This chronic lung disease, primarily caused by smoking, can be very debilitating. This Practice Nurse-run clinic aims to improve quality of life for patients and control symptoms. An annual check provides an opportunity to assess lung function and monitor disease progression, address lifestyle issues and give support and advice.  Julie Rowell and Melanie Pick are our specialist nurses trained in monitoring COPD.

This Practice Nurse-run asthma clinic provides advice and ongoing support for newly diagnosed and established asthmatics. All aspects of care are provided including assessing symptoms, triggers and treatments as well as self-management plans. Adjustments to medication and devices may be made if appropriate and prescriptions issued in liaison with Doctors.

All new patients with asthma registering with the Practice are invited to attend the Asthma Clinic and annually thereafter if well controlled.

Over the last few years we have been providing our Practice Nurses with advanced training in chronic disease management. This means that they have extensive knowledge and experience in the management of conditions such as diabetes, heart disease, asthma and high blood pressure. If you have been diagnosed with one of these conditions, your Doctor will involve the Practice Nurse in your care at the earliest opportunity. We also offer a Specialist Health Clinic for patients with more complex cases.

Once your condition has been stabilised, the Practice Nurse will assume responsibility for the monitoring and routine follow-up of your chronic disease. This will involve you making an appointment to see the Practice Nurse regularly for a review. The Practice Nurse will advise you how frequently you need to be seen and if you need to have any blood tests taking before your appointment. If this monitoring reveals any problems that may require a significant change in therapy, the Practice Nurse will refer you back to your Doctor.

However, if at any time you develop new symptoms that you are concerned about, you should make an appointment to see either the Practice Nurse or your Doctor.

Here’s a checklist of the vaccines that are routinely offered to everyone in the UK for free on the NHS and the age at which your child should ideally have them.

Two Months Old

• Diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (Hib)
  • Vaccine given: DTaP/IPV/Hib (Pediacel)
  • Site**: Thigh
• Pneumococcal disease
  • Vaccine given: PCV (Prevenar 13)
  • Site**: Thigh
• Rotavirus
  • Vaccine given: Rotavirus (Rotarix)
  • Site**: By mouth
• Meningococcal group B (MenB)
  • Vaccine given: MenB
  • Site**: Left thigh

Three Months Old

• Diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (Hib)
  • Vaccine given: DTaP/IPV/Hib (Pediacel)
  • Site**: Thigh
• Meningococcal group C disease (MenC)
  • Vaccine given: Men C (NeisVac-C or Menjugate)
  • Site**: Thigh
• Rotavirus
  • Vaccine given: Rotavirus (Rotarix)
  • Site**: By mouth

Four Months Old

• Diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (Hib)
  • Vaccine given: DTaP/IPV/Hib (Pediacel)
  • Site**: Thigh
• Pneumococcal disease
  • Vaccine given: PCV (Prevenar 13)
  • Site**: Thigh
• Meningococcal group B (MenB)
  • Vaccine given: MenB
  • Site**: Left thigh

One Year Old

• Haemophilus influenzae type b (Hib)/MenC
  • Vaccine given: Hib/MenC (Menitorix)
  • Site**: Upper arm/thigh

• Pneumococcal disease
  • Vaccine given: PCV (Prevenar 13)
  • Site**: Upper arm/thigh
• Measles, mumps and rubella (German measles)
  • Vaccine given: MMR(Priorix or MMR VaxPRO)
  • Site**: Upper arm/thigh
• Meningococcal group B (MenB)
  • Vaccine given: MenB booster
  • Site**: Left thigh

Two to Six Years Old(including children in school years 1 and 2)

• Influenza (each year from September)
  • Vaccine given: Live attenuated influenza vaccine LAIV4
  • Site**: Both nostrils

Three years and four Months old (or soon after)

• Diphtheria, tetanus, pertussis and polio
  • Vaccine given: dTaP/IPV (Repevax) or DTaP/IPV(Infanrix-IPV)
  • Site**: Upper arm
• Measles, mumps and rubella (German measles)
  • Vaccine given: MMR (Priorix or MMR VaxPRO)(check first dose has been given)
  • Site**: Upper arm

**Where two or more injections are required at once, these should ideally be given in different limbs. Where this is not possible, inections in the same limb should be given 2.5cm apart.

The Practice has a screening programme with automatic recall. Current recommendations state that women between 25 and 49 years should have a smear test every 3 years and women between 50 and 64 years should be tested every 5 years. A smear test is a simple way of assessing the health of the cervix. Experts can check and recognise changes which suggest that cancer may develop in the future.

Please contact the Surgery for your result. Occasionally you may be asked to have a repeat test. This can be for technical reasons (the cell sample was obscured) or because there is a concern regarding some of the cells.

The Doctors may be instructed to repeat the test at intervals or to refer you to a gynaecologist for a closer inspection or for colposcopy (an out patient procedure).

We know that some of our patients do not take up the offer of cervical screening, despite several invitations. If you have not responded to 3 invitations we will send you a letter to sign, instructing us that you do not wish to take part in the screening programme.

You will be given the opportunity every 5 years to change your mind.

You can see any of our nurses for a smear test.

Midwifes are based at the Evesham Medical Centre.

Once you have a positive result to confirm that you are pregnant you can contact your GP surgery who will refer you to the Midwife Team.

You will be provided with contact telephone numbers to enable you to contact a Midwife at any time if you have concerns or problems.

We recommend an influenza immunisation to all patients aged 65 or over and patients with chronic heart, lung or kidney disease, diabetes and asthma and residents of nursing and rest homes or a carer. This is usually available during October and November and clinics are run during this time. Please ask at Reception for details.

Immunisation with pneumococcal vaccine (Pneumovax), which is a one off vaccination, is also available and currently recommended for the over 65’s and those with chronic illness. This can be done at the same time as the ’flu vaccination.

All patients are encouraged to keep their tetanus immunity up to date; after the initial course of 5 tetanus vaccinations has been given, no further vaccination should be required unless there has been a major injury or travel to a remote area with limited access to medical facilities is planned. Single dose tetanus is no longer available – it is now a combination shot called Revaxis which combines tetanus, diphtheria and polio.

Adults at risk should make an appointment with the Practice Nurse for other immunisations such as hepatitis A and B and meningococcus A and C.