28 Beaumont Street 28 Beaumont Street Oxford, OX1 2NP Surgery 01865 311 811 Website www.28beaumontstreet.co.uk When the surgery is closed call 0845 345 8995 The friendly Oxford surgery – Quality with Kindness Welcome to 28 Beaumont Street, a practice that offers a full range of medical services to residents and students in and around Oxford. We are a small practice in the centre of the town. Our small size means you can expect a personal service, with appointments at the times which suit you, and with the clinical staff of your choice. We are ideally situated for people who live or work in the centre of Oxford, but welcome residents and visitors based in any part of Oxford. As a practice we have scored very well on the Quality and Outcomes Framework, the national programme for resourcing and rewarding good medical practice. Find out more here (www.qof.ic.nhs.uk/index.asp) . Opening Hours Find out when our practice is open, what the GP consulting times are and what to do if you need help when the practice is closed.Find out more Repeat Prescriptions Do you need to re-order your medication? Visit our prescriptions page and complete the online form.Find out more Like To Register? New to the area and would like to join our practice? We would be happy to help you. Fill in our registration forms and come see us.Find out more Dealing With Emergencies For information about emergencies please see our Emergencies Section Opening Times The times when the reception and telephone lines are open are as follows: Monday 08:00 - 18:30 Tuesday 08:00 - 18:30 Wednesday 08:00 - 18:30 Thursday 08:00 - 18:30 Friday 08:00 - 18:30 Weekend closed Clinic Times Our doctors and nurses clinics generally run from 9.00 to 12.00am in the mornings and from 2.00 to 5.30pm in the afternoons. The doctors make most of their telephone calls after the morning clinics and routine home visits are scheduled between 12.30pm and 3.00pm. In addition we offer the following clinics which are extensions to these times: Tuesday Evening Surgery 18:30 - 20:00 Wednesday Morning Surgery 07:00 - 08:00 Wednesday Phlebotomy (blood tests) 07:00 - 08:00 When We Are Closed If you telephone the surgery outside of opening hours you will be redirected to the OXEMS outof-hours service provider which is situated in East Oxford. You must always telephone first to arrange an appointment with the out-of hours service. The number to call directly is 0845 345 8995. The nearest emergency department is at the John Radcliffe Hospital in Headington, Oxford. Injuries such as bumps to the head, sprains, broken bones, minor burns, cuts, bites and stings can all be dealt with at the Minor Injury Unit at Abingdon Hospital, Marcham Road, Abingdon (10:00 - 22:30 daily). A summary of PCT minor injury services can be found here (www.oxfordshirepct.nhs.uk/local-services/minor-injuries-units-and-first-aid-units.aspx) If you do choose to go directly to the A&E department or to the Minor Injury Service you may need to prepare for a long wait as there is no appointment system. NHS Direct In the case of urgent need when the practice is closed you can call NHS Direct (www.nhsdirect.nhs.uk/) (0845 4647) to speak to a triage nurse. Your needs will be assessed and advice offered or arrangements made for you to see a doctor. Please do not ask to see a doctor out of hours unless you genuinely cannot wait until the surgery re-opens. Dealing With An Emergency (www.nhsdirect.nhs.uk/) Call 999 in an emergency. Chest pains, increasing difficulty in breathing, impaired consciousness and any of the signs of a stroke (facial weakness, inability to lift a limb or slurred speech) constitute an emergency. In a less urgent situation, consider seeking advice from a GP first Remember that in the daytime you can be seen by a GP at the practice at 28 Beaumont Street on the same day if there is a pressing but less urgent situation. If not in working hours then you can call the OXEMS out of hours GP service (see above) to arrange an urgent GP consultation or home visit. If you do then need secondary medical care (ie at the hospital) a GP visit in the first instance might enable you to be directed to the right specialist more efficiently than if you were to go first to the A&E department. Appointments We aim to offer all our patients access to a doctor or nurse within 48 hours but can offer sooner appointments if the problem is urgent. A standard appointment with a doctor is allocated 10 minutes. If you feel you need longer than this, then we do encourage you to request a “double appointment”. This helps the doctor’s appointment schedule to run on time. Standard nurse appointments are allocated between 10-30 minutes depending upon the nature of the problem Telephone Advice You can talk to one of the doctors or practice nurses during the day by telephoning the surgery before 12:30. Your call will then be returned after morning surgery. If you phone after this time your call will be returned by the duty doctor. When you request a telephone consultation, you will be given an approximate time to expect your call from the doctor or nurse. The doctor or nurse will attempt calling the number you leave twice, and if they fail to get through, you will be expected to call again to rearrange the appointment. When you arrange a telephone consultation please let the receptionist know if you do not want a message left on the number you leave. In summary the types of appointment available include: Same day telephone consultations (you are encouraged to call to speak to a doctor or nurse if you problem could easily be rectified over the phone) Advance booking (routine) medical or nurse appointments (single or double) Same-day (urgent) medical or nurse appointments College surgeries (Monday and Thursday lunchtimes at New College and Tuesday lunchtimes at Hertford College) Home visits Minor surgical procedures Tuesday evening surgery (6.30-8.00pm; GP appointments available) Wednesday early morning surgery (7.00am -8.00 am: GP and phlebotomist appointments available) Any appointment can be made by calling the surgery on 01865 311 811 or by booking online. To book online you need first to open an EMIS account, and you can ring the surgery to arrange for this to happen. Should you need to cancel an appointment please let us know as soon as possible. Home Visits Although we prefer patients to come to the surgery to make consultations as efficient as possible for the clinical staff, we do understand that there will be times when you'll be too ill to travel. If possible please try to telephone reception on 01865 311 811 between 08:45 and 10:15 if you require a home visit. Requests for home visits after this time will only be accepted if there is an emergency. You can be visited at home by a district nurse if you are referred by your GP. You will also be visited at home by a health visitor if you have recently had a baby or if you are newly registered with a GP and have a child under five years. Sickness Certificates You do not require a doctor's sickness certificate for any illness lasting seven days or less. Your employer may however require you to complete a self-certification form (SC2) which is available from your employer or on the HMRC website (www.hmrc.gov.uk/forms/sc2.pdf) . Evidence that you are sick If you are sick for more than seven days, your employer can ask you to give them some form of medical evidence to support payment of SSP (statutory sick pay). It is up to your employer to decide whether you are incapable of work. A medical certificate, now called a 'Statement of Fitness for Work’ (see below) from your doctor is strong evidence that you are sick and would normally be accepted, unless there is evidence to prove otherwise. You could also provide evidence from someone who is not a medical practitioner, e.g. a dentist. Your employer will decide whether or not this evidence is acceptable. If your employer has any doubts, they may still ask for a medical certificate from your GP. Statement of Fitness for Work - ’Fit Note' The 'fit note' was introduced on 6 April 2010. With your employer's support, the note will help you return to work sooner by providing more information about the effects of your illness or injury. For more information see the DirectGov website (www.direct.gov.uk/en/MoneyTaxAndBenefits/BenefitsTaxCreditsAndOtherSupport/Illorinjured/ DG_175850) (where this information was sourced) Prescription Medication Your doctor will enable you to obtain a medication by writing you a prescription. This is a form which can be taken or sent to the pharmacy. A prescription permits the pharmacist to issue you with a medication which cannot normally be obtained over the counter, or which would otherwise be expensive for you to buy. Normally your doctor will only issue medications for no more than two months at a time. There are a number of reasons for this, the most important being that over this time scale the taking of the medication can be monitored for correct use. This policy also minimises waste of prescription medications, and having a fixed time scale for prescribing ensures that all patients are treated equally. If your prescription is for a long term medication, then it can be prescribed as a “repeat medication” for a period of up to a year. A repeat medication can be requested from the practice without prior authorization from a doctor. This means a standard repeat prescription will allow the issue of 6 prescriptions before the prescription has to be reauthorized. See our repeat prescriptions page After a year, the reauthorization of a repeat medication will require some form of discussion with your doctor, either face to face or on the telephone. This is to ensure that the medication is still appropriate for your health needs. . NHS Prescriptions Many medications are approved for prescribing on the NHS, in which case the cost to the patient is simply the fixed prescription fee. For patients who are eligible to NHS healthcare, the pharmacist will charge a fixed prescription fee for each separate item on the prescription. This charge is currently £7.40 per item. You may be eligible for free prescriptions. You are eligible for free prescriptions if, at the time the prescription is dispensed, you: are 60 or over are under 16 are 16-18 and in full-time education are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx) have a specified medical condition and have a valid medical exemption certificate (MedEx) have a continuing physical disability that prevents you from going out without help from another person and have a valid MedEx hold a valid war pension exemption certificate and the prescription is for your accepted disability are an NHS inpatient You are also entitled to free prescriptions if you or your partner (including civil partners) are named on, or are entitled to, an NHS tax credit exemption certificate or a valid HC2 certificate or you receive either: Income Support Income-based Jobseeker’s Allowance Income-related Employment and Support Allowance, or Pension Credit Guarantee Credit If you have to pay for more than 4 prescription charges a month, then it may be worth discussing obtaining a prepayment certificate (PPC) from your pharmacist, so that you pay no more than a maximum of £29.10 a month If you will have to pay for four or more prescription items in three months, or more than 14 items in 12 months, you may find it cheaper to buy a PPC. Telephone advice and order line 0845 850 0030 General Public - Buy or Renew a PPC On-line There is further information about prescription exemptions and fees on the NHS website (www.nhs.uk/NHSEngland/Healthcosts/Pages/Prescriptioncosts.aspx) Private Prescriptions Not all medications can be prescribed on the NHS. However, most cost-effective medications can be found in the NHS Drug Tariff, and so will be made available to you on NHS prescription if your doctor feels there is a clinical need. However, there will be situations when a doctor makes a decision that a medication on the NHS tariff is not a clinically appropriate choice for a patient. This will always be a clinical decision (ie a decision which made in the best interests of patients) and may be informed by national or local (Oxfordshire Area Prescribing Committee) policy. The doctor who makes this decision should be able to give you a clear explanation for why they have decided that a certain medication which you might have requested cannot be prescribed on the NHS. There may be a situation in which a patient requests a medication which the doctor decides is not clinically necessary, or one which is not on the NHS Drug Tariff. In this case, as long as it is safe to do so, the medication can be prescribed by the doctor using a private prescription. With a private prescription, the patient will be expected to fund the cost price of the medication. If a private prescription is issued by your doctor, the cost of the medication will be charged by the pharmacist, not the doctor. Medications for use abroad or for preparing for overseas trips (travel medications) are also not funded by the NHS. However, in the case of travel medications you will also be charged an additional fee of £15 by your doctor for the issuing of a private prescription. Repeat prescriptions Order Your Repeat Prescription Online There are a number of ways to request a repeat prescription. This ideally makes it as easy as possible for you to get your necessary medication without needing to see a doctor every time. Email Email your request to sichelandpartners@nhs.net including your name, address, date of birth, contact number, and name, quantity and dose of each drug. Website Fill in the prescription request form to be found on this website (link) In Writing Post your request to 28 Beaumont Street, Oxford, OX1 2NP, including a stamped addressed envelope if you want your prescription returned to you. If you don’t include an SAE, your prescription will be ready for collection directly from the practice within 48hours of the request. Remember to include your name, address, date of birth, contact number, and name, quantity and dose of each drug on your prescription request. At The Practice The right-hand (white) part of your prescription lists your details and your regular medication simply tick which medications you require and drop it into the box on the reception desk. Telephone You can request your medication over the telephone. Please have your repeat prescription request to hand as you may be asked to spell the names of your medication to ensure we write down the correct information. For non-urgent requests we would be grateful if you called to arrange repeat prescriptions after 11.00am. Collecting Your Prescriptions You can choose to collect your prescription from the practice, have it returned to you in a stamped addressed envelope (SAE). Alternatively, if you use one of the pharmacies which are close to the practice, we will fax the prescription directly to them. The pharmacies from which you to can arrange with us to pick up prescriptions directly include: Boots, Cornmarket Street Boswells, Cornmarket Street Jenners, Manzil Way, Cowley Road Lloyds, Botley Road Lloyds, Walton Street Rowlands, 227 Banbury Road Rowlands, Prama House, Summertown Woodlands, Botley Road Woodstock Road Chemist, 59 Woodstock Road If you are on a regular repeat prescription, then some pharmacies will co-ordinate the ordering of the repeat medication when it is due, but for this to be enabled you will have to set this up with the pharmacist. Please allow 48 hours, excluding weekends and Bank Holidays, for your request to be processed. Any problems please telephone the surgery. Our Clinics & Services Our Clinics & Services As well as providing a general practice service 28 Beaumont Street offers a range of extra clinical skills. Some of these are offered by non-NHS practitioners and in these cases a fee will be charged. Our specialist services include: Diabetic services Asthma clinic Minor Surgery Travel advice Child health clinic Stop smoking advice Contraception and sexual health advice Sports medicine Medical acupuncture Physiotherapy (non-NHS) Psychological services (NHS counsellor) Psychotherapy (non-NHS) Homeopathy (non-NHS) Alexander technique (non-NHS) Osteopathy (non-NHS) NHS Clinics and Services NHS Clinics and Services Child Health Clinic Our child health clinic runs on Wednesday afternoons. At this time you will be able to talk to the health visitor, meet the practice nurse for immunisations, and also consult with one of the GPs. It is an ideal time to come to the practice when you have a baby, as you will have a good chance of meeting other parents with small children. If the time is not convenient for you then you are welcome to bring your baby along to the surgery to any of our general clinics for advice or vaccination, and you can contact the Health Visitor on 01865 552391. Find out more on our Children's Health Page Detailed vaccination information is available on our Vaccinations Page Diabetes2gether (www.oxfordshirepct.nhs.uk/your-health/Long-term%20conditions/Diabetes2gether.aspx) (dietary advice) and Oxford Diabetic Eye Screening Services (www.oxfordradcliffe.nhs.uk/eyehospital/ODESS/odess.aspx) (ODESS). See also our Diabetes Advice Asthma clinic A range of services for our patients with asthma and COPD Our GPs and practice nurses offer asthma and chronic obstructive pulmonary disease (COPD) annual reviews, which include peak flow monitoring, spirometry, inhaler technique and medication reviews. Please specify that you require an asthma or COPD review when you book your appointment, and you will be referred to the specialist clinic. For more information on Asthma and COPD see the advice to be found here British Acupuncture Council website (www.acupuncture.org.uk) . For more information on medical acupuncture see the British Medical Acupuncture Website (www.medicalacupuncture.co.uk) . website (www.principal-medical.co.uk/our-services.html#psycho) University Counselling services for students. Visit their website (www.ox.ac.uk/students/shw/counselling/) Referral to the NHS counselling service 'Talking Space' for a range of services including problem-solving, Cognitive Behavioural Therapy (CBT) in individual or group, CBT-based guided self-help. More information here (www.oxfordshire-mind.org.uk/help/talkingspace) Referral to our NHS Psychiatry team at the Warneford Hospital. More information here (www.oxfordhealth.nhs.uk/?directory=oxford-city-central-adult-community-mental-health-team) Private Clinics & Services Private clinics and services We have a number of private therapists who work from 28 Beaumont Street, and their details are listed below. If you are interested in any of these therapies please contact the individual practitioner to arrange an introductory consultation. Alexander Technique The Oxford Alexander Training School run by Stephen Cooper is based at the practice. Stephen offers Alexander sessions for clients as well as training courses for students in Alexander Technique at the practice. More info can be found on the OATS website (home.btconnect.com/sc1/OATS.html) Homeopathy Dr Diana Ferguson MA MB BChir MRCGP DCH DRCOG MF Hom Dr Diana Ferguson is both a qualified GP and Homeopath (she has BUPA accreditation for this therapy) She has worked for many years as a GP in Beaumont Street and has much experience in providing homeopathy to patients in an NHS setting. At present Dr Ferguson offers a private homeopathy service which is separate from the NHS surgeries of the practice. Her consultations last a minimum of one hour. Contact: 01865 311811 Email: sichelandpartners@nhs.net Osteopathy Monica Franke and Ben Ousey The scope of osteopathic treatment includes back and neck pain, as well as knee, ankle, shoulder and other joint problems. Monica and Ben are passionate about the structure and workings of the body and aim to give you an understanding of the particular way in which your body functions, and how to optimise your health. Treatment lasts for 45 minutes and will usually include some joint movement and muscle massage, amongst other treatment techniques. Monica began practising in 2004. She works with people of all age groups, capabilities and ambitions, and her focus is on how best to aid the physical being to meet our everyday tasks and our greatest challenges. She enjoys showing how and why osteopathy & Pilates can help to resolve musculoskeletal aches and injuries and improve performance. This is achieved through establishing the source of dysfunction and why problems have arisen, followed by appropriate treatment and guided exercise coaching, when suitable. Monica is also qualified in dry needling and on occasion uses acupuncture to assist with treatment and healing. Monica has worked in university, national, and international level sport for five years, and has spent a period of four years as a senior lecturer and clinic tutor on Oxford Brookes Osteopathy Program. Ben graduated with a BSC Hons in Osteopathy from Oxford-Brookes University in 2010. He is registered with the General Osteopathic Council and is a member of the British Osteopathic Association. Ben applies a structural approach and incorporates a variety of osteopathic techniques in order to reduce pain and improve mobility. He is particularly interested in the treatment of sporting injuries and in the potential for osteopathic therapy to enhance sporting performance. Telephone: Monica – 07970119721 ; Ben - 07896542463 Email: mfranke.osteo@googlemail.com ; or b_ousey@hotmail.com Website: http://www.monicafranke.com/ (www.monicafranke.com/) Blog: www.frankeosteopathy.tumblr.com (Newly under construction) Physiotherapy Anna Reid Anna is a Chartered Physiotherapist specialising in sports and musculoskeletal injuries. She qualified with a BSc in Physiotherapy at the University of Birmingham in 2002, and gained a distinction in an MSc in Sports Physiotherapy at University College London in 2007, also gaining MACP membership. She has worked in the Oxford Radcliffe Hospitals, the Manor Hospital Oxford, and privately with British Rowing among other sports. She is a member of the Physiotherapy Board of New Zealand, having spent a year working in Wellington. Anna has a strong bias for rehabilitation and prevention of recurrence of injury as well as practising manual therapy, pilates and acupuncture. She is a Member of the Manipulation Association of Chartered Physiotherapists (MACP), the Acupuncture Association of Chartered Physiotherapists (AACP), and is a fully certified pilates instructor under the Australian Physiotherapy and Pilates Institute (APPI). Anna is also a keen rower. In 2009 she won gold in coxed fours at the National Championships of Great Britain, gold in coxless fours at Ghent International Regatta, and was placed 5th woman overall at the Sculler's Head of the River race. In 2011 she got to the final at Henley Women's Regatta in senior single sculls, represented England at the Home International Regatta, winning gold in both the women's single scull and women's eight, and won the women's senior pennant at the Sculler's Head of the River Race. To book an appointment, please contact Anna directly: Phone 07824 337826 Email anna@annareidphysio.co.uk Website http://www.annareidphysio.co.uk (www.annareidphysio.co.uk) This service is offered to patients outside our NHS commitment thus a fee is payable. Psychotherapy The practice currently has two psychotherapists based in the building. Penny Hill Penny Hill is a registered UKCP analytic Psychotherapist and Counsellor with over 20 years experience working with many different people from all walks of life. She has been in private practice in Oxford for many years seeing people for both long term psychotherapy and short term focused therapy. She also works for several statutory and voluntary organisations offering work place counselling. A person may not quite know what is wrong or what is causing them distress and unhappiness, but there can be a feeling that they have lost their way and can't get back to a sense of who they are. Talking with a therapist at this point in their life maybe extremely valuable. Penny works with a wide range of problems such as Anxiety and depression Relationship problems Marital counselling Life crisis and transitions Eating disorders Low self esteem Loss and bereavement. Email: penny_Oxford@hotmail.com Mobile: 07879626037 Website: http://www.pennyhill-therapy.co.uk/contact/ (www.pennyhill-therapy.co.uk/contact/) Kay Lynn Kay Lynn has an MA in Gestalt Psychotherapy and is UKCP registered. She retired as a Director and Tutor at the Gestalt Centre, London in July 2009. Kay holds an MA and MPhil in Contemporary Dance and is trained in Authentic Movement. She integrates her arts background with her therapeutic approach, supporting creativity through bodywork and the arts. Her other area of interest is in working with difference and identity. She works with individuals, groups and offers supervision. Tel: 01491 651628 Email: kaylynn@freedom255.com Other complementary therapies We are very supportive of the use of complementary therapies in the practice. Dr Clare Stephenson has experience of working as an acupuncturist in a local multi-therapy clinic, and was also co-founder and Chair of the Oxford Acupuncture in Childbirth Team (www.actoxford.org.uk/) . She has had first-hand experience of witnessing patients experiencing good results from diverse therapies in a complementary therapy setting. Dr Stephenson is in the process of building up an informal register of experienced local private therapists who have qualifications from reputable professional bodies and who also have been recommended by patients. If you would like to discuss whether a complementary therapy might have anything to offer you, but do not know how to choose a therapist appropriate to your condition, then please feel free to discuss this with Dr Stephenson as part of a normal medical consultation. Private fees Private fees Schedule of Private Fees (updated January 2012) Except in the case of a genuine emergency. private charges apply to all non-NHS patients and also to a range of more administrative tasks which a doctor’s surgery may be requested to perform: Find out more link to BMA fact sheet (www.bma.org.uk/patients_public/whygpchargefees.jsp) Medical services Private doctor’s Consultation £60.00 Private nurse Consultation £40.00 Electrocardiogram with printout of result £37.00 Taking of blood test and printout of result (does not include £21.00 cost of analysis: see below) Analysis of pathology samples and blood tests: prices vary according to test (these are sent to John Radcliffe Hospital and prices will be derived from the current hospital tariff for pathology samples) variable Meningitis vaccination (single shot) £25.00 Rabies vaccination (course of three shots) £60.00 Hepatitis B vaccination for travel (course of three shots) £60.00 (no charge for health workers) Hepatitis B booster for travel (single shot) (no charge for health workers) £20.00 Yellow Fever vaccination Only available at 19 Beaumont Street practice (01865 240501) Japanese encephalitis vaccination Only available at the Manor Hospital, Headington (01865 307777) Certificates Fitness to Travel, Driving Licence and Passport Form £20.00 (N.B. for passport form the doctor needs to have known £20.00 the patient for over 2 years.) Holiday Cancellation Letter £20.00 Short Letter / Form filling /certificate £15-£25 Character reference (eg for shotgun licence or job) £30.00 More complicated certificate up to £55.00 Full Medical examination and report[1] £150.00 Medical report – no examination (30minutes) [2] £100.00 Medical report on proforma (20 minutes) [3] £70.00 Access to computerised records under Data Protection Act £10.00 Access to paper records under Data Protection Act £50.00 Extract from records £50.00 or 30p/sheet PSV/LGV medical and report (paid for by individual) for DVLA £63.00 PSV/LGV medical and report (paid for by local authority) £100.00 Other medical certification for fitness to drive up to £80.00 GP Factual Report for attendance allowance £33.50 (Paid by dept. for work and pensions) GP Factual Report for DS1500 form £17.00 (Paid by dept. for work and pensions) GP Factual Report for Blue Badge Scheme £25.00 (Paid by local authority) Pre-Employment Consultation £50.00 Private prescription fee (for travel medications only) (n.b. the patient will also have to pay the pharmacist for the cost price of the medication) £15.00 Vaccination Certificate £20.00 [1] NB reduced fees will be offered to NHS and local authority employees [2] NB reduced fees will be offered to NHS and local authority employees [3] NB reduced fees will be offered to NHS and local authority employees Registration New Patient Registration NHS Patients Whether or not you are entitled to NHS care depends on if you are ordinarily resident in the UK. This definition depends partly upon whether or not you are a student. The UK Department of Health has defined ordinary residency as “ living lawfully in the United Kingdom voluntarily and for settled purposes as part of the regular order of life for the time being, with an identifiable purpose for residence here which has a sufficient degree of continuity to be properly described as settled”. In the case of most students, the course of study has to last for over six months for the definition of residency to apply. In all other cases the intention to settle in the UK can be demonstrated by evidence of rental agreements, employment contracts or utility bills. Find out more link to DoH website (www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/Browsable/DH_074373) You are not necessarily entitled to NHS care simply because you are of British nationality. British nationals also have to demonstrate residency before they can be entitled to NHS care. If you are resident in the UK according to the definition above, are planning to stay for three months, and wish to register with us, simply call into the surgery during opening hours to pick up an NHS registration form and confidential health questionnaire. You will need to demonstrate some form of evidence of residency (e.g. evidence of rental agreements, employment contracts or utility bills) as well as proof of identity (eg passport or photocard driving licence) to be able to register. For all patients who are registering and who have previously been registered at another GP practice in the UK, the process of registration triggers the transfer of your medical records from your old to new practice. This process can take some weeks, and so it may be helpful for you to bring a medical summary with you from your old practice (including copies of hospital letters) if you have a significant medical history. This means that the medical staff can have this essential information to hand when they first meet you. Once you have had a health check with one of our nurses/healthcare assistants, we can give you the details necessary to use our online facilities (EMIS Access). Newly registered patients who require a repeat prescription will need to meet with a doctor to arrange for a repeat prescription to be set up. Please speak to a receptionist or call 01865 311811 to book an appointment. Temporary residents If you are entitled to NHS care, but are visiting Oxford for less than 3 months, you can register at 28 Beaumont Street as a temporary resident. Find out more: Link to Temporary registration page Non-NHS Patients Not all people are entitled to NHS health care. The NHS will provide care for 14 days for all people irrespective of residency in the case of a situation in which care is absolutely necessary for a newly arising serious condition (“immediately necessary care”). However, for all forms of routine medical care for ongoing conditions or newly arising minor conditions, only residents and members of the European Union (and Switzerland, Norway, Iceland and Liechtenstein) are eligible. To prove eligibility in this situation you will be required to produce an EHIC card. A passport will not prove residency, and so is not acceptable in this situation. Some countries have partial reciprocal agreements with the UK which mean that immediately necessary primary and secondary care is funded, but routine primary and secondary care is not. If you are a visitor to England, it is worth clarifying whether or not you are eligible to either full or partial NHS care. If you find you are not eligible, you are strongly encouraged to take out medical insurance so that you can claim retrospectively for any medical care you may have to access when in the UK. If you do not qualify for NHS care you are welcomed at 28 Beaumont Street to receive private medical care. This would mean that you would be required to pay for individual medical and nursing consultations. There would be separate fees for any investigations such as blood tests or Xrays which may be required. All medications you are prescribed can be purchased at cost price from local pharmacies. See our fees information If necessary, your GP can refer you to locally respected hospital consultant doctors for specialist advice and management of your condition. You will be provided on the day of the consultation with a printed summary of your medical consultation for your personal records, and this will also enable you to make an insurance claim. The registration process for private patients is free of charge. Please contact us to arrange registration or for more information. Oxford University Students All new Hertford College and New College students are registered at the start of the Michaelmas term. If you missed the registration for any reason please contact us as soon as possible to arrange an appointment. Once you register with us your medical records will transferred to 28 Beaumont Street for the duration of your studies. You do not have to register with us, but if you do not, there will not be access to your medical records should you need to consult a doctor in Oxford. Also, if you remain registered at your home address, then your home health authority may not agree to funding of NHS hospital care in Oxfordshire, should you need it. If you choose not to register with us or transfer to another practice please make sure to inform your college of this choice in case of emergencies. The Royal College of General Practitioners has produced a useful guide for patients about the services on offer at GP Surgeries and how to access them. You can download the guide below. A Patient Guide to GP Services (www.rcgp.org.uk/pdf/rcgp_iyp_full_booklet_web_version.pdf) Registration Form Temporary Registration Temporary Registration If you are entitled to NHS care, but are visiting Oxford for less than 3 months, you should register at 28 Beaumont Street as a temporary resident. Temporary registration means that you will stay registered with your doctor at home, and your medical notes will remain in your home practice. If you are taken seriously ill while away from home or if you are not already registered with a doctor, you can receive emergency (“immediately necessary”) treatment from the local GP practice for 14 days. After 14 days you will need to register as a temporary or permanent patient. You can be registered as a temporary patient for up to three months. However, you cannot register as a temporary patient at a practice in the town or area where you are already registered. Once you are registered as a temporary resident, you can be on the local practice register for up to three months. After three months you will be asked to register permanently with our practice. This will enable us to obtain access to your old medical records and so enable us to provide you with the best long tem care. This is particularly important if you require referral for hospital treatment. NHS practices are not obliged to accept you as a temporary patient, although they do have an obligation to offer emergency treatment. However, it will be unusual for a request for temporary registration to be turned down at 28 Beaumont Street. If this does occur it will be because we have experienced an unusual demand for registrations which can compromise our ability to offer a good service to our registered patients. Download the Temporary Resident Registration Form Tests and Results Results The nurse, doctor or phlebotomist responsible for taking your tests will tell you, at the time of your consultation, when the results can be expected. Please call reception between 14:00 and 18:00 on the expected date. Note that the practice has a strict policy regarding confidentiality and data protection and we will only release test results to the person to whom they relate unless that person has given prior permission for the release of this data, or to their official carer if the person is not capable of understanding the results. The results will have been checked by one of the doctors before you are told the result. Our policy is that the reception staff can tell you only the information the doctor has summarised over the telephone. If you need to discuss the detail of your results you are encouraged to make an appointment with you doctor. Although we will of course make every effort to contact you if a result shows the possibility of a serious condition, we cannot contact you about every test result. Therefore, we ask that you take the responsibility of calling to check your results and to make an appointment to follow them up with your doctor if you have been advised to do so. Blood Tests A blood test involves drawing a sample of blood 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. The usual place for a sample is the inside of the elbow or the back of the 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. In the case of children may be appropriate for the blood test to be taken in the children’s ward at the John Radcliffe Hospital and this option will be offered to you if your child is advised to have a blood test. You can find out more about blood tests, their purpose and the way they are performed on the NHS Choices website. Find out more here (www.nhs.uk/conditions/blood-tests/Pages/Introduction.aspx) X-Ray An X-ray is a widely used diagnostic test to examine the internal organs of the body. X-rays are an 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. In Oxford there is a walk in service for routine X-rays which have been requested by a GP. This means that once you have been given a referral by your GP you can go to the John Radcliffe hospital at any of the times when the X-ray department is open. The result of the X-ray is usually made available by a computer link to 28 Beaumont Street within the next couple of days. In the case of suspected fractures, then you need to go to the A+E (minor casualty) department in the John Radcliffe Hospital. Your X-ray, if needed, will be arranged in the A+E department. If you see your GP before you go, then you can obtain a GP referral for the required X-ray which may streamline your visit to the hospital. You can find out more about X-ray tests, how they are performed, their function and the risks by visiting the NHS Choices website. Find out more here (www.nhs.uk/conditions/x-ray/Pages/Introduction.aspx) Other investigations Other investigations such as MRI scans, CT scan, ultrasound scans and bone scans will require a medical referral and the arrangement of a hospital appointment. In the NHS there is a lot of pressure on these essential services. Only in the most urgent cases will these tests be possible to arrange within 1-2 weeks. Otherwise, you can expect an appointment for within 4-6 weeks. Teaching and Training At 28 Beaumont Street, we pride ourselves on being a well-established and successful teaching practice. This section contains relevant information for our patients, and for prospective medical students and doctors hoping to train here. Medical Students We welcome medical students on placement from the Oxford University Medical School at the practice. Medical students will spend most of their time observing GPs and other staff as they work. This is an essential aspect of their training. Medical students will never be given the responsibility of making a clinical decision, although may be asked to interview or examine you before your own doctor does. Notices will be posted in reception informing you which doctors may have medical students in their consulting rooms with them. You can simply inform the receptionist if you do not wish a student to be present. There will also be an opportunity to remind your doctor that you have decided not to have a medical student present when your doctor invites you to come into the consulting room. Hospital doctors in training Doctors on the hospital training scheme at the Oxford University Hospitals are encouraged to work from 3-12 months in general practice at different stages in their training, depending on their choice of specialism. The earliest stage at which a doctor may join us is for a 3 month spell in their 2 nd foundation year (F2) of being a junior doctor. At this stage they will be experienced in clinical examination, making diagnoses and prescribing, and will be qualified to see you and advise you without a trained GP in attendance. If they have any concerns they will ask one of the GPs at the practice to give advice, and also all hospital referrals they might wish to make are overseen by one of the GPs. Our F2 doctors bring with them enthusiasm and a wealth of up to date knowledge about the hospital system in which they have been recently working. They are a great asset to the practice. Junior doctors may also join us at a later stage in their training for a whole year as a “GP registrar”. A GP registrar will have completed three years of hospital training in diverse specialties, such as paediatrics, obstetrics and gynaecology, and care of the elderly. GP registrars are committed to the career of general practice. During their year at 28 Beaumont Street, they will be completing a “portfolio” or computerised record of their learning to ensure they have experienced all the important aspects of general practice in this final year of their vocational training. At 28 Beaumont Street we encourage our registrars to work towards seeing patients on their own in surgeries after which they are encouraged to discuss difficult cases and reflect on their learning. As with our F2 doctors we enormously benefit from the willingness to learn, commitment, and breadth of up to date knowledge of our registrars. For information specific to interested registrars: link to Information for Registrars page How this affects our patients When you visit 28 Beaumont Street as a patient you will occasionally be asked if you mind having a medical student see you or be present during your consultation. You may also be offered a medical consultation with one of our qualified F2 or registrar doctors. As is true with our practice doctors and nurses, all medical students and training doctors will hold your confidentiality, consent and privacy in the highest importance. Our training doctors know always to work within the limits of their competence as doctors, and will be prepared to seek advice from a more senior doctor should they have to deal with a situation which is unusual for them. Dr Sri Subramaniam co-ordinates the teaching for undergraduate and post-graduate students and doctors within the practice, and also oversees their clinical practice. He would welcome your comments about your experience of meeting medical students or doctors in training at 28 Beaumont Street. You can contact Dr Subramaniam by making a telephone appointment at the practice or sending an email to the practice email address. Information for Registrars Welcome to 28 Beaumont Street Surgery, Oxford We are a small city practice, located in the centre of Oxford City. We hope to provide a friendly and enthusiastic environment for our GP registrars, who we consider an integral part of the team. Population We have a healthy mix of patients with one third being inner city residents, a third students, and a third being from surrounding areas. Currently our list size is just over 4000, which means we are a relatively small general practice. We look after students from both Hertford and New College, with weekly clinics held at both, and also provide medical cover for a residential home. Location and Premises We are located in the centre of town and metres from landmarks such as the Ashmolean Museum, Oxford Playhouse and the Randolph Hotel. We have a small car park for doctors located behind the surgery. The surgery is spread over four floors, including a ground floor consultation room. The practice is equipped with video recording equipment, and has extra medical equipment such an ECG, pulse oximeter, sonicaid and defibrillator well as equipment for minor surgery. The practice is fully computerised, and uses the EMIS clinical record system. All the computers are networked, and blood and pathology requests are done online using the ICE system. Results and hospital discharge letters are communicated to us electronically which means we are kept up to date with the secondary care of out patients. We use the “Choose and Book” system for arranging outpatient appointments. This offers patients the freedom of calling on the day of their GP consultation to book an appointment at the hospital of their choice. Team We currently have four partners. The patient list is shared, and this means that patients can choose which doctor they would like to see at any time. However, all of the partners have specialist interests, and may see a different spread of problems for this reason. Dr Sri Subramaniam is both the GP Trainer as well as the supervisor for F2 trainees at the practice. Sri was originally trained in radiology, but now has developed interests in psychiatry and student medicine. He also runs minor surgery clinics. Sri also does regular out of hours cover for the local OXEMS cooperative, and there will be appropriate opportunities to do the required on call cover. You can find out more about the practice team on the practice staff pages of the website pages: link to practice staff/doctors When you are based here, you will have your own room to arrange as you want, and hope you will take a full and active role within the practice, working with your own regular patients as you become more established. Your week with be structured so that your Tuesdays are free for the VTS training days. Your working week will involve morning and afternoon surgeries, a fortnightly educational meeting with other doctors, a fortnightly practice management meeting, and occasional staff meetings. You will have one session a week set aside for one to one training, and will be encourage to perform audits during your time with us. Our practice covers a large area, so a car will be necessary on some of the days you will be here for the purposes of home visits. We very much look forward to our registrars joining the team, and encourage you to be involved in the practice as much as possible. Practice Policies Confidentiality & Medical Records The practice complies with data protection and access to medical records legislation. Identifiable information about you will be shared with others in the following circumstances: To provide further medical treatment for you e.g. from district nurses and hospital services. To help you get other services e.g. from the social work department. This requires your consent. When we have a duty to others e.g. in child protection cases Anonymised patient information will also be used at local and national level to help the Health Board and Government plan services e.g. for diabetic care. If you do not wish anonymous information about you to be used in such a way, please let us know. Reception and administration staff require access to your medical records in order to do their jobs. These members of staff are bound by the same rules of confidentiality as the medical staff. Freedom of Information Act Information about the General Practitioners and the practice required for disclosure under this act can be made available to the public. All requests for such information should be made to the practice manager. Find out more here (www.ic.nhs.uk/data-protection/freedom-of-information-foi) Access to Records In accordance with the Data Protection Act 1998 and Access to Health Records Act, patients may request to see their medical records. Such requests should be made through the practice manager and may be subject to an administration charge. No information will be released without the patient consent unless we are legally obliged to do so. Complaints We make every effort to give the best service possible to everyone who attends our practice. However, we are aware that things can go wrong resulting in a patient feeling that they have a genuine cause for complaint. If this is so, we would wish for the matter to be settled as quickly, and as amicably, as possible. To pursue a complaint please contact Jane Belcher, the practice manager who will deal with your concerns appropriately. Violence Policy The NHS operate a zero tolerance policy with regard to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons. Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it. Practice Complaints Procedure 28 Beaumont Street (reviewed January 2012) 1. General provisions The practice will take reasonable steps to ensure that patients are aware of: (a) the complaints procedure; (b) the role of the Primary Care Trust and other bodies in relation to complaints about services under the contract; and (c) their right to assistance with any complaint from independent advocacy services The practice will take reasonable steps to ensure that the complaints procedure is accessible to all patients. 2. Receiving of complaints The practice may receive a complaint made by, or (with his/her consent) on behalf of a patient, or former patient, who is receiving or has received treatment at the practice, or: (a) where the patient is a child: (i) by either parent, or in the absence of both parents, the guardian or other adult who has care of the child, (ii) by a person duly authorised by a local authority to whose care the child has been committed under the provisions of the Children Act 1989; or (iii) by a person duly authorised by a voluntary organisation by which the child is being accommodated (b) where the patient is incapable of making a complaint, by a relative or other adult who has an interest in his/her welfare. Period within which complaints can be made The period for making a complaint is: (a) six months from the date on which the matter which is the subject of the complaint occurred; or (b) six months from the date on which the matter which is the subject of the complaint comes to the complainant's notice provided that the complaint is made no later than 12 months after the date on which the matter which is the subject of the complaint occurred. Complaints handling The practice will nominate: (a) a person (the ‘Complaints Officer’) to be responsible for the operation of the complaints procedure and the investigation of complaints; and (b) a Partner, or other senior person associated with the practice, to be responsible for the effective management of the complaints procedure and for ensuring that action is taken in the light of the outcome of any investigation. The Complaints Officer for 28 Beaumont Street is the practice manager, Jane Belcher. The Partner responsible for the effective management of the complaints procedure is Dr Clare Stephenson Action upon receipt of a complaint Complaints may be received either verbally or in writing and must be forwarded to the Jane Belcher (the Complaints Officer), who must: acknowledge in writing within the period of three working days beginning with the day on which the complaint was made or, where that is not possible, as soon as reasonably practicable ensure the complaint is properly investigated within the period of 10 working days beginning with the day on which the complaint was received by the Complaints Officer where that is not possible, as soon as reasonably practicable, the complainant must be given a written statement of the investigation and its conclusions Confidentiality All complaints must be treated in the strictest confidence Where the investigation of the complaint requires consideration of the patient's medical records, the Complaints Officer must inform the patient or person acting on his/her behalf if the investigation will involve disclosure of information contained in those records to a person other than the practice or an employee of the practice The practice must keep a record of all complaints and copies of all correspondence relating to complaints, but such records must be kept separate from patients' medical records. Statistics and reporting The practice must submit to the Primary Care Trust periodically/at agreed intervals details of the number of complaints received and actioned. Staff Details Doctors Dr John Sichel MB BS FRCP General Practitioner and Senior Partner Dr Diana Ferguson Dr Sichel read Modern Languages at Exeter University and travelled in Europe and the Middle East Trained at the Middlesex Hospital, London, qualifying in 1975 Entered General Practice in Oxford in 1982, following broad training in General Medicine, including Cardiology and Chests at Papworth Hospital and Renal Medicine at St Heliers Hospital, Carshalton Has devoted his time to his Central Oxford Practice, which includes a substantial student population In 1984 he joined the Oxford Centre for Diabetes, Endocrinology and Metabolism, specialising in the care of Young Adults. He retired from that post in 2007 but remains on the Specialist Register Set up the first inclusive GP Diabetic Clinic in Oxford in 1984, which continues to the present day Also specialises in Sports Medicine and Psychiatry, and is a member of the Society of Orthopaedic Medicine and the British Institute of Manipulative Medicine Became Medical Officer to the Oxford University Boat Club in 1993 Dr Sichel is a member of the ARA Medical Committee, and has served the Rowing community by providing health care to the Head of the River Race and the Oxford and Cambridge Boat Race Dr Sichel is currently retained by Magdalen College School in an advisory capacity MA MB BChir MRCGP DCH DRCOG MF Hom General Practitioner and Partner Studied medicine at Girton College, Cambridge, and the Middlesex Hospital, London, where she qualified in 1975. Previously a Paediatric Registrar, she has taken on a lot of the responsibility for child health within the practice. Dr Ferguson has a special interest with women's health within the practice. Dr Ferguson is a qualified Homeopath (she has BUPA accreditation for this therapy) as well as a GP, and provides homeopathy (www.28beaumontstreet.co.uk/specialistclinics/complementary-therapies.php) to patients. Dr Ferguson has been a GP Tutor for five years and teaches first and fifth year medical students. Dr Ferguson is planning to retire from regular medical clinics at 28 Beaumont Street from April 1st 2012. She will however continue to work at the practice, both as a GP on an occasional basis and also in a private medical capacity, as a homeopath. Dr Sri BSc (Hons) BM BCh (Oxon) MRCGP Subramaniam General Practitioner and Partner Obtained First Class Honours in Physiology and Pharmacology at Manchester University, qualified in Clinical Medicine in Oxford (Lady Margaret Hall) in 1996. Dr Clare Stephenson Did General Medicine at Addenbrookes Hospital Cambridge and went on to do do Radiology at University College London. Trained in GP in Cambridge and has been working as a full time GP in Bedfordshire since 2003 Has been a Clinical Tutor in Cambridge since 2003, teaching at Trinity Hall, Pembroke and Trinity College. Special interests include student medicine, psychiatry, women's health, paediatrics, medical education and ultrasound scanning. Dr Sri is training the F2 registrar and teaching medical students at the Practice. Dr Sri is a local GP trainer and GP appraiser MA (Oxon) BM Bch MRCP MRCGP DFSRH MSc (Public Health Medicine) LicAc General Practitioner Studied undergraduate medicine at Trinity College Cambridge, and Clinical Medicine at Oxford Medical School (whilst attached to New College Oxford) from where she qualified in 1988. Practiced General Medicine in Middlesbrough and Psychiatry in the Tindal Centre, Aylesbury. Trained as a GP at Summertown Health Centre, Oxford. Worked for 4 years in the Oxford Department of Public Health Medicine. Has a Diploma in Family Planning and Sexual and Reproductive Healthcare. Studied acupuncture in China and the UK and over the course of 10 years has taught clinical medicine to undergraduate students in Chinese medicine. Is the author of a textbook of clinical medicine designed to meet the needs of Complementary Therapists. Special interests include women’s health, psychiatry, reproductive medicine, minor surgery and complementary medicine. Interests include women’s health, student health, psychiatry and complementary medicine. Nurses Jane Lambert Jane joined the practice in 2005 and has taken on responsibility for reviewing patients with diabetes, asthma and chronic obstructive pulmonary disease (COPD). She is also has a particular interest in women's health and contraception. Jane trained as a Registered nurse at Northwick Park Hospital in 1982. She has worked in A+E and surgical nursing, and trained as a midwife in 1993. Before joining the practice she worked in Hertfordshire as a practice nurse. Sarah Nichol Sarah joined the practice in 2004. She qualified as a Registered General nurse from Guy's Hospital, London in 1994 and then went on to specialise in Critical Care here in Oxford. Sarah has worked abroad in Australia and Borneo and has a particular interest in travel medicine. She is also very interested in family planning and the assessment and treatment of minor illnesses. Sarah has an interest in complementary therapies and is a qualified yoga and yoga for pregnancy teacher. Claire Webster Claire is a New Zealand State Registered nurse. She qualified in 1989. Most of her nursing career has been in the general practice setting in between breaks for travel and starting a family. Claire has lived in the UK for a number of years and is married with two children aged 11 and 9. Claire enjoys all aspects of practice nursing but would consider her special interests as travel medicine, family planning and child related health issues Claire is responsible for overseeing the nurses role in chronic disease management in the practice. Healthcare Assistants Maria Marquick Maria runs phlebotomy (blood tests) clinics, performs ECGs, and runs the new patient checks for the surgery. She is also qualified to counsel patients about giving up smoking and permitted to administer vaccinations to adults. Practice Management Jane Jane is our practice manager and is responsible for the efficient, effective Belcher and safe management of the practice and its finances. This oversight safeguards the well-being of patients, doctors and staff, and maintains the successful, smooth running of the practice. Jane is the person to contact if you have any cause for concern about your experience at 28 Beaumont Street. Find out more here Administration Jayne Jayne maintains our EMIS system which stores our electronic patient records. She also Manuell supports Jane Belcher in ensuring that the practice is run according to standards such as those specified in the Quality Outcomes Framework (www.qof.ic.nhs.uk/index.asp ) and by the Care Quality Commission (www.nhs.uk/NHSEngland/thenhs/healthregulators/Pages/carequalitycommission.aspx) . Susan Brain Susan is responsible for maintaining our patient data and keeping our medical records in good shape. She is also oversees the cervical cancer screening programme and the Chlamydia screening testing service for young people and ensures that patients are reminded about these important services. Reception Our reception team deal with all the telephone calls which come into the practice and also they greet the patients who come in through the door. Sometimes they have to deal with multiple requests for attention which arrive at the same time. They aim always to provide a cheerful and welcoming service despite the demands of the job. The team consists of Elaine Worley (manager), Catherine Austin, Lesley Pearson, Jane Smith and Caroline Bradley. Attached Staff College nurses The practice provides the college doctors for New College and Hertford College. Our doctors work as part of an integrated team with the New College nurse, Tara McGuinness, and the Hertford College nurse, Mrs Yo Davies. District nurses (community nurses) The district nursing team is led by Clare Allen and provides nursing care to patients in their own home. They have a broad range of skills, including: supporting and advising carers, dressings and ulcer care, care of bed-bound patients, continence problems and catheter care, and care of the dying. The district nurses can be contacted on 01865 794502. Health visitors Health visitors are qualified nurses with specialist training in the health and development of babies and children. They provide information, advice and support for mothers with young children. They will visit new mothers and babies and play and essential role in Child Health Clinic at the practice where they can advise about vaccinations and general health care. They have expertise in many problems affecting babies and children, including breast and bottle feeding advice, teething, sleep disorders, behavioural problems and child welfare concerns. The health visitors who work of 28 Beaumont Street are called Kathy and Vanessa. They can be contacted on 01865 552391. Community midwife Midwifes are qualified nurses with specialist training in the care of pregnant women and the delivery of babies. They liaise with the specialist midwives and doctors in the obstetrics department and the delivery suite in the Women’s Centre at the John Radcliffe hospital. Appointments with Louise, the 28 Beaumont Street midwife, can be arranged by ringing 01865 311811. If you become pregnant, please book an appointment with a GP so that your care during pregnancy can be arranged. It is wise to consider taking the vitamins folic acid and vitamin D before conception (if possible), or at least as soon as you know you are pregnant. Vitamin supplements for pregnancy can be purchased at low cost from a pharmacy and should be continued up until the first 12 weeks of pregnancy. As soon as you know you are pregnant it is advisable to avoid alcohol and stop smoking. Find out more on the NHS choices website (www.nhs.uk/Planners/pregnancycareplanner/Pages/Antenatalhome.aspx) See also our Pregnancy Planner