexwise

Your contraception guide – NHS (www.nhs.uk)

Contraception Methods | Birth Control Options | Patient

Contraception information, tools and advice | SH:24 (sh24.org.uk)

Cystitis

Who do I see?
Community Pharmacy

Triage team

Advice:
A pharmacist can often help with simple or mild cases of cystitis.

Cystitis – NHS (www.nhs.uk)

If you need further assistance please speak to the triage team. Please be aware you are likely to be asked to provide a urine sample. Specimen pots are available at the front of reception.

Chronic Heart Disease

Who do I see?
Practice Nurse

Advice:
Annual clinic appointments will be sent to all CHD patients, this will usually be in the month of your birth. Please ask for an earlier appointment if you are worried.

We will contact you when your review is due, if you think you are overdue or have been missed then please phone the surgery to arrange your appointment.

Further information about heart disease from NHS UK.

Chronic Kidney Disease

Who do I see?

Practice Nurse

Advice:

Chronic kidney disease (CKD) is a long-term condition where the kidneys don’t work as well as they should. It’s a common condition often associated with getting older and often doesn’t cause any symptoms. Around 10% of people in the UK have CKD, rising to 20% of people over 80.

Chronic kidney disease is usually caused by other conditions that put a strain on the kidneys such as diabetes, high blood pressure, high cholesterol and long term use of anti inflammatory medications such as Ibuprofen.

There are different stages of CKD, from stage 1 to stage 5. the stage is determined by the results of a blood and urine test. Those patients who reach stage 4 or who have a rapidly progressive decline in their kidney function will need a referral to a specialist. Patients with stage 1-3 CKD can be monitored routinely at the surgery and you will be invited for an annual review.

Chronic kidney disease – NHS (www.nhs.uk)

Chronic kidney disease (CKD) | Kidney Care UK

Cold Sores

Who do I see?
Self Care / Community Pharmacy

Advice:
Cold sores are common and usually clear up on their own within 10 days. There are things you can do to help ease the pain, and treatments that can be tried, a pharmacist will be able to guide you.

Cold sores – NHS (www.nhs.uk)

Cough

Who do I see?
Community Pharmacy

Triage team if persists for more than 3 weeks

Advice:
Coughs can be caused by a number of reasons including chest infections, acid reflux, smoking, post nasal drip and asthma / COPD.
A cough will usually clear up on its own within 3 to 4 weeks.
A pharmacist can help with treatments for cough.

Further information how to treat your cough from NHS UK.

NHS (hereforyouhampshire.nhs.uk)

TYIRTI Pictorial v3.3 UKHSA.doc (live.com)

Dementia Screening

Who do I see?
GP

Advice:
Memory problems do not necessarily mean you have dementia. These problems can have other causes, such as depression and anxiety, delirium, an underactive thyroid and side effects of some medications.

To help rule out other causes of memory problems, the GP will do a physical examination and may organise tests, such as a blood test and urine test. You will also be asked to do a memory test.

How to get a dementia diagnosis – NHS (www.nhs.uk)

Specialist support to families facing dementia | Dementia UK

About dementia | Alzheimer’s Society (alzheimers.org.uk)

Depot Injection (Contraception)

Who do I see?
Practice Nurse

Advice:
Please speak to the GP for an initial assessment when first starting and then see the nurse for your follow up injections which take place every 3 months.

Please ensure your cervical smear test is up-to-date.

Further information about the contraceptive injection from NHS UK

Diabetes Monitoring

Who do I see?
Diabetic Nurse

Advice:
We will call you for your annual diabetic review in the month of your birth. You will need to have a blood test and a urine test (ACR test) prior to this appointment.

Further information about diabetes from NHS UK.

Healthy Living

TREND UK | Know Diabetes

For retinal screening information and appointments please see below.

Diabetic Eye Screening Homepage | Hampshire & Isle of Wight Diabetic Eye Screening Programme | HIOW DESP (desphiow.co.uk)

Winchester and Basingstoke Hospitals both have a specialist service for patients already under their care.

Diabetes patients resources :: Hampshire Hospitals

There are also numerous support groups available for patients with diabetes.

Local support groups | Diabetes UK

Diet / Lifestyle Changes

Who do I see?
Health Care Assistant or Practice Nurse

Advice:
Our nursing team can help with dietary and lifestyle advice. Further information is available online.

BMI calculator | Check your BMI – NHS | Please fill in your details (www.nhs.uk)

Live Well – NHS (www.nhs.uk)

12-week fitness plan – NHS (www.nhs.uk)

Dressings

Who do I see?
Practice Nurse or Health Care Assistant

Advice:
Please phone the surgery to arrange your appointment if you require a dressing.

Drug Addiction

Who do I see?
Talk to Frank / Inclusion Hampshire

Advice:
For help and support with drug addiction for yourself or a family member, take a look at the websites below. You can self refer without speaking the to the GP.

Honest information about drugs | FRANK (talktofrank.com)

Phone: 0300 1236600 for assistance.

Home – Inclusion Hants

Dental Problems

Who do I see?
Dentist

Advice:
Please book an appointment with your dentist or find a dentist near you: 

Find a dentist – NHS (www.nhs.uk)

NHS 111 can advise on an emergency dentist if needed.

Please note: our team are not qualified or insured to be able to help with dental problems and you will be re directed by the reception team. This includes pain relief requests, your dentist is able to prescribe this for you.

Delaying Periods

Who do I see?
Submit an E consult

Routine GP appointment

Advice:

There are a number of ways to delay your period if needed.

How can I delay my period? – NHS (www.nhs.uk)

A hormonal medication called Norethisterone can be used if it is safe for you to do so. The dose is one tablet three times a day. You start three days before your period is due. It can be continued until you want to have a period and then your period will then normally begin 2-3 days after stopping. Norethisterone should be taken for no longer than 20 days. This is only for use on an occasional basis rather than something that can be taken regularly.

Side effects can include nausea (feeling sick), breast tenderness, tiredness, bloating, reduced sex drive or headache.

Norethisterone when taken in the manner needed for period delay will not act as a contraception and you should therefore ensure alternative suitable contraception is used.

This medication will not be suitable for you if you are at increased risk of blood clots. You may be able to take an alternative tablet called Medroxyprogesterone instead.

Depression

Who do I see?
iTALK / Mind

Primary Care Mental Health Team

Triage team

Advice:

As part of our team we are lucky to have mental health practioners from the primary care mental health team working with us on Mondays. You can book an appointment via reception.

You can also self refer to iTALK and Mind for free support and counselling;

Call Mind on 0300 123 3393

About depression | Mind, the mental health charity – help for mental health problems

italk, Hampshire’s NHS Talking Therapy Service

There is lots of support online which you might like to take a look at before your appointment.

SilverCloud, free and easy to access online CBT (italk.org.uk)

Depression – NHS (www.nhs.uk)

How to cope with depression – NHS (www.nhs.uk)

For urgent help out of hours or if you find yourself in crisis you can contact the Samaritans on 116 123 for 24-hour confidential, emotional support. You can text SHOUT to 85258 or you can use NHS 111 who have a mental health service.

To discuss medication for depression, please speak to the GP.

Overview – SSRI antidepressants – NHS (www.nhs.uk)

Diarrhoea

Who do I see?
Community Pharmacist

Triage team if persisting

Advice:
Diarrhoea is passing looser or more frequent stools than is normal for you.

It affects most people from time to time and is usually nothing to worry about.

Most cases of diarrhoea clear up after a few days without treatment, and if so, you do not need to seek medical advice.

However, diarrhoea can lead to dehydration so you should drink plenty of fluids – small, frequent sips of water – until it passes. It’s very important that babies, small children and elderly patients do not become dehydrated.

If your symptoms are persistent then please call to speak to the GP.

Further information about diarrhoea and vomiting from NHS UK.

Self-help guide: Diarrhoea | NHS inform

For children:

Diarrhoea and vomiting :: Healthier Together (what0-18.nhs.uk)

Dizziness

Who do I see?
Triage ANP / GP if acute episode

Routine GP appointment if persistent problem

Advice:

Dizziness includes feeling: off-balance, giddy, lightheaded or faint, like you or things around you are spinning (vertigo).

There are lots of reasons to feel dizzy, speak to a GP if it is not settling down or you are worried.

Dizziness – NHS (www.nhs.uk)

Dizziness (Causes, Symptoms, and Treatment) | Patient

Dyslexia

Who do I see?
School / Dyslexia Association

Advice:

Dyslexia is a common learning difficulty that can cause problems with reading, writing and spelling.

It’s a specific learning difficulty, which means it causes problems with certain abilities used for learning, such as reading and writing.

Unlike a learning disability, intelligence isn’t affected.

It’s estimated up to 1 in every 10 people in the UK has some degree of dyslexia.

If you are concerned about your child then speak to their teacher or SENCO. For adults you will need to arrange a private assessment.

Dyslexia – NHS (www.nhs.uk)

Assessments – British Dyslexia Association (bdadyslexia.org.uk)

DWP: GP letters for Personal Independence Payment (PIP) and Employment and Support Allowance

Who do I see?
We are unable to provide letters of support for the DWP.

Advice:
The DWP will usually contact your GP or healthcare professional to obtain medical evidence when you submit a PIP or ESA claim, the information is then sent to the DWP as part of your claim process. 

We regret we are unable to provide additional letters of support as the information we provide will be included in the report requested by the DWP.

However you may request your medical records if you feel this may help your case. If you wish to have a copy of your medical records, please contact the practice who will advise accordingly. There is no charge for this.

We have provided some useful contacts shown below to help you:

Our social prescribing team may be able to help.

Social Prescribing (andoverpcn.co.uk)

Useful contacts
Action for M.E.
Information and support for people with M.E. and their carers. General enquiries: 0117 927 9551 (Mon-Fri 9am-5pm).

Online M.E. CentreAction for M.E

Welfare Rights Line: 0845 122 8648 (times vary)

Citizens Advice Bureau
Offers advice on a range of issues and may complete a benefits check for you. Find your local Citizens Advice Bureau.

Disability Information and Advice Line (DIAL)
To find your local DIAL office, contact Scope, 6 Market Road, London N7 9PW Tel: 0808 800 3333

Disability Rights UK
Factsheets on benefits, tax credits and independent living from disability rights uk

Local councils
Some local councils employ welfare rights workers. Your local council may also have information about other services that offer welfare rights advice in your area.

Ear Care / Ear Wax

Who do I see?
Community Pharmacy / Practice Nurse or HCA (Health Care Assistant)

Advice:

A pharmacist can help with ear wax build up. We offer ear syringing at the practice if this is required. You must use ear drops for the week before this appointment to soften the wax.

Earwax build-up – NHS (www.nhs.uk)

For concerns over gradual onset hearing loss please arrange a hearing test initially via Specsavers.

Book an Eye Test Online | Book an Appointment | Specsavers

Eating Disorders

Who do I see?
GP

Advice:

An eating disorder is a mental health condition where you use the control of food to cope with feelings and other situations.

Unhealthy eating behaviours may include eating too much or too little or worrying about your weight or body shape.

Anyone can get an eating disorder, but teenagers between 13 and 17 are mostly commonly affected.

For adults, there is a specialist service for further assessment called April House. Speak to the GP to discuss this in more detail.

For children, additional support is available through CAMHS.

Overview – Eating disorders – NHS (www.nhs.uk)

The UK’s Eating Disorder Charity – Beat (beateatingdisorders.org.uk)

Eating Disorders Service :: Southern Health NHS Foundation Trust

Eating Difficulties – CAMHS (hampshirecamhs.nhs.uk)

Early Pregnancy Referrals

Who do I see?
Self referral if applicable

Triage ANP / GP if worrying symptoms

Advice:
Winchester and Basingstoke hospitals both offer an early pregnancy assessment unit for patients up to 13 weeks pregnant.

If you have had a previous ectopic or molar pregnancy or 2 previous miscarriages you can self refer to the unit.

Early Pregnancy Assessment Unit (EPAU) :: Hampshire Hospitals

If you are having abdominal pain or bleeding in early pregnancy please speak to the triage team or 111 out of hours.

Emergency Contraception

Who do I see?
Community Pharmacy / Sexual Health Clinic / GP / ANP

Advice:

Emergency contraception is commonly referred to as “the morning after pill”. If you have had sex without using contraception, or think your contraception might have failed, you can use emergency contraception.

You should access emergency contraception as soon as possible. In Hampshire it is free from most pharmacies.

Emergency contraception – Let’s Talk about It (letstalkaboutit.nhs.uk)

Earache

Who do I see?
Self Care / Community Pharmacy / GP / ANP

Advice:
Ear ache is common and can have various causes. A pharmacist can advise, speak to the triage GP or ANP if it is not settling down.

Earache – NHS (www.nhs.uk)

Ear infections – NHS (www.nhs.uk)

Ear ache is children is extremely common and usually does not require antibiotics. Please see the helpful advice below.

Earache :: Healthier Together (what0-18.nhs.uk)

Eczema

Who do I see?
Community Pharmacy

Triage GP / ANP if persists for more than 4 weeks or any concerns it is infected

Advice:
Eczema is the name for a group of conditions that cause the skin to become itchy, inflamed, or have a rash-like appearance.

Eczema is very common. It can begin during childhood, adolescence, or adulthood and it can range from mild to severe. In the UK, one in five children and one in ten adults have eczema.

The most important part of eczema management is keeping the skin well moisturised. Steroid creams may be required for flare ups, low strength steroid creams can be purchased over the counter for adults.

Our skin and eczema | National Eczema Society

Atopic eczema – NHS (www.nhs.uk)

Eye Problems

Who do I see?
Minor Eye Conditions Service

The MECS service can be directly accessed online via the link below or on 01264 339369. They operate out of SpecSavers in Andover. You do not need a GP referral.

Minor Eye Conditions Service (MECS) covers minor eye problems (primaryeyecare.co.uk)

Find a Practice – Search for your nearest participating optical practice (primaryeyecare.co.uk)

If you have an urgent or sight threatening problem there is an emergency ‘eye casualty’ at Southampton Hospital. You do not need an appointment, it is a walk in service.

Fatty Liver Disease

Who do I see?
Routine GP Appointment

Advice:

Most people are aware of the link between alcohol excess and liver damage. This is known as ‘alcohol related liver disease’ (ARLD) and includes conditions such as alcoholic hepatitis and liver cirrhosis.

Less well known is ‘non-alcohol related fatty liver disease’ (NAFLD) which is a general term for fatty liver disease that has not been caused by alcohol. In the UK most but not all cases of NAFLD are caused by being overweight / obesity. It is very common – around 1/4 people in the UK have fatty liver.

Most people with NAFLD won’t develop serious liver disease but in a small number of people it can progress to cirrhosis, liver cancer or liver failure.

If you have a long term condition such as diabetes or heart disease, a liver function blood test will be included as part of your annual review. If you are at high risk of NAFLD you will be offered a Fibroscan test (ultrasound scan of the liver) for further assessment.

NAFLD, NASH and fatty liver disease – British Liver Trust

Non-alcoholic fatty liver disease (NAFLD) – NHS (www.nhs.uk)

Liver Fibroscan (midhampshirehealthcare.co.uk)

Flu Vaccine

Who do I see?
Practice Nurse / HCA (Health Care Assistant)

Advice:

We will invite you for your annual flu vaccine if you are eligible.

Further information about the flu vaccine from NHS UK.

Fear Of Flying

Who do I see?
Mental Health Services

Advice:

Patients sometimes ask us to prescribe diazepam for fear of flying. There are a number of reasons why prescribing this drug is not recommended.

1) Diazepam is a sedative, which means it makes you sleepy and more relaxed. If there is an emergency during the flight it may impact your ability to concentrate, follow instructions and respond to the situation. This could have serious safety consequences for you and those around you.

2) Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung. Blood clots are very dangerous and can prove fatal. This risk is even greater if your flight is greater than 4 hours.

3) Whilst most people find medications like diazepam sedating, a small number of people report agitation and increased aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law.

4) According to the prescribing guidelines doctors follow, medications such as diazepam are contraindicated (not allowed) in treating phobia. Your doctor would be taking a significant legal risk by prescribing against the guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.

5) Diazepam and similar drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police on arrival if you are carrying them.

6) Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing you may fail this having taken diazepam.

We appreciate that fear of flying is very real and very frightening. Some airlines runs courses designed to try and help with this issue.

Fear of flying course | Fearless Flyer (easyjet.com)

flyingwithoutfear | Virgin Flying Without Fear

Fever

Who do I see?
Self Care / Community Pharmacy

Triage ANP / GP

Advice:

Adults: A high temperature is usually considered to be 38C or above. This is sometimes called a fever. Many things can cause a high temperature, but it’s usually caused by your body fighting an infection. This may be bacterial such as a pneumonia or viral like the flu or COVID.

High temperature (fever) in adults – NHS (www.nhs.uk)

Children: Fever is extremely common in children and usually suggests that your child has an infection.

Viral infections are far more common than bacterial infections. Symptoms such as runny nose, cough, wheeze, sore throat, red eyes and diarrhoea are more suggestive of a viral infection than a bacterial infection. If a number of people are unwell in the same household, this also suggests a viral infection (because viral infections are easily spread).

Viral infections tend to get better on their own and do not need treatment with antibiotics. Antibiotics may actually cause side effects such as rash and diarrhoea and can increase the risk of them developing resistance to antibiotics.

Fever / High Temperature :: Healthier Together (what0-18.nhs.uk)

Babies: Fever in babies less than 90 days of age is much more likely to be due to a serious infection requiring urgent treatment compared to fever in an older child. For this reason, all children under 90 days of age with a temperature above 38°C should be urgently reviewed by a healthcare professional.

The exception to this is babies who are up to 48 hours after receiving immunisations – it is OK to give paracetamol after the MenB vaccine without seeking medical advice if your baby is otherwise well.

My baby has a fever / high temperature :: Healthier Together (what0-18.nhs.uk)

Fungal Skin Infections

Who do I see?
Community Pharmacy

GP / ANP if it persists

Advice:

Fungal skin infections are common and include athlete’s foot, ringworm of the scalp and body, groin infections and intertrigo. They can often be treated with creams from a pharmacist.
Ringworm – NHS (www.nhs.uk)

Fungal Groin Infection (Tinea Cruris) | Symptoms and Treatment | Patient

UNDER-BREAST SORENESS (INTERTRIGO) (ruh.nhs.uk)

Fertility Concerns

Who do I see?
Routine GP appointment

Advice:

Most couples (around 84%) will get pregnant within a year if they have regular sex and don’t use contraception. Having regular sex means having sex every 2 to 3 days throughout the month. This figure rises to 92% after 2 years.

If you’re trying to get pregnant it’s important to take folic acid daily, eat a healthy diet, and drink no more than 1 or 2 units of alcohol once or twice a week. This will help your baby develop healthily.

Fertility problems affect 1 in 7 couples in the UK, these can be caused by a variety of issues which may affect either person or both. In 25% of couples, fertility problems can’t be explained.

Risk factors for infertility include smoking, obesity, occupational risks, excessive alcohol consumption, and drug use. Female fertility declines with age; the effect of age on male fertility is less clear.

Trying to get pregnant – NHS (www.nhs.uk)

Infertility – NHS (www.nhs.uk)

Investigations for infertility are not usually recommended until the couple has been unable to conceive after 1 year of regular unprotected sex. However, investigations should be offered earlier than 1 year to couples who have been identified as less likely to conceive or if the woman is aged 36 years and older.

Before a referral can be made, both partners will need to have further tests completed, these can be arranged by the GP. For men this is a sperm sample and for women this requires 2 blood tests, an ultrasound scan and STI screening.

You will then be referred to the specialist fertility clinic who will be able to discuss options with you based on your test results and individual circumstances.

Fertility treatments include:

  • Medication for lack of regular ovulation
  • Surgical procedures such as treatment for endometriosis, repair of fallopian tubes, or removal of scarring (adhesions) within the womb or abdominal cavity
  • Assisted conception such as intrauterine insemination or IVF

In Hampshire you are only eligible for NHS funded IVF if you are under 35, have been trying to conceive for one year and have not fallen pregnant and have not had IVF before. Both partners must not have any previous children. For same sex couples or single people you need to have had 12 failed insemination cycles, of which 6 need to be in a clinic using intra-uterine insemination OR a diagnosed fertility problem.

The person having IVF must have a BMI between 19-29.9 and both partners must be non smokers for at least 6 months.

Flu

Who do I see?
Self Care / Community Pharmacy

Triage ANP / GP if persists for more than 7 days or difficulty breathing

Advice:

Flu will often get better on its own, but it can make some people seriously ill. It’s important to get the flu vaccine if you’re advised to.

Flu | NHS inform

Flu – NHS (www.nhs.uk)

Fungal Nail Infections

Who do I see?

Self Care / Pharmacist

GP if persisting problem

Advice:
If your nail symptoms do not respond to over the counter treatment you may be able to take anti fungal tablets to clear the infection. Prior to doing this you will need to provide nail clippings to confirm the type of infection present.

Please discuss routinely with the GP or send a request via an E consult.

Fungal nail infection – NHS (www.nhs.uk)

Forms, certificates and medicals

Who do I see?
GP Administrative Team

Advice:
Completion of forms, certificates and medicals are not covered under the NHS but are provided privately. Payment for reports must accompany the request or appointment booking (i.e. in advance).

Charges are aligned with the BMA’s guidelines. Please read the form carefully and fill in and sign any parts that you need to complete before you bring the form to the surgery.

Please allow up to 21 days for the process to be completed, you will be contacted by phone when your form is ready for collection.

Please note we do not sign passport forms.

Genital Infections including Herpes

Who do I see?
Genitourinary (GUM) Clinic

Triage GP / ANP

Advice:
The best place to seek advice regarding any possible genital infection is at the Sexual Health clinic. They have access to more specialist testing than we do at the surgery and can also help with home testing kits and arranging to speak to any affected contacts on your behalf if necessary.

Home | Sexual Health, hampshire, portsmouth, southampton (letstalkaboutit.nhs.uk)

Vaginal discharge – NHS (www.nhs.uk)

Why is my penis smelly and sore? – NHS (www.nhs.uk)

Haemorrhoids

Who do I see?
Self Care / Pharmacy

ANP / GP if not responding to treatment or they keep coming back

Advice:

Piles (haemorrhoids) are lumps inside and around your bottom (anus). They often get better on their own after a few days. A pharmacist can help with treatment in the first instance.

Piles (haemorrhoids) – NHS (www.nhs.uk)

Hay Fever

Who do I see?
Community Pharmacy

GP if not responding to treatment

Advice:
Hay fever medications are available from the chemist without needing to see your GP. This includes anti histamines, nasal sprays and eye drops. If your symptoms are particularly troublesome you can speak to the GP at a routine appointment or submit an E consult.

Hay fever – NHS (www.nhs.uk)

Hay Fever | Allergy UK | National Charity

High Blood Pressure

Who do I see?
HCA or Practice Nurse for reviews

GP for treatment

Advice:

High blood pressure is very common, around 1 in 3 adults. Many people are unaware they have high blood pressure as it often does not cause any symptoms.

If you are found to have high blood pressure at a check up then it is usually recommended you have either a 24 hour blood pressure monitor fitted or take 2 weeks of home blood pressure readings to confirm the diagnosis.

If your blood pressure is high, you are likely to be recommended medication to try and lower it. This is due to high blood pressure being a risk factor for other serious medical problems such as strokes and heart attacks.

You can lower your blood pressure through making lifestyle changes such as weight loss, increasing exercise, stopping smoking and reducing your salt, caffeine and alcohol intake.

High blood pressure (hypertension) – NHS (www.nhs.uk)

How do I control my blood pressure? Lifestyle options and choice of medicines patient decision aid (nice.org.uk)

Head Lice

Who do I see?
Self Care / Community Pharmacy

School Nurse

Advice:

Headlice can be treated at home without the need for medical assistance.
Head lice and nits – NHS (www.nhs.uk)

Head Lice and Nits | Symptoms and Causes | Patient

HRT

Who do I see?
Routine GP Appointment

Practice Nurse for your annual review

Advice:

Hormone replacement therapy (HRT) is a treatment to relieve symptoms of the menopause. It replaces the hormone oestrogen which your body stops producing as you go through menopause.

This can cause a variety of symptoms (see Menopause section) which can be very debilitating. HRT can help to reduce these symptoms for lots of women. You are able to start HRT during peri menopause (before your periods have stopped).

There are a number of considerations to take into account when considering HRT.

  1. Do you need any tests prior to starting? Usually no testing is required to diagnose menopausal symptoms. A blood test is often suggested if you are under 45 (termed ‘early menopause’) and would definitely be recommended if you are under 40 (termed ‘premature ovarian insufficiency’ or POI).
  2. What are the risks of taking HRT? As with all medications there are some risks to using HRT but there are also many benefits. Please see attached links for further details.
  3. What type of HRT will you need? HRT can be oestrogen only or combined HRT (oestrogen and progesterone). Oestrogen only HRT is for women who have had a hysterectomy (surgery to remove their womb), or are using an intrauterine system (IUS) such as a Mirena coil. This type of HRT does not contain progesterone (which is otherwise needed to protect the lining of the womb). Combined HRT can be used cyclically or continuously, this depends on whether you are still having periods or not. Cyclical HRT will give a monthly bleed and continuous HRT gives no bleed. Continuous HRT is recommended once you have not had a period for 1 year.
  4. How do I use HRT? Oestrogen can be given as a gel, patch, spray or tablet. Progesterone can be included in a combination patch, taken as a tablet, used vaginally or via an IUS (coil).
  5. How long can I take HRT for? HRT can be taken for as long as you require it, provided the risks do not outweigh the benefits, there is no maximum length of time it can be taken for.

General info:

Hormone replacement therapy (HRT) – NHS (www.nhs.uk)

Layout 1 (balance-menopause.com)

Hormone-Replacement-Therapy-HRT-the-basics.pdf (balance-menopause.com)

HRT-Types-and-doses-v21-02.pdf (newsonhealth.co.uk)

Info on risks:

HRT: Benefits and risks – Women’s Health Concern (womens-health-concern.org)

01-WHC-FACTSHEET-BreastCancer-NOV2020-C.pdf (womens-health-concern.org)

HRT-Myths-Uncovered.pdf (pcwhf.co.uk)

Practical info:

FAQs-about-HRT-v21-02.pdf (newsonhealth.co.uk)

Some women are unable to use HRT due to other medical conditions. There are also some non hormonal treatments that can help.

RMM_Alternatives-to-HRT.pdf (rockmymenopause.com)

Vaginal Oestrogen (‘Local HRT’):

The menopause can cause problems with vaginal dryness and irritation. For this particular symptom, ‘local’ HRT can be applied directly to the affected area as a cream or a pessary.

Vaginal-Dryness-v21-02.pdf (newsonhealth.co.uk)

There is a wealth of information on the menopause and HRT available via the following sites.

Newson Health – Resources

WHC factsheets and other helpful resources – Women’s Health Concern (womens-health-concern.org)

Holiday Cancellation Certificate

Who do I see?
GP Administrative Team

Advice:

Holiday Cancellation forms are not covered by the NHS, there will be a charge for this service.
Payment for reports must accompany the request or booking (i.e. in advance). Charges are aligned with the BMA’s guidelines. Please read the form carefully and fill in and sign any parts that you need to complete before you bring the form to the surgery.

We ask that you allow up to 21 days for the process to be completed, you will be contacted by phone when your form is ready for collection.

Head Injuries

Who do I see?
Minor Injuries Unit

Use A+E for a severe or significant head injury or if you are on blood thinning medication

Advice:

The NHS website has a full list of symptoms that require A+E attendance.
Head injury and concussion – NHS (www.nhs.uk)

Andover Minor Injuries unit can help if none of the worrying features are present.

Andover Minor Injuries Clinic :: Hampshire Hospitals

Head Injury Advice | Patient

For children:

Head Injury :: Healthier Together (what0-18.nhs.uk)

CS45385_NHS_Head_Injury_advice_sheet_April_20.pdf (what0-18.nhs.uk)

Headaches

Who do I see?
A+E if very severe or sudden onset

Triage ANP / GP if acute symptoms

Routine GP appointment if long standing or recurrent

Advice:
Headaches are very common and not usually caused by anything serious. There are various types of headache including migraines, tension headaches and cluster headaches. Some headaches can even be caused by taking too much pain relief.

Headaches – NHS (www.nhs.uk)

Headaches | Types, Warning Signs, Causes & Treatment | Patient

For longer term headaches it can be very helpful to keep a ‘headache diary’ to try and work out if there are any particular triggers. You can then discuss this with the GP.

Keeping a headache diary – The Migraine Trust

Hospital Appointments

Who do I see?
Medical Secretary

Advice:

Once you have been referred to hospital by the surgery, your information will be reviewed by their team and an appointment will be allocated to you. We do not have any control over the time scale of this, unless there is a significant change in your symptoms. Please contact the department you have been referred to in the first instance.

If you are waiting for tests or scans arranged by the hospital or for follow up appointments please contact the Consultant’s secretary.

Please be aware that we are not able to give you the results of blood tests or scan results that have been organised for you by the hospital team. Please contact the Consultant’s secretary.

Outpatient information :: Hampshire Hospitals

Email addresses available for patient use:

Medical Specialties: Medical.BookingOfficerRHCH@hhft.nhs.uk

Respiratory Team: RespiratoryAdminRHCH@hhft.nhs.uk

Elderly Care Team: EldercarestrokeAdminRHCH@hhft.nhs.uk

Hospital Transport

Who do I see?

Transport service

Advice:

Certain patient groups are eligible for assistance with non emergency hospital transport.

How to organise transport to and from hospital – NHS (www.nhs.uk)

Hampshire NEPTS | South Central Ambulance Service NHS Foundation Trust (scas.nhs.uk)

The number for the patient booking line is 0300 123 9833

Housing – letter of support

Who do I see?
We normally do not provide this service – Advice and help is available from Shelter England

Advice:
From time to time GPs are requested to provide reports for patients to Local Housing Authorities and Housing Associations. This is not part of our core services and therefore we may charge an appropriate fee for the work involved or we may be unable to assist. Please check with our reception team.

Further information and help is available from Shelter England

Indigestion

Who do I see?
Self Care / Community Pharmacy

Triage ANP or GP if acute severe episode

Routine GP appointment if persistent problem

Advice:

Indigestion or heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat (acid reflux). If it keeps happening, it’s called gastro-oesophageal reflux disease (GORD).

Lots of people get indigestion from time to time, there is not always a clear cause why but certain things can increase your risk. These include being overweight, smoking, pregnancy, spicy foods and some medications such as Ibuprofen.

Indigestion – NHS (www.nhs.uk)

Indigestion – Guts UK (gutscharity.org.uk)

If you have ongoing or recurrent symptoms that are not responding to treatment you may be advised to have an gastroscopy test.

Gastroscopy – NHS (www.nhs.uk)

Having_a_gastroscopy.pdf (hampshirehospitals.nhs.uk)

Insect Bites

Who do I see?
Community Pharmacy

Minor Injuries Unit

Triage ANP or GP

Advice:

Most bites and stings will get better within a few days. A pharmacist can help with anti histamine medication and medicated creams. If there are any concerns over an infection or allergic reaction then seek medical assistance.

Insect bites and stings – NHS (www.nhs.uk)

Andover Minor Injuries Clinic :: Hampshire Hospitals

Insurance Reports

Who do I see?
GP Surgery Receptionist

Advice:
Completion of forms, certificates and medicals are not covered under the NHS. Please read the form carefully and fill in and sign any parts that you need to complete before you bring the form to the surgery.

We ask that you allow up to 21 days for the process to be completed, you will be contacted by phone when your form is ready for collection.

Infected Wounds

Who do I see?
Practice Nurse

Advice:
You can book an appointment with the Practice Nurse for any concerns over a possible wound infection.

Long Covid

Who do I see?
GP

Advice:
For some people, coronavirus (COVID-19) can cause symptoms that last weeks or months after the infection has gone. This is sometimes called post-COVID-19 syndrome or “long COVID”.

If you are struggling with symptoms suggestive of long COVID then speak to the GP routinely. There is no cure or medication, treatment is supportive and based on symptom management.

Long-term effects of coronavirus (long COVID) – NHS (www.nhs.uk)

Your COVID Recovery | Supporting your recovery after COVID-19

Living With Covid Recovery | UCL Institute of Healthcare Engineering – UCL – University College London

Lyme Disease

Who do I see?
ANP / GP

Advice:
Lyme disease is a bacterial infection spread by ticks. It can give a characteristic ‘bullseye’ rash and may be associated with other symptoms such as headache, muscle pains and fever.

If you are worried about acute Lyme disease infection then please speak to the duty team. For longer term symptoms or concerns then arrange a routine GP appointment.

Lyme disease – NHS (www.nhs.uk)

Medication Queries and Reviews

Who do I see?
Clinical Pharmacist

Advice:
At AMC we have a clinical pharmacy team who are able to discuss medication queries and concerns with you directly. Reception can book you an appointment with them.

easy-read-clncl-pharm.pdf (england.nhs.uk)

In the month of your birth we will also undertake an annual review of your repeat prescription. You will be contacted if you require a blood or urine test as part of this review. If the pharmacist or GP identifies any problems we will contact you. If you wish to report any issues as part of your annual review you can do this through our website.

Reviews – Adelaide Medical Centre (webgp.com)

Menopause

Who do I see?
Routine GP Appointment

Advice:

Menopause is the medical term for when your periods stop. The menopause is a natural part of ageing that usually occurs between 45 and 55 years of age, as a woman’s oestrogen levels decline. In the UK, the average age for a woman to reach the menopause is 51. Menopause is diagnosed once you have not had a period for 1 year. This is usually a clinical diagnosis and no blood tests are required.

Some patients will have an early or premature menopause and some patients will go through surgical menopause if they have had their ovaries removed.

My Menopause Centre | Understanding the Menopause

What-is-the-Menopause-updated-Feb-22-final.pdf (newsonhealth.co.uk)

Menopause and me (balance-website-prod.s3-eu-west-1.amazonaws.com)

Menopause – NHS (www.nhs.uk)

Menopause can cause a wide variety of symptoms including hot flushes, mood swings, memory loss, headaches and many more. This questionnaire can help you to understand the symptoms better.

Menopause Symptoms Questionnaire (balance-menopause.com)

Many women wish to consider HRT to help with menopausal symptoms – see HRT section of this webpage.

There is lots of support and information online:

The menopause – Women’s Health Concern (womens-health-concern.org)

Menopause Matters, menopausal symptoms, remedies, advice

menopausesupport.co.uk – Supporting You Through Change

Menopause and Me|Official Website

Specific to ‘POI’ (menopause under 40):

Charity for Women with POI | The Daisy Network

Medical Reports

Who do I see?
GP Secretary Team

Advice:
Completion of forms, certificates and medicals are not covered under the NHS and therefore incur a charge. Please phone us to discuss your requirements. Please read the form carefully and fill in and sign any parts that you need to complete before you bring the form to the surgery.

We ask that you allow up to 21 days for the process to be completed, you will be contacted by phone when your form is ready for collection.

Mental Health Crisis

Who do I see?
Triage ANP / GP

A+E or 111 if out of hours

Mental Health Charities

Advice:

There are many places you can get support from if you are in crisis, please do reach out if you are struggling.

Crisis services – Mind

Where to get urgent help for mental health – NHS (www.nhs.uk)

Staying Safe

Samaritans operates a free service 24 hours a day, 365 days a year for people who want to talk in confidence. Call them on 116 123 or visit their website.

Samaritans | Every life lost to suicide is a tragedy | Here to listen

Local NHS urgent mental health helpline for SP10 – NHS (www.nhs.uk)

If you are a patient already known to the community mental health team you can call them directly in a crisis.

Crisis Resolution Home Treatment team :: Southern Health NHS Foundation Trust

Minor Injuries

Who do I see?
Andover Minor Injuries Unit

Advice:
Andover Minor Injuries Clinic :: Hampshire Hospitals

Treatment at the clinic includes:

  • Treating minor head injuries
  • Facial and eye injuries
  • Foreign body removal
  • Limb injuries and concerns over fractures
  • Animal and insect bites
  • Minor burns
  • Wound assessment and closure
  • An X-ray facility on site (if required) Monday to Friday from 9am to 5pm, excluding bank holidays. 
  • Contact 111 to arrange an appointment at MIU.

Moles

Who do I see?
GP

Advice:

If you are worried about changes to any moles or skin lesions please arrange a routine appointment with the GP or submit an E consult. Please be aware that we are unable to offer any treatment for cosmetic issues related to skin lesions. This would need to be obtained privately. Speak to the GP if you are unsure.

When to worry about a mole | Skin Cancer Checking | Patient

Moles – NHS (www.nhs.uk)

British Association of Dermatologists – ABCD-Easy guide to checking your moles (bad.org.uk)

Mouth Problems

Who do I see?
Community Pharmacy / Dentist

Advice:
Please book an appointment with your dentist in the first instance for any mouth related problems. If you are not registered with a dentist then 111 can assist with this.

Find a dentist – NHS (www.nhs.uk)

Please be aware, our team are not trained or insured to assist with dental issues.

Mouth problems | Oral Health Foundation (dentalhealth.org)

Musculoskeletal Problems

Who do I see?
First Contact Physiotherapy Service (16+)

Physiotherapy Self Referral Scheme (18+)

Advice:

For any musculoskeletal issues (back pain, shoulder pain, knee pain, problems following injuries etc.) you can see a specialist physiotherapist without seeing the GP first.

We have a first contact physiotherapist at the practice each week, reception can book you an appointment with them directly. We also have direct access to physiotherapy with Southern Health, you can refer yourself via the link below.

Physiotherapy form :: Southern Health NHS Foundation Trust

Patient_information_sheet_-_self_referral.pdf (southernhealth.nhs.uk)

NHS England » First contact physiotherapists

Neck Pain

Who do I see?
Community Pharmacy

First Contact Physiotherapist

Triage GP / ANP

Advice:

Neck pain – NHS (www.nhs.uk)

Neck pain | Causes, exercises, treatments | Versus Arthritis

Neck Pain | Causes and Treatment | Patient

Torticollis is the medical name for when your neck gets trapped or stuck to one side. This usually settles over the course of a few days without any treatment.

Spasmodic Torticollis (Twisted Neck) | Symptoms, Causes and Treatment | Patient

New Baby

Who do I see?
Health Visitor / GP

Advice:

Having a new baby is an exciting time but can also feel very overwhelming. There are plenty of ways to access support. Your health visitor can help with issues such as feeding, tongue tie, sleep and general advice. They will also weigh your baby. If you are ever concerned your baby is unwell call the surgery for the triage GP or use 111 out of hours.

Any baby with a temperature above 37.5 degrees under 3 months of age should go straight to A+E for further assessment.

Concerned about your baby aged less than 3 months? :: Healthier Together (what0-18.nhs.uk)

Parents Advice | ICON (iconcope.org)

Pregnancy, baby and toddler health information at BabyCentre UK – BabyCentre UK

How to reduce the risk of SIDS for your baby – The Lullaby Trust

Adjusting to life with a new baby: 15 practical tips | NCT

Baby | Start4Life (www.nhs.uk)

Nappy rash

Who do I see?
Community Pharmacy

Health Visitor

Triage ANP / GP if worsening or no response to treatment

Advice:

Nappy rash is common and often doesn’t require any prescription treatment. A pharmacist can help with suitable creams to use in the first instance.

Nappy Rash prevention, treatment and causes | Patient

Nappy rash – NHS (www.nhs.uk)

Nosebleeds

Who do I see?
Self Care

Triage ANP or GP

Attend A+E straight away if your nosebleed lasts longer than 15 minutes or the bleeding is heavy

Advice:

Try to stop your nosebleed by sitting down and leaning forward and pinching your nose just above your nostrils. Do not lean head back or apply pressure to the bridge of your nose. You can apply an ice pack if you wish.

Nosebleed – NHS (www.nhs.uk)

Nosebleeds (Epistaxis) (entuk.org)

To avoid another nose bleed please follow the advice below for at least three days:

  • All food and drink should be cool.
  • Avoid strenuous activity.
  • Avoid constipation and straining.
  • Do NOT sunbathe or take hot baths.
  • Avoid alcohol and smoking.
  • Avoid scratching or blowing your nose. Sneeze with your mouth open if needed.

Passport Forms

Who do I see?
We are not able to assist with signing passport forms

Advice:
Passport forms are not covered by the NHS.

Accepted occupations that can countersign your passport photo.

Proactive Care Team

Who do I see?
Proactive Care Nurse

Advice:

The proactive care team are an invaluable local resource and can help with all kinds of problems.

For patients over 65 they can support with the following:


COVID Proactive Care Team (midhampshirehealthcare.co.uk)

Panic Attacks

Who do I see?
iTALK / Mind

Primary Care Mental Health Team

Routine GP appointment

Advice:

See the below advice on panic attacks and how to help control the symptoms. Talking therapies are likely to be beneficial in helping you understand the triggers and how to manage the attacks.

What is a panic attack? – Mind

Panic disorder – NHS (www.nhs.uk)

How to deal with panic attacks | NHS inform

Period Problems

Who do I see?
Routine GP appointment

If struggling with heavy bleeding then triage ANP / GP

Advice:

Periods can cause lots of problems. The most commonly encountered are heavy, painful or irregular periods. Problems are often worse for young women just starting their periods or around the time of menopause.

There are a number of problems that can cause changes to your periods. Please see below for more information.

Contraception is often used to try and regulate heavy, painful or irregular bleeding if appropriate. There are also medications that can help to stop heavy periods or be used to control the pain. You can discuss this with the GP.

Irregular periods – NHS (www.nhs.uk)

Heavy periods – NHS (www.nhs.uk)

Polycystic ovary syndrome – NHS (www.nhs.uk)

Endometriosis – NHS (www.nhs.uk)

Periods and Period Problems | Patient

Fibroids – NHS (www.nhs.uk)

Pregnancy

Who do I see?
Midwife

Advice:
If you are newly pregnant, you can self refer to the midwife. There is a wealth of information on the NHS website about what to expect during pregnancy and how antenatal care is provided in England.

Please ensure you have started taking folic acid and vitamin D as recommended. Any concerns speak to your midwife or the GP.

Badger Notes – Self-refer your pregnancy to SHIP Maternity Referral

Pregnancy – NHS (www.nhs.uk)

Pregnancy | Start4Life (www.nhs.uk)

Vitamins, minerals and supplements in pregnancy – NHS (www.nhs.uk)

Pre Diabetes (Borderline Diabetes)

Who do I see?
HCA or Practice Nurse

Online Support

Advice:

13.6 million people in the UK are at increased risk of developing Type 2 Diabetes. This is often termed ‘pre diabetes’ or being ‘borderline’ diabetic. A simple blood test is used to work out if you are at increased risk, this is called an HbA1c test.

You can also take a test online.

Diabetes UK – Know Your Risk of Type 2 diabetes

Developing Type 2 Diabetes has huge implications on our health and increases the risks of stroke, heart attack, visual loss, kidney damage and many more.

Pre diabetes and Type 2 diabetes are both reversible conditions through simple lifestyle changes. Find out more below.

If you have been informed you are at risk of diabetes then we can refer you to a service to help. This is called the Diabetes Prevention Programme – please book an appointment with our nursing team who can discuss the diagnosis with you and refer you to the programme.

Prediabetes | Diabetes UK | Reduce risk type 2 diabetes

Healthier You | Diabetes Prevention Programme (preventing-diabetes.co.uk)

nhsdpp.pdf (england.nhs.uk)

Pneumoccocal Vaccine

Who do I see?
Practice Nurse/ HCA (Health Care Assistant)

Advice:
You can book an appointment with reception if you are eligible for vaccination. This vaccination is only required once.

Who should have the pneumococcal vaccine? – NHS (www.nhs.uk)

Pre and Postnatal Depression

Who do I see?
Routine GP Appointment

Midwife Team

Advice:

A ‘perinatal’ mental health problem is one that you experience any time from becoming pregnant up to a year after you give birth.

Having a baby is a big life event. It’s natural to experience a range of emotions during pregnancy and after giving birth. But if any difficult feelings start to have a big effect on your day-to-day life, you might be experiencing a perinatal mental health problem. 

Your midwife will be able to put you in touch with a specialist mental health midwife and there is also a specialist perinatal mental health team.

Perinatal mental health – PANDAS Foundation UK

Hampshire Lanterns – No mum ever has to feel alone!

Postnatal depression (PND) | Tommy’s (tommys.org)

Mental health and wellbeing | Tommy’s (tommys.org)

Perinatal and postnatal mental health – Mind

If your partner is pregnant or recently gave birth, you may also experience mental health problems during this time. Please see below.

Partners – Mind

PSA Testing

Who do I see?

Request a test via E Consult

Discuss results with GP if abnormal

Advice:

A PSA test is a blood test that can help to detect prostate cancer. The test is not always accurate and this is why there is no official screening programme for prostate cancer.

If you are over 50 you can ask to have a PSA blood test. We would recommend reading the information below to help you decide if you wish to go ahead.

If you’re having a PSA test, you should not have:

  • ejaculated in the past 48 hours
  • exercised heavily in the past 48 hours
  • a urinary infection
  • had a prostate biopsy in the past 6 weeks

Each of these may give an inaccurate PSA reading.

Prostate cancer – Should I have a PSA test? – NHS (www.nhs.uk)

Prostate cancer – PSA testing – NHS (www.nhs.uk)

Prostate Problems

Who do I see?
Routine GP Appointment

Advice:

Prostate problems are common, particularly in men aged over 50. The prostate is a small gland found only in men and trans women. It surrounds the tube that carries urine out of the body (urethra).

The prostate gland produces a thick, white fluid that gets mixed with sperm to create semen. The prostate gland is about the size and shape of a walnut but tends to get bigger as you get older. It can sometimes become swollen or enlarged by conditions such as:

Benign prostate enlargement (BPH)

Prostatitis

Prostate cancer

Prostate problems – NHS (www.nhs.uk)

Symptoms of an enlarged prostate can include getting up over night to pass urine, a poor flow, having to strain to go, urinary incontinence and dribbling.

To help better assess these symptoms, you will likely be asked to provide a urine sample, have a PSA blood test and have a prostate examination.

PSA test | Prostate Cancer UK

Examination of your prostate | Prostate cancer | Cancer Research UK

You may also be asked to complete this questionnaire –

ipss.pdf (fhft.nhs.uk)

Rectal Bleeding

Who do I see?
Community Pharmacy if haemorrhoids present

Triage GP / ANP if acute episode

A+E if the blood loss is very heavy or black and tarry

Routine GP appointment if recurrent or longstanding issues

Advice:
Rectal bleeding can have a range of causes ranging from simple haemorrhoids to gastroenteritis and gut inflammation.

The type of bleeding and the colour of the blood can help determine the cause.

Bleeding from the bottom (rectal bleeding) – NHS (www.nhs.uk)

Rectal Bleeding (Blood in Stool) | What to do | Causes and Treatment | Patient

Rashes

Who do I see?
Community Pharmacy

Triage ANP / GP

Routine GP appointment if ongoing problem

Advice:

There are many causes for rashes. Most are not concerning but it is important to act quickly if you are worried.

Non blanching rashes are rashes that do not fade under pressure. These rashes need urgent attention.

Rashes can be caused by allergies (known as hives), heat, eczema, infections such as hand, foot and mouth, chicken pox, shingles and more.

Self-help guide: Rash | NHS inform

For children:

Rashes :: Healthier Together (what0-18.nhs.uk)

NHS (hereforyouhampshire.nhs.uk)

Removal of Stitches

Who do I see?
HCA (Health Care Assistant)

Advice:
Please phone the surgery to arrange your appointment if you require removal of stitches.

Sick Note (Fit Note)

Who do I see?
Please ensure you self certify for first 7 days, then please submit your request via an E consult

If you are unable to do this then please speak to reception.

Advice:
Employees unable to work because of coronavirus can now access a digital isolation note from 111.nhs.uk without having to go to the doctor.

If you have been discharged from hospital, your hospital team will issue any fit notes for the entire period of your recovery. Please contact the ward staff (even after discharge)

Schools should not request a GP letter to confirm absence, this can be written by a parent or guardian.

A fit note can be backdated if required, please provide the required dates and as much information as you can. Please note – requests for fit notes are not appropriate for same day / emergency triage calls, please follow the process above.

Self Certify
You can obtain this form from your employer or by visiting the HMRC website.

Taking sick leave – GOV.UK (www.gov.uk)

Employee’s statement of sickness to claim Statutory Sick Pay – GOV.UK (www.gov.uk)

Private Certificates
If you or your employer require further information concerning your period(s) of illness, then your doctor may require to issue you with a letter. Please note that a charge may apply for this service. Please check with our reception desk.

Sore Throat

Who do I see?
Self Care / Community Pharmacy

Triage ANP or GP if persisting

Advice:
If you have a sore throat, there are a number of ways you can help yourself.

Paracetamol can help with the pain, and gargling with warm, salty water may help shorten the infection (this isn’t recommended for children). In most cases, you only need to see your GP if your sore throat doesn’t improve after a week.

Sore throat – NHS (www.nhs.uk)

NHS (hereforyouhampshire.nhs.uk)

For children:

Sore throat :: Healthier Together (what0-18.nhs.uk)

Sleep Problems

Who do I see?
Self Care / Community Pharmacy

Routine GP appointment if persisting

Advice:

Simple lifestyle changes can make a world of difference to your quality of sleep. You can get advice and medication from a pharmacist. There are also a number of sleep apps available and a range of other resources online.

Insomnia (Poor Sleep) | How to sleep better | Causes & Treatment | Patient

10 tips to beat insomnia – NHS (www.nhs.uk)

Home – The Sleep Charity

Sleepstation – sleep improvement & insomnia course

Sleepio | Can’t sleep? Get to sleep and stay asleep without pills or potions

Pzizz | Sleep at the push of a button

Sleep Apnoea

Who do I see?
Routine GP appointment

Advice:
Sleep apnoea is when your breathing stops and starts while you sleep. The most common type is called obstructive sleep apnoea (OSA).

Sleep apnoea – NHS (www.nhs.uk)

If you are worried you may have sleep apnoea please complete this questionnaire prior to your GP appointment.

Epworth Sleepiness Scale | British Lung Foundation (blf.org.uk)

Stings

Who do I see?
Community Pharmacy

Triage GP / ANP if concerns over infection

Advice:
See a pharmacist for concerns over simple insect bites and stings. Anti histamine medication and medicated creams can be obtained without a prescription. Insect bites and stings do not usually require antibiotics. Skin redness and itching are common and may last for up to 10 days.

Insect bites and stings – NHS (www.nhs.uk)

Sunburn

Who do I see?
Self Care / Community Pharmacy

Advice:

Sunburn – NHS (www.nhs.uk)

Sunburn – Injuries & first aid | NHS inform

Shingles Vaccine

Who do I see?
Practice Nurse / HCA (Health Care Assistant)

Advice:
We will send you an invite for your shingles vaccine when you are eligible. If you think you have been missed please let us know.

Shingles vaccine overview – NHS (www.nhs.uk)

Sinusitis

Who do I see?
Community Pharmacy

Triage ANP / GP if worsening or persisting symptoms

Advice:

Sinusitis is common and often takes 2-3 weeks to fully clear. It is usually caused by a virus and therefore antibiotics are not often recommended.

Some patients get relief from nasal rinses and decongestant sprays which can be obtained from the chemist. Nasal steroid sprays may also help, speak to the pharmacist for advice.

Sinusitis (sinus infection) – NHS (www.nhs.uk)

Acute Sinusitis | Symptoms and Treatment | Patient

Smoking Cessation

Who do I see?
Smokefree Hampshire

Advice:

Stopping smoking isn’t easy, but giving up will greatly improve your own health as well as the health of your friends and family.

Self refer to this service via the link below:

Smokefree Hampshire | Your Stop Smoking Service

Quit smoking – Better Heath – NHS (www.nhs.uk)

Sore Penis

Who do I see?
Sexual Health Clinic

Triage ANP / GP

Advice:

In children the most common cause is balanitis.

Balanitis – NHS (www.nhs.uk)

Why is my penis smelly and sore? – NHS (www.nhs.uk)

Social Prescribing Service

Who do I see?
Health and Wellbeing Advisor

Advice:

Social Prescribing is a service that works alongside the GP surgery. The social prescribers, also known as health and wellbeing advisors, accept referrals from the surgery to link patients to community and non-clinical services. Our reception team can refer you.

Health and wellbeing advisors are equipped to help with a range of issues, including;

Social isolation

Loneliness

Emotional wellbeing

Healthy lifestyle choices and help with weight loss

Loss of confidence

Poor health linked to housing problems

Accessing work

Sprains

Who do I see?

Self care

Minor Injuries Unit

First Contact Physiotherapist

Advice:

Sprains and strains – NHS (www.nhs.uk)

For concerns about sprains and strains you can use Andover Minor Injuries Unit.

Andover Minor Injuries Clinic :: Hampshire Hospitals

If you have an ongoing issue following an injury then please book an appointment with our first contact physiotherapy team via reception.

Statin Medication

Who do I see?

Routine GP appointment

As part of your long term condition review

Advice:

Statin medication is used to lower cholesterol, this can help to protect you from conditions such as stroke and heart attack.

Statins – NHS (www.nhs.uk)

Statins are a type of medication used to lower the level of cholesterol in the blood and protect the insides of the artery walls. | BHF

Statins may also be recommended to you even if your cholesterol is normal if you have diabetes or high blood pressure.

In order to determine who would benefit from statin medication we calculate your ‘cardiovascular risk score.’ This is usually done as part of your annual medication or long term condition review. If your score is above 10% then a statin is usually recommended.

Cardiovascular Risk Score (QRISK2) Patient Information Leaflet – Winchmore Hill Practice

Please discuss with the GP or nurse if you have any concerns. Not everyone needs a statin – you can also reduce your cholesterol with lifestyle and dietary changes.

How do I lower my cholesterol? we answer 5 of your most common questions – BHF

Termination of Pregnancy

Who do I see?
BPAS

Advice:
The termination of pregnancy service is for women who are pregnant and want to discuss their pregnancy options, which might include having a termination. Your local clinic will offer advice and information, and can help you with a hospital appointment if that is what you decide to do. You can self refer to this service through their website.

Abortion clinics, Information, Advice and Treatment | BPAS

Abortion – NHS (www.nhs.uk)

Marie Stopes

Threadworms

Who do I see?
Community Pharmacy

Advice:

Threadworms (pinworms) are tiny worms in your poo. They’re common in children and spread easily. You can treat them without seeing a GP (unless you are under 2 years old or pregnant or breastfeeding).

Threadworms – NHS (www.nhs.uk)

Tiredness and Fatigue

Who do I see?
Routine GP Appointment

Advice:
Feeling exhausted is so common that it has its own acronym, TATT, which stands for “tired all the time”.

There are numerous reasons for feeling tired, symptoms can be discussed with the GP to try and determine the likely cause. A blood test will often be recommended to check for certain things such as thyroid problems and low iron levels.

Sleep and tiredness – NHS (www.nhs.uk)

Urinary Incontinence

Who do I see?
Routine GP Appointment

Advice:

Urinary incontinence is the unintentional passing of urine. It’s a common problem thought to affect millions of people. The main risk factor is advancing age. There are several types of urinary incontinence, including:

  • Stress incontinence – when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh.
  • Urge incontinence – when urine leaks as you feel a sudden, intense urge to pee, or soon afterwards.

Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.

Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder. Some patients will have symptoms of both types, known as mixed incontinence.

Urinary incontinence – NHS (www.nhs.uk)

There are a number of ways to help. Lifestyle changes can improve symptoms, these include weight loss and reduced caffeine intake. For stress incontinence symptoms it is recommended you have a 3 month trial of pelvic floor exercises. For urge incontinence or overactive bladder symptoms, bladder re training is advised. If exercises do not help then medication may be offered or a referral to women’s health physio or to the Urologist for consideration of surgery.

Pelvic Floor:

Home Page – Squeezy (squeezyapp.com)

How_to_exercise_your_pelvic_floor_muscles.pdf (hampshirehospitals.nhs.uk)

Pelvic Floor Exercises | Bladder & Bowel Community (bladderandbowel.org)

Your_referral_to_the_womens_health_physiotherapy_team.pdf (hampshirehospitals.nhs.uk)

Bladder Retraining:

65610Poveractivebladder.pdf (ouh.nhs.uk)

Retraining_your_bladder.pdf (hampshirehospitals.nhs.uk)

Urine Infections

Who do I see?
Community Pharmacy (for mild symptoms)

Triage ANP / GP

Advice:
Urinary tract infections or ‘UTI’s are very common.

Typical symptoms include stinging or burning when you pass urine, pain in the lower abdomen or back, cloudy urine and needing to wee more frequently than normal.

If you have a very high temperature, are shivering or confused – seek help immediately.

If you suspect a urine infection please call the triage line. You will usually be asked to provide a urine sample – sterile pots are available at reception.

If you are under 65 your urine sample can be ‘dipstick’ tested a the surgery to see if there is any infection or blood present. If you are over 65 the dipstick testing is inaccurate so your sample will be sent to the hospital for further analysis (this take 24-48hrs).

If you have symptoms and are female, you are likely to be prescribed an antibiotic for 3 days whilst we wait for the result from the hospital – this is the standard course of treatment. If you are male, you will be given a week long course of antibiotics.

Based on your results you may require a change in antibiotic or an extended course of treatment. We will contact you if this is the case.

Urinary tract infections (UTIs) – NHS (www.nhs.uk)

TYI-UTI GenPract V23.5 UKHSA.pdf (rcgp.org.uk)

TARGET UTI leaflet for older adults V2.4 COVID-19 advice UKHSA.pdf (rcgp.org.uk)

Some patients struggle with recurrent urine infections. This information leaflet from West Suffolk Hospital is very informative, if you are having repeated episodes of UTIs then please speak to the GP at a routine appointment.

Urinary-Tract-Infections-recurrent-infections- (wsh.nhs.uk)

Verrucae

Who do I see?
Community Pharmacy

Advice:

Warts and verrucas – NHS (www.nhs.uk)

get-file.ashx (bad.org.uk)

Numerous treatments are available over the counter, a pharmacist will be able to advise on these.

Unfortunately we do not have any facility to freeze verruca’s at the surgery.

Vomiting

Who do I see?
Self Care / Community Pharmacy

Triage ANP / GP if persisting / concerned

Advice:

Adults:

Nausea and vomiting in adults is often short lived and nothing to worry about. It can be caused by a variety of issues including infections such as gastroenteritis and food poisoning, pregnancy, alcohol excess and some medications. If you are vomiting blood or have chest pain and nausea you must seek immediate advice.

Vomiting in adults | NHS inform

Children:

Diarrhoea and/or Vomiting :: Healthier Together (what0-18.nhs.uk)

Babies:

Most babies vomit small amounts from time to time and bring up some milk when they burp. This is known as possetting and is usually nothing to worry about. Vomiting can also be caused by reflux, milk allergy, a stomach bug or something called pyloric stenosis. Click the link below for more information.

My baby is vomiting :: Healthier Together (what0-18.nhs.uk)

Vomiting in Pregnancy:

Whilst simple morning sickness can be very common, some women will have significant nausea and vomiting during pregnancy, this is known as hyperemesis. Anti sickness medication can be provided to help with the symptoms.

Severe vomiting in pregnancy – NHS (www.nhs.uk)

What is Hyperemesis Gravidarum? (pregnancysicknesssupport.org.uk)

bumps – best use of medicine in pregnancy (medicinesinpregnancy.org)

What To Do When Someone Dies At Home

Who do I see?
Reception Team

Registrar

Advice:
When a patient passes away, they must be verified dead by a medical practitioner, this can be a specialist nurse or the GP. You can call the surgery or 111 if the surgery is closed. Once this has happened, the funeral directors can be contacted to collect the body.

A death certificate will be completed by the GP, this used to be available to collect as a hard copy but currently is submitted electronically to the registrar. A hard copy will be available at a later stage.

If a cremation is planned then the GP will also complete a cremation form which will be sent directly to the funeral directors.

What to do when someone dies – what should I do next? | Age UK

What to do when someone dies: step by step – GOV.UK (www.gov.uk)

What to do after a death – Citizens Advice

Travel Vaccinations

Who do I see?
Practice Nurse

Advice:

Please book an appointment, at least 6 weeks or more before travelling. Have a look at your destination on the NaTHNaC website to find out which vaccinations you will need.

Travel vaccinations – NHS (www.nhs.uk)

NaTHNaC – Country List (travelhealthpro.org.uk)

Home – Fit for Travel

Tetanus Injection

Who do I see?
Practice Nurse / HCA (Health Care Assistant)

Advice:

Tetanus – NHS (www.nhs.uk)

Thrush (Vaginal)

Who do I see?
Self-Help / Community Pharmacy

Sexual Health Clinic

Advice:
You can obtain treatment for vaginal thrush easily over the counter as a cream or vaginal tablet (pessary). If you are unsure you can discuss with the pharmacist. There is more information here Thrush in men and women – NHS (www.nhs.uk).

If you are sexually active, you can also visit your local sexual health clinic for any concerns about vaginal discharge or possible sexually transmitted infections.

If you have frequent / recurrent episodes of thrush or your symptoms are not resolved with the usual treatments then please discuss this routinely with a GP.

Thrush (Oral)

Who do I see?
Community Pharmacist

Triage GP / ANP if for a baby under 4 months old or symptoms do not resolve with OTC treatment

Advice:

Treatment is available over the counter from a pharmacist unless this is for a baby under 4 months of age. Steroid inhalers can cause oral thrush, be sure to use your spacer or rinse your mouth out following inhaler use.

Oral thrush (mouth thrush) – NHS (www.nhs.uk)

Oral Thrush. Causes, Symptoms & Treatment of oral thrush | Patient

My baby has thrush :: Healthier Together (what0-18.nhs.uk)

Vaginal Discharge

Who do I see?
Sexual Health Clinic / Practice Nurse / GP

Advice:
You can book an appointment with the Practice Nurse/GP.

Further information about vaginal discharge available from NHS UK.

Vasectomy

Who do I see?
Routine GP appointment or Sexual Health Clinic

Advice:

Speak to the GP if you wish to be referred for a vasectomy. A vasectomy should be considered as a permanent and irreversible method of contraception. It’s usually carried out under local anaesthetic, where you’re awake but don’t feel any pain, and takes about 15 minutes.

There is more information on the procedure below.

Sterilisation (vasectomy and tubal occlusion) – Contraception – Sexwise

Vasectomy procedure specific information (wsh.nhs.uk)

Vitamin B12 Injection

Who do I see?
Practice Nurse or HCA

Advice:

This injection must have been initially advised by the GP. If you are having continued injections you will need to be seen every 3 months for a further dose.

Further information about Vitamin B12 or folate deficiency anaemia, available from NHS UK.

Warfarin Monitoring

Who do I see?

Anticoagulation clinic

Advice:
If you are a patient taking warfarin you should be under the care of the Anticoagulation Clinic run by the hospital. They will advise when your blood tests are due, you are welcome to have your blood test performed at the surgery or at AWMH Phlebotomy department.

If you are new to the area and taking warfarin blood thinning tablets, we can refer you for this service, please contact reception.

Patient resources :: Hampshire Hospitals

Warfarin FAQs available at Warfarin.pdf (hampshirehospitals.nhs.uk)

Weight Loss Support

Who do I see?
Online Resources

Social Prescribing service

Routine GP appointment

Advice:

There is so much advice available on different methods for weight loss it can be hard to know where to turn. Ultimately, it is about finding a method that is safe, effective and fits with your lifestyle. Maintaining a healthy weight is one of the best things you can do to help keep healthy for the future.

Weight Management – Adelaide Medical Centre

Home – Shapeup4life Hampshire

Lose weight – Better Health – NHS (www.nhs.uk)

NHS England » The NHS Digital Weight Management Programme

Orlistat (Weight Loss Medicine) | Patient

Increasing activity levels will also help with weight loss:

home | Andover parkrun | Andover parkrun

Andover Leisure Centre | Gym & Pool | Places Leisure – Places Leisure – discounted memberships are available if you meet certain criteria, reception can help with this.

I Can Therapy Centre – Power Assisted Exercise Facility in Andover