CHOICES WEB-SITEThe NHS has set up a website called choices which allows feedback on this and other practices. Comments are then available to anyone who may, for example, be considering joining a new practice. We hope that you receive a good standard of service and care from the practice and we are always keen to seek feedback.

It is human nature that most people will only make the effort to write a letter or send a response if they are unhappy with a service or goods. We would like therefore to encourage positive and negative feedback on the choices website which can be found at http://www.nhs.uk and entering the postcode NG2 7DR under ‘Find GP practices’.

REGISTRARSDr Katherine Earis remains with us until the autumn 2010 while Dr Kamayani Singh is returning to hospital posts before completing her GP training. We wish her well with her future career. We will be joined in December by Dr Alex Brodie who already has some general practice training in Nottingham

BOWEL CANCER SCREENINGAll patients aged between 60 and 69 are invited to take part in the national NHS Bowel Screening Programme which currently underway. A number of people have opted out of the scheme by personal choice but it is also possible for the test to be arranged, if requested, for those 70yrs and over.

If you are over 70 or over you can request a bowel cancer testing kit by teleponing the NHS Bowel Cancer Screening Programme on:

0800 707 60 60

Patients are sent a simple test kit to complete in the privacy of their home. This will involve collecting a small sample from three separate bowel motions and, using a specially designed prepaid envelope and returning the kit to the laboratory for analysis. The test does not diagnose bowel cancer but gives an indication as to whether further investigations are required.

FLU VACCINATIONThere are 2 simultaneous vaccination campaigns currently in progress and as a result, some confusion as to who should have which vaccine.

The SEASONAL flu vaccination is unchanged from previous years and is recommended for all over 65yrs and those with:

• a serious heart or chest complaint, including asthma,
• serious kidney disease,
• diabetes,
• lowered immunity due to disease or treatment such as steroid medication or cancer treatment, or if you have ever had a stroke.
• Or if you are a carer of any of the above.

The SWINE flu vaccine is recommended for:

• People aged between six months and 65 years in the at risk groups above.
• All pregnant women.
• People who live with someone whose immune system is compromised (for example, people with cancer or HIV/AIDS).
• People aged over 65 WHO ARE ALSO in the seasonal flu vaccine at-risk groups.
• Children aged 6 months to 5 years. This is a single injection, not two as previously anticipated.

If you are unclear then please discuss with the practice nurse or the doctor.

PATIENT PARTICIPATION GROUPWe would like to thank Prof Bryan Button who has worked hard for the patient participation group from it’s beginning who has recently retired from the group and we all wish him well. We have been joined by Mr Philip Locking and welcomed him at that last meeting in November. Current projects include finding local facilities for losing weight and improving fitness (see below), work on a new practice leaflet and a new website and forging links with other patient groups and Principia. There is still availability for newcomers and some current members are due for re-election. If you are interested then ask at the reception desk.

WEIGHT LOSS & FITNESSObesity and lack of fitness is becoming an epidemic in this and other countries which threatens to reduce or reverse the trend of increasing life expectancy. A variety of national and local initiatives have been launched and the PPG has been helping us draw up a catalogue of useful organisations, groups, information and services. An example is the NHS website www.nhs.uk/Change4Life which has advice on dieting, portion sizes, recipes and ways of achieving ‘Five-a-day’ for fruit and veg. Over 400,000 families have joined so far. It is also possible to find out where local sports and exercise facilities can be found in the local area. There is a ‘Prescription for Exercise’ scheme which gives, those who qualify,  cut price gymn membership at some participating organisations. Some pharmacies are running diet regimens and anti-obesity medications can be prescribed in some circumstances

ACCIDENT & EMERGENCY / 999 - A FREE SERVICE?In the UK it is reassuring to know that if you are seriously ill and in need of urgent medical attention, help is at hand via 999 and the ambulance service or the local Accident & Emergency Department. These services are free to the user and the provision is national. So who pays for these services? Well in South Nottingham, Principia does. There is a fee for all ambulance call outs, journeys to hospital and casualty attendances. An ambulance call out costs £150 to £200 or more. The tariff for a casualty department attendance varies from approx £50 to £100. For the UK the cost of A&E attendances for 2006-7 was £6.1 billion.

Principia contracts these services on our behalf,  but has a finite budget. Money also has to be found for all hospital stays, operations, drug budgets and local primary care services.

With costs in mind we should think carefully about our use of 999 ambulance and A&E. The practice is notified of each contact. East Midlands Ambulance Service (EMAS) made 42,000 call-outs in 2007 to attend older people who had fallen. Most did not require hospital treatment. We have in the past been phoned from the casualty department to see if it is quicker to get an appointment at the surgery or wait in the queue. The details of some attendances reveal problems that have been present for weeks or that many have not waited for treatment.

The converse is also true that some delay calling. For genuine emergencies such as chest pain or suspected stroke then 999 is the correct choice.