The The Newsletter Published by the Patients'
Association of the Elliott Hall Medical Centre Number 23
Reg Charity No: 1048910 Oct 2004
ElliottEar
Principal Contents
List
Chairman’s Report
From the Treasurer
The Weekend Tea Parties
Transport Service
Babble and Chat
Want to book an
appointment with a Doctor
via the Internet?
Carer’s Support Group –
Happy Birthday
Flu Vaccination 2004
DaRT Dial-a Ride
& Taxicard
Famous names in medicine - Baron Muenchhausen
Obituary: Leslie Thomas Morton
Sendoff of Sendoffs !
Congratulations Reena Majus FRCGP
Out of Hours / HARMONI
Community Oriented Primary
Care (COPC)
Depression
Account of visit to our local Diabetes Group
Education Class
Improvements to Childhood
Immunisation Programme
Malaria Prevention
Staff changes at Elliott
Hall Medical Centre
CHAIRMAN'S REPORT
The summer season began
with a very successful Quiz Evening and fish and chip supper in early May. The
evening was enjoyed by a good number of patients and my thanks go to the
members of the Social Committee for all their work in organising
the evening, and in particular to June and Eric Pleass
who prepared and ran the quiz.
At the
AGM in May, attended by at least twice as many people as usual, the business
side of the meeting was conducted speedily, and after coffee Dr Alan Byers and
his family entertained us with a number of amusing stories interspersed by
musical pieces, which were thoroughly enjoyed by us all and demonstrated not
only his caring nature as a doctor but his amazing musical talent. Thank you,
Alan, so much.
Just a
couple of weeks later came the most amazing event that the Practice and
Patients' Association have ever attempted - a farewell concert to Dr Byers performed
by artistes ranging in age from 6 to 103 - all being introduced by Barry Cryer with wit and enthusiasm. Thank you very much, Barry.
After what appeared to be the end of the music session, Dr Byers was presented
with a French horn, a Sibelius computer programme and a book which contained all the messages sent
in by you, the patients. May I thank you all for
sending in these messages and for your great generosity in the donations which
enabled us to purchase these presents. However, all was not over; suddenly a
complete orchestra appeared and the afternoon ended with Dr Byers playing his
new horn with them.
Many
people gave a lot of their time and energy to help and my thanks go out to each
and every one who helped in any way and to all of you who came to the concert.
If you missed it, there are copies of the event on video which we hope will be
available shortly. If you did miss it, I recommend you watch the video. During
the planning stage, the date, the venue, and the format were all altered, but thanks
to the Practice Manager, Denise Lavey, it was
"all right on the day".
Many volunteers came to
the Volunteers' Tea Party at Pam Bertolotti's house
and garden (thank you very much, Pam) and enjoyed a lovely social occasion on a
very pleasant Sunday afternoon towards the end of August. My thanks to all who
helped to stage that event - which reminds me - Why are you not a volunteer?
This is an appeal to everyone but particularly to those just retired or about
to retire - please spare us a few hours if you can. The services we provide are
listed on the back cover - ring one of the co-ordinators
or me to get more information.
Finally,
I am delighted to announce that the Committee filled the casual vacancy of
Vice-Chairman recently and Lesley Walmsley is taking
this on.
My thanks to everyone who
contributes in any way to the Patients' Association and I look forward to
seeing you all at the coffee morning on Saturday 20 November.
Cyril Flood Chairman
* * * * * *
From the Treasurer
This has been for me a very busy few months on
"Treasurer's business". Firstly there was the Quiz Supper, which
raised a net £345.74. Then, following the very successful farewell concert for
Dr Alan Byers, there were more than 360 donations for him, reaching a large
sum. We were able to buy him a
top-of-the-range French horn, which he played to the assembled audience, and a piece of computer software for composing
music. Even after buying the book for the tributes to him, and paying the
photographer, there was a substantial sum which we sent to him, but Alan Byers
- who was overwhelmed by the enthusiasm which greeted him at the concert -
donated a large amount to the funds of this Association.
Those of us who were lucky
enough to be at
We
have already bought some special stationery for the practice, and have agreed
to pay about £2,400 for further medical equipment and for the refurbishment of
some of the chairs in the waiting room. There have been some generous donations
to the Patients' Association funds, and these sums are used carefully for the
benefit of the practice and of course ultimately for us.
Victor E. Davis
Treasurer
* * * * * *
The Weekend Tea Parties
Pondering
how best to extend the pastoral work of the practice, I thought of the many
patients who perhaps don't get to see a friendly face as often as they would
like. The idea of the weekend tea party was born in the informal and warm
atmosphere of my home. Now, thanks to many volunteers, to whom I am so
grateful, we have been able to hold six weekend tea parties, which have hosted
close to 50 people in total.
We enjoy a
high tea and most importantly the indispensable ingredients of companionship
and a nice chat. It's just wonderful
seeing smiling faces and so rewarding knowing that people have been able to
look forward to and enjoy an afternoon in pleasant company. Patients are collected and brought home by
volunteers, and the teas always have a good ratio of carer-volunteers.
Should you
wish to join us, please contact your doctor. And if you are able and willing to help with
transport and/or help on the day (for just two hours) once every six weeks or
so, do please call me.
Tova
Salomon
* * * * * *
Transport
Service
Aim: To provide transport
for patients to the Medical Centre and local
hospitals
Co-ordinators: David and Pat James
Operation:
The system is operated by volunteers at the Medical Centre
on Tuesday and Friday mornings from
The
charge: This remains the same: £2.00 for a return journey to the Medical Centre and £5.00 for a return journey to a hospital.
Once again, many thanks
from all concerned to the drivers, and to Rita, Norma and Marcia who take the
calls at the surgery.
David and Pat James
* * * *
* *
Babble and Chat
Babble
and Chat is a parent/carer and baby/toddler group
which meets weekly. We provide the
opportunity for adults and children to get together for a chat, to play and to
have a cuppa.
We are
now planning the Christmas Party in December (date to be announced). Attendance
is by ticket only @ £2.50 per child. This will include an entertainer and a
wrapped gift from Father Christmas. Please contact us to book your ticket(s).
The date for the party will be displayed on the notice board at the Medical Centre.
Babble and Chat meets every Tuesday afternoon,
We look
forward to meeting you.
Lisa Harvey and Carole
Lesser
- * * * * *
Want to book an appointment with a Doctor via
the Internet?
Our clinical database supplier, EMIS, has recently introduced the
facility to book appointments on the Internet - they call it ACCESS. We hope
that this will be a convenient way for some people to make their appointments,
as the service is available round the clock.
There are a few rules for use:
You can only book an appointment for a doctor, no other member of the team
This service is only available to patients over the
age of 16
You will have to get your registration details
(ACCESS ID and PIN number) from the practice - we need a couple of days to
process the request
We can only issue registration details to the
patient, not to a relative or friend - this is for confidentiality reasons
Please note that the ACCESS website is not directly
linked to our clinical database. The only part of the clinical database that is
interrogated is the available appointments for the designated doctors
The
practice can look at bookings made through the ACCESS system - if someone is
found to be abusing the system their ACCESS facility will be stopped. Abuse
might be booking multiple appointments and then cancelling,
making appointments and not attending, or cancelling
a pre-booked appointment at the last minute, making it impossible for it to be
offered to another patient. If your access is stopped, you will be informed of
the reason in writing.
If you want to try Internet access appointment
booking:
Make
your request to use this service in writing - include your name, address and
date of birth, plus your signature. We need two working days to process such requests.
You can then collect your Internet Registration password from Reception, or we
can post it if you give us a SAE.
Log on to the practice website - www.ehmc.co.uk
- and click on the link
There is detailed information
on the website on how to create your "account" and how to make or
cancel bookings
It would be good to know how
the system is going - any feedback, good or bad, to me, please.
Denise Lavey Practice Manager
·
* * * * *
·
CARERS'
SUPPORT GROUP - HAPPY BIRTHDAY!
At the end of November 1994 we arranged the first informal meeting for Carers although, due to a minor operation I had to have,
the first meeting did not actually take place until
In February 2005 we shall be celebrating our tenth birthday with a
lunch, and we look back on the happy times we have spent with many carers.
In issue 4 of The EIIiottEar I wrote that the word "Carer"
is not one that many people who care for a loved one
on a day to day basis, 52 weeks a year, would use to describe what they do. To
them, they are looking after someone they love - it doesn't have a title. Over
the last ten years Anne Flood and I have been very humbled to work with many carers: their devotion to their loved one is immeasurable,
and they are so uncomplaining. We both feel privileged to work with them, and
perhaps help in some small way. Our meetings are never dull - they all retain
their sense of humour and many are delighted to have
a short respite from their caring by coming to them.
As we celebrate ten years of "Caring", the carers,
Anne and I would like to say "Thank you" to Ann Kirby from Social
Services. Ann has been involved with the
Group on a voluntary basis since the beginning, and her help and advice has
been so appreciated by the carers. Ann is retiring from Social Services on 8
September, but will still continue to come to our meetings - it wouldn't be the
same without her. We wish her a happy
retirement - she deserves it.
Despite their total commitment to caring, most of the carers find the time to come to social and fund-raising
events of the Patients' Association, and we are indebted to the Home Visiting volunteers
who make this possible for some carers. They sit with the loved one to enable the carer to come to meetings and social events.
We have had our sad times when a member's loved one dies, but the Group
is there to support the carer. Several ex-carers still attend our
meetings, and their experience is of great benefit to new carers.
Meetings still continue on every
third Thursday of the month. If you are a carer why
don't you join us? The venues are on the
Patients' Association notice board at the Medical Centre.
Here's to the
next ten years!
Beryl Peacop
* * * * * *
Flu Vaccination 2004
As in previous years, the national policy for 2004/05 is that influenza immunisation should be offered to
• All those aged 65 years and over
• All those aged
over 6 months in a clinical risk group, such as patients with diabetes, chronic
respiratory disease including asthma, chronic heart disease, chronic
renal disease
• All those living in residential care homes
The Pneumococcal (pneumonia) immunisation programme
Current recommendations are for all patients over 75 years and those in
risk groups as above who have not been previously immunised. Please note: re-immunisation with pneumococcal vaccine is not currently recommended.
Those who are housebound will be
visited when times are available, and patients will be contacted in advance.
Helen Jenner Nurse
Practitioner
* * * * * *
DaRT ... is a registered charity which
campaigns for a public transport system fully accessible to all
Dial-a-Ride: If
you are unable to use public transport because of a disability, you may be
entitled to register with the
Taxicard: The Taxicard scheme allows Londoners with a mobility impairment, which prevents them from using buses and trains, to travel in the contractor's licensed radio taxis - black cabs - at subsidised rates.
For further
information and application forms, please contact DaRT,
Room 210, Colourworks,
* * * * * *
FAMOUS NAMES IN MEDICINE
BARON MUENCHHAUSEN
In late 1951 Dr Richard Asher, a Harley Street practitioner and father
of the distinguished actress Jane Asher, published a letter in a medical
journal reporting a patient he had encountered who travelled
from one hospital to another deliberately simulating acute illness, and even
submitting to investigations and operations. A few days after admission the
patient would discharge himself, having had free food and lodgings at the
expense of the state.
More correspondence followed, reporting cases of patients simulating
acute abdominal catastrophes ("neurologia diabolica"), fits, faints and spurious external haemorrhages ("haemorrhagica
histrionica").Dr Asher suggested that this
condition be named "Muenchhausen's
syndrome".
Who was Muenchhausen?
Baron Karl Friedrich Hieronymus von Muenchhausen was a German hunter and soldier, born in
Marvellous Travels and
Campaigns in
Leslie Morton
Leslie Morton contributed an
article on a famous name in medicine in The EIIiottEar for several years, and had planned to balance
each "famous name" with an "infamous name", of which this
was the first. Sadly,
Leslie died earlier this year, and the following tributes come from Paul Samet, a patient who had known Leslie since 1939, and from
Dr Reena Majus.
* * * *
* *
Leslie Thomas
Morton
Leslie had lived at 44 The Lawns
in Hatch End since 1938, when he was Librarian at
He was renowned throughout the
medical world for his Medical Bibliography: an annotated check-list of texts
illustrating the history of medicine, the first edition appearing in 1943, with
a fourth in 1983. After his retirement
he worked mostly at home on indexing and proof-reading new medical books, and,
with Robert Moore, his successor at Mill Hill, on A
chronology of medicine and related sciences, which was published in 1997. Just
before his death he heard that the publishers had agreed to produce a second
edition. He wrote several other books and numerous articles.
For his outstanding work in the
field of medical reference books he was awarded several honours,
in both the
Leslie was also very active in the Scouts,
serving as District Secretary for
Despite all the renown that he achieved, Leslie
was always a modest man, with a cheerful smile and a joke for everybody.
Paul Samet
Leslie and Bertha Morton transferred
to EHMC in April 1996. Chatting soon
revealed what a formidable talent we had in Leslie, and he was co-opted to help
advise on setting up our library when the extension
was completed in 1997. He attacked his job vigorously (child's play compared to
somewhat more important libraries he had run), despite caring very tenderly for
his ailing wife. Soon the Medical Centre had a very
professional fine library, which is unique amongst general practice
surgeries. He continued to maintain
this, and could be found regularly in the library whistling, while he helped
research information needed or induct new learners in the practice. He
regularly helped out with the medical student teaching. His excellent heart
"murmurs" and his medical knowledge soon had him giving a better
examination of the heart practical session than I could manage.
He was a firm favourite
with the staff, and enjoyed attending staff functions, usually being one of the
last to leave, even at
We do miss Leslie but feel enriched by our
association with him.
Reena Majus
* * * * *
*
SENDOFF OF SENDOFFS
!
I still can't believe the
magnificent sendoff I received from EHMC. So many sent me lots of kind messages,
most of which I could not respond to as it would have been a full-time job in
itself to have written to everyone as I would have liked. So please let me take
this opportunity to thank the many that I have not answered.
Originally, I thought that my
goodbye would hinge around the talk I was invited to give at our Patients'
Association's AGM on 1 1 May, an occasion which I
thoroughly enjoyed. It included my mnemonics for the no less than 49 (7x7)
qualities that the patient would like from a doctor, and the 7 items that the
doctor hopes for from the patient!
However, only a few days before
the Sunday afternoon of 9 June, I caught wind of the amazing surprise concert
which was to take place at
Barry Cryer
compered the first half, in which I was treated to
some lovely playing and intriguing magic. Tom Well,
aged 18, was not only magician but an expert piano accompanist too, and also a
notable double bass player. Our oldest pianist is also our oldest patient,
Alice Milsom aged 103. Unfortunately, there is no
space here for me to mention all the wonderful performers.
We were also entertained by some great singing
which included some humorous renderings of well known songs with the words
rewritten, personalising them for me in a witty and
very touching way. For example, "Anything Reena
can do, Alan can do better! ;hotly disputed!),
"He'll do it Byers way!", "Hello Alan!'', 'Oh Dr Byers what
shall we do?!', and words to that well known third movement of Mozart's fourth
horn concerto.
In the second half our wind quintet played. We
called it The 5 Ds Wind Quintet because we consist of 2 Doctors and 3 Davids. Then out of the blue, Reena
Majus presented me with a magnificent Alexander
French horn, far better than the one I had. My old one was on its last legs and
full of dents, bought second-hand when I was 16 and in urgent need of
replacement. Apparently there had been an enormous secret collection (truly
secret from me till that moment) where hundreds of people had been very
generous! Well of course it was a flabbergasting moment.
Chris Jenner then
suggested I play a few notes in front of everybody! (Actually it takes 3 months
to break in a new horn!) The next thing I knew, a whole 32-piece orchestra
appeared out of nowhere from the back of the hall, under the direction of
Adrian Parker. They were mostly made up of patients and some friends too, many
of whom were connected with the Harrow Young Musicians.
The new horn has
already greatly improved my playing and I am very grateful to all who
contributed to it, who appear in a lovely farewell book that I was also
presented with, along with a valuable music writing computer programme, Sibelius 3. It is
lucky that I have had a two-month break from work to help me get my head around
how the "Sibelius 3" programme works. It has enabled me to produce lovely
printed music arrangements for the choir I lead.
There was far too much to my Farewell from EHMC for
me to write about it all here. Our practice administrator, Mrs
Ann Knight, produced two of her famous goodbye poems for me, and Ann's daughter
Laura (our reception co-ordinator) shared her 21st
birthday celebration with a final "goodbye Alan" lunch for our team
at the surgery, at which I received more presentations, including an absolutely
incredible lit- up model of my surgery consulting room, hand made by our
talented Mrs Chris Elton, our receptionist, who also
makes bespoke models professionally as a small sideline.
So I was very "spoilt" and made a great
fuss of, and left feeling that perhaps I should not be leaving at all! I have
in fact been infused with some feeling of self- doubt about things, but I was
finding work at EHMC becoming too strenuous and heavy for me and felt in need
of a change. So now I am looking out for part-time work at St Elsewhere. Any suggestions?! I do feel humbled by and grateful for all
the trouble so many people took to make my leaving so special.
Finally, once again all my
grateful thanks to all of you who gave me such a wonderful sendoff and to all
those who have made my nearly 25 years at EHMC, Hatch End such a rich and happy
experience. I
maintain that the people in our Hatch End area must be the best people
anywhere, and I hope to see many of you again in the future. I wish you all
that life has to offer, in good health.
Alan Byers
* * * * * *
Congratulations Reena Majus
FRCGP
We hope all our EIIiottEar readers will join us in
congratulating Reena on having been awarded a
Fellowship of the Royal College of General Practitioners. A
"Fellowship" is the highest award that can be bestowed on a Member of
the RCGP and recognises Reena's
significant contribution to general practice above and beyond what is normally
expected.
For Reena's patients this will come as no surprise,
as I know of no other GP who is so meticulous and caring in their work. What
many patients may not be aware of is her contribution "outside the
consulting room". Reena has for many years been
a trainer, and her trainees have "graduated" and formed a significant
part of the modern day GP workforce in and around
Reena has been an examiner for the
London Deanery and is considered by all of us to be an authority on audit in
general practice. Essentially all GP Learners have to pass an Audit, and Reena is one of the senior and most experienced assessors.
Not confined to examining learners
Reena is also an Appraiser for other local GPs.
Finally, working at EHMC is only Reena's day job. For one evening each week and at weekends
she also works for St Luke's Hospice at the Grange Kenton, and as many of you
will again know she really is our in-house expert in Palliative Care.
Well done, Reena. We are all very proud of your achievement and
wish you every success at the forthcoming presentation of your Fellowship.
Out of Hours /
HARMONI
Historically out-of-hours
care was provided by one's own family doctor, but over the last two decades
increasingly "in-hours" and "out-of-hours" workload has
seen many GPs look to alternative sources of help. The
commercial deputising services emerged and about ten
years ago Harrow GPs formed a co-operative - HARrow
Medics Incorporated or HARMONI. Most
GPs in
When you call the surgery a
message will either advise you to call the doctor via a pager or you will be given
the number for NW London NHS Direct. A nurse will ask a series of questions
based on your condition, using a computerised
protocol, and together with his or her judgement will
suggest a course of action. This is
often giving some advice but may also range from attending A & E to coming
to the Primary Care Centre. If housebound or the condition demands, a
Home Visit will also be offered.
At the
Primary Care Centre, Harrow GPs typically take it in
turns to provide medical cover. Shifts
are usually after evening surgery or at a weekend, and can be 5-6 hours
long. During a shift we tend to see a
variety of people with a range of complaints. Examples include parents with unwell children and pregnancy-related problems. One
memorable occasion was when a child was brought along on a particularly busy
weekend shift. The waiting room was full of unhappy children and adults. This
particular boy was conspicuous as he was lying passively in his Dad's arms,
making little noise. We called this child out of turn and within a minute or so
it was clear that he might have an appendicitis.
Luckily, at that time A & E was only a short trip downstairs, and I called
ahead to the surgical team to expect the boy.
Later that evening he had an operation and a perforated appendix was
removed!
Working at HARMONI has the
benefit of seeing patients from different parts of
On the
downside, separation of out-of-hours under the New GP Contract could result in
a proliferation of providers and a more fragmented service.
If you need help out of
hours, please remember always to dial the surgery number first, and then follow
the instructions given. The arrangements do vary from time to time, so storing
numbers" from previous occasions is inadvisable.
Ashok Kelshiker
******
Community Oriented Primary Care (COPC)
In the last issue of The
Elliot Ear, we invited you to take
part in an innovative research and development project to improve services at
Elliott Hall Medical Centre. Using a method called
Community Oriented Primary Care (COPC), the aim was to
put patients and service isers at the centre of service development.
This is very much a practice-led initiative to improve services at
Elliott Hall; our role is to support the process. As researchers we are based
at the Royal Free and
A short-list of topics was produced by the practice team and circulated
in the last EIIiottEar. Patients were asked to rank the three topics
they felt were most in need of attention, and from the 32 patients who responded,
the results were as follows:
1 Depression and other mental
health problems
2 Improving repeat
prescribing
3 Getting the best care for
housebound patients
Twenty-two of these patients were happy to be
contacted by us and involved further in consultation process. These patients
were invited to participate in focus groups held on each of the three topics
above. Focus groups are a useful method for exploring people's knowledge and
experiences and gaining a detailed understanding not only of what people think,
but how and why they think as they do. The focus groups were held at the
Medical Centre, facilitated by the researchers, and
participants were given an assurance that their views would be fed back to the
practice anonymously.
Below is a summary of the discussions from the focus groups:
Depression and other mental health
problems
Participants gave detailed accounts of
their own and others' experiences of how depression can develop and be dealt
with. Complex models of the origin and expression of depression were described
along with a variety of coping mechanisms.
In terms of service use, both the triggers and perceived obstacles to
accessing help from professionals were given. Practical solutions to a number
of the issues were suggested:
•:• A greater amount of information about the condition itself as well as
the services and help available, both from the practice and from other sources
•.• Increasing public awareness
of depression would help to lessen the stigma felt by those who suffer with
depression and those trying to seek help
•:•
Encouraging participation in social networks (for example for new mothers)
could help to lessen the feelings of isolation within a supportive environment
•:• Family and friends may have an important role in the care of those
with depression Strategies to improve self-esteem, such as counselling,
may help prevent/deal with depression.
Improving repeat prescribing
Both the
28-day rule imposed by the PCT and the 48-hour practice rule had the net effect
of transferring costs and inconvenience to patients and carers,
in terms of journeys to the practice, time, fuel, fares and general planning
required. The increased workload for the practice was also acknowledged. In
response to the rules, patients had developed individual strategies for minimising their inconvenience.
The variety of services
provided by local pharmacists was described. It was felt that pharmacists had a
role to play in improving the repeat prescribing process and that they should
be involved in future discussions.
Getting the best care for
the housebound
Participants
had a lot of expertise in being carers for the
housebound. Definitions of what it means
to be "housebound", factors leading up to being housebound and the
subsequent effects, both on the housebound themselves and their carers,
were shared.
Care
currently available from social services was felt to be unco-ordinated
and poorly resourced; home carers were often
inadequately trained. Private carers were
prohibitively costly and of variable quality.
The
impact on family carers - for example, stress and
tiredness, isolation and economic - was considerable. Carers
wanted:
üAn
information leaflet detailing help available from social services, private
agencies and voluntary organisations, other local and
national organisations, and their contact details
,üGreater
monitoring of the housebound. This was thought to be best served by a
practice-based individual with a "welfare/co-ordinating
role" who would also be the main contact for the housebound, their carers and the professionals involved in their care.
Next steps
The
detailed findings from the focus groups have been fed back to the practice team
at Elliott Hall. They have been keen to hear your views on these issues and are
currently working on how best to act on them. We plan to meet with them again
in the autumn to discuss how to take this work forwards. We will keep you
informed of developments in future issues of The EIIiottEar.
If you would like any further information on this work or would like to
share your views on any of the above topics, you can contact Kalpa Kharicha
by phone on 020 7328 8199
by email on k.kharicloa@pcps.ucl.ac.uk
or by post at Department of Primary Care and Population
Sciences, Royal Free and University College Medical School, Royal Free Campus,
Rowland Hill Street,
Kalpa Kharacha and Steve Iliffe
DEPRESSION
One of the focus groups of the recent COPC research project (see the
article above) looked at depression and other mental health problems. The group
shared the problems of lack of knowledge of what it was; where and to whom to
go to for help; and the variety of that "help". I hope to answer some
of these queries in this article and also give some useful links for people to
access directly for further information and help.
This information is taken from the Royal
College of Psychiatrists' information leaflet on depression and I am grateful
to them for it.
What does it feel like
to be depressed?
The feeling of depression is much more
powerful and unpleasant than the short episodes of unhappiness that we all
experience from time to time. It goes on for much longer, and can last for
months rather than days or weeks. Most people with depression will not have all
the symptoms listed here, but will have at least five or six.
With depression you:
• Feel unhappy most of the time (but may feel a little better in the
evenings)
• Lose interest in life and can't enjoy anything
• Find it harder to
make decisions
• Can't cope with things that you used to
• Feel utterly tired
• Feel restless and
agitated
• Lose appetite and weight (some people do the reverse and put on weight)
• Take 1-2 hours to get off to sleep, and then wake up earlier than usual
• Lose interest in sex
• Lose your self-confidence
• Feel useless, inadequate and hopeless • Avoid other people
• Feel irritable
• Feel worse at a particular time each day, usually in the morning
• Think of suicide
You may not
realise how depressed you are, because it has come on
so gradually. You may be determined to struggle on and can blame yourself for
being weak and lazy or feeble. Other people may need to persuade you that it is
not a sign of weakness to seek help. You may try to cope with your feelings by
being very busy, which can make you even more stressed and exhausted. You will
often notice physical pains, constant headaches and sleeplessness. Sometimes
these physical symptoms are the first sign of a depression.
Irrespective of the
cause, if depression significantly affects your life it is worth treating or
getting help. There are many ways of helping depression so it's important to
let others know how you are feeling, either by telling family, friends or a
health care professional. We are as concerned about your mental state as about
your physical one.
There are
a range of talking therapies in addition/in preference to medication so
get the correct facts to make an informed choice and start to feel better!
Some useful sources of information
http://www.mental
health.org.uk
http://www.depressionalliance.org
http://rcpsych.ac.uk
http://mind.org.uk
http://www.youngminds.org.uk
So, if
you need help or information about mental health issues PLEASE ASK ANY OF THE DOCTORS
OR NURSES AT EHMC.
Reena Majus
******
An account of a visit to our local
Diabetes Group Education Class
Have you ever wondered what
diabetes actually is or why it has occurred? Have you wondered what kinds of foods
you can eat and what to avoid? Have you worried about foot care and what the
signs of foot disease are? Perhaps the
Diabetes Group Education Class can answer these and many more of your
questions.
The classes are usually held
in the afternoon, and you spend 2 hours in the company of a diabetes specialist
nurse, dietician and podiatrist. The session is interactive and the audience are invited to ask any questions they may have. The
explanations are clear and simple, and enough information is given without it
becoming dry or boring.
At the
session I attended about 16 people came, some 75 per cent of whom
were relatively newly diagnosed with diabetes. The session did have something
for everyone, and experienced people with diabetes as well as family and
friends seemed
to enjoy
and learn from it. Learning took place from one another as well as from the
leaders.
The dietician
was a big hit. She was asked about the role of "diabetic foods",
which
types of cheeses were best to have and
which breakfast cereals were suitable. She
talked about how to make sense of food labelling, and
provided some useful handouts. The podiatrist
invited the audience to air their concerns about foot disease and helped to
dispel some of the myths regarding gangrene. She gave some practical tips on
footwear and foot care, and discussed what the signs of foot disease are. The
audience wanted to know whether "glucose intolerance" and diabetes
could be reversed once diagnosed, and why some of them had been advised to check
their blood sugars and some hadn't.
The above is just a flavour of the topics covered and questions asked. Judging by the crowds surrounding the
speakers afterwards, the session could have been twice as long and still have
had a captive audience.
One of the aims of the new "Diabetes National Service
Framework" is to make structured education available to all people with
diabetes. With accurate and reliable information people will be better able to
manage their condition and work more purposefully with health care professionals.
If you would
like more information or would like to attend a session, please contact Dr Kelshiker or any of the diabetes team at the surgery.
Ashok Kelshiker
Improvements to Childhood Immunisation Programme
Changes to this programme
have been announced by the Department of Health, following advice from the
Joint Committee on Vaccination and Immunisation
(JCVI). These changes are:
·
Using inactivated polio vaccine
(IPV) instead of live oral polio (OPV) vaccine for all ages. Due to the success of the global vaccination programme, polio has been eliminated from large parts of
the world, and the risk of infection in the
·
Using a new acellular
pertussis vaccine instead of whole cell pertussis vaccine to protect babies and children against
whooping cough. This new acellular pertussis vaccine
provides the same high level of protection but tends to cause fewer minor
reactions in children.
·
The new vaccines are also thiomersal free. This
meets the internationally agreed aim of reducing the exposure of children to
mercury if it can be avoided.
·
The new vaccines are combined so
that children will be able to receive them injection.
The new vaccines for primary, pre-school and teenage immunisation
will be introduced from late September this year. Parents and health professionals will be able to access information about
the changes to the routine programme on the new immunisation website:
www.immunisation.nhs.uk.
Malaria Prevention
Many people underestimate just how
dangerous malaria can be, but it is important that travellers
assess the risk of it in areas they are to visit.
Malaria is an infectious disease
caused by the Plasmodium parasite and depends upon both humans and mosquitoes
to maintain its deadly life cycle. It is carried from person to person by an
infected female mosquito, and all it takes to be infected is just one bite.
Malaria is one
of the major causes of death worldwide yet it can be both prevented and
treated. Each year between 300 and 500
million people will be infected, and more than a million will die from that
infection. It is not a seasonal disease
and the risk runs throughout the year.
In the
Air-conditioned
accommodation means that the mosquitoes are unlikely to enter the room as long
as it is working and windows are not opened.
It is not necessarily true that there is no risk if staying in large
cities or good quality hotels.
Where there is no air conditioning
rooms must be sprayed and mosquito coils burnt. If staying outside, mosquito
nets are essential, and should be treated with permethrin
and tucked into mattresses.
Ideally travellers should seek advice on an appropriate
anti-malarial several weeks before travelling. There
are several options available and choice will depend as much on individual need
as on destination and length of stay. Antimalarials are not available on an NHS prescription.
Proguanil and Chloroquine
are very effective in preventing malaria in certain malarious
regions, and are usually used together (or occasionally on their own) in areas
of lower malarious risk. Chloroquine 300 mg
is taken once a week and Proguanil 200 mg is taken daily.They should be started one week before travel, during
the holiday and forfour weeks after return home. They are available over the counter at most
pharmacies, and cost approximately £18 for a two-week holiday.
Mefloquine (Larium)
is a very effective antimalarial and 250 mg is taken
once weekly, starting usually two weeks before travel, during the holiday and
for four weeks on return home. The cost is
approximately £37 for a two-week holiday. It is not suitable for a child under
5 kg.
Doxycycline, although not licensed, is very
effective in preventing malaria. A dose
of 100 mg is started 1-2 days before travel, during the holiday and for four
weeks on return. The cost is £10 based on a two-week holiday. It is not
suitable for a child under 12 years.
Atovaquone with Proguanil
(Malarone) is very effective against Plasmodium Falciparum, the more serious strain of malaria. It is to be taken once a day starting 1-2
days before travel, during the holiday and for one week on return. The cost is approximately £42 based on a
two-week holiday.
As with all medication, there may be unwanted side effects, so it may be
necessary to change to an alternative and this can be discussed at a travel
consultation.
The risk of malaria exists long after return from
holiday, and the signs can easily be mistaken for flu, so it is important to
report any foreign travel when there is an unexplained fever. Most importantly of all is to
complete the antimalarial course after returning
home.
A useful
website address is www.malariahotspots.co.uk, or you can call The Hospital for
Tropical Diseases' Travellers' Healthline
on 09061 337733 for up-to-date travel health information (calls cost 50p per
minute).
Happy holidays!
Angela Bradley
******
STAFF CHANGES AT
ELLIOTT HALL MEDICAL CENTRE
Some sad goodbyes and a few welcomes
Dr Byers
finished his time at EHMC at the end of June after his concert and a joint
leaving/21st party with Laura, our Reception Co-ordinator
(details were on the website). Sister Alison Willis made the decision to return
to hospital work as a Nurse Practitioner at Northwick
Park A & E.
Dr Kleinberg
has been on maternity leave since late April but will be returning to work at
the end of October.
We are very pleased to report that Dr Naomi Vaughan, Dr Majus's registrar, is staying on at the practice as a
salaried doctor. Dr Manmeet
Sekhon (Dr Jenner's
registrar) has already joined us for a year's placement. Dr Majus
also has a new registrar starting - Dr Naziq Kausar (this is a
welcome back, as Dr Kausar was a PRHO at EHMC last
year!). In addition, Dr Kamran Ahmed has recently commenced a fourmonth placement as a PRHO under Dr Kelshiker's
tutelage.
There are also two new additions
to the Administrative Team - Gloria
Smith and Bhavini Popat joined
us in June. They have settled well and have been key
in changing our mail-handling system for the better.
Denise Lavey Practice Manager
Manmeet Sekhon
For those of you who haven't met me so far, I am the
new GP Registrar working for Dr Jenner. I started this post at Elliott Hall in August
and will be here for a year.
I qualified in 2001 from Madras Medical School (MMC) in
In 2001 I came to the
I am married to
a doctor who was in the same year at medical school, and he currently works in
General Practice in Ealing.
When not working I enjoy cooking, decorating, listening to music or just
relaxing and reading a book in the garden.
I am already impressed with the effort everyone at the surgery puts in
to deliver the highest standards of care for the community, and I look forward
to spending the rest of my time here and to making my best contribution.
Mary Taylor
As a nurse practitioner new to Elliott Hall, this
is my "compulsory" introduction.
I qualified in 1972 (which fits my status with a 7-year-old
granddaughter) but, despite the NHS, I am still very young at heart and
enthusiastic.
My initial years
of nursing were in theatres and, after marrying and starting my family - two
girls and a boy, now 27,1 7, and 25 respectively - changed direction to burns
and plastic surgery where I was involved for over 10 years at Stoke Mandeville
and Mount Vernon Hospitals. I really enjoyed this speciality
before deciding that a move to more sociable, non-hospital hours would be more
compatible with bringing up a family.
My most recent
13 years were spent as a Practice Nurse and then Nurse Practitioner in my local
surgery in Little Chalfont, working with two GPs and absolutely loving the job.
I gained my qualifications in family planning, asthma and heart disease, as
well as my degree.
I was really thrilled to have joined EHMC in March of this year and feel
I have begun to settle into the team well. I have really enjoyed my first few
months working here in Hatch End.