Patients eligible for FLU inoculation can now book an appointment with Reception.

Our Services Intro

About our services

Services
The services we provide are described in detail in the tabs above.

  • Clinics
  • Tests & health checks
  • Minor Surgery
  • Physiotherapy; Counselling
  • Online services

Click here for a brief introduction to our services

Who provides the services?

General Practioners: provide a full range of general medical services and perform some minor surgery procedures.
Contacted here at the Medical Centre - learn more

Practice nurses: provide a range of services in support of the doctors in the medical centre.
Contacted here at the Medical Centre - learn more

District Nurses: provide nursing care to patients in their own homes and give practical advice and assistance to patients, relatives and carers, coping with illness at home.
Contacted here at the Medical Centre or direct 01892 526362.

Health Visitors: look after the welfare and and development of children under 5 years of age.
Contacted via their advice line from 09.00-12.00 direct on 03007 900243.

Community Midwife: Sally Sadler is responsible for ante-natal and early post-natal care provided in close co-operation with the Doctors and the Hospital.
Contacted here at the Medical Centre or 01892 638035.

Counsellor: we offer appointments with a counsellor on site. You can self refer.
Contacted via 0800 2799500 (24 hours); out of working hours leave a voicemail message.

Physiotherapist: a physiotherapist is based at the Practice. Speak with your GP in the first instance to see if you meet criteria to be referred for treatment using this service.
Contacted here at the Medical Centre.

How to book an appointment
You can make appointments for the services shown in the sections above in a number of different ways - see left menu for full details

 

Clinics A-Z

Clinics A-Z

To see the other services we provide please click on the tabs above.

Anticoagulation/Warfarin
Purpose: To regularly monitor the blood of patients taking Warfarin. Clinics are held most days by the nurses who offer a one-stop service: test, result, dosage and next appointment.
Eligibility: Patients taking Warfarin.
Click to download a
Warfarin Advice Leaflet

Book an appointment: with the Practice Nurse.

Asthma
Purpose: To offer every patient with Asthma an annual review of their control.
Eligibility: All patients with Asthma.

Book an appointment: with the Practice Nurse.
Click to download an
Asthma Annual Review form, complete it and bring it with you to your review.

Carers
Purpose: To give advice and assistance to carers. See also CARERS section on the left menu.
Eligibility: Anyone who provides unpaid support to family member or friend who could not manage without this help, is ill, frail, disabled or has mental health or substance misuse problems.

Book an appointment: at Reception for the drop in clinic here on the 4th Monday of every month.

Child Clinics click on separate tab above

Diabetes
Purpose: To provide support, and advice to diabetic patients on how to improve their diet and increase exercise. It may entail increasing medication. You will be invited for an annual review, usually during your birthday month; however, if your control is suboptimal, this may need to be more regular.
Eligibility: All patients with Diabetes.

Book an appointment: with the Practice Nurse in co-ordination with your doctor.
Preparation: You will be asked to have blood tests a week before your appointment. You can also click here to download and complete a Diabetes Weekly Record Sheet.
Further information:

Our specialist nurse Anne Goodchild has 26 years’ experience and spends part of her working week training GPs and Practice Nurses across England to provide diabetes services to a high standard. Her nationally recognised PIT Stop course has been highly commended by Diabetes UK and enables people with type 2 diabetes to remain supported by their own practice team, even when they require insulin and other injectable therapies.
Take a look at her website

Click here to download a booklet 100 things I wish I had known about living with diabetes.

Ear irrigation
Purpose: To help patients who are experiencing hearing difficulties.
Eligibility: You will need to have your symptoms investigated by your doctor. Please see the information leaflet. You will not be able to have the procedure performed at the initial investigation consultation.

Book an appointment: with your GP or one of the nurses to confirm suitability for the ear irrigation procedure and if you have received this confirmation make an appointment with the Practice Nurse.
Preparation: Click here to download our Ear Irrigation Information leaflet

Flu - click on separate tab above

Hypertension & coronary heart prevention
Purpose: To monitor, advise and carry out tests on patients suffering from hypertension or coronary heart disease.
Eligibility: At risk groups include smokers, overweight people with sedentary lifestyle and those with a family history of heart disease or already diagnosed with hypertension.
Book an appointment: at Reception.

Maternity care
Purpose: To provide support and advice to women both before and after giving birth.
Ante Natal Clinics are held on Monday and Tuesday afternoons. If it is the first consultation of your pregnancy ask for a 'booking visit' as you will need a longer appointment. Book Post-natal checks and eight-week checks with your doctor.

Book an appointment: at Reception.

Shingles prevention
Purpose: To reduce the risk of getting this painful skin disease. The vaccination is given once in a lifetime as a single injection and can be given at any time of the year.
Eligibility: Patients who are aged EITHER 70, 78 or 79 on the 1st Sept 2014. These are the only 3 age groups that the vaccine is available to.
Book an appointment: at Reception.

Travel & vaccinations click on separate tab above

Child clinics

Child clinics - health screening and immunisations

When: At regular intervals - see table below - by the Doctors, Health Visitors and Practice Nurses.

Purpose: checks and monitors growth, development and the wellbeing of children.

  • It is very important for children to be immunised against childhood illnesses
  • If you have any questions about immunisations please discuss with your Doctor
  • The Practice Nurses immunise all children regardless of age

Before coming to surgery, please check the following points:

  • Is your child suffering from any feverish illness? Don’t worry about a runny nose without a fever
  • Does either of the child’s parents or brothers and sisters suffer from epilepsy? Epilepsy in more distant relatives is not considered a problem
  • Is your child taking steroid treatment?
  • Does your child suffer from any disease affecting his/her immune system?
  • Does your child suffer from a severe reaction to eggs?
  • Has your child suffered from a reaction to any previous immunisation injection?

If the answer to any of these questions is 'yes', then tell your Doctor and/or your Nurse.

Check-ups and Immunisations for your Child
You will receive invitations automatically at the appropriate times. If you have any problems please contact the surgery for advice. Don't forget to bring your child's RED BOOK when you visit the medical centre.

AGE

DETAILS

6 - 8 weeks Full developmental assessment by Doctor
2, 3, & 4 months Immunisation against Diphtheria, Tetanus, pertussis (Whooping Cough), HIB (Haemophilus Influenza type B-the most common cause of bacterial meningitis) and Polio is combined in one injection. Rotavirus by mouth at 2 & 3 months
2 & 4 months Pneumococcus 7 (Prevenar) protects against meningitis, blood poisoning and serious pneumonia caused by bacterium called pneumococcus
The Meningitis C Vaccine Part of the routine immunisation programme at 3 months. Babies that are between 5 & 12 months who are not previously vaccinated should receive one meningitis vaccine. Children and young people not previously vaccinated should receive one meningitis vaccine
7-9 months Full development assessment by the Health Visitor
Between 12 & 13 months Hib/Men C booster injection – (One injection) &  MMR and Pneumoccocus 7 (Prevenar) – (two injections)
18 months Developmental review and advice by Health Visitor
3 years Developmental review by Health Visitor
3 years & 4 months or soon after (usually pre-school) Boosters of MMR, Diphtheria, Pertussis, Tetanus and Polio – two injections
Girls 12 to 13 years Human papillomavirus types 16 & 18 usually given at school
13 – 18 years Diphtheria, Tetanus and Polio – one injection

 


 

Flu protection

Flu protection inoculation & advice 2017-18

 

Appointment booking (for those who are eligible)
Book an appointment by phoning Reception after 3.00pm.


Children and flu
Click for a chart to see whether your child is eligible.

If you are suffering from flu-like symptoms

  • Please DON'T come into the surgery, unless specifically requested to do so by your GP

  • If you need immediate advice ring NHS 111 (dial 1-1-1)

  • Alternatively phone your Doctor telephone) if: 

    • you have a serious underlying illness

    • you are pregnant

    • you have a sick child under one year old

    • you or your child’s condition suddenly gets much worse

    • your condition is getting worse after 7 days (5 for a child)

Flu-like symptoms
High temperature (38c or over) plus 2 or more of the following

  • Cough

  • Excessive tiredness

  • Chills

  • Headache

  • Loss of appetite

  • Severe nasal congestion

  • Muscle aches and pains

  • Sore throats

  • Vomiting and diarrhea

Help to avoid passing flu on

  • Avoid contact with other people as much as possible

  • Cover your nose/mouth when sneezing/coughing – use tissues and dispose of promptly and carefully

  • Maintain good hygiene by washing hands frequently with soap to reduce the spread of virus

  • Clean hard surfaces (e.g. door handles) frequently

  • Make sure that your children follow this advice

Minor Surgery

Minor Surgery

We undertake a number of minor operations here at St Andrews Medical Centre on Tuesday mornings. During a minor surgery consultation you may be asked to consent to a procedure.

Click here to download a Consent to a procedure information leaflet.

Carpal tunnel injections - what to expect

  • This entails an injection of steroid with anesthetic injected into the wrist, just below the hand crease; these are useful in relieving pain experienced in carpal tunnel syndrome.
  • The procedure takes approximately 10 minutes.
after the procedure 
  • We ask you to rest after the procedure to gain the maximum benefit from the steroid.
  • Consider also purchasing a futuro splint.

Coil fitting - what to expect

  • It is paramount that you are not pregnant when a coil is fitted. We aim to fit these within 7 days of your period, or ask that you abstain from intercourse following your last period to ensure this.
  • You will be asked to lay on the bed and will be examined just like when having a smear. Coil fittings vary from 10 minutes to 20 minutes and can cause cramping feelings like a period during the insertion of the coil.
  • After the procedure, you may notice a bloody discharge, which is normal for the first day. You will be asked to re-attend after your next period or within 6 weeks.
preparation
  • Prior to your appointment consider taking some paracetamol and ibuprofen, this relaxes you and makes the procedure less painful. It is also advisable to bring a sanitary towel with you for afterwards.
after the procedure
  • Do not use tampons for the next 3 days.
  • No sexual intercourse for 7 days.
  • Look for signs of infection, such as abdominal pain, malodorous vaginal discharge, fever. If you experience any of these, it is important that you contact the Surgery.

Implants for contraception - what to expect

  • It is paramount that you are not pregnant when this is fitted. We aim to fit these within 7 days of your period.
  • The procedure is very quick, and entails a small amount of anesthetic being injected in your upper inner arm, the implant is then deployed into the skin of your upper arm, the device used is a bit like having your ears pieced.
  • Paper stitches will be applied to the insertion site and a bandage wrapped around your arm. You may feel a little bruised for a few days.
after the procedure
  • No follow up is needed following this, provided that you are happy with the implant.

 Joint injections - what to expect

  • Steroid injections are used to ease pain and reduce swelling in joints.
  • The doctor will examine the joint before injecting a mixture of steroid and anesthetic. The process is painful but the pain is short-lived, usually seconds.
  • You may feel instant relief for a few hours as the anesthetic takes effect.
  • You may encounter a steroid flare, which is when you feel pain worse than prior to the injection, this is as the steroid takes effect, again this is short-lived and occurs approximately 8-12 hours after the injection.
after the procedure
  • It is important that during the following 24 hours that you rest to gain the best response from the steroid.

Removal of skin lesions - what to expect

  • Removing a skin lesion is likely to leave you with a small scar depending on the size of the lesion.
  • It is important that you let the doctor know if you are taking Warfarin/aspirin.
  • A local anesthetic will be injected, at which point you may feel a sting. After this time the area will be numb so that the lesion can be excised comfortably. The area will then be closed and a dressing applied.
after the procedure
  • Depending on the site you may be asked to refrain from exercise for the next few days.
  • You may have sutures which will need a follow up appointment with the nurse to get these removed a week later.

IT statement

St. Andrew's Medical Centre - Statement of Intent - Information Technology

New contractual requirements came into force from 1st April 2015 requiring that GP practices should make available a statement of intent in relation to the following IT developments:

  • Referral Management
  • Electronic Appointment Booking
  • On line Booking of repeat prescriptions
  • Summary Care Record
  • GP2GP transfers
  • Patient Access to records

Please find below details of the practice stance with regards to these developments.

Referral management

All practices must include the NHS Number as the primary identifier in all NHS clinical correspondence issued by the practice.
SAMC includes the NHS Number on all correspondence

Electronic appointment booking
Practices are required to promote and offer the facility for all patients, who wish to, to book, view, amend, cancel and print appointments online.
SAMC currently offers the facility for booking and cancelling appointments online.

Online booking of repeat prescriptions
Practices are required to promote and offer the facility for all patients, who wish to, to order online, view and print a list of their repeat prescriptions for necessary drugs, medicines or appliances.

SAMC currently offers the facility for ordering repeat prescriptions online.

Summary Care Records (SCR)
Practices are required to enable successful automated uploads of any changes to a patient’s summary information, at least on a daily basis, to the SCR.
Having your SCR available will help anyone treating you without your full medical record.  They will have access to information about any medication you may be taking and any drugs that you have a recorded allergy or sensitivity to.

SAMC is already live with SCR.

GP2GP record transfers
There is a contractual requirement to utilise the GP2GP facility for the transfer of patient records between practices, when a patient registers or de-registers.
It is very important that you are registered with a doctor at all times.  If you leave your GP and register with a new GP, your medical records will be removed from your previous GP and forwarded on to your new GP via NHS England.  It can take several weeks for your paper records to reach your new surgery.  With GP to GP record transfers, your electronic record is transferred to your new practice much sooner.

SAMC confirms that GP2GP transfers are already active and we send and receive patient records via this system.

Patient access to their GP record
Practices are required by 31st March 2016 to promote and offer the facility for patients who wish to, to view online, export or print the detailed information from their medical record. The information is: test results, list of problems and consultation titles, allergies, immunisations and acute and repeat medication, the information held is in coded form.

SAMC is working with our clinical system supplier to achieve this functionality which will be available to patients by 31st March 2016.

Other Medical Services

Other Medical Services

To see the other services we provide please click on the tabs above.

Private medical examinations
To arrange private medical examinations for driving, insurance, diving etc ask at reception. Allow 2 weeks for this process.

General counselling
Eligibility: If you feel you would benefit from talking to someone speak with your GP in the first instance who will then refer you to a Councellor as necessary.
Appointments:  A Councellor will then contact you.

Physiotherapy
Eligibility: Speak with your GP in the first instance to see if you meet criteria to be referred for treatment using this service.
Appointments: The physiotherapist based at the Practice will then contact you.

Non-Medical Services


Non-medical services available at St. Andrew's

The Government's contract with GPs, (who are self-employed, not employed by the NHS), covers medical services to NHS patients. The NHS provides most health care to most people free.

For services not covered by the NHS, GPs charge a fee (in line with NHS guidelines), to cover staff costs etc., When a GP signs a certificate/completes a report, it is a condition of remaining on the Medical Register that we only sign what is known to be true; completing even the simplest of forms might require checking an entire medical record and is very time consuming - carelessness/inaccuracy can have serious consequences for the GP, with the General Medical Council or even the Police.
 
NHS services for which GPs can charge their NHS patients,
e.g. accident/sickness insurance certificates; certain travel vaccinations; private medical insurance reports
Non-NHS services for which GPs can charge other organisations
e.g. medical reports for insurance companies; some reports for the DSS/Benefits Agency if they have written directly to your GP; examinations of their employees requested by a Local Authority.

Cick here for SAMC Non-medical service fees.
 
We need at least 10 working days to process letters and 21 working days for forms.
 
A huge amount of time is spent completing forms and preparing reports for patients, either direct, or for organisations on their behalf. Sometimes we are only approached because we are in a position of trust in the community, or because an insurance company or employer wants to be sure that information provided is true and accurate. However, some services can be provided by other professionals or even non-professionals for free, for example when seeking lasting power of attorney. So please do try to seek other help than from SAMC.
 
Lasting power of attorney (LPA)
Anyone aged 18 or older who has the mental ability to make decisions for themselves can arrange for someone else to make these decisions for them in the future. This legal authority is called ‘power of attorney’.

The person giving LPA is the ’donor’. The person given LPA is known as the ‘attorney’ and must be over age 18 There are different types of LPA: (1) personal welfare LPA and (2) property and affairs LPA. Donors should understand exactly what powers they are giving to someone else.

LPAs can be made online. Once an LPA is completed, it must be printed and signed (or ‘executed’) in the presence of a witness, who certifies that when the form was signed, the ‘donor’ granting the LPA:

  • understood its purpose and the scope of authority being granted
  • was not being unduly pressured or being defrauded 
  • was not affected by anything else that could affect the validity of the document

This certificate can be signed by either someone known to the ‘ donor’ for at least two years, or by someone who ‘because of their relevant professional skills and expertise, considers themselves able to provide the certificate’. This person must be acting independently, not be a relative, business partner or employee, or anyone involved in a care home where the ‘donor’ lives - it isn't necessary for your GP to sign as witness.

Doctor's letters
We can arrange a doctor's letter or signature on documents e.g. insurance claims form, there will be a charge.

Support letters
If you need a support letter for housing or care needs ask The Benefits Agency, Dept. of Work & Pensions or Housing Association to write to your GP. This will be processed as non urgent/ non NHS work - there may be a charge.

Sickness certificates/fitness to work certificates

  • For illness lasting 7 days or less you don't need a doctor's sickness certificate - so need to come to SAMC
  • Your employer may however require you to complete a self-certification form (SC2),  available from your employer or the HMRC website
  • For illness lasting more than 7 days, your employer may ask you for some form of medical evidence to support payment of SSP (statutory sick pay). It is up to your employer to decide whether you are incapable of work.
    • A medical certificate, called a Statement of fitness for work' (see below) from your doctor is strong evidence that you are sick and would normally be accepted, unless there is evidence to prove otherwise
    • Evidence can be obtained from someone who is not a medical practitioner, e.g. a dentist. Your employer will decide whether or not this evidence is acceptable. If your employer has any doubts, they may still ask for a medical certificate from your GP

Statement of Fitness for Work -'Fit Note'
The 'fit note' was introduced on 6 April 2010. With your employer's support, the note will help you return to work sooner by providing more information about the effects of your illness or injury. For more information see the DirectGov website

 

Tests & Health Checks

Tests and Health checks A-Z

Here are a few of the tests and checks we do. To see the other services we provide please click on the tabs above.

Blood pressure
Purpose: To check the blood pressure of patients with high blood pressure, at least once a year.
Eligibility: Patients with high blood pressure.
Book an appointment with the Practice Nurse or Health Care Assistant.

Cervical smear
Purpose: To detect early cell changes which can lead to cervical cancer.
Eligibility:

  • Women between ages 25 & 49 will be invited to have a cervical smear every 3 years.
  • Women between ages 50 & 65 will be invited to have a cervical smear every 5 years.

Book an appointment at Reception once you received an automatic reminder from the local Primary Care Agency to make an appointment.

Chlamydia
Purpose: To identify and provide medical treatment to those with this condition. Left untreated it can cause infertility and long term pelvic pain.
Eligibility: Patients under 25 years of age. Collect a self-testing kit from the box at the entrance to the medical centre.

Cholesterol
Purpose: To monitor patients with raised cholesterol or identify new patients with the condition.
Eligibility: If you are over 40 with a family history of IHD, CVD or hyperlipidaemia.
Book an appointment with the Practice Nurse.
Preparation: this requires a fasting blood test see PHLEBOTOMY below.

Heath checks
Purpose: To provide general consultations and examinations as appropriate, for certain age groups of patients.
Eligibility: Any patient over the age of 16 who has not attended the surgery for three years is welcome to book a health check with our nurses. If you are over 75, you will be offered a health check. Health checks are also offered to our patients that are aged between 40-74 once every five years**.
Book an appointment at Reception ** you will receive a letter from SAMC when this is due.

Phlebotomy (Blood tests)
Purpose: To take a sample of blood for laboratory testing.
Eligibility: As ordered by your GP or Practice Nurse.
Book an appointment with the Practice Nurse.
Preparation: If you are asked to have your glucose or cholesterol checked, we ask that you starve for 14-16 hours. We will ask you when booking your appointment whether this is a fasting blood test, and give advice; we will aim to book your appointment as early as possible if you are fasting.

Test results

Test Results

  • After your test leave at least 2-3 days before calling for results or making enquiries
  • Please call after 15.00 when our telephone lines are less busy
  • Give your full name, date of birth, address and date of the test
  • Results are received here electronically throughout the day but the reception team cannot give them to you unless the Doctor has seen the results. So please be patient; the reception team are not clinically trained and are following a protocol set by the doctors
  • If your results are normal requiring no further action, we will not normally contact you
  • If your test results are abnormal and require any action a member of the reception team will contact you and pass on information from your Doctor
  • Cervical cytology results (smears) will be posted to you. Please allow at least 4 weeks for these to arrive.

Travel clinics

Travel advice & vaccinations

Availability: all year

  • Click here for a Travel Clinic form or collect one from Reception 
  • Return completed form to the surgery by email to standrews.mc@nhs.net or fax 01892 514019 
  • Call us on 01892 515455 to confirm safe receipt
  • A nurse will assess the information and call you to advise what (if any) vaccinations are required
  • We need your form here 8 weeks prior to your travel date
  • A travel appointment will be booked for you preferably 4 weeks prior to your travel date

Last minutes trips

  • We will endeavour to book you an appointment as soon as possible. However, please be aware that because of the pressure on nursing appointments we may not be able to meet your timing needs.

  • You may then be redirected to one of the local travel clinics to access necessary vaccinations. (Other agencies that can provide travel advice and vaccinations: Warders Medical Centre in Tonbridge 0330 100 4314; Boots in Tunbridge Wells 01892 525561).

Specialist vaccinations

  • Providing vaccines and travel certificates is not a free NHS service. There are charges
  • We can provide specialist vaccinations for travel that are not available on the NHS.