|Anti-coagulation / Warfarin||Blood Thinning Stroke Prevention||Dr S Emanuel
|Cardiology||Heart Disease||Dr Lim
|Chiropody||Foot Problems||Louise Roberts|
|Counselling||Talking Therapies||Dr. James|
|Dermatology||Skin Disorders||Dr Steventon|
|Diabetes||Problems with Sugar Metabolism||Dr Rodin
|Dietitian||Advice about Diet||Seamus Kirk|
|Elderly Care||Care of the Elderly||Dr Bryce
|ENT||Ear, Nose and Throat Disorders||Mr Robb
|General Medicine||General Medical Problems||Dr Rangedera|
|General surgery||Conditions Amenable to Operations||Mr McFarland
Mr Nou Nou
|Gynaecology||Women’s Conditions||Ms Nadim
|Minor Operations||Removal of Lumps and Bumps|| Dr Hills
|Neurology||Diseases of the Nerves and Brain||Dr Reynolds|
|Ophthalmology||Eye Disorders||Mr Gillespie
|Orthopaedics||Diseases of the Bones||Mr Mok
|Paediatrics||Problems in Children|| Dr Wadey
|Palliative Care||End of Life Care|
|Physiotherapy||Treatment involving exercise, heat and massage||Sara Allen
|Plastic Surgery and Skin Cancer Surgery||Corrective Surgery||Mr Moss
|Plastic Surgery for Children||Corrective Surgery for Children||Mr Wilson
|Podiatric Surgery||Feet Operations e.g. Bunions in-growing toe nails||Dr Pabari|
|Psychiatry appointments||Problems of the Mind e.g. Depression||Dr Lyons
|Respiratory||Asthma COPD / COAD Breathing Disorders||Dr Cowlard
|Rheumatology||Disease of the Joints||Dr Duke
|Ultrasound||No ante-natal Scans or mammograms||Various|
|Urology||Urinary Tract Disorders||Mr Le Roux
Any copies requested by patients will incur a fee of £5.00
|No mammography bariums etc Xray||Various|
The referral procedure for all these services is via your GP.
Other services are offered by our practice nurses (please see leaflet “making an appointment with the nurse”
ICP provides a comprehensive travel health advice and vaccination service through our dedicated travel clinics.
We are a registered Yellow Fever Vaccination Centre and can dispense anti-malarial medication.
The travel clinics are open to both registered patients of the Practice and to the general public. We are also able to provide corporate travel immunisation services.
General information on health risks and vaccination requirements is available to the public on-line at www.fitfortravel.scot.nhs.uk. Please be aware that requirements and recommendations for a particular destination may change at short notice so it is essential to obtain up to date information.
Ideally, an appointment with the travel clinic should be made at least 6-8 weeks before leaving the UK to allow sufficient time to complete vaccination courses. Please bring as much information about your travel itinerary as possible to your appointment to enable us to give accurate advice.
If you are not a registered patient of the Practice or have received vaccinations elsewhere, please bring your immunisation record to the consultation.
A number of travel vaccinations and anti-malarials are not available under the NHS.
Click here for details of our current fees.
Please ensure you bring adequate means of payment with you. We are now accepting credit/debit cards as well as cash or cheque.
For travelers going to remote or distant locations, the Practice has negotiated a special discount for travel health items including mosquito repellents, mosquito nets and sterile medical packs. These are available by mail order direct from the supplier
Our aim is to provide a comprehensive and personal service with continuity of care within the familiar surroundings of your GP Practice
- Unless you specifically wish to attend the hospital, all your Diabetes care can be received in the familiar surroundings of your GP surgery.
- Two Diabetes Nurses trained in the initiation and management of insulin therapy.
- Regular visits by a Consultant in Diabetes to provide specialist input and advice for patients with more complex medical problems.
- Blood tests, Dietitian reviews and routine Chiropody Service provided within the GP setting.
The ICP Diabetic Team
Sister Debbie Phillips – Diabetes Nurse
Dr Joanna Rendell – GP and Diabetic Lead
Dr Alun Jones – GP
Dr A Rodin – Consultant Endocrinologist and Diabetologist
All members of the Team attend meetings and courses to keep up to date with the latest information on Diabetes.
- We provide clinics at The Old Cottage Hospital [OCH] and Fitznells Manor Surgery [FMS]
- We aim to provide appointments that are convenient for you and depending on availability, we are happy for you to attend either practice for this aspect of your care.
Currently our clinics only provide care to patients registered at ICP.
|Tuesday||Dr. J Rendell||AM||OCH|
|Wednesday & Friday||Sister Debbie Phillips||AM||OCH|
- Newly diagnosed with diabetes? -Your GP will refer you to the clinic once the diagnosis has been confirmed.
- Newly registered at our practice? Please speak to your GP, who can make a referral to the clinic, alternatively you can leave a message with reception for the Diabetes Nurse to contact you.
You should receive a phone call or letter within two weeks of referral to arrange an appointment and any further tests, if required.
Subsequent appointments are pre-booked at the end of your clinic consultation for your convenience.
Cancellations / Rescheduling
- Please contact reception if you need to cancel or reschedule – they will leave a message for the diabetic nurse for you if necessary.
- If you cannot keep an appointment we would be grateful if you could let us know in advance so that someone else can take your place.
We have an annual recall system in place so that should you forget to attend the clinic at least yearly we will send you a written reminder.
- For convenience, we may be able to manage some interim reviews over the telephone.
- If you have diabetes questions between appointments, or are concerned that you may need a sooner appointment, please call the surgery and ask to speak to a member of the Diabetes Team.
Arranging a Blood Test
- You tests are performed at the surgery and can now be pre-booked at the same time as booking your next diabetic clinic appointment.
- Fasting tests: If you have been told to fast please do not eat or drink anything other than water for 14 hours before the test.
- We recommend that you attend the clinic six-monthly if your condition is well controlled and stable.
- There will be times that you will need to come more often until your control is optimized.
- Foot checks and Retinal Screening will be done on an annual basis and more frequently if you are at higher risk of complications. These can be carried out at home if necessary.
What care should I expect?
- The following tests, measurements and discussion points should be covered over a period of twelve months; some will be done more frequently depending on clinical need.
- Remember – these tests are all done to help detect potentially modifiable factors in order to prevent the complications of diabetes developing.
- Targets will vary for each individual.
|Blood Pressure [BP]||High BP is a risk factor for Heart disease, Stroke and kidney damage.Guidelines vary but the general rule is lower is betterAim around 140/80 or 135/75 if kidney disease is present [NICE Guidance]|
|Body Mass Index [BMI]||
A measure of your weight relating to your height20- 25 is desirable weightAbove 25 is overweight
Above 30 is obese
|Foot Check||The circulation in your feet and sensation will be checked to detect early signs of ‘blocked arteries’ and ‘neuropathy’ – detection and treatment can reduce complications such as ulcers and gangrene|
You should receive an annual invitation to attend the Diabetic Retinopathy Screening Service for Surrey. The back of the eye (retina) is viewed to detect early diabetic changes that, if left untreated, could lead to blindness.
Note: If you are already under the care of an Opthalmology Clinic (eg; for Glaucoma ) you must still attend for your annual retinal screening appointment. However, if you attend the Opthalmology Clinic for treatment of diabetic retinopathy you will be screened there instead.
|Waist Circumference||Increased amounts of fat inside your abdomen (typical ‘beer belly’ appearance) reduces your body’s ability to use insulin [‘Insulin Resistance’] – reducing this will improve your health and glucose control, hopefully reducing how much medication you need|
|Glomerular Filtration Rate [GFR]||A measure of your kidney function.Persistent readings below 60 ml/min are defined as Chronic Kidney DiseaseHigher is better|
A measure of your long term glucose control (over previous 3 months)Lower is betterReductions will reduce risk to your eyes and feet
Cholesterol / Triglycerides
A measure of your ‘Blood fats’Aim total cholesterol below 5Aim LDL ‘bad’ cholesterol below 3
Lower targets may be needed in some patients
|Liver function Test||This will be monitored if you are taking cholesterol-lowering tablets or ‘glitazones’ and is requested periodically in all diabetic patients|
|A blood count and thyroid hormone test will be requested around the time of diagnosis||Others|
|Urinalysis (dipstick test) for protein||To detect damage to the kidneys shown by leakage of protein|
|Albumin:Creatine Ratio [ACR]||To detect microalbuminuria – an indicator that we need to control your BP and cholesterol more tightly|
|Other issued to be covered:|
|Depression||Help and support available|
|DVLA||If and when to inform them|
|Erectile problems||Advice and treatment is available for this common problem|
|Prescription Exemption||If you take medication for diabetes blood glucose control you can apply for free prescriptions|
|Smoking||Reception can book you an appointment for our one-one smoking cessation clinic|
|Vaccinations||Please check that you have had a pneumococcal and annual flu vaccination, since these infections can effect you more seriously if you have diabetes|
- It is recommended that you have a Diabetic Foot Check at least annually.
- If you do not have any foot problems, this will be done by the Diabetes Nurse during your diabetic appointment.
- If you are at a higher risk of foot complications or have any foot problems, the Diabetes Nurse or Doctor will refer you into the Chiropody Clinic.
- You can choose from various Chiropody Clinics in the area; however, we are privileged to have a weekly chiropody service at The Old Cottage Hospital and monthly clinics at Fitznells Manor Surgery.
- If you develop more severe vascular problems (‘blocked arteries to the feet’) the diabetes doctor will refer you to a Vascular Surgeon.
- If you think you have an infection in your foot, a new ulcer, sudden onset of pain and swelling over the foot or discolouration please speak to your GP as an emergency.
- There is an Emergency Community Clinic at Leatherhead on Fridays 1.30-4 pm
If you are on insulin treatment you will be given a prescription for a sharps bin. On no account should soft drink cans, plastic bottles or similar containers be used for the disposal of needles, since these could present serious hazards to staff if they were disposed of in domestic waste
- Epsom and Ewell Borough Council. The council now offer one free collection per year per patient. They offer 1 litre, 5 litre or 11.5 litre bin for sharps. Please telephone the council on 01372 732000.
- Reigate and Banstead Borough Council. Telephone 01737 276775. The council offers free pick up once a week.
- Elmbridge Borough Council. The council offers a free collection service of domestic sharps once a week – the day can be either a Thursday or a Friday, with the exception of an area called Whiteley Village which is collected on a Wednesday. There are no collections on any other days.They can also provide yellow clinical waste bags or sharps bins. For further information contact the Environmental Care Division [email protected] or call 01372 474775.
- Mole Valley Council does not currently have a collection service for domestic sharps in the area.
- If you are thinking about becoming pregnant it is essential that you discuss this with the Diabetes Nurse or doctor prior to conceiving.
- It is essential that you have optimal blood glucose control in the months before and during pregnancy to limit complications to you and your baby.
Housebound / Nursing home
- We have good communication with the District Nurses [DNs] who will visit to perform blood tests as requested by the Diabetes Nurse.
- DNs will perform blood glucose monitoring and insulin injections when necessary.
- You are still entitled to annual Retinal (eye) Screening regular Chiropody reviews which can be arranged in the home if necessary.
- Housebound patients – annual retinal screening can be carried out at home by the Outside Service ( 0800 854 477 )
FURTHER INFORMATION & LINKS
- Please ask the diabetes team for any further information, or refer to the websites below.
- Diabetes UK is an excellent source of information, providing free access to their website. If you decide to become a member you will receive regular magazines. Their local voluntary group has been active in improving the diabetes service in this area – to join them please see their website or ask us for information at your next clinic appointment.
British Dietetic Association: