CLINICS AND SERVICES

CONTRACEPTION

All the doctors provide family planning services in normal surgeries. The practice nurses are trained to give family planning advice and information is also available to take away in the form of leaflets. IUDs (Mirena) and IUCDs (coils) need to be discussed with your doctor before making an appointment. Special longer appointments are reserved for those with the doctors who fit them. Dr Mah also fits Implanons and an appointment needs to be made with him for this. FOR URGENT ADVICE FOR THE MORNING AFTER PILL PLEASE ASK TO SPEAK TO A DOCTOR OR NURSE. This should be obtained on the next working day. The practice nurses hold a "drop-in" emergency contraception clinic every weekday between 4.00 - 4.30pm which can be attended without appointment whether the patient is registered at Balmoral or elsewhere. Please notify the receptionist on arrival. At present free condoms are not available via the surgery but can be obtained from the Family Planning clinic in Dover Health Centre on:

Tuesday 2nd and 4th week in the month 6.00 - 8.30pm Wednesday weekly between 9.00 - 11.00am Thursday Weekly between 6.00 - 8.30pm

Appointments to be made during clinic hours.

Choices 4 Young People

Monday 4.00 - 5.30pm at Deal Community Clinic.

Pre-pregnancy Advice

If you are planning a pregnancy it is important to be healthy and to eat well. Include foods containing folic acid (mainly green vegetables) and take folic acid supplements available without prescription at pharmacies, health food shops and supermarkets. A prescription is not needed as this can be bought over the counter at the chemist from before conception until the twelfth week of pregnancy. The doctors are happy to see you for further pre-pregnancy advice before you become pregnant.

CLINICS

In the surgery:- Antenatal Asthma Diabetic Weight Management Travel Advice Smoking cessation Elsewhere:- Skips (Prescription for fitness) at Tides Leisure Centre Smoking cessation at local pharmacies

Flu Vaccinations

We offer flu vaccinations from September every year. These are for people aged 65 years and over and anyone suffering from heart or kidney disease, diabetes, asthma, COPD, immunosuppression and those in residential care.

Appointments can be made at reception from the beginning of September.

Tooth Problems

We are not dentists! If you have a problem with your teeth eg toothache or an abscess then it is your dentist you need to see. If you are registered with a dentist, check how to obtain emergency treatment. There is now an emergency dental clinic at Kent and Canterbury Hospital (01227 766877) and QEQM, Margate (01843 225544).

We do not become dentists at night! If you have difficulty in finding a dentist ring the Primary Care Trust on 01227 795050.

Sexually Transmitted Diseases Clinics (Helpline 01303 228808)

William Harvey Hospital, Ashford 01233 633331 Thurs 9.30am - 12 noon Men and Women Kent and Canterbury Hospital, Canterbury (Outpatient Department, Annexe of Clinic B) 01227 766877 Mon 2.00 - 4.00pm Women Tues 2.00 - 4.00pm Women Wed 2.00 - 4.00pm Men Thurs 1.30 - 4.00pm Men and Women Folkestone, Foord Road Clinic 01303 58286 Tues 9.30 - 11.30am Men and Women 2.00 - 4.00pm Men and Women Wed 9.30 - 11.30am Men and Women Dover Health Centre 202525 Wed 2.00 - 4.00pm Men and Women (No appointment necessary)

NHS HEALTH CHECK

The Government has introduced an NHS Healthcheck for all patients aged between 40 and 74. Patients registered with Balmoral Surgery will receive an invitation to attend at the practice on a rolling programme within the next five years in the year that their age ends in a 0 or a 5 or they are 74. Patients who are already receiving care for a vascular related problem or who have already had tests done that would be performed at this healthcheck will not be invited.

Any patient registered at Balmoral who has not had a consultation with a clinician here for three years, is welcome to ask for an appointment to see a healthcare professional for a routine check up.

CHILD HEALTH

The practice runs its own child health clinics and immunisation service. Eight week health checks are conducted at the surgery and appointments are sent automatically. Subsequent checks are arranged via the health visitors who can be contacted on 01304 865460. Immunisations are given by the practice nurses at the surgery. The current schedule for immunisation is set out below. It is very important that you have your child immunised for their own safety. Serious reactions to vaccines are very rare and far less common than serious reactions to the diseases they help prevent.

8 Weeks Diphtheria, tetanus, pertussis, polio, Hib and pneumonia 12 Weeks Diphtheria, tetanus, pertussis, polio, Hib and meningitis C 16 Weeks Diphtheria, tetanus, pertussis, polio, Hib, pneumonia and meningitis C 12 - 13 months Hib, meningitis C, pneumonia and MMR (measles, mumps and rubella) 3.4 - 4.5 years (Pre-school) Diphtheria, tetanus, pertussis, polio, MMR and Hib (this may vary depending upon recommendations) Before leaving school Diphtheria, tetanus and polio

THE SICK CHILD

It is often difficult to know when to seek help about a poorly child, especially your first. Here is some general advice we hope is helpful. There are no hard and fast rules and if in doubt speak to your doctor or health visitor or NHS Direct.

In general, a child who is drinking, happily playing or watching television is unlikely to have anything seriously wrong. Your child will not be made worse by being brought to the surgery.

Children whose parents smoke have more coughs, chest and ear infections than those whose parents don’t. Babies should not be placed on their stomachs in the cot and if unwell should be kept in the parents' room at night. A child with a temperature should have clothing reduced until cool and (if over three months) given paracetamol syrup (Calpol or Disprol).

Important symptoms are a refusal to drink, a faster rate of breathing, persistent stomach pains or vomiting, neck pain or stiffness, unusual drowsiness. It is important to note that in small babies an illness can develop quickly without the above and persistent crying or refusal of food, if the child appears unwell, should lead you to contact the doctor.

Earache will usually settle with paracetamol or ibuprofen (Nurofen for children) but if associated with a fever or persisting for several days this should lead you to come to the surgery. Earache is not an emergency though it is distressing with no magic answer.

MENINGITIS

Meningitis is a rare but serious disease caused by a variety of different germs.

Bacterial meningitis can come on very quickly. The symptoms are a very ill looking child (or adult) with a severe headache, neck pain or stiffness which is made worse by bending forwards, light hurting the eyes, vomiting, drowsiness, confusion or a rash like a little blood blister or bruise which does not fade on pressing. If you suspect meningitis contact the doctor straight away. A child with a headache without the above symptoms should initially be treated with paracetamol. Close contacts of proven bacterial meningitis will often be contacted by the public health department. Contacts of contacts who are not ill are not at increased risk.

Immunisation can prevent some forms of this disease.

INFECTION CONTROL

The practice takes the risks of cross-infection very seriously. If you feel that you may have an infectious condition please let the staff know so they can make arrangements to limit the risks of spreading. Most cross-infection including flu and respiratory conditions are dramatically reduced by simple hand-washing with soap and water.

MINOR SURGERY

All the doctors are registered for this and usually carry out minor operations at the Surgery.

OCCUPATIONAL HEALTH

Vaccines for occupational health purposes, such as Hepatitis B, are normally provided by the employer’s occupational health service.

REFERRAL TO HOSPITAL

If your doctor feels you need to be seen in a hospital, you will be offered a choice of where you are seen. This will be the various local hospitals and further afield and also includes the NHS-funded private sector services. Access to choice may be made when you discuss the referral with your doctor, or via Choose & Book, telephone or computer systems.

DEAL HOSPITAL

We are fortunate in Deal in that we have most services available at our local hospital where many outpatient clinics are held in most disease areas, as well as x-ray, physiotherapy, minor surgery, day-case surgery and inpatient beds.

HOSPITAL TRANSPORT

The practice is unable to arrange hospital transport to outpatient appointments. If you think you are eligible and require this transport you should contact the Eastern and Coastal Kent PCT on 01303 852791. The criteria for patient transport are very strict and determined purely on medical need. There is also a volunteer-run hospital car service for which a charge is made.