A blood test is when a sample of blood is taken for testing in a laboratory. Blood tests have a wide range of uses and are one of the most common types of medical test. For example, a blood test can be used to:

• assess your general state of health
• confirm the presence of a bacterial or viral infection
• see how well certain organs, such as the liver and kidneys, are functioning

A blood test usually involves the phlebotomist taking a blood sample from a blood vessel in your arm and the usual place for a sample is the inside of the elbow or wrist, where the veins are relatively close to the surface. Blood samples from children are most commonly taken from the back of the hand. The childs hand will be anaesthetised (numbed) with a special cream before the sample is taken.

You can find out more about blood tests, their purpose and the way they are performed on the NHS Choices website: https://www.nhs.uk/conditions/blood-tests/ 

An X-ray is a widely used diagnostic test to examine the inside of the body. X-rays are a very effective way of detecting problems with bones, such as fractures. They can also often identify problems with soft tissue, such as pneumonia.

You will be asked to lie on a table or stand against a surface so that the part of your body being X-rayed is between the X-ray tube and the photographic plate.

An X-ray is usually carried out by a radiographer healthcare professional who specialises in using imaging technology, such as X-rays and ultrasound scanners.

You can find out more about x-ray tests, how they are performed, their function and the risks by visiting the NHS Choices website: https://www.nhs.uk/conditions/x-ray/

What is it?

Social Prescribing focuses on tackling the social factors that impact health and well-being by connecting residents of Islington to non-medical support available within the borough.

Many individuals discuss non-medical issues with their GPs and other healthcare providers simply because they are unsure where to seek help. These concerns may include social isolation, mental health, financial difficulties, housing challenges, employment, access to exercise opportunities, and volunteering options. If these issues are not addressed, they can have a detrimental effect on an individual’s overall health and well-being.

What can service users expect

When booked with our in-house Social Prescribers, a dedicated professional will work with the patient to assess their needs and identify the appropriate local support. Our Social Prescribers are committed to providing a welcoming environment where individuals can discuss their concerns comfortably and privately.

We aim to contact clients in need of support within a reasonable timeframe. However, during periods of high demand, we will inform you of an estimated waiting time.

Please note, this is not an emergency service.

Our Key Objectives

Prevention:
By addressing broader social factors that impact health and well-being, we aim to prevent the onset of related complications that can arise when these factors are not addressed.

Self-Care:
We empower residents to take an active role in their own health and well-being by helping them understand the local social support available and building their confidence in accessing these resources.

Personalisation and Collaborative Working:
We focus on enhancing the local support available through a person-centred approach to health and well-being. This is achieved by encouraging residents to collaborate with healthcare providers to plan tailored interventions.

Accessing Social Prescribing

Our in-house Social Prescribers are available to all individuals registered with our practice; for an initial appointment, you will need to be booked in by a member of the practice team. If you would like to see a Social Prescriber, please call the practice or submit an online consultation.

LONG TERM CONDITION CARE

St. John’s Way Medical Centre are improving the way we work with patients with long-term conditions

What is a long term condition?

Long term conditions (LTCs) are those that impact individuals over a long period of time, such as diabetes, high blood pressure or asthma It is recommended that patients living with LTCs attend for review each year with their practice or specialist to optimise their care.

How has the LTC Annual Review process changed?

From October 2023 patients with the following LTCs will be invited for review within the month of their birth:

• Diabetes (Type 1 and Type 2)
• Cardiovascular disease (for example strokes, heart failure, ischaemic heart disease, and peripheral artery disease)
• Hypertension (High blood pressure)
• Hyperlipidaemia (High cholesterol)
• Non-alcoholic fatty liver disease
• Atrial fibrillation
• Chronic kidney disease
• Asthma
• Chronic obstructive pulmonary disease

If you have more than one of these long term conditions we will try to group these a far as possible to streamline your overall number of reviews and reduce unnecessary duplication of tests and checks.

We will aim to work with you to improve your health by considering what matters to you. We will consider your individual needs and preferences as well as best practice for your long-term condition. Our goal is that by planning together with care, patients will have the confidence to manage their health, reduce their risk of being admitted to hospital, and have a better quality of life.

What can you expect?

If you have one of the long-term conditions listed above, you will be offered at least three check-ins per year – starting in your month of birth. Each stage is described below for you:

1. Part 1 Appointment

In your Part 1, our nurses or health care assistant will carry out all the checks and tests you need to monitor and manage your long-term condition. You will receive a blood test on the day in practice (where

possible) and have other checks like a blood pressure and weight. Our nurses will also discuss a few lifestyle factors with you such as smoking and exercise.

Please note that some patients may receive a text with a questionnaire in advance of your Part 1 review so that we can collect some basic information about the control of your condition and your general health ahead of time. Responding to these messages will better inform the clinician who undertakes your review – so please try to do so where possible.

2. Receive your test results and your Care Plan

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 you manage your health and support day to day. In your Care Plan, you can record things that are important to your health and wellbeing.

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 results and care plan with you in your Part 2 appointment. Please start to fill in your Care Plan ahead of this appointment where possible.

3. Part 2 Appointment

You will then be invited to a Part 2 Appointment with a healthcare professional. This may be with a doctor or another member of our team such as a nurse, health care assistant or pharmacist who is well 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. Together, we will aim to look at what matters most to you and agree some goals. Your Care Plan will then be updated with what has been agreed.

4. Part 3 or Follow-up Appointment

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. Some patients may require more than one follow-up appointment in a year.

How will I be contacted if this is for me?

We will contact you within your month of birth (or a little earlier) via text, phone call, or letter to organise your appointment. If you don’t hear from us in this time frame and you have one of the named conditions above please get in touch via our reception team.

This is a visual representation of the new process:

Healthcare assistants support practice nurses with their daily work and carry out tasks such as phlebotomy (drawing blood), blood pressure measurement and new patient checks. They may act as a chaperone when a patient or doctor requests one.

Practice nurses are qualified and registered nurses. They can help with health issues such as family planning, healthy living advice, blood pressure checks and dressings. The practice nurses run clinics for long-term health conditions such as asthma or diabetes, minor ailment clinics and carry out cervical smears.

Advanced Nurse Practitioner (ANP)

General Practice is also under increasing strain. The demand for appointments is increasing, more people require more medicine and more clinics are running in General Practice than ever before.

As a Practice we are trying to provide a good service to our Practice Population going forward in the years to come, which is why we have two ANP’s who work at the surgery on Tuesday, Wednesday and Thursday.

Do I need to see a GP or the Advanced Nurse Practitioner?

Advanced Nurse Practitioners (ANPs) are all trained specialist nurses who have undertaken additional education in order to provide advanced nursing care. They can provide treatment and advice for many problems for which you may have seen a Doctor for in the past. Their main areas of expertise are in the management of common illnesses and long-term conditions. If you are uncertain whether the ANP’s can help you, please ask the receptionist for advice.

Appointments

ANP appointments are available most days for common illnesses. Routine appointments are also available if you prefer to book in advance.

The ANP can assess and examine you, make a diagnosis and provide advice, organise blood tests or x-rays if appropriate, and treatment including a prescription if required. She can make referrals to hospital doctors or other health care professionals, and admit patients into hospital when necessary.

Unfortunately ANPs are unable legally to sign a “Fit Note” for work, but if they feel you require one she can arrange this with the GP.

The ANP works closely with your GP and will liaise frequently with them about your care.

The ANP can see you for the following:

Routine Appointments

• Newly diagnosed Type 2 Diabetes
• New Hypertension diagnosis
• Contraceptive advice/reviews
• New Asthma/COPD diagnosis
• Diabetic Reviews
• Asthma/COPD reviews
• Discussion of nexplanon and or coil
• Spirometry results

What ANP cannot deal with

Problems associated with pregnancy/ Mental health issues / Children under 2 years old/ Medical certificates

Ear Wax and Ear Irrigation

Ear wax is a normal body secretion; it provides protection against infection and dust particles. The ear is self-cleaning, and the wax usually works its way out naturally. Never use cotton buds to clean inside your ears, as they can irritate the delicate skin inside the ear canal and may push the wax deeper, compacting it.

Ear irrigation is not risk-free; therefore, it is only performed if the ear is completely blocked with ear wax. Partial blockages are typically resolved with drops rather than irrigation. We use our clinical judgment to determine whether irrigation is necessary.

Ear irrigation can cause injury to the ears, ranging from minor infections and acute or chronic tinnitus (ringing in the ears), to perforation of the ear drum and hearing loss.

If you have had surgery on your ears or experienced a perforated ear drum, it is important to inform us before the procedure is carried out.

To facilitate easy removal of wax, olive oil drops should be used at least twice daily for a minimum of 5 days prior to your consultation. A good dose of oil is essential, as insufficient application of drops (e.g., only 2-3 times) may not effectively soften the wax, leading to unsuccessful irrigation. In many cases, individuals can clear their ears by applying olive oil diligently, potentially avoiding the need for irrigation altogether.

Unsuccessful irrigation carries a higher risk of infection, as it can leave damp wax in the ear. If you have any concerns during the procedure, please let the nurse know immediately.

Irrigating the ears removes the protective layer of wax, so it is important to keep your ears dry for a few days after the procedure.

For those who have an appointment with audiology, it is recommended to have their ears checked for wax clearance before attending. This is typically arranged by the referring clinician, but those seen annually for hearing aids should have their ears checked prior to their appointment.

Clinical pharmacists work as part of the general practice team to improve value and outcomes from medicines and consult with and treat patients directly. This includes providing extra help to manage long-term conditions, advice for those on multiple medicines and better access to health checks.

What is a Practice based Pharmacist ?

They work together with the Nurses, GPs, HCAs, Physios in the practice to provide support with medication/prescription queries to the public and Surgery team, review medications, review long-term condition, do medical/drug safety audits, transcribe medical letters and prescribe prescriptions if qualified.

Who is eligible to use this service ?

Everyone

Who is not eligible to use this service ?

If it is something out of our scope, we would let the patient know that its best to speak to their GP

How do I book for the service ?

Call reception

What is the availability of the service ?

We have two different slots (one for medication queries where there is some available everyday day) and the long-term conditions review need to be booked in advance. However, as we are reviewing our appointments system this might change in the near future.

New Community Pharmacist Consultation Service 

We are also referring many patients to local Pharmacies through the Community Pharmacist Consultation Service. This service offers patients a same-day appointment for minor illnesses with their local community pharmacy for conditions such as acne, athletes’ foot, cough, cold and flu, headaches, hearing problems, lower back pain, skin rash, vomiting and many others. For a full list see below along with a video clip explaining more about the CPCS program.