Surgery clinics

Around 2,600 women are diagnosed with cervical cancer in England each year and around 690 women die from the disease.

It is estimated that if everyone attended screening regularly, 83% of cervical cancer cases could be prevented; however, attendance is at a 20-year low, with one in four women in the UK not attending their cervical screening.

Don’t ignore your invitation letter. Pop into reception or call us on 0208 887 8329 to book your screening appointment.

The practice nurses perform smear tests. The first invitation will be sent out at the age of 25 years. From 25 to 49 years, smear tests should be performed every 3 years, and from 50 to 64 years, at intervals of 5 years.

Please phone to make an appointment to see the practice nurse when you have received your invitation letter.

Contraceptive advice is given by the doctors or by the practice nurses. Please phone to make an appointment.

We also offer a coil and contraceptive implant fitting service at this practice. If you would like to have a coil or contraceptive implant fitted, please book a counselling appointment with Dr Heredia to discuss. Please note that your first appointment will be a consultation followed by a second appointment for procedures.

Childhood and teenage mental health

While it is commonly believed that depression only effects adults, around 10% of children in Great Britain aged between 5 and 16 have a recognisable mental disorder; with about 4% of children suffering from an emotional disorder such as anxiety or depression.

The problem for many is that depression is difficult to spot and often regarded as teenage mood swings. However, if your child is appearing to have an extreme emotional response to a life event or has lost interest in activities which previously interested them they may be suffering from an emotional disorder.

If you are worried about your child’s mental health please visit your GP, who will be able to offer a range of support to help both you and your child. There are a range of talking therapies which are highly effective in dealing with both short term and long term depression, for more information on these therapies please view the NHS Talking Therapy Guide.

While it is commonly believed that depression only effects adults, around 10% of children in Great Britain aged between 5 and 16 have a recognisable mental disorder; with about 4% of children suffering from an emotional disorder such as anxiety or depression.

The problem for many is that depression is difficult to spot and often regarded as teenage mood swings. However, if your child is appearing to have an extreme emotional response to a life event or has lost interest in activities which previously interested them they may be suffering from an emotional disorder.

If you are worried about your child’s mental health please visit your GP, who will be able to offer a range of support to help both you and your child. There are a range of talking therapies which are highly effective in dealing with both short term and long term depression, for more information on these therapies please view the NHS Talking Therapy Guide.

If you are pregnant and would like to go ahead with the pregnancy, you can self refer directly to a local maternity department without seeing or speaking to a GP. Please follow the links below to self-refer to a local hospital of your choice.

North Middlesex University Hospital
Sterling Way
London
N18 1QX

Chase Farm Hospital (Royal Free NHS Foundation Trust)
The Ridgeway
Enfield, Middlesex
EN2 8JL

Our surgery provides a travel vaccinations service, which includes a detailed assessment of which vaccinations are required. If you are travelling abroad, please make sure you contact us in plenty of time to arrange any vaccinations that may be necessary. To help the travel nurses assess your travel needs it is important that they are in receipt of the travel risk assessment form before your appointment.

We may need up to 8 weeks notice of your travelling arrangements so that we have time to order any special vaccines and so that you can receive a full course of any multiple vaccinations that may be required, so please give us as much notice as possible.

It would be useful if you could take a look at the Travel Health website before your appointment. This website gives information about the latest travel alerts and you can also access the vaccination advice for the country you are travelling to. This will enable you to make informed decisions during the consultation. Please be aware that some vaccinations require a series of injections at intervals prior to travel.

If you require urgent advice/vaccination, we will do our best to offer you an appointment, but if this is not possible please see the Masta website to find a local clinic.

We offer advice and vaccinations. Most vaccines are held in stock; however, some have to be ordered. Please note that we do have to charge for vaccines which are not available on the NHS.

One of the most important things that a parent can do for their child is to make sure that they have all their routine childhood vaccinations. It’s the most effective way of keeping them protected against infectious diseases.

If your child requires immunisations, the receptionist will book the appointment within this baby clinic.

Ideally, children should have their jabs at the right age to protect them as early as possible and minimise the risk of infection.

Find out which jabs your child needs, when they need them, and what the benefits of each jab are.

Please call the surgery on 0208 887 8329 to make an appointment.

We are currently running baby immunisation clinics with our practice nurses.

We offer a range of clinics and services here at the Rainbow Practice to help manage chronic diseases.

Chronic heart disease

The most common symptoms of coronary heart disease (CHD) are chest pains (angina) and a heart attack.

You can also experience other symptoms, such as palpitations and unusual breathlessness. In some cases, people may not show any symptoms before they are diagnosed.

Angina

If your coronary arteries become partially blocked, it can cause chest pain (angina). This can be a mild, uncomfortable feeling similar to indigestion.

However, a severe angina attack can cause a painful feeling of heaviness or tightness, usually within the centre of the chest, which may then spread to the arms, neck, jaw, back or stomach.

Angina attacks are often triggered by physical activity or stressful situations. Although symptoms of Angina usually pass within 10 minutes, you can alleviate the symptoms by resting or using a nitrate tablet or spray.

Heart attacks

If your arteries become completely blocked, it can cause a heart attack (myocardial infarction). Heart attacks can cause permanent damage to the heart muscle and, if not treated straight away, can be fatal.

If you think you are having a heart attack, dial 999 for immediate medical assistance.

Although symptoms can vary, the discomfort or pain of a heart attack is usually similar to that of angina but often more severe. During a heart attack you may also experience the following symptoms:

• Sweating
• Light-headedness
• Nausea
• Breathlessness

The symptoms of a heart attack can be similar to indigestion. For example, they may include a feeling of heaviness in your chest, a stomach ache or heartburn. However, these symptoms can also be accompanied by a pain that affects the arms (particularly the left arm), the neck and the jaw.

A heart attack can happen at any time, including while you are resting. If heart pains last longer than 15 minutes, it may be the start of a heart attack.

Unlike angina, the symptoms of a heart attack are not usually relieved using a nitrate tablet or spray.

In some cases, you may have a heart attack without any symptoms, called a silent myocardial infarction. This is more common in people with diabetes.

Heart failure

Heart failure can also occur in people with CHD when the heart becomes too weak to pump blood around the body, which can cause fluid to build up in the lungs that makes it increasingly difficult to breathe.

Heart failure can happen suddenly (acute heart failure) or gradually over time (chronic heart failure).

• British Heart Foundation – Cardiovascular Disease
• British Heart Foundation – Heart Attack

Diabetes

Diabetes is a long-term condition caused by too much glucose, a type of sugar, in the blood. It is also known as diabetes mellitus.

There are two main types of diabetes, which are explained below:

• Type I Diabetes
• Type II Diabetes

Normally, the amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas. The pancreas is a gland behind the stomach. When food is digested and enters your bloodstream, insulin moves any glucose out of the blood and into cells, where it is broken down to produce energy.

However, in people with diabetes, the body is unable to break down glucose into energy. This is because there is either not enough insulin to move the glucose, or because the insulin that is there does not work properly.

Our specialist diabetes team will provide you with support, regular reviews and the day-to-day care of your needs.

All Diabetic patients are entitled to an annual review. The Practice will normally contact you if yours is due. The review takes place in two parts – a data collection appointment and where appropriate, a follow up care plan appointment. If you feel you have been missed, or require a more urgent review, then please contact the Practice to arrange an appointment.

At the initial data collection appointment, your blood pressure, weight, urine, feet and well-being will be checked. It is necessary for you to bring an early morning urine sample with you. Following your initial appointment, a care plan booklet will be sent to you and if necessary, an appointment with your GP or one of our specialist nurses will be arranged.

For more information please visit the websites below:

• Diabetes UK

Hypertension

Hypertension relates to high blood pressure. If you have been advised by the surgery to submit your blood pressure readings on a regular basis, please use the blood pressure review form.

High blood pressure often causes no symptoms, or immediate problems, but it is a major risk factor for developing a serious cardiovascular disease (conditions that affect the functioning of the heart and the circulation of blood around the body), such as a stroke or heart disease.

• NHS: High Blood Pressure Explained
• Blood Pressure Association
• British Heart Foundation

Respiratory

Our respiratory clinics are primarily intended for patients with Asthma and COPD.

If you have been advised by the surgery to submit an annual review of your asthma symptoms please use the Adult Asthma Review form.

If your child (aged 4-11) has asthma, please submit a Child Asthma Review form.

If you have been advised by the surgery to submit a COPD assessment, please use the COPD Assessment form.

Asthma is caused by inflammation of the airways. These are the small tubes, called bronchi, which carry air in and out of the lungs. If you have asthma, the bronchi will be inflamed and more sensitive than normal. Our practice nurses have specialist asthma qualifications. During their clinics they monitor your overall condition, offer advice, answer any queries and ensure your treatment is effective.

Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have trouble breathing in and out. This is referred to as airflow obstruction. Breathing difficulties are caused by long-term damage to the lungs, usually because of smoking.

Asthma and COPD clinics

We hold clinics to diagnose and to help patients to manage their asthma or COPD.

We like to see all our patients who have been diagnosed with these conditions at least once a year, depending on the severity of your condition, we may invite you to come to the clinic more often in order to ensure we give you the care you require.

Asthma UK

For more information please visit our vaccinations page.

We offer a range of clinics and services here at the Rainbow Practice to support and maintain a healthy lifestyle.

Alcohol advice

If you have been invited to submit an alcohol consumption review, please complete the alcohol consumption review form.

NHS Advice on drinking recommends that men should not regularly drink more than 3-4 units of alcohol a day and women should not regularly drink more than 2-3 units a day, “Regularly” means drinking every day or most days of the week.

• NHS: Where to find alcohol support
• Drinkaware
• Change Grow Live

Chlamydia screening

Chlamydia screening is available from the surgery.

Simply ask at reception for a kit. It is a completely confidential service where you can send a urine sample in the envelope provided and receive the results easily.

Sexual health

A range of sexual health services are offered at the surgery including:

• Contraception and contraception advice. If you have been advised by the surgery to submit a contraceptive pill review, please use the contraceptive pill review form
• Emergency contraception and emergency contraception advice
• Testing and treatment for sexually transmitted infections (STIs), such as chlamydia, syphilis, gonorrhoea and genital warts
• Testing and counselling for HIV and AIDS

If you need advice and support with a sexual health matter or you think you have a problem you would like to discuss, please call the surgery to make an appointment with your GP.

Sexual health services are freely available for everyone.

For more information please visit the websites below.

• Family Planning Association: Sexual Health Advice
• British Pregnancy Advisory Service

Smoking cessation

If you’re trying to give up smoking, we can help. Studies show that your chances of success will be greatly improved if you get advice and support from health care professionals to help you stop smoking and if you don’t pay for your prescriptions then giving up is free.

The services we offer from the practice can:

• Boost your willpower to stop smoking
• Concentrate your efforts by getting advice from someone who knows your medical background
• Help you feel that you’re not doing it alone
• Help you to cope when you are tempted to smoke
• Monitor improvements to your health so that you can see the benefits

If you have been advised by the surgery to submit smoking reviews on a regular basis, please use the smoking review form.

Weight loss

If you would like to know more about weight and diet advice, we offer a weight management clinic giving you advice on how to lose weight and stay healthy.

A range of options are available to support people with weight loss. To understand which of them may be the best fit for you please arrange an appointment with your GP who will be happy to discuss them with you.

One suitable option may be our Health Trainers who offer 1:1 sessions for people wanting to improve their health and change their behaviour. They can support individuals with healthy eating, weight management and getting physically active.

Many doctors now believe that when it comes to your health, your waist measurement is important.

While knowing your body mass index (BMI) is a good way to decide if you’re overweight, it doesn’t tell the whole story.

BMI is a measure of how healthy your weight is for your height. You can work out what your BMI is by using the NHS Choices BMI healthy weight calculator.

If you have a high BMI, you’re likely to be carrying extra fat. But your health could be at greater risk depending on where you store that fat. If you have been advised to submit your BMI to the practice, please use the BMI calculator form.

Having a large amount of tummy fat (compared to fat around your bottom or thighs) makes you more likely to develop diabetes and heart problems.

A healthy waist circumference for men is less than 94cm (37 inches), and for women it’s less than 80cm (32 inches).

Losing weight and keeping it off isn’t easy, but it has many benefits. You may only need to make small changes to your lifestyle to maintain a healthy weight.

If you’d like to find out more about how you can lose weight in a healthy way please book an appointment with one of our nurses.

For more general information about weight loss, please see the websites below:

NHS: 8 tips for healthy eating

NHS: Calculate your BMI

Initially, we will cover nine long term conditions:

• Cardiovascular disease (for example, strokes, health failure, ischaemic heart disease, and peripheral artery disease)
• Diabetes
• Hypertension (high blood pressure)
• Hyperlipidaemia (high cholesterol)
• Non-alcoholic fatty liver disease
• Atrial fibrillation
• Chronic kidney disease
• Asthma
• Chronic obstructive pulmonary disease

In the future, we will look to expand this to cover more long term conditions.

If you have one of the long term conditions listed above, you will be encouraged to have at least three check ins per year. Each stage is described below for you.

In your check and test appointment, a health professional will carry out all the checks and tests you need to monitor and manage your long term condition. You may be sent for a blood test and have other checks like a blood pressure check and weight check. We may discuss lifestyle factors such as smoking and exercise with you too.

If you need an interpreter, please let us know so we can arrange one for your appointment.

After two to four weeks, you will receive your test results (by post, text, or email, however you prefer).

We will also send a blank document called a care plan.

A care plan is an agreement between you and your healthcare professional to help manage your health and support day to day. In your care plan, you can record things that are important to your health and wellbeing. This can include anything from your life, like employment, housing, or mental health.

A care plan covers:

• What is important to you and the goals you have
• How to get the most out of your medication
• The care and support you need from others

A healthcare professional will review your care plan with you in your discussion appointment. You can start filling out your care plan before your appointment or you can fill it during your appointment.

You will then be invited to a discussion appointment with a healthcare professional. This may be another team member (such as a nurse, health care assistant, pharmacist, social prescriber link worker) who is best placed to support your care and can spend more time with you. This appointment will take around 30 minutes.

You can discuss your long term conditions, test results, treatment, and anything else that is affecting your health, from housing to employment. Together we will look at what matters most to you and agree some goals. Your care plan will be updated with what has been agreed.

Three to six months later, you will be invited to a follow up appointment. This will last up to 15 minutes and is an opportunity to update your care plan with a healthcare professional, considering what is going well and where you may need more support. You may have more than one follow up appointment in a year.

Watch the short film below to see an example of a patient’s journey through the key stages of the process and help you understand what to expect from your yearly health check.

Your yearly health check – without subtitles

Your yearly health check – with subtitles

We will contact you via text, phone call, or letter to organise your appointments. We will contact patients over the year so please do not worry if you do not hear from us right away.

If you are concerned or have questions, please contact us.