Regional Medical Centre
Regional Medical Centre (RMC)
Telephone : (01760) 337261 Ext 7226
Working Hours - Emergencies : Ext 222
Out of Hours - Emergencies
BT : (01603) 488488 (MEDICOM)
Duty Ops Officer (24 Hours) (01760) 337261 Ext 2044
The RMC is open Monday to Friday 8 am to 12 noon and 1 pm to 5 pm - Excluding Holidays/Grants/Stand-downs when special clinic times may operate. All appointments are booked through Reception on a computerised appointment system. An Emergency Clinic is held on Saturday and Sunday mornings from 10 am to 11 am on a first come - first served basis.
The staff of the Regional Medical Centre can provide a full medical service to registered families. Unfortunately, the number of dependants that can be looked after by the medical centre is limited to 1,500. In addition, only family members living in Marham FQs or Marham village are eligible for registration.
The service includes first aid and emergency cover on the Station, primary health care (general practice) for Service personnel and for the families who choose to register with us, and consultations with visiting specialists at the medical centre. Regular health education and preventive medicine measures are undertaken.
Working Hours Contact Numbers:
Appointments BT : (01760) 337261 Ext 7226
Emergencies Only Direct Line to RMC Ext 222
General Enquiries Ext 7026 / 7025 / 7466 / 7515
Practice Nurses Ext 7022 / 7023
Practice Manager Ext 7220
Deputy Practice Manager Ext 7024
Environmental Health Technician Ext 7842
Medical Stores & Pharmacy Ext 7021
Hospitals:
Queen Elizabeth BT : (01553) 613613 (King's Lynn) Ask for : Maternity, Casualty, GU Clinic
Wisbech BT : (01945) 585781
Norfolk & Norwich (Norwich) BT : (01603) 286286
Addenbrooke's (Cambridge) BT : (01223) 245151
Hospital facilities are provided by the Queen Elizabeth Hospital in King's Lynn. Referral to hospital is arranged through the Medical Centre. Close liaison is also maintained with the Community Services such as the Community Midwives, Health Visitors, Community Psychiatric Service and Social Services.
It is essential that families living in FQs at RAF Marham or private accommodation in Marham village register with either a civilian GP or the medical centre as soon as they arrive at RAF Marham. Their NHS medical records can then be obtained and addresses noted in case of emergency. Families who are eligible to register can do so at any time during normal working hours. If you have a NHS card or a record of your NHS number please bring it with you when you register. An appointment for a health screening will be offered at the time of registration.
The medical centre offers a 24 hour emergency service. The contact number for emergencies occurring on Station, during normal working hours is Ext 7226. Out of hours the Duty Doctor can be contacted (MEDICOM) of Norfolk Ambulance Service on 01603 488488, they will take details and contact the Duty Doctor who will get back to you. Please note this is NOT a '999' service and out of working hours it may be more appropriate to dial 999 for an immediate life threatening emergency such as severe chest pain, heavy bleeding or shortness of breath.
Surgeries
Surgery hours are Monday to Friday 08:30 to 11:50 am. However, priority will be given to Service personnel from 08:30 to 09:50 am and to dependents from 10:30 to 11:50 am. Except for emergencies, patients are seen by appointment only. These can be made via Reception, either by telephoning Ext 7226 or by calling at the medical centre.
There is no parking immediately outside the Medical Centre and the road must be kept clear for emergency vehicles. However, there is no problem drawing up outside the front entrance to drop patients off. Cars should be parked in the main station car park from which there is a path leading to the Medical Centre. For cyclists a bicycle rack is provided to the rear of the Medical Centre. Please do not prop bicycles against the front of the Medical Centre.
Babycare
A baby changing facility is provided in the female patients' toilet opposite the waiting room.
Disabled
A ramp is provided at the front entrance to the Medical Centre for wheelchair access. A toilet is provided opposite the treatment room, for use by disabled persons.
Urgent cases will always be seen the same day although you may have to wait a while if the doctors are busy.
Non urgent cases will be seen by the next working day.
Cancellation of Appointments
Please inform the Medical Centre as soon as possible if you are unable to keep any appointment so this slot may be used by others.
If you are late and completely miss your appointment slot, non urgent cases will be asked to rebook in order to prevent delays to all those patients who follow in the clinic. Please remember that missed appointments may prevent others from being seen that day.
Each appointment is allocated ten minutes. This allows enough time to deal with one problem per patient. If you feel you require longer, or have more than one problem to address please request a double appointment.
If you would like to discuss matters by telephone please phone between 0800 and 0830 or between 1000 and 1030. If the surgery is busy the receptionist will take your details so that the doctor can phone you back as soon as he or she is free.
Home Visits
Please make every effort to get to the Medical Centre as facilities for examination and treatment are much better than on a home visit, but if you are too unwell to attend telephone the Medical Centre on Ext 7226. Please give the staff as much information as possible to allow the doctor to assess the degree of urgency. If you reside locally we can sometimes arrange an ambulance to bring patients to the RMC.
Nights, Weekends and Station Holidays
The Duty Doctor supported by the Duty Medic provides emergency cover out of hours. At weekends and during holidays "a drop in" clinic is held at 1000 hrs to 1100 hrs to deal with urgent problems. This facility is not an extension of the normal surgery hours. It is helpful to telephone the Medical Centre between 0930 and 1000 so we can add your name to the clinic and prepare your notes.
In an emergency telephone:
07768 928461 - (Mobile) and speak to the Duty Medic direct. Please note reception in this area is not always ideal and you should use the number below if you have any difficulty getting through or staying connected. The Duty Medic can then contact the Duty Doctor.01603 488488 - (Medicom). This is answered by a medical receptionist who will ask you for your details before passing them on to the doctor. Please ensure you ask for the doctor covering RAF Marham and not Marham village.
At night please ensure that your house is easily identified. Remember: many conditions get better on their own and can be successfully treated at home.
Repeat Prescriptions
Long-term medication is available through a computerised repeat prescription system. After your doctor has issued your medication for the first time, the pharmacy will give you a tear-off slip with the details of the items on repeat prescription for you. When you require your medication tick the box next to the item(s) you need and hand it into the pharmacy.
A minimum of 24 hours is required to process requests so please ensure that you do not run out of your medication. At the bottom of the request slip is a review date, medication cannot be issued by pharmacy after this date. Please see your doctor if further repeat prescriptions are required. Repeat prescriptions can be collected Monday to Friday between 1330 hrs and 1645 hrs daily, excluding Public Holidays and Stand-downs.
Vocational Training in General Practice
The Medical Centre at RAF Marham is approved for the higher professional training of doctors wishing to specialise in General Practice, known as "GP Registrars". You may be asked to contribute to this training by seeing the registrar either alone, or together with your usual doctor. Very occasionally you may be asked for your consent to the video recording of your consultation. These recordings are only viewed by the doctors concerned with training and are erased after use.
You will always be asked for your consent before joint or video consultations and have the right to refuse at any time without altering the service you receive in any way. In the case of a video consultation the consent must be written on the forms provided both before and after the consultation, and you may request the consultation to be erased immediately if you should so wish.
Your help and co-operation in GP training is greatly appreciated.
Practice Nurses
There are three Service and one civilian practice nurses available by appointment to deal with a variety of problems, including the treament of minor illness and injury, phlebotomy, wound management verrucae/wart treatment, ear syringing, infant immunization and family planning advice.
In addition we are able to give specific health education on smoking cessation and other aspects of health and lifestyle.
Travel vaccination and immunization advice features prominently in the scope of our duties. When attending travel health appointments you are requested to bring any vaccination records you hold with you.
New borns requiring their primary immunization will need to be pronounced 'fit for Imms' at their 6 week check with the Dr prior to commencement of their vaccines. It is advisable to book the appointments-required at 2, 3 and 4 months - well in advance.
Well Woman Clinic
Our nurses in accordance with NHS Cervical Screening Programme guidelines run the well woman clinic. All women aged 20-64 yrs are invited to participate in the screening programme. Please state the reason when arranging this appointment to allow adequate time to be allocated.
Health Visitor
The Health Visitor ia available to advise on health matters relating mainly to the under-fives eg. sleep, feeding difficulties and behaviour management. The Health Visitor's office is located in the medical centre. The Health Visitor's office can be contacted on Ext 6098 at the RMC or leave a message on the answerphone. When the Health Visitor is unavailable please contact NHS Direct on 08454647. Child health Drop-In Clinic runs 2nd and 4th Wednesday of the month at the Oasis Lounge in the Chaplaincy Centre 9:30 am - 11:30 am. Please contact the Health Visitor on arrival to RAF Marham with children under 5 years and please notify of change of address if you move to a new families quarter.
Maternity Care
Maternity care is shared between the doctors, midwife and The Queen Elizabeth Hospital, King's Lynn. This is organised through the Midwife. Antenatal booking examinations are taken at home, reviews are taken on Monday mornings, both by appointments. The Midwife organises Parent-Craft classes. The Midwife's office is located upstairs in the RMC. For MMR information visit : http://www.immunisation.org.uk/
New Baby ? - New Parents ?
CONGRATULATIONS ! - IMPORTANT, PLEASE READ....
We would like to take this opportunity to welcome you and your new baby to RAF Marham, and we have jotted down a few notes about the immunisations your baby will need, to help you organise them.
Firstly, your baby will be due a 'Child Health Surveillance' check at 8 weeks old. This must be done by a Doctor and no immunisations can be given before this takes place. The Doctor will examine your baby, and complete the appropriate section in your 'Red' book, annotating that your baby is 'FIT FOR IMMUNISATIONS' both in the book and on the computer.
An appointment can then be made for the Thursday afternoon 'Baby Jabs' clinic, run by the Practice Nurses in the Medical Centre. The jabs are due when your baby is 8 weeks old, but don't worry if an appointment cannot be attended immediately. A couple of weeks late won't hurt.
At the clinic, the nurses will ask you to fill in a health questionnaire as a double check to ensure there are no reasons why your baby should not receive their immunisations. Please feel free to ask any questions and we will do our best to answer them.
Your baby needs 3 lots of injections. The first ones are due when he or she is 8 weeks old. The second ones are due 4 weeks later when your baby is 12 weeks old and the third ones are due 4 weeks after the second ones when your baby will be 16 weeks old. Appointments need to be made in advance to ensure you get the appointment you want. The schedule for the immunisations is detailed both inside and on the back of the 'A new guide to childhood immunisations' book, which can be obtained from your Health Visitor. However, we have spare copies if you have not received one, and will be happy to give you a copy.
Don't worry, we will explain it all again when you bring your baby for their first ones. If you have any queries in the meantime, please feel free to ring one of the Practice Nurses, Debs, Carol or Tracey or alternatively speak to your Health Visitor, Margaret.
Some telephone numbers that may be of assistance to you are listed below:-
Medical Centre Reception 01760 337261 Ext 7226
Practice Nurses 01760 337261 Ext 7226
Health Visitor 01760 337261 Ext 6098
Duty Medic Phone 07768 928461 } EMERGENCIES ONLY
Duty Medic Pager 07659 407277 } EMERGENCIES ONLY
Family Planning
The doctors deal with this during normal surgery hours. Please note Diaphragm fittings and Coil checks and removals can be performed by some doctors at the practice but coil fittings will need to be referred to a family planning clinic. Advice is also available from one of our practice nurses. Please state reason for this appointment when using the service to enable reception staff to allocate the appropriate clinician and adequate time.
Medicals
Screening Medicals are offered to all patients on registration. Ground Medical examinations are undertaken (by appointment) on Mondays, Tuesdays and Thursdays from 1300 hrs. Aircrew medical slots are available daily.
Medical examination for insurance, solicitor's reports, employment, certain sports and other purposes may be arranged by appointment (some of these examinations are not available through the service, or on the NHS, and may attract a fee).
SSAFA Social Workers
The SSAFA Forces Health Social Work Area Manager and Worker are available daily for help with welfare and related matters. Area Manager : Liz North Ext 7955. Personal & Families Support Worker : Tom Smith Ext 6051.
Chiropodist
The chiropodist holds a weekly clinic in the Medical Centre. If you require chiropody please discuss your needs with one of the doctors who will refer you to the clinic. Please note you cannot self refer to this clinic.
Physiotherapy Information
This information outlines the service available from the physiotherapists at RAF Marham.
Physiotherapy Waiting List - To see a physiotherapist you must be referred by a doctor.
Once your referral is received by the physiotherapist you will be placed on a waiting list. The length of time on the waiting list is dependent on the nature of your condition and is determined by the physiotherapist and your doctor.
You will receive a phone call to inform you of your appointment. If you have not received an appointment within 5 weeks of seeing the doctor please contact the receptionist at the Medical Centre on Ext 7226. The receptionist will then contact the physiotherapist for you.
Sometimes the physiotherapist is unable to take calls during clinic hours, however if you leave a message with reception Ext 7226 we will get back to you as soon as possible.
It is important that you try to keep your appointment as there is much demand for these services. If you find that you cannot attend your appointment please inform the receptionist preferably 24 hours before your appointment. This allows us to rebook that appointment and reduces the waiting list.
Patients Charter
The Rights of the Patients:
All members of staff seek to improve the quality of care provided for their patients.
1. All patients will be able to consult a Medical Advisor within one working day, and there will be an adequate and responsive out of hours call out service. Acute situations will have priority and will be dealt with as soon as possible. Procedures will be carried out locally where practical.
2. The surgeries are clean and comfortable. They have good telephone access and patients will be treated with courtesy and respect. Patients should not have to wait more than 20 minutes for their appointments, without an adequate explanation.
3. Patients will be advised of the services available to them and they will have access to personal medical information as required by the (National) Patients Charter.
4. The Practice is committed to improving the long-term health of patients as a whole and contributing towards the aims of HM Government set out in the White Paper "Health of the Nation". The present range of in-house clinics will be maintained and the value of additional ones assessed and provided as the Medical Officers judge appropriate.
5. The Practice seeks to ensure that hospitals provide an efficient and effective service for patients with the minimum delay. The quality of their service will be monitored by consulting patients, other practices and the hospitals themselves. The Practice will recommend how improvements can be brought about and promote their implementation.
6. A nominated member of staff will be responsible for monitoring the performance of both the Practice and the hospitals, and will be available for consultation by patients.
7. Patients have the right to be involved in their own management and their wishes will be sought, particularly in the difficult area of terminal illness. Such wishes will be followed as far as possible.
The Responsibilities of the Patient:
1. All patients are responsible for their own health and that of their dependants. They should take action on the advice given, e.g. regarding not smoking, diet, exercise, etc.
2. Patients should attend promptly for their appointment, and advise the Practice if they wish to cancel it or are likely to be late.
3. When patients are unable to keep a hospital appointment it is imperative that they inform the appropriate department directly, as soon as possible. This will save wasting valuable appointment time, and be to the benefit of other patients.
4. If more than one member of the family wishes to see a doctor, patients should advise the practice so that an appointment of appropriate duration can be made.
5. Patients should always endeavour to consult the doctor at the surgery rather than ask for a home visit. This makes better use of the doctor's time and the wider facilities available, and enables him/her to deal with a greater number of patients effectively.
6. Some patients require more of the doctor's time than was anticipated when the original appointment was made. Patients waiting for their own appointment are asked to consider that on some future occasion they, too, may need more of the doctor's time and to act accordingly.
Complaints Procedure
We are proud of our practice and our staff. Nonetheless we recognize that problems may occasionally arise in the services our practice provides. Experience shows that the majority of problems are due to simple misunderstandings, please feel free to discuss your grievance with whoever you have been dealing with. If this proves unsatisfactory, or should you wish to make a complaint about us or our work, we have an Informal Complaints Procedure. You should initially contact the Practice Manager, either in person or in writing. If you have a problem, please raise the matter as soon as possible so that any investigation can be made while events are still fresh in everybody's mind. The RMC Complaints Manager is the Practice Manager.
In dealing with any complaints, we give the following undertakings:
1. We will acknowledge your complaint, in writing, within 2 working days of receipt.
2. We will make a written response to you within 10 working days.
3. We will ensure that you have the opportunity to discuss the problem with those concerned if you would like this. You may bring a friend or relative along with you, with your consent.
4. We will make sure you receive an apology, verbal or written as you request, where this is appropriate.
5. We will make every effort to ensure that the problem does not recur, and amend protocols and working systems accordingly.
We hope that we will be able to resolve your problem. If, despite our efforts, you feel that your complaint has not been dealt with adequately you have the right to take the matter further, by writing to the Station Commander. Further advice can be obtained from OC PMS.
Medical Notes
Your GP (General Practitioner or family Doctor) is an expert in health care. But only you know exactly what and how you feel. The more openly you and your GP can talk together, the better the service he or she will be able to give you.
Before the consultation:
If you have an appointment it is helpful to tell the Reception staff if you are going to be late. If you can't keep your appointment, let the Reception staff know as they may be able to fit someone else in at short notice. If the problem is not urgent and you are late you may be asked to rebook to prevent delays for all those patients who follow you in the clinic.
Most appointments are for ten minutes. It is usually best to concentrate on one health problem during the consultation and not try to cover several different problems at once, unless you think they are connected. If you want a longer appointment to discuss several problems, tell the receptionist. If you want to consult your GP about a family member, make a separate appointment rather than trying to cover it during your own consultation.
It would be useful to show your GP any medication or important documents you may have, such as a computer printout of your prescriptions, X-rays or a medical report. This is not essential but it would be helpful.
You may take along a friend or relation to accompany you during the appointment.
Try to remember:
When you first started feeling ill or noticed something unusual.
What makes your condition better or worse.
What the pain or problem actually feels like.
During the consultation:
In order to make a diagnosis, the doctor relies on what you say, although a physical examination is sometimes necessary as well. Be prepared to talk about what is really wrong. There may be an underlying problem that is causing your illness or making it worse. If you feel depressed, then say so: such feelings are very common.
Make sure you leave the consulting room having told your GP everything you wanted to say, and make sure you understand what your GP has told you. Always ask your GP to explain anything that isn't clear. All doctors should take care to tell you about your health, even if you don't ask them to. But doctors may omit to tell patients something if they think the anxiety could be harmful to their condition - so it is best to ask, to make sure you find out everything you want to know. All doctors should reply fully and truthfully to your questions.
Be ready to tell your GP what you hope to get out of the consultation. There is no need to be nervous or shy with your GP. Don't hold anything back, even if it is a bit embarrassing or sounds silly. Doctors hear all kinds of things and nothing will surprise or shock them! They want to help you, but need your help in order to do that.
If your GP gives you a prescription, he or she should tell you why you need it and what effects the medication will have. Alternatively, if you are not given a prescription you may wish to know why. Do ask. If you need more information or if you are not happy with the diagnosis, say so.
Questions you might ask your GP:
What caused the problem?
How is it normally treated?
What can I do about it?
Are there any long-term effects?
Is there anything I can do to prevent it happening again?
Write down anything you need to remember (or ask your GP to write it down for you). This includes instructions about taking medicines.
Getting advice over the telephone:
It is not always necessary to see a doctor. Most GPs are happy to give advice over the phone and this may be all you need. If you would like to discuss matters by telephone please phone between 0800 and 0830 or between 1000 and 1030. If the surgery is busy the receptionist will take your details so that the GP can phone you back as soon as he or she is free.
Getting a second opinion:
If you are not happy with what your GP says, you can ask to see another doctor to get a second opinion. You don't have the right to a second opinion, but if you express your worries and your feelings to your GP, he or she will probably arrange for you to get one.
Deciding whether to go to the surgery or to request a visit at home:
You may see your GP during the daytime either at the surgery or at home. All GPs will make home visits, but only to patients they think are too ill or immobile to come to the surgery.
Please phone before mid-morning to arrange a home visit. When you phone, be prepared to describe your problems to the receptionist; this will help the GP to decide if he or she needs to make a home visit.
Please remember that it takes much longer to see you at home. GPs can see several people at the surgery in the time it takes to drive to a patient's home. Also, when visiting people at home, the GP does not have the facilities and equipment which the surgery provides. Nevertheless, home visits are an important part of the health service and you should feel you can ask for one if you think you need it.
Helping to choose your treatment:
There are often different ways to treat a medical condition. Your GP should explain the options so that you can discuss them and choose which you prefer. Ask if there are alternatives and how each one works. Ask if there is any evidence that one works better than the others. Patients can play an important part in deciding how they are treated. But in an emergency, it is usually best to rely on what the doctor recommends and then stick to this advice.
Referral to a specialist or hospital:
GPs are able to deal with all but a few of the problems that patients bring to them. Many GPs also carry out simple operations in their own surgery. But if you need to see a specialist (or consultant) or be admitted to hospital, your GP can arrange this. Remember that there will be a waiting list for non-emergencies.
Getting repeat prescriptions:
If you have a long-term condition, your GP can write repeat prescriptions without seeing you each time. Repeat prescriptions can be arranged by dropping the repeat note off at dispensary. Please ensure that the repeat review date has not expired before requesting the repeat. During a long course of treatment, the GP will probably suggest that you make an appointment to review the situation, rather than keep on getting repeat prescriptions. Try not to run out of tablets or medicine, or request more than you need. Repeat prescriptions can only be collected on normal working days and following at least two days notice.
Test results:
If the doctor or nurse carries out a test, such as a blood test or a smear test, make sure you know how to find out the results. You may be asked to telephone. If you want to discuss your test results, ask whom you should see.
Your medical records:
Patients can apply for access to their medical records or ask GPs for copies of their own medical records. You can generally get access to records which have been kept since 1991. There may be a charge for this. It may be useful to keep your own record of your treatment as well. The Deputy Practice Manager or Administration Manager can advise on how to apply.
Privacy:
What goes on in the consulting room is just between you and your GP. Doctors cannot tell other people (even if they are close relatives of yours) what has been said without your express permission, even if you are under the age of 16.
You can ask who sees your records and discuss with your GP what you would like put in your records and whether there is anything which you want to be kept private between the two of you. We use computers as well as keeping records on paper, and are registered under the Data Protection Act. You have a right to see your personal computer records.
Training:
This Medical Centre is a training practice. This means fully qualified doctors receive specialist training in General Practice. As a result some consultations may be with more than one doctor and others may be videotaped. Patients' participation in training is welcomed but voluntary.
Confidentiality of Medical Records
Formal Staff Visits:
During Formal Staff Visits the visiting medical team carry out a quality control check on a proportion of Service and National Health Service medical records. Any confidential information about an individual will not be divulged by the visiting team, however, individuals have the right to deny the Formal Staff Visit team access to their own documents if they so wish. If you have concerns please contact either the Practice Manager or Deputy Practice Manager.
General Practice Vocational Training Inspections:
This station is approved for General Practice Vocational Training. In order to maintain this approval the medical centre is inspected periodically by members of the Armed Services General Practice Advisory Board and the Joint Committee on Postgraduate Training for General Practice, all of whom are qualified doctors. Their terms of reference include inspection of National Health Service medical records to check whether they are being kept to the required standard. Any confidential medical information about an individual will not be divulged by visiting Doctors but individuals have the right to deny the visitor access to their own documents should they so wish.
Action Required by Service Personnel:
Service personnel are to inform their dependants that if they are registered with the medical centre, visiting doctors and RAF Medical Personnel may inspect their medical records.
Action to Deny Access:
Any individual who does not wish their records to be inspected should inform the Senior Medical Officer in writing. It is advisable to contact the Practice Manager initially to discuss your concerns.
You and Your GP at Night and Weekends
Your GP provides a 24-hour service. You have the right to ask for medical advice from a GP at any time. GPs will visit you at home if they feel this is the best option. They may ask you to go to the surgery, or they may arrange for an ambulance to take you to hospital without delay.
Be prepared for emergencies:
If you or someone you look after has a long-term condition (such as diabetes, asthma or heart trouble) it is best to be prepared for emergencies. Ask your GP for information about problems associated with the condition and what you should do if they arise.
Deciding whether to call the GP:
Don't take risks. But if you can wait, make an appointment or go to the surgery in the morning. If the problem has been building up all day, try to phone your GP during working hours rather than wait until the problem has worsened.
Being ill at night can be frightening and it's sometimes difficult to tell how serious something is. It's easy to think that any symptom is the sign of a serious illness, but it's much more likely to be something minor.
Emergencies:
In an emergency you can:
Dial 999 for an ambulance or
Go straight to the nearest Accident and Emergency (Casualty) department which is The Queen Elizabeth Hospital, King's Lynn.
If you're not sure what to do, call the Duty Medic immediately using the numbers below:
07768 928461 - Mobile
(Please note reception in this area is not always ideal and you should use the pager number below if you have any difficulty getting through).
01603 488488 - (Medicom).
This is answered by a medical receptionist who will ask you for your details before passing them on to the doctor. Please ensure you ask for the doctor covering RAF Marham and not Marham village.
These may be signs of an emergency, whether in adults or in children:
Severe chest pain:
Warning signs include:
Looking pale or grey, feeling sick or cold, sweating, or having breathing difficulties that last more than 10 minutes.
Breathing difficulties:
These are serious if the person is gasping or panting for air, choking, or is unable to swallow or drink.
A high temperature or fever:
Watch out for:
A temperature of over 40°C or 104°F
A stiff neck, cramps or vomiting or
A child that seems weak and listless or suffers a fit or convulsion.
Bad injuries:
These include serious eye injuries, deep cuts or wounds where the bleeding will not stop and injuries where the edges of the cut cannot be pulled together. 'Bad' means that it is difficult to clean the wound properly or that the area around the wound has become red and inflamed, possibly with red lines going down the arms or legs.
Head injuries:
These are serious if the person has passed out (become unconscious), has developed double vision, seems confused or drowsy, or cannot remember what happened.
Broken bones:
A bone may be broken if the person cannot put any weight on it, if an arm or leg is twisted, or if the person is in great pain.
Sudden severe pains:
These are serious if the person has no idea what has caused the pain and if the pain lasts more than 10 minutes.
The person has collapsed, is unconscious and cannot be woken.
Bad burns or scalds:
These are serious if there is heavy blistering or the skin is broken, if the burn covers a large area or is on the face, or if the skin has turned white or black. The burned area may feel numb.
Vomiting with stomach pains which are getting worse.
Vomit or diarrhoea containing blood.
Nose bleeds:
Take action if the patient is taking anti-coagulants (blood-thinning medicines) or if the bleeding does not stop after holding the nose closed for at least 15 minutes.
Insect bites or stings:
These are serious when the person has been stung in the mouth or throat, if the person normally suffers reactions to bites or stings, or if blisters or a rash appears on another part of the body.
Serious allergic reactions:
These may be reactions to bites and stings, or reactions to drugs or to foods like peanuts.
Watch out for:
Swellings, especially the lips and eyelids
Feeling generally unwell with aches and pains
Difficulty in breathing and tightness of the chest
Turning pale and fainting
Widespread itching or rash.
Bites from animals or humans.
Serious sunburn:
Large burned areas and blistering, with cold shivers
Queasiness or sickness
Vomiting, fever or palpitations.
Getting medical help at night, at weekends and on public holidays:
The GPs in this practice take it in turns to be 'on call'. Occasionally there may be a locum (stand-in) doctor on-call in the absence of your usual GP.
When you phone for medical help, be prepared to describe how you feel or how the person seems and why you're worried. The GP will probably be able to tell how serious the problem is and in many cases can give advice and reassurance over the phone. You may be asked to go to the Regional Medical Centre, alternatively, the GP may visit you at home.
If the GP has to visit at night or at the weekend:
If the GP comes to visit at night or at weekends, help him or her to find your house with good directions and leave a light on so that the house can be seen easily. Try to see the GP in a quiet room and keep dogs (and perhaps other adults and children) out of the way.
If you are a parent with a young baby:
If your baby becomes unwell outside surgery hours you can always telephone for advice from the GP. There are also leaflets and guides on how to recognise and deal with minor childhood illnesses. Your GP, practice nurse or health visitor will be able to advise you about the kinds of health problems that might occur with a new baby.
Coping with Minor Ailments
Research shows that people cope with their own symptoms in eight out of ten cases. You probably already act as your own doctor and nurse most of the time. If you feel unwell, you immediately try to work out why and take steps to make yourself feel better. This is 'diagnosis' and 'treatment'. When you can't solve it yourself, that's when you go for medical help.
Self-care means recognising minor illnesses and being able to treat the symptoms, preventing health problems developing and knowing when to call for outside medical help. People often worry that any symptom is the sign of a serious illness when it is much more likely to be something very simple.
People recover from most minor illnesses by themselves and don't need to be seen by a doctor. For instance, many minor illnesses, including colds and flu, are caused by a virus. There are thousands of different viruses and there is no direct cure (antibiotics can't help). But there are often things you can do to ease the symptoms while your body gets on with overcoming the virus. Rest and take plenty of drinks (not alcohol). Paracetamol or aspirin may help relieve aches and fever, but don't give aspirin to children under the age of 12.
With a little more knowledge and information, you may be able to diagnose and treat yourself and members of your family a lot of the time. Some basic knowledge of first aid (for example, for burns, sprains or reviving people) can help you deal with accidents. You can then decide whether something is serious enough to need medical help.
Self-care doesn't mean dealing with health problems on your own. Your GP and the practice team are there to help with any problems or situations you can't cope with. The pharmacist can give you advice on treating minor illnesses.
The pharmacist can help you stock your home medicine chest and can advise you on home remedies.Organisations such as the British Red Cross and St John Ambulance provide first aid information and courses.
Keep medicines away from children.
First Aid
Burns:
Immediately cool down the affected area with lots of cold water and continue to do this for at least 10 minutes. If the burn is larger than 4 or 5 inches across, if it is on the face or if the skin is broken, see the nurse at your GP's practice as soon as possible. If the burn is deep, heavily blistered and very painful, or if the skin has turned white or black, go to the nearest Accident and Emergency (Casualty) department immediately.
Cuts:
Try to stop the bleeding from a minor cut by pressing it, with clean hands, for a few minutes; hold a cut arm or leg up high. If a cut bleeds freely any germs will normally be washed away by the blood. If it is a deep cut and the edges cannot be pulled together, consult your GP's surgery or go to the Accident and Emergency department. Redness or swelling can be a sign of infection in a cut or graze and you should make an appointment to have it seen at your GP's surgery. You may be advised to have a tetanus injection if you haven't had one for 10 years.
Sprains:
Remember I-C-E
I - stands for ice.
Immediately pack the sprained area with ice or a bag of frozen peas, wrapped in a cloth, to reduce swelling and speed up the healing process. Keep this on for about 20 minutes.
C - means compression.
Bind the injured area with an elastic bandage, so it is well supported, but not so tight that it restricts the flow of blood. Retighten a few times a day.
E - means elevation.
Rest the sprained area and keep it held high. For example, if you have a sprained ankle, rest it on a stool that is higher than the chair you are sitting on.
Head injuries:
For a minor knock or bump, put on a cold damp cloth. A person should be seen by a GP or taken to Accident and Emergency without delay if they have any of the following symptoms: vomiting, unconsciousness, double vision, drowsiness or confusion.
Choking:
Stand behind the person and hug them firmly above the waist, pushing your fist up under their ribs to make them cough up the blockage. For a young child, hold the child upside down and thump on the back.
The recovery position:
This is a position in which to place a person who is unconscious. Turn the person on to their side, with the head turned to one side. Then bring the top leg over so that it is resting on the ground. This will prevent the person from vomiting and choking.
Changing your lifestyle:
The way we live can affect our health. Lifestyle changes - giving up smoking, cutting down on heavy drinking, learning to relax or reducing our intake of fatty foods - can have a big impact on our health. Well person clinics and Quit Smoking clinics are run by the practice nurses.
Testing services:
There are tests and checks that you can have done to help prevent illnesses developing or to catch them in the early stages when they are most easy to treat. Some illnesses show no early symptoms and simple checks at regular intervals can sometimes detect any warning signs.
GP surgeries offer testing and advice on such things as:
Blood pressure (to prevent strokes and heart attacks).
Cervical smears (to prevent cervical cancer).
Keeping up to date with immunisations.
Relatives of people with glaucoma (high pressure in the eye) can have eye pressure measured regularly by opticians if they are over 40. This is a free service also available to people with diabetes.
Medical advice by telephone:
You can get medical advice over the telephone. Ring your GP's surgery for a phone consultation with the doctor or nurse. The receptionist may take a message for your GP to phone you back. You can also phone for advice and reassurance in urgent situations at night and weekends.
Some people tend to ignore symptoms when they feel unwell. People who are looking after others, whether they are parents with a family or carers looking after someone who is ill or disabled, often tend to neglect their own health. Some older people think pains and problems are just a sign of old age. And men are particularly likely to ignore warning signs and not go to the surgery for simple checks or consultations with their GP. A quick phone call or visit can reassure you or ensure that a problem is caught early and receives effective treatment.
Warning signs:
These warning signs may tell you something is wrong and that you should contact the GP soon.
Losing weight by seven pounds (three kilograms) or more without obvious reason.
Feeling thirsty without obvious reason.
Feeling very tired or exhausted without good reason.
Losing blood when coughing or vomiting or going to the toilet.
A change in a mole (changing colour, getting bigger or thicker, itching or bleeding).
A change in the voice (getting husky or hoarse and continuing that way for more than three weeks).
Indigestion or belching acid, lasting more than a month (especially in the over-45s).
A change in a breast or nipple.
Danger signs:
In children, these warning signs mean you should get medical advice immediately:
Violet-coloured spots that don't fade when pressed.
Breathing difficulties - gulping, gasping, wheezing and being unable to speak or drink.
The child seems to be in pain when breathing in.
The child is weak, drowsy or confused and doesn't react to you or its surroundings.
The child is vomiting a lot and seems ill.
The child cannot sit up or bend the head forward.
How to treat a temperature:
A raised temperature often occurs even with mild infections like colds and flu. Normal temperature is 37°C or 98.4°F. People usually know if they have a temperature - they feel hot or cold, sweaty or shivery, and unwell. Children may be miserable and listless or look flushed. Small babies may seem very sleepy and not want to feed.
A higher temperature or fever means the body is fighting the infection. Help it along by drinking plenty of water or weak squash, keeping the room at a comfortable temperature with fresh air circulating, and sponging with cool or lukewarm water. Paracetamol or aspirin can be taken as tablets by adults and paracetamol syrup can be given to children.
Contact the GP immediately if the person has a temperature of over 40°C or 104°F, if there is a stiff neck, cramps or vomiting, or if a child seems weak and listless or suffers a fit or convulsion.
Useful items for stocking your home medicine chest:
Paracetamol syrups (e.g. Calpol, Disprol, etc) for pain or fever in children.
See the label for the correct dose for the age of child.
Paracetamol or aspirin for adults and teenagers for headaches, colds, fever, sore throats and pain. Do not give aspirin to children under 12 years old.
Cough medicines.
Menthol crystals - add to hot water according to the instructions and inhale the steam to treat catarrh and dry, painful coughs or sinusitis. Not suitable for children - use a steam-filled bathroom instead.
Calamine lotion for dabbing on insect bites, sunburn, stings and itches.
Antiseptic solution - one teaspoonful mixed with warm water for cleaning cuts and grazes.
Rehydration mixture (e.g. Dioralyte) for use in cases of diarrhoea or vomiting.
Plasters - a mixture of sizes.
Cotton wool to clean cuts and grazes.
An elastic bandage and dressings to support sprains or bruises.
A thermometer for taking temperatures.
Tweezers for removing splinters.
All these are useful medicines and dressings to keep at home in readiness for minor illnesses or accidents. Ask your pharmacist for advice on other remedies or medicines which may be of use at home. Keep them up to date and out of the reach of children.