Chatham Street Surgery121 Chatham StreetReadingBerkshire, RG1 7JETel: 0118 950 5121
Whooping Cough vaccines are available for women between 28 and 38 weeks pregnant.
We aim to give you an appointment within 48 hours, it may not always be with the Doctor of your choice.
You can also book up to 8 weeks in advance if you wish to do so.
We offer the full range of travel vaccinations, including Yellow Fever (We are a registered Yellow Fever Centre), and our nursing staff are always happy to advise on the requirements for your trip. They will also advise on malaria prevention, and other health issues which may be relevant to your journey. Please note that you should attend for travel vaccinations at least 8 weeks in advance of your journey, for immunity to develop.
Some vaccinations will require boosters before you travel, so please always consult the nurse at the earliest opportunity after you have planned your journey.
Please note that many travel vaccinations are not NHS services and therefore attract a fee. Details are available at reception or from the nurses.
Many types of minor operation are available in the surgery. These include the removal of moles and other skin lesions, cryotherapy (freezing treatment usually used for warts), injections of joints and surrounding structures (for tennis elbow, frozen shoulder, etc.) and incision of abscesses.
The midwives and doctors share a programme of regular checks on women who are pregnant, or who have recently given birth. As soon as you know you are pregnant, make a routine (not emergency) appointment to see your doctor. Please note that we do not routinely do tests to confirm pregnancy, as the pregnancy-testing kits available in chemists are every bit as accurate as the hospital urine tests. The doctor will work out your dates, and give you some basic information, including the schedule of antenatal checks, blood tests and scans. You will then be asked to see the midwife for a ‘booking’ at 7-8 weeks (from your last period) and must be before 12 weeks. The ‘booking’ appointment is probably the most important. It is usually an hour long and as well as providing you with a large quantity of booklets and information on your pregnancy, the midwife arranges your first blood tests (to be done at 16 weeks) and ultrasound scans (at 10 weeks and 19-20 weeks). In an uneventful pregnancy, antenatal checks follow at 16, 18-20, 25, 28, 31, 36, 38, 40 (the due date for your baby) and 41 weeks, if you get that far. The 18 week check is with the GP and subsequent checks alternate with the midwife. At each check they will test your urine for sugar and protein, do a blood pressure and check on your baby, as well as deal with any questions or problems you may have.Please remember to bring a urine sample to each antenatal check and, if you are seeing the doctor, make sure you tell the receptionist when you book the appointment that it is for an antenatal check (antenatals are given longer appointments, and different records have to be given to the doctor).
After your baby is born, the midwife will see you both regularly for the first two weeks, and then hand over your care to your health visitor. At about 8 weeks after delivery you should see the doctor for a postnatal check and your baby’s child health check and first course of vaccinations. Please bring your red book to this appointment.
Again, when booking this appointment, make sure you tell the receptionist it is for a postnatal check - The appointment has to be at least 30 minutes long.
The Diabetes Clinic is run by one of our practice nurses. All diabetics over the age of 16 years are invited to attend,
When attending the clinic, please bring a specimen of your urine.
Nearly 1 in 10 of our patients have asthma and two thirds of these had some kind of treatment in the last 12 months. We recommend that all our patients with asthma have a special check for their asthma at least once a year.Our practice nurses have had special training in the care of people with asthma, and will be happy to see you.
Why is an asthma check necessary? Good control of asthma helps to prevent serious attacks and may possibly prevent development of another kind of breathing disorder called COPD (chronic obstructive pulmonary disease). It improves your quality of life.Regular checks are designed to make sure that you are having the best treatment for your particular needs.
What happens at an asthma check? Please bring along any inhalers or other medication you are using for your asthma, because we will want to make sure that you are using your treatment correctly. If you are a smoker they will be able to offer you help with stopping. They will take a peak flow measurement and if you are a child may measure your height . If necessary, they will make recommendations about improving your treatment.
Flu immunisation We recommend that some of our asthmatic patients have a flu injection every year (please check with the Practice Nurse if this is reccommended for you.) around October to November. This may help to prevent severe chest infections and asthma attacks due to flu.
Peak Flow This is measured with a meter that we can prescribe for you to use at home. It measures how quickly you can expel the air from your lungs. If your peak flow measurement begins to fall it can be an early warning sign of a worsening of your asthma and allows you to adjust your treatment to prevent this.
Spirometry We sometimes use this special test that involves blowing into a device attached to a computer. It measures the function of your lungs and can help to diagnose asthma and distinguish it from another wheezy chest problem called chronic obstructive pulmonary disease.It is important to tell the which condition you have, because the treatments are slightly different.
All patients with the above diseases are invited to attend. The clinic focuses on tackling risk factors (obesity, smoking, cholesterol) and in making sure any drug treatment is optimal.
This clinic is designed to encourage weight loss and management through dietary advice and regular weighing.
Blood tests arranged by your GP can be carried out in the surgery or at the Royal Berkshire Hospital. The walk-in service is available at the Practice On Monday,Tuesday Wednesday and Thursday mornings, between 9.00am and 11.00am. You should arrive at the surgery no later than 11.00am. If you have been advised that it is a Fasting Blood Test, you should not eat for 12 hours prior to the test, although you may drink a small amount of plain water only. If you are taking any medication for your heart, you should take this as usual. All other medication should not be taken as it might affect the test.
The cervix is the lower part of the womb, often called the neck of the womb. Cancer of the cervix may be caused by a virus. It is very rare in women that have not been sexually active. Those who smoke are at greater risk of the disease. About 1500 women still die from this every year, most of these have never had a smear test.Most of the 1500 women dying of cancer of the cervix every year have never had a smear test.Luckily, this cancer usually develops slowly, and goes through a treatable "pre-cancerous" stage first. This early stage can last several years, and if treated before cancer has developed the cure rate is virtually 100%.
How can cancer of the cervix be prevented?
The smear test is the basis of our country's campaign against cervical cancer.
All women between the ages of 25 and 64 are offered a test through the NHS. Under some circumstances those aged 65 and over need a smear, please check with us.
We advise that everyone should have this test every three years.
This test can detect the abnormal cells on the cervix in the pre-cancerous stage so that treatment can be started early.
The test doesn't hurt, though sometimes if you tense up it may feel a bit uncomfortable. Remember not to come for a smear test during a period, or within 24 hours of making love if you use a barrier method of contraception because the spermicide chemicals can interfere with the test. Even if you have had a hysterectomy you may sometimes need a smear test, so check with us before assuming you don't need one. Please be aware that no screening test detects all cases. If you develop any abnormal symptoms despite a normal test, such as bleeding after intercourse, then come and see us.
What if my smear result is abnormal?
Because the test is designed to pick up minor changes in the cervix before any problems develop, it is almost certain that there is nothing to worry about, especially if you have regular smears.
What do the results mean?
Borderline changes or mild dyskaryosis, are small changes that can return to normal by themselves. In this situation we usually repeat the test in 6 months. If the test is still abnormal you may then need a further check up (colposcopy), at hospital to see if any treatment is needed.Moderate or severe dyskaryosis is unlikely to return to normal by itself, though it is still unlikely that you have cancer. You will need to have a colposcopy.
What is colposcopy?
Colposcopy is a simple examination that helps the doctor decide if any treatment is needed. It is similar to having a smear test taken except a telescope is used to look at the cervix more closely. If you need treatment you probably won't need to stay in hospital, and remember that it's nearly always 100% successful.
We offer a full range of children’s health services including baby checks, child health checks and immunisations.
All babies have a routine check within the first couple of days of birth by the hospital doctors (or, in the case of a home delivery, by the GP). In addition they are seen at 8 weeks of age by the GP for a second general examination, before they have their first immunisations. Newborn babies are checked by the midwife during their first 2 weeks of life, and after this the health visitors continue monitoring the baby’s development, and providing support to the family.
The doctors and health visitors run a programme of regular developmental assessments on all under-fives (the over-fives are monitored by the School Health Service). Your child’s Health Record (the Red Book) has full details on these checks.
We encourage all children and young people to complete a full course of immunisation. The first immunisations start when your baby is 8 weeks old. Normally, Appointments for Childhood Immunisations are sent out automatically by the local Primary Care Trust, and the vaccines are administered by our practice nurses. You will also be invited to attend to have your child vaccinated once children start school.
Serious diseases that could be fatal or disabling in various ways have disappeared from our country and to a large extent this is due to the immunisation programme.
Many people alive now will not have had any experience of these diseases, and it is easy to forget what life used to be like when children were dying of diphtheria or were paralysed by polio.
Your GP's surgery, local health centre, or baby clinic will send you an appointment when your baby's vaccination is due. It is important that your baby has their vaccinations as near to two, three and four months of age as possible, to keep the risk of them catching these diseases as low as possible. Premature babies should also be vaccinated from two months after birth, regardless of how premature they were.
Your child's health record book forms the only complete record of their childhood vaccinations.Vaccinations given at a health clinic or school are not necessarily added to the child's notes held by their GP - therefore it is very important to keep the health record book in a safe place. Details of childhood illnesses and vaccinations are often needed later in life. Without them, booster vaccinations may be required if the level of immunity is unknown.
If you are concerned about MMR safety, please visit this site: www.mmrthefacts.nhs.uk
Diphtheria is a serious infection that initially affects the throat. It can progress to damage nerves and heart muscle, and can kill. It is very rare in this country, but there was an epidemic in Russia in the early 1990's following the collapse of their immunisation programme.
Hib is short for haemophilus influenzae type B,( it shouldn't be confused with the germ that causes flu). Hib can cause pneumonia, blood poisoning and one type of meningitis. It can also cause a dangerous form of croup.
Measles is another virus infection . It causes a high fever and a rash. Complications include chest and ear infections, fits and occasionally brain damage.About one out of every 1000 to 2000 children with measles get a serious brain infection called encephalitis which causes a high fever, fits and coma.Rarely, in around 10 in a million children with measles, a chronic brain disease called SSPE develops. This condition can start many years after the child has had measles and is almost always fatal.
Meningitis C is one kind of Meningitis . There are several other types of meningitis. It is a dangerous infection that affects the covering of the brain. It can also cause septicaemia (blood poisoning). If it is not treated rapidly it can be fatal.
Look for the following symptoms in babies
The baby may be difficult to wake, or look very sleepy, or have a staring expression
A high temperature
Irritability when picked up, with a high pitched moaning cry
Refusing to feed, or vomiting
Pale or blotchy skin
Red or purple spots that don't fade when a glass is pressed on them
A stiff body with jerky movements or else floppy and lifeless
The soft spot may be tense or bulging
Look for the following signs in older children
Stiffness of the neck, the child may not be able to kiss his or her knee, or put his or her forehead on the knee.
Red or purple spots that don't fade when a glass is pressed on them.
A severe headache
Confusion or drowsiness
A dislike of bright light
Not all babies or children get all these symptoms, so trust your instinct and if you think you child is very ill get help immediately. Visit the Meningitis Research Foundation website for more information about meningitis and how to diagnose it. If you think your child may have meningitis, get urgent medical help.
The mumps virus causes swollen glands on the sides of the neck. Rarely it causes infertility by affecting the testicles. before the vaccine was introduced, it was the commonest cause of viral meningitis in children under 15.
Polio is a virus that attacks the nervous system. It can cause permanent muscle paralysis and if it affects the chest muscles it can be fatal. The old vaccine, given by mouth, contained live viruses, and very occasionally caused infection in contacts of the person immunised. The new injectable vaccine is inactivated, that is to say, there are no live viruses in it. It doesn't cause infections in other people.
Rubella (German Measles)
The main danger from rubella is to the unborn child. If a woman catches rubella in early pregnancy the baby can develop brain damage and deafness.Side effects of the MMR vaccine (mumps, measles and rubella)Some children develop a rash like measles about 7-10 days after the vaccination, together with a fever and loss of appetite. They can also get symptoms of rubella and mumps which are milder than the real diseases. This is part of the body's process of developing immunity to these diseases. Rarely children may have a bad reaction to the MMR vaccine. About one in a 1000 children has a febrile fit. However a child who catches measles is 10 times more likely to have a fit.
Tetanus is caused by a germ in the soil. It can be caught by a wound that is contaminated with soil. Penetrating wounds are particularly dangerous as the germ multiplies best away from the air. The wound does not have to be serious to get tetanus, a prick from a thorn may be enough. Also, it doesn't matter how many times someone is exposed to the germ, they will never develop immunity naturally. Tetanus is very dangerous, causing muscle spasms and breathing problems and up to half those affected may die. Everyone, children and adults, should make sure that they have a full course of tetanus vaccine. A full course is three injections a month apart. A booster is needed after 5 years then again a further 10 years later. Boosters may also be needed after some wounds, check with the practice nurse.
TB is a serious infection that attacks the lungs. It was often fatal before the invention of anti-TB drugs. It can also affect the bones and brain. There are still around 5,000 cases a year in this country. There is an increasing problem with resistance to anti-TB drugs. The vaccination is called BCG. Before giving this a skin test is performed to check if the child is already immune.
The Chinese word for whooping cough is "100 day cough". This disease is at the least very unpleasant as it causes severe prolonged spasms of coughing. It is called whooping cough because at the end of the coughing fit the child takes a deep breath that sounds like a "whoop". The prolonged coughing fit often causes vomiting. At worst the illness can be fatal, or can cause lung damage that affects the child in later life
It's not just children that need immunisations, adults need to keep theirs up to date as well.
The following are common immunisations that adults should consider. Everybody needs to make sure they keep their tetanus up to date, and certain groups of people need some of the others as well.
We offer the full range of travel vaccinations, including Yellow Fever, and our nursing staff are always happy to advise on the requirements for your trip. They will also advise on malaria prevention, and other health issues which may be relevant to your journey. You may find this site useful when planning a trip abroad: http://www.fitfortravel.scot.nhs.uk/
Please note that you should attend for travel vaccinations at least 8 weeks in advance for immunity to develop. Some vaccinations will require boosters before you travel, so please always consult the nurse at the earliest opportunity after you have planned your journey.
Tetanus is a germ that is caught when a wound becomes contaminated by soil. It is serious and around half those infected die. The wound may only be trivial, such as a prick from a thorn. It doesn't matter how old you are or how often you have been cut, you never develop immunity to tetanus naturally. All you need is a course of three injections a month apart, then a booster every 10 years. Don't wait until you get a cut because the vaccine isn't effective until you have had the full course.Adult Tetanus boosters are now combined with diphtheria vaccine to keep up immunity against this other disease.
If you look after a baby that has just had its polio immunisation there is a small risk that you can catch polio from the faeces (poo) when you change the nappy. For this reason it is worth making sure your polio is up to date. It is also a good idea to have it for travel abroad outside Western Europe, check with our practice nurses who have up to date information.
Everyone over the age of 65 is entitled to a free flu injection every year. This has been shown to reduce the number of people that need to go into hospital or that die from flu.The virus that causes flu changes frequently so you need to have a flu injection every year to get protected against the latest variety.People in certain high risk groups also need to be immunised, those with the following conditions:
People with asthma who use steroid inhalers or who often have courses of steroids by mouth, or who have been in hospital because of their asthma
COPD (chronic bronchitis and emphysema)
Poor immunity due to long-term treatment with steroids, or treatment for cancer such as radiotherapy or chemotherapy.
Finally medical staff, nurses, ambulance drivers and those who look after others in nursing and residential homes should have the vaccine.
Everyone over the age of 65 is advised to have a pneumonia vaccination. The vaccine protects against a very common kind of pneumonia caused by the pneumococcus germ. Usually this is a "once only" injection though a few people need a booster after five years, for example some people with reduced immunity or who have no spleen.Those without a spleen (or a spleen that isn't working properly) also need the Hib vaccine and meningitis C.
Hepatitis B is caused by a virus which is transmitted sexually or through blood from a carrier (who may appear healthy). It is a lot more infectious than HIV (the virus that causes AIDs). It can kill around half those who develop hepatitis, and others may become carriers of the disease.People who may come into contact with blood because of their occupation, such as health care workers, police or firemen should have a course of hepatitis B vaccine followed by a blood test three months later to check that it has been effective. Boosters are needed every five years.Hepatitis B is common in institutions caring for those with mental impairment. It can be transmitted by biting, so those working with these people also need to be immunised. Gay men and drug injectors may also be at risk of hepatitis B and should consider whether they need immunising.
We offer the full range of contraceptive methods, including contraceptive injections, the ‘pill’ (combined oral contraceptive), the ‘mini-pill’ (progesterone-only oral contraceptive), coils (including the new hormonal coil, or intra-uterine system), emergency contraception, barrier methods and advice/referral for sterilisation.
We are also very happy to provide contraceptive services and advice to teenagers.
The same rules of confidentiality apply to teenagers, as with adults - in other words, if a you wish a medical consultation to be secret from your parents, the doctor or nurse has to respect this wish.
Also, you do not have to tell the reception staff why you wish to see us.
The midwives and doctors share a programme of regular checks on women who are pregnant, or who have recently given birth. As soon as you know you are pregnant, make an appointment to see the Midwife. Please note that we do not routinely do tests to confirm pregnancy, as the pregnancy-testing kits available in chemists are every bit as accurate as the hospital urine tests. The ‘booking’ appointment is probably the most important. It is usually an hour long. At this appointment you will discuss :-
Lifestyle considerations, pregnancy care services, Identify worries that may need additional care, determine risk factors for gestation. Advise women on taking Vit D Supplements, screening, early USS.
BP, Urinalysis, Weight, BMI, blood tests( FBC, Serology, Group and Screen, Haemoglobinopathies).
Inform women younger than 25years about high prevelance of infection and offer screening. Ask if any previous group B strep infection.
Booking forms and scan request form sent to RBBH within 48 hours.
Mothers who may require a special blood test:
> Those with a body mass index above 35kg.
> Previous macrosomic baby weighing above 4.5kg.
> Previous gestational diabetes.
> Family history of diabetes in a first degree relative i.e. mother,father,brother or sister.
> Family origin with a high prevelence of diabetes.
> Polycystic Ovary Syndrome.
> Previous unexplained intrauterine death.
Please remember to bring a urine sample to each antenatal check and, if you are seeing the doctor, make sure you tell the receptionist when you book the appointment that it is for an antenatal check (antenatals are given longer appointments, and different records have to be given to the doctor).
After your baby is born, the midwife will see you both regularly for the first two weeks, and then hand over your care to your health visitor. At about 8 weeks after delivery you should see the doctor for a postnatal check and your baby’s second child health check (the first is done in the first couple of days after delivery, usually by the hospital doctor). Baby will also have their first vaccination.
8 to 10 weeks Midwife
11 to 13 weeks+ 6 days Hospital
15 to 16 weeks Midwife
19 to 22 weeks Hospital
25 weeks 1st baby GP
28 weeks Midwife
31 weeks 1st baby GP
34 weeks Midwife
36 weeks GP
38 weeks Midwife
40 weeks 1st baby GP
41 weeks Midwife
Not all of our services come under the umbrella of the NHS, and these services consequently attract a fee (just as an accountant or solicitor would charge for their time). As a general rule the NHS does not pay for:
Not all fees are payable by the patient. Some will be paid by the insurance company or employer, and this can cause some confusion. If you have any doubt about whether you will have to pay please ask our reception staff. Payment may be in cash or by cheque and a receipt will be given.For information on our current fees ask at our reception desk. Please note that some fees vary according to how much time the private service takes.
Insurance companies frequently ask for a medical report from your GP when you take out life insurance, and many other financial products. In some circumstances they may also require a medical examination. Both of these are paid for by the insurance company.We will not give any information about your health to anyone without your written permission.The insurance company will have asked you to sign a consent form for this with your application. On this you can state whether you give your consent, and if so, whether you wish to see any reports before they are sent off - in this situation we will hold on to the report for up to three weeks to give you a chance to request a copy from us (the rules we follow are those laid down in the Medical Reports Act).
These frequently have a medical section when the insurance relates to your health - eg. loan insurance, holiday cancellation insurance, private health insurance. You should fill in your section of the form before asking the GP to complete their section. These forms are not paid for by the insurance company and you will therefore be charged a fee for our time.
The DSS Med3 form (or ‘sicknote’) can only be issued to patients who have been off work for more than six consecutive working days due to their own illness, and who have been seen by us during this illness. Employers may sometimes request certificates for absences which do not fall within these strict rules. In these circumstances we can provide a private certificate, but you will have to pay a fee - some employers reimburse this cost, so do ask them. Employers may also write to us, with your written consent, for a medical report (in much the same way as insurance companies). In this situation the employer would usually pay the fee.
All letters to schools, colleges, universities and exam boards are private and attract a fee.
It is increasingly common for the Housing Department to request a letter from a doctor as a means of verifying claims of special housing need.
We prefer not to get involved in housing issues, but may be willing to provide a letter in certain circumstances. Ideally the Housing Department should write to us, enclosing the patient’s consent, and agreeing to pay our fee.
Alternatively the patient can request a letter directly from us, but in this situation the fee is payable by the patient.
Medical examinations are sometimes requested by insurance companies, employers, and potential employers, or they may be required in order to hold a particular driving licence, or to take part in certain sports. Employment and insurance medicals are usually paid for by the company, but most other medicals are paid for by the patient. Because of the time it takes to do a full medical examination the fees are considerably more than our other private services. In addition there may be fees for blood tests, X-rays and ECGs.
You are entitled to see copies of your medical records. In many cases such requests are made by a solicitor acting on your behalf and representing you in a legal dispute. Requests should be made in writing, enclosing your written consent if someone is acting on your behalf.
We charge either you or your representative according to the number of copied pages and the time it takes to check through your records.
The doctors will countersign passport applications, provided that you have been registered with the practice for at least 2 years.
There will be a fee payable by the patient for this.
People who normally reside outside the UK are not entitled to NHS treatment, unless they have an emergency need for medical care. This rule applies regardless of their nationality, or which passport they hold. Non-UK residents who do not have an emergency medical need, but need to see a doctor or other health professional, will be charged as a private patient. Please ask at reception for information on private consultation fees.
For babies between 2 weeks and 1 year only to make an appointment please call the surgery for more information.
Please phone the surgery (choosing option number 1) for the results of blood tests, X-rays, smears and other tests.If we receive a test that indicates that urgent action is required we will try to contact you.
It is important that you always let us know of any change of telephone number or address to prevent any problems .
We always encourage you to take a share in the responsibility for finding out your results to allow for the rare eventuality of the result going missing.
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