Surgery clinics

Our in house physiotherapist Aleena holds clinics every Tuesday, Wednesday and Friday. This can be face to face or phone consultation. If you would like to book in with Aleena, please contact our reception team on 01332 552461.

Counselling is provided by Trent Psychological Therapies Services (Trent PTS). You can now self refer into this service.

Visit the Trent PTS website at: www.trentpts.co.uk or call them on 01332 564900

Do you want to talk? You can contact the Rape and Sexual Abuse Support line 24/7 and speak to one of Rape Crisis specialists – at any time of day or night.

Call free on 0808 500 2222 or visit www.rapecrisis.org.uk for more details.

Every Thursday, we have an antenatal clinic offering care and advice during pregnancy and after childbirth. Please make your first appointment to see the midwife when you are between 8 and 10 weeks pregnant.

The community nursing teams are part of our integrated community teams. They provide care to patients in their homes and residential care settings across Derbyshire. The nursing teams are based in health centres, community hospitals and GP practices and work in geographical patches or localities eg High Peak, South Derbyshire.

A community nursing team may include district nurses, community nurses, healthcare support workers, community matrons, rapid response nurses, wound clinic nurses, and end of life care nurses.

Our rapid response nursing and therapy teams’ priority is to respond to urgent requests for interventions that will help keep patients in their own homes as much as possible.

The line is open seven days a week, 8am to 6.30pm. Someone will always answer your call during opening hours.

Phone
01332 564 900

We offer limited appointments here at Park Lane Surgery. These will need to be organised by our clinicians and booked by our reception team. These are extremely limited and are largely based upon clinical need.

You may find it quicker to book your appointment using the Swiftqueue booking service, please press the link below:

www.swiftqueue.co.uk/uhdb.php

Blood tests can be done at the following locations. Please remember to take your blood form with you to these appointments:

• Phlebotomy (blood test) clinics and opening times | University Hospitals of Derby and Burton NHS

If you have been instructed to have a fasting blood test (usually for glucose, glucose tolerance test, or cholesterol test), the clinician would have informed you prior to receiving the form.

Procedure for fasting blood test

You should have nothing to eat or drink (other than plain/unflavoured water) for at least 12 hours before the test (this includes chewing gum & sucking sweets).

If you are on regular medication that you can put off taking before your test, please do so. However, if this is not possible, please advise the person taking your blood test of the medication so that it can be recorded on the form.

Generally, non fasting blood tests do not need any specific instructions unless the clinician tells you otherwise.

Blood test results

If you have given consent to receive SMS text messages, the clinician may send you a message with regards to your results. If you have not given consent to SMS messages and the clinician wishes to arrange an appointment, the reception team will contact you directly.

If you would like to discuss your results and have not heard anything, this is normally an indication that all is ok. Please call reception for clarification if in doubt.

Female genital mutilation (FGM) is a procedure where the female genitals are deliberately cut, injured or changed, but there’s no medical reason for this to be done.

It’s also known as female circumcision or cutting, and by other terms, such as Sunna, gudniin, halalays, tahur, megrez and khitan, among others.

FGM is usually carried out on young girls between infancy and the age of 15, most commonly before puberty starts.

It’s illegal in the UK and is child abuse.

It’s very painful and can seriously harm the health of women and girls.

It can also cause long-term problems with sex, childbirth and mental health.

For more information and for National FGM support clinics, please use the NHS website.

Hay fever is usually worse between late March and September, especially when it’s warm, humid and windy. This is when the pollen count is at its highest.

Check if you have hay fever

Symptoms of hay fever include:

• sneezing and coughing
• a runny or blocked nose
• itchy, red or watery eyes
• itchy throat, mouth, nose and ears
• loss of smell
• pain around your temples and forehead
• headache
• earache
• feeling tired

If you have asthma, you might also:

• have a tight feeling in your chest
• be short of breath
• wheeze and cough

Hay fever will last for weeks or months, unlike a cold, which usually goes away after 1 to 2 weeks.

A pharmacist can help with hay fever

Speak to your pharmacist if you have hay fever.

They can give advice and suggest the best treatments, like antihistamine drops, tablets or nasal sprays to help with:

• itchy and watery eyes and sneezing
• a blocked nose

Call a pharmacy or contact them online before going in person. You can get medicines delivered or ask someone to collect them.

How to treat hay fever yourself

There’s currently no cure for hay fever and you cannot prevent it.

But you can do things to ease your symptoms when the pollen count is high.

Do

• put Vaseline around your nostrils to trap pollen
• wear wraparound sunglasses to stop pollen getting into your eyes
• shower and change your clothes after you have been outside to wash pollen off
• stay indoors whenever possible
• keep windows and doors shut as much as possible
• vacuum regularly and dust with a damp cloth
• buy a pollen filter for the air vents in your car and a vacuum cleaner with a HEPA filter
• try to stay at home and avoid contact with other people if you have a high temperature or you do not feel well enough to do your normal activities

Don’t

• do not cut grass or walk on grass
• do not spend too much time outside
• do not keep fresh flowers in the house
• do not smoke or be around smoke – it makes your symptoms worse
• do not dry clothes outside – they can catch pollen
• do not let pets into the house if possible – they can carry pollen indoors

Get more tips on managing hay fever from Allergy UK

Treatments for hay fever from a GP

Your GP might prescribe a steroid treatment, such as a steroid nasal spray.

If steroids and other hay fever treatments do not work, your GP may refer you for immunotherapy.

This means you’ll be given small amounts of pollen as an injection or tablet to slowly build up your immunity to pollen.

This kind of treatment usually starts in the winter about 3 months before the hay fever season begins.

Immunotherapy is a specialist service that may not be available everywhere.

GPs are often asked to make mental capacity assessments (COP3) for patients. These assessments can be requested for a variety of different reasons. As GPs it is an essential part of our role that we are able to perform capacity assessments which relate to decisions regarding medical investigations, treatment and care. However, capacity assessments relating to overall welfare, finances and property are often more complex and sit outside our expertise.

The level of risk and responsibility linked to capacity assessments can be extremely high. Decisions such as whether someone’s house is sold or how their life savings are spent can depend on capacity assessments. It is therefore essential that adequate time and attention is dedicated to these assessments. It is also essential that those carrying out these assessments for legal purposes are highly trained and experienced in this area.

Legal capacity assessments (LPA) do not fall within the NHS duties of GPs. Some GPs do agree to perform these assessments privately at a fee, but many others feel the risks of doing so are too high or that the time needed to perform an adequate assessment is not available to them. There are other professionals who can perform mental capacity assessments including solicitors and psychiatrists.

As a surgery we do not feel we have the capacity to offer mental capacity assessments for legal purposes for our patients. To do so would require significant resources being diverted from our core duties as a health care provider. It would also pose a significant legal and financial risk to our GPs. We feel there are other professionals available with more appropriate training, legal protection and expertise who can perform these assessments.

We realise that this practice policy may cause some inconvenience to our patients but hope you can understand that our priority must be to our core NHS duties as a health care provider. If, in the future, the funding crisis in general practice is adequately addressed by government we may find ourselves able to reconsider our position.

The menopause is when a woman’s periods stop due to lower hormone levels. This usually happens between the ages of 45 and 55. It can sometimes happen earlier naturally, or for reasons such as surgery to remove the ovaries (oophorectomy) or the uterus (hysterectomy), cancer treatments like chemotherapy, or a genetic reason. Sometimes the reason is unknown.

Symptoms usually start months or years before a woman’s periods stop, this is called the perimenopause.

Menopause and perimenopause can cause symptoms like anxiety, mood swings, brain fog, hot flushes and irregular periods. These symptoms can start years before periods stop and carry on afterwards.

These symptoms can have a huge impact on a person’s life, including relationships and work.

Mental health symptoms

Common mental health symptoms of menopause and perimenopause include:

• changes to your mood, like low mood, anxiety, mood swings and low self esteem
• problems with memory or concentration (brain fog)

Physical symptoms

Common physical symptoms of menopause and perimenopause include:

• hot flushes, when you have sudden feelings of hot or cold in your face, neck and chest which can make you dizzy
• difficulty sleeping, which may be a result of night sweats and make you feel tired and irritable during the day
• palpitations, when your heartbeats suddenly become more noticeable
• headaches and migraines that are worse than usual
• muscle aches and joint pains
• changed body shape and weight gain
• skin changes including dry and itchy skin
• reduced sex drive
• vaginal dryness and pain, itching or discomfort during sex
• recurrent urinary tract infections (UTIs)

There are things that can be done to help with these symptoms. There are also medicines available that can replace the missing hormones and help relieve the symptoms. For more information on the menopause, please press the link below

• www.nhs.uk/conditions/menopause/things-you-can-do

If you feel you are having any of these symptoms, please book an appointment with one of our GPs to discuss. You can also fill out the following questionnaire to bring with you to your appointment

• Menopause symptoms questionnaire (PDF)

Treatment for menopause and perimenopause

The main medicine treatment for menopause and perimenopause symptoms is hormone replacement therapy (HRT), which replaces the hormones that are at low levels.

There are other treatments if you cannot, or choose not to, have HRT.

Please find a comparison of lifestyle risk factors versus Hormone Replacement Therapy (HRT) treatment below.

• Fast facts HRT and breast cancer risk (PDF)
• Lifestyle risk factors verses HRT (PDF)
• HRT patient sheet (PDF)
• Testosterone gel (PDF)

For more information on the testosterone treatment, please visit the link below.

• www.midandsouthessex.ics.nhs.uk/health/personalised-care/medicines-management/medicines-advice/testosterone-gel/

Food, nutrients and bone health

Please see the link below for more information on food and nutrients and bone health:

• www.theros.org.uk – Fact sheets, booklets and information films

Park Lane Surgery presented a perimenopause and menopause debate and discussion evening, hosted by Dr Parkes on Thursday 8th June 2023 which proved to be a huge success.

If you would like to see the slides from this discussion, please see the link below

• Perimenopause and menopause presentation (PDF)

NHS Hormone Replacement Therapy Prescription Prepayment Certificate (HRT PPC)

The Department of Health and Social Care have announced that they are introducing the HRT PPC to reduce the cost of HRT prescriptions.

This service will be available as of 1st April 2023.

For more information on this service, please go to the NHSBSA website. 

Self care – What does that mean to you?

Its so important to look after ourselves whenever we can. Self care is about not only looking after yourself physically but also looking after your mental well being. Please see the following advice about healthy living, including eating a balanced diet, healthy weight, exercise, quitting smoking and drinking less alcohol.

• www.nhs.uk/live-well

Self care helps relieve pressures on GP practices, A&E and walk-in centres, potentially saving the NHS around 136m each year. You can treat minor ailments with simple, over the counter solutions that are available from local pharmacies and supermarkets. Please see below for more details:

• Self care bulletin no.1 – May 2023 (PDF)

Check if it’s sepsis

Sepsis is life threatening. It can be hard to spot.

There are lots of possible symptoms. They can be like symptoms of other conditions, including flu or a chest infection.

If you think you or someone you look after has symptoms of sepsis, call 999 or go to A&E. Trust your instincts.

Immediate action required: Call 999 or go to A&E if:

A baby or young child has any of these symptoms of sepsis:

• blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
• a rash that does not fade when you roll a glass over it, the same as meningitis
• difficulty breathing (you may notice grunting noises or their stomach sucking under their ribcage), breathlessness or breathing very fast
• a weak, high-pitched cry that’s not like their normal cry
• not responding like they normally do, or not interested in feeding or normal activities
• being sleepier than normal or difficult to wake

They may not have all these symptoms.

Find your nearest emergency services

Immediate action required: Call 999 or go to A&E if:

An adult or older child has any of these symptoms of sepsis:

• acting confused, slurred speech or not making sense
• blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
• a rash that does not fade when you roll a glass over it, the same as meningitis
• difficulty breathing, breathlessness or breathing very fast

They may not have all these symptoms.

Urgent advice: Call 111 now if:

You, your child or someone you look after:

• feels very unwell or like there’s something seriously wrong
• has not had a pee all day (for adults and older children) or in the last 12 hours (for babies and young children)
• keeps vomiting and cannot keep any food or milk down (for babies and young children)
• has swelling or pain around a cut or wound
• has a very high or low temperature, feels hot or cold to the touch, or is shivering

Do not worry if you’re not sure if it’s sepsis, it’s still best to call 111.

They can tell you what to do, arrange a phone call from a nurse or doctor, or call you an ambulance.

Sepsis can be especially hard to spot in:

• babies and young children
• people with dementia
• people with a learning disability
• people who have difficulty communicating

Information

Further information on sepsis for people with a learning disability and their carers:

• NHS England: easy read information about sepsis for people with a learning disability
• YouTube: NHS Sherwood Forest Hospitals video about sepsis for people with a learning disability
• YouTube: NHS Sherwood Forest Hospitals video about sepsis for families and carers of people with a learning disability

What is sepsis?

Sepsis is a life threatening reaction to an infection.

It happens when your immune system overreacts to an infection and starts to damage your body’s own tissues and organs.

You cannot catch sepsis from another person.

Sepsis is sometimes called septicaemia or blood poisoning.

Urinary tract infections (UTIs) affect your urinary tract, including your bladder (cystitis), urethra (urethritis) or kidneys (kidney infection). UTIs may be treated with antibiotics, but they’re not always needed.

Check if it’s a urinary tract infection (UTI)

Symptoms of a urinary tract infection (UTI) may include:

• pain or a burning sensation when peeing (dysuria)
• needing to pee more often than usual during the night (nocturia)
• pee that looks cloudy, dark or has a strong smell
• needing to pee suddenly or more urgently than usual
• needing to pee more often than usual
• blood in your pee
• lower tummy pain or pain in your back, just under the ribs
• a high temperature, or feeling hot and shivery
• a very low temperature below 36C

Things you can do yourself

To help ease symptoms of a urinary tract infection (UTI):

• take paracetamol up to 4 times a day to reduce pain and a high temperature – for people with a UTI, paracetamol is usually recommended over NSAIDs such as ibuprofen or aspirin
• you can give children liquid paracetamol
• rest and drink enough fluids so you pass pale urine regularly during the day
• avoid having sex

Some people take cystitis sachets or cranberry drinks and products every day to prevent UTIs from happening, which may help. But there’s no evidence they help ease symptoms or treat a UTI if the infection has already started.

A pharmacist can help with UTIs

You can ask a pharmacist about treatments for a UTI.

A pharmacist can:

• offer advice on things that can help you get better
• suggest the best painkiller to take
• tell you if you need to see a GP about your symptoms

Some pharmacies offer a UTI management service. They may be able to give antibiotics if they’re needed. The following pharmacy offers UTI management

Markeaton Pharmacy
126 Kedleston Road
Darley Abbey
Derby
DE22 1FX
01332 344049

If you are under the age of 65 years old and are female, you may go to Markeaton to obtain a 3 day course of antibiotics, if they feel this is appropriate.

Alternatively, please call reception to book a telephone appointment with our nurse to discuss your symptoms.

Children

Children with UTIs may also:

• have a high temperature – your child is feeling hotter than usual if you touch their neck, back or tummy
• appear generally unwell – babies and young children may be irritable and not feed or eat properly
• wet the bed or wet themselves
• be sick

Older, frail people or people with a urinary catheter

In older, frail people who have problems with memory, learning and concentration (such as dementia), and people with a urinary catheter, symptoms of a UTI may also include:

• changes in behaviour, such as acting agitated or confused (delirium)
• wetting themselves (incontinence) that is worse than usual
• new shivering or shaking (rigors)

Non-urgent advice: See a GP if:

• you have symptoms of a urinary tract infection (UTI) for the first time
• your child has symptoms of a UTI
• you’re a man with symptoms of a UTI
• you’re pregnant and have symptoms of a UTI
• you’re caring for an older, frail person who may have symptoms of a UTI
• you have symptoms of a UTI after surgery
• your symptoms get worse or do not improve within 2 days
• your symptoms come back after treatment

Urgent advice: Ask for an urgent GP appointment or get help from NHS 111 if:

You think you, your child or someone you care for may have a urinary tract infection (UTI) and:

• have a very high temperature, or feel hot and shivery
• have a very low temperature below 36C
• are confused or drowsy
• have pain in the lower tummy or in the back, just under the ribs
• can see blood in your pee

These symptoms could mean you have a kidney infection, which can be serious if it’s not treated as it could cause sepsis.

If you cannot speak to or see a GP, or your symptoms are getting worse, call 111 or get help from 111 online.

Treatment from a GP

If a GP thinks you may have a urinary tract infection (UTI), they may do a urine test, although this is not always needed.

A GP may also:

• offer self-care advice and recommend taking a painkiller
• give you a prescription for a short course of antibiotics
• give you a prescription for antibiotics, but suggest you wait for 48 hours before taking them in case your symptoms go away on their own

It’s important to take all the medicine you’re prescribed, even if you start to feel better.

Treatment from a GP for UTIs that keep coming back

If your UTI comes back after treatment, or you have 2 UTIs in 6 months, a GP may:

• prescribe a different antibiotic or prescribe a low dose antibiotic to take for up to 6 months
• prescribe a vaginal cream containing oestrogen, if you have gone through the menopause
• refer you to a specialist for further tests and treatments

In some people, antibiotics do not work or urine tests do not pick up an infection, even though you have UTI symptoms.

This may mean you have a long-term (chronic) UTI that is not picked up by current urine tests. Ask the GP for a referral to a specialist for further tests and treatments.

Long term UTIs are linked to an increased risk of bladder cancer in people aged 60 and over.

Causes of urinary tract infections (UTIs)

Urinary tract infections (UTIs) are usually caused by bacteria from poo entering the urinary tract.

The bacteria enter through the tube that carries pee out of the body (urethra).

Women have a shorter urethra than men. This means bacteria are more likely to reach the bladder or kidneys and cause an infection.

Things that increase the risk of bacteria getting into the bladder include:

• having sex
• pregnancy
• conditions that block the urinary tract – such as kidney stones
• conditions that make it difficult to fully empty the bladder – such as an  enlarged prostatein men and constipation in children
• urinary catheters (a tube in your bladder used to drain urine)
• having a weakened immune system – for example, people with diabetes or people having chemotherapy
• not drinking enough fluids
• not keeping the genital area clean and dry

How to prevent urinary tract infections (UTIs)

There are some things you can try to help prevent a urinary tract infection (UTI) happening or prevent it returning.

Do

• wipe from front to back when you go to the toilet
• keep the genital area clean and dry
• drink plenty of fluids, particularly water – so that you regularly pee during the day and do not feel thirsty
• wash the skin around the vagina with water before and after sex
• pee as soon as possible after sex
• promptly change nappies or incontinence pads if they’re soiled

Don’t

• do not use scented soap
• do not hold your pee in if you feel the urge to go
• do not rush when going for a pee – try to fully empty your bladder
• do not wear tight synthetic underwear, such as nylon
• do not drink lots of alcoholic drinks, as they may irritate your bladder
• do not have lots of sugary food or drinks, as they may encourage bacteria to grow
• do not use condoms or a diaphragm or cap with spermicidal lube on them – try non-spermicidal lube or a different type of contraception

Other ways to prevent some UTIs coming back

If you keep getting a bladder infection (cystitis), there’s some evidence it may be helpful to take:

• D-mannose – a sugar you can buy as a powder or tablets to take every day
• cranberry products – available as juice, tablets or capsules to take every day

Speak to your doctor before taking any of these during pregnancy.

Be aware that D-mannose and cranberry products can contain a lot of sugar.

If you’re taking warfarin, you should avoid cranberry products.