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Long Term Conditions

We are improving the way we work with patients with long-term conditions 

Patients living with certain long-term conditions will be encouraged to attend a Yearly Health Check. Long-term conditions are those that impact over a long period of time, such as diabetes and heart diseases. 

Patients will receive personalised care and support from healthcare professionals from their general practice. This will cover things that patients say matter most to their health and wellbeing, from the best treatment for their condition, to wider things like employment, housing, and mental health. 

Our goal is that by planning care together with care, patients will have the confidence to manage their health, reduce their risk of being admitted to hospital, and have a better quality of life.

Who is this for? 

Initially, we will cover nine long-term conditions: 

  • Cardiovascular disease (for example, strokes, health failure, ischaemic heart disease, and peripheral artery disease) 
  • Diabetes 
  • Hypertension (High blood pressure) 
  • Hyperlipidaemia (High cholesterol) 
  • Non-alcoholic fatty liver disease 
  • Atrial fibrillation 
  • Chronic kidney disease 
  • Asthma 
  • Chronic obstructive pulmonary disease. 

In the future, we will look to expand this to cover more long-term conditions.

Non-urgent advice: What can you expect? 

If you have one of the long-term conditions listed above, you will be encouraged to have at least three check-ins per year. Each stage is described below for you: 

1. Attend your Check and Test Appointment 

In your Check and Test Appointment, a health professional will carry out all the checks and tests you need to monitor and manage your long-term condition. You may be sent for a blood test and have other checks like a blood pressure check and weight check. We may discuss lifestyle factors such as smoking and exercise with you too. 

If you need an interpreter, please let us know so we can arrange one for your appointment. 

2. Receive your test results and your Care Plan 

After two to four weeks, you will receive your test results (by post, text, or email, however you prefer). 

We will also send a blank document called a Care Plan. 

A Care Plan is an agreement between you and your healthcare professional to help manage your health and support day to day. In your Care Plan, you can record things that are important to your health and wellbeing. This can include anything from your life, like employment, housing, or mental health. 

A Care Plan covers: 

What is important to you and the goals you have 

How to get the most out of your medication 

The care and support you need from others 

A healthcare professional will review your Care Plan with you in your Discussion Appointment. You can start filling out your Care Plan before your appointment or you can fill it during your appointment. 

3. Attend your Discussion Appointment 

You will then be invited to a Discussion Appointment with a healthcare professional. This may be another team member (such as a nurse, health care assistant, pharmacist, social prescriber link worker) who is best placed to support your care and can spend more time with you. This appointment will take around 30 minutes. 

You can discuss your long-term conditions, test results, treatment, and anything else that is affecting your health, from housing to employment. Together we will look at what matters most to you and agree some goals. Your Care Plan will be updated with what has been agreed. 

4. Attend your Follow-Up Appointment 

Three to six months later, you will be invited to a Follow-Up Appointment. This will last up to 15 minutes and is an opportunity to update your Care Plan with a healthcare professional, considering what is going well and where you may need more support. You may have more than one Follow-Up Appointment in a year. 

Watch the short film below to see an example of a patient’s journey through the key stages of the process and help you understand what to expect from your Yearly Health Check. 

How will I be contacted if this is for me? 

We will contact you via text, phone call, or letter to organise your appointments. We will contact patients over the year so please do not worry if you do not hear from us right away. If you are concerned or have questions, please contact us.

Ante Natal Checks

What is antenatal care?

This is the care you receive while you’re pregnant to make sure you and your baby are as well as possible.

The midwife or doctor providing your antenatal care will:

  • check the health of you and your baby
  • give you useful information to help you have a healthy pregnancy, including advice about healthy eating and exercise
  • discuss your options and choices for your care during pregnancy, labour and birth
  • answer any questions you may have

If you’re pregnant in England you will be offered:

You may also be offered antenatal classes, including breastfeeding workshops.

Ask your midwife about classes in your area.

Starting antenatal care

You can book an appointment with your GP or directly with your midwife as soon as you find out you’re pregnant.

Your GP surgery or a children’s centre can put you in touch with your nearest midwifery service.

You can find your nearest children’s centre through your local council.

It’s best to see a midwife or GP as early as possible to get the information you need about having a healthy pregnancy.

Some tests, such as screening for sickle cell and thalassaemia, should be done before you’re 10 weeks pregnant.

If you have special health needs, your midwife, GP or obstetrician may take shared responsibility for your maternity care.

This means they’ll all be involved in your care during pregnancy.

Let your midwife know if you have a disability that means you have special requirements for your antenatal appointments or for labour.

If you do not speak English, tell your midwife.

How many antenatal appointments will I have?

If you’re expecting your first child, you’ll have up to 10 antenatal appointments.

If you have had a baby before, you’ll have around 7 appointments, but sometimes you may have more – for example, if you develop a medical condition.

Early in your pregnancy, your midwife or doctor will give you written information about how many appointments you’re likely to have and when they’ll happen.

You should have a chance to discuss the schedule of antenatal appointments with them.

If you cannot keep an appointment, let the clinic or midwife know and rearrange it.

Where will I have my antenatal appointments?

Your appointments can take place at:

  • your home
  • a Children’s Centre
  • a GP surgery
  • a hospital

You’ll usually go to the hospital for your pregnancy scans.

Antenatal appointments should take place in a setting where you feel able to discuss sensitive issues, such as domestic abuse, sexual abuse, mental health problems or drugs.

To make sure you get the best pregnancy care, your midwife will ask you many questions about your and your family’s health, and your preferences.

Your midwife will carry out some checks and tests, some of which will be done throughout your pregnancy, such as urine tests and blood pressure checks.

The results may affect your choices later in pregnancy, so it’s important not to miss them.

Your midwife will also ask about any other social care support you may have or need, such as support from social workers or family liaison officers.

These are carried out by our GPs and is a shared care service with the midwife at the hospital.

Alcohol Advice & Counselling

We provide specialist treatment across two sites to anyone over the age of 18 living in Enfield who is worried about their alcohol or drug use.

Contact details

Address:
Claverings
12 Centre Way
Edmonton
London
N9 0AH

Tel: 020 8379 6010
Manager: Serena Mccabe

You can visit our Claverings site for a face to face discussion without an appointment Monday – Friday between 10am – 4pm.

Address:
Vincent House
2e Nags Head Road Ponders End
EN3 7FN

Tel: 020 8379 4909
Manager: Serena Mccabe

Our Vincent House site is an appointment only service.

Who we are

Enfield alcohol and drug service provides a range of clinical, therapeutic and recovery interventions across two sites.  The majority of our clinical interventions delivered from our Clavering Site, with Vincent House providing a wide range of therapeutic and recovery focused interventions.

What we offer

We will help to reduce or stop your drug and alcohol use by:

  • Substitute prescribing and community alcohol detoxification for opiate users
  • Using community alcohol detoxification
  • Giving you access to a range of group programmes and workshops to help you make positive changes in your life
  • Providing access to funded treatment for detox, residential rehab or structured day programme

We can help to improve your health with:

  • Our nursing team who can provide health and wellbeing sessions
  • Testing and vaccination for blood borne viruses
  • Workshops and activities to improve your health and wellbeing
  • Complementary therapies

We can help to improve your relationships by providing:

  • Support for carers, friends and family
  • A specialist team that can support you around parenting and the impact of your substance misuse may be having on your children
  • Support for people experiencing domestic violence

We can help you to build support networks through:

  • Access to education and training opportunities
  • Support with benefits, housing and welfare
  • Volunteering and peer mentoring programs

Who the service is for

Enfield drug and Alcohol service will accept referrals from individuals, family members and friends experiencing problems with drugs or alcohol. We also accept referrals from other professionals. We are open to anyone living in Enfield and is aged over 18.

How you can access our service

There are a number of ways that people can access the service

Telephone – you can self-refer by calling 020 8379 6010. A recovery worker who will complete a brief assessment to help identify which of our services will best support your needs.

Email – email us at beh-tr.enable@nhs.net and one of our recovery workers will contact you within one working day.

Drop in – visit our Clavering site for a face to face discussion without an appointment on a Monday to Friday between 10am – 4pm.

Referral – we accept referrals from any professional, contact the service on 020 8379 6010.

Asthma Clinic

For patients who are due an annual asthma review (annually)

Please would you answer the questions by clicking on this link: https://www.asthmacontroltest.com/

Please complete the questionnaire and email this to us prior to your appointment or bring in a hard copy if its easier.

If your symptoms are deteriorating or you have any concerns, please make an appointment to the practice nurse or in house pharmacist who can review your asthma.

For inhaler technique videos for your specific inhaler please see: https://www.asthma.org.uk/advice/inhaler-videos/

Staying safe during Travel & Travel Vaccinations

Travel Vaccinations

If you require any vaccinations relating to foreign travel:

Please ensure you give us at least 6 weeks notice if this is not the case you may not be best protected and vaccinated before your travels.

You will need to complete a Travel questionnaire (also available at reception) and return the form to reception,  this can be emailed in too. Your destination(s) with details of areas within countries that you are visiting, length of stay at each location and your contact details (including your email address).

The reception team will contact  you and will book you in with the practice nurse having checked your immunisation records we hold, if you feel we may not have all of your records, please send this through at the same time of the sending in your travel questionnaire form so this can be updated onto your immunisation records.

There is further information about countries and vaccinations required on https://www.travelhealthpro.org.uk

It is important to contact us at soon as possible before you travel as some vaccines have to be ordered as they are not stock items.

Some travel vaccinations are ordered on a private prescription and these incur a charge over and above the normal prescription charge. This is because not all travel vaccinations are included in the services provided by the NHS.

Anti malarials can no longer be given on NHS Prescription

Recent changes in Southwark mean that unfortunately GPs can no longer prescribe malaria prevention medicines for travel on NHS prescriptions, but can do so on private prescriptions. Please contact us for charges.

For more information such as malaria, travel vaccinations, EHIC, travel insurance, DVT and jet lag see: https://travelhealthpro.org.uk/countries

 

 

Despite many people being fully vaccinated and some pandemic restrictions being lifted, it is still possible to catch and spread Covid-19. Here are some tips to keep as safe as you can whilst travelling and away on your holiday; continue to wash your hands often and wear your masks indoors where the virus is circulating widely.

Pneumococcal Vaccines

Who should have the pneumococcal vaccine?

There are 4 groups of people who are advised to get vaccinated against pneumococcal infections:

  • babies
  • people aged 65 and over
  • anyone from the ages of 2 to 64 with a health condition that increases their risk of pneumococcal infection
  • anyone at occupational risk, such as welders

Babies and the pneumococcal vaccine

Babies are routinely vaccinated with a type of pneumococcal vaccine known as the pneumococcal conjugate vaccine (PCV) as part of their childhood vaccination programme.

Babies are usually given the PCV at:

  • 12 weeks old
  • 1 year old

Adults aged 65 or over and the pneumococcal vaccine

If you’re 65 or over, you should be offered a type of pneumococcal vaccine known as the pneumococcal polysaccharide vaccine (PPV).

This one-off vaccination is very effective at protecting you against serious forms of pneumococcal infection.

People with health problems and the pneumococcal vaccine

The PPV vaccine is available on the NHS for children and adults aged from 2 to 64 years old who are at a higher risk of developing a pneumococcal infection than the general population.

This is generally the same people who are eligible for annual flu vaccination.

You’re considered to be at a higher risk of a pneumococcal infection if you have:

Adults and children who are severely immunocompromised (including anyone with leukaemia, multiple myeloma, genetic disorders affecting the immune system, or after a bone marrow transplant) usually have a single dose of PCV followed by PPV.

Welders and metal workers and the pneumococcal vaccine

Some people with an occupational risk are advised to have the pneumococcal vaccine, including those who work with metal fumes, such as welders.

Booster doses of pneumococcal vaccine

If you’re at increased risk of a pneumococcal infection, you’ll be given a single dose of the PPV vaccine.

But if your spleen does not work properly or you have a chronic kidney condition, you may need booster doses of PPV every 5 years.

This is because your levels of antibodies against the infection decrease over time.

Ask your GP surgery if you think you should have the pneumococcal vaccine booster. A GP will then decide if you should have it.

What to do if you miss a dose of pneumococcal vaccine

If you or your child has missed a routine dose of pneumococcal vaccine, speak to your GP surgery about when you can complete the course.

6-8 Week Baby Check

PHYSICAL CHECKS ON YOUR BABY

Your baby will have been given a complete physical check during his first 72 hours. Many of these checks are repeated again at the 6-8 week check to make sure that all is well with your baby’s development.

Your healthcare professional will explain what the checks are for and will tell you if there is any cause for concern. Your baby will have the following checked:

  • Head circumference and length
  • Fontanelle (soft spots on the head)
  • Mouth and palate
  • Heart and lung sounds
  • Groin pulses
  • Abdominal organs and belly button
  • Genitals (in boys to make sure the testicles have descended)
  • Feet, spine and hips
  • Ears and eyes
  • Reflexes

HEARING TESTS

By 4-5 weeks old, your baby’s hearing should have been checked. Sometimes this happens before you leave hospital, otherwise the test should be given no later than five weeks after the birth.

If for any reason your baby hasn’t had a hearing test you should ask for an appointment for one now.

 

You should have your postnatal check 6 to 8 weeks after your baby’s birth to make sure you feel well and are recovering properly. The baby checks are carried out by our GPs when the baby is 8 weeks old, we usually book this appointment just before your baby has their first 8 week immunisations, so you can do this all on the same day. The GP will also carry out a post natal check for the mother after the baby check.

From the time he’s born your baby will be offered a number of health checks, designed to monitor your child’s health and development.

The first health check is normally within 72 hours of the birth which is followed by a further check at between six and eight weeks of age.

Your baby may be examined at the same appointment as the mothers postnatal check/ when the baby has their first immunisations.

When you go, remember to take your Personal Child Health Record (also known as the ‘Red Book’) with you as your healthcare professional will need it. 

If you have concerns about your baby at any time you should always contact your health visitor or GP.

NHS Health Check Clinics (40-74 year olds)

The NHS Health Check programme is for all adults aged 40 to 74.

It assesses their risk of heart diseasestrokekidney diseasediabetes and dementia every 5 years.

These will be done by the health care assistant.

Cervical Smears

Done by the female practice Nurses

  • Cervical screening (a smear test) checks the health of your cervix. The cervix is the opening to your womb from your vagina.
  • It’s not a test for cancer, it’s a test to help prevent cancer.
  • All women and people with a cervix aged 25 to 64 should be invited by letter.
  • During the screening appointment, a small sample of cells will be taken from your cervix.
  • The sample is checked for certain types of human papillomavirus (HPV) that can cause changes to the cells of your cervix. These are called “high risk” types of HPV.
  • If these types of HPV are not found, you do not need any further tests.
  • If these types of HPV are found, the sample is then checked for any changes in the cells of your cervix. These can then be treated before they get a chance to turn into cervical cancer.
  • You’ll get your results by letter, usually in about 2 weeks. It will explain what happens next.

When you’ll be invited for cervical screening in England

AgeWhen you’re invited
Under 25Up to 6 months before you turn 25
25 to 49Every 3 years
50 to 64Every 5 years
65 or olderOnly if 1 of your last 3 tests was abnormal

You can book an appointment as soon as you get a letter.

If you missed your last cervical screening, you do not need to wait for a letter to book an appointment.

How cervical screening is done

  1. You’ll need to undress, behind a screen, from the waist down. You’ll be given a sheet to put over you.
  2. The nurse will ask you to lie back on a bed, usually with your legs bent, feet together and knees apart. Sometimes you may need to change position during the test.
  3. They’ll gently put a smooth, tube-shaped tool (a speculum) into your vagina. A small amount of lubricant may be used.
  4. The nurse will open the speculum so they can see your cervix.
  5. Using a soft brush, they’ll take a small sample of cells from your cervix.
  6. The nurse will close and remove the speculum and leave you to get dressed.

During cervical screening a small sample of cells is taken from your cervix for testing.

The test itself should take less than 5 minutes. The whole appointment should take about 10 minutes.

It’s usually done by a female nurse or doctor.

Before starting, they should explain what will happen during the test and answer any questions you have.

When your results should arrive

The nurse or doctor will tell you when you can expect your results letter.

If you have waited longer than you expected, call your GP surgery to see if they have any updates.

Information:

Try not to worry if it is taking a long time to get your results letter.

It does not mean anything is wrong, and most people will have a normal result.

What your results mean

Your results letter will explain what was tested for and what your results mean.

Sometimes you’ll be asked to come back in 3 months to have the test again. This does not mean there’s anything wrong, it’s because the results were unclear. This is sometimes called an inadequate result.

Human papillomavirus (HPV) is not found in your sample

Most people will not have HPV (an HPV negative result).

This means your risk of getting cervical cancer is very low. You do not need any further tests to check for abnormal cervical cells, even if you have had these in the past.

You’ll be invited for screening again in 3 or 5 years.

HPV is found in your sample

Your results letter will explain what will happen next if HPV is found in your sample (an HPV positive result).

You may need:

  • another cervical screening test in 1 year
  • a different test to look at your cervix (a colposcopy)

There are 2 different kinds of HPV positive result:

ResultWhat it means
HPV found (HPV positive) but no abnormal cellsYou’ll be invited for screening in 1 year and again in 2 years if you still have HPV. If you still have HPV after 3 years, you may need to have a colposcopy.
HPV found (HPV positive) and abnormal cellsYou’ll be asked to have a colposcopy.

Important

Try not to put off cervical screening. It’s one of the best ways to protect yourself from cervical cancer.