The Milton Surgery

Flu Vaccinations

Every autumn we recommend an influenza vaccination for all our patients over 65 years of age and for those patients under 65 with diabetes, chronic heart, lung or kidney disease.

Swine flu vaccinations are offered in line with the Department of health regulations regarding priority categories.

Family Planning

Confidential advice on contraception is available from all of the doctors at a routine appointment. If you require a coil fitted, please advise reception who will arrange a double appointment.

Minor Surgery

Dr Smith and Dr Lakin perform minor surgery for the practice, eg some treatment of warts, removal of cysts, injection of joints etc. Please see one of the doctors for an initial assessment before booking for minor surgery. It is not possible to offer treatment for cosmetic reasons.

Newly Registered Patients

All newly registered patients are invited to make an appointment with our practice nurse. You will be asked for a few details about your past health and present lifestyle. You will be offered a health check.

Non-NHS Examinations

If you need a non-NHS examination eg HGV, elderly driver, fitness to undertake certain sports, pre-employment, etc, this will be done by special arrangement, and a fee will be charged.

We act as examiners for several life insurance companies. If we examine you for their purposes the insurance company will be responsible for your fee.

Occupational Health

Dr Smith holds a diploma in Occupational Medicine and he gives advice to a number of local employers through our specialist company called Occupation Medical Services that operates from the surgery premises. This company may be contacted through the surgery.

When should your children be immunised?

Children's immunisations are performed by the nursing team; simply make an appointment in the usual way and tell the receptionist it is for an immunisation.

The recommended immunisation schedule is:

The doctors recommend that you immunise your child fully to protect both your child and those they meet in the community. This surgery supports the MMR catch-up programme.

*Please contact your Health Visitor or one of the Practice Nurses for the vaccination programme for children born before this date.Please note that children who are behind with their vaccinations should catch up as soon as possible. We feel it is very important that all children are vaccinated against serious illnesses.

Please contact the surgery and talk to a nurse if you have any queries regarding your child's vaccinations.

Personal Medical Services

The practice has a local Personal Medical Services Contract with North Somerset Primary Care Trust, Waverley House, Old Church Road, Clevedon, North Somerset. BS21 6NN. (Telephone 01934 546770. Website: www.northsomerset.nhs.uk)

Under this contract the practice provides essential services and the following additional and enhanced services:

Medical Equipment Fund

We have a fund for purchasing equipment for the benefit of our patients. So far, we have purchased nebulisers, syringe drives for pain and symptom relief with the terminally ill, and two digital cameras for taking pictures of symptoms in support of hospital referrals.

We are always grateful for donations.

Surgery Delays

An overview from Dr Paul B Wilson, Senior Partner:

We mainly run a “book-on-the-day” appointment system to avoid patients having to “wait three weeks to be ill”! (When we used to book in advance you could wait three weeks for the first available appointment.)

We book at 10 minute intervals, and if there is no available appointment and you really need to see a doctor on the day, we will see you as an ‘extra’ on a ‘first-come first-served’ basis by the doctors on duty after they finish their booked appointments. It is not possible to say who you will see and when you will be seen.

The doctors don't have a break until the last patient is seen, whether that is 12 noon, 1.00pm, 2.00pm or even later. If we have telephone interruptions, emergencies or, as is usually the case, patients take longer than the 10 minutes allocated, we may become delayed.

It is unusual for us to finish seeing patients before 1.00pm at the earliest, but sometimes it is after 2.00pm before the waiting room is empty. We would like to have a lunch break but this is often not possible as we have visits, prescriptions and letters etc to do. Then the whole process starts again at 3.30pm with afternoon surgery.

We therefore have a very full day from 9.00am right through until late evening, and running late is not of any benefit to the GPs as it just makes their days that bit longer. Nevertheless, we must put the needs of the patient first, and if that means running over the allotted 10 minute appointment so be it, as we cannot compromise on the well being of the patient.

We hope that this explains the understandably frustrating situation if you have a long wait.

Going Abroad

Please make sure that you don't turn your holiday into a horror story - consult a nurse at the surgery at least two months before your departure. She will advise you what vaccinations are required and what medications you may need.

You should also arrange adequate medical insurance, and if you are visiting an EEC country you will need a European Health Card which is available from Health Service Executive. Their contact details are at the front of the telephone directory.

Points to note:

• Take a small first aid kit.


• Personal hygiene is essential.


• Beware bites from insects and animals. Many diseases are insect-borne and rabies is widespread.


• Be careful with raw vegetables, salads, fruit, shellfish and ice-cubes.


• Respect the power of the sun and use sun creams regularly.


• Sexually transmitted diseases (including AIDS) are a major health threat throughout the world; condoms offer some protection.

If you are advised to take anti-malarial tablets remember to follow the manufacturer's instructions: for example "start one week before departure and continue for four weeks after your return"

Self Treatment Of Common Illnesses And Accidents

Many common illnesses, aches and pains can be simply treated at home without the need to consult your doctor.

Back Pain

It is advisable to consult your doctor if back pain persists for more than a few days. Initially be sensible and take things easy. It may be necessary to rest horizontally to take weight off the back or to take extra care to sit as upright as possible, with support for the small of the back. Take paracetamol or aspirin; this will relieve the pain and also help to relieve inflammation. If matters do not improve, your doctor may well prescribe stronger drugs, heat treatment, gentle exercise or further measures.

Bedsores

These are caused by prolonged pressure to certain parts of the body when lying in bed for long periods. They are best prevented by encouraging the patient to shift position as often as possible and taking care to smooth out the creases in the bottom sheet, which could lead to localised irritation. Keep your eye open for red marks appearing at pressure points such as heels, elbows, buttocks and hips. If they begin to appear inform your doctor or district nurse, before they get worse.

Burns

Apply large quantities of cold water to the affected area as soon as possible and maintain this until the pain subsides. This may take as long as 20 minutes. If the skin is unbroken but blistered apply a loose dry dressing. If the burn is large or if the skin is broken, consult your doctor.

Chickenpox

On the first day a rash appears as small red patches. Within a few hours of these developing, small blisters appear in the centre of these patches. During the next three to four days further patches occur and the earlier ones turn crusty and fall off. Calamine lotion may be applied to soothe the often severe itching. Cool baths may also help. The most infectious period is from two to three days before the rash appears and up to five days after. Children may return to school as soon as the last crusts have fallen off.

Colds

There is no magic cure for the common cold. Go to bed and take plenty of drinks. If you have a headache or are feverish, take aspirin (if over the age of 16) or paracetamol. Antibiotics will not help, unless you happen to have a secondary bacterial infection.

Coughs

Dry coughs usually cure themselves and can be eased by medicine from the chemist. Children with colds often cough at night and this may be eased by propping them up with a pillow.
Decongestant measures may help.

Diarrhoea And Vomiting

Usually due to a viral infection or a sudden change of diet. The best treatment is to rest, eat nothing and drink clear fluids such as Dioralyte. It is unwise to take 'over the counter' preparations, as these may prolong the illness. Young children and babies need careful attention and advice should be sought from your doctor.

Earache

This can often be helped by paracetamol and measures to decongest (including steam and inhalations like Karvol). Children with persistent earache should see a doctor the next day.

Irritated Eyes

Try to avoid rubbing the eye as this will make things worse. Small pieces of grit or dirt in the eye are best washed out with plenty of water. If the eye is still sore after this, then medical help may be necessary.

Fever

Cooling down hot children will make them feel better.

1. Give paracetamol suspension (Calpol or Disprol) regularly four times daily.
2. Strip the child down to light underwear and bathe with a tepid sponge if still hot.
3. Plenty of fluids by mouth will help replace the fluid lost by sweating.

Head Lice

Regular application of hair conditioner and fine tooth combing the hair is the best prevention.

Influenza: Seasonal flu or "pandemic" e.g. Swine, Bird etc

A viral illness that is common in winter. High temperature, aching muscles and fatigue can last several days. Rest, plenty of clear fluids and regular aspirin and paracetamol are usually all that is needed. If you have another medical problem (diabetes, heart disease or chest trouble) it would be wise to seek medical advice. We have an active campaign of influenza immunisation that usually starts each October. Ask at reception if you would like to be immunised.

Be sensible: It is a contagious disease and so minimise contact and follow good hygiene practice to minimise transmitting this virus to the people around you.

Insect Bites And Stings

Antihistamine tablets can be obtained from the chemist without prescription and will usually relieve most symptoms.

Measles

The rash is blotchy and red and appears on the face and body around the fourth day of illness. It is at its most infectious from two or three days before the rash appears until eight or ten days after that date. It is therefore important that all contacts are informed in order that anyone who may be pregnant can contact their doctor.

Minor Cuts And Grazes

Wash the wound thoroughly with water and a little soap. To stop bleeding apply a clean handkerchief or dressing to the wound for about five minutes. Cover with a clean, dry dressing.

Mumps

The symptoms are swelling of the glands in front of one ear, often followed, after a couple of days, by swelling in front of the other ear. It is infectious from two or three days before the swelling appears until eight or ten days after that date. If the pain is severe you should consult your doctor.
Vaccination against measles, mumps and rubella (MMR) is offered to children and susceptible adults.

Nosebleeds

Sit in a chair, leaning forward with your mouth open and pinch your nose just below the bone for approximately 30 minutes, by which time the bleeding should have stopped. Avoid hot drinks or hot food for 24 hours. If symptoms persist consult your doctor.

Slapped Cheek

Seen in children between six and 10 years, it starts with a mild fever and slight malaise and is followed by a characteristic facial rash resembling a 'slapped cheek' and a fine widespread rash on the limbs and body. The disease is self-limiting. Care should be taken if contacts of this disease are pregnant or immuno suppressed.

Sore Throat

Almost always caused by a virus, antibiotics therefore have no place in the treatment. Generally a sore throat lasts two to five days. The best treatment for adults is to gargle with soluble aspirin and then swallow it, four times daily. Remember that children under 16 should not be given aspirin. Plenty of cold drinks and paracetamol regularly will help.

Sprains

First apply a cold compress, containing ice if possible, for up to 30 minutes to reduce the swelling. Then apply a crepe bandage and give the sprain plenty of rest until all discomfort has subsided. Further strain will inevitably lead to further swelling and a longer recovery period. If matters do not improve after a few days, consult your doctor as he may wish to refer you for sports physiotherapy.

Stomachache

Most attacks are not serious and are usually caused by indigestion or wind. A hot water bottle will often relieve the symptoms and, in the case of indigestion, a teaspoon of bicarbonate of soda in half a glass of water will help. If the pain lasts longer than six to eight hours, or increases in intensity, you should consult your doctor.

Sunburn

Treat as for other burns with cold water and remove the heat. Calamine lotion will help to relieve the irritation whilst paracetamol will also help. Children are particularly susceptible to sunburn and great care should be taken to ensure sufficient protection is taken.

Ticks

Applying Vaseline or nail varnish remover to a tick will kill it and cause it to drop off. If you pull or scrape them off, parts get left behind and may set up a local infection.