Blood Pressure Home Monitoring
Instructions for Home Blood Pressure Monitoring (DOCX, 21KB)
Concerned your child is unwell (3 months and older)?
Information on what to do when your child is unwell
Weight Loss Injections
We are getting increasing requests for weight loss injections, following recent media coverage. Unfortunately these are NOT currently prescribable by GPs at this stage. There is an aim in the future for this to occur but not at the moment.
In North Yorkshire, we have to follow the commissioning guideline and national guidance which states the drug currently has to be prescribed by a Tier 3 weight management service in appropriate patients. There is also a national shortage of this drug so supplies are very low currently.
The criteria to refer to Tier 3 is as follows:
- Aged 18Y+
- BMI equal to or over 40 or 35 with significant co-morbidities.
AND
- Have maximised primary care and community conservative management e.g. a Tier 2 service
You can refer yourself for Tier 2 weight management support at Fit4Life. Fit4Life project – Brimhams Active.
or if you are living with obesity and hypertension, diabetes or both you can be referred to the NHS Digital Weight Management Programme NHS England » The NHS Digital Weight Management Programme Please complete an eConsult if you would like a referral for this.
If you are unhappy with this, you can complain directly to the Humber and Yorkshire ICB commissioning organisation (hnyicb.contactus@nhs.net).
Dental Issues
The number of patients seeking dental advice and treatment from their GPs is increasing.
GPs are not responsible for treating dental problems. The GMC requires doctors to have the appropriate skills and training for any treatment they provide. The GPs at the surgery have no dental training and are therefore not covered by their medical indemnity to provide advice or treatment for dental problems.
Therefore, if it is determined that the condition requires only dental treatment, then GPs are legally and contractually obliged to direct the patient to the appropriate dental service.
General dental practitioners have an ethical responsibility to provide access to advice and emergency treatment for their patients, including those under a private contract and to provide access to emergency treatment outside normal hours.
If you are not registered with a dentist, or are unable to contact your dentist, please contact NHS 111 where they will be able to advise you about other emergency dental services
To find a dentist near you: NHS Find Dentist Services.
Some patients request medication prior to dental visits to help with feelings of anxiety. These are usually sedative medications such as Diazepam. GPs have no dental training, so we have limited knowledge of what is entailed in dental procedures. It is therefore not possible for us to determine which medications are safe to use, so we are unable to prescribe.
Dentists have this specialist knowledge and are able to prescribe medications listed in the Dental Formulary. We therefore recommend that you speak to your dentist if you have any concerns about upcoming visits or procedures and they will be able to advise and/or prescribe where appropriate on a case by case basis.
Diazepam for flying
The Doctors have taken the decision not to prescribe diazepam in cases where there is a fear of flying. There are a number of reasons for this that are set out below.
- Diazepam is a sedative, which means it makes you sleepy and more relaxed. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and those around you.
- Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours.
- Whilst most people find benzodiazepines like diazepam sedating, a small number of people experience the opposite effect and may become aggressive. Benzodiazepines can also cause disinhibition and lead you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law.
- According to the national prescribing guidelines that doctors follow (the British National Formulary, or BNF) benzodiazepines are not allowed to be prescribed in cases of phobia. Thus your doctor would be taking a significant legal risk by prescribing diazepam for fear of flying as it is going against these guidelines. Benzodiazepines are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.
- Diazepam and similar drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police.
- Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing you may fail this having taken diazepam.
We appreciate that fear of flying is very real and very frightening. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines. We have listed a number of these below.
Easy Jet
www.fearlessflyer.easyjet.com
Tel: 0203 8131644
British Airways
flyingwithconfidence.com
Tel: 01252 793 250
Virgin Atlantic
Tel: 01423 714900 1252250
We recognise that there may be a waiting list for these courses, so if you plan to fly before you are able to complete a course, there is lots of information available online, including tips for reducing anxiety before and during a flight and recommendations for in-flight meditation and mindfulness apps.
Hear to Help
Do you need a moment to talk?
Hear to Help is a helpline providing support and advice to those who are feeling anxious or struggling with their emotional wellbeing around the COVID-19 outbreak.
Available to children, young people and adults across the Harrogate District from Monday 23rd, 8.00am to 8.00pm, seven days a week.
Hear to Help is a service provided by Just ‘B’, part of Saint Michael’s Hospice.
Call on (01423) 856 799
NHS Harrogate And Rural District CCG
01423 799300
1 Grimbald Crag Court, St James Business Park,Knaresborough, North Yorkshire HG5 8QB
www.harrogateandruraldistrictccg.nhs.uk
NHS 111
This is a new telephone service to call when you need medical help fast, but it’s not a 999 emergency. This easy to remember, free to call number has been introduced to help reduce the pressure on A & E departments and the 999 service. It is available 24 hours a day, 365 days a year, and is for people who aren’t sure if they need to go to A & E, don’t have a GP to call, or generally need reassurance and advice. You will be assessed, given advice, and directed straight away to the local service that can help you best. This could be A & E, an out of hours GP, a community nurse, a late-opening pharmacy, a Minor Injuries unit or an emergency dentist.
There are now only 3 numbers you need to remember, your GP surgery, 111 for urgent healthcare advice, and 999 for a life-threatening emergency.
Harrogate District Hospital
01423 885959
Lancaster Park Road, Harrogate HG1 7SX
Walk in Centre
The nearest walk in centre is now located within the Emergency Department at York Hospital, Wigginton Road, York YO31 8HE
Social Services
0845 034 9410
Citizens Advice Bureaux
01423 567150
Useful websites
www.patient.co.uk
www.besttreatments.co.uk
www.labtestsonline.org.uk
Mental Health & Young People
Recovery College Online