18 people die by suicide every day in England and Wales, but help is out there.

There’s always someone to listen.

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Carers Bucks is a local charity that supports carers of all ages, from all communities who are looking after a friend or family member who could not manage without them. We support carers in Buckinghamshire from the ages of 6, with our Young Carers service, through to people who are in their 90s. They might be caring for someone with dementia, a physical or learning disability, serious illness or mental health problem. Whatever their caring role we can help.

Many people do not recognise themselves as carers – they are just a mum, dad, husband or daughter doing what any family member or friend would do. However carers have rights and are entitled to information and support for themselves.

Carers Bucks provides:

• up to date information and advice on carers’ issues including benefits
• help to get a break
• training to help carers with their caring role
• an In Case of Emergency service (ICE) if carers are suddenly taken ill or have an accident.
• opportunities to meet other carers at support groups and events
• someone to talk to in confidence
• advice and support for working carers
• a Young Carer service for children and young people caring for a family member.

For more information contact Carers Bucks on 0300 777 2722; email mail@carersbucks.org or visit our website at www.carersbucks.org

Pharmacy First

The Pharmacy First service builds on the NHS Community Pharmacist Consultation Service which has run since October 2019. The consultation service enables patients to be referred into community pharmacy for a minor illness or an urgent repeat medicine supply.

The new Pharmacy First service, launched 31 January 2024, adds to the existing consultation service and enables community pharmacies to complete episodes of care for 7 common conditions following defined clinical pathways.

The benefits of Pharmacy First

In May 2023, NHS England and the Department of Health and Social Care announced a Delivery plan for recovering access to primary care. Part of the plan includes enabling patients to get certain prescription medications directly from a pharmacy, without a GP appointment.

This new service is expected to free up GP appointments for patients who need them most and will give people quicker and more convenient access to safe and high quality healthcare. It includes the supply of appropriate medicines for 7 common conditions including earache, sore throat, and urinary tract infections, aiming to address health issues before they get worse.

Currently, NHS patients in England must visit their GP to access prescription only medication, meaning repeated GP visits and delays in treatment.

Community pharmacies offer a more convenient way to access healthcare that includes support with healthy eating, exercise, stopping smoking, monitoring your blood pressure, contraception, flu and covid vaccinations.

The public perceptions of community pharmacy survey found that over 90% of patients who sought guidance from a community pharmacy within the past year reported receiving good advice.

The government and NHS England are committed to ensuring patients receive the right treatment at the right time. The NHS Long Term Plan highlights the need to make greater use of community pharmacists’ skills and opportunities to engage patients. This is why we have launched a new Pharmacy First service.

Accessing Pharmacy First services

The following table shows the 7 conditions pharmacists can manage across various age ranges.

Clinical pathway	Age range
Acute otitis media*	1 to 17 years
Impetigo	1 year and over
Infected insect bites	1 year and over
Shingles	18 years and over
Sinusitis	12 years and over
Sore throat	5 years and over
Uncomplicated urinary tract infections	Women 16-64 years

* Distance selling pharmacies will not complete consultations for acute otitis media.

Patients will be able to access the 7 clinical pathways element via referrals from referring organisations including general practice, urgent and emergency care settings, and NHS 111 (online and via telephone). In addition, for the 7 common conditions clinical pathway consultations only, patients can access the service by attending or contacting the pharmacy directly without the need for referral.

Providing high quality health and care services

For the 7 common conditions, pharmacists will follow a robust clinical pathway which includes self care and safety-netting advice and, only if appropriate, supplying a restricted set of prescription only medicines without the need to visit a GP.

These clinical pathways have been developed with input from various experts including practising GPs, pharmacists, and antimicrobial resistance specialists as well as representatives from national organisations such as the National Institute for Health and Care Excellence (NICE) and UK Health Security Agency. This ensures that the steps we take together match the care patients would receive in general practice and follow the latest national guidelines.

Pharmacies have private consultation rooms that can be used for consultations with patients, and pharmacists can see patients for clinical services without always needing an appointment.

Every pharmacist trains for 5 years in the use of medicines and managing minor illnesses, so they are well equipped to provide health and wellbeing advice to help people stay well. They are also experienced in spotting warning signs, otherwise known as red flag symptoms, which may warrant a referral to another healthcare provider.

After a consultation with the pharmacist, the pharmacy will send a notification to the patient’s GP on the same day or on the following working day. 

To self-refer to the Pharmacy First service – please follow the link below:

We strongly advise all smokers to STOP SMOKING. Seek advice from the smoking cessation clinic. You can contact Be Healthy Bucks (BHB)  who offer a range of support solutions.

Visit click here for more information or you can Self Refer by calling: 01296 322 738.

The NHS Health Check is a free check-up of your overall health.

It can tell you whether you’re at higher risk of getting certain health problems, such as:

• heart disease
• diabetes
• kidney disease
• stroke

Who is the NHS Health Check for?

The check is for people who are aged 40 to 74 who do not have any of the following pre-existing conditions:

• heart disease
• chronic kidney disease
• diabetes
• high blood pressure (hypertension)
• atrial fibrillation
• transient ischaemic attack
• inherited high cholesterol (familial hypercholesterolemia)
• heart failure
• peripheral arterial disease
• stroke
• currently being prescribed statins to lower cholesterol
• previous checks have found that you have a 20% or higher risk of getting cardiovascular disease over the next 10 years

You should have regular check-ups if you have one of these conditions.

How can I arrange to have an NHS Health Check?

You’ll be invited for a free NHS Health Check every 5 years if you’re between 40 and 74 years of age and do not already have a pre-existing condition.

Once invited, book your appointment using our AskFirst online booking service: http://bit.ly/3JTNnTQ – NHS Health Check option. If you have not received an invitation, but believe you are eligible to have an NHS Health check, please use AskFirst – General Enquiry – Admin Query option. If your eligibility is confirmed, we will contact you with an appointment date.

What happens at the NHS Health Check?

An NHS Health Check takes about 20 to 30 minutes, which is split between two appointments.

The health professional – often a nurse or healthcare assistant – will ask you some questions about your lifestyle and family history, measure your height and weight, and take your blood pressure and do a blood test. The blood test will be done either before the check with a blood sample from your arm, or at the check.

Your blood test results will be discussed at your follow-up appointment, that can show your chances of getting heart disease, stroke, kidney disease, and diabetes.

If you’re over 65, you will also be told the signs and symptoms of dementia to look out for.

You will then receive personalised advice to improve your risk.

This could include talking about:

• how to improve your diet and the amount of physical activity you do
• taking medicines to lower your blood pressure or cholesterol
• how to lose weight or stop smoking

Additional information on healthy Living:

• Getting Active
• BHF Healthy Heart Booklet
• BHF Eat Well Booklet
• Dementia – Helping your Brain to Stay Healthy

We are committed to preventative medicine. Several dangerous infections can be avoided by keeping immunity up to date. This is achieved by vaccinations, which take a few seconds but give protection for many years. We strongly advise all patients to make sure that they and their children all have their immunisations up to date, according to the following schedule and that they keep their own records.

Children

The children’s immunisation clinic is run jointly by health visitors, doctors and the nurses by appointment. Please let us know in advance if you cannot attend an immunisation appointment on 01494 434344.

The established immunisations as detailed below will be given at the times shown.

Two months old: Diphtheria, Tetanus, Whooping Cough, Polio, Hib, Hep B and Pneumococcal Infection and Rotavirus, Meningitis B

Three months old: Diphtheria, Tetanus, Whooping Cough, Polio, Hib, Hep B and Rotavirus

Four months old: Diphtheria, Tetanus, Whooping Cough, Polio, Hib, Hep B and Pneumococcal Infection, Meningitis B

Around 12 to 13 months: Hib, Meningitis C, Measles, Mumps and Rubella, Pneumococcal Infection and Meningitis B

Three years four months to five years old: Pre-school Booster – Diphtheria, Tetanus, Whooping Cough and Polio Measles, Mumps and Rubella

13 to 18 years: Tetanus, Diphtheria, Polio and Meningitis AWCY. Completed by School immunisation team.

Adults

Diphtheria and Tetanus Booster

Required every 10 years, to a maximum of five doses. If you have never had a full course of tetanus immunisation please make an appointment now with the practice nurse.

Polio Booster

A polio booster is required every 10 years for travel and will be given with combined diphtheria and tetanus.

Pneumovax Immunisation

Anyone who suffers from chronic heart, lung, kidney, liver problems, diabetes, has had their spleen removed or is over 65 years of age should be vaccinated. This is a single vaccination against one form of pneumonia and lasts for at least 10 years.

Shingles Vaccine

A vaccine to prevent shingles, a common, painful skin disease is available on the NHS to people in their 70s. The shingles vaccine is given as a single injection into the upper arm. Unlike the flu jab, you’ll only need to have the vaccination once and you can have it at any time of the year.

Please click for more information on Shingles and the vaccination

Flu Vaccinations (Adults)
These are held every September – December, so we advise patients to book up in September. We recommend flu vaccination for:

• Anyone over 65 years old and all patients with:
• Chronic respiratory disease
• Heart disease
• A history of stroke
• Diabetes
• Liver or kidney disease
• Most chronic debilitating illnesses, as well as for those living in residential homes or taking drugs to suppress the immune system or have had their spleen removed.
• Pregnant women
• Main carers of elderly or disabled people whose welfare may be at risk if the Carer falls ill.

Flu Vaccination for Children

A programme started in September 2013 to offer Fluenz® nasal flu vaccine to children starting with children aged 2 to 3 years on 1 September 2013. The programme was extended to all pre-school and primary school children in 2014, and from 2015 all children aged between 2 and 16 years will be offered the nasal flu vaccine. One dose of vaccine will be given.

Fluenz® nasal flu vaccine will also be offered to children aged 2 up to 17 years in clinical risk groups (e.g. children using steroid inhalers for asthma, children with diabetes), as it has been shown to provide a higher level of protection for children than the injected inactivated influenza vaccine. One dose of Fluenz® vaccine annually will be given to children in this group who have previously been given influenza vaccination. Children in a clinical risk group who have never had a flu vaccination will be given two doses of Fluenz® at least four weeks apart and after that will have one dose annually.

The only exception where Fluenz® cannot be administered is when he child has previously required Admission to an intensive care unit for severe anaphylaxis to egg, which then will need referral to a specialist to be administered under a hospital environment.

Fluenz® is a live vaccine so it cannot be given to children who are immune-suppressed or those with an immuno-compromised family member.

All women and people with a cervix between the ages of 25 and 64 should go for regular cervical screening. You’ll get a letter in the post inviting you to make an appointment. Please contact the surgery to arrange an appointment with our Practice nurse.

If you are aged 25 and have never had a smear test, or if it has been more than 3 to 5 years since your last screening, you should arrange an appointment with our Practice Nurse. You should not have the test while you are having your period as this can affect the sample.

What is cervical screening?

Cervical screening is not a test for cancer. It is a method of preventing cancer by detecting and treating early abnormalities which, if left untreated, could lead to cancer in a woman’s cervix (the neck of the womb).

A sample of cells is taken from the cervix for analysis. A doctor or nurse inserts an instrument (a speculum) to open the woman’s vagina and uses a spatula to sweep around the cervix. Most women consider the procedure to be only mildly uncomfortable.

Early detection and treatment can prevent 75 percent of cancers developing but like other screening tests, it is not perfect. It may not always detect early cell changes that could lead to cancer.

Advice for Travellers

Travel Vaccines Process

If you are travelling abroad and would like to see your vaccination history, you can view all these details via the NHS App. You may then be able to research if you would require additional vaccinations before completing the Assesment Form.

Travel Health Pro provides country information including vaccine recommendations. You can find this via the link below:

www.travelhealthpro.org.uk

If after reviewing the vaccine recommendations, you believe you require travel vaccines, the following processs should be followed:

A Travel Vaccine Assesment Form should (if possible) be completed 6 weeks before travel. We will always do our best to provide this service, however, if you have booked a last minute trip and we are unable to offer an appointment, DoctorNow based in Beaconsfield (01494 410888) may be able to help.

A form is required per person for each traveller. This includes children under 18.

The best and most efficient way of accessing the travel form is via the Ask First App.  You can also fill click below to access an internal form.

Travel Vaccine Assessment Form Download (PDF, 225KB)

Please email to admin.ahc@nhs.net

The nurse will then be in contact via text message to discuss your requirements and if necessary organise an appointment for you to come in to the surgery for the relevant vaccine.

If you are taking regular medication, discuss with your doctor or practice nurse any special arrangements or precautions. If you have a condition such as asthma, which may occasionally require medication, be sure to take an emergency supply with you, and carry it in your hand luggage. Always make sure you have enough of any prescription medicines.

Pack a small first aid and holiday health kit containing:

• Travel sickness tablets
• Paracetamol, including paracetamol and/or ibuprofen syrups for children
• Sunscreen – SPF 15 or higher (SPF 16 or higher for small children)
• Sunburn treatment, eg calamine
• Plasters and antiseptic wipes
• Oral rehydration solution; anti-diarrhoea
• Indigestion remedy, eg antacid
• Insect repellent
• Water purification tablets
• Condoms/other contraceptives
• Antihistamine tablets
• In some developing countries or where medical supplies may not be reliable, it may be wise to include sterile needles and syringes, dressings and suture materials

All these items should be available from your chemist.

When Abroad

Check on the quality of drinking water. Where there is a risk of food or water-borne disease, it is wise to eat food that is freshly cooked, or fruit that can be peeled. Avoid drinking the local water supply or raw food washed in it. Remember, this includes ice in drinks and cleaning your teeth. Bottled water is usually available in tourist areas; choose carbonated where possible as this cannot easily be filled from a tap! Water purification tablets can be used if you are ‘roughing it’.

Diarrhoea and vomiting can ruin a holiday. Apart from eating and drinking wisely, be prepared – take antidiarrhoeals with you. However, these are not suitable for children or if the diarrhoea contains any blood. Antidiarrhoeals will alleviate the symptoms and electrolyte solutions will replace essential salts. If you are afflicted, try to replace fluid loss with bottled water and remember, as children dehydrate more quickly than adults, it may be wise to call for help.

It is advisable to use effective insect repellents wherever there are mosquitoes. Apart from the irritating bites they can inflict, mosquitoes may also carry diseases – including malaria and yellow fever – in countries where contact with these diseases is a risk.

Beware of the sun! Use a high factor sun screen particularly in the first few days of exposure. Small children burn very easily and need adequate protection from a total sun block applied frequently. Keep children in the shade as much as possible and provide plenty of water.

In hot climates drink plenty of non-alcoholic drinks. If you are not passing water regularly, you are not drinking enough.

On Your Return

If you are ill and need to see your doctor, don’t forget to mention that you have recently travelled abroad.

If you receive medical treatment abroad, tell your own doctor on your return.

Our practice nurses offer a wide range of nursing services by appointment through reception.

 These include dressings, removal of sutures, treatment of leg ulcers, injections, ecg etc.

Appointments are available for blood tests with a phlebotomist that are pre booked from 8.40 am Monday, Wednesday, Thursday, and Friday and 7.00am on a Tuesday morning at the surgery.

For routine non urgent blood tests we recommend using the online booking system at the Hospital.

Patients can select a date and time that suits them via an online booking system. Being able to book appointments in advance online will reduce, and may remove, waiting times for patients.

Patients can access the system via www.buckshealthcare.nhs.uk/our-services/blood-test-phlebotomy

Paediatric blood test clinics are available at Stoke Mandeville and Wycombe hospitals.

The patient’s parent, guardian or Carer or an adult representative, need to call the following numbers to arrange a blood test:

• Wycome Hospital Children’s outpatients: 01494 426484
• Stoke Mandeville Hospital Children’s outpatients: 01296 316426

Blood tests cannot be carried out without a GP request form.