Private practice is significantly restricted in terms of NHS registered patients for GMS (general medical services).

New contractual regulations introduced in October 2019, restrict GP practices from offering or advertising – during NHS working time and on NHS funded property – private services to anyone (whether a registered patient or not), if those services fall within the scope of primary medical services.

Some services however are not within the scope of primary care services and therefore are not covered by the NHS and a charge will be made in line with the BMA scale of fees.

These include medical examinations e.g.:

• HGV licence
• Employment medicals
• Driving insurance etc
• Assessment of capacity for Power of Attorney

as well as certain certificates e.g.:

• Private insurance claims
• Private sick notes Holiday cancellations etc.

Services outside the scope of the NHS will be charged according to a list of recommended fees. The list can be downloaded by clicking on the link below, it can also be found in the waiting room.

Private Fees

Non NHS services include:

• HGV and PSV medicals
• Insurance company reports and medicals
• Private certificates
• Holiday cancellation
• Medical insurance reports/forms
• Pre-employment medicals
• Vaccination certificates, etc.

The above list is not exhaustive.

Please inquire at reception if you are not sure of the cost when handing in your form for completion.

Power of Attorney

A Power of Attorney is a legal document that allows someone to act for you or make decisions on your behalf if you are no longer able to do so yourself. There are two types of Lasting Power of Attorney; one for Personal Welfare and one for Property and Affairs. In order to be valid the lasting Power of Attorney must be registered with the Office of the Public Guardian.

Anyone who is aged 18 or older and has the mental ability to make decisions for him/herself can choose to give Power of Attorney to relatives or people that they trust.

The following websites have more detailed information about what a Power of Attorney is, how to set one up and what are the costs of doing so.

NHS Choices

Office of the Public Guardian

Age UK

Applying for a Power of Attorney

You can apply for a Power of Attorney online

The forms need to be signed before sending them off to the Office of the Public Guardian.

Portcullis GPs provide non-NHS services in relation to Power of Attorney applications. Because these services do not fall under those provided by the NHS, there are fees associated with this.

As at February 2018 the fees charged are as follows:

• Countersignature of a Power of Attorney application, no medical examination required £105
• Countersignature of a Power of Attorney application, with medical assessment for capacity or home visit £155

N.B. Other professionals, such as solicitors, also provide services in relation to Power of Attorney applications.

Healthcare Assistant Clinics-Angie and Megan (HCA) or Joanne and Heidi (Practice Nurses)

*blood tests

*ECGs

Daily clinic 8.30am-12.30

Blood test appointments can be booked directly by the receptionist and there is no need for a telephone appointment first. Please remember to cancel and rebook your appointment if you develop symptoms of possible Covid-19 and to wear a facemask as you come in to the practice

*Health Checks– carried our by Angie (HCA)

What is an NHS Health Check?

The NHS Health Check is a free check-up of your overall health. It can tell you whether you’re at higher risk of getting certain health problems, such as:

• heart disease
• diabetes
• kidney disease
• stroke

During the check-up you’ll discuss how to reduce your risk of these conditions.

How do I get an NHS Health Check?

If you’re aged 40 to 74 and do not have a pre-existing health condition, you should be invited to an NHS Health Check by your GP or local council every 5 years.

If you think you are eligible but have not been invited, contact your GP surgery to find out if they offer NHS Health Checks or contact your local council to find out where you can get an NHS Health Check in your area.

Some pharmacies also offer NHS Health Checks.

What happens at an NHS Health Check?

Your NHS Health Check will be done by a healthcare professional. This will usually be a nurse, but it could also be a doctor, pharmacist or healthcare assistant.

The check takes about 20 to 30 minutes and usually includes:

• measuring your height and weight
• measuring your waist
• a blood pressure test
• a cholesterol test, and possibly a blood sugar level test, which is usually a finger-prick blood test. You may be asked to have a blood test at or before the NHS Health Check

You’ll also be asked some questions about your health including:

• whether any of your close relatives have had any medical conditions
• if you smoke, and how much
• if you drink alcohol, and how much
• how much physical activity you do

Your age, gender and ethnicity will also be recorded.

Your NHS Health Check results

You’ll usually be told your NHS Health Check results during the appointment.

You’ll be given your cardiovascular risk score of developing a heart or circulation problem, such as heart disease, stroke, type 2 diabetes or kidney disease, over the next 10 years.

The healthcare professional may describe this risk score as low, moderate or high.

Everybody’s cardiovascular risk rises with age, so the next time you have an NHS Health Check your risk score may be higher, even if your test results are the same.

Wound and Dressing clinics (Angie and Karen)

Monday and Thursday afternoons

Review Dressing appointments can be booked directly by the receptionist and there is no need for a telephone appointment first. Please remember to cancel and rebook your appointment if you develop symptoms of possible Covid-19 and to wear a facemask as you come in to the practice

New wounds or dressings

Please call the practice its urgent, to make an initial telephone call with a nurse in order to discuss your need for a dressing and the nurse will book you in to the next available appointment. If its not urgent you can also book a telephone appointment online or via email:

Patients who are housebound need to contact the District Nurses for their dressings to be done at home on 01588 676323.

Portcullis Surgery is committed to providing best practice, high-quality medical care. Most ear wax build up will improve with olive oil treatment alone.

Your pharmacist can help with earwax build-up. They can give advice and suggest the treatment.

Our MICROSUCTION EAR CLEANING AND EAR IRRIGATION  CLINICS:

• all patients will need to book a face to face appointment with our nurses Heidi or Jo first so we can discuss your need for microsuction or ear irrigation with you and discuss possible alternative treatments.
• They will look inside your ears to check if they are blocked and might carry out some simple hearing tests before booking you in for an appointment to have your ears irrigated or microsuctioned with Angie our HCA.
• Prior to the appointment with Angie: PLEASE READ THE INFORMATION LEAFLET BELOW AND SIGN THE CONSENT FORM BELOW

Microsuction: Usually micro suction does not need pre-treatment with drops but two days of Earol (clinically treated olive oil) is the best preparation.

Ear Irrigation: You will be asked to use olive oil or use and ear wax bulb syringe for 1-2 weeks if you have not done so already

Waiting times for Microsuction and ear irrigation:

Please remember that in most other areas and practices this is a private service and the NHS does not fund Microsuction for any patients at all and ear irrigation is normally restricted to patients who have an audiology appointment ONLY.

• We will always prioritise all patients who have been referred for an audiology appointment for hearing loss and will usually ask for a copy of your letter with an audiology appointment.
• Therefore if you do not have an audiology appointment you may have to wait some weeks for the next available microsuction or ear irrigation appointment or you may have to seek private treatment if our waiting times are too long for you

Microsuction:

We give priority to patients who need ear syringing or microsuction prior to an audiology appointment or who have contraindications to microsuction. We do not repeat microsuction more frequently than every 3 months for any patient who does not have proof of an audiology appointment.

Ear syringing:

We give priority to patients who need ear syringing prior to an audiology appointment. We do not repeat ear irrigation more frequently than every 6 months for any patient who does not have proof of an audiology appointment.

Housebound patients:

We are sorry but we do not have the capacity to carry out housebound visits for ear irrigation or ear microsuction. Also we would be concerned about our equipment getting damaged during visits and do not have insurance for a home visiting service.

If you cannot possibly come in to the practice for this service then you will need to look in the internet for a private provider. 

BEFORE THE APPOINTMENT WITH ANGIE PLEASE READ THE INFORMATION LEAFLET BELOW AND SIGN THE CONSENT FORM BELOW (YOU CAN ALSO ASK FOR A PAPERCOPY FROM RECEPTION OR THE NURSE)

Patient Information Leaflet

Download the consent form, print and hand in to reception or fill in online below

Information and Consent for Ear Irrigation or Microsuction

Cryotherapy

The cryotherapy device destroys the tissue by freezing the fluid inbetween the cells, forming ice shards and crystals which rupture the membrane, thereby destroying the cell. That means there will be no collateral damage to healthy tissue. It’s so incredibly accurate and practical.

Please note: Cryotherapy is a cosmetic procedure which is no longer funded by the NHS. Our partners have decided to continue offering cryotherapy as a free service in the practice however, we are asking all patients who have this procedure done in the practice to make a donation towards the patient donation fund on a voluntary basis in order to fund the costs of the nitric acid canisters.

Cryotherapy offers the ideal treatment for

• Skin Tags
• Sun Damage
• Age Spots
• Warts
• Cherry Spots
• Verrucae
• Milia

BEFORE THE APPOINTMENT FOR CRYOTHERAPY YOU WILL NEED TO FILL IN THE CONSENT FORM BELOW AND READ THE INFORMATION LEAFLETS (YOU CAN ALSO ASK FOR A PAPERCOPY FROM RECEPTION) BELOW:

YOU CAN THEN BE BOOKED WITH OUR NURSE JO GRAY OR OUR HCA ANGIE RUNICLES FOR CRYOTHERAPY 

Cryotherapy Patient information leaflet

INFORMATION ABOUT PATIENT DONATIONS

For more information about the Patient donation Fund follow the link

What is benign paroxysmal positional vertigo (BPPV)?

BPPV is a common cause of dizziness. It occurs in people of all ages but is more common
in middle-aged and elderly people. It causes short bursts of intense dizziness when the body
or head is placed in certain positions such as lying on one side in bed or looking upwards.

People can feel sick and are sometimes unsteady for a few hours after the dizziness has
gone away.

• Benign – this means the cause of dizziness is not a threat to your health.
• Paroxysmal – the dizziness comes in short bursts.
• Positional – the dizziness is provoked by certain body or head positions.
• Vertigo – the medical name for the spinning sensation.

Home Epley manoeuvre

BPPV can usually be cured using the home Epley manoeuvre. Dr Beanland is happy to explain how to do this in an appointment. Arrangements are made on an individual basis and you need to book a single FACE TO FACE appointment with the Dr Beanland.

This is a simple treatment that involves you turning your head in a series of movements. The movements are specifically designed to use gravity to dislodge the crystals from the semi-circular canals and return them to where they belong, treating the symptoms of vertigo. You can perform the series of movements in your own home.

BEFORE THE APPOINTMENT WITH DR BEANLAND PLEASE READ THE INFORMATION LEAFLETS BELOW  (YOU CAN ALSO ASK FOR A PAPERCOPY FROM RECEPTION) AND FILL IN THE CONSENT FORM BELOW

Please read the information leaflet below prepared by the University of Southampton Hospital

Home-Epley-manoeuvre-to-treat-BPPV-left-ear-2782-PIL#

Information and Consent for an Epley Manouvre

Most of the minor surgery carried out here involves the removal of lumps and bumps.

Once the lump has been removed the skin will be closed using a few stitches, these will have to be removed by the NURSE at a time specified by the our Minor Surgery lead Advanced Paramedic Sian Wood (usually 1 week).

All specimens removed are sent to the laboratory for examination.

The local anaesthetic lasts approximately 2 hours.

The wound may therefore start to become painful after this period of time.

Arrangements are made on an individual basis, you may to book a single FACE TO FACE appointment with the our Minor Surgery lead Sian Woods to discuss your problem first or you may booked directly to the next minor operation slot available with our Advanced Paramedic Sian and Nurse Jo.

BEFORE THE APPOINTMENT WITH APP Sian FOR YOUR SURGERY PLEASE READ THE INFORMATION LEAFLETS BELOW AND SIGN THE CONSENT FORM BELOW (YOU CAN ALSO ASK FOR A PAPERCOPY FROM RECEPTION)

Once you send your consent we will let you know if you need to be seen by the Dr first OR if you can be booked directly to the next available minor surgery slot

Please read the information leaflet below regarding Joint injections

Patient-Information-Leaflet Minor Surgery

Joint Injections

• Hydrocortisone injections for joint pain work by releasing the medicine slowly into the joint. This reduces pain and swelling.
• After an injection, your joint may feel better for several months –sometimes as long as a year.
• Some people get increased pain and swelling in their joint immediately after having the injection. This pain tends to go away after a few days.
• Depending on which joint is being treated, you may be able to have injections in the same place up to 4 times a year.
• Hydrocortisone injections can affect your immune system, so you’re more likely to get infections. Tell your doctor if you come into contact with chickenpox, shingles or measles as these infections could make you very ill.
• If you have been having long-term hydrocortisone injections for a long time, you may need to carry a steroid emergency card. Ask your pharmacist or doctor if you do not have one.

Arrangements are made on an individual basis and you need to book a single FACE TO FACE appointment with the Doctor to discuss your problem first.

BEFORE THE APPOINTMENT WITH DR PERKS, DR BEANLAND or DR WOOD, PLEASE READ THE INFORMATION LEAFLETS BELOW AND SIGN THE CONSENT FORM BELOW (YOU CAN ALSO ASK FOR A PAPERCOPY FROM RECEPTION)

Please read the information leaflet below regarding Joint injections

Please sign this consent form for a joint injection

All patients with a long-term medical condition are asked to have an annual check with a nurse once a year. To help make it easy for you to remember when your check-up is due, the Practice aims see you during the month of your birthday. Medication reviews are available everyday morning and afternoon, every Monday and Wednesday evening and one Saturday a month (ask surgery for details)

Medication Reviews are a telephone first service

The reception team will book any bloods tests you need aswell as an initial telephone call with a nurse.

Overdue Medication Reviews

You will be asked to see a nurse or a doctor at regular intervals for a check-up usually around your birthday month, so sometimes we will remind you that your review is overdue. If its your birthday month or you get a reminder note from us please come in for your medication review as soon as possible, this may include annual blood tests. We may refuse to issue medications if your review is very overdue.

Your Annual Medication Review – What do you need to do?

Due to your medication conditions and any medication you are taking, it is important that you have a check-up each year with a NURSE.

To help make it easy for you to remember when your check-up is due, the Practice aims see you during the month of your birthday. There are 1 or 2 steps to your annual review depending on your conditions/medications.

The first step is to have an appointment with a Healthcare Assistant for any blood tests, blood pressure checks or pulmonary function tests that may be needed.

The second step is an appointment with a Practice Nurse to discuss your test results and your medication.

Frequently Asked Questions:

Why do I need to wait a week to see the Practice Nurse?
It can take a few days for blood tests to be processed by the hospital and the results to be sent to the GP Surgery.
I have more than one condition which needs a yearly check-up.

Can I have a single check-up for everything?
Yes. You may need to book a longer appointment with the Practice Nurse.

Your nurse will indicate what length appointment is needed for your combination of conditions. Ask the receptionist and they will usually know how long your appointment needs to be for.

How do I know when to book an apt?
You will NOT be contacted to remind you that your check-up is due.
Near your birthday, please call Portcullis GP Surgery (01584 872939) after 10am and make 1 or 2 appointments:
If you are unsure what appointments you need or how long your appointment needs to be PLEASE DO NOT BOOK YOUR APPOINTMENT ONLINE, CALL THE PRACTICE and the receptionist will be able to guide you on what you need to do.

What can I do if I am a patient who is housebound or a relative of a patient who is HOUSEBOUND?
If you are unable ever to leave your home due to poor mobility and cannot come to the practice please call the practice and ask for a TELEPHONE apt with a nurse, who will be able to organise any tests to reviews you may need over the phone or with the District Nurses.

New patients and Medication Reviews

If you are a new patient you will be offered a telephone appointment with one of the partners to welcome you to the practice. If you have any of the following conditions below you may be offered an appointment for a bloods and a review with a nurse as soon as possible and not wait as usual for your birthday month:

• Asthma
• Atrial Fibrillation
• Chronic Obstructive Pulmonary Disease (COPD)
• Dementia
• Diabetes
• Epilepsy
• Heart Failure
• Mental Health
• Osteoarthritis
• Chronic Pain
• Parkinson’s Disease
• Rheumatoid Arthritis
• Stroke or Transient Ischaemic Attack
• Underactive Thyroid (Hypothyroidism)

Wedneday and Thursday afternoons

Smear test appointments can be booked directly by the receptionist and there is no need for a telephone appointment first. Please remember to cancel and rebook your appointment if you develop symptoms of possible Covid-19 and to wear a facemask as you come in to the practice

We recommend ALL women from the age of 25 have a cervical smear every 5 years, as problems detected this way can usually be cured. Appointments can be made with your Doctor during normal Surgery, provided you request a ‘Smear’ appointment. Our Nurses are also fully trained to perform smears and can do so during any Nurse Surgery. We request you make an appointment for this to be done.

HPV Immunisation

We vaccinate from the age of 14 against cervical cancer as per the National Programme. Please ask at the Reception or one of our Practice Nurses for more information.