Services

Cervical Smear Screening

If you need a smear, please make an appointment with one of our practice nurses. we have appointments from 8am every weekday and until 19:30 Tuesday, Wednesday and Thursday & Saturday mornings.  
 
Cervical smears test cells from the cervix to check for early abnormalities which, left untreated, could develop into cervical cancer.
 
Current UK guidelines recommends 3 yearly smear from the age of 25y to 49y and then 5 yearly until 64y.  However, if there are any previous abnormalities or concerns you may need to be seen more frequently than this (you will be informed about this with the results of your test if this is the case).
 
You will get a letter informing you of the results of your smear and any recommendations after about 2 weeks.  Please let us know if you don’t receive a letter.

See the leaflet for more information, Cervical Screening - the facts.

If you require a chaperone please inform the surgery when you book your appointment so that this can be arranged for you.
 
Please note that we are only able to offer smear tests for permanent patients. If you are registered as a temporary patient you should book your smear test at the practice where you are registered permanently.

Child Immunisations

The practice nurses will give routine childhood immunisations as outlined in the following schedule:

When to ImmuniseDiseases Protected Against
Two months oldDiphtheria, tetanus, pertussis (whooping cough), polio and Haemophilus influenzae type b (Hib) Pneumococcal infection, Rota Virus, Meningitis B
Three months oldDiphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (Hib) Meningitis C, Rota Virus
Four months oldDiphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (Hib)
Meningitis C
Pneumococcal infection
Meningitis B
Around 12 months oldHaemophilus influenza type b (Hib) 
Meningitis C,Measles, mumps and rubella (MMR). 
Pneumococcal infection
Meningitis B
Around 18 months oldMeasles, mumps and rubella (MMR)
Three years and four months 
or soon after (pre school booster)
Diphtheria, tetanus, pertussis and polio
Girls aged 12 to 13 yearsHuman papillomavirus types 16 and 18. (These vaccines are usually carried out by the school nurses)
13 to 18 years oldDiphtheria, tetanus, polio
Meningitis ACWY (These vaccines are usually carried out by the school nurses)

 

Immusation Clinics

Monday, Tuesday and Wednesday afternoon are designated for children’s immunisations. However, if you cannot make these clinics, the practice nurses are usually able to see you in one of their other clinics. 
8 week check appointments will be held on either a Monday or a Wednesday between 13:00 - 14:00.  This is one appointment which consists of a development check by the GP and the 1st set of immunisations with the nurse.
If you have any queries about childhood immunisations or are worried that your child’s immunisations may not be up to date, please make an appointment with a practice nurse.

Please note that if your child has started their immunisation course abroad it may differ from the UK vaccine program. You may have to go privately to complete a course of vaccines not on the UK NHS schedule e.g. chickenpox vaccine

For more information regarding baby and childhood vaccinations, please see the website below:
http://www.nhs.uk/conditions/vaccinations/pages/vaccination-schedule-age...

**REMEMBER TO BRING THE CHILD’S RED BOOK TO ALL APPOINTMENTS**

Meningitis B Vaccine & Information on Accessing Privately

This vaccine is now currently part of the NHS child immunisation programme for children born after 1st May 2015 ONLY. If your child is not eligible for it within the NHS guidelines and you wish your child to have this vaccine; it is available at these clinics:

My Healthcare Clinic - Wandsworth, tel: 0207 099 5555
Chartfield Surgery - Putney, tel: 0208 788 3252

N.B. It is not available privately at Balham Park Surgery.

For further information please see the websites below:
http://www.nhs.uk/Conditions/vaccinations/Pages/meningitis-B-vaccine.aspx 
http://www.meningitis.org/menb-vaccine

Contraception

At Balham Park Surgery we offer all the methods of contraception that are available on the NHS.

Please make an appointment with one of the Practice Nurses if:

  • You would like to start the ORAL CONTRACEPTION PILL or request a repeat prescription for the pill. We will ask to see you on an annual basis for a pill review
  • You would like to start or continue on the CONTRACEPTIVE INJECTION - Depo Provera
  • You would like to be fitted with the DIAPHRAGM - Please make an appointment with Sara Moloney - Lead Practice Nurse
  • You require the EMERGENCY CONTRACEPTIVE PILL 'Morning After Pill' - please contact a Practice Nurse, on 020 8772 8772, as soon as possible; as this can be done via a telephone consultation
  • You are considering being fitted for a copper IUD or IUS - Mirena (COILS). Please look at the podcast on the Health Information page of this website. If it is something you would like to consider, please contact the Practice Nurse to discuss this option further or would like to make an appointment for a fitting.

Dr Marietta Swanne, Dr Sian Morris and Dr Eleanor Beecraft have allocated appointments to fit both types of coil. At your appointment you will be asked to make a 6 week post fitting 'coil check' with one of the Practice Nurses. If you wish for your coil to be removed, make an appointment with the Nurses.

N.B Please note that unless your intention is to get pregnant after the removal of the coil, you must not have had any unprotected sexual intercourse for 7 days prior to the removal of your coil.

  • If you are considering the CONTRACEPTIVE IMPLANT - Nexplanon, please contact Kate Taylor (Practice Nurse) to discuss this option or you would like to book an appointment for a fitting or removal of the implant.

For further information please look at the NHS Choices website  Contraception Choices  Or the  Family Planning Association  website.

District Nurses

This page is under review

Electronic Prescription Service

Get your repeat prescriptions sent electronically to the place of your choice, instead of collecting from the surgery - read the leaflet and complete the form and hand it in at Reception

Friends and Family

Friends and Family Test

Results for June 2017

Thank you to the 2 people who completed the test during the month of June 2017

 

We asked you “What could we do better”

You suggested : Our response

I had a very good service and the waiting time is very good (10 minutes waiting for a blood test) and I booked an appointment with the doctor Thursday evening for Friday morning. But unfortunately I experienced a poor quality services with the phlebotomist. She didn't wash her hands prior and after taking bloods neither she cleaned my skin prior to insert the needle. She was not wearing and gloves and touched materials doors, computer palpate my vain and inserted the needle all with the same unwashed hands.  This is quite dangerous and can lead to a serious spread of infections from patient to patient. And more this not follow the infections control policies at all. I would suggest to Improve quality of the procedures more than the waiting time.

 

We are very sorry to hear that you felt you received poor quality service from our phlebotomist and take infection control very seriously.  We are committed to making improvements and have reviewed our policy on phlebotomy.  This has been discussed with the phlebotomists.  A copy of the policy is attached which deals specifically with the matters you raise about hand washing and cleaning the area where blood is being taken from. 

 

How about a little music when one has to hang on for ages "in the queue" Hearing the same message over and over again gets a bit tedious and perhaps irritating. NB not complaining about hanging on - realise how busy you are.

 

We are constantly looking at ways to reach our patients about current issues.  The telephone system is one way that we can inform and educate our patients about the services we provide and how to access healthcare.  We recognise that the same message can become tedious or irritating so we have recently updated the telephone message with relevant and varied information which we will continue to do to add variety.

 

 

 

 

We really value positive comments as we use them to try to retain, where we can, what patients value most.

 

Please do complete the test for us in

July 2017

 

 

 

 

 

 

 

 

 

 

 

Protocol for Blood taking for all Phlebotomist

This is also the standard operating procedure at St Georges Hospital

 

The phlebotomists will take blood samples from patients as they have completed the phlebotomy study day course.

 

The phlebotomists have been immunised against hepatitis B and have had a blood test to confirm immunity.( a copy of hepatitis B immunity to be retained by HR )

Make sure all samples from previous patients have been safely stored away and out of sight and are ready for dispatch , before new patient is called in.

 

Explain procedure to patient

Warn them that there may be a bruise.

Sit patient down with arm extended on pillow, apply tourniquet above elbow.

Be aware that patient may faint during or after the procedure.

If patients say that they faint then lie them down before taking the blood

 

Hand washing

Adequate hand washing is of course essential to maintain hygiene. Any broken skin on the hands of the clinician should be covered, and in these incidences glove wearing may be more pertinent

All Phlebotomist are advised and encouraged, to wash their hands frequently, and immediately if soiled, and must use Alcohol Gel to disinfect their hands after washing.  Phlebotomists are also encouraged to use the hand barrier cream provided, as an added protection and to minimize the development of rashes and abrasions which can result from the wearing of disposable gloves and/or regular hand-washing.

 

Alcohol Gel

Phlebotomists may use Alcohol Gel in between attending to patients, provided hands are visibly clean and free of any cuts, scratches, abrasions or other lesions and the patient is not a known infection risk.

Gel must be applied before attending to each patient.  Hands must be washed thoroughly after every 5 patients attended to or sooner if soiled.

 

Prepare vacutainer / needles and blood bottles

Label the bottles and check that the blood form has been filled in.

 

If unsuccessful try again if possible and refer to walk in phlebotomy or rebook if necessary.

 

Be mindful of patients with additional needs ie patients with Dementia or learning disabilities and children who may needs Ametop cream before blood is taken.

     

Gloves

All Phlebotomists are strongly advised and encouraged,  but not compelled, to wear disposable laboratory/clinical latex free gloves provided they are using the ‘closed’ blood collection Vacutainer system and they have no cuts, scratches, abrasions or other lesions on their hands, and the patient is not a known infection risk.

 

However, Phlebotomists must wear gloves if they have cuts, scratches, abrasions or lesions on their hands, even if these are covered by dressings. 

 

The purpose of wearing gloves is to protect the healthcare professional from contamination as opposed to protection of the patient. Gloves alone would not reduce or eradicate incidences of needle stick injuries, where the clinician may be placed at risk. Wearing a glove for venepuncture can make the procedure considerably more difficult, due to the reduced ability to palpate a suitable vein, and the reduction of general dexterity. It is with this in mind that some clinicians do not wear gloves for the sole procedure of venepuncture.

 

Phlebotomists must also wear gloves provided, when bleeding patients using ‘open’ blood collection methods such as a finger-prick using a sterile disposable lancet when a capillary blood collection is necessary.  This system poses a much greater risk of contamination of the operator with blood. 

 

Furthermore, phlebotomists must wear gloves provided when bleeding patients who are of known infection risk, irrespective of the method of blood collection. 

 

Gloves must be changed immediately if soiled. 

 

The Phlebotomist must change his or her gloves after each patient.

 

 For cannulation there is a greater risk of contamination to the clinician and consequently gloves should be worn at all times.

 

Cleaning the area where blood is being taken from

There is some evidence to suggest that for simple venepuncture cleaning the skin with an alcohol or chlorhexidine wipe, removes bacteria that are normally present to keep pathogens at bay, and as a result therefore actually increases the risk for pathogenic bacteria to infect the area. There are occasions where cleaning the skin may be necessary e.g excessive dirt on the skin. 

 

Sharps disposal

After taking the blood the phlebotomist should dispose of the needles/sharps of any kind into the sharp boxes which are either on the desk or by the sink.

 

After taking blood press with cotton wool ball over the puncture site until bleeding stops. Apply a plaster or tape.

 

 

Any policies that cover the procedure of venepuncture will indicate the necessity of glove wearing due to the risk of contamination to the clinician. However in incidences where that clinician may feel that glove wearing could be of detriment to their own safety, it is not of any risk to the patient in terms of infection if gloves are not worn. Therefore, a fully trained and experienced blood taker may choose not to wear them, at their own discretion. However; if a patient requests that gloves are worn; this request should be complied with. Adequate hand washing should remain essential if this is the case.

 

 

 

 

References: advice taken from St Georges microbiology team

MDU hand out

COSHH guidelines

 

 

Updated: Sara Moloney June 5th 2017

Due review June 2019

 

Health checks and WELL MAN/WELL WOMAN checks

Patients aged 40-75 are entitled to the new NHS healthcheck to assess for cardiac risk factors- please book an appointment for a fasting blood test then after the results are back (usually one week) please book a further appointment with Daksha (healthcare assistant) for the full health check.

Health Visitors

Health visitors will provide support and advice in the weeks following birth, and up until your child is 5 years old. 
You will be contacted by the health visitor and visited at home soon after birth.
You will be contacted by letter to invite you to the clinic for an 8 month and a 2 year developmental check.

The Health Visitors run drop in clinics at Balham Health Centre (120-124 Bedford Hill, SW12 9HS) on a Wednesday 09:30-11:30 AM.  

They would prefer you to access their help via the drop in clinics, but can also be contacted on 0208 812 6212.

Courses/groups run by the Health Visitors:

  • Weaning groups
  • Baby massage

Please contact the Health Visitors directly on the above number for more information on when these take place and if you would like to attend.

Get the free "baby buddy" app from your app store.

Maternity

If you are planning a pregnancy, please make an appointment to see the practice nurse for health advice.
Please make an appointment with the GP in the first 8 weeks of pregnancy: the GP can provide you with information and advice about common symptoms of pregnancy and will arrange for referral for booking at the hospital of your choice.
We usually provide shared care with your hospital. You can see your doctor in a normal surgery for ante-natal and post-natal checks, or see a midwife at Balham Health Centre.
Community midwife office: 020 8725 2535

To book a tour of the maternity unit at St George's Hospital you can call: 02087252536
Postnatal check: 6 weeks after having your baby you should make an appointment with the GP for a general health check.

 

Balham Breastfeeding Cafe: http://www.babyintuition.co.uk/balham-breastfeeding-cafe-turns-5-years-old/

Minor Surgery

 

We are pleased to offer a range of minor surgery skin procedures.

Minor Surgery
We can treat skin lumps & moles.
 
Please book an appointment with any of our GP’s or Practice Nurse Sara Moloney, and if clinically indicated you can be booked into one of our Minor Surgery Clinics that run weekly.
 
 
Our Practitioners:
Dr Punit Makwana (GP)
Dr Elizabeth Marston (GP)
Sara Moloney (Practice Nurse Partner)
 
 

Non NHS Services

Not all services that we are required to provide are funded by the NHS, for example medicals for travel, insurance or employment. 
Balham Park Surgery is entitled to charge for all Non-NHS Services. We generally apply rates recommended by the BMA (British Medical Association).

 

 

Non NHS Fees-   Please call the Non NHS Team for the latest fees on 020 8772 3322.

Why GPs charge fees

Accessing your medical record

 

GP Referrals To Private Consultants

Patients may have private health cover which they wish to use to see a specialist privately.  If their insurance company require a referral from a GP, the GP may ask to see them to discuss it first, and provide a referral letter at a later date.

Prescription Requests Followings Private Consultations

GPs are not obliged to prescribe drugs at the request of a private specialist or a patient following a private consultation.

Local guidance on this subject dictates that;

"If patients opt to be treated privately then they should be prepared to be responsible for all costs associated with the management of what they are being seen for, including drugs".

Medications recommended following a private consultation may be prescribed at the discretion of GPs if they feel it falls within their remit and it is in-line with what they normally would have prescribed had the patient been seen under the NHS (with reference to local and national guidelines). Patients should therefore note that these drugs will not necessarily be prescribed on the NHS .

In general, private referral and all costs associated are the responsibility of the patient. Costs of any prescribed medications resulting from private consultations are also the responsibility of the patient, who should not expect them to be prescribed on NHS prescriptions.

Access to Medical Record

How do I access my medical records?

Doctors have always had the discretion to allow patients to see their health records and to share information where appropriate with the carers of children and incapacitated adults. Additionally in recent years Acts of Parliament have given certain statutory rights of access to records. None of the legislation prevents doctors from informally showing patients their records or, bearing in mind duties of confidentiality, discussing relevant health issues with carers.

The implementation of data protection legislation in early 2000 changed patients' statutory rights of access to their health records. The purpose of this guidance is to set out in some detail the legal requirements on doctors as holders of health records. This summary highlights the main points.

What records are covered?

All manual and computerised health records about living people are accessible under the Data Protection Act 1998.

Does it matter when the records were made?

No, access must be given equally to all records regardless of when they were made.

Does the Act cover all of the UK?

Yes.

Who can apply for access?

Competent patients may apply for access to their own records, or may authorise a third party, such as their lawyer, to do so on their behalf. Parents may have access to their child's records if this is in the child's best interests and not contrary to a competent child's wishes. People appointed by a court to manage the affairs of mentally incapacitated adults may have access to information necessary to fulfill their function.

Are there any exemptions?

Yes, the main exemptions are that information must not be disclosed if it:

  • is likely to cause serious physical or mental harm to the patient or another person; or
  • relates to a third party who has not given consent for disclosure (where that third party is not a health professional who has cared for the patient).

Must copies of the records be given if requested?

Yes, patients are entitled to a copy of their records, for example a photocopy of paper records or print out of computerised records.

Can a fee be charged?

No, due to the new GDPR regulations. A fee will be charged however, if a request is deemed repetitive or excessive(these limits are set by the Practice).

If you are applying to access your health record you will need to;
  • Let our Non NHS / Finance Administrator know in writing or complete a consent form in reception.
  • Provide identification as well as proof of current address. Original copies must be available when collecting your information.

What about access to the records of deceased patients?

The Data Protection Act 1998 only covers the records of living patients. If a person has a claim arising from the death of an individual, he or she has a right of access to information in the deceased's records necessary to fulfill that claim. These rights are set out in the Access to Health Records Act 1990 or Access to Health Records (Northern Ireland) Order 1993. The provisions and fees are slightly different from those in the Data Protection Act.

In these circumstances please contact our Non NHS / Finance Administrator  on 020 8772 3322. Latest guidance on confidentiality and on sharing information with relatives and carers is available from the BMA's Medical Ethics Department.

Phlebotomy / Blood Tests

We have a booked appointment phlebotomy (adults and children) service for our registered patients at the practice on most days of the week - if a doctor or nurse has advised a blood test please book an appointment at reception.

Alternatively we provide a walk-in service for any patients in Wandsworth if referred by their GP Monday - Friday 12.00noon - 2.00pm and 9.00am-11.00am on Saturdays

Information about having a blood test at Balham Park Surgery

Blood test information leaflet

You can also have blood tests at:

ADULTS

Balham Health Centre

Monday to Friday: 8.30 12.15
No appointment necessary

St George's Hospital (Lanesborough Wing)

Monday to Friday: 07.30 – 16.30, Saturdays: 08.30 - 11.30 (No Saturday service on Bank Holiday Weekends)
No appointment necessary

St. John's Therapy Centre, SW11 1SW

Monday to Friday: 08.00 – 16.15, *Fri 08.00 - 12.45 and 13.30 - 16.15 (*Children will take priority on Fridays)

The Nelson Health Centre (Kingston Rd, SW20 8DB)

Monday to Friday: 08.00 – 19.30, Saturdays: 08.30 - 13.30

CHILDREN

St George's Hospital (Dragon Centre)

Monday to Thursday: 09.00 - 12.45 and 14.00 - 16.15

St. John's Therapy Centre, SW11 1SW

Friday: 08.00 – 12.45 and 13.30 - 16.15

The Nelson Health Centre (Kingston Rd, SW20 8DB)

Monday to Friday: 08.00 – 19.30, Saturdays: 08.00 - 13.30

 

St George's Phlebotomy telephone: 020 8725 1733

Nelson Phlebotomy telephone: 020 3668 3352

 

South West London Pathology

 

FASTING BLOOD TESTS:

If you have been asked to have a fasting blood test you should attend in the morning and have had nothing to eat for 12 hours prior to the test. You may drink water but nothing else in this time period.

RESULTS:

It is important that you follow up and find out the results of your blood tests.  You may have been asked to make a follow up appointment to discuss your blood tests.  If you are phoning for results please allow about 1 week before calling the surgery (your GP will inform you if the test may take longer to come back) 

  • Normal results: the receptionists may be able to tell you over the phone if all the tests were normal
  • Abnormal results: the GPs review all the results and will contact you if there is anything that needs to be discussed urgently.  If not, they may contact you by text, phone or letter or wait for you to phone in.  Ideally you should speak with the GP who ordered the results, who has assessed you and understands your case- if the GP concerned is not working on the day you phone in, this may mean arranging with reception a call back from that GP when they are next in. When the GP gives you the blood form please check what days they are at work and, therefore, available to discuss results.

Psychology

There are several options for psychology therapies including one to one therapy, group therapy and guided self-help. 

Please make an appointment with a GP to discuss your symptoms and they will advise on how to access the "psychological therapies in primary care" service.

We have 2 psychologists based at the practice who are linked to this service.

Substance Misuse

Claire Bown is the Primary Care Liason Nurse for Substance Misuse.  Currently, she runs clinics at the surgery on Wednesdays.

She deals with patients who have problems with:

  • Alcohol dependency
  • Illicit drug dependency
  • Cannabis use
  • Prescription dependency (for example, to pain killers or sleeping tablets)

She will also see patients who are at risk of relapse from any of the above problems. 

The GP may suggest a referral or patients can self-refer by booking an appointment with Claire via reception.

Taking Sick Leave

Employees only need a fit note from a doctor after 7 days off work sick. If you are ill just before or during your holiday, you can take it as sick leave instead.

 

Fit notes and proof of sickness

Employees must give their employer a doctor’s ‘fit note’ (previously called a ‘sick note’) if they’re off sick for more than 7 days in a row (including non-working days). Hospital doctors or GPs provide them. We charge a fee of £30 if a fit note is asked for before the 7th day.

The fit note will say the employee is either ‘not fit for work’ or ‘may be fit for work’.

If it says the employee ‘may be fit for work’, employers should discuss any changes that might help the employee return to work (e.g. different hours or tasks). The employee must be treated as ‘not fit for work’ if there is no agreement on these changes.

Employers can take a copy of the fit note, the employee should keep the original.

Self-certification

Employers can also ask employees to fill in a form when they return to work to confirm they have been off sick for up to 7 days. This is called ‘self-certification’. Employers usually provide their own version of this form. Please clink the link to electronically complete and print the  Self Certification Form

For further information on taking sick leave please click the following link  Taking Sick Leave

Need a fit note?

If you have been off for 7 days and need a fit note please contact the practice. You can do this with a message if you have EMIS ACCESS or email admin@balhamparksurgery.co.uk (please note neither of these options are for urgent requests) or speak to reception. Information you need to have to hand is the last day you worked, the reason you need a fit note and your anticipated return date to work. If we have any problems fulfilling your request the surgery will contact you. Please do not book a GP appointment for a fit note, if we need to see you in person we will contact you.

Thinking About Quitting

Karen Henderson (Senior Health Care Assistant) is our smoking cessation counsellor and she consistently has one of the highest success rates in Wandsworth at helping people quit smoking.
She can advise and support you in all aspects of smoking cessation, including medication and nicotine replacement therapy.

Your GP/practice nurse may advise you to make an appointment, or you can self refer to the service by booking at reception. Please tell reception the reason for the appointment as the initial appointment needs to be for 30min.

A message from Karen: "It's never too late to give up. Even if you've tried before...try, try again!"

http://www.nhs.uk/smokefree

If you need help to stop smoking don’t go it alone, call the Wandsworth NHS Stop Smoking Service today on freephone 0800 389 7921 and get details of the best clinic for you. You can also visit www.wandsworth.gov.uk/stopsmoking.

Travel Clinic

GPs do not deal with travel immunisations and antimalarial medication- you will need to see the practice nurse.  Please tell the receptionist when you book the appointment that it is for travel advice/medication. 

For “gap year” or “backpacking” trips you need to come at least 8 weeks before you travel; for more standard holidays 2 weeks before travel is usually sufficient. As these are usually longer appointments and can get booked up, please remember to book in plenty of time

Tetanus, diphtheria, polio, hepatitis A, hepatitis B & typhoid:No charge
Yellow fever:We are a yellow fever centre and will issue a certificate.  The vaccine costs £65.
Malaria tablets:These are issued on a private prescription, there is a charge of £20 for the prescription
Rabies:£65 per dose, £195 for the course of 3
Meningitis ACWY:

There is a charge for this vaccine of £65 for trips abroad such as Saudi Arabia and certain countries in Sub-Sahara Africa.

The exception are for teenagers who are advised to have this vaccine as part of the NHS vaccine program and patients under 25 who are going to University who have not been previously vaccinated.

Hepatitis B:£35 per dose £105 course of three.

We do not stock certain vaccines (eg Japanese B encephalitis), but if these are required we can recommend where you can get them.

Useful websites: 

www.fitfortravel.nhs.uk

www.nathnac.org

Walk-in Blood Clinic

Clinic Tim​es: 8.00am - 2.00pm Monday - Friday, 9.00am - 11.00am Saturday

People will come in and be seen on a first come first served basis - the last people that we can see will be those arriving by 2.00pm weekdays or 11.00am on Saturdays.

Patients from other Wandsworth practices can be referred to us by their GPs to use this service.

Our patients are warmly welcomed, though we will continue to offer pre-booked appointments for those registered with us.

Please make sure you have your blood forms with you as we will be unable to see you without it.

The clinic will be run by our phlebotomist Valbona Gjura.