Surgery clinics

What is asthma?

Asthma is a long-term condition that affects the airways in the lungs. The airways become inflamed and sensitive, causing intermittent symptoms such as wheezing, coughing, chest tightness and shortness of breath.

Common symptoms

Common symptoms of asthma include:

● Wheezing
● Shortness of breath
● Chest tightness
● Coughing, particularly at night or early in the morning

For more information about asthma, please visit:

● Asthma + Lung UK
● NHS website: asthma

Do you think you may have asthma?

If you are experiencing symptoms that may be caused by asthma, please contact the
surgery via an e-consultation.

Seek urgent help if:

● You are becoming increasingly breathless.
● You have asthma and your symptoms are worsening.
● You are needing your reliever inhaler more often than usual.
● Your reliever inhaler is not helping your symptoms as much as normal.

Call 999 if:

● You are too breathless to speak in full sentences.
● You are struggling to breathe.
● Your lips or fingers appear blue, grey or pale.
● Your symptoms are severe or rapidly worsening.

If you already have asthma

Patients with asthma will usually be invited annually for an asthma review.

This invitation is normally sent by text message and will include a short questionnaire to help us assess how well your asthma is controlled. Patients who have not received a prescription for asthma medication within the previous 12 months will not routinely be invited for review. If you feel that you would benefit from an asthma review anyway, please contact the surgery via e-consultation.

If you feel that your asthma symptoms are not well controlled, please do not wait for your annual review invitation. Contact the surgery to arrange an appointment with a GP or other appropriate clinician.

All patients with asthma should have a personalised Asthma Action Plan. This plan explains what to do if your symptoms worsen and when to seek medical help.

Inhaler technique

Using your inhaler correctly is essential to ensure that the medication reaches your lungs and works effectively. Poor inhaler technique is a common cause of poorly controlled asthma.

If you are unsure how to use your inhaler, please mention this at your asthma review or arrange an appointment with a member of the practice team.

Please bring all of your inhalers with you to your asthma review so that we can check your technique and ensure you are using the most appropriate devices.

You can also view inhaler technique videos on the Asthma + Lung UK website.

Smoking cessation

Stopping smoking is one of the most important things you can do to improve your lung health and reduce asthma symptoms.

If you would like support to stop smoking, please visit Hertfordshire Stop Smoking Services. You’re 3 times more likely to stop smoking with help than trying to quit alone.

What is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is a long-term lung condition that causes narrowing of the airways and damage to the lungs, making it harder to breathe. COPD usually develops gradually over many years and is most commonly caused by smoking, although other factors can contribute.

Common symptoms

Common symptoms of COPD include:

● Breathlessness, particularly during physical activity
● A persistent cough
● Regular chest infections
● Wheezing
● Producing excess phlegm (sputum)
● Reduced exercise tolerance

For more information about COPD, please visit:
● Asthma + Lung UK: COPD
● NHS website: COPD

Do you think you may have COPD?

Symptoms of COPD can develop slowly and are often mistaken for a normal part of ageing or the effects of smoking. If you are aged over 35, smoke or have smoked in the past, and experience symptoms such as breathlessness, a persistent cough, or recurrent chest infections, please contact the surgery via an e-consultation.

Seek urgent help if:

● Your breathlessness is worsening.
● You develop a chest infection and your symptoms are deteriorating.
● You are producing more sputum than usual, or it has changed colour.
● Your usual inhalers are not helping your symptoms.

Call 999 if:

● You are severely short of breath.
● You are struggling to breathe.
● You have chest pain.
● You become confused, drowsy, or difficult to wake.
● Your lips or fingers appear blue, grey or pale.

If you already have COPD

Patients with COPD will be invited annually for a COPD review.

This invitation is normally sent by text message but those who cannot receive a text
message will be contacted by other means.

During your review we may discuss:

● Your symptoms and exercise tolerance
● Your inhalers and inhaler technique
● Smoking cessation
● Vaccinations
● Any recent flare-ups or hospital admissions
● Whether further support or treatment may be helpful

If you feel that your COPD symptoms are not well controlled, please do not wait for your annual review invitation. Contact the surgery via e-consultation to arrange an appointment with a GP or other appropriate clinician.

COPD flare-ups (exacerbations)

A COPD flare-up (sometimes called an exacerbation) is a worsening of your usual
symptoms that lasts for several days or longer.

Common signs of a flare-up include:

● Increased breathlessness
● Increased coughing
● Producing more sputum (phlegm) than usual
● A change in the colour of your sputum
● Wheezing or chest tightness
● Reduced ability to carry out your usual daily activities

Early treatment can often prevent symptoms from becoming more severe. If you think you may be experiencing a flare-up, please contact the surgery via e-consultation or seek advice from NHS 111 when the surgery is closed. If your symptoms are severe or you are struggling to breathe, call 999.

Inhaler technique

Using your inhaler correctly is essential to ensure that the medication reaches your lungs and works effectively. Poor inhaler technique is a common cause of poorly controlled COPD symptoms.

If you are unsure how to use your inhaler, please mention this at your review or arrange an appointment with a member of the practice team. Please bring all of your inhalers with you to your review so that we can check your technique and ensure you are using the most appropriate devices.

You can also view inhaler technique videos on the Asthma + Lung UK website.

Vaccinations

Respiratory infections can be particularly serious for people with COPD. We recommend that patients with COPD keep up to date with vaccinations, including:

● Annual flu vaccination
● Pneumococcal vaccination (one-off)
● COVID-19 vaccination, where eligible

Smoking cessation

Stopping smoking is the most effective way to slow the progression of COPD and improve your long-term health.

If you would like support to stop smoking, please visit Hertfordshire Stop Smoking Services. You’re 3 times more likely to stop smoking with help than trying to quit alone.

Six week checks for babies prior to vaccination should be booked through reception.

Website
www.hertsfamilycentres.org

We run childhood immunisation clinics at both Peartree Lane and Moors Walk surgeries. These will be discussed with parents of newborn babies by either the health visitor or doctor.

Appointments are usually sent out by the health authority but more information may be obtained from the surgery.

The practice offers a full range of family planning services including prescriptions for oral contraceptives, morning after pill, fitting caps and coils and ring pessary insertion and removal

Smear tests involve an examination of the cervix (the neck of the womb) to check for warning signs which may occur before cancer develops. We recommend that all women between the ages of 25 and 65 should have regular smear tests.

These are offered each winter from early October. Vaccination is particularly recommended for patients with asthma, heart disease, diabetes or suffer with recurrent bronchitis, or those patient who are over 65 years of age.

Flu vaccination clinic details may be obtained from reception. Please contact us to arrange an appointment.

We provide antenatal care and postnatal examinations in conjunction with the community midwives at both Peartree Lane and Moors Walk surgeries.

These are held on Tuesdays and Thursdays.

The doctors undertake minor surgical procedures at both Peartree Lane and Moors Walk surgeries. Please arrange a call back with your duty doctor to discuss whether your case is suitable for minor surgery or not.

He or she will then recommend that you make an appointment for the minor surgery clinic.

A booster may be needed for patients over 15 years old if they completed a tetanus course more than 10 years ago. If you completed a course and think you may need a booster please check with a practice nurse before booking an appointment.

If you would like a heath review you must be:

• Aged between 40 and 74
• Have no pre-existing long-term conditions such as: COPD, asthma, diabetes, dementia and cardiovascular disease
•  Have not had a health check in the past five year

The diabetic clinic is supervised by two senior GP partners and run by a team of trained nurses. The nursing team have attended specialist diabetes training and accreditation in order to deliver this service.

Patients at Peartree who are diagnosed with diabetes will be invited for an annual review. The administration team at Peartree will invite each diabetic annually to have a blood test and book an appointment at the surgery. Peartree operate 3 diabetes clinics each week to provide ongoing care for our diabetic patients. If you are overdue a review and have not been invited please contact the surgery to allow us to investigate.

It is important you attend annual review to ensure your lifestyle and medications are working optimally for you.

• COPD clinics
• Travel clinics
• Asthma clinics
• Wound management
• 12 lead ECGs
• Ear irrigation / ear wax removal
• Home blood pressure monitoring