Your GP will discuss with you and, if appropriate, your carer why a referral is being recommended.

You are usually referred because your GP wants a specialist’s help in deciding how best to treat your condition or they do not have the equipment at the surgery for the required tests and investigations.

If your GP needs to refer you to a consultant-led service for a physical or mental health condition, in most cases you have the right to choose which hospital you go to.

If you do not express a preference, your GP will tend to refer you to a local hospital near where you live that is part of the local healthcare system.

For more information on referrals information please see here.

Certain small surgical operations can be performed at the surgery.

With minor surgery the recovery time is usually short and you will be back to your usual activities fairly quickly (depending on your procedure).

Before attending for minor surgery you will need to see a doctor for the diagnosis and then you will be given an appointment to attend for your procedure.

Working together to improve your health

Everyone is at risk of developing heart disease, stroke, diabetes, kidney disease and some forms of dementia. The good news is that these conditions can often be prevented – even if you have a history of them in your family. Have your free NHS Health Check and you will be better prepared for the future and be able to take steps to maintain or improve your health.

Visit NHS Choices – Health Checks for further information.

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Why do I need an NHS Health Check?

We know that your risk of developing heart disease, stroke, type 2 diabetes, kidney disease and dementia increases with age. There are also certain things that will put you at even greater risk.

These are:

• being overweight
• being physically inactive
• not eating healthily
• smoking
• drinking too much alcohol
• high blood pressure
• high cholesterol

Both men and women can develop these conditions, and having once could increase your risk of developing another in the future.

• In the brain a blocked artery or a bleed can cause a stroke.
• In the heart a blocked artery can cause a heart attack or angina.
• The kidneys can be damaged by high blood pressure or diabetes, causing chronic kidney disease and increasing your risk of having a heart attack.
• Being overweight and physically inactive can lead to type 2 diabetes.
• If unrecognised or unmanaged, type 2 diabetes could increase your risk of further health problems, including heart disease, kidney disease and stroke.

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What happens at the check?

• This check is to assess your risk of developing heart disease, type 2 diabetes, kidney disease, and stroke.
• The check will take about 20–30 minutes.
• You’ll be asked some simple questions. For example, about your family history and choices which may put your health at risk
• We’ll record your height, weight, age, sex, and ethnicity.
• We’ll take your blood pressure.
• We’ll do a simple blood test to check your cholesterol level.

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What happens after the check?

• We will discuss how you can reduce your risk and stay healthy
• You’ll be taken through your results and told what they mean. Some people may be asked to return at a later date for their results.
• You’ll be given personalised advice on how to lower your risk and maintain a healthy lifestyle.
• Some people with raised blood pressure will have their kidneys checked through a blood test.
• Some people may need to have another blood test to check for type 2 diabetes. Your health professional will be able to tell you more.
• Treatment or medication may be prescribed to help you maintain your health.

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Questions you may have

Please review our list of Non NHS work that we offer at the practice, which attract a fee.

This includes certificates, forms, medical examinations and various travel vaccinations.

Certificates and Forms
Private Letter / TWIMC
Private Sick Certificate
Private Prescription for Travel
Freedom from Infection Certificate
Sickness / Accident Insurance Form
Lighter Life Forms
Housing Letter (payable in advance)
Children Letter for Ballet / Stage etc.
Fitness to Fly Letter
Cancellation Holiday Form / Letter
Fitness to Exercise Certificate
Overseas Pension Form
Power of Attorney Form
Power of Attorney Form (Home Visit)
School Health Report
School Health Report (Ofsted)
Letter for taking Meds on Plane
Passport Form / Photograph
Firearms / Shotgun Licence

Medical Examinations and Reports
HGV
All Taxi Medicals and Bus Medicals
Pre-employment Medical (Including elderly driver fitness to drive)

TRAVEL VACCINATIONS
Hepatitis B
Yellow Fever
Polio Certificate
Rabies (three injections)
Japanese Encephalitis (Adult – Two Injections)
Japanese Encephalitis (Child – Two Injections)
Tickbourne Encephalitis (Adult – Two Injections, 1 year cover)
Tickbourne Encephalitis (Child – Three Injections, 1 Year Cover)
Meningitis
MMR (Over 16s)

We offer a range of clinics and services here at Cator Medical Centre for all your vaccination needs and advice.

Childhood Immunisations

One of the most important things that a parent can do for their child is to make sure that they have all their routine childhood vaccinations. It’s the most effective way of keeping them protected against infectious diseases.

Ideally, children should have their jabs at the right age to protect them as early as possible and minimise the risk of infection.

Find out which jabs your child needs, when they need them, and what the benefits of each jab are.

Please call the surgery to make an appointment.

For more information please visit the websites below:

Useful links

• NHS Choice – Vaccinations for you and your family
• Childhood Immunisation Schedule
• National Immunisation Schedule

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Flu Immunisation

Seasonal flu is a highly infectious illness caused by a flu virus.

The virus infects your lungs and upper airways, causing a sudden high temperature and general aches and pains.

You could also lose your appetite, feel nauseous and have a dry cough. Symptoms can last for up to a week.

We offer ‘at risk’ groups the flu vaccine at a certain time each year to protect you against the flu virus.

You may be invited for a flu jab if you are:

• over 65 years of age
• pregnant

or have:

• a serious heart or chest complaint, including asthma
• serious kidney disease
• diabetes
• lowered immunity due to disease or treatment such as steroid medication or cancer treatment
• if you have ever had a stroke
• If you have any queries please contact the surgery.

For more information please visit the websites below:

Useful links

• NHS Choices – Flu and the Flu Vaccine

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Pneumococcal Vaccine

The pneumococcal vaccine (or ‘pneumo jab’ or pneumonia vaccine as it’s also known) protects against pneumococcal infections.

Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia, septicaemia (a kind of blood poisoning) and meningitis.

Read more about why the pneumococcal vaccination is needed.

Who should have the pneumococcal vaccine?

A pneumococcal infection can affect anyone. However, some people need the pneumococcal vaccination because they are at higher risk of complications.

These include:

• all children under the age of two
• adults aged 65 or over
• children and adults with certain long-term health conditions, such as a serious heart or kidney condition

Read more about who should have the pneumo jab.

How often is the pneumococcal vaccine given?

Babies receive the pneumococcal vaccine as three separate injections, at 2 months, 4 months and 12-13 months.

People over-65 only need a single pneumococcal vaccination which will protect for life. It is not given annually like the flu jab.

People with a long term health condition may need just a single one-off pneumococcal vaccination or five-yearly vaccination depending on their underlying health problem.

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Travel Clinic

In order to assist us to make a full assessment of the potential risks to your health from your planned travel, we would ask that you make a Travel Clinic appointment with our Practice Nurse. Ideally, this appointment should be made around the time of booking your holiday, at least 6 weeks before you travel.

At your appointment we may ask the following questions to help us plan for your trip:

• When are you departing and for how long?
• Where are you going, including the destinations within a country?
• Where are you staying, e.g. backpacking, camping, hotels?
• Are you planning to undertake any high risk activities?
• Have you taken out travel insurance and have you informed the company of any existing medical condition?
• If female and of child bearing age, is there any possibility you could be pregnant, or are you planning a pregnancy?
• Do you have any medical conditions, or a history of significant medical illness? (these can influence the choice of malaria tablets we recommend)

Please fill out our Travel Risk Assessment Form before your appointment.

It would help us greatly if you had some awareness of the travel problems that you may be at risk from on your trip before you come for your appointment.

Useful links

• Fit for Travel
• NaTHNaC

We offer a range of clinics and services here at St James Practice to help with cancer screening.

Bowel Cancer

Bowel cancer is a term used to describe cancer in the colon, rectum or the small bowel.

The symptoms of bowel cancer can include:

• Bleeding from the back passage (rectum) or blood in your stools
• A change in normal bowel habits to diarrhoea or looser stools, lasting longer than 4 to 6 weeks
• A lump that your doctor can feel in your back passage or abdomen (more commonly on the right side)
• A feeling of needing to strain in your back passage (as if you needed to pass a bowel motion)
• Losing weight
• Pain in your abdomen or back passage
• A lower than normal level of red blood cells (anaemia)

Because bowel tumours can bleed, cancer of the bowel often causes a shortage of red blood cells. This is called anaemia and may cause tiredness and sometimes breathlessness.

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Bowel cancer screening

How do I get a screening kit?

If you are aged 60-69 years, you will be sent your screening invitation automatically through the post. All you need to do is make sure that your GP has your correct address.

‘People aged 70 years and over or under the age of 60, who wish to be screened, should request a kit. Simply telephone the free helpline on 0800 707 60 60.’

Macmillan Cancer Support

Have questions about cancer? Visit www.macmillan.org.uk or call 0808 808 000 free (Monday to Friday 9am – 8pm).

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Breast Screening

The National Breast Screening Programme was introduced in 1988 as an early detection service for breast cancer. It states that all women who are aged between 50 – 70 years of age will be routinely invited for free breast screening every three years. The programme is very successful and currently saves around 1,400 lives per year.

Breast screening aims to find breast cancer at an early stage, often before there are any symptoms. To do this, an x-ray is taken of each breast (mammogram). Early detection may often mean simpler and more successful treatment. When women are invited for their mammogram depends on which GP they are registered with, not when their birthday is.

The screening office runs a rolling programme which invites women by area. The requirement is that all women will receive their first invitation before their 53rd birthday, but ideally when they are 50.  If you are under 50 and concerned about any aspect of breast care, please contact the surgery to make an appointment with your GP.

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Cervical screening test

Cervical screening, or smear test, is a method of detecting abnormal (pre-cancerous) cells in the cervix in order to prevent cervical cancer. The cervix is the entrance to the womb from the vagina. Cervical screening is recommended every three years for women aged 25 to 49 and every five years for women aged 50 to 64 or more frequently if smear results indicates abnormal changes.

Cervical screening is not a test for cancer; it is a test to check the health of the cells of the cervix. Most women’s test results show that everything is normal, but for 1 in 20 women the test will show some abnormal changes in the cells of the cervix.

Most of these changes will not lead to cervical cancer and the cells may go back to normal on their own. However, in some cases, the abnormal cells need to be treated to prevent them becoming cancerous.

Our nurses are qualified to carry out cervical screening and tests in the form of cervical smears. In order to have a cervical smear the patient must have received a letter requesting that they have a cervical smear and the appointment must please be made for when the patient is not menstruating.

These appointments typically take around 15 minutes. For any further information or to book an appointment, please call the surgery.

Useful links

• NHS Choices – Cervical Screening

If you would like to book one of these clinics, please book your appointment online, or contact us on 0208 650 0568.

Clinics/Services
New Patient Check
Health Promotion
Child Immunisations
Vaccinations
Diabetes Management
Ear Syringing
Asthma Check
Cervical Smears
Weight Management
Influenza Vaccination
Over 75 Checks
Coronary Heart Disease Check
Pill Check
Travel Immunisations
Blood Pressure Check
Family Planning Advice
Stop Smoking Advice
Cholesterol Check
HRT Check
Antenatal Clinic
Maternity Care
Minor Surgery
Child Health Surveillance

We offer a range of clinics and services here at St James’ Practice, ranging from long term conditions and health care clinics, to vaccinations and doctor’s sick notes. We have an integrated well established team offering a multitude of services particularly during the current pandemic.

We would also like to support the mental health of our community during the pandemic and have GPs with special interests in that field. This has become a growing problem in society today and more so during Covid.

The UK’s leading digital mental health platform, Kooth has developed an online tool for UK university students seeking mental health support for themselves or friends. By clicking on https://explore.kooth.com/uni and searching for their university or home postcode, students can discover if Kooth or other online NHS-commissioned mental health services are available, and easily accessible to them while they are at university or at home.

It is an online Tool supported by UCAS and Universities UK signposts students to free and confidential support, 24/7, 365 days a year. Kooth is a free, anonymous digital mental health platform commissioned across 90 per cent of NHS England. In south east London, students have immediate access to its mental health services and support – 24/7, 365 days a year – by simply using a computer, smartphone or tablet. What’s more, there’s no need for a referral or any waiting lists – which helps students to access the support and guidance, whenever and however they need it.