STOP PRESS! COVID-19 UPDATE - Elliott Hall Medical Centre

 
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STOP PRESS! COVID-19 UPDATE - Elliott Hall Medical Centre
STOP PRESS! COVID-19 UPDATE
                           SATURDAY 21st MARCH 2020

As we are all aware, we are currently in unprecedented times within the NHS, and
the changes that have taken place at EHMC over the past 1-2 weeks have been
significant, but we thank all of our incredible staff and patients for supporting us
during this challenging time.

There are a few updates below that we would like to make you aware of, but please
keep an eye on our website www.ehmc.co.uk - in particular the FAQ document that
is being updated as regularly as possible. There are also links to the government
websites specifically around advice to the public on what coronavirus is and how
to look after yourself and your families.

1.      If you are unwell with a continuous cough, fever, shortness of breath,
flu-like symptoms, loss of smell or taste, please stay at home and self-isolate
from the rest of your household for a minimum of 7 days. Your household will need
to stay at home for 14 days. If you feel you are becoming more unwell contact 111
via https://111.nhs.uk/covid-19/ or by calling 111. Please do not ask the GP for a
sick note if you are unwell or self-isolating. You can self-certify for 7 days, or if you
require longer please see https://111.nhs.uk/isolation-note

2.     It is important more than ever to look after our vulnerable friends and
relatives. Please make sure if you are aware of someone self-isolating that you
offer your services where you can. If you would like to volunteer to help some of our
vulnerable patients, please email ehmc.pa@nhs.net

3.      We have had a significant number of prescription requests over the past week, at
a level more than double what we usually receive. Please DO NOT OVER-REQUEST
your medications, as these requests for early or extra amounts of medication cannot
be authorised. The NHS has been advised to manage prescriptions as usual. Please
remember to nominate a pharmacy for electronic prescribing to prevent you
from having to pick up a script from the medical centre.

You can register for online access via the NHS app - which allows you to request
these medications online. Future requests should ideally be done electronically
to reduce unnecessary contacts. Please also be aware that the pharmacies have
been overwhelmed and are finding it difficult to home-deliver, so please, wherever
possible, arrange your own collections from the chemist.

4.     To prevent unnecessary face to face contact, we have converted all of our
regular routine face to face appointments with a doctor into telephone consultations.

                                           1
STOP PRESS! COVID-19 UPDATE - Elliott Hall Medical Centre
Whilst you have an appointment time please be aware the call could be any time
in the morning between 8.30-12pm and afternoon 2-6pm. Please ensure we have
up-to-date details for you - in particular mobile telephone numbers. Our telephone
system is working at full capacity so if you are expecting a call back it may be from a
withheld number.

5.     We will only bring patients into the surgery where it is medically required to do
so for an examination. Please be aware, if you are unwell and have been asked to
come in for an examination due to concerns about COVID-19, you will be asked to
wait in your car before being called by a clinician to come in. Please DON’T walk
into the medical centre if you are suspected of having the virus.   For your and
our staff’s safety we have taken the decision to lock our front door - this means that
to enter the surgery you will need to speak to Reception on the intercom.

6.      We are currently still doing blood tests and nurse appointments face to
face - but this may change in coming weeks. Please do not attend your appointment
if you are unwell but call ahead to cancel.

7.     As per CCG recommendations - be aware that moving forward, non- urgent
referrals may not be processed. Previous referrals, as we are sure you understand,
may be postponed due to hospital staff being deployed elsewhere. As far as we are
aware, cancer referrals are being processed as normal under the “two week wait”.
Routine operations are also being postponed.

8.      There are plans in the next week that there will be local medical centres used
as COVID HUBs - this means that potential COVID-19 patients will be sent there for
assessment rather than to EHMC. Please be aware that you may be directed there
for a further assessment after speaking to 111 or a GP at EHMC. This is because
they will be better equipped than we are and are there to reduce the pressure on the
local hospital A+E departments.

                      The key message is for everyone:
             AVOID SOCIALISING, STAY at HOME and STAY SAFE

If you are in a high-risk group (see FAQs on our website if you aren’t sure), see if
someone else can get your food shopping for you and avoid any unnecessary social
contact.  

We thank you more than ever for your continued support. A number of our staff
are working remotely or may be seconded to help in the COVID HUB or in the local
hospitals, so please bear with us if we do not respond in our usual timely fashion,
but we hope that we can continue to offer you the excellent patient care that we pride
ourselves in doing.

This information was up-to-date as of 21st March, but please continue to look
at our website and at the gov.uk websites for the most recent information.

Chris Jenner, Ashok Kelshiker, Carly Szasz and Helen Jenner
Partners at EHMC

                                           2
STOP PRESS! COVID-19 UPDATE - Elliott Hall Medical Centre
CHAIRMAN’S REPORT
W
            elcome to the April                these difficult times.
            edition of The ElliottEar          On a personal level, I have
            which includes articles            volunteered for the P.A. for a long
from our Co-Ordinators with the                time, wearing a number of different
purpose of explaining our services             hats, but, after eight years as your
to those of you who are, perhaps,              Chairman, I have decided to step
new to the Medical Centre, and,                aside from that role. The time has
hopefully, might be interested in              come for a fresh outlook, and a new
joining our team of volunteers.                Chairman will provide this. I have
As usual lots of interesting                   been very proud to chair our P.A.
information can be found within the            I have met a wonderful group of
EE and I hope that you will spare              volunteers and made many friends
a little time to read it, particularly         along the way. The relationship
the article about the Primary Care             we have with the Medical Centre,
Network (PCN) which will impact                clinicians and administrators alike,
on all of us. Just as we go to press           is quite remarkable - we are a team
the Coronavirus outbreak has                   without a doubt, and that is why it
occurred and there is information              works and we are still here.
about how this may affect our                  I am not going too far, however! I
services and those of the Medical              have offered to serve as Vice Chair in
Centre during this hard time for us            order to support our new Chairman.
all. Please read them carefully and            With many thanks
do your part to get us all through                   Jane Billenness, Chairman

Thank You to our Chairman
It does not seem possible that it has been eight years since Jane Billenness took over
as Chairman of our Patients’ Association. Behind the scenes she has supported the
Association in so many ways – advising and helping
Co-ordinators, recruiting new volunteers, visiting the Medical Centre to ensure close
working and good relations, and then visiting other medical centres and encouraging
and supporting them to involve patients. Jane is always present at meetings and
functions and has given of her time so generously – she also works, so this role she
juggles with her “day job”. Such is Jane’s commitment to the Patients’ Association
that she has even offered to stay on as Vice Chairman to support the new Chairman.
On behalf of the patients and staff at the Medical Centre:
THANK YOU, JANE!
                                                                   Dr Chris Jenner
                                           3
The impact of the Coronavirus outbreak on the
 Patients’ Association activities and services
It is with regret that I have to announce that the EHMCPA Annual General Meeting
will not now take place in May as had been planned. At that meeting the Committee
were going to propose the following people to serve as Officers of the Association:
       Jacqui Martin		   Chairman
       Jane Billenness		 Vice Chairman
       Michelle Davis		  Treasurer
       Kate Deed			Secretary
If you have any other nominations for these positions they must be proposed and
seconded by members of the Patients’ Association and sent in writing to me c/o the
EHMC by 4 May 2020.
In the meantime, those currently nominated by the Committee will serve as Officers
until a formal ratification can take place, hopefully later this year.
It has also been agreed that it would be prudent to postpone our
annual Fish and Chip Quiz supper.
As far as our services are concerned we will endeavour to keep them going as best we
can. All the Co-ordinators are working hard in order to achieve this. It may mean
that we have to change the way we do things, at least for the time being, for example,
fewer face to face meetings and more use of the telephone. It will, of course, affect
each service in different ways. Whilst we are concerned about maintaining the
health of our service users we must also acknowledge the concerns of our brilliant
band of volunteers.
                                                                        Jane Billenness, Chairman

Patients’ Association Contacts
Chairman                                   Miss Jane Billenness                                      020 8428 3739
Vice-Chairman                              Mr Tony Berry                                             020 8428 5112
Treasurer                                  Mrs Michelle Davis                                        020 8428 3957
Secretary                                  Mrs Kate Deed
Co-ordinators for Services
Bereavement Visiting Scheme                Mrs Jacqui Martin                                         020 8863 1386
Carers’ Support Group                      (vacancy)
Home Visiting                              Mrs May Chin                                              07941738838
Shopping                                   Mrs Pat Ball                                              020 8428 3251
Social and Fund-raising                    Mrs Tricia Baron                                          020 8428 2846
Tea Parties                                Mrs Tova Salomon                                          020 8428 4063
Transport                                  Mr David & Mrs Pat James                                  020 8428 1711
The ElliottEar
Editor                                      Miss Lesley Walmsley                                     020 8428 7954
Advertising Manager                         Mrs Jacqui Manning                                       020 8421 0978
Business Manager                            Mr Tony Berry                                            020 8428 5112
Distribution Managers                       Messrs James & Ken Brown                                 020 8428 7669
Member at Large                             Mr Arthur Peacop                                         020 8428 6533
Elliott Hall Medical Centre, 165-167 Uxbridge Road, Hatch End, HA5 4EA                               020 8428 4019
                                        The ElliottEar is designed by Laura Phelan and printed by The Print Shop, Pinner Green

                                                  4
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                                             5
VOLUNTEERS NEEDED
 Please can you help?
     If you can help with any of our volunteer groups
        please call us on the numbers shown below
       or contact Jane (Chairman) on 020 8428 3739

 BEREAVEMENT                                             SOCIAL AND
 VISITING SERVICE                                        FUND-RAISING
Aim: To help those who are finding it hard to           Aim: To arrange social events to raise funds to
cope with bereavement.                                  enable the PA to pay running costs, including
Contact: Jacqui Martin 020 8863 1386                    insurance for volunteers and a contribution
                                                        towards the production costs of The ElliottEar.
                                                        Contact: Trisha Baron 020 8428 2846

 TRANSPORT SERVICE
                                                         TEA PARTIES
Aim: To provide transport to the Medical Centre
and local hospitals (not Northwick Park)
Needed: Drivers                                         Aim: An opportunity for small groups to meet
Contact: David and Pat James 020 8428 1711              up for tea and a chat.
                                                        Needed: Drivers
                                                        Contact: Tova Salomon 020 8428 4063

 SHOPPING SERVICE
                                                         THE ELLIOTEAR
Aim: To provide shopping facilities for the
housebound.
Needed: Shoppers                                        Aim: To deliver The ElliotEar Newsletter twice
Contact: Pat Ball 020 8428 3251                         yearly to every patient household.
                                                        Needed: Deliverers
                                                        Contact: James Brown 020 8428 7669

 HOME VISITING SERVICE
                                                         CARERS’ SUPPORT GROUP
Aim: To provide visitors for housebound and
isolated patients, and to give respite to carers.
Needed: Visitors                                        Aim: To provide help and information for carers
Contact: May Chin 07941 738838                          through monthly meetings and individual visits.
                                                        Needed: Companions (male and female) to sit
                                                        with a loved one while a carer goes to Group.
                                                        Contact: ehmc.pa@nhs.net
 GAMES GROUP

Aim: To help people play board games together
Needed: Leader
Contact: ehmc.pa@nhs.net

                                                    6
W
            ith this copy of The ElliottEar          is for people working with children
            you will have found a                    or vulnerable adults in a regulated
            document about the work                  activity. The Police Act 1997
of the Patients’ Association and the                 (Criminal Records) Regulations 2002
different groups run by volunteers to                defines a volunteer as “any individual
support EHMC.                                        engaged in an activity which involves
Why be a Volunteer? The joy of                       spending time, unpaid (except for
providing support for others is that you             travel and other approved out of
can see the improvements in the lives                pocket expenses), doing something
of patients who need assistance. As                  which aims to benefit some third
there are different groups you select the            party and not a close relative.”
area which you feel most comfortable              • The process explained. The
supporting. And you don’t need to be                organisation provides the volunteer
volunteering every week – just a few                with an application form, which
hours every month.                                  must be returned with several forms
What makes you a good                               of identification, such as a driving
Volunteer? If you like having a good                licence or passport. The DBS will
chat, enjoy the company of others, can be           then issue a certificate to the applicant
flexible as to timing and can be reliable           to provide them with the result
in attending, then being a volunteer                of the check.
can work for you. If you have retired             • Please do not be afraid of
you would make an ideal volunteer –                 having a DBS check. It is not
volunteering can fill some of your free             that you are not trusted – it is to
hours while providing a wonderful gift to           ensure that you and EHMC are
the people you are helping.                         meeting Government requirements.
DBS Police Check. Due to                          So will you help? If you are
                                                                                              Image courtesy of Freepik

Government requirements relating                  interested in being a volunteer please
to volunteering you will have to                  complete and return the form
satisfactorily complete a DBS Police              enclosed with this Newsletter,
Check, the cost of which will be met              or email your details to:
by the P.A.                                       ehmc.pa@nhs.net. We will get back to
• Why should I? This requirement                  you as soon as possible.

                                              7
Thank you to all our volunteers
We have over 160 people who help support the Patients’ Association and no
matter how large or small your contribution we at the practice would like
to thank you. Together you design and commission this very newsletter,
usually over 30 pages in size. You deliver over 4,000 copies to EVERY
household where our patients reside, and arrange enough advertising
space to almost cover the costs. James, our delivery co-ordinator, is always
looking for more deliverers so please email us on ehmc.pa@nhs.net if you
would like to help share the load and deliver to roads in our locality. Lesley,
our Editor, is also looking for help with the editorial work, so again if you
have an interest (experience would be a luxury) then get in touch.
You can read about the other volunteers elsewhere and we are also open to
suggestions of new ways we can work more closely with our patients, so let
us know your thoughts.
We would also like to thank those patients who help us with our teaching.
This can involve attending medical student teaching, helping us to inspire
and motivate the next generation of doctors, or those of you who help
with our weekend teaching when we run a course for experienced doctors
(mainly GPs and consultants) who are wanting to improve their skills in
understanding more about the complex medical needs of older people.
The feedback from our participants is very positive and most go on to pass
their postgraduate examination - the Diploma in Geriatric Medicine -
which allows them to further their careers in this direction. None of this
would be possible without the support of patients, some of whom are not
necessarily in the best of health.
Thank you to all our volunteers - you are amazing!
                                                           Dr Chris Jenner        Image courtesy of Freepik

                                       8
ADVERTISEMENTS

      9
CO-ORDINATORS’ REPORTS
BEREAVEMENT VISITING SCHEME
The Bereavement Team comprises a              attend have the opportunity to meet and
group of EHMC patients who have               have companionship from others who
trained to work as Visitors to support        have also been bereaved.
other patients who need help following        If you feel you could benefit from meeting
a bereavement. We are not counsellors         a Visitor on a one-to-one basis or would
but we can offer you a person to talk to,     like to attend the Friendship Group please
support while you may be finding things       ask your GP to refer you.
difficult and help in looking forward.                                    Jacqui Martin,
The Team also runs the Friendship Group                 Bereavement Team Co-ordinator
which meets once a month. Those who

CARERS’ SUPPORT GROUP
For many years the Carers’ Group, co-ordinated by Beryl Peacop, has provided
amazing support to EHMC patients who work as carers to family members.
The Group has met regularly once a month and allows carers to meet up with others
in the same situation and to provide support and companionship to each other.
Regrettably Beryl has stepped down after many years’ service and this group is now
not functioning, which is a huge loss to the carers. We are looking to recruit another
Co-ordinator to run it. This voluntary role would ideally suit someone who has
experience in the social care/nursing field. If you think you might be interested in
volunteering for this role but would like more information please email
ehmc.pa@nhs.net and we will arrange to tell you all about it.

HOME VISITING
I would like to begin by thanking my team of volunteers for giving the gift of time.
Most of the patients referred to the Home Visiting Service are elderly, live alone and
do not often have the opportunity to socialise with others.
If you have an hour or two to spare weekly and would like to volunteer or find out
more about the Home Visiting Service please don’t hesitate to ring me.
                                                             May Chin, 07941 738838

GAMES GROUP
As part of the Patients’ Association drive    Rummikub and a Book Club –
to find more volunteers and to further        and others can be included.
improve what we can offer, we would           If you would like to run the Group or
like to develop the Games Group, and          would like more information about what
with this in mind we are looking for          would be involved, please either complete
a volunteer to run the Group. Some            and return the document inserted in
examples of activities which patients         The ElliottEar or email ehmc.pa@nhs.net
have expressed an interest in are: Bridge,
                                                               continues on page 12...
                                             10
ADVERTISEMENTS

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  Proprietors:           Residential Care Home for the Elderly                    Registered with
Farrington Care                                                                   London Borough
  Homes Ltd.                   A happy and caring home                               of Harrow

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                  Visitors and inspection prior to admission welcome by appointment
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                     Jemma Klein-Besser BSc (Hons) McPod
                                 Chiropodist/Podiatrist
                    Member of the Health and Care Professions Council
   Monday & Thursday afternoon Clinics at The Elliot Hall Medical Centre
                Home visits are available for immobile patients
   For an appointment Tel: 0208 203 3078 Mobile number: 07818 438 552
You can have a look at our Website for more information on services provided
                         at: www.jemsfootcare.co.uk

                                                             ARE YOU OR
                                                            YOUR BUSINESS
                                                            MISSING OUT?

                                                       Your advertisement could be in
                                                         The ElliotEar – published in
                                                             April and October.
                                                       If you’d like to advertise please
                                                                       call
                                                       Jackie Manning 020 8421 0978
                                                                    or email
                                                       jacqui.manning@yahoo.co.uk
                                                            (Monday–Friday, 9–5)

                                                 11
continued from page 10...

SHOPPING SERVICE
This service is for those patients who         your help would really be appreciated by
cannot shop for themselves and have            someone who is tied to the house. We
no family to do so, and we are always          stronger people may sometimes consider
looking for volunteers able to help. This      shopping a chore, but if you can’t get out
can mean either doing the shopping for         to do it it becomes almost a luxury.
patients yourself or sometimes taking          Please contact me if you can help.
them shopping if they are fit enough to go.                                      Pat Ball,
If you have any time to spare and would                           Shopping Co-ordinator
be willing to join the shopping service                                   020 8428 3251

SOCIAL AND FUND-RAISING
I am Co-ordinator of the Social and            and also to provide extra equipment at
Fund-Raising Group and have a small            the surgery as needed, such as home
team of local helpers. We organise             blood pressure monitors, extra seating in
two social events during the year for the      the waiting rooms, etc., things which the
benefit of patients.                           NHS would not otherwise provide.
The first one, in May, is the Fish and Chip                                 Tricia Baron,
Quiz supper. This is very much a social              Social & Fund-raising Co-ordinator
event (with a reasonable charge) and a bit                                 020 8428 2846
of fund-raising as we hold a raffle too.
The second is in November/early
December when we have a Christmas
Coffee Morning, which is very popular.
We have gift, book and cake stalls, and
also serve light refreshments, including
mince pies. There is also a very good
raffle, with a Christmas hamper and
bottles of wine, amongst other things.
All funds raised are used to cover
expenses incurred in running PA services,

TEA PARTIES
Good company, a social chat and a lovely           private homes on a Saturday afternoon.
tea along with warm hospitality, hosted            However, we would now like to increase
by volunteers for patients who are less            the number of parties, perhaps holding
mobile or who live alone. There is no              some during the week as well as at
charge to participants and transport               the weekend. If you would be willing
is provided by volunteers, also free of            to give up a couple of hours once a
charge. This sums up our Tea Parties,              month to open your home, and provide
which have been running successfully for           refreshments, to some of our patients
over 10 years.                                     who are looking for company we would
Currently the Tea Parties are held in              be delighted.

                                              12
We are also looking for volunteers to             If this is something that is of interest
drive for the Tea Parties – even once or          to you and you would like to know
twice a year – to pick up a patient and           more about what is involved, please
drop off. It would take an hour out of            contact me and I would be delighted to
your time and you would be giving a               chat or meet up.
patient some quality time to meet and                             Tova Salomon , Tea Parties
socialise with others.                                          Co-ordinator 020 8428 4063

THE ELLIOTTEAR DELIVERY TEAM
Our purpose is to deliver a copy of The           reasons the surgery provides addresses
ElliottEar to all addresses where one or          but no names.
more Elliott Hall Medical Centre patients         As you can imagine, we rely on this small
are registered – there are                        army of volunteer deliverers to enable
well over 4,000 addresses                                             the process to work,
to be delivered to. Most                                              and we are always in
are concentrated in the                                               need of new deliverers.
core surgery catchment                                                Some move out of area
area and the adjacent                                                 and others must retire
surrounds, but for                                                    as they age, etc. The
historical reasons there                                             more dispersed areas
are a significant number                                             are normally the most
of patients who live                                                 time-consuming to
further out still, e.g.                                              deliver as the distance
Northwood, towards                                                  between addresses
Rayners Lane and even                                               is greater. We also
in Moor Park.                                                       sometimes need to
The list of addresses has                                          find stand-in deliverers
been divided up into 90                                            as people can go away
or so delivery rounds,                                             for several weeks at
some concentrated,                                                 delivery time. Normal
and some on the edge of the catchment             holidays are no problem as the target is to
with lower numbers but quite dispersed.           complete deliveries within a month of the
There are a few addresses we must                 newsletter being printed.
post to because they are so far out, and          After the newsletters are printed, they are
some blocks of flats with keycode entry           counted out into the rounds, which can
where our team cannot gain access,                take a few days. Most deliverers then
and this adds to the cost to the Patients’        pick up their bundle from my house, over
Association. The lists are updated by me          a week or so. We do deliver bundles to a
every edition of the newsletter to include        few concentrated areas whose deliverers
the addresses of new patients or those            don’t drive.
who move within the catchment, or to                   James Brown – ElliottEar Newsletter
delete the addresses of those who have                                 Delivery Co-ordinator
left the surgery. For data protection                                          020 8428 7669
                                                                    continues on page 14...
                                             13
continued from page 13...

EXERCISE GROUP
Very many of us could benefit from doing         Church in Rowlands Avenue, 10.15 –
a bit of exercise but can’t find a group that    11.30, ending with refreshments and a
really suits us. The PA runs a group for         chance to chat with other people and
those who are getting older or who are           make new friends.
being encouraged to do some exercise             If you would like to come please contact
following an illness or condition that has       the Patients’ Association on
slowed us down a bit.                            ehmc.pa@nhs.net or Lesley Walmsley on
The group is run by a trained                    lesleymwalmsley@gmail.com
physiotherapist and takes place every            tel. 8428 7954 - or just come along.
Thursday morning at Hatch End Baptist

TRANSPORT
Our Transport Service continues to help patients unable to get to the surgery or
hospitals for appointments on their own. This is due to the wonderful band of
volunteers, both at the surgery and the drivers. To them all we send our grateful
thanks and the thanks of all the patients involved. Anyone who has recently retired
and possibly has a few hours to spare would be very welcome to join our team of
volunteers.
To help new patients, and to remind all others, we give below details of the operation
of the Service. Patients are reminded that to be eligible to use it they must have prior
approval from a doctor.
                      Pat and David James, Transport Co-ordinators , 020 8428 1711

  DETAILS OF THE OPERATION OF THE TRANSPORT SERVICE
  l ELIGIBILITY                                  be dealt with on 020 8428 1711 by
  Patients must have prior approval              David & Pat James. Drivers do not
  of a doctor and be mobile from                 take bookings.
  house to car. No wheelchairs can
  be accommodated.                               l STATUTORY DONATION of
                                                 £5 return journey to hospitals
  l BOOKINGS                                     (excluding Northwick Park) and
  Volunteers are available at the                local clinics, and £2 return journey
  Medical Centre (020 8428 4019)                 to Medical Centre. Money to be
  to take bookings on Tuesday (Rita)             given to the driver.
                 and Friday (Marcia)
                 10.00 a.m. – 12     l ANYONE NEEDING
                 noon. Emergency     ASSISTANCE AT THE HOSPITAL
                 appointments will should take an escort with them.

                                                14
ADVERTISEMENTS

      15
Thank You Beryl and Arthur

O
          n Saturday 30th November the       prosper. It became clear to Beryl that
          Association held its annual        Carers needed more support and a voice
          Coffee Morning. Thank you to       locally, so she set up the Carers’ Group
all those who donated so generously and      which has been meeting monthly at her
those who braved the elements to join        house for over 20 years. Beryl then also
us. It was once again a successful event     joined the Bereavement Visiting team.
raising over £600 to support Association
                                               Beryl, as we know, is one half of “Team
activities.
                                               Peacop” so it was only natural that
Those who were there will also know            Arthur would also join the fold. Indeed,
that I hijacked the fun on behalf of the       it was Arthur who was instrumental in
Medical Centre and the patients to say         helping us get planning permission for
a huge thank you to Beryl and Arthur           the Medical Centre, which before 1993
Peacop. As a token of our gratitude            operated out of two rooms in the ground
from the Medical Centre we presented           floor of a house at 118 Uxbridge Road,
them with an engraved Glass                                opposite our current Medical
Pyramid in recognition of              “Even  at  the      Centre. Arthur later on
their achievements over more         Coffee Morning helped us design and build our
than 26 years.                      Beryl was selling lift, and together with Beryl
Beryl and Arthur have               raffle tickets and masterminded the “Lift Fund”.
supported the Patients’              Arthur was our So many generous patients
                                        ‘bouncer’. ”       contributed, and our patients
Association from its inception,
                                                           now enjoy this wonderful
and even at the Coffee
                                                           facility which the NHS would
Morning Beryl was selling raffle tickets
                                               not otherwise fund.
and Arthur was our “bouncer”.
                                               Even in the last few years Beryl stepped
I remember well nearly 30 years ago
                                               up as Vice Chairman to help support our
being introduced to Beryl by Dr
                                               current Chairman, Jane. Beryl always
Elizabeth James when we first discussed
                                               leads from the front and would not ask
the possibility of setting up a patient
                                               anyone to do something that she would
group. At the time Beryl was a Guide
                                               not do.
Commissioner and active locally
supporting her voluntary work. Beryl           Beryl’s magic has touched all of us
offered us her support in becoming our         involved in the Association over the last
leader and from that day to now has            26 years and we wish both her and Arthur
been instrumental in helping to set up         a happy retirement. Huge shoes to fill!
the Association and ensuring its stability. I also know Beryl will continue to support
As our first Chairman for seven years it       our activities and keep in touch.
was under her leadership that the very
                                               Thank you both so much
services we have today still continue to
                                                                     Dr Chris Jenner

                                           16
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                                                 17
Thank you from a patient

W
             ell, here we are almost forty      Commission report which has awarded
             years on as patients at EHMC! the practice “Outstanding” in every single
             During our time with the           category and “Outstanding” overall. The
practice, we have seen it evolve from a         comparison facility with other practices
small one based in a converted house            also makes interesting reading.
on Uxbridge Road, to the streamlined            Whenever I am in the surgery, I
modern building and multifacility               notice the number of patients’ missed
practice it is today. In those days there       appointments. Of course there are
were two doctors, and on arrival patients genuine emergencies, but these may not
wrote their name on a piece of paper            represent entirely the reason for around
at the small reception desk and the             160 missed appointments each month.
receptionist pulled out their notes and         I appreciate the NHS was set up on the
they were seen in order of arrival.             principle of being free at point of use, but
The practice has been revolutionised            that doesn’t mean ab-use.
by the use of state-of-the-art medical          We are privileged to have a high level of
software, and now operates an online            medical expertise within the practice,
appointments system which also includes with many of the medical staff having
access to test results and the                              specialist areas of knowledge
facility to order medications.            “The CQC          and interest. Over a period
For those of us who enjoy the            has awarded        of years, as well as providing
odd foray with Dr Google(!),             the practice       clinical advice, our doctors
it’s worth remembering that             ‘Outstanding’       have become trusted
when you look at your online           in every single confidantes.
results, a doctor will have               category.”        The reception and admin team
marked them as normal or you                                have an enormous amount
will have been contacted with anything          of paperwork to deal with behind the
that has been flagged for follow-up.            scenes, and are never less than kind
Even with a change of building and a            and courteous to older patients or those
massive increase in patients there has          who are experiencing difficulty. The
always been consistency in the level of         Patients’ Association has been remarkably
care provided. On the odd occasion              successful and is used as a model for
when there is an absolute emergency and other NHS practices.
you may have a longer wait than usual, we We have seen many changes in Hatch
all try to appreciate that we are not that      End, the loss of many local shops, the
patient who is awaiting the ambulance.          advent of chain cafes, the loss of the
The numerous accolades to the whole             library, to name but a few.
team and the various NHS awards can be We are fortunate to live within walking
read on the website and elsewhere on the distance of the practice which continues
internet. Perhaps the best measure of           to grow from strength to strength.
EHMC is the Care Quality
                                                                      A grateful patient

                                            18
ADVERTISEMENTS

      19
PRIMARY CARE NETWORKS
It has been just over six months since       physiotherapists may also join surgeries,
Primary Care Networks were launched          and patients may have the opportunity to
as part of a new NHS Long Term plan.         be seen by them in preference to a GP for
This article is to update you on what’s      musculoskeletal problems.
happened and what the future may hold.       Thirdly, it is clear that NHS spending
                                             isn’t always directed at where there is the
                                             most need or impact. A lot is talked about
 Elliott Hall Medical Centre is part of      prevention, but relatively little of the NHS
 Sphere Primary Care Network (PCN)           budget is spent on keeping people healthy.
 consisting of 6 surgeries including         Those that allocate resources (Clinical
 GP Direct, Hatch End Medical Centre,        Commissioning Groups - CCGs) can
 Northwick Surgery, St Peter’s Medical       work with PCNs and other organisations
 Centre and Streatfield Health Centre.       like Social Services, community nursing,
                                             mental health trusts and hospitals to
                                             match resources to where they will have
Sphere PCN is one of 5 PCNs in Harrow        the biggest impact. Historically, although
which range in size from 30,000 patients     hospitals may have 10% of patient
to over 80,000. Sphere has over 60,000       contacts they use 90% of the healthcare
patients.                                    budget, which is not a sustainable model.
It is worth remembering the background Sphere PCN has made a good start, with
to the formation of PCNs. The drivers        the different surgeries meeting regularly
were many and included recognition of        and outlining a vision for healthcare of
three main things.                           providing “holistic care in a digital age”.
Firstly, with an ageing population,          A PCN pharmacist has been employed
many of whom now live with long-term         and from April more will be working
conditions, the old model of splitting       in the practices. Regular meetings are
care between GP surgeries, community         happening with the CCG and there
services and hospitals isn’t ideal any more. is more say in how services may be
The PCN model will in time allow these       reconfigured to benefit patients. The
different parts of the system to be brought PCN has piloted its first service with a
together under one umbrella to create a      Stop Smoking pilot being run by St Peter’s
better experience for patients.              Medical Centre.
Secondly, GPs and nurses are under more Connecting with patients has been
pressure than ever, with many choosing       highlighted as a priority, and by the time
to leave the profession. Recruitment is      this is printed, connections will have been
therefore a challenge and the thinking       established with the patient groups in the
was to introduce into GP surgeries new       different surgeries.
roles with complementary skillsets. In       Lastly, it is recognised that this is a
many parts of the country practice           journey on which PCN has embarked
pharmacists are now routinely members        but that it will only succeed in delivering
of the GP surgery team, seeing patients      a better healthcare experience with the
for medication reviews or asthma and         input of professionals and patients alike.
diabetes checks. Over the next year                                 Dr Ashok Kelshiker

                                           20
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                                 21
APPOINTMENTS AT HUBS
                                                 SMS Text Reminders
When EHMC is full to capacity, as part of
Harrow we are lucky enough to be able to         If we have your mobile phone
book patients directly into Access Centres       details and consent, the practice
for appointments. These centres offer            may contact you to remind you
1,100 appointments a week - that’s 60,000        about upcoming appointments, as
appointments a year!                             well as to inform you of test results
There are two Access Centres within our area:    or with other information relating
                                                 to your health. Please note that
Alexandra Avenue Health and                      it is not possible for us to read or
Social Care Centre -                             respond to any replies you send.
Tel. 020 8427 2470                               Occasionally the message may
275 Alexandra Avenue                             direct you to respond with a specific
Harrow, HA2 9DX
                                                 word which will update your
The Belmont Health Centre -                      medical record (e.g. CANCEL if you
Tel. 020 8866 4100 option 1                      wish to cancel an appointment).
516 Kenton Lane                                  Please note that replying with
Harrow, HA3 7LT                                                    anything other than
                                                                   the word requested
Harrow Clinical Commissioning Group have                           may lead to your
invested money into this service to enable                         message not
patients to have an appointment with a GP                          working.
when their own surgeries are full to capacity.                     Thank you.
As well as normal daytime appointments                                    Laura Knight,
they also offer evening and weekend ones.                               Deputy Practice
After a consultation they email details of it                       Manager & IT Lead
to Elliott Hall so that we can action any
follow-ups required.
These appointments can only be booked
through a patient’s GP surgery, or through
111 when the surgery is closed. In order            Did you know?
to cancel an appointment once it has been
made patients need to phone the Access              We are now able to
Centres on the numbers above.
The Access Centres are unable to do referrals
                                                   accept card payments
unless it is an urgent cancer referral.                at the surgery.
Please leave plenty of time to find parking as
patients who arrive late may not be seen.
                                                      We have recently
There is also a walk-in service                     set up a card reader
open 8am-8pm 7 days a week, including
bank holidays, at:
                                                   available at the front
                                                  desk to accept payment
Pinn Medical Centre
37 Love Lane                                        for any private work
Pinner, HA5 3EE. 			                                     that we do.
         Marie Jolly, Practice Manager
                                           22
                                           A
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                                                  23
                                                  A
Cervical Screening (Smear Tests)
The NHS Cervical Screening                  procedure is usually done in less than
Programme has made a significant            10 minutes and, if normal, will only
impact on cervical cancer mortality         need to be repeated every 3-5 years.
since it was established in 1988,           The sample collected will be tested
saving an estimated 5,000 lives a year.     for high risk strains of a virus called
Cervical screening (a smear test) is        Human Papillomavirus (HPV).
to check the health of your cervix,         High risk strains of HPV are known
the opening to your womb from               to cause changes to the cells in the
your vagina. The screening allows           cervix and these changed cells can
early cellular changes to be detected       go on to transform into cancer. If
and gives women the opportunity to          the sample is negative for HPV it
seek treatment before these changes         will not be further analysed. If the
have the chance to turn into cervical       sample is positive for HPV, the smear
cancer. At the age of 25, all                        sample will be assessed to
women in the UK will                                     decide whether you need
be invited to attend for                                   follow-up in a specialist
cervical screening. If                                       clinic for further tests/
you are under 25 and                                          treatment or to be
concerned regarding                                           recalled for a repeat
any symptoms you                                              smear in a year’s time.
may be experiencing                                          If any abnormalities
and feel you may                                            are detected, it does
need a smear test,                                        NOT always mean you
please discuss this with a                            have cervical cancer. It may
doctor, as smear tests taken in                 mean that you require further
anyone under the age of 25 will not         specialist tests and possible treatment
be processed as part of the national        of any abnormal cells to prevent
screening programme.                        these from turning into cervical
During the test, a speculum (plastic        cancer. The results of your screening
tool used for internal exams)               are usually posted to you within 2
is inserted into the vagina and             weeks of your procedure.
allows the clinician to visualise the       Our nurses perform cervical
cervix. Lubrication is applied to           screening regularly and are happy to
the speculum to avoid discomfort on         discuss any concerns or queries you
insertion into the vagina. Once the         may have regarding the screening
cervix is seen, a small brush is used       process.
to collect some cells from it, a process    To book in for your cervical
which is not usually painful. The           screening please call 020 8428 4019.
                                                                      Dr Ujali Patel
                                           24
ADVERTISEMENTS

 HAY FEVER TREATMENT GUIDE
Hay fever is caused by the body’s
defences over-reacting to pollen
released into the air by plants. The
pollen causes the release of a substance
called Histamine from cells in the skin.
Histamine stimulates the allergic reaction
that causes many of the symptoms such
as sneezing, sore and runny eyes, blocked
nose and ears, sinus pain and tickly throat
or itchy palate.
       Different pollens are present at
different times of the spring and summer,
so when you are affected depends upon          pollen is the ideal solution – but not
                                                                                             Images courtesy of Freepik

which pollen you are allergic to. Muggy        always practical. A simple “treatment
weather and poor air quality can also          tree” is shown on page 28 to help you
aggravate the situation.                       deal with your hay fever effectively – so
       So, what’s the most effective way       that you can concentrate on enjoying
to treat hay fever? Staying away from          your summer.
                                                                   continues on page 26...
                                              25
continued from page 25...

                            How to help yourself
                            There are several things you can do to           Hay fever
                            avoid contact with pollen and so lessen          treatment guide
                            symptoms:
                            • High 5! Stay inside with doors and             A full range of effective medication for
                               windows closed when pollen counts             hay fever is available over the counter
                               are at their highest – between 5 and 7        from pharmacies.
                               p.m, and 7 – 9 a.m.
                            • Sleep soundly Keep windows                     There are 4 types of hay fever product:
                               closed when you’re in bed at night.            • Oral antihistamines
                               It may also help to wash your hair if          • Nasal preparations
                               you’ve been outside, as pollen could           • Oral decongestants
                               be trapped in your hair.                       • Eye preparations
                            • Summer-clean! Keep pollen and
                               dust out of your home by vacuuming            If you only suffer some symptoms and
                               and damp-dusting regularly. When              you prefer a specific product, check
                               you get home after a walk in the              the “Treatment Tree” to find the
                               country, change your clothes and              product which suits you best.
                               brush your pets – they could be
                               carrying pollen too!                          Ask your pharmacist for the
                            • Shady days Always wear close-                  most suitable treatment
                               fitting sunglasses when you go                Some hay fever products are not
                               outside.                                      suitable if you’re taking certain other
                            • Confirm the Count Pollen counts                medicines, and some shouldn’t be
                               are usually broadcast with the                taken by children or pregnant women.
                               weather, or be prepared by checking                  If at all unsure, ask your
                               www.allergyadvice.co.uk for a 4-day           pharmacist for advice. Some older
                               forecast                                      antihistamine treatments may cause
                            • No-go areas Try to avoid areas of              drowsiness, but newer ones are
                               high pollen count, such as gardens,           unlikely to. If you drive or operate
                               parks and woodland (especially if the         machinery, ask your pharmacist for the
                               grass has just been cut). If you need         most suitable treatment for you.
                               to work in those areas a mask and
                               goggles may help.                             Oral antihistamines
                            • Fuming Try to avoid unnecessary                Antihistamines are generally effective
                               irritants such as pollution and fumes.        in controlling the typical symptoms
                                                                             of hay fever: sneezing, runny nose,
                                                For more info on             watery eyes, itching nose and throat.
                                                  hay fever visit            They are more effective if taken before
                                                   www.chic.org.uk           the symptoms occur rather than after
                                                                             they have started.
Image courtesy of Freepik

                                                                             Treatment choices:
                                                                             • Benadryl Allergy Relief Capsules

                                                                        26
or One a Day tablets                   Oral decongestants
•   Clarityn Allergy Tablets and Syrup     If you’re congested, you may prefer
•   Histergan Syrup                        a tablet to a nasal spray. These can
•   Piriteze Tablets                       be used for longer periods than nasal
•   Piriton Allergy Tablets and Syrup      decongestants.
•   Zirtek Allergy Tablets                 Treatment choices:
                                           • Contac
Nasal preparations                         • Sudafed
These are suitable if you only suffer
nasal symptoms. Most can be used           Eye preparations
throughout the hay fever season. Ask       Most eye symptoms caused by
your pharmacist for advice.                hay fever will be controlled by oral
Anti-inflammatory and                      antihistamines. If your eyes are
antihistamine sprays                       particularly troublesome or if your hay
These work by suppressing or blocking      fever symptoms only occur in the eyes,
the allergic response and reducing         you may find it helps to use some eye
the inflammation and swelling that         drops. These preparations contain
can be caused by hay fever. For best       antihistamine or anti-inflammatory
results start using before the hay fever   ingredients.
season begins, as they take about 3        Antihistamines
days to begin working. You should use      Treatment choices:
these products throughout the season       • Aller-eze Eye Drops
even if your symptoms seem to have         • Livostin Direct Eyedrops
disappeared.                               Anti-inflammatories
Treatment choices:                         Treatment choices:
• Beconase Hayfever Spray                  • Clarityn Allergy Eyedrops
• Care Hayfever Relief Nasal Spray         • Opticrom Allergy Eyedrops
• Flixonase Allergy Nasal Spray            • Optrex Allergy Eyedrops
• Livostin Direct Nasal Spray              Antihistamine and decongestant
Nasal Decongestants                        Treatment choices:
These can help relieve a blocked           • Otrivine-Antisin eye-drops
nose, but they can cause “rebound          If you wear contacts always check with
congestion” and should not be used for     your pharmacist or optometrist before
more than about a week at a time.          using eye drops. You should see your
Inhalants                                  GP if any of the following applies to you:
Products containing natural essential      You are experiencing
oils such as eucalyptus, mint and          • Wheezing
menthol can be inhaled to ease a stuffy    • Breathlessness
nose.                                      • Tightness in the chest
Treatment choices:                         • You are pregnant
• Happinose                                • You are breastfeeding
• Olbas Oil

                                           27
HAY FEVER TREATMENT TREE
 Have you got the main symptoms of hay fever – sneezing, runny nose,
         blocked nose, itchy nose and throat, watering eyes?
                                        YES
     Refer to the Treatment Guide for a list of antihistamine products that will
    help relieve your symptoms. Ask your pharmacist for advice if you’re still not
              sure of the best way to treat your hay fever this summer.

       Oral antihistamines will treat most symptoms of hay fever.
       If you suffer badly with any of the symptoms below use the
    treatments in the boxes as well as or instead of an antihistamine.

                      Blocked    Blocked                               Tickly Throat
    Sore Eyes                                       Sinus Pain
                       Nose        Ears                                /itchy palate

                            Use an
                                                   Use a simple
                       antihistamine or
                                                   analgesic and
                      anti-inflammatory                                 Take an oral
        Use                                          an oral or
                          nasal spray,                                 antihistamine
 antihistamine or                                  topical nasal
                        plus an oral or                                    and try
anti-inflammatory                                  decongestant
                         topical nasal                                 sucking throat
    eye drops                                   (maximum 1 week)
                        decongestant                                      lozenges
                                                 with the advice of
                     (maximum 1 week)
                                                 your pharmacist
                         if necessary

           Are your hay fever symptoms controlled after 1 week?

                 YES                                             NO

     Continue to use treatment(s)
                                                     See your GP or Practice Nurse
   throughout the hay fever season

 This fact sheet has been produced by CHIC (Consumer Health Information Centre),
          an information service to help you understand and treat every-day
                       healthcare problems. www.chic.org.uk

                                           28
FAILING TO ATTEND APPOINTMENTS
When patients fail to show up              times to see a GP.
to an appointment - or do not              It is not just appointments at the
attend (DNA) - it can be hugely            surgery which are missed but often
frustrating for a number of reasons.       patients fail to attend specialist
Appointments which are booked and appointments. All too often we
not cancelled mean those who wish          read about the increasing waiting
to see a clinician have to wait longer times for specialist appointments,
to be seen.                                and this waiting time is not helped
If you have an appointment but feel        by the number of individuals failing
you cannot attend please cancel it at to attend an appointment. NHS
the earliest opportunity. This allows England report almost eight million
someone else to use this                               hospital appointments were
appointment instead of            “In December         missed, or “did not attend”,
you. Appointments can be            alone 166          in 2017/18, and that does
cancelled online (via patient         missed           not include appointments
access) or by telephone           appointments cancelled in advance
(020 8428 4019).                   amount to a         by either the hospital
We send a text reminder           loss of £4,980 or the patient. With
24 hours before an                 to the NHS.”        each hospital outpatient
appointment to patients                                appointment costing the
whose mobile numbers we have on            NHS approximately £120, that could
file. If you do not get this reminder mean almost £1 billion worth of
this may mean that we don’t have the missed appointments, equivalent to
correct contact details for you,           257,000 hip replacements or 990,000
so please check with Reception             cataract operations.
or the clinician.                          If you do not attend an appointment
In December alone 166                      at the surgery, a text message will be
appointments at the surgery were           sent informing you that you have
not attended, which amounts to a           not attended the appointment and
loss of £4,980 to the NHS. In               reminding you to cancel ahead of
the entire year of 2019, 2,013                 time in future. If you repeatedly
appointments were not attended                   fail to attend appointments at
at Elliott Hall Medical Centre.                     the surgery, we will write to
This is approximately                                   you to highlight this and
£60,390 of wasted                                       will formally discuss your
                                                                                      Image courtesy of Freepik

resources that could be                                 case at a practice meeting
used to fund another                                    to decide on further action
clinician in the practice and                           which may be taken.
significantly reduce waiting                                        Dr Ujali Patel
                                        29
MMR – The latest update
Whilst 95% of all children in our      outbreaks in universities every few
practice are vaccinated there is a     years, we are seeing a significant
small number of children who have      number of cases, the highest
not been protected from Measles,       quarterly figure since 2009.
Mumps and Rubella, conditions that     “Coupled with the continued
are currently on the increase.         measles outbreaks these figures
 Measles is associated with brain      clearly demonstrate the need for
damage because of a complication       sustained high vaccination rates.”
called subacute sclerosing pan            We’re urging parents and their
encephalitis and measles                        children, no matter how
pneumonia. Mumps is                               old they are, to check
commonly associated                                  that they’ve had 2 doses
in boys and girls                                     of MMR. Measles is
with later infertility                                 easy to catch and can
because the ovaries                                    kill. Vaccines are there
and testicles can be                                  to stop the spread of
affected. In England,                               disease and to save lives.
301 new measles infections                       It’s never too late to protect
were confirmed in the                         yourself and others!
period between April and June          Nearly half of the mumps cases this
2019 compared to 231 in the first      quarter were in vaccinated people.
quarter of that year. Cases were       While the mumps component of
reported in all regions except the     the Measles, Mumps and Rubella
North East, most cases (266) being     (MMR) vaccine is highly effective
in unvaccinated individuals aged 15    at protecting young children,
years and over.                        immunity can reduce over time.
Continuing the increase seen           Therefore, older teenagers and
between January and March, 2,028       adults who received two doses of
cases of mumps were also confirmed     MMR in childhood can still get
in the second quarter of 2019, this    mumps, although this is generally
increase mostly driven by outbreaks    mild compared to those who are
in university students. Cases          unvaccinated.
were reported across England,          One new case of rubella
predominantly in young adults          re-infection in a pregnant woman
aged 15 to 34 years.                   was also reported.
Dr Mary Ramsay, Head of                Please ensure your child has had
Immunisation at Public Health          2 doses of MMR (1st dose 1year, 2nd
England (PHE), said:                   dose pre-school).
“Although it is normal to see mumps                    Sister Helen Jenner
                                      30
Pneumonia vaccine
 There is currently a nationwide shortage of this vaccine as there has
 been a growing demand and also manufacturing constraints. These
 problems have led to an interruption in the supply from the drug
 company to all NHS GP surgeries, and our supplier has told us it will
 be not available until April at the earliest. Be assured that we will
 keep you updated on our surgery screens and our website.
                                                     Nurse Ruth Godfrey

                        Pre-Diabetes

P
        re-diabetes is a condition        the development of type 2 diabetes.
        where your blood sugar level      Research has shown that 3 out of
        (or HbA1c) is raised. The         5 cases of type 2 diabetes can be
raised sugar level is not quite high      prevented in this way.
enough to be diagnosed as diabetes,       There are 2 real areas which can
but is high enough for there to be an     really be beneficial to work on if
increased risk of developing it. We       you have pre-diabetes. The first is
routinely look at HbA1c levels as part    exercise – the NHS recommends
of health checks and annual reviews       150 minutes of moderate intensity
                                                                                Images courtesy of Freepik

at Elliott Hall Medical Centre.           exercise every week. This may
Pre-diabetes is an important              sound a lot, but works out at just
condition to be aware about,              over 20 minutes each day of the
as with early interventions and           week! Being more active doesn’t
lifestyle changes we can prevent          always mean going to the gym –

                                         31
little everyday things like walking to        RUN, ELLIOT
the train station instead of driving, or
taking the stairs instead of the lift, can    HALL, RUN!
all add up to help reach your target!         In June 2019 Elliott Hall Medical
The second area to focus on is diet           Centre joined the Royal College
and lifestyle. Reducing alcohol intake        of General Practitioners (RCGP)
can help with weight loss as alcoholic        Parkrun initiative to encourage us
drinks contain lots of calories and           to prescribe “active lifestyles” to
sugar. Stopping smoking can make              our patients.
getting active easier and improve             Parkruns are 5km running (or
                    exercise tolerance,       walking) events that take place
 “The Diabetes which in turn can              every Saturday morning at over
   UK website       help with pre-            1,400 locations all over the
    has lots of     diabetes. Eating          world. They are free to enter
    good meal       a well-rounded,           and organised by volunteers.
    plans and       Mediterranean             The concept, launched in the
exercise advice.” diet and reducing           UK over 15 years ago, now has
                    the amount of             over 5 million registered runners
carbohydrates (bread, pasta, rice) can                          worldwide.
be extremely beneficial in preventing
diabetes. The Diabetes UK website has
lots of good resources including meal
plans and exercise advice. If you are
overweight, just a 5% loss in weight
can significantly reduce your risk of
developing type 2 diabetes!
There are lots of ways the practice
can help with losing weight and
pre-diabetes. If you are diagnosed
with pre-diabetes we can refer you
to the National Diabetes Prevention
Programme, which has lots of useful
information and ways to improve
health. Next time you are seeing
your doctor or nurse ask us for
some more information on pre-
diabetes! You can also join
our monthly Parkrun –
see right for more details!
         Dr Sanjay Joshi
                                         32
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