Enhanced Services

What is an Enhanced Service?

The new GMS Contract was introduced in April 2004. As part of the new Contract, GP Practices can opt to provide services over and above the essential/additional services normally provided to patients. These services are known as Enhanced Services and are delivered to a higher specified standard. By providing these services GPs help reduce the burden on secondary care (e.g. Hospitals) and expand the range of services to meet local need and improve convenience and choice for patients.

There are three types of enhanced service:

Directed Enhanced Service (DES) – Primary Care Trusts must ensure that this service is provided for the population, e.g. child immunisation programme.

National Enhanced Service (NES) – Services commissioned to meet patient needs with national specifications, e.g. specialised services for multiple sclerosis.

Local Enhanced Service (LES) – Locally developed services designed to meet local health needs.

Enhanced Services Provided by the Practice

Directed Enhanced Services

• Alcohol
• Child Immunisations
• E-Booking
• Ethnicity
• Influenza and Pneumococcal Immunisation
• Learning Disabilities
• Minor Surgery (e.g. joint injections)
• Osteoporosis
• Practice Based Commissioning

National Enhanced Services

• Anti-Coagulation Monitoring
• Multiple Sclerosis
• Near Patient (or point of care) Testing (Screening for patients taking high risk prescribed medication)

Local Enhanced Services

• BP – 24 hours ambulatory
• Care Home (Nursing)
• Chlamydia
• Chronic Leg Ischemia (PVD)
• Counselling
• Diabetes
• ECG – 24 hour + 48 hours + 7 day
• Epilepsy
• End of Life
• Extended Hours
• HPV vaccine
• Infectious Diseases
• OGTT Testing (Oral Glucose Tolerance Testing)
• Palliative Care
• Phlebotomy (blood tests)
• Tissue Viability
• Treatment Room

Cervical Smears

If you are female between 25 and 65 then your Doctor strongly recommends that you have a regular cervical smear test. These tests are carried out routinely every 3 years between the ages of 25 and 49, and every 5 years between the ages of 50 and 65. You will be notified when your test is due.

This test makes it possible to detect and treat the early stages of abnormalities of the cervix before they have a chance to become apparent to you. The test is quick, simple and painless and may be performed by the nurse.

Childhood Immunisations

A comprehensive programme is offered to all children. Vaccinations are given at the following ages:

2 months, 3 months, 4 months, 12 months, 13 months, 3 years 4 months to 5 years old and 13 years to 18 years old.

Please contact one of our nurses if you would like more information. You will receive a letter from the surgery when any immunisation is due.

For information on child immunisations please visit the NHS Immunisation Information website.

Mental Health

We now have 2 mental health nurses on separate days who come to the surgery.  Book appointments via Reception

Physiotherapists

We now have two different types of physiotherapy services at the surgery. 

Diabetes Clinic

We have a nurse who has received specialist training in the management of diabetes, who will help you manage your own diabetes. She is also available should you have any questions. You can either book an appointment or if it is a quick query you can telephone she will return your call when she is available, which will be as soon as possible.

The doctors support our specialist nurse in your diabetic care.

Mammography

Women between 50 – 65 will be offered 3 year mammography as a screen for breast cancer. The service is run by the Health Authority and invitations are sent by post from the Breast Screening service. If you have a family history of early breast cancer or have any concerns please come and discuss this with a doctor.

Ultrasound Scans

If, when you see your GP they decide you need an Ultrasound scan, you can choose to be referred to services at local hospitals or to the Ultrasound scanning service being held at our Practice.  Your GP will give you the details and choice during consultations.

Ear Syringing

Please nose that ear syringing is only carried out by the Practice Nurses/Healthcare Assistants at the surgery.  Please ensure that you soften the wax with olive oil, 5-7 days prior to your appointment.

Travel Vaccinations

It is important to make this initial appointment as early as possible  - at least 8 weeks before you travel - as a second appointment will be required with the practice nurse to actually receive the vaccinations.  These vaccines have to be ordered as they are not a stock vaccine.  Your second appointment needs to be at least 2 weeks before you travel to allow the vaccines to work.

Some travel vaccines are ordered on a private prescription and these incur a charge over and above the normal prescription charge.  This is because not all travel vaccinations are included in the services provided by the NHS.

Travel Health Questionnaire

To help us offer the appropriate advice, please fill out the online form before coming to see the nurse.

Travel Questionnaire

Europe & Russia	North America
Central America	South America
Caribbean	Africa
Middle East	Central Asia
East Asia	Australasia and Pacific

See NHS choices travel pagehttps://www.nhs.uk/conditions/travel-vaccinations/  for further advice and information.  Also more resources about which vaccinations required for where you are travelling, can be found at the Fit for Travel website which provides useful guideline information at http://www.fitfortravel.nhs.uk/destinations.aspx

Non-NHS Services

Some services provided are not covered under our contract with the NHS and therefore attract charges. Examples include the following:

• Medicals for pre-employment, sports and driving requirements (HGV, PSV etc.)
• Insurance claim forms
• Prescriptions for taking medication abroad
• Private sick notes
• Vaccination certificates

The fees charged are based on the British Medical Association (BMA) suggested scales and our reception staff will be happy to advise you about them along with appointment availability. 
 

See Private Charges Price List tab for full cost details.

If you wish to request some information, please complete the attached form and email or hand in to Reception.

Request form for items from Medical Records

Northdown Surgery – Scale of Private Charges

*may be available free of charge if you are registered with our Patient Access system.  If you have registered for full access, you will be able to view/download / print this information yourself.   Links can be found on our website.

• Please note that charges are per form / appointment
• We are only able to accept cheques for amounts over £15
• If you have a form for completion by a Doctor, please speak to the reception staff.
• Please do not give it direct to the Doctor.

Test Results

When you attend for a test of any kind you will be told how long you should expect to wait for the results. Please bear this in mind and only call the surgery after sufficient time has elapsed.

To obtain test results, please call the surgery after 2pm each day.  If you have signed up for our Patient Access system and have full access, you will be able to view most test results on this system, once the clinician has reviewed your test results.  This will save you having to ring the surgery.

Our reception staff are not qualified to comment on results therefore it is your responsibility to check them and make any necessary follow-up appointment with the doctor.

Please note that we do have a strict policy regarding confidentiality and data protection. In this respect we will only give out results to the person they relate to unless that person has given prior permission for their release or if they are not capable of understanding them.

Blood Tests

A blood test is when a sample of blood is taken for testing in a laboratory. Blood tests have a wide range of uses and are one of the most common types of medical test. For example, a blood test can be used to:

• assess your general state of health
• confirm the presence of a bacterial or viral infection
• see how well certain organs, such as the liver and kidneys, are functioning

A blood test usually involves the phlebotomist taking a blood sample from a blood vessel in your arm. and the usual place for a sample is the inside of the elbow or wrist, where the veins are relatively close to the surface. Blood samples from children are most commonly taken from the back of the hand. The child's hand will be anaesthetised (numbed) with a special cream before the sample is taken.

To obtain test results, please call the surgery after 2pm each day.  If you have signed up for our Patient Access system and have full access, you will be able to view most test results on this system, once the clinician has reviewed your test results.  This will save you having to ring the surgery.

You can find out more about blood tests, their purpose and the way they are performed on the NHS Choices website.

X-Ray

An X-ray is a widely used diagnostic test to examine the inside of the body. X-rays are a very effective way of detecting problems with bones, such as fractures. They can also often identify problems with soft tissue, such as pneumonia or breast cancer.

If you have a X-ray, you will be asked to lie on a table or stand against a surface so that the part of your body being X-rayed is between the X-ray tube and the photographic plate.

An X-ray is usually carried out by a radiographer, a healthcare professional who specialises in using imaging technology, such as X-rays and ultrasound scanners.

You can find out more about x-ray tests, how they are performed, their function and the risks by visiting the NHS Choices website.

Self Help

In-House

First Contact Physiotherapy

Mental Health Nurses

Clinical Pharmacist

Pregnancy

Self-refer to midwives via www.ekhuft.nhs.uk/pregnancy

Self-refer to Marie Stopes (termination service) 0345 300 8090

Maternity triage QEQM 01843 234483

Inclusion Criteria

Gestations of 16 weeks pregnancy and above

Nausea and vomiting resistant to first line treatment at any gestation

Acute onset of abdominal/epigastric pain

Vaginal bleeding

Ruptured membrane

Raised blood pressure +/- proteinuria

Headache not relieved by Paracetamol

Visual disturbances

Severe oedema including facial oedema

Reduced or/no fetal movements or change to movements(complete RFM checklist)

Abnormal trauma/fall directly onto abdomen

Community midwife referral for concerns

RTA (after being assessed in the ED)

Suspected pre-term labour

Women feeling generally unwell

Suspected labour

Complication following operation or procedure undertaken within maternity directorate during pregnancy

Unbooked women requiring urgent care

Post natal complications up to 28 days

Exclusion Criteria

Any non-obstetric issues should be referred to GP or A+E

Women below 16 weeks

Non-pregnant women or more than 6 weeks after delivery

Complication after gynaecology procedure

Women needing HDU or labour ward admission

Sexual Health 0300 7900 245

Kent Continence Service

0300 123 3167

kentchft.continence@nhs.net

https://www.kentcht.nhs.uk/service/continence-service/

Minor Eye Clinic - R&J Moore

Birchington 01843 846016

Broadstairs 01843 864866

Conditions covered by the service are as follows:

Sudden or recent reduction in vision in one or both eyes

Red eye(s) or eye lids

Pain and/or discomfort in the eyes, around the eye area or temples

Recent onset or sudden increase of flashes and/or floaters in one or both eyes (appears like a fly, black specks or a cobweb moving across your vision)

Mild trauma, for example a scratch to the outer surface of the eye(s) or lid(s)

Suspected foreign body in the eye

Dry eye

Significant recent discharge from or watering of the eye

Trichiasis (in growing eyelashes)

If you are unsure whether your symptoms qualify, please contact one of the approved opticians who can offer help and advice

Drug and Alcohol Services - Forward Trust (Support/Recovery/Family Support/ Needle Exchange)

www.forwardtrust.org.uk/service/thanet-hub/

Mental Health (Adults)

Samaritans 116 123

NHS 111

Mental Health Matters 0800 107 0160

Live Well Kent 0800 567 7699

Release The Pressure - Text 'KENT' to 85258 for 24hr support via text

Safe Haven Thanet - thanet.mhm@nhs.net 07850 655877

Thanet Safe Haven

Holy Trinity Church

St Mary's Avenue

Margate

CT9 3TN

Mental Health (Children)

Childline www.childline.org.uk/get-support/ 0800 1111

NHS 111

Adolescents Crisis Team 0808 808 4994

Bereavement

Cruse 0808 808 1667

Lifestyle - NHS One You - www.kentcht.nhs.uk/service/one-you-kent/

Weight loss

Smoking

Physical activity

Age UK - 01843 223881

Handyman

Footcare

Befriending service

Dementia support

Shopping

Cleaning

Age UK 'The Silver Line' - 0800 470 8090

Free, confidential telephone service providing friendship, support and conversation for older people

Veterans