Ruston Street Clinic

Ranitidine SUPPLY Distrubtion Alert

There is contamination of some supplies of Ranitidine and the Swiss and German regulatory authorities have started an investigation.

NDMA is the contaminant.

GP’s will review if you need to take the medication and if gastric treatment is needed will switch you to omeprazole.

Over the counter medications

From 1st April 2019, Tower Hamlets is making changes to the prescribing of medicines that can be bought over the counter for 35 minor, short-term health conditions in line with guidelines published by NHS England. These changes will benefit patients by freeing up valuable GP time and promoting self-care through community pharmacy. NHS England (NHSE) published prescribing guidance (29 March 2018) which covers 35 minor, short-term health conditions, which are either ‘self-limiting’ or suitable for ‘self-care’.

The new guidance recommends that:

Please click here for Tower Hamlets CCG policy on this and who it applies to.

List of minor illness or items for which prescribing is restricted

Self-limiting illnesses:
Acute Sore Throat
Infrequent Cold Sores of the lip
Conjunctivitis
Coughs and colds and nasal congestion
Cradle Cap (Seborrhoeic dermatitis – infants)
Haemorrhoids
Infant Colic
Mild Cystitis

Minor illnesses suitable for self-care:
Mild Irritant Dermatitis
Dandruff
Diarrhoea (Adults)
Dry Eyes/Sore (tired) Eyes
Earwax
Excessive sweating (Hyperhidrosis)
Head lice
Indigestion and Heartburn
Infrequent constipation
Infrequent Migraine
Insect bites and stings
Mild Acne
Mild Dry Skin
Sunburn
Sunburn Protection
Mild to Moderate Hay fever/Seasonal Rhinitis
Minor burns and scalds
Minor conditions associated with pain, discomfort and/fever. (e.g. aches and sprains, headache, period pain, back pain)
Mouth ulcers
Nappy Rash
Oral Thrush
Prevention of tooth decay or cavities
Ringworm/Athletes foot
Teething/Mild toothache
Threadworms
Travel Sickness
Warts and Verrucae
Items of limited clinical effectiveness:
Probiotics
Vitamins and minerals

Pregabalin and Opioid Not on Repeat Dispensing Scheme

From 1 April 2019, gabapentin and pregabalin will be reclassified as class C controlled drugs. Increased restrictions are intended to improve safety. These medicines are used to treat nerve pain and sometimes epilepsy or anxiety.

What patients need to know:

We will no longer be able to issue electronic prescriptions for gabapentin or pregabalin. Pharmacies will only be able to accept hand-signed paper prescriptions. This may mean you need to make alternative arrangements for collecting your prescriptions.
Repeat dispensing prescriptions will no longer be allowed (also known as ‘batch prescriptions’). This means patients will need to order their medications through reception, online or with their pharmacy each time they need a new supply.
We will only be able to issue prescriptions for a maximum of 30 days’ supply.

Patients who receive these medications in a blister pack (dosette box) do not need to do anything, the practice will make the necessary arrangements with our local pharmacies.

Please allow sufficient time for ordering repeats around the time of this change. If you have any queries please contact one of the practice pharmacists or your GP.

Avoiding regular use of Gastric medications Lansoprazole and Omeprazole

Proton Pump Inhibitors (or PPIs) are a group of medicines used to reduce stomach acid and include omeprazole, lansoprazole, esomeprazole and pantoprazole. These medicines are very commonly prescribed but many patients continue taking them for longer than they may need. Usually a course of two to three months is sufficient to help heartburn or indigestion to settle.

As with any prescription medication, PPIs can cause side effects which are more likely if you take a high dose or use them for a long period of time. More and more evidence is coming out that suggests this group of medications may be linked to more problems than we knew about previously. We are therefore re-assessing which of our patients these medicines remain the best choice for.

What are the possible risks from long-term use of a PPI?

Increased risk of serious stomach infections including Clostridium difficile

Increased risk of bone fractures

Decreased absorption of nutrients including magnesium, calcium, and vitamins

Reduce the effectiveness of other medicines you may take including medicines used to prevent heart attack and stroke

May increase risk of kidney disease, pneumonia, dementia and certain cancers – more research is being done on all these possible links.Always speak to your GP or pharmacist before stopping prescribed medicines. PPIs should be reduced slowly to minimise rebound symptoms. If you have a history of stomach ulcers or bleeding, or have severe symptoms it is likely that continuing your PPI is the best option – your GP can help you to make this decision.

Emollients

Emollients are products like diprobase, doublebase, epaderm and E45. These are moisturisers that are used for many chronic skin conditions. They are very important for conditions like eczema and psoriasis, and we want to make sure patients with these conditions are given enough to be able to use them frequently. However they are very costly for the NHS, and so we are being asked to prescribe the lower cost options first, and only to change to higher cost options if necessary. You may start to see different versions of your emollient being prescribed, with a message about this. Please be reassured that although the name and packaging may be different, the ingredients are in most cases identical, if not very similar. We are also being asked not to prescribe emollients at all for people who don’t suffer with chronic skin conditions like eczema, but who just have dry skin.

There are emollients being prescribed such as Zerobase equivalent to Diprobase, or Zeroqas equivalent to Aqueous cream. This is part of the cost effective prescribing in the NHS.

Patients on co-codamol;

 Why has my medication been changed?

Some time ago the agency responsible for safe prescribing advised doctors that it was safer for patients to take pain relieving medications such as paracetamol and codeine separately rather than as one tablet. This reduced the chance of overdose and adverse events with combination medicines such as co-codamol. This is now considered standard ‘best practice’ in the prescribing of codeine and paracetamol and indeed any other pain relieving medications.

How do I know I will get the same pain relieving effects?

The dose is calculated by your doctor to give the equivalent dose of codeine and paracetamol to that which you are currently taking. For example; Co-codamol 30/500 is equivalent to 30mg of codeine and 500mg of paracetamol.

How do I adjust the dose with the separate tablets?

The separate tablets allow you to have much more flexibility from day to day as to the amount of pain killer tablets you take. For example they allow you to take a maximum dose of paracetamol whilst taking less codeine if you need to. When the tablets are combined you are forced to take an equal amount of both tablets.

What if I don’t like the switch after I have tried it?

If you have reasons for not liking the switch you can discuss this with your doctor or pharmacist but try it first!

News

  • Ramadan- Self Care guide

    Fasting during Covid crisis has to be done safely. Please stay at home and use technology to link up with your family,.

    https://youtu.be/5a30R4ZVGPQ?

    If you have long term conditions please do not push your self to fast as your health might deteriorate. Seek advice from your GP if you are unsure.

  • Total Triage System at Ruston St Clinic

     We have now adopted a Total triage system.

    • Most routine bookings to be made on the day and dealt with on the day
    • Please avoid calling in advance for appointments
    • Advanced booking will not be made, however if your problem is an emergency it will be dealt with on the day.
    • Trained administrators will take your call and ask the reason for the call and then a clinician will contact you back
    • If you want to speak to a specific clinician please ask
    • Please provide your up to date details such as current address, telephone number and email address
    • If you need a translater please indicate this when you make the initial call to the admin staff.
    • To book and appointment with Health care Assistant and Nurse will be via reception team.
  • Coronavirus Update

    Patient to AVOID coming to the clinic if they have

    • COUGH
    • FEVER

    Please self isolate for 14 days.

    If you are very unwell with shortness of breath, fever for several days and dehydrated and in the high risk group then please call 111 first.

    If you need advise and would like to inform Gp then call or do an E- CONSULT

    PLEASE CAREFULLY READ THE NHS GUIDANCE ON COVID 19
    https://www.nhs.uk/conditions/coronavirus-covid-19/

    The UK government has also provided lots of useful information and guidance on SOCIAL DISTANCING

    https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults

    Get a self isolation note
    https://111.nhs.uk/isolation-note/ 

  • Coordinate My Care

    GP’s with other health professionals will be adding complex and terminal patients records on CMC database to help coordinate with ambulances/ A and E about your wishes with health care and resuscitation.

    www.coordinatemycare.co.uk

    Patients can also make their own care records informing health professionals under “My CMC”

  • Keep fit and improve heart health!

    Local patient is organising a running club.

    More than just a running club. A community of people taking steps to raise mental health awareness and fighting the stigma that steals young lives.

    Where we run.

    Every Saturday: Victoria Park (Pavilion Café) at 10am.

    Why we run.

    1 in 4 people will have a mental health issue this year. Suicide is the leading cause of young deaths in the UK. Let’s talk about it.

    Join us. All levels welcome!

    www.run4rene.com

    Social: @run4reme

    facebook.com/groups/run4rene

     

  • Do you know what is happening with the NHS? Why not find out

    Under the knife

    Documentary created by crowdfunding to help public understand what is happening to your public NHS with privatization over the years. Please watch and learn.

    Watch video

     

    Dr Bob Gill’s analysis on the NHS and private finance initiative …..

    Watch video

     

    Dr Alison Pollock professor of public health’s analysis of what would happen with a private NHS

    Watch video


     

  • AVOID WASTAGE IN THE NHS!

    We are fully aware that the NHS is free at source service, but all of us should take responsibility for our actions.

    We are constantly being told by unhappy patients we had to wait 2 weeks for an appointment at our clinic. This may be the reason

    2020

    January data

    • 96 DNA at Ruston St Clinic
    • 22 DNA hospital appointments

    2019

    September data

    • 100 DNA at Ruston St Clinic
    • 10 DNA hospital appointments

    October data

    • 105 DNA at Ruston St Clinic
    • 16 DNA hospital appointments

    November data

    • 110 DNA at Ruston st clinic
    • 27 DNA at hospital appointments

    December data

    • 89 DNA at Ruston st clinic
    • 13 DNA at hospital appointments

     

  • Extended Hours

     

    Dr Spahn and Dr Hubbard will be providing extended hours every week as part of the new NHSE e contract.

    The appointments can be booked via NHS GP app or Emis online.

    The appointments will be a mixture of face to face, telephone or e- consultations.

     

  • Get Emis Online Access

    We are aiming for as many patients to have online access to their records.

    Emis Online access allows you to book appointments, view your medications, order medications and view your records.

    A consent form will need to be signed and you will receive a pin.
    All our newly registered patients will automatically offered this, our existing patients can make enquiry with reception.

  • Primary Care Network/ Bow Health Network

    RSC is one of 5 practices in the Bow area forming our network serving 31,000 patients.

    The government is encouraging all areas across London to work in networks to improve in service delivery.

    Lots of local projects are run via the network. Recent inhaler recycling project, nasal flu vaccine in young children delivery, Diabetes prevention programme.

    Check out the website for upcoming projects.

    http://www.bowhealthnetwork.com

  • Intermittent slow internet connectivity and N3 line upgrade

    We experience drop in internet connection at the clinic from time to time. Many practices in the area are due to get an upgrade shortly. We shall keep patients updated when problems occur and we hope you will understand if econsult, EPS or online bookings are temporarily affected and our advised is to revert to telephone call to the practice or walking in and booking appointments in these circumstances.

     

  • Need a fit note, GP letter or test result?

     

  • Online services

    It is not necessary to always book a face to face appointment to see a GP.

    Use our e-consult blue banner to make contact with practice staff whether for admin purpose or to seek medical advise. Photographs of conditions can also be uploaded. The Gp will make a decision to call you with advise or ask reception to book an appointment for you or sign post to another service provider.

    Often patients are left frustrated that they have long waiting times on the telephone to book appointments. Did you know by downloading the Patient Access app you can book appointments, request for medications and view your medical records.

    WATCH THIS SPACE- online registration is soon coming!

  • How we use your medical records

    Important information for patients

    • This practice handles medical records in-line with laws on data protection and confidentiality.
    • We share medical records with those who are involved in providing you with care and treatment.
    • In some circumstances we will also share medical records for medical research, for example to find out more about why people get ill.
    • We share information when the law requires us to do so, for example, to prevent infectious diseases from spreading or to check the care being provided to you is safe.
    • You have the right to be given a copy of your medical record.
    • You have the right to object to your medical records being shared with those who provide you with care.
    • You have the right to object to your information being used for medical research and to plan health services.
    • You have the right to have any mistakes corrected and to complain to the Information Commissioner’s Office. You can click to read the practice privacy notice here or speak to a member of staff for more information about your rights.
  • HUBS

    Walk in centres no longer exist, however some practices around Tower Hamlets offer extended evening and weekend appointments. Our reception staff may offer you appointments for emergency or new symptoms at these HUB practices especially if we have no appointments to offer. Please consider taking them up.

    Hub practices are: Harley Grove Surgery (E3 2AT), Blithehale medical centre (E2 6JA), Strouds Place (E2 7QU), East One Health Centre (E1 2QA).

    Click here for more information

  • Mental health

    If you are feeling suicidal and having a mental health crisis call the Tower Hamlets crisis number 02077715807.

    If you would like to speak to a therapist please contact Tower Hamlets Talking Therapies 0208 475 8080 and self refer.

  • DRUGS and ALCOHOL self referral

    Based at Mile End Hospital they accept self referral telephone 02081215301.

    Click here for more information

  • Registering now!

    Our list is open for new patients. Contact our reception on 020 8980 1652 for details.