Practice Medical Condition Reviews

Asthma Reviews

 

The practice offers annual Asthma reviews to patients who have been diagnosed with Asthma. You will be invited for your review with the practice nurse once a year, but if at any point you feel that your Asthma is not controlled then you must book an appointment with the Doctor.

Asthma is a common lung condition that causes occasional breathing difficulties.

It affects people of all ages and often starts in childhood, although it can also develop for the first time in adults.

There's currently no cure, but there are simple treatments that can help keep the symptoms under control so it does not have a big impact on your life.

Symptoms of asthma

The main symptoms of asthma are:

  • a whistling sound when breathing (wheezing)
  • breathlessness
  • a tight chest, which may feel like a band is tightening around it
  • coughing

The symptoms can sometimes get temporarily worse. This is known as an asthma attack.

When to see a GP

 

See a GP if you think you or your child may have asthma.

Several conditions can cause similar symptoms, so it's important to get a proper diagnosis and correct treatment.

The GP will usually be able to diagnose asthma by asking about symptoms and carrying out some simple tests.

Find out more about how asthma is diagnosed.

Treatments for asthma

Asthma is usually treated by using an inhaler, a small device that lets you breathe in medicines.

The main types are:

  • reliever inhalers – used when needed to quickly relieve asthma symptoms for a short time
  • preventer inhalers – used every day to prevent asthma symptoms happening

Some people also need to take tablets.

Causes and triggers of asthma

Asthma is caused by swelling (inflammation) of the breathing tubes that carry air in and out of the lungs. This makes the tubes highly sensitive, so they temporarily narrow.

It may happen randomly or after exposure to a trigger.

Common asthma triggers include:

  • allergies (to house dust mites, animal fur or pollen, for example)
  • smoke, pollution and cold air
  • exercise
  • infections like colds or flu

Identifying and avoiding your asthma triggers can help you keep your symptoms under control.

How long asthma lasts for

Asthma is a long-term condition for many people, particularly if it first develops when you're an adult.

In children, it sometimes goes away or improves during the teenage years, but can come back later in life.

The symptoms can usually be controlled with treatment. Most people will have normal, active lives, although some people with more severe asthma may have ongoing problems.

Atrial Fibrillation

The practice offers annual Atrial Fibrillation reviews to patients who have been diagnosed with AF. You will be invited for your review with the nurse once a year, but if at any point you feel that your condition is not controlled then you must book an appointment with the nurse or Doctor.

 

Atrial fibrillation is a heart condition that causes an irregular and often abnormally fast heart rate.

A normal heart rate should be regular and between 60 and 100 beats a minute when you're resting.

You can measure your heart rate by checking your pulse in your wrist or neck.

Symptoms of atrial fibrillation

In atrial fibrillation, the heart rate is irregular and can sometimes be very fast. In some cases, it can be considerably higher than 100 beats a minute.

This can cause problems including dizziness, shortness of breath and tiredness.

You may be aware of noticeable heart palpitations, where your heart feels like it's pounding, fluttering or beating irregularly, often for a few seconds or, in some cases, a few minutes.

Sometimes atrial fibrillation does not cause any symptoms and a person who has it is completely unaware that their heart rate is irregular.

When to see a GP

See a GP or call 111 if:

  • you have chest pain that comes and goes
  • you have chest pain that goes away quickly but you're still worried
  • you notice a sudden change in your heartbeat
  • your heart rate is consistently lower than 60 or above 100 (particularly if you're experiencing other symptoms of atrial fibrillation, such as dizziness and shortness of breath)

It's important to get medical advice to make sure it's nothing serious.

Urgent advice:Call 999 if:

You have sudden chest pain that:

  • spreads to your arms, back, neck or jaw
  • makes your chest feel tight or heavy
  • also started with shortness of breath, sweating and feeling or being sick
  • lasts more than 15 minutes

You could be having a heart attack. Call 999 immediately as you need immediate treatment in hospital.

What causes atrial fibrillation?

When the heart beats normally, its muscular walls tighten and squeeze (contract) to force blood out and around the body.

They then relax so the heart can fill with blood again. This process is repeated every time the heart beats.

In atrial fibrillation, the heart's upper chambers (atria) contract randomly and sometimes so fast that the heart muscle cannot relax properly between contractions. This reduces the heart's efficiency and performance.

Atrial fibrillation happens when abnormal electrical impulses suddenly start firing in the atria.

These impulses override the heart's natural pacemaker, which can no longer control the rhythm of the heart. This causes you to have a highly irregular pulse rate.

The cause is not fully understood, but it tends to affect certain groups of people, such as older people and people living with long-term (chronic) conditions such as heart disease, high blood pressure or obesity.

It may be triggered by certain situations, such as drinking too much alcohol or smoking.

Atrial fibrillation can be defined in various ways, depending on the degree to which it affects you.

For example:

  • paroxysmal atrial fibrillation – episodes come and go, and usually stop within 48 hours without any treatment
  • persistent atrial fibrillation – each episode lasts for longer than 7 days (or less when it's treated)
  • permanent atrial fibrillation – when it's present all the time
  • long-standing atrial fibrillation – where you've had atrial fibrillation usually for over a year

Who's affected

Atrial fibrillation is the most common heart rhythm disturbance, affecting around 1.4 million people in the UK.

It can affect adults of any age, but it's more common in older people.

More men than women have atrial fibrillation. 

Atrial fibrillation is more likely to occur in people with other conditions, such as high blood pressure (hypertension), atherosclerosis or a heart valve problem.

Information:

Social care and support guide

If you:

  • need help with day-to-day living because of illness or disability
  • care for someone regularly because they're ill, elderly or disabled (including family members)

Our guide to care and support explains your options and where you can get support.

Treating atrial fibrillation

Atrial fibrillation is not usually life threatening, but it can be uncomfortable and often requires treatment.

Treatment may involve: 

  • medicines to prevent a stroke (people with atrial fibrillation are more at risk of having a stroke)
  • medicines to control the heart rate or rhythm
  • cardioversion – where the heart is given a controlled electric shock to restore normal rhythm
  • catheter ablation – where the area inside the heart that's causing the abnormal heart rhythm is destroyed using radiofrequency energy; afterwards you may then need to have a pacemaker fitted to help your heart beat regularly

Atrial flutter

Atrial flutter is less common than atrial fibrillation, but shares the same symptoms, causes and possible complications.

Some people with atrial flutter also have atrial fibrillation.

Atrial flutter is similar to atrial fibrillation, but the rhythm in the atria is more organised and less chaotic than the abnormal patterns caused by atrial fibrillation.

Treatment for atrial flutter is also slightly different. Catheter ablation is considered to be the best treatment for atrial flutter, whereas medicine is often the first treatment used for atrial fibrillation.

 

Some people with atrial fibrillation, particularly older people, do not have any symptoms.

The irregularity in heart rhythm is often only discovered during routine tests or investigations for another condition.

Typically, a cardioversion (where the heart is given a controlled electric shock to restore normal rhythm) is carried out.

At this point, many people feel much better and realise they had not been feeling normal.

People often attribute tiredness and feeling lethargic to ageing, but once normal rhythm is restored, they realise these symptoms were caused by atrial fibrillation.

Heart palpitations

The most obvious symptom of atrial fibrillation is heart palpitations – where the heart feels like it's pounding, fluttering or beating irregularly, often for a few seconds or possibly a few minutes.

As well as an irregular heartbeat, your heart may also beat very fast (often considerably higher than 100 beats per minute).

You can work our your heart rate by checking your pulse in your neck or wrist.

Other symptoms you may experience if you have atrial fibrillation include:

The way the heart beats in atrial fibrillation reduces the heart's performance and efficiency.

This can lead to low blood pressure (hypotension) and heart failure.

See a GP or call 111 if:

  • you have chest pain that comes and goes
  • you have chest pain that goes away quickly but you're still worried
  • you notice a sudden change in your heartbeat
  • your heart rate is consistently lower than 60 or above 100 (particularly if you're experiencing other symptoms of atrial fibrillation, such as dizziness and shortness of breath)

It's important to get medical advice to make sure it's nothing serious.

Urgent advice:Call 999 if:

You have sudden chest pain that:

  • spreads to your arms, back, neck or jaw
  • makes your chest feel tight or heavy
  • also started with shortness of breath, sweating and feeling or being sick
  • lasts more than 15 minutes

You could be having a heart attack. Call 999 immediately as you need immediate treatment in hospital.

Electrocardiogram (ECG)

An electrocardiogram (ECG) can be used to confirm a diagnosis of atrial fibrillation. An ECG is a test that records the rhythm and electrical activity of your heart.

Baby clinic and checks

The practice runs a baby immunisation clinic every Tuesday. If your baby/child is due for immunisations then the practice will contact you directly to book this appointment. 

If you have recently had a baby then the practice will contact you directly to book an appointment for an eight week check up of your baby and first immunisations.

 

 

Your baby can still have their vaccinations if:

  • they have a minor illness without a high temperature – such as a cold
  • they have allergies, asthma, eczema or food intolerances
  • they were born prematurely

Important:Premature babies

It's really important that premature babies still have their vaccinations from 8 weeks old. They may be at higher risk of catching infections if you wait.

It may seem very early to give a vaccination to such a tiny baby. But many scientific studies have shown that it's a good time to give them vaccines.

Non-urgent advice:Speak to your GP surgery if your child:

  • has missed any vaccinations
  • has a vaccination appointment booked – but you've missed it or cannot attend
  • is ill with a high temperature
  • has a bleeding disorder (such as haemophilia)
  • has a fit (seizure) without a high temperature

They can book the next available appointment or give you advice.

It's best to have vaccines on time, but you can still catch up on most vaccines if you miss them.

Information:

You can take your baby swimming at any time before and after their immunisations.

Can I refuse my child's vaccinations?

Vaccines are not mandatory in the UK and you should be asked for your consent before each vaccination.

However, it's important to remember that vaccines will protect your child for many years against a range of serious illnesses.

Without vaccination your child is at greater risk of getting these illnesses.

Read about why vaccination is safe and important

Can I change my mind about vaccinating my child?

Sometimes parents choose not to vaccinate, but then later decide to make sure their child is protected.

It's best for your child to have their vaccinations according to the NHS vaccination schedule, but it's never too late to check if they can still have them.

Call or visit your GP surgery to make sure your child has any vaccinations they've missed, whatever the reason.

 

NHS vaccination schedule

Babies under 1 year old

A table showing when vaccines are offered to babies under 1 year old
Age Vaccines
8 weeks 6-in-1 vaccine
Rotavirus vaccine
MenB
12 weeks 6-in-1 vaccine (2nd dose)
Pneumococcal (PCV) vaccine
Rotavirus vaccine (2nd dose)
16 weeks 6-in-1 vaccine (3rd dose)
MenB (2nd dose)

 

Children aged 1 to 15

A table showing when vaccines are offered to children aged 1 to 15
Age Vaccines
1 year Hib/MenC (1st dose)
MMR (1st dose)
Pneumococcal (PCV) vaccine (2nd dose)
MenB (3rd dose)
2 to 10 years Flu vaccine (every year)
3 years and 4 months MMR (2nd dose)
4-in-1 pre-school booster
12 to 13 years HPV vaccine
14 years 3-in-1 teenage booster
MenACWY
Cancer

The practice is here to support you through your cancer diagnosis, treatment and beyond. We work alongside the hospitals to manage your care throughout your treatment. If you have other long-term health conditions the practice will continue to monitor these, alongside any side effects from your treatment, including medication, radiotherapy, chemotherapy. If at any point you need to see or speak to a Doctor then you will always be given priority.

Cancer is a condition where cells in a specific part of the body grow and reproduce uncontrollably. The cancerous cells can invade and destroy surrounding healthy tissue, including organs.

Cancer sometimes begins in one part of the body before spreading to other areas. This process is known as metastasis.

1 in 2 people will develop some form of cancer during their lifetime. In the UK, the 4 most common types of cancer are:

There are more than 200 different types of cancer, and each is diagnosed and treated in a particular way. You can find links on this page to information about other types of cancer.

Spotting signs of cancer

Changes to your body's normal processes or unusual, unexplained symptoms can sometimes be an early sign of cancer.

Symptoms that need to be checked by a doctor include:

  • a lump that suddenly appears on your body
  • unexplained bleeding
  • changes to your bowel habits

But in many cases your symptoms will not be related to cancer and will be caused by other, non-cancerous health conditions.

Read more about the signs and symptoms of cancer.

Reducing your risk of cancer

Making some simple changes to your lifestyle can significantly reduce your risk of developing cancer.

For example:

Find out more about how a healthy lifestyle reduces your chances of developing cancer on the Macmillan Cancer Support website

Cancer treatment

Surgery is the first treatment to try for most types of cancer, as solid tumours can usually be surgically removed.

2 other commonly used treatment methods are:

Waiting times

Accurately diagnosing cancer can take weeks or months. As cancer often develops slowly over several years, waiting for a few weeks will not usually impact on the effectiveness of treatment.

The National Institute for Health and Care Excellence (NICE) has produced referral guidelines for suspected cancer.

You should not have to wait more than 2 weeks to see a specialist if your GP suspects you have cancer and urgently refers you.

In cases where cancer has been confirmed, you should not have to wait more than 31 days from the decision to treat to the start of treatment.

NHS England has more detailed statistics on cancer waiting times

Cancer services

Other cancer pages

The Health A-Z covers many different types of cancer:

Information:

Social care and support guide

The guide to care and support explains your options and where you can get support if you:

  • need help with day-to-day living because of illness or disability
  • care for someone regularly because they're ill, elderly or disabled – including family members
Cervical Screening

If you have received a letter inviting you for your cervical screening, then please contact the practice to book your appointment with one of our practice nurses. We also have appointments available in our extended hours clinics based at Eccles Gateway. These are available in the evening and at the weekend. Please ask a member of the reception staff if you would like to be booked in to one of the extended hours appointments.

  • Cervical screening (a smear test) checks the health of your cervix. The cervix is the opening to your womb from your vagina.
  • It's not a test for cancer, it's a test to help prevent cancer.
  • All women and people with a cervix aged 25 to 64 should be invited by letter.
  • During the screening appointment, a small sample of cells will be taken from your cervix.
  • The sample is checked for certain types of human papillomavirus (HPV) that can cause changes to the cells of your cervix. These are called "high risk" types of HPV.
  • If these types of HPV are not found, you do not need any further tests.
  • If these types of HPV are found, the sample is then checked for any changes in the cells of your cervix. These can then be treated before they get a chance to turn into cervical cancer.
  • The nurse or doctor will tell you when you can expect your results letter.

How cervical screening helps prevent cancer

Cervical screening checks a sample of cells from your cervix for certain types of human papillomavirus (HPV).

These types of HPV can cause abnormal changes to the cells in your cervix and are called "high risk" types of HPV.

If these types of HPV are found during screening (an HPV positive result), the sample of cells is then checked for abnormal changes. If abnormal cells are not treated, they may turn into cervical cancer.

What is HPV?

HPV is the name for a very common group of viruses.

Most people will get some type of HPV during their lives. It is very common and nothing to feel ashamed or embarrassed about.

You can get HPV from any kind of skin-to-skin contact of the genital area, not just from penetrative sex.

This includes:

  • vaginal, oral or anal sex
  • any skin-to-skin contact of the genital area
  • sharing sex toys

Some types of HPV (called "high risk" types) can cause cervical cancer. In most cases your body will get rid of HPV without it causing any problems. But sometimes HPV can stay in your body for a long time.

If high risk types of HPV stay in your body, they can cause changes to the cells in your cervix. These changes may become cervical cancer if not treated.

If you do not have a high risk type of HPV it is very unlikely you will get cervical cancer, even if you have had abnormal cell changes in your cervix before.

Who's at risk of cervical cancer

If you have a cervix and have had any kind of sexual contact, with a man or a woman, you could get cervical cancer. This is because nearly all cervical cancers are caused by infection with high risk types of HPV.

You can get HPV through:

  • vaginal, oral or anal sex
  • any skin-to-skin contact of the genital area
  • sharing sex toys

You're still at risk of cervical cancer if:

  • you have had the HPV vaccine – it does not protect you from all types of HPV, so you're still at risk of cervical cancer
  • you have only had 1 sexual partner – you can get HPV the first time you're sexually active
  • you have had the same partner, or not had sex, for a long time – you can have HPV for a long time without knowing it
  • you're a lesbian or bisexual – you're at risk if you have had any sexual contact
  • you're a trans man with a cervix – read about if trans men should have cervical screening
  • you have had a partial hysterectomy that did not remove all of your cervix

If you've never had any kind of sexual contact with a man or woman, you may decide not to go for cervical screening when you are invited. But you can still have a test if you want one.

If you're not sure whether to have cervical screening, talk to your GP or nurse.

Cervical screening is a choice

It's your choice if you want to go for cervical screening. But cervical screening is one of the best ways to protect you from cervical cancer.

Risks of cervical screening

You may have some light bleeding or spotting after cervical screening. This should stop within a few hours.

If abnormal cells are found and you need treatment, there are some risks, such as:

  • treating cells that may have gone back to normal on their own
  • bleeding or an infection
  • you may be more likely to have a baby early if you get pregnant in the future – but this is rare

For more information to help you decide, read the NHS cervical screening leaflet.

How to opt out

If you do not want to be invited for screening, contact your GP and ask to be taken off their cervical screening list.

You can ask them to put you back on the list at any time if you change your mind.

When you'll be invited for cervical screening in England

Chart showing age range and when you'll be invited for screening in England
Age When you're invited
Under 25 Up to 6 months before you turn 25
25 to 49 Every 3 years
50 to 64 Every 5 years
65 or older Only if 1 of your last 3 tests was abnormal

You can book an appointment as soon as you get a letter.

If you missed your last cervical screening, you do not need to wait for a letter to book an appointment.

 
Chronic Kidney Disease Reviews

The practice offers six monthly reviews to patients who have been diagnosed with Chronic Kidney Disease. You will be invited for your review with the nurse every six months, but if at any point you feel that your condition is not controlled then you must book an appointment with the nurse.

 

 

Chronic kidney disease (CKD) is a long-term condition where the kidneys don't work as well as they should.

It's a common condition often associated with getting older. It can affect anyone, but it's more common in people who are black or of south Asian origin.

CKD can get worse over time and eventually the kidneys may stop working altogether, but this is uncommon. Many people with CKD are able to live long lives with the condition.

Symptoms of CKD

There are usually no symptoms of kidney disease in the early stages. It may only be diagnosed if you have a blood or urine test for another reason and the results show a possible problem with your kidneys.

At a more advanced stage, symptoms can include:

See a GP if you have persistent or worrying symptoms that you think could be caused by kidney disease.

Find out more about the symptoms of CKD.

Causes of CKD

Chronic kidney disease is usually caused by other conditions that put a strain on the kidneys. Often it's the result of a combination of different problems.

CKD can be caused by:

You can help prevent CKD by making healthy lifestyle changes and ensuring any underlying conditions you have are well controlled.

Tests for CKD

CKD can be diagnosed using blood and urine tests. These tests look for high levels of certain substances in your blood and urine that are signs your kidneys aren't working properly.

If you're at a high risk of developing kidney disease (for example, you have a known risk factor such as high blood pressure or diabetes), you may be advised to have regular tests to check for CKD so it's found at an early stage.

The results of your blood and urine tests can be used to tell the stage of your kidney disease. This is a number that reflects how severe the damage to your kidneys is, with a higher number indicating more serious CKD.

Find out more about how CKD is diagnosed.

Treatments for CKD

There's no cure for CKD, but treatment can help relieve the symptoms and stop it getting worse.

Your treatment will depend on how severe your condition is.

The main treatments are:

  • lifestyle changes to help you remain as healthy as possible
  • medicine to control associated problems such as high blood pressure and high cholesterol
  • dialysis – treatment to replicate some of the kidney's functions; this may be necessary in advanced CKD
  • kidney transplant – this may also be necessary in advanced CKD

You'll also be advised to have regular check-ups to monitor your condition.

Find out more about how CKD is treated and living with CKD.

Outlook for CKD

CKD can range from a mild condition with no or few symptoms, to a very serious condition where the kidneys stop working, sometimes called kidney failure.

Most people with CKD will be able to control their condition with medicine and regular check-ups. CKD only progresses to kidney failure in around 1 in 50 people with the condition.

If you have CKD, even if it's mild, you're at an increased risk of developing other serious problems, such as cardiovascular disease. This is a group of conditions affecting the heart and blood vessels, which includes heart attack and stroke.

Cardiovascular disease is one of the main causes of death in people with kidney disease, although healthy lifestyle changes and medicine can help reduce your risk of developing it.

COPD Annual Reviews

The practice offers annual COPD reviews to patients who have been diagnosed with COPD. You will be invited for your review with the practice nurse once a year, but if at any point you feel that your COPD is not controlled then you must book an appointment with the Doctor.

 

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties.

It includes:

  • emphysema – damage to the air sacs in the lungs
  • chronic bronchitis – long-term inflammation of the airways

COPD is a common condition that mainly affects middle-aged or older adults who smoke. Many people do not realise they have it.

The breathing problems tend to get gradually worse over time and can limit your normal activities, although treatment can help keep the condition under control.

Symptoms of COPD

The main symptoms of COPD are:

  • increasing breathlessness, particularly when you're active
  • a persistent chesty cough with phlegm – some people may dismiss this as just a "smoker's cough"
  • frequent chest infections
  • persistent wheezing

Without treatment, the symptoms usually get progressively worse. There may also be periods when they get suddenly worse, known as a flare-up or exacerbation.

Find out more about the symptoms of COPD.

When to get medical advice

See a GP if you have persistent symptoms of COPD, particularly if you're over 35 and smoke or used to smoke.

Do not ignore the symptoms. If they're caused by COPD, it's best to start treatment as soon as possible, before your lungs become significantly damaged.

The GP will ask about your symptoms and whether you smoke or have smoked in the past. They can organise a breathing test to help diagnose COPD and rule out other lung conditions, such as asthma.

Find out more about how COPD is diagnosed.

Causes of COPD

COPD happens when the lungs become inflamed, damaged and narrowed. The main cause is smoking, although the condition can sometimes affect people who have never smoked.

The likelihood of developing COPD increases the more you smoke and the longer you've smoked.

Some cases of COPD are caused by long-term exposure to harmful fumes or dust. Others are the result of a rare genetic problem which means the lungs are more vulnerable to damage.

Find out more about the causes of COPD.

Treatments for COPD

The damage to the lungs caused by COPD is permanent, but treatment can help slow down the progression of the condition.

Treatments include:

  • stopping smoking – if you have COPD and you smoke, this is the most important thing you can do
  • inhalers and medicines – to help make breathing easier
  • pulmonary rehabilitation – a specialised programme of exercise and education
  • surgery or a lung transplant – although this is only an option for a very small number of people

Find out more about how COPD is treated and living with COPD.

Outlook for COPD

The outlook for COPD varies from person to person. The condition cannot be cured or reversed, but for many people, treatment can help keep it under control so it does not severely limit their daily activities.

But in some people, COPD may continue to get worse despite treatment, eventually having a significant impact on their quality of life and leading to life-threatening problems.

Coronary Heart Disease

The practice offers annual Coronary Heart Disease reviews to patients who have been diagnosed with CHD. You will be invited for your review with the nurse once a year, but if at any point you feel that your condition is not controlled then you must book an appointment with the nurse or Doctor.

Coronary heart disease (CHD) is a major cause of death in the UK and worldwide. CHD is sometimes called ischaemic heart disease or coronary artery disease.

Symptoms of coronary heart disease (CHD)

The main symptoms of coronary heart disease are:

  • chest pain (angina)
  • shortness of breath
  • pain throughout the body
  • feeling faint
  • feeling sick (nausea)

But not everyone has the same symptoms and some people may not have any before coronary heart disease is diagnosed.

Causes of coronary heart disease (CHD)

Coronary heart disease is the term that describes what happens when your heart's blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries.

Over time, the walls of your arteries can become furred up with fatty deposits. This process is known as atherosclerosis and the fatty deposits are called atheroma.

Atherosclerosis can be caused by lifestyle factors, such as smoking and regularly drinking excessive amounts of alcohol.

You're also more at risk of getting atherosclerosis if you have conditions like high cholesterol, high blood pressure (hypertension) or diabetes.

Diagnosing coronary heart disease (CHD)

If a doctor feels you're at risk of coronary heart disease, they may carry out a risk assessment.

They'll ask you about your medical and family history and your lifestyle, and they'll take a blood test.

Further tests may be needed to confirm coronary heart disease, including:

Read more about how coronary heart disease is diagnosed.

Treating coronary heart disease (CHD)

Coronary heart disease cannot be cured but treatment can help manage the symptoms and reduce the chances of problems such as heart attacks.

Treatment can include:

  • lifestyle changes, such as regular exercise and stopping smoking
  • medicines
  • angioplasty – where balloons and stents are used to treat narrow heart arteries
  • surgery

Recovering from the effects of coronary heart disease (CHD)

If you've had a heart attack, an angioplasty, or heart surgery, it's possible to get back to a normal life.

Advice and support is available to help you deal with aspects of your life that may have been affected by coronary heart disease.

Read more about recovering from the effects of coronary heart disease.

Preventing coronary heart disease (CHD)

You can reduce your risk of getting coronary heart disease by making some simple lifestyle changes.

These include:

  • eating a healthy, balanced diet
  • being physically active
  • giving up smoking
  • controlling blood cholesterol and sugar levels

Keeping your heart healthy will also have other health benefits, such as helping reduce your risk of stroke and dementia.

The heart

The heart is a muscle about the size of your fist. It pumps blood around your body and beats approximately 70 times a minute.

After the blood leaves the right side of the heart, it goes to your lungs where it picks up oxygen.

The oxygen-rich blood returns to your heart and is then pumped to the body's organs through a network of arteries.

The blood returns to your heart through veins before being pumped back to your lungs again. This process is called circulation.

The heart gets its own supply of blood from a network of blood vessels on the heart's surface called coronary arteries.

Dementia

The practice offers annual Dementia reviews to patients who have been diagnosed with AF. You will be invited for your review with the nurse and Doctor once a year, but if at any point you feel that your condition is not controlled then you must book an appointment with the Doctor.

Dementia is not a disease itself. It's a collection of symptoms that result from damage to the brain caused by different diseases, such as Alzheimer's. These symptoms vary according to the part of the brain that is damaged.

Common early symptoms of dementia

Different types of dementia can affect people differently, and everyone will experience symptoms in their own way.

However, there are some common early symptoms that may appear some time before a diagnosis of dementia. These include:

  • memory loss
  • difficulty concentrating
  • finding it hard to carry out familiar daily tasks, such as getting confused over the correct change when shopping
  • struggling to follow a conversation or find the right word
  • being confused about time and place
  • mood changes

These symptoms are often mild and may get worse only very gradually. It's often termed "mild cognitive impairment" (MCI) as the symptoms are not severe enough to be diagnosed as dementia.

You might not notice these symptoms if you have them, and family and friends may not notice or take them seriously for some time. In some people, these symptoms will remain the same and not worsen. But some people with MCI will go on to develop dementia.

Dementia is not a natural part of ageing. This is why it's important to talk to a GP sooner rather than later if you're worried about memory problems or other symptoms.

Symptoms specific to Alzheimer's disease

The most common cause of dementia is Alzheimer's disease. Common symptoms of Alzheimer's disease include:

  • memory problems, such as regularly forgetting recent events, names and faces
  • asking questions repetitively
  • increasing difficulties with tasks and activities that require organisation and planning
  • becoming confused in unfamiliar environments
  • difficulty finding the right words
  • difficulty with numbers and/or handling money in shops
  • becoming more withdrawn or anxious

Read more about Alzheimer's disease.

Symptoms specific to vascular dementia

Vascular dementia is the second most common cause of dementia, after Alzheimer's. Some people have both vascular dementia and Alzheimer's disease, often called "mixed dementia".

Symptoms of vascular dementia are similar to Alzheimer's disease, although memory loss may not be as obvious in the early stages.

Symptoms can sometimes develop suddenly and quickly get worse, but they can also develop gradually over many months or years.

Specific symptoms can include:

  • stroke-like symptoms: including muscle weakness or temporary paralysis on one side of the body (these symptoms require urgent medical attention)
  • movement problems – difficulty walking or a change in the way a person walks
  • thinking problems – having difficulty with attention, planning and reasoning
  • mood changes – depression and a tendency to become more emotional

Read more about vascular dementia.

Symptoms specific to dementia with Lewy bodies

Dementia with Lewy bodies has many of the symptoms of Alzheimer's disease, and people with the condition typically also experience:

  • periods of being alert or drowsy, or fluctuating levels of confusion
  • visual hallucinations (seeing things that are not there)
  • becoming slower in their physical movements
  • repeated falls and fainting
  • sleep disturbances

Read more about dementia with Lewy bodies.

Symptoms specific to frontotemporal dementia

Although Alzheimer's disease is still the most common type of dementia in people under 65, a higher percentage of people in this age group may develop frontotemporal dementia than older people. Most cases are diagnosed in people aged 45-65.

Early symptoms of frontotemporal dementia may include:

  • personality changes – reduced sensitivity to others' feelings, making people seem cold and unfeeling
  • lack of social awareness – making inappropriate jokes or showing a lack of tact, though some people may become very withdrawn and apathetic
  • language problems – difficulty finding the right words or understanding them
  • becoming obsessive – such as developing fads for unusual foods, overeating and drinking

Read more about frontotemporal dementia.

Symptoms in the later stages of dementia

As dementia progresses, memory loss and difficulties with communication often become severe. In the later stages, the person is likely to neglect their own health, and require constant care and attention.

The most common symptoms of advanced dementia include:

  • memory problems – people may not recognise close family and friends, or remember where they live or where they are
  • communication problems – some people may eventually lose the ability to speak altogether. Using non-verbal means of communication, such as facial expressions, touch and gestures, can help
  • mobility problems – many people become less able to move about unaided. Some may eventually become unable to walk and require a wheelchair or be confined to bed
  • behavioural problems – a significant number of people will develop what are known as "behavioural and psychological symptoms of dementia". These may include increased agitation, depressive symptoms, anxiety, wandering, aggression, or sometimes hallucinations
  • bladder incontinence is common in the later stages of dementia, and some people will also experience bowel incontinence
  • appetite and weight loss problems are both common in advanced dementia. Many people have trouble eating or swallowing, and this can lead to choking, chest infections and other problems. Alzheimer's Society has a useful factsheet on eating and drinking

 

Diabetic Reviews

The practice offers six monthly diabetic reviews to patients who have been diagnosed with diabetes. You will be invited for your review with the practice nurse every six months, but if at any point you feel that your diabetes is not controlled then you must book an appointment with the Doctor.

 

  • Type 2 diabetes is a common condition that causes the level of sugar (glucose) in the blood to become too high.
  • It can cause symptoms like excessive thirst, needing to pee a lot and tiredness. It can also increase your risk of getting serious problems with your eyes, heart and nerves.
  • It's a lifelong condition that can affect your everyday life. You may need to change your diet, take medicines and have regular check-ups.
  • It's caused by problems with a chemical in the body (hormone) called insulin. It's often linked to being overweight or inactive, or having a family history of type 2 diabetes.

 

Medicines for type 2 diabetes

There are many types of medicine for type 2 diabetes. It can take time to find a medicine and dose that's right for you.

You'll usually be offered a medicine called metformin first.

You may need to take extra medicines, or a different medicine such as insulin, if:

  • treatment is not keeping your blood sugar levels within a healthy range
  • you have heart problems or need to lose weight

Your GP or diabetes nurse will recommend the medicines most suitable for you.

Your medicine might not make you feel any different, but this does not mean it's not working. It's important to keep taking it to help prevent future health problems.

Metformin

Metformin is the most common medicine for type 2 diabetes. It can help keep your blood sugar at a healthy level.

It comes as tablets you take with or after meals.

Common side effects of metformin include feeling or being sick and diarrhoea. If this happens to you, your doctor may suggest trying a different type called slow-release metformin.

Find out more about metformin

Other diabetes medicines

If metformin does not work well enough on its own, you cannot take it or you have other health problems, you may need to take other medicines alongside or instead of metformin.

These include:

Insulin

You'll need insulin if other medicines no longer work well enough to keep your blood sugar within a healthy range.

Sometimes you may need insulin for a short time, such as if you're pregnant, if you're ill, or to bring your blood sugar level down when you're first diagnosed.

You inject insulin using an insulin pen. This is a device that helps you inject safely and take the right dose.

Using an insulin pen does not usually hurt. The needles are very small, as you only inject a small amount just under your skin. Your diabetes nurse will show you where to inject and how to use your pen.

Your GP or diabetes specialist will recommend the type of insulin treatment that's best for you.

Find out more about insulin from Diabetes UK

Side effects

Your diabetes medicine may cause side effects, but most people do not get any.

The side effects you may get depend on which medicines you're taking.

Do not stop taking your medicine if you get side effects. Talk to your doctor, who may suggest trying a different medicine.

Low blood sugar (hypos)

Some diabetes medicines can cause low blood sugar, known as hypoglycaemia or hypos.

If you take medicine that can cause hypos, your doctor might recommend that you check your blood sugar regularly. You'll be given a testing kit and shown how to do a finger-prick test.

If you take insulin at least twice a day and have frequent or severe hypos, you might also be offered a continuous glucose monitor (CGM) or flash monitor.

This is a small sensor you wear on your skin that lets you check your blood sugar level at any time.

Learn more about checking your blood sugar levels from Diabetes UK

How to get free prescriptions for diabetes medicine

If you take diabetes medicine, you're entitled to free prescriptions for all your medicines.

To claim your free prescriptions, you'll need to apply for an exemption certificate. This is known as a PF57 form.

To do this:

  • fill in a form at your GP surgery
  • you should get the certificate in the post about a week later – it'll last for 5 years
  • take it to your pharmacy with your prescriptions

Save your receipts if you have to pay for diabetes medicine before you receive your exemption certificate. You can claim the money back if you include the receipts along with your completed PF57 form.

Hypertension Annual Reviews

The practice offers annual Hypertension reviews to patients who have been diagnosed with high blood pressure. You will be invited for your review with the nurse once a year, but if at any point you feel that your blood pressure is not controlled then you must book an appointment with the nurse.

 

High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes.

Around a third of adults in the UK have high blood pressure, although many will not realise it.

The only way to find out if your blood pressure is high is to have your blood pressure checked.

What is high blood pressure?

Blood pressure is recorded with 2 numbers. The systolic pressure (higher number) is the force at which your heart pumps blood around your body.

The diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels.

They're both measured in millimetres of mercury (mmHg).

As a general guide:

  • high blood pressure is considered to be from 140/90mmHg (or an average of 135/85mmHg at home) – or 150/90mmHg (or an average of 145/85mmHg at home) if you're over the age of 80
  • ideal blood pressure is usually considered to be between 90/60mmHg and 120/80mmHg, while the target for over-80s is below 150/90mmHg (or 145/85mmHg at home)

Blood pressure readings between 120/80mmHg and 140/90mmHg could mean you're at risk of developing high blood pressure if you do not take steps to keep your blood pressure under control.

Everyone's blood pressure will be slightly different. What's considered low or high for you may be normal for someone else.

Risks of high blood pressure

If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes.

Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening health conditions, such as:

If you have high blood pressure, reducing it even a small amount can help lower your risk of these health conditions.

 

Hypothyroidism Annual Reviews

The practice offers annual Hypothyroidism reviews to patients who have been diagnosed with an underactive thyroid. You will be invited for your review with the nurse once a year, but if at any point you feel that your condition is not controlled then you must book an appointment with the nurse.

 

An underactive thyroid gland (hypothyroidism) is where your thyroid gland does not produce enough hormones.

Common signs of an underactive thyroid are tiredness, weight gain and feeling depressed.

An underactive thyroid can often be successfully treated by taking daily hormone tablets to replace the hormones your thyroid is not making.

There's no way of preventing an underactive thyroid. Most cases are caused either by the immune system attacking the thyroid gland and damaging it, or by damage to the thyroid that occurs during some treatments for an overactive thyroid or thyroid cancer.

When to see a GP

Symptoms of an underactive thyroid are often similar to those of other conditions, and they usually develop slowly, so you may not notice them for years.

For example, if you are an age where you may be expecting the menopause, you may think you have started the menopause rather than having an underactive thyroid.

You should see a GP and ask to be tested for an underactive thyroid if you have symptoms including:

  • tiredness
  • weight gain
  • depression
  • being sensitive to the cold
  • dry skin and hair
  • muscle aches

The only accurate way of finding out whether you have a thyroid problem is to have a thyroid function test, where a sample of blood is tested to measure your hormone levels.

Read more about testing for an underactive thyroid.

Who's affected

Both men and women can have an underactive thyroid, although it's more common in women. Children can also develop an underactive thyroid and some babies are born with it.

All babies born in the UK are screened for congenital hypothyroidism using a blood spot test when the baby is about 5 days old.

Treating an underactive thyroid

Treatment for an underactive thyroid involves taking daily hormone replacement tablets, called levothyroxine, to raise your thyroxine levels.

You'll initially have regular blood tests until the correct dose of levothyroxine is reached. This can take a little while to get right.

Once you're taking the correct dose, you'll usually have a blood test once a year to monitor your hormone levels.

You'll usually need treatment for the rest of your life. However, with proper treatment, you should be able to lead a normal, healthy life.

If an underactive thyroid is not treated, it can lead to complications, including heart disease, goitre, pregnancy problems and a life-threatening condition called myxoedema coma (although this is very rare).

The thyroid gland

The thyroid gland is a small butterfly-shaped gland in the neck, just in front of the windpipe (trachea).

One of its main functions is to produce hormones that help regulate the body's metabolism (the process that turns food into energy). These hormones are called triiodothyronine (T3) and thyroxine (T4).

Many of the body's functions slow down when the thyroid does not produce enough of these hormones.