Abdominal Pain

Who do I see: If the pain is acute or you have had longer than a week then you should make an appointment with a GP. Advice: Please click here for information and self care advice.

Acute Asthma

Who do I see: If you are have had an acute attack then you should make an appointment with your GP or nurse. Advice: Please click here for information and self care advice.

Alcohol Advice

Who do I see: If you are concerned about yours or someone else's alcohol consumption there are organisations within the borough that can help you. Please click here for information  Advice: Please click here for further information and self care advice

Anxiety

Who do I see: In Hounslow there are a number of health professionals you can see to help with mental health problems. Please click on the services below to be taken to their sites some of which where self referrals can be made. You are also able to see your GP with mental health concerns.

• Hounslow IAPT
• Primary Care Plus
• West London Mental Health Trust

Advice: Please click here for information and self care advice.

Back Pain

Who do I see:  There are numerous different causes and treatments for back pain but if the pain is severe and / or continuous you should seek an appointment with your GP. you may be referred to one of the clinics below.

• Hounslow Musculoskeletal Physiotherapy Service
• Hounslow Pain Management Clinic

Advice:  Please click here for information and self care advice.

Blood Pressure Monitoring

Who do I see: If you are concerned about your blood pressure then you can make an appointment with our nurse or health care assistant if they are concerned they will consult the GP as necessary. You can ask for a blood pressure test if you're worried about your blood pressure at any point. You can get your blood pressure tested at a number of places, including:

• at your local GP surgery via our height, weight and blood pressure machine.
• at some pharmacies
• in some workplaces
• at home
• at an NHS Health Check appointment offered to adults in England aged 40-74

Advice: Please click here for information and self care advice.

Blood Tests

Who do I see: Phlebotomist / Health Care Assistant Advice: Clinics are held daily at various times. Appointments for blood tests MUST have been requested by your doctor or other health care professional from Chiswick Health Practice. If you are in doubt please call to speak to one of our nurses who will advise you. Please click here for further information. 

Blue Badge Forms

Who do I see: Contact Hounslow Council Advice: Please click here for further information and access to blue badge application.

Boils

Who do I see: With boils, you don't usually need to see a doctor as most boils burst and heal by themselves. If you are concerned about a boil, speak to a pharmacist in the first instance and follow their advice. It might be that the pharmacist suggests to make an appointment to see a nurse / nurse practitioner or GP. Advice: Please click here for further information and self care advice.

Breast Feeding Advice

Who do I see: If you need advice on breast feeding there are a number of groups and organisations in Hounslow who are able to offer advice and support. Please click here for more information For details of midwives at West Middlesex Hospital please click here. Advice: For more information on breastfeeding please click here

Breathlessness

Who do I see: See a nurse or GP if you have shortness of breath and:

• it's lasted for longer than a month
• it gets worse when you've been active
• it gets worse when you lie down
• you've been coughing for 3 weeks or more
• you've got swollen ankles

Advice: Please click here for further information and self care advice.

Bruised Ribs

Who do I see: If you have injured your ribs you may need to make an appointment with a nurse practitioner or GP, alternatively  go to a minor injuries unit if your pain hasn't improved within a few weeks. The doctor can prescribe stronger painkillers if necessary or refer you to hospital if you need further treatment. Click here for the closest minor injuries units Please click on the name of the service below for further information:

• Hounslow Falls Prevention Team
• Integrated Community Response Service (Hounslow)

Advice: Please click here for further information and self care advice.

Burns

Who do I see: Depending on how serious a burn is, it may be possible to treat it at home. For minor burns, keep the burn clean and don't burst any blisters that form. More serious burns require professional medical attention. You should go to a hospital A&E department for:

• all chemical and electrical burns
• large or deep burns – any burn bigger than your hand
• burns that cause white or charred skin – any size
• burns on the face, hands, arms, feet, legs or genitals that cause blisters

Advice: Please click here for further information and self care advice.

Cellulitis

Who do I see: Cellulitis is a skin infection that's treated with antibiotics. It can be serious if it's not treated quickly.  See  our nurse practitioner or a GP if your skin is red, hot and painful (it may also be swollen and blistered, you can also have swollen, painful glands Advice: Please click here for further information and self care advice.

Cervical Smears

Who do I see: You'll receive a letter through the post asking you to make an appointment for a cervical screening test. The letter should contain the details of the place you need to contact for the appointment. Screening is usually carried out by the practice nurse at your GP clinic. You can ask to have a female doctor or nurse. Advice: Please click here for further information and self care advice.

Chest Infections

Who do I see: Chest infections often follow colds or flu. The main symptoms are a chesty cough – you may cough up green or yellow mucus, wheezing and shortness of breath, chest pain or discomfort, high temperature (fever) of 38C or above, headache, aching muscles and tiredness These symptoms can be unpleasant, but they usually get better on their own in about 7 to 10 days. The cough and mucus can last up to 3 weeks. You will need to see a nurse practitioner or GP if you have a chest infection and:

• you feel very unwell or your symptoms get worse
• you cough up blood or blood-stained mucus
• you've had a cough for more than 3 weeks
• you're pregnant
• you're over 65
• your immune system is weak – for example, you have a condition like diabetes or you're having chemotherapy
• you have a long-term health condition, such as a heart, lung or kidney condition

Advice: Please click here for further information and self care advice. 

Chickenpox

Who do I see: Chickenpox is common and mostly affects children, although you can get it at any age. It usually gets better by itself within a week without needing to see a GP. Children with chickenpox should be kept at home, drinking plenty of fluids to stay hydrated and away from school and other public places.  The use of calamine lotion, moisturising creams or cooling gels to ease itching are suggested and available from your local pharmacist. Advice: Please click here for further information and self care advice.

Children's Immunisations

Who do I see: Children's immunisations require an appointment with the nurse. Please click here for a  list of immunisations  from birth onwards. Advice: Appointments are needed for Immunisations,  If you require an appointment for an immunisation please contact the practice on 0208 630 1601.

Chronic Heart Disease

Who do I see: If your doctor thinks you may be at risk of Chronic Heart Disease , they may carry out a risk assessment for cardiovascular disease, heart attack or stroke. Advice: Please click for further information and self care advice.

Cold Sores

Who do I see: Cold sores can be treated with over the counter medicines from a chemist.  If the sore shows no signs of improvement or started to heal after 10 days then you may need to make an appointment to see a nurse practitioner or GP. Advice: Please click for further information and self care advice.

Colds

Who do I see: Treatment for a common cold should consist of rest and over the counter remedies from a local chemist. However if the symptoms don't improve after three weeks, your symptoms get suddenly worse, your temperature is very high or you feel hot and shivery,  you're concerned about your child's symptoms,you're finding it hard to breathe or develop chest pain, you have a long-term medical condition – for example, diabetes, or a heart, lung, kidney or neurological disease, you have a weakened immune system – for example, because you're having chemotherapy then you may need to book an appointment with your GP. Advice: Please click here for further information and self care advice.

Constipation

Who do I see:  Treatment for constipation can be bought over the counter from a pharmacist. If your regular pattern does not return after 2-3 days, you have blood in your poo or have unexpectedly lost weight then make an appointment to see your GP Advice: Please click here for further information and self care advice.

Contraception/Family Planning

Who do I see: There are a number of sexual health / family planning clinics in Hounslow please click here for information alternatively make an appointment to see the nurse practitioner or GP.    Advice: Please click here for further information and self care advice. 

Cough

Who do I see: For a common cold it is not usually necessary to see a health professional, there are plenty of medicines available over the counter in your local chemist.  However if you've had a cough for more than 3 weeks (persistent cough), your cough is very bad or quickly gets worse, for example – you have a hacking cough or can't stop coughing, you have chest pain, you're losing weight for no reason, the side of your neck feels swollen and painful (swollen glands), you find it hard to breathe or you have a weakened immune system, for example because of chemotherapy or diabetes See a GP urgently if you're coughing up blood. Advice: Please click for further information and self care advice.

Cystitis

Who do I see: Women don't necessarily need to see their GP if they have cystitis, as mild cases often get better without treatment. You can try the self-help measures or ask your pharmacist for advice. Advice: Please click here for further information and self care advice.

Dementia Screening

Who do I see: If you are concerned a friend or family member might be suffering from dementia, you are able to go through this test with them - please click here      You can find out more information regarding dementia here If you are concerned about yourself, a friend or family member it would be good to see your GP to a diagnosis can be made.

Please click here for information regarding the cognitive impairment and Dementia (CIDs) team

Advice: For further information and advice please click here

Dental Problems

Who do I see: For normal dental issues or appointments you will need to speak to your dentist, however if you need an appointment out of hours call 111. Advice: To find a local NHS dentist please click here.

Depo Injection / Contraception Injection

Who do I see: There are a number of sexual health / family planning clinics in Hounslow please click here for information alternatively emergency contraception is also available through most pharmacists alternatively you can make an appointment with a nurse or GP    Advice: Please click here for further information and self care advice. 

Depression

Who do I see: In Hounslow there are a number of health professionals you can see to help with mental health problems. Please click on the services below to be taken to their sites some of which where self referrals can be made. You are also able to see your GP with mental health concerns.

• Hounslow IAPT
• Primary Care Plus
• West London Mental Health Trust

Advice: Please click here for information and self care advice.

Diabetes Monitoring

Who do I see: Patients are encouraged to book an appointment with our diabetes specialist nurse or their GP for the monitoring of their diabetes. Advice:  Please click here for more information and self care advice.

Diarrhoea and Vomiting

Who do I see:  A pharmacist can help if your baby is under 12 months old and has diarrhoea or vomiting, you or your child (over 12 months old) have signs of dehydration– such as dark, smelly pee or peeing less than usual, your child has more than 5 bouts of diarrhoea or vomits more than 3 times in 24 hours. They may recommend oral rehydration sachets that you mix with water and drink, medicine to stop diarrhoea for a few hours (like loperamide) – not suitable for young children Advice: Please click here for more information and self care advice.

Diet/Lifestyle Changes

Who do I see: In Hounslow "One You Hounslow" are commissioned to assist patients with diet and lifestyle changes. Alternatively you can make an appointment to see the nurse at your GP practice. For more information on the services "One You Hounslow"  There are various downloadable apps for your smartphone to assist you with lifestyle changes and advice. Please click here for further information on the apps suggested by the NHS. Advice:  Please click here for more information and self care advice.

Dizziness

Who do I see: Dizziness usually goes away on its own. But there are things you can do to take care of yourself while you're feeling dizzy. These include lying down until dizziness passes, then get up slowly, moving slowly and carefully, getting plenty of rest, drinking plenty of fluids, especially water and avoiding coffee, cigarettes, alcohol and drugs Advice: Please click here for more information and self care advice

Dressings

Who do I see: If you have had an operation or have a sore that needs regular dressing change you will need to contact our reception team. Some dressing changes can be fulfilled by one of nurses in the practice, others will need to got through the community service. Advice: For more information please contact the practice on 0208 630 1600

Drug Addiction

Who do I see:  A number of people do not want to talk to their GP regarding a drug problem so there are specific services in the borough who can help people with addictions. Please see a list of drug misuse services in Hounslow by clicking here.  Advice: For further information please click here

Ear Wax

Who do I see: If you have tried over the counter medicines and the problem still persists after 5 days or you have a very badly blocked ear and cannot hear out of it then you will need to make an appointment to see a nurse. Advice: If you think you may need ear irrigation ('syringing' )please speak to one of our nurses who will advise you. Also please check the following information on NHS Choices.

Earache

Who do I see: If you or your child has had earache for more than 3 days , a very high temperature or feels hot and shivery, swelling around the ear,  earache in both ears, fluid coming from the ear, something stuck in the ear, hearing loss or a change in hearing, a severe sore throat or vomiting then you should make an appointment with our nurse practitioner or GP. Advice: Please click here for more information and self care advice.

Electrocardiogram (ECG)

Who do I see: An electrocardiogram (ECG) is a simple test that can be used to check your heart's rhythm and electrical activity. Sensors attached to the skin are used to detect the electrical signals produced by your heart each time it beats. These signals are recorded by a machine and are looked at by a doctor to see if they're unusual. An ECG may be requested by a heart specialist (cardiologist) or any doctor who thinks you might have a problem with your heart, including your GP. The test can be carried out by a specially trained healthcare professional at Chiswick Health Practice Despite having a similar name, an ECG isn't the same as an echocardiogram, which is a scan of the heart. Advice: Please click here for further information.

Eczema

Who do I see: You should make an appointment with a nurse if you have symptoms of atopic eczema. They'll usually be able to diagnose atopic eczema by looking at your skin and asking questions such as:

• whether the rash is itchy and where it appears
• when the symptoms first began
• whether it comes and goes over time
• whether there's a history of atopic eczema in your family
• whether you have any other conditions, such as allergies or asthma
• whether something in your diet or lifestyle may be contributing to your symptoms

Advice: Please click here for more information and self care advice.

Emergency Contraception

Who do I see: There are a number of sexual health / family planning clinics in Hounslow please click here for information alternatively emergency contraception is also available through most pharmacists alternatively you can make an appointment with a nurse or GP    Advice: Please click here for further information and self care advice. 

Eye Infection

Who do I see: Treatment will depend on the cause of your eye infection. If it's a bacterial infection you might be prescribed antibiotics. But these won't work if it's caused by a virus (viral conjunctivitis) or an allergy. Some sexually transmitted infections (STIs) can cause conjunctivitis. This type takes longer to clear up. Advice: Please click here for further information and self care advice.

Eye Injuries

Who do I see: If you have a serious eye injury, you should be seen by an eye specialist called an ophthalmologist or a specialist eye nurse.

You'll be asked how the injury happened, your vision and eye movements will be checked, and the eye will then be examined to determine how severe the injury is.If there's a foreign object in your eye, they may remove it using water or a cotton wool bud. Local anaesthetic drops are used to numb your eye before any objects are removed.You may be prescribed a course of antibiotic ointment or eye drops for a week to help prevent infection. Infections after eye injuries are uncommon, but they can potentially be very serious.If you have a cut on your eye or damage to the bones around your eye, you may need an operation to repair them.Depending on the severity of your injury, the doctor may recommend a follow-up appointment with your GP the next day to check whether your eye is healing.Your GP may refer you to an ophthalmologist for further specialist care if your eye hasn't improved after 48 hours or it's got worse.

Preventing eye injuries Many eye injuries are preventable if you take appropriate safety precautions during leisure activities or work – for example, wearing eye protection when hammering metal and using power tools.You should also follow instructions on the safe and hygienic use of contact lenses.

 Advice: Please click here for further information and self care advice.

 

 

Fit Note (Sick Note)

Who do I see: You are able to self certificate for up to 7 days sick - click here for more information  If your GP after seeing you believes a sick note is necessary this will be provided on that day. Advice: To book an appointment with your GP please book online or call 0208 630 1601

Flu

Who do I see: The Department of Health issues advice as to who should be immunised. This is reviewed from time to time. The aim is to protect people who are more likely to develop complications from flu. Current advice is that you should be immunised against the seasonal flu virus each autumn if you:

• Are aged 65 or over.
• Have any ongoing (chronic) lung diseases. Examples include chronic bronchitis, emphysema, cystic fibrosis and severe asthma (needing regular steroid inhalers or tablets). It is also recommended for any child who has previously been admitted to hospital with a chest infection.
• Have a chronic heart disease. Examples include angina, heart failure or if you have ever had a heart attack.
• Have a serious kidney disease. Examples include nephrotic syndrome, chronic kidney disease, a kidney transplant.
• Have a serious liver disease such as cirrhosis.
• Have diabetes.
• Have a poor immune system. Examples include if you are receiving chemotherapy or steroid treatment (for more than a month), if you have HIV/AIDS or if you have had your spleen removed.
• Have certain serious diseases of the nervous system such as multiple sclerosis or have had a stroke in the past.
• Live in a nursing home or other long-stay residential care accommodation.

Chiswick Health Practice will runs flu vaccine clinics for patients who would like to have their yearly "flu jab" these start in early September. You are able to book into the clinic online or by calling the practice on 0208 630 1601 Advice: Please click here for further information and self care advice.

Forms, Certificates and Medicals

Who do I see: The practice secretary Please be aware that your GP will need 7 working days notice to complete any forms/letters/certificates that you ask for.  The Doctors are very busy during surgery hours and any additional paperwork is dealt with when possible. Requests of this type fall outside the NHS contract, and therefore a charge will be made. A list of charges is available at the surgery on request. Advice:  Completion of forms, certificates and medicals are not covered under the NHS. You will be charged for these services. Please discuss your requirements with our secretarial team. Examples are Passport forms, insurance reports, HGV medicals, holiday cancellation forms.

Fungal infections

Who do I see: Most fungal infections can be treated with over the counter medicines from a pharmacist, however if the infection does not seem to be improving talk to your pharmacist or contact the surgery to make an appointment with our nurse practitioner Advice: Please click here for further information and self care advice.

General Advice

Who do I see: For general medical advice the first point of call for most people should be their local pharmacist. Pharmacists are medically trained and can advise on the best course of treatment for numerous medical complaints. If they are unable to help they will be able to advise on which medical professional will be able to help you. If your local pharmacy is closed or you are unsure who to speak to, you can CALL 111 where you will be asked a series of questions to ensure you see the correct medical professional. 111 are able to book you appointments with a nurse or GP in your local area 8am - 8pm 7 days a week or suggest the medical professional who is able to help. There are also numerous healthcare websites, However Chiswick Health Practice suggests that patients use the following sites if looking for medical advise.

• NHS Website
• Patient Info

Genital Herpes

Who do I see: With Genital Herpes it is best to go straight to a sexual health clinic as soon as possible. There are a number of sexual health / family planning clinics in Hounslow please click here for information. Advice:  Please click here for further information and self advice

Hay Fever

Who do I see:  With Hay Fever the first point of call should be to seek advice from a pharmacist and use over the counter medication. However if the symptoms do not improve or are getting worse then you may need to see our nurse practitioner. Advice: Please click here for further information and self care advice.

Head Injuries

Who do I see:  If the injury is minor and you do not need to go to hospital, you can usually look after yourself or your child at home. It's normal to have symptoms such as a slight headache, or feeling sick or dazed, for up to 2 weeks. If the injury is more serious and you have any of the following symptoms get yourself or the patient to A&E straight away

• been knocked out but have now woken up
• been vomiting since the injury
• a headache that doesn't go away with painkillers
• a change in behaviour, like being more irritable
• problems with memory
• been drinking alcohol or taking drugs just before the injury
• a blood clotting disorder (like haemophilia) or take blood-thinners (like warfarin)
• had brain surgery in the past

Symptoms usually start within 24 hours but sometimes may not appear for up to 3 weeks. If the patient has any of the following symptoms CALL 999 Immediately.

• been knocked out and hasn't woken up
• difficulty staying awake or keeping their eyes open
• a fit (seizure)
• problems with their vision
• clear fluid coming from their ears or nose
• bleeding from their ears or bruising behind their ears
• numbness or weakness in part of their body
• problems with walking, balance, understanding, speaking or writing
• hit their head in a serious accident, such as a car crash

Advice: For further information on head injuries please click here

Head Lice

Who do I see: A visit to your local pharmacy is all that is necessary, ask your pharmacist what they would suggest. There's nothing you can do to prevent head lice. You can reduce the risk of lice spreading by avoiding head-to-head contact. Don't use medicated lotions and sprays to prevent head lice as this can irritate the scalp. There's no need for children to stay off school, or to wash laundry on a hot wash. Advice: Please click here for further information and self care advice.

Headaches

Who do I see: Most people get headaches from time to time, Most headaches will go away on their own and aren't a sign of something more serious. However if your headache keeps coming back, painkillers don't help and your headache gets worse, you have a bad throbbing pain at the front or side of your head - this could be a migraine or, more rarely, a cluster headache, you feel sick, vomit and find light or noise painful or you get other symptoms - for example, your arms or legs feel numb or weak then you should make an appointment to see our nurse practitioner or a GP. Advice: Please click here for further information and self care advice.

Holiday Cancellation Certificate

Who do I see: The practice secretary Please be aware that your GP will need 7 working days notice to complete any forms/letters/certificates that you ask for.  The Doctors are very busy during surgery hours and any additional paperwork is dealt with when possible. Requests of this type fall outside the NHS contract, and therefore a charge will be made. A list of charges is available at the surgery on request. Advice:  Completion of forms, certificates and medicals are not covered under the NHS. You will be charged for these services. Please discuss your requirements with our secretarial team. Examples are Passport forms, insurance reports, HGV medicals, holiday cancellation forms.  

Indigestion

Who do I see: Most people have indigestion at some point. Usually, it's not a sign of anything more serious and you can treat it yourself with over the counter medication from your local pharmacist. However if you keep getting indigestion, are in severe pain, are 55 or older, have lost a lot of weight without meaning to, have difficulty swallowing (dysphagia), keep vomiting, have iron deficiency anaemia feel like you have a lump in your stomach or have bloody vomit or poo. These symptoms can be a sign of something more serious and an appointment with our nurse practitioner or GP should be made Advice: Please click here for more information and self care advice.

Infected Wounds

Who do I see: If you are concerned a wound is infected you should make an appointment with our nurse practitioner Infection can develop in any type of wound. In certain types of wounds and certain circumstances, developing an infection is more likely. There are a number of precautions to take which help to prevent wound infections developing. In most cases wound infections can be cured with an antibiotic cream or medicine. Advice: Please click here for more information and self care advice.

Ingrowing Toenail

Who do I see:  Taking care of your feet will help prevent foot problems such as ingrown toenails. It’s important to cut your toenails properly (straight across, not at an angle or down the edges). Wash your feet every day, dry them thoroughly and use foot moisturiser. You can also use a foot file or pumice stone to remove hard or dead skin. Wearing shoes that fit properly will help to ensure your feet remain healthy. You should also change your socks (or tights) every day. An ingrown toenail develops when the sides of the toenail grow into the surrounding skin. The nail curls and pierces the skin, which becomes red, swollen and tender. if this happens you may need to see a podiatrist please click here for a list of podiatrists in the local area.  Advice: Please click here for further information and self care advice.

Insect Bites

Who do I see: Most insect bites and stings are not serious and will get better within a few hours or days. But occasionally they can become infected, cause a severe allergic reaction (anaphylaxis) or spread serious illnesses such as Lyme disease and malaria. Bugs that bite or sting include wasps, hornets, bees, horseflies, ticks, mosquitoes, fleas, bedbugs, spiders and midges. If bites are sore or causing discomfort, your pharmacist can provide medicines to help. Call NHS 111 or contact the practice for advice if:

• you're worried about a bite or sting
• your symptoms don't start to improve within a few days or are getting worse
• you've been stung or bitten in your mouth or throat, or near your eyes
• a large area (around 10cm or more) around the bite becomes red and swollen
• you have symptoms of a wound infection, such as pus or increasing pain, swelling or redness
• you have symptoms of a more widespread infection, such as a fever, swollen glands and other flu-like symptoms

Get the patient to A&E department if able to or call 999 for an ambulance immediately if you or someone else has symptoms of a severe reaction, such as:

• wheezing or difficulty breathing
• a swollen face, mouth or throat
• nausea or vomiting
• a fast heart rate
• dizziness or feeling faint
• difficulty swallowing
• loss of consciousness

Advice: Please click here for further information and self care advice.

Insomnia

Who do I see:  You can get sleeping aids from a pharmacy. However, they won't get rid of your insomnia and they have side effects. Sleeping aids can often make you drowsy the next day. You might find it hard to get things done. You shouldn't drive the day after taking them. The most common causes are:

• stress, anxiety or depression
• noise
• a room that's too hot or cold
• uncomfortable beds
• alcohol, caffeine or nicotine
• recreational drugs like cocaine or ecstasy
• jet lag
• shift work

See your GP if, changing your sleeping habits hasn't worked, you've had trouble sleeping for months, your insomnia is affecting your daily life in a way that makes it hard for you to cope Your GP will try to find out what's causing your insomnia so you get the right treatment. Sometimes you will be referred to a therapist for cognitive behavioural therapy. This can help you change the thoughts and behaviours that keep you from sleeping. GPs now rarely prescribe sleeping pills to treat insomnia. Sleeping pills can have serious side effects and you can become dependent on them. Advice: Please click here for further information and self care advice.  

Insurance Reports

Who do I see: The practice secretary Please be aware that your GP will need 7 working days notice to complete any forms/letters/certificates that you ask for.  The Doctors are very busy during surgery hours and any additional paperwork is dealt with when possible. Requests of this type fall outside the NHS contract, and therefore a charge will be made. A list of charges is available at the surgery on request. Advice:  Completion of forms, certificates and medicals are not covered under the NHS. You will be charged for these services. Please discuss your requirements with our secretarial team. Examples are Passport forms, insurance reports, HGV medicals, holiday cancellation forms.  

Medical Reports

Who do I see: The practice secretary Please be aware that your GP will need 7 working days notice to complete any forms/letters/certificates that you ask for.  The Doctors are very busy during surgery hours and any additional paperwork is dealt with when possible. Requests of this type fall outside the NHS contract, and therefore a charge will be made. A list of charges is available at the surgery on request. Advice:  Completion of forms, certificates and medicals are not covered under the NHS. You will be charged for these services. Please discuss your requirements with our secretarial team. Examples are Passport forms, insurance reports, HGV medicals, holiday cancellation forms.

Medication Review

Who do I see: A medication review is a meeting with your doctor, pharmacist or nurse to talk about your medicines. Your medicines should be reviewed regularly (usually once a year) to check that they are right for you. Why are medicines reviews needed? When you are first prescribed a medicine, your doctor, pharmacist and/or nurse checks that it is the best medicine for you. However, things can change, for example: You might have developed a side effect from the medicine.  Your health might have changed, such as developing a long-term condition.  You might have started taking other additional medicines.  The guidelines for treating your condition might have changed.  You may be taking a large number of medications.  A medication you are on may be no longer essential for your health day to day. All of these factors can affect whether a medicine remains the best choice for you.  

Missed Contraceptive

Who do I see: There are a number of sexual health / family planning clinics in Hounslow please click here for information alternatively emergency contraception is also available through most pharmacists alternatively you can make an appointment with a nurse or GP    Advice: Please click here for further information and self care advice. 

Moles

Who do I see: It's important to get a new or existing mole checked out by a nurse practitioner or GP if it:

• changes shape or looks uneven
• changes colour, gets darker or has more than 2 colours
• starts itching, crusting, flaking or bleeding
• gets larger or more raised from the skin

These changes can happen over weeks or months. They're sometimes a sign of melanoma, a type of skin cancer. If the medical professional thinks it is melanoma you'll be referred to a specialist in hospital. You should have an appointment within 2 weeks. The main treatment for melanoma is surgery to remove the mole. Advice: Please click here for further information and self care advice.

Nappy Rash

Who do I see: Up to a third of babies and toddlers in nappies have nappy rash at any one time. It doesn't usually develop in newborns, but all babies can get nappy rash. Nappy rash can be caused by:

• your baby's skin being in contact with wee or poo (stools) for a long time
• the nappy rubbing against your baby's skin
• not cleaning the nappy area or changing the nappy often enough
• soap, detergent or bubble bath
• alcohol-based baby wipes
• your baby recently taking antibiotics

If you are concerned that your baby's rash is getting worse or not going away, in the first instance talk to your pharmacist or midwife or health visitor alternatively make an appointment to see our nurse practitioner at the practice Advice: Please click here for further information and self care information.

Neck Pain

Who do I see: Most neck pain only lasts a few weeks. However if the pain or stiffness doesn't go away after a few weeks, painkillers like paracetamol or ibuprofen haven't worked, you're worried about the pain, you have other symptoms, like pins and needles or a cold arm – this could be something more serious. and you should see our nurse practitioner or a GP. Advice: Please click here for further information and self care information.

Nosebleeds

Who do I see: Nosebleeds aren't usually a sign of anything serious. They're common, particularly in children, and most can be easily treated at home. However if the nosebleed is in a child under 2 years old, you have regular nosebleeds, you have symptoms of anaemia – such as a faster heartbeat (palpitations), shortness of breath and pale skin, you're taking a blood-thinning medicine, such as warfarin, you have a condition that means your blood can't clot properly, such as haemophilia then you should make an appointment to see our nurse practitioner or a GP. Advice: Please click here for further information and self care information.

Panic Attacks

Who do I see: In Hounslow there are a number of health professionals you can see to help with mental health problems. Please click on the services below to be taken to their sites some of which where self referrals can be made. You are also able to see your GP with mental health concerns.

• Hounslow IAPT
• Primary Care Plus
• West London Mental Health Trust

We would suggest you see your GP if you've been experiencing symptoms of panic disorder. They'll ask you to describe your symptoms, how often they occur and how long you've had them. They may also carry out a physical examination to rule out other conditions that could be causing your symptoms. Although it can sometimes be difficult to talk to someone else about your feelings, emotions and personal life, try not to feel anxious or embarrassed. You may be diagnosed with panic disorder if you experience recurrent and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks. Advice: Please click here for information and self care advice.

Passport Forms

Who do I see: The practice secretary Please be aware that your GP will need 7 working days notice to complete any forms/letters/certificates that you ask for.  The Doctors are very busy during surgery hours and any additional paperwork is dealt with when possible. Requests of this type fall outside the NHS contract, and therefore a charge will be made. A list of charges is available at the surgery on request. It is worth noting that the practice will no longer deal with passport forms for Australian or Irish passports. Advice:  Completion of forms, certificates and medicals are not covered under the NHS. You will be charged for these services. Please discuss your requirements with our secretarial team. Examples are Passport forms, insurance reports, HGV medicals, holiday cancellation forms.

Period Problems

Who do I see: If problems with your periods are affecting your life, there's help and support available. Before you see your nurse or GP about period problems, it can be useful to keep a diary of your symptoms throughout the menstrual cycle. This can give your doctor a detailed idea of what happens, and when, during your cycle. Advice: Please click here for further information and self care information.

Phobias

Who do I see: In Hounslow there are a number of health professionals you can see to help with mental health problems. Please click on the services below to be taken to their sites some of which where self referrals can be made. You are also able to see your GP with mental health concerns.

• Hounslow IAPT
• Primary Care Plus
• West London Mental Health Trust

Advice: Please click here for information and self care advice.

Pneumococcal vaccine

A pneumococcal infection can affect anyone. However, some people are at higher risk of serious illness and can be given the pneumococcal vaccination on the NHS. These include:

• babies
• adults aged 65 or over
• children and adults with certain long-term health conditions, such as a serious heart or kidney condition

Read more about who should have the pneumo jab. You will need to book an appointment with our nurse or HCA for a pneumococcal vaccination. this can be done online or by calling 0208 630 1600. Advice: Please click here for further information and self care advice.

Prescriptions

Repeat prescriptions can be requested either online or by coming into the practice and filling in the repeat prescription form and posting into the box at reception. Once your medication request has been reviewed and completed, If you have a nominated pharmacist these will be ready for collection from there, if not you will need to come back to the surgery to pick up your script. PLEASE NOTE - Prescriptions will be ready for collection after 5pm two days after the request is made. If you have any issues with your repeat prescriptions or have any other prescription medication queries please email c.practice@nhs.net or call 0208 630 1600. Advice: Please click here for further information regarding prescriptions.

Rashes

Who do I see:  There are many different types of skin rashes and many different causes of skin rashes. Although most skin rashes are harmless, some do need treatment from your  pharmacist, nurse or GP. Some rashes (especially dark red or purple rashes that don't fade with pressure) may even need urgent medical treatment as they can be associated with meningitis and blood infection (septicaemia). Click here to link through to pictures of rashes in children. Advice: Please click here for information and self care advice.

Rectal Problems

Who do I see: You might be bleeding from the bottom if you have:

• blood on your toilet paper
• red streaks on the outside of your poo
• pink water in the toilet bowl
• blood in your poo or bloody diarrhoea
• very dark, smelly poo (this can be blood mixed in poo)

A small amount of one-off bleeding can often go away on its own without needing treatment. However you should our nurse practitioner if:

• your child has blood in their poo
• you've had blood in your poo for 3 weeks
• your poo has been softer, thinner or longer than normal for 3 weeks
• you're in a lot of pain around the bottom
• you have a pain or lump in your tummy
• you've been more tired than usual
• you've lost weight for no reason

Get an urgent appointment or call 111 if:

• your poo is black or dark red
• you have bloody diarrhoea for no obvious reason

Advice: Please click here for further information and self care advice.  

Removal of Stitches

Who do I see: You will be told if you need to return to your practice to see a  nurse to have your stitches removed. These are the usual time periods:

• stitches on your head – you'll need to return after 3 to 5 days
• stitches over joints, such as your knees or elbows – you'll need to return after 10 to 14 days
• stitches on other parts of your body – you'll need to return after 7 to 10 days

Some stitches are designed to dissolve gradually and will disappear on their own. Find out how long stitches take to dissolve. Advice: Please click here for further information and self care advice.

Ring Pessary

Who do I see:  A vaginal pessary is a plastic device that fits into your vagina to help support your uterus (womb), vagina, bladder, or rectum. Pelvic organ prolapse symptoms include:

• a feeling of heaviness around your lower tummy and genitals (pelvis)
• a dragging discomfort inside your vagina
• feeling like there is something coming down into your vagina – it may feel like sitting on a small ball
• feeling or seeing a bulge or lump in or coming out of your vagina
• discomfort or numbness during sex
• problems peeing – such as feeling like your bladder isn't emptying fully, needing to go to the toilet more often, or leaking a small amount of pee when you cough, sneeze or exercise (stress incontinence)

Sometimes pelvic organ prolapse has no symptoms and is found during an internal examination carried out for another reason, such as cervical screening. See your GP or nurse if you have any of the symptoms of a prolapse, or if you notice a lump in or around your vagina. Advice: Please click here for further information.

Sepsis - under 5 year olds

Who do I see: Sepsis is a rare but serious complication of an infection. Without quick treatment, sepsis can lead to multiple organ failure and death. Go straight to A&E or call 999 if your child has any of these symptoms:

• looks mottled, bluish or pale
• is very lethargic or difficult to wake
• feels abnormally cold to touch
• is breathing very fast
• has a rash that does not fade when you press it
• has a fit or convulsion

Get medical advice urgently from NHS 111 Temperature

• temperature over 38C in babies under three months
• temperature over 39C in babies aged three to six months
• any high temperature in a child who cannot be encouraged to show interest in anything
• low temperature (below 36C – check three times in a 10-minute period)

Breathing

• finding it much harder to breathe than normal – looks like hard work
• making "grunting" noises with every breath
• can't say more than a few words at once (for older children who normally talk)
• breathing that obviously "pauses"

Toilet/nappies

• not had a wee or wet nappy for 12 hours

Eating and drinking

• new baby under one month old with no interest in feeding
• not drinking for more than eight hours (when awake)
• bile-stained (green), bloody or black vomit/sick

Activity and body

• soft spot on a baby's head is bulging
• eyes look "sunken"
• child cannot be encouraged to show interest in anything
• baby is floppy
• weak, "whining" or continuous crying in a younger child
• older child who's confused
• not responding or very irritable
• stiff neck, especially when trying to look up and down

 

Sepsis - older children and adults

Early symptoms of sepsis may include:

• a high temperature (fever) or low body temperature
• chills and shivering
• a fast heartbeat
• fast breathing

In some cases, symptoms of more severe sepsis or septic shock (when your blood pressure drops to a dangerously low level) develop soon after. These can include:

• feeling dizzy or faint
• a change in mental state – such as confusion or disorientation
• diarrhoea
• nausea and vomiting
• slurred speech
• severe muscle pain
• severe breathlessness
• less urine production than normal – for example, not urinating for a day
• cold, clammy and pale or mottled skin
• loss of consciousness

Advice: For more information on Sepsis please click here.  

Shingles

Who do I see: If you suspect you have shingles you should see our nurse practitioner or a GP as soon as possible, they can prescribe medicine to help speed up your recovery and avoid longer-lasting problems. These work best if taken within 3 days of your symptoms starting. Click here to check if you may have shingles 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. Advice: Please click here for further information and self care advice

Sick Certificates

Who do I see: You are able to self certificate for up to 7 days sick - click here for more information  If your GP after seeing you believes a sick note is necessary this will be provided on that day. Advice: To book an appointment with your GP please book online or call 0208 630 1601

Sick Note (Fit Note)

Who do I see: You are able to self certificate for up to 7 days sick - click here for more information  If your GP after seeing you believes a sick note is necessary this will be provided on that day. Advice: To book an appointment with your GP please book online or call 0208 630 1601

Sinusitis

Who do I see: Sinusitis is common after a cold or the flu. Symptoms of sinusitis include:

• pain, swelling and tenderness around your cheeks, eyes or forehead
• a blocked nose
• reduced sense of smell
• green or yellow mucus from your nose
• a sinus headache
• a high temperature of 38C or above
• toothache
• bad breath

Signs of sinusitis in young children may also include irritability, difficulty feeding, and breathing through their mouth. A pharmacist can advise you about medicines that can help, such as:

• decongestant nasal sprays, drops or tablets to unblock your nose
• salt water nasal sprays or solutions to rinse out the inside of your nose

You can buy nasal sprays without a prescription, but they shouldn't be used for more than a week. If your symptoms do not improve after a week, your symptoms are severe, painkillers don't help or your symptoms get worse or you keep getting sinusitis you should see our nurse practitioner or a GP. Advice: Please click here for further information and self care advice.

Skin Conditions

Who do I see: A lot of skin conditions can be treated with medications and lotions from a pharmacist. However some will require specific medications to treat which will require seeing a nurse practitioner or GP Advice: Please click here for further information and self care advice.

Smoking Cessation

Who do I see: There are a number of pharmacies in Hounslow where you can meet and talk with a stop smoking advisor, alternatively One You Hounslow run specific clinics at various venues throughout Hounslow borough. Advice:  Please click here for further information and self care advice.

Sore Eyes

Who do I see: Sore eyes can be caused by a number of things. You should speak to your pharmacist first as over the counter medication can treat most causes of sore eyes. However depending on the cause your pharmacist may suggest making an appointment with our nurse practitioner or a GP. Advice: Please click here for further information and self care advice.

Sore Penis

Who do I see: Many infections are easily treated, for example:

• with medications, such as antibiotics or antifungal creams
• by using simple self-care measures, such as more frequent washing

If the skin of your penis is irritated, avoid anything that might make it worse, such as particular brands of soap. Read the answers to more questions about penis health. There are a number of sexual health / family planning clinics in Hounslow please click here for information Advice: Please click here for further information and self care advice.

Sore Throat

Who do I see: A pharmacist can help with sore throats To help relieve the pain and discomfort of a sore throat you can:

• use paracetamol or ibuprofen
• use medicated lozenges or anaesthetic sprays (although there's little proof they help)

You can buy them from a supermarket or from a pharmacist without a prescription. you should see our nurse practitioner or GP if  your sore throat doesn't improve after a week, you often get sore throats, you're worried about your sore throat, you have a sore throat and a very high temperature, or you feel hot and shivery or you have a weakened immune system – for example, because of diabetes or chemotherapy Advice: Please click here for further information and self care advice.

Spirometry Testing

Who do I see: Spirometry is a simple test used to help diagnose and monitor certain lung conditions by measuring how much air you can breathe out in one forced breath. It's carried out using a device called a spirometer, which is a small machine attached by a cable to a mouthpiece. Spirometry may be performed by a nurse or doctor at the surgery. Conditions that can be picked up and monitored using spirometry include:

• asthma – a long-term condition in which the airways become periodically inflamed (swollen) and narrowed
• chronic obstructive pulmonary disease (COPD) – a group of lung conditions where the airways become narrowed
• cystic fibrosis – a genetic condition in which the lungs and digestive system become clogged with thick, sticky mucus
• pulmonary fibrosis – scarring of the lungs

Advice: Please click here for further information regarding spirometry testing.

Sprains

Who do I see:  A pharmacist can help with sprains and strains Speak to a pharmacist about the best treatment for you. They might suggest tablets, or a cream or gel you rub on the skin. Painkillers like paracetamol will ease the pain and ibuprofen will bring down swelling. However, you shouldn't take ibuprofen for 48 hours after your injury as it may slow down healing. Go to a Minor Injuries Unit / Urgent Care Centre if:

• the injury isn't feeling any better after treating it yourself
• the pain or swelling is getting worse

Find a minor injuries unit Or see a GP if:

• you also have a very high temperature or feel hot and shivery

as these could be signs of an infection. If you have a sprain or strain that's taking longer than usual to get better, your GP may be able to refer you to a physiotherapist. Physiotherapy from the NHS might not be available everywhere and waiting times can be long. You can also get it privately. Advice: For further information please click here.

Stings

Who do I see: Most insect bites and stings are not serious and will get better within a few hours or days. But occasionally they can become infected, cause a severe allergic reaction (anaphylaxis) or spread serious illnesses such as Lyme disease and malaria. Bugs that bite or sting include wasps, hornets, bees, horseflies, ticks, mosquitoes, fleas, bedbugs, spiders and midges. Contact your GP or call NHS 111 for advice if:

• you're worried about a bite or sting
• your symptoms don't start to improve within a few days or are getting worse
• you've been stung or bitten in your mouth or throat, or near your eyes
• a large area (around 10cm or more) around the bite becomes red and swollen
• you have symptoms of a wound infection, such as pus or increasing pain, swelling or redness
• you have symptoms of a more widespread infection, such as a fever, swollen glands and other flu-like symptoms

Advice: Please click here for further information and self care advice.

Styes

Who do I see: To reduce swelling and help the stye heal:

1. Soak a clean flannel in warm water.
2. Hold it against your eye for 5 to 10 minutes.
3. Repeat this 3 or 4 times a day.

To relieve the pain, take painkillers such as paracetamol or ibuprofen. Don't give aspirin to children under 16. See a GP if your stye:

• is very painful or swollen
• doesn't get better within a few weeks
• affects your vision

Advice: Please click here for further information and self care advice.

Sunburn

Who do I see:  If you or your child has sunburn, you should get out of the sun as soon as possible – head indoors or into a shady area. You can usually treat mild sunburn at home, although there are some circumstances where you should get medical advice. To help relieve your symptoms until your skin heals:

• cool you skin by having a cold bath or shower, sponging it with cold water, or holding a cold flannel to it
• use lotions containing aloe vera to soothe and moisturise your skin
• drink plenty of fluids to cool you down and prevent dehydration
• take painkillers, such as ibuprofen or paracetamol, to relieve pain (but don't give aspirin to children under 16)

Try to avoid all sunlight, including through windows, by covering up the affected areas of skin until it's fully healed. Call NHS 111 if you feel unwell or you're concerned about your sunburn, particularly if you're burnt over a large area or have any of the more severe symptoms listed below. You should also see your GP if a young child or baby has sunburn as their skin is particularly sensitive. Signs of severe sunburn can include:

• blistering or swelling of the skin
• chills
• a high temperature (fever) of 38C (100.4F) or above
• dizziness, headaches and feeling sick – symptoms of heat exhaustion

Special burn cream and burn dressings may be needed for severe sunburn. These are available from your GP or nurse at your GP surgery. Treatment in hospital may occasionally be needed. Advice: Please click here for further information and self care advice.

Threadworm

Who do I see: You can buy medicine for threadworms from pharmacies. This is usually a chewable tablet or liquid you swallow. Treat everyone in your household, even if they don't have symptoms. Tell the pharmacist if you need to treat a child under 2, or if you're pregnant or breastfeeding. Treatment might not be suitable and you may need to speak to a GP. Advice: Please click here for further information and self care advice.

Travel Vaccinations

Who do I see: You can find out which vaccinations are necessary or recommended for the areas you'll be visiting on these two websites:

• NHS Fit for Travel
• Travel Health Pro

Some countries require you to have an International Certificate of Vaccination or Prophylaxis (ICVP) before you enter. For example, Saudi Arabia requires proof of vaccination against certain types of meningitis for visitors arriving for the Hajj and Umrah pilgrimages. Many tropical countries in Africa and South America won't accept travellers from an area where there's yellow fever unless they can prove they've been vaccinated against it. Read more about the vaccines available for travellers abroad. Advice: Please click here for further information regarding Chiswick Health Practice Travel Clinic.

Urinary tract infections (UTIs)

Who do I see: Symptoms of a UTI include:

• needing to pee suddenly or more often than usual
• pain or a burning sensation when peeing
• smelly or cloudy pee
• blood in your pee
• pain in your lower tummy
• feeling tired and unwell
• in older people, changes in behaviour such as severe confusion or agitation

Children with UTIs may also:

• appear generally unwell – babies may be irritable, not feed properly and have a high temperature (fever) of 37.5C or above
• wet the bed or wet themselves
• deliberately hold in their pee because it stings

you should make an appointment with our nurse practitioner or GP if:

• you're a man with symptoms of a UTI
• you're pregnant and have symptoms of a UTI
• your child has symptoms of a UTI
• you're caring for someone elderly who may have a UTI
• you haven't had a UTI before
• you have blood in your pee
• your symptoms don't improve within a few days
• your symptoms come back after treatment

If you have symptoms of a sexually transmitted infection, you can also get treatment from a sexual health clinic. Advice: Please click here for further information and self care advice.

Vaginal Discharge

Who do I see:  Vaginal discharge usually isn't anything to worry about if it:

• doesn't have a strong or unpleasant smell
• is clear or white
• is thick and sticky
• is slippery and wet

You can get vaginal discharge at any age. The amount of discharge varies. You usually get heavier discharge during pregnancy, if you're sexually active or if you're using birth control. It's often slippery and wet for a few days between your periods (when you ovulate). Go to a sexual health clinic or make an appointment with with our nurse practitioner or GP if, your discharge changes colour, smell or texture, you produce more discharge than usual, you feel itchy or sore, you bleed between periods or after sex, you get pain when peeing or you get pain in the area between your tummy and thighs (pelvic pain) Advice: Please click here for further information and self care advice.

Verrucae

Who do I see: Most fungal infections including verrucaes and warts can be treated with over the counter medicines from a pharmacist, however if the infection does not seem to be improving talk to your pharmacist or contact the surgery to make an appointment with our nurse practitioner Advice: Please click here for further information and self care advice.

Vomiting

Who do I see: Nausea is the feeling of wanting to be sick (vomit). Vomiting is when you are sick, or 'throw up'. The contents of your stomach rise up your food pipe (gullet, or oesophagus) and spill out of your mouth or nose. Nausea and vomiting are controlled by a combination of the vomiting centre in your brain, and areas within your gut. Nausea and vomiting may be due to many different causes. Common causes include food poisoning, a tummy bug (viral infection), drinking a lot of alcohol, and being pregnant. You should seek medical advice if you vomit repeatedly for more than 48 hours or feel unwell or weak. If you vomit blood or have unexplained problems like weight loss or difficulty swallowing, you should see your GP urgently. Advice: Please click here for further information and self care advice.

Warts

Who do I see: Most fungal infections including verrucaes and warts can be treated with over the counter medicines from a pharmacist, however if the infection does not seem to be improving talk to your pharmacist or contact the surgery to make an appointment with our nurse practitioner Advice: Please click here for further information and self care advice.