The Future of the Care Record Service
Jan 07

Family doctors have long seen themselves as trusted guardians of their patients’ confidential medical records.  The Department of Health is attempting to develop an England wide computer database of health information for about 40 million people known as the NHSCRS (the NHS Care Record Service).

Each patient must give explicit consent before personal information on, for instance, their medication and drug allergies, can be accessed.  There will be rigorous security measures in place to make sure that notes are not accessed inappropriately.   Patients’ notes will automatically be put on the NHSCRS, unless the patient informs us that they do not wish this to happen.  Notes will be audited to check that they have not been accessed without patient consent or contact with that individual patient.  Access will only be allowed with a series of passwords.

Information included will be the summary of care record including

  • repeat prescriptions active and recent
  • acute prescriptions in the last six months
  • suspected adverse and allergic reactions. 

This information shared across health professionals will improve safety and enhanced patient care significantly.  If, for instance, you were attend casualty whilst on holiday in Devon and could not remember your medication the treating doctor would be able to access that information with your consent.  There are also advantages for public health care because of the tremendous advantages of huge amounts of anonymous but aggregated data that can be used for health planning and public health policy.

Hampshire have been leading the way in this area, piloting a model that started in 2000.  100,000 leaflets were sent to households to gauge opinion and of 250,000 people only 12 wrote letters to say they did not want their records included.

The NHSCRS is currently under discussion, with the finer details of the system yet to be finalised.  We wish to bring to your attention that you may opt out of the NHSCRS if you wish to, by writing to us.  If we do not hear from you, then we will assume that you are happy for your medical notes to be included on the database.

More information can be obtained about this on www.thebigoptout.org, or on the advice line on
01494 882458.


July 06

BETA_BLOCKERS

Many of you will have read the recent discussions in the popular press about the use of β-blockers. These are a class of drug that are widely used in the treatment of heart disease and high blood pressure. Recent research has shown that in the treatment of blood pressure, for some people, there are more effective medicines than β-blockers.

The doctors at the Wilson Practice have been aware of the published work on β-blockers for some time. Many people who would previously have been commenced on β-blockers for high blood pressure, have been started on different drugs over the past year.

If you are on a β-blocker for high blood pressure do not panic! The drugs are safe and effective. In those people who should be on other medicines, we are changing them over at the time of their routine blood pressure review. Please do not stop your medicine without discussing your treatment with your doctor or clinic nurse.

Please remember that many people use β-blockers for reasons other than high blood pressure e.g. angina or migraine. There is no evidence suggesting that these people should change to another drug and we would ask you to continue with them.

Summary: Beta-blockers are safe drugs for most people

  • We now know that in some people there are medicines that are more effective than β-blockers for treating high blood pressure.

  • Do not stop your medicine without discussing your situation with a clinic nurse or your doctor first.

  • If your medicines need changing we will suggest an alternative at your next routine review.

 

  Bird Flu-Popular myths dispelled
Jan 06

Bird flu is caused by a virus which usually affects birds. It can occasionally cross the species barrier and infect humans. At present the bird flu viruses cannot be passed from one human to another and infection depends on close contact with infected birds.

Recently, one form of bird flu has been identified which is associated with a very high death rate when humans are infected. This strain of flu virus does not have the capability to cause a pandemic at present, however if it was ever to mutate so that it could be transmitted between humans, a pandemic could follow.

There is no way of knowing if and when this may happen. Vaccine cannot be produced until it happens as we do not know what virus to manufacture vaccine against. Antiviral drugs exist but until we know what virus we are dealing with we will not know how effective they will be.

Flu Pandemic- How can I protect myself and my family?

You can reduce, but not eliminate, the risk of catching or spreading influenza during a pandemic by:

• Covering your nose and mouth when coughing or  sneezing, using a tissue when possible

• Disposing of dirty tissues promptly and carefully - bag and bin them

• Avoiding non-essential travel and large crowds whenever possible

• Maintaining good basic hygiene, for example washing your hands frequently with soap and water to reduce the spread of the virus from your hands to your face, or to other people.

• Cleaning hard surfaces (e.g. kitchen worktops, door handles) frequently, using a normal cleaning product

• Making sure your children follow this advice.

If you do catch flu:

    Stay at home and rest

• Take medicines such as aspirin, ibuprofen or paracetemol to relieve the symptoms (following the instructions with the medicines). Children under 16   must not be given aspirin or ready made flu remedies containing aspirin

• Drink plenty of fluids.


SUNPROOF YOUR CHILD
June 2005

Children who have had one blistering episode of sunburn in childhood are far more likely to suffer from melanoma later on in life. It appears that young skin is more vulnerable to UV light than adult skin because it contains immature pigment cells which, when exposed to UV light, divide more rapidly. It is thought that this rapid proliferation increases the chance that DNA damaged cells will reproduce, and in the future, produce a tumour.

In addition, UV exposure can affect the developing immune system of a child. This reduces the chance of producing an immune response, which could destroy the tumour when it starts developing.

Research shows that up to the age of 19, the risk for a future melanoma is accrued with all exposure to UV light, making it vital that we protect our children from excess UV radiation until their adolescence, at the very least. Taking any child abroad to a hot climate before the age of 9 will give that child an ‘Australian’ risk of melanoma for the rest of their life. Most melanomas will develop after the age of 50, and are not always found on sun-exposed parts of the body.

 Sunscreens will avoid sunburn, but it is far from clear that they lessen the risk of skin cancer. They can lead us into a false state of security, leading us to believe that our children are safe in the UV light. What is clear is that covering ourselves and our children up and staying out of the sun is effective in reducing skin cancer risk.

So what can you do to protect your child?

 Avoid the midday sun- stay in the shade or indoors during the middle of the day

Cover up-make your child wear a wide brimmed hat and long sleeved clothes ALL the time you are outside.

Use sunscreen every day- look for a sunscreen that protects against both UVA, with a star rating of 4 (****) at least, and UVB rays (at least factor 20)

 The Australians say ‘No hat, no play’. Teach your child safe sun behaviour


Mumps and MMR vaccine
May 05

There is a national increase in mumps and cases have occurred in young people at Alton College -

What is mumps?

Mumps is an infectious disease caused by the mumps virus. It is a mild disease in most people and may even go completely unnoticed. Symptoms begin with a headache and fever, followed by swelling of glands in front of the ears on one or both sides. Rarely, it can cause complications which could be unpleasant and require admission to hospital. These include viral meningitis, hearing problems and inflammation of the testicles. It is spread through coughs and sneezes. People with mumps should stay at home for 5 days after the start of swollen glands and avoid contact with other people where possible. There is no treatment for mumps.

How can it be prevented?

The only way to prevent mumps is to be immunised with MMR vaccine Many young people are not fully protected against mumps as they have not had 2 doses of the MMR vaccine. (Students immunised in 1994 at school would have received the MR vaccine which only protects against measles and rubella, not against mumps. Students bom before 1987 generally will not have had MMR vaccine as young children.) You are advised to check with your surgery who will be able to offer you MMR vaccine if you are not fully protected. Immunisation is recommended for those born after 1980 as older people are more likely to be immune.

MMR vaccine

The vaccine is extremely safe. Further information is available on www.mmrthefacts.nhs.uk. Medical reasons for not having the vaccine include a very weak immune system and pregnancy ~ pregnancy should be avoided in the month after immunisation,

Many universities are requesting that new students are immunised before

starting their courses. This is because large outbreaks have happened in

universities.

 

AVOID MUMPS BY BEING PROTECTED WITH MMR  


Hormone replacement therapy update
Feb 04

Many of you will be aware that HRT has recently received a significant amount of adverse press, relating to its long term risks versus benefits. This was precipitated by publication of trials from the USA and , more recently, the UK.

The latest evidence suggests that HRT provides effective relief from menopausal symptoms and is effective in preventing osteoporosis and fractures, in the long term. It has also been shown to reduce the risk of colorectal cancer. Against these benefits, HRT increases the risk of breast cancer, endometrial cancer and ovarian cancer in a duration dependent manner. There is no evidence for a beneficial effect of HRT on cardiovascular disease – in fact the risk of heart attack and deep vein thrombosis is increased in the first year of use. The risk of stroke is also increased.

The Committee on Safety of Medicines have reviewed HRT and have made the following recommendations.

  • The risk:benefit of HRT is favourable for the treatment of menopausal symptoms
  • The risk:benefit of HRT is unfavourable for the prevention of osteoporosis as first-line use.
  • In healthy women, without symptoms, the risk:benefit of HRT is generally unfavourable.

Key messages for patients on HRT

  • There is no need to contact your doctor urgently.
  • There is no need to change your treatment if you are taking HRT in the short term for relief of menopausal symptoms, but you should discuss your treatment with Sister Robinson or your doctor, at least annually, to make sure that it is still right for you.
  • If you are aged 50 or more, taking HRT for the prevention of osteoporosis (and are not suffering from menopausal symptoms) you should make a routine appointment with your doctor to discuss whether an alternative may be more suitable for you.
  • There is no need to change your HRT if you have experienced an early menopause and are not yet 50 years old.
  • If in doubt, make a routine appointment to see your doctor.

More information is available at www.mhra.gov.uk