What is Advance Care Planning (ACP)?

ACP is a process in which you can think, talk and write about what is important to you, and describe the kind of care you would want if you became unable to make decisions for yourself. It broaches the subject of dying, and how you would like to be looked after at that time.

Why is this important for me and my family?

It may seem difficult to think ahead in this way, but writing an advance care plan makes a clear record of your wishes so that these can be respected and, where possible, carried out by people caring for you in the future.

It will also help you to talk about your plans with the people close to you, and those involved in your care, so that they know what is important to you.

How can I complete an Advance Care Plan?

Bedfordshire Clinical Commissioning Group has developed an ACP booklet that is available either to download below, or you can ask for the booklet at the surgery as we hold a small stock.

Download the Advance Care Plan booklet.

Remember that an ACP is a ‘living’ document, and you can update and change it at any time.

What do I do with it once I have completed it?

Give copies of your completed ACP (and when you update it) to whoever you wish to have a copy. A copy can be held by the surgery, and we will scan this on to your records.

Asthma

Asthma is a disease that can vary in severity throughout the year. If you notice a worsening of symptoms, such as a cough, wheeze or tight chestiness please make an appointment for an asthma check as soon as possible so we can ensure you have the correct medication.

Please ensure you are seen annually by the asthma nurse even if you feel well.

The practice aims to review all patients who need regular use of medication or who suffer from severe or troublesome Asthma every year. Patients will be invited for review in or around their birthday month.

Who does this mean?

Any patient who has received regular medication for Asthma within the last 12 months

Asthmatics who have received care during an emergency admission to hospital

Asthmatics who have difficulty in controlling or monitoring their condition.

What are the aims of treating Asthma?

If you smoke the aim will be to stop smoking and we will provide you with support to enable you to do this.

The aim is that symptoms of Asthma should be reduced or stopped completely to allow you to live a normal active life. This may require the use of inhaled and/or oral therapy on an intermittent or continuous basis.

Give sufferers or their carers an understanding of the causes and triggers of Asthma and knowledge of effective preventative measures to reduce these in the future.

To teach sufferers or their carers how to recognise and react to changes in symptoms of Asthma and to develop a plan of personal care.

To tailor therapy to maximise effectiveness and safety from possible side-effects.

Diabetes

Once a patient has been diagnosed with this condition via a blood test an initial 30 minute appointment with the nurse will take place for general discussion and advice.

We will then see you for an annual review during your birthday month. This will involve a fasting Blood Test, followed a week or so later with an appointment with either the Diabetes nurse alone or nurse and a doctor. You will also be seen 6 monthly for a quick review and update with the nurse. The practice will contact you in advance to remind you to book these appointments. Advice will be given on diet, smoking, exercise and checking of feet. Patients are able to have access to a chiropodist if needed.

You will be invited by Bedford Hospital retinopathy Screening as part of the Diabetic Screening programme.

Management of your condition depends on the severity of your symptoms and presence of complications and other medical conditions.

Coronary Heart Disease

If you have been diagnosed with Heart Disease we will see you for an annual review during your birthday month. This will involve a fasting Blood Test, followed a week or so later with an appointment with your usual GP.

You will also be seen 6 monthly by the specialist Nurse. The practice will contact you in advance to remind you to book these appointments.

Dressing Clinics are run by the Practice Nurses – Monday, Wednesday and Friday each week. The length of your appointment depends upon the complexity of the wound being dressed.

The following services are available to Patients of the Practice. Please contact our Reception Team who will advise of appointment availability.

For coils and implants, please go to our Wellbeing Centre where you will find details of the Integrated Contraception and Sexual Health Service (iCaSH) located in Bedford.

Contraceptive Pill

Initiation of the Contraceptive pill needs to be via an appointment with the Family Planning Nurse or a Doctor. Repeat prescriptions are issued on a 3 monthly basis. For patients already taking the pill, an annual check-up is required with the Nurse.

Depo-provera Contraceptive Injection

Please book a Nurse appointment.

Emergency Contraception

Please contact our Reception team.

Bedfordshire Hearing Advisory Service visit the practice once a month on a Tuesday between 2.00 and 3.00pm, usually the first Tuesday of the month. This is a free service to help with any hearing aid related problems, including the issue of NHS hearing aid batteries and re-tubing of ear moulds if necessary. Batteries and re-tubing are only available to NHS hearing aid patients.

Assistive equipment demonstrations can also be arranged, so if you need help with the telephone/T.V./radio/doorbell etc., please make an appointment to discuss with the Hearing Advisory Service.

Please ring our reception to book a 10 minute appointment.

For more information visit  www.hhas.org.uk/bedfordshire/

Please also note that the practice has a supply of hearing aid batteries for NHS hearing aids.  You need to bring along your book and old batteries in order to get your replacement batteries.  Thank you.

A community midwife works with the team at Harrold Medical Practice, (she is employed by Bedford Hospital NHS Trust). The midwife provides care in pregnancy, during birth and the early postnatal period. The antenatal clinic is every Thursday 2-5 pm.

When you find out that you are pregnant, it is advisable to make an appointment through reception to see the midwife as soon as possible, ideally between 6 – 8 weeks of pregnancy. This is to initiate antenatal care and complete a referral for an ultrasound scan at the hospital of choice. The next appointment, called the booking appointment, is to: complete the comprehensive pregnancy records, discuss recommended screening tests available, make an individual care plan for the pregnancy

The initial meeting to undertake the booking history will take place either at the surgery, at home, at a children’s centre or at a hospital-based booking clinic.

Thereafter antenatal appointments with the community midwife or GP will take place at regular intervals throughout pregnancy. Should referral to a consultant obstetrician be required, the midwife or GP will refer you for an obstetric opinion at the hospital.

You will be assessed on an individual basis with safety for both the mother and the baby being a priority. Therefore at the booking visit each pregnancy will be assessed as to the level of care required:

Standard Care: Your care will be shared between the GP and the community midwife

Intermediate Care: Your care will be shared between the community midwife and Obstetric Consultant

Intensive Care: Most of your care will be delivered by the Consultant led antenatal clinic at the hospital however you will also continue to see your community midwife.

You can give birth at home, in a unit run by midwives (a midwifery unit or birth centre) or in hospital. Some hospitals have a separate midwifery unit. The choice you have about where to have your baby will depend on your needs and risks and, to some extent, on where you live.

Wherever you choose, the place should feel right for you, and the midwife will provide information and advice.

For further information about pregnancy and birth, visit the NHS website.

You are entitled to a free health check every 5 years if you are between 40 and 74 years of age and have not been previously diagnosed with Diabetes, Heart Disease, Hypertension or you are prescribed a statin.

If you would like a health check then please speak to reception who will advise on the process.

Blood tests are carried out at the doctors request. Phlebotomy clinics currently run at the practice on Monday, Tuesday and Wednesday mornings.

Having your blood taken at hospital

If you would prefer to go to Bedford Hospital to have your blood taken, you will need to book your appointment through the following link: Blood Tests (Phlebotomy) – Bedfordshire Hospitals NHS Trust

Please note: you will need to pick up the blood test request form from the surgery and take this to the appointment. The hospital will be unable to take blood without the request form.

Children’s Blood Tests

We are unable to take blood from patients under the age of 17. Children’s blood tests can be booked through the following link: Children’s Phlebotomy at Bedford Hospital – New patient appointment booking system – Bedfordshire Hospitals NHS Trust.

Please note: you will need to pick up the blood test request form from the surgery and take this to the appointment. The hospital will be unable to take blood without the request form.

Here at the Harrold Medical Practice we have a number of private clinics .  You do not have to be registered with the practice to access these services:

Podiatrist

Graeme Paterson, BSc, SRCh, FpodA.

Graeme offers a wide range of services including routine foot and nail care, provision of orthoses and a full range of ambulatory foot surgery.

Please contact the Practice Reception for appointment availability.

Chlamydia Screening Programme 16-24 year olds

Chlamydia is a sexually transmitted infection (STI) that is widespread amongst 16-24 year olds.

Chlamydia is the most common curable STI in this country and most people don’t know they have it because there are often no symptoms.  It is easily passed on from one person to another during sexual activity.

If left untreated, it can lead to serious health problems such as infertility (unable to have children), for men and women, a painful infection in the testicles and problems with pregnancy and childbirth.

Testing is easy, all we need is a urine sample and it’s simple to treat with free antibiotics.  All sexual partners must also be tested to stop chlamydia from spreading and to help stop you from being infected again.

Screening is free and confidential.  Simply make an appointment to see the practice nurse.

For more information on chlamydia go to iCaSH.

Help Lines/Websites

National Stop Smoking Help Line 0800 013 0553.

www.smokefreebedfordshire.co.uk

www.nosmokingday.org.uk

A Practice Nurse can give guidance to encourage weight loss through a healthy diet and lifestyle.  In certain circumstances referral to Weight Watchers or Slimming World may be possible.

Appointments are 15 minutes.