Litchdon Patient Participation Group, Barnstaple Devon

NHS Information

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Cheaper Prescriptions

Get a prescription prepayment certificate. You can buy prescription prepayment certificates (PPCs) from the NHS which may make your prescriptions cheaper. You can only get a PPC if you live in England. A 3 or 12 month PPC covers all your prescriptions for that period, no matter how many you need. A prescription costs £8.40 per item, but a PPC costs: £29.10 for 3 months £104 for 12 months. This means if you're going to buy 4 or more prescriptions in 3 months, or 14 or more prescriptions in 12 months, it may be cheaper to buy a PPC. You can pay in 10 monthly installments if you buy a 12 month PPC. How to buy You can buy PPCs online or call the order line and pay by debit or credit card. PPC order line Telephone: 0300 330 1341.

Some advice on Antibiotics

Winter is here which means many of us will be asking the doctor for something to at least soothe the symptoms if not cure common coughs and colds as well as some other ailments. But antibiotics aren't always the answer, in fact, truth to tell, they are increasingly less the answer as bacterial resistance to them is on an irrepressible rise.

Litchdon PPG thinks it might be helpful to give patients some information on antibiotics and explain why our GPs might not always be willing to prescribe them. Not just for coughs and colds but for some other conditions as well.

You can check out all the information given here on various websites, including the NICE guidelines: here is a link: http://www.nice.org.uk/guidance/cg69 but we hope the summary below will be helpful.

Our knowledge of bacteria goes back many centuries but the watershed moment in our treatment of the infections caused by them came in the 1920s when Alexander Fleming discovered penicillin. Since then medical history has been transformed and the use of antibiotics has brought the cure of many hitherto lethal infections.

Nevertheless, there is a downside to the use of antibiotics and that is that resistance to them by the bacteria they are set to kill can develop, rendering them useless. This resistance can develop pretty fast or much more slowly, depending on how freely they are used. The medical research profession has been aware of this for many decades and for many years new strains of antibiotics could be developed but over the last ten years or so, as antibiotic use has become ever more intense and widespread, we have had increasingly worried reports that antibiotics are becoming less and less viable and our world is under threat of major bacterial infections that could cause huge pandemics.

The good news is that there is a way of slowing down this resistance and thereby buying time to develop new strains, but this can only be done if we are very careful in our use of the strains we currently have. Many patients will turn up at the surgery thinking that a cough or cold or possibly some other complaint they have, can be cured more or less straight away by a course of antibiotics. This is not only a fallacy, it has also contributed fairly extensively to the situation of an antibiotics shortage in which we now find ourselves. Many respiratory tract infections, aka coughs and colds, are not caused by bacteria at all: they are viral infections and antibiotics are useless in the face of viruses, although taking them can add to the overall lowering of their effectiveness.

This is why GPs have been cutting back on prescribing antibiotics. It is for our good, not because they are trying to save money, although that is another aspect of this strategy. Other courses of treatment, such as steaming menthol crystals or saline sprays for nasal infections, or warm water, lemon and honey for a sore throat can in most cases be more effective. However, if your doctor does prescribe antibiotics be sure to take the course exactly as instructed - complete the course, don't stop taking them simply because you feel better and observe all the other guidelines. By all means ask your GP for antibiotics if that is what you think you need, but don't be surprised or upset if they don't think it's a good idea.

Devon CCG (clinical commisioning group)

Devon CCG like most other CCGs country wide are in Debt. This means they are having to tighten the belt on various areas of work. As GPs we have to be mindful of this and try to reduce inappropriate admissions or referrals to secondary care.

This is currently being carried out with admission avoidance work within the practice and also across the country. This involves a detailed review of our most vulnerable patients who are most likely to be admitted. We aim to work out specific management plans to help hit illnesses or conditions that are likely to cause admission early and hopefully avoid admission. In addition we review our referrals regularly and try to see if a more appropriate non hospital based treatment or management plan could have been initiated. The education as a result of this helps to give the patient better care and reduce secondary care referrals, the latter which tends to lead to a number of additional investigations which often are not required but cause additional cost.

In terms of care, the CCG are having to look at prioritising work and appropriately reducing co morbidities (obesity, smoking, high blood pressure etc) for patients prior to surgical procedures, therefore reducing risk of inoperative and post operative complications. For example wound healing, DVT, chest infections, wound infection these both extend hospital stay and cause re admissions and therefore extra costs for the CCG.

We hope this is helpful, we do not believe any of this work will compromise patient care and GPs will continue to refer with regard to risk in the same manner.

Flu

How can flu affect you?

Flu occurs every year, usually in winter, which is why it's sometimes called seasonal flu. It's highly infectious, with symptoms that come on very quickly. A bad bout of flu is much worse than a heavy cold.

The most common symptoms of flu are fever, chills, headache, aches and pains in the joints and muscles, and extreme tiredness. The symptoms are usually quite mild, but can be very serious. Healthy people usually recover in two to seven days, but the disease can lead to hospitalisation, disability or even death. As well as making you more vulnerable to flu, your existing condition can be made worse if you do get flu.

What causes flu?

Flu is caused by viruses that infect the windpipe and lungs. And because it's caused by viruses and not bacteria, antibiotics won't treat it.

How do you catch flu? Can you avoid it?

When an infected person coughs or sneezes, they spread the virus in tiny droplets. These can then be breathed in by other people or picked up by touching surfaces. You can prevent the spread of the virus by covering your mouth and nose when you cough or sneeze, and you can wash your hands frequently to reduce the risk of picking up the virus.

But the best way to avoid catching and spreading flu is by having the vaccination before the flu season starts.

Who should have a flu vaccination?

Free vaccination is available to everyone over the age of 65 and to people of any age who have certain existing medical conditions, because they are particularly vulnerable to flu. More specifically, you should come for vaccination if you have:

- a heart problem
- a chest complaint or breathing difficulties, including severe asthma, chronic bronchitis or emphysema
- kidney or liver disease
- lowered immunity due to disease or treatment (such as steroid medication or cancer treatment)
- had a stroke or a transient ischaemic attack (TIA)
- diabetes
- a neurological condition, such as multiple sclerosis (MS), cerebral palsy or Parkinson's
- a problem with your spleen, such as sickle cell disease, or you have had your spleen removed
- a learning disability

If you are unsure whether you should have the vaccination because of your medical condition, please ask.

What about children and young people?

If you have children who are are over six months of age and have any of the conditions set out above, please bring them to the surgery for vaccination. The vaccine can be given at the same time as all routine childhood vaccines.

Is there anyone who shouldn't have the vaccination?

Almost everybody can have the vaccine, but you should not be vaccinated if you have had a serious allergy to the vaccine, or any of its ingredients, in the past. If you are allergic to hen's eggs or have a condition that weakens your immune system, you may not be able to have certain types of flu vaccine - check with us first. If you have a fever, the vaccination may be delayed until you are better.

How does the vaccine work and will I get any side-effects?

The vaccine works by stimulating your immune system, so it can recognise and fight off the flu virus if you come into contact with it later. When the vaccine is well-matched to virus strains, around three-quarters of those vaccinated are likely to be protected. The rest may have some protection that reduces the severity of symptoms.

There are some fairly common but mild side-effects. Your arm may feel a bit sore where you were injected, and some people get a slight temperature and aching muscles for a couple of days afterwards. The vaccine doesn't give you even a mild dose of flu, as it doesn't contain the active virus. Any other reactions are very rare.

You should have it even if you have already had flu or had the vaccination last year, as there are different types of the virus.

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