Microsoft word - practice leaflet a4 june 2009

30 Lockwood Road, Beverley. East Yorkshire. HU17 9GQ Telephone: (01482) 888690 Fax: (01482) 888689 Internet Site at Bsc MB ChB DA DCH DFFP MRCGP DFOM ADVDFOM The Surgery is open from 8am to 6pm Mon to Friday* ** Joint Rapid Access Clinic – where Doctor and Nurse work together operates on most Tuesday & Thursday mornings – Please ring to confirm. *Occasionally the surgery will close for the afternoon for staff training – details will Firstly, can I welcome you to the surgery on behalf of Dr Clayton and Dr Williams. We are a small practice with two part-time GP’s. We try very hard to provide a personal service with the emphasis on high quality clinical care. It is our aim to provide the best possible standards of service and care to our patients within the time limitations of the National Health Service; to be honest with you; to maintain our skill through regular training and to provide a welcoming and friendly service. Our current appointment system to see a doctor, requires patients to telephone the surgery from 8am on the day that an appointment is required in order to book an on the day appointment, it is not currently possible to make an appointment in advance. However, where medical circumstances dictate the doctor will call patients back for a review as required. Since we usually only have one doctor on duty at any one time there can be potential problems in achieving appointment times that suit patients with other commitments. Please be aware that this is a limitation of smaller surgeries. We accept that some of the larger surgeries offer more flexibility with this regard and therefore, we try to make it clear at the outset what our limitations may be. The catchment area of this practice is deliberately geographically small to ensure that we can provide appropriate clinical care to all our patients and our practice list is currently open to new patients from Lockwood Road estate, Rowan Avenue estate and Leconfield. We will endeavour to provide you and your family with excellent clinical care and we are always happy to receive feedback from you. About Us The Surgery premises were purpose-built in 1997 with the help of East Riding Health Authority. Particular attention was paid to providing good facilities for the elderly and disabled. There is a large, free car park and child – friendly waiting area. The Doctors Dr Guy Clayton (male) MBChB DA DCH DFFP MRCGP DFOM ADVDFOM Qualified in Manchester (UK) in 1989 Dr Dafydd Williams (male) BMedSci BM BS. Qualified in Nottingham (UK) in 1982. Special interests include care of patients with diabetes mellitus and sports injuries. The Nursing Team Rachael Byas (female) Nurse Practitioner - Monday, Tuesday & Thursday’s Wendy Stabler (female) Childhood Immunisations Nurse - Thursday 9am to 11am The District Nurses (Based at Manor Road Health Centre, Beverley) Sue Gridley (female) & Amanda Clark (female) - Community Staff Nurse The Health Visitors (Based at Manor Road Health Centre, Beverley) Pippa Dixon (female) The Midwife Alison (female) Friday 1.30 to 3.00 pm The Phlebotomist (Takes Blood Samples) Barbara Smith (female) Wednesday 8.30am to 12noon The Practice Manager John Ledger The Admin Team Ann – (Secretary / Receptionist), Mary – (Admin / Receptionist), Kathy, Mary, Pat and Vera (Receptionists) Alternative Practitioners (Private) Some alternative practitioners work from the surgery – for further details including charges and how to book their services please contact reception. How To Register As A Patient We accept new patients living in the practice catchment area and spouses / siblings of existing patients registered with another local doctor. Please bring your medical card (if you can find it) or simply pick up a registration for from reception. It is perfectly acceptable for members of the family to be registered with different surgeries. From 1 April 2004 you will be registered with the practice rather than an individual doctor. You have the right to express a preference to see a particular doctor and we will make every effort to comply with this request. How To Make An Appointment Please note that appointments can not currently be booked from the web site. To See the Doctor - Telephone the surgery after 8.00am on the day that you would like the appointment to see the doctor. We will endeavor to see all genuinely urgent cases on the same day, but need your cooperation (and honesty) to ensure these limited appointments are fairly allocated. Please note it is not currently possible to make an appointment in advance. The early morning surgeries are designed for those who have difficulty attending at other times, especially those who work full time. On Joint Rapid Access mornings (currently Tuesday & Thursdays – please telephone first to confirm) the nurse will triage all patients in the order that they arrive and refer through to the doctor where appropriate. To See the Practice Nurse, Phlebotomist or Midwife:- Telephone the surgery anytime between the hours of 8am and 6pm Monday to Friday to make an appointment. Appointment Times Telephone Advice Telephone advice can usually be given by the duty doctor between 11.30am and 12.30pm. You may be asked to phone back or leave a contact number. Alternatively, NHS Direct operates a 24 hour service on Tel: 0845 46 47 Repeat Prescriptions Repeat prescriptions can be requested by either ordering online over the internet from our website @ (then click on ‘order online’ on the left of the screen), completing the right hand side of your prescription and faxing to 01482 888689 or handing the repeat prescription slip in at the surgery. To order your repeat prescriptions on the internet you will need a registration form which has to be issued by the practice – please ask at reception. Please allow 48 hours before collection. These can be passed directly on to Molescroft pharmacy (the nearest), posted back to you (if you provide a stamped addressed envelope) or collected from the reception desk. Some items e.g. Calpol, head lice treatments and cold sore creams can be purchased over the counter from the pharmacy. Periodically you will be asked to attend for a medication review to ensure that your medications are still appropriate for your condition. Antibiotics are rarely prescribed over the telephone. Medication Reviews If you are receiving repeat medication you will be required to have a medication review every 6-12 months depending on the medication you are on. This is important, and to ensure that the medication is working correctly (or is not causing a reaction) and for the clinician to assess whether other medication is still appropriate for you. When your medication review is due, a reminder will show on your prescription counterfoil. Please make an appointment with the Practice Nurse. Important: If you do not attend a medication review when requested the practice may only produce weekly prescriptions until a medication review has been performed. In An Emergency Telephone (01482) 888690. Have a pen and paper ready out of hours and at weekends as our answer phone will provide details of the out of hours services currently in place. East Riding of Yorkshire Primary Care Trust, Health House, Grange Park Lane, Willerby. HU10 6DT. Tel:01482-650700 is responsible for the commissioning of the GP Out of Hours Service. Your call may be recorded and you may receive advice or be asked to attend the Local walk-in Centre at Westwood Hospital, Beverley. This service is closely monitored and should only be used in a genuine emergency. To ring the out of hours service directly Telephone 0845 056 8060. For Life Threatening Emergencies E.g. Severe breathing difficulties, choking unconscious patients and those possibly suffering a heart attack, please call 999 for an ambulance. NHS Direct Telephone: 0845 46 47 for 24 hour advice from NHS direct. Online: HELPING US TO HELP YOU Please respect the following ground rules: - Only one patient per appointment please - Most appointments are for a maximum ten minutes. Please ask for additional appointments if you have several problems - Surgeries may run late through no fault of the doctor or receptionist - Receptionists are not allowed to give priority to patients except for genuine medical reasons following discussion with the doctor - At busy times, demand for appointments may exceed supply - Please therefore, be courteous and patient with all of our staff. We Home Visits Home visits are almost exclusively reserved for the house bound, disabled and frail elderly, due to the extra time that these incur. If you do need a home visit, please phone the surgery before 10am and be prepared to give the receptionist as much detail as possible. The final decision to visit will be at the discretion of the doctor and can only be for medical reasons rather than convenience or transport difficulties. The Services We Offer New Patients Checks All new patients are encouraged to attend for a new patient check, usually with the practice nurse. This simple check enables us to summarise current and previous relevant health problems and organize appropriate follow up. It also provides us with an opportunity to get to know you. Please bring any vaccination details, along with a fresh sample of urine for testing. Antenatal Care Provided jointly by the doctors during normal surgery hours and by the midwife who runs a clinic on Friday from 1.30 to 3.30pm. Contraceptive Advice Is free, confidential and provided by all doctors and nurse practitioner during normal surgeries. Sexual Health Initiatives within General Practice – Health 4 U We participate in the Condom/Pregnancy Testing Scheme initiative developed to provide free condoms and pregnancy testing for the under 20’s We operate our own Health 4 U drop in clinic for young people combining free, friendly and confidential chat, general contraceptive advice, pregnancy testing, free condoms and advice and support to help quit smoking in association with CHUCK IT. Emergency Contraception Can be provided in the surgery up to 72 hours after unprotected intercourse and will normally be given a ‘Same day’ appointment. At weekends and Bank Holidays please contact the Out of Hours Emergency Doctors Service who can provide similar advice during normal pharmacy opening hours. Smears / Breast Examination Smears are usually undertaken by the Practice Nurse. A chlamydial swab may be offered at the same visit as an additional screening test for this silent and potentially serious infection. Travel Vaccinations inc. Malarial Avoidance Advice Can be discussed and planned with the practice nurse. You will need to pay for certain items. Please note we are NOT a Yellow Fever Vaccination Centre. Tetanus Vaccination Last for 10 years and should be kept up to date. A total of 5 in a lifetime are generally felt to offer long-term immunity. Flu Vaccines / Pneumonia Vaccinations These are generally recommended for the over 65’s (especially in residential or nursing home care), those with chronic lung, heart or kidney problems, diabetes or an absent spleen. Each Autumn the practice runs a flu campaign for ‘at risk’ patients. Child Health Clinics The Health Visitors team currently run a drop in clinic at Beverley Leisure Complex from 12 to 1pm on Fridays contact Jane Weatherston, Health Visitor on 01482 335067 or Cate Gillingwater, Community Development Coordinator on 01482 392534 for further information and other clinic times. Over 75 Checks These are offered to this age group on an annual basis with the doctor or practice nurse. Other Services Health Promotion and treatment of temporary visitors / tourists. Also high blood pressure, heart, asthma and diabetes clinics. Requests for non-NHS examinations / medical reports / form and certificate completion In line with other surgeries, we charge a fee as suggested by the BMA and displayed in the reception area. Confidentiality, Security and the Data Protection Act We are always careful to preserve patient confidentiality and keep all medical information as secure as possible. As a patient, you have certain rights with respect to the security of your medical records and any computerised data about you which is held by us; you also have certain rights of access to it - please ask for more details of this if necessary. As part of the provision of health care, we store and process patients’ medical records for all types of routine and emergency care. The processing of medical records may include administration, claiming and verification of NHS or other fees payable to the surgery, financial recording, audit, training and research. GP surgeries are obliged to exchange information about patients with other Health Departments and Government Agencies including certain statutory disclosures relating to infectious diseases. These may or may not be anonymous but for certain specific Health Service functions identifiable information is exchanged. The Data Protection Act gives patients certain rights to know what data is being exchanged and also to be excluded from some data exchanges (except statutory), including the anonymous ones. If you wish further details about any of these things, please ask to speak to the Practice Manager. Further details about local services: Details of primary medical services in this area may be obtained from East Riding of Yorkshire Primary Care Trust, Health House, Grange Park Lane, Willerby. HU10 6DT. Tel: 01482 650700. Medical Certificates for Illness The Law says that you can self certify your sickness absence for the first 7 days of illness. These forms are obtained from your employer or the local social security office. NHS Sickness Certificates are issued after the first 7 days and cannot usually be issued without a face-to-face consultation with the doctor. Sick notes also cannot usually be backdated. In A Bereavement 1) Telephone the doctor, who will need to confirm the death, and under certain circumstances may need to report the matter to the coroner 2) Collect death Certificate from hospital; 3) Take this to the registrar; 4) Take form to funeral director The Patient – Surgery Partnership Relies on mutual respect, goodwill and patience Please: - Cancel unwanted appointments - Treat all staff with courtesy - Accept there are time constraints on the NHS – we may not be able to offer an appointment at a convenient time for you We Cannot: - Offer home visits on demand - Accommodate excessive demands - Tolerate threats or abuse - Cure everything - Prioritize patients except for medical reasons - Be in two places at once - Under certain exceptional circumstances we reserve the right to remove patients from our list as a last resort. Help us to help you – We are human too! Miscellaneous Chaperones Chaperones are available if the doctor needs to perform an intimate examination. These save embarrassment for patients and protect both patients and doctors alike. Please ask if you have any questions or concerns. Training The practice may close on some afternoons per month to enable training and updating of staff. This enables us to keep up to date with the latest advances in the delivery of care. Emergency cover only will be provided on these afternoons. Students Occasionally students may be attached to the surgery to gain medical or work experience, whilst we are grateful for any input you feel able to give there is no obligation whatsoever to allow them to be present during a consultation. Students are bound by the same strict rules on confidentially as all of our staff. Complaints / Compliments Whilst we all endeavour to do our best, there are limits on the time and resources available within the NHS. A copy of our complaints procedure can be obtained from the reception, if you feel that our service has failed to match our aspirations. Compliments are also gratefully received and a suggestion box is located in the waiting room. The healthy limits on alcohol are 21 units per week in women and 28 units per week in men. One unit of alcohol equals half a pint of lager or beer, a small glass of wine or a single measure of spirits. Binge drinking in particular can cause liver damage and people under the age of 18 are particularly sensitive to this. Some patients have a particularly severe allergic reaction to certain substances e.g. peanuts or bee stings. If you do have a tendency towards any of these reactions, which include facial swelling or breathing difficulties, please do ask the Doctor for advice. We would recommend that you carry an emergency adrenaline pen and a Medic Alert or similar SOS bracelet informing others of your condition. Antibiotics can have many side effects including Thrush, Diarrhoea and occasionally allergic reactions that can be severe. Antibiotics will not treat all infections but simply those caused by bacteria. There is particular concern that “Super Bugs” should not be allowed to flourish by the inappropriate or excessive prescribing of antibiotics. Please therefore be aware that it may not be in your best interest to receive an antibiotic. We are pleased to offer further written information if required. Asthma is especially common in younger children any may present with a night cough only or wheezing with exercise. If you are treated with an inhaler, please ensure you have a regular check-up with the Practice Asthma Nurse to ensure you are using these correctly. Minor modifications to the inhaler techniques may make an enormous difference to symptom control. For asthmatic children, putting the soft toys which share the child’s bed and the pillow in the freezer once a week dramatically cuts down the number of dust mites they contain. It is also important to use the preventer inhaler and spacer device if prescribed. The peak flow meter gives a very good indication of asthma control. The best advice is to eat plenty of fresh fruit and vegetables, cut down on your fat intake, use low fat spreads and choose wholemeal bread instead of white. Drinking at least 2 pints of water per day, reducing your salt intake and not overcooking vegetables will also help (over cooking vegetables causes a huge loss of minerals and vitamins). Back pain is extremely common and can be avoided by lifting with a straight back and regular exercise eg. swimming, to keep the spine well supported by good muscles. Sciatica presents with electric shock type pains down the back of the legs. Other causes may simply cause localised spasm. Treatment with Paracetamol, local heat and massage may help. Seek help if the pain is not settling within a few days or if you develop any numbness or weakness of the lower limbs. Numbness around the groin, genitalia or back passage requires urgent advice. We advise ladies that they examine their breasts regularly for lumps and bumps. Women over the age of 50 should automatically receive appointments for Mammograms every 3 years. If you do feel a lump, seek help early. This is particularly important if there is a strong family history of breast cancer in an immediate relative. Fortunately, most breast lumps are entirely benign and reassurance is all that is required. Regular examination of yourself helps you to exclude normal breast tissue from abnormal lumps. Treatment – Apply large quantities of cold water to the affected area as soon as possible and maintain this for at least 15 minutes. Afterwards, apply a clean dry dressing and seek further help if there is evidence of blistering or persisting inflammation. Significant burns or scalds may require treatment in the Casualty Department. Most chest pains are entirely innocent however you should seek help for the following:- Severe crushing chest pains associated with feeling sick, unwell and sweating. This could signify heart problems and you should seek advice urgently or call an Ambulance by dialling 999. Sharp pains associated with coughing, shortness of breath or the coughing of blood. Early advice should also be sought for these especially if you are a young women on the oral contraceptive pill or have a swollen painful calf or leg. Innocent chest pains are generally sharp, short lasting and made worse by squeezing one particular side of the chest. If in doubt, please seek help. The main reason for testing blood cholesterol levels is to detect the approximately 1 in 500 people who suffer from particularly high cholesterol levels secondary to abnormal handling in the body of cholesterol. The people may have yellow elevated patches around the eyelids and / or a strong family history of heart disease in close family members before the age of 55 years old. The vast majority of us have levels which hover around the normal range and can be improved by lowering saturated fat in the diet, increasing intake of fish and considering modifying margarine intake from the usual type to either Benecol or Flora Activ. Those with diabetes, established heart disease, a family history of very high cholesterol levels or high blood pressure tend to be monitored more closely, and tablets can be commended if their cholesterol levels are too high. Unfortunately there is no magic cure for the common cold which usually presents with a running nose, high fever and joint aches. Clear fluids, regular Paracetamol and rest should generally cause the symptoms to settle over 48 hours. Antibiotics will not have any affect on a viral infection. It is vitally important that any sexually active woman is using reliable contraception. This is particularly important for younger people who are extremely fertile. Advice can be given by the Doctor, Nurse or at the Family Planning Clinic locally. All advice is entirely confidential. You can ask for emergency contraception within 72 hours of unprotected intercourse. The use of additional condoms may also significantly reduce the risk of sexually transmitted infections including HIV. If in doubt, please do not be afraid to ask. This is extremely common and usually down to a diet lacking in fibre or enough clear fluids. If the history of constipation is short, extra fluids, Lactulose and an increased fibre intake will normally clear the problem. Seek help if the constipation persists for more than 2 weeks or is associated with abdominal pains, bleeding from the bottom or a loss of weight. Rectal bleeding in particular should always be assessed by a Doctor to exclude more sinister cause. Offensive diarrhoea associated with colicky abdominal pains is a common feature of gastroenteritis. This is usually viral in nature and self-limiting. Try to replace the fluid loss by drinking large quantities of clear fluids. Flat lemonade or coca-cola (the full sugar version!) when diluted 50/50 with water make a palatable alternative to the rehydration salts e.g Dioralyte. Milk is best avoided for at least 24 hours. Seek advice if the patient is particularly unwell, passes blood in the motions, has constant rather than colicky abdominal pains, is becoming lethargic or dehydrated or seems not to be improving with fluids alone. Vomiting commonly accompanies the diarrhoea of gastroenteritis but when present by itself, may represent other illnesses. Seek advice in any particularly unwell patient presenting with persistent vomiting. Earache is particularly common in younger children and is usually caused by a self-limiting viral infection of the middle ear. Give the child Paracetamol suspension and wait 1 – 1½ hours. Antibiotics will only cure a small proportion of these infections since most are viral. Seek help if either the symptoms persist, the child becomes unwell or there is profuse discharge from the ear. This is extremely common, especially in young children. The condition is caused by a tendency to dry skin, which can be aggravated by the excess use of soaps or contact with chemicals. Reduce bathing to 2 or 3 times per week and use regular emollients rather than soap. Steroid creams can be used for short periods only but can damage the skin in long-term use. Occasionally, a low-grade infection can cause particularly resistant patches. If in doubt, please ask for advice, as eczema is one of the easier skin conditions to treat. High temperatures in children are not necessarily associated with significant underlying infections. If your child is hot, remove the outer clothing and consider tepid sponging of the skin. As a rule of thumb, a child should be much happier 1½ hours after a full dose of paediatric paracetamol (Calpol or Disprol). Even very high temperatures should respond well to this. If you have any concerns, especially in very lethargic children, children who vomit repeatedly, have offensive urine, are panting for breath or have any purple spots at all on the skin (which do not blanch with light pressure from a clean glass) then seek medical advice quickly. In order to avoid deep vein thrombosis, it is advised that patients drink plenty of non-alcoholic drinks when flying, move the legs frequently to keep blood pumping around them and if possible walk up and down the plane corridor at least once per hour. Provided that you do not suffer from allergies, stomach ulcers or medication induced asthma, taking a junior aspirin once daily for 2 days before the flight may also help to reduce the incidence of clots. Children should not take aspirin under the age of 16. If in doubt, please ask the Doctor or Pharmacist. High blood pressure is extremely common and very easy to treat. It may present with no symptoms at all and we would recommend that all patients have their blood pressure routinely checked at least once every 2 or 3 years. If you are diagnosed with high blood pressure, it is particularly important you have this checked every 3 to 4 months with the Practice Nurse and see the Doctor annually. Losing weight, reducing the salt in your diet and exercising regularly can all help to reduce your blood pressure however please do not stop any medications prescribed without the agreement of the Doctor treating you. These tiny creatures prefer clean heads and are therefore not a sign of poor hygiene. Previously medicated head lotions were used but now it is generally accepted that regular combing with a special nit comb is safer and cheaper. Please ask the Pharmacy for advice if you have concerns. Please be aware that many young people will be approached by someone selling illicit drugs. Many can be extremely dangerous and it is important that anyone taking drugs is well aware of the potential dangers. If you have concerns about yourself or your family taking drugs, please ask for advice. We would recommend that all parents discuss the dangers of drug use With their children from an early age as openly and frankly as possible. You may be embarrassed to discuss this subject but your Doctor won’t be ! Please do seek help if you are having difficulties, whatever your age. Bee stings should be scraped away rather than plucked from the site in order to avoid squeezing the contents of the venom sac into the wounds. Antihistamine tablets can reduce the inflammation and Paracetamol generally relieves the pain. Seek help if the patient develops any breathing difficulty or tongue swelling shortly afterwards. Wash the wound thoroughly with clean water and soap if there is likely to be contamination. Press a clean dry dressing on the wound for around 5 minutes if there is residual bleeding. Afterwards cover with a clean dry dressing. If the wound is gaping, seek further advice. The elderly may sustain flap lacerations of the shins, which will need assessing in the Casualty Department. Sit the patient in a chair, leaning forward slightly with the mouth open. Pinch the nose just below the bone for approximately 10 minutes by which time the bleeding should have stopped. If symptoms persist, please consult your Doctor or the Casualty Department. Please seek help with any of the following:- Burning on passing urine, blood in urine, bedwetting at any age, any type of incontinence including with coughing and sneezing or difficulty in passing a good stream of urine in older men especially. A blood test is available to test for one of the markers of potential prostate cancer. Use of this test is controversial but is available on request. It is particularly useful for men over the age of 50 with a family history of either breast or prostate cancer in an immediate relative. This test may also be performed if you notice blood in the urine or note difficulty in passing urine. A poor stream of urine and frequently needing to get up at night time to pass urine are reasons to see your family doctor. Further information leaflets on this are available at the surgery. Most rashes are very minor in nature and self-limiting. The exceptions include purple, bruise like rashes, particularly in hot and unwell patients. Blistering rashes may also cause concern. If the rash is pink, blanches easily on light pressure e.g with a clean glass, and the patient is very well, no further action need be taken. Some of these rashes are caused in association with viral illnesses. If the rash appears within 2 weeks of an antibiotic, please inform the Surgery in case a drug allergy is the cause. Bleeding from the back passage generally does require assessment from a doctor. In the vast majority of cases, the cause is a simple haemorrhoid or tear around the anal region following constipation. This type of bleeding tends to be bright red and on toilet paper. Rectal bleeding associated with a change in bowel habits, occurring on several occasions or mixed in with a motion passed are all reasons to seek further help especially if there is a family history of bowel cancer or inflammatory bowel disease in a near relative below the age of 50. Patients’ main fear is of bowel cancer and although a significant condition, an early diagnosis results in a very high cure rate. Please therefore ask early rather that fret at home! Most moles are entirely innocent but you should report any enlargement, itching or bleeding in a mole. Keep covered up in the sun or use a high factor sun cream, especially for children and those with fair skin. Most sore throats are caused by a viral infection and will settle without treatment. Seek help if the patient is particularly unwell, for example with shivering and swollen neck glands. A small proportion of throat infections will respond to the treatment with an antibiotic if symptoms are persisting for more than 48 hours, but these are not given routinely as inappropriate use can cause many additional problems including the development of “super bugs” and allergies. Best avoided by wearing a baggy tee shirt and hat that covers the back of the neck particularly. Treat as other burns with cold water to remove the heat. Calamine lotion can relieve the irritation and paracetamol acts as a good painkiller. Children particularly are susceptible to skin damage and care should be taken to avoid over exposure to the harmful effects of the sun. Seek advice if you have any doubts. Each cigarette you smoke is estimated to reduce your lifespan by approximately 5 ½ minutes. Smoking can also cause impotence, lung cancer, bronchitis, heart disease, facial cancers and loss of limbs. Motivation is very important and help can be obtained from the Practice Nurse, Health Visitor or Doctor. For some patients, Zyban or Nicotine Replacement patches can be used successfully. Using the money saved for treats can be more effective. Two foreign holidays a year may compensate for the loss of enjoyment of smoking ! We would advise all young men in particular, to check their testicles regularly for any change in size, texture or specific lumps. These may be entirely symptom free otherwise. If in doubt, please ask for further help. We would recommend a regular check-up eg. on a monthly basis in the bathroom! If you have flu-like symptoms and have recently returned from Mexico or another affected area, or been with someone who has, stay at home and contact your GP or NHS Direct on 0845 4647. Do not go into your GP surgery, or to a hospital, as you may spread the disease to others. Remember, preventing the spread of germs is the single most effective way to slow the * Ensure everyone washes their hands regularly with soap and water * * Use tissues to cover your mouth and nose when you cough or sneeze * Place * You can also prepare now in case the swine flu becomes widespread by: * Establishing a network of ''flu friends'' - friends and relatives - who can help if you fall ill. They could, for example, collect medicines and other supplies for you, so you * Having a stock of food and other supplies, including basic cold remedies, available at home. This should be enough to last two weeks, in case you and your family are ill. Patient Information Leaflets are available from the link on our website @


Microsoft word - 540.docx

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