There are numerous sources of support that can help with your mental wellbeing:

iThrive -   Edinburgh’s new Thrive Welcome Teams can support you to access the right support for your mental health.

Each Thrive Welcome Team has friendly, skilled, and experienced mental health practitioners. The team members work closely together, in a collaborative and supportive way to think about ways in which they can help and support you.

They will give you a warm welcome, putting you and your needs at the very centre of the support they offer you. The teams can see people aged 18 and over .

Who is Thrive Welcome Team suitable for?

Support is avialable for a variety of things which may be affecting your mental health including:

• Help to manage their emotions

• Feeling anxious

• Having low confidence

• Feeling lonely and isolated

• Having difficulties in their relationships

• Experiencing feelings of low mood, and depression

• Carers’ mental health and wellbeing

The local Thrive Welcome Team drop-in runs every Tuesday afternoon from 1.30pm to 4pm at: 

Oxgangs Library,

343 Oxgangs Road North,

Edinburgh EH13 9LY

No appointment is required. This leaflet also gives you information about what to expect at a Thrive Drop-in 

Click here to find out more.

Breathingspace - providing support for anyone in Scotland experiencing low mood, depression or anxiety. 

You can also call the national breathingspace helpline free on 0800 83 85 87: 

Weekdays: Monday-Thursday 6pm to 2am

Weekend: Friday 6pm-Monday 6am

Mind to mind - is a NHS Inform wellbeing website with short videos on how people living with mental health conditions manage them. It also has lots of useful links to various support services. 

Sorted:mental health:  is a positive mindset App  to help overcome stress, low mood & worry. Information and instructions on how to download here.

Dr Alastair Dobbin talks about  feeling good with positive mental training here  

There is also a Feeling Good Teens App for 10 – 14 yr olds. Information about this  can be found here. 

Daylight: Daylight is an easy-to-use app for adults who have difficulty with worry and anxiety. It was  designed by experts to help control worry with four proven exercises. More information can be found here. 

Go to trydaylight.com/nhs to get started.

Mental Health Information Station: offers general mental health advice and will be reopening on Thursday 8th October 2020 and every Thursday from 11 am till 3 pm in the Walpole Hall, (next to St Mary's Cathedral), Palmerston Place. EH12 5AW, Edinburgh

You can speak with a NHS Mental Health trained staff on a Thursdays 9.30am - 4.30 pm or phone 

on 0131 537 8688 or by email MentalHealthInformation@nhslothian.scot.nhs.uk

More information can be found here.

If you feel that you are in crisis and need help immediately  call the  Edinburgh Crisis Centre: 0808 801 0414

Health Active Minds:  this  is a physical activity  project for  adults aged 18 years.  It aims to  introduce inactive individuals with mild to moderate depression, stress or anxiety to regular physical activity.  Referral by a GP or mental health professional is required. More information can be found here.

Hope Park Counselling Centre: provides counselling from counsellors in training at the University of Edinburgh for people aged 16 and over living in Edinburgh and the Lothians. 

You can self refer online: http://www.hopepark.org.uk/

More information can be found here 

Art Therapy:  The NHS Lothian Arts Therapies Service has several arts and mindful resources  helpful for anyone managing and self-caring for their mental health. Information can be found here

Oxgangs Befriending Service:  provides a befriending service for the over 60s who live in the local area. How to contact them can be found here. 

Silver Line Helpline is a free, 24-hour telephone service for older people, offering  friendship, conversation, and support for older people, especially those who may be experiencing feelings of loneliness and isolation. Call free on: 0800 4 70 80 90

ADHD 

If you think your child may have ADHD there are lots of helpful resources on the CAMHS Resouces website which can  help to support your childs mental health and well-being. 

Helpful information and support can also be found on our own ADHD resources page. 

If your child has an appointment with the GP it would be helpful if you could  complete and bring along or send in advance of the appointment this form. This information will be helpful  for the GP to assess your child for ADHD. 

ANXIETY 

NHS Lothian provides a two part recorded information session for parents to help you learn more about what anxiety is  and how you can support your child to overcome it:

Part 1: Understanding Anxiety 

Part 2: Supporting Children with Anxiety 

Silver Cloud provides online intervention, based on cognitive behaviour therapy, aimed to help parents and carers support young people with worry and anxiety. It can be accessed  here. 

The access code is 'Lothian'.

Hands On Scotland can be access here and provides help and practical advice for supporting children and young people's mental health and emotional wellbeing.

The Centre for Psychological Therapies can offer psychological therapies for mild to moderate mental health issues such as anxiety and low mood in children and young people up to the age of 26 years old . More information and how to self refer can be found here. 

Other websites and resources for parents and carers on anxiety and worry in childern can be found here. 

The Practice now has a permanent GP Advanced Physiotherapy Practitioners (APP), Louise Cockburn, who is in the Practice each week on a Tuesday, Thursday and Friday. 

She can assess, diagnose and manage musculoskeletal (MSK) conditions such as  joint, muscle or bone pain. 

You can book directly with the physiotherapist without the need to see a GP first. 

Find out here how the Advanced Physiotherapy Practitioner can help you. 

Edinburgh Health and Social Care Partnership also provide an MSK ADULT PHYSIOTHERAPY self-referral service for patients registered with an Edinburgh GP Practice. 

Information about the service and how to self refer can be found here.  

Alternatively you can also download the self referral form here. 

Advice and self care information for muscle or joint problems can be found HERE 

Children and Young People’s Physiotherapy service: Information and advice on a range of  common conditions in children and young people can be found in the leaflet section on the Paediatric Physiotherapists website here. 

There is also a helpline for concerns regarding  childrens motor skills or development: This helpline is only available on Thursday mornings from 9am -11am. The number to call is:  0131 312 2347

For concerns about bone, joint or muscle pain in children you can contact the Edinburgh, East and Mid Lothian Paediatric Physiotherapy Musculoskeletal Team  on: 0131 312 1079 

Interested in being more active ? 

Hearts FC have launched two  new  fun health initiatives to support men and women over the age of 50 become more active. 

These are both free 12 -week courses based at Herriot Watt University Campus offering walking football and walking netball. 

Futher information,  including how to sign up to   'Step into Health – Have a Little Less and Feel a Lot Better – Hearts ' and 'Step into Health - Walking Sport Programme'   can be found at:  

Step into Health – Have a Little Less and Feel a Lot Better – Hearts

Step into Health - Walking Sport Programme - Universe

Minor Injury Assessment (MIA) Service 

If you have an injury that needs urgent or immediate attention, you should call 111 to make an appointment with an expert in one of NHS Lothian’s Minor Injury Units  (MIU).

The MIU team can help adults and children over 12 months who have a recent minor injury of up to two weeks, including:

• Strains, sprains and suspected broken bones to limbs only (not back, chest or abdomen)

• Wounds and minor burns (not to face, groin or hands)

• Minor bumps to head and face (with no vomiting or loss of consciousness)

• Simple eye injuries

• Insect bites and stings with localised swelling and no evidence of allergic reaction

More information about the MIA service can be found here 

The ‘Call MIA’ service can be reached 24/7 by phoning NHS24 on 111.  Virtual and face-to-face scheduled appointments are available between 10am-10pm, 7 days a week

You will be offered an appointment for a private and secure video call assessment with a specialist Nurse Practitioner. 

If the specialist decides the injury needs treated, you will be ask to attend the nearest minor injuries clinic at a set appointment time, depending on severity. 

Children under 12 years old with a minor injury should attend one of the services at the Royal Hospital for Sick Children, Western General Hospital or St John’s Hospital, but if under 1 year old should attend the Emergency Department at RHSC or SJH.

Sleepio is an online sleep improvement programme to help tackle poor sleep and insomnia.

It includes six-sessions  of digital Cognitive Behavioural Therapy  to help with Insomnia. 

Cognitive Behavioural Therapy for Insomnia is the first line recommended treatment for insomnia in both national and international clinical guidance. 

You can access the programme at www.sleepio.com/nhs

If you have an appointment with the GP to discuss ADHD it would be helpful if you could  complete and bring along or send in advance of the appointment this form. 

This information will be helpful  for the GP to assess you  for ADHD. 

Braids Medical Practice ADHD prescribing for children and adults. 

November 2023

Background: In November 2023 Braids Medical Practice made the decision to no longer issue new ADHD prescriptions generated from private consultations. We recognise that this may bring understandable disappointment but this decision stems from our commitment to uphold the highest standards of care and ensure the safety and well-being of all our patients and is also influenced by workload capacity issues and the lack of funding in primary care.

ADHD medication requires regular monitoring and is only prescribed by NHS GP’s under a shared care agreement.  Many of these drugs are controlled drugs which require closer monitoring and are associated with higher health risks.

If a diagnosis of ADHD has been made in the NHS, ongoing follow up and care from a psychiatrist is being provided, and the patient is attending for follow up with a psychiatrist, then your GP will prescribe the requested medication under the terms of the NHS shared care agreement. If any of these requirements are not met, then ADHD medication will not be prescribed. As the patient it is your responsibility to attend for monitoring. 

In line with the practice of local surgeries and guidance from our Local Medical Committee we will only enter into shared care agreements for those who are diagnosed and managed within the NHS.

If you have been assessed by a private provider, given an ADHD diagnosis and started on medication we will not be able to prescribe this medication for you until you are under the care of the NHS ADHD service and they have agreed to prescribe medication. Whilst we recognise this may feel frustrating, this approach has been taken due to the increase in clinical workload, inconsistent approaches from private providers and the need to ensure safe prescribing. If you wish to have your care taken over by the NHS, then we can refer you to the NHS ADHD service.

What does this mean for you?

If you were obtaining your private ADHD medication from us before November 2023 we will continue to prescribe this provided you have had a referral to the NHS ADHD service and you attend for regular monitoring with your private provider. 

If you were obtaining your private ADHD medication from us before November 2023 and decline a referral to the NHS ADHD service, the you will need to go back to your private provider for ongoing prescriptions. 

If you have had an ADHD diagnosis and commenced treatment with a private provider after November 2023 then we will not take over your prescription, but you can talk to us about referring you into the NHS ADHD Service. 

Braids Medical Practice

November 2023

Support for adults with ADHD

NHS Lothian Adult AD(H)D Team Self Help have  created a Resource Pack for  People with Attention Deficit (Hyperactivity) Disorder (AD(H)D).  

This resource  has been put together using tips that adults with AD(H)D have found helpful and can be found here. 

Support for children and young people with ADHD

A range of self help resources to support young people and carers with mental health and well-being can be found on the CAMHS website here. 

The Autistic Girls Network provides helpful information about how autism presents in girls and how best they can be supported. 

Support at school could be considered at a young persons planning meeting and this template may be helpful  

EPIC Strategy booklets, which can be found here, are booklets aimed at parents and teachers. They have lots of good strategies for supporting young people, and in particular young people who are neurodivergent. 

If your child is struggling with sleep you can contact the sleep advisors at Sleep Action by emailing sleepsupport@sleepaction.org. 

Sleep Action can offer families one-to-one sleep support for any child aged 18 months-18 years.

Edinburgh Drug and Alcohol Recovery Hub is a one-stop shop offering a full range of drug and alcohol treatment and support services. Information about the services can be found here. During the Coronavirus pandemic they can still be contacted by telephone. 

Alcoholics Anonymous  - runs a national telephone helpline as well as an online 'chat now' service providing support for those wishing to stop drinking alcohol. 

Website: www.alcoholics-anonymous.org.uk 

Phone: 0800 9177 650 - a 24 hour helpline 

In Edinburgh and Midlothian meetings are now  currently being held online due to the Coronavirus and there  are  49 online meetings available. Information about these can be accessed on the local website here. 

Edinburgh and Lothian Council on Alcohol (ELCA) offers help to anyone worried about their own or someone else’s drinking. Information about the support they can provide can be found here. 

They can be contacted in the following ways: 

Phone:  0131 337 8188 

Email:   elca@btconnect.com

Asthma Reviews 

Asthma reviews are an essential opportunity to review your asthma control and ensure you are on the right treatment, to reduce your symptoms and lower your risk of asthma attacks.  

Most people don’t realise their asthma could be better controlled. 

Did you know that good asthma control means you will rarely or never have symptoms ? 

Or that if you need two or more (blue) reliever inhalers a year, this could mean your asthma control needs improvement? 

Our practice nurse team are skilled in giving you advice on how best to manage your asthma, so please book an appointment for an asthma review once a year in your birthday month, or at any time if your asthma control is not great.  

A useful way to assess if your asthma control is good is to review the Asthma Control Test score. 

Bringing this to your asthma review appointment will be useful to allow the nurse to help talk your through your symptoms and how to improve them.  

ACT Test 

Personalised Action Plans

Personalised action plans can help to promote good self management of asthma, teach you how to respond to change in your asthma symptoms. 

Adult  Action Plan 

Child  Action Plan 

Asthma and good control 

It is really important that you know how to use  you inhaler correctly. To find out more information about how to control your asthma well please visit:

https://s40639.pcdn.co/wp-content/uploads/Canva-Asthma-inhalers.pdf 

Useful videos demonstrating specific inhaler techniques can be found here  

High dose steroid inhalers

Some asthma patients require a high dose steroid inhaler to manage their asthma symptoms.  Symptoms such as wheeze, cough and tightness or being short of breath are caused by inflammation in the airways. 

A steroid inhaler will reduce the inflammation and often after a few months (3-6) the dose of the steroid inhaler can be reduced,  maintaining the same level of asthma control.  

It is important to always use the lowest dose of steroid inhaler required to control your symptoms.

 Regular asthma review with our Practice Nurse is necessary to decide your required dose.

Inhaler devices and the environment  

Good asthma control is important but some inhalers create greenhouse gases that contribute to climate change. Information about choosing an inhaler which is good for you and good for the planet can be found here. 

How to use your inhaler 

Improve your inhaler technique in 3minutes, to ensure the medication is getting to the right place in your lungs! 

https://www.asthmaandlung.org.uk/living-with/inhaler-videos 

Asthma UK Charity 

Asthma UK has lots of great information and resources available.  

https://www.asthmaandlung.org.uk/ 

Lothian NHS provide a range of information and support on bereavement related issues which can be found here.  

Information about local and national bereavement counselling service can be found here.  

Various third sector organisations also offer a range of services, depending on the circumstances of loss

SANDS is a charity which offers information and support for bereavement following stillbirth or neonatal loss and has a confidential free helpline. It also provides local support groups, an online community and bereavement information and resource.

https://www.sands.org.uk/

CRUSE is a national bereavement charity which gives information on bereavement, and offers support and individual counselling. It also offers specific support to parents, those experiencing traumatic loss and for military families. http://www.crusescotland.org.uk/

Marie Curie offers support not only to patients who are terminally ill, but also their families. They also offer a bereavement support group. https://www.mariecurie.org.uk/help/hospice-care/edinburgh#help

Child Bereavement  is a  UK charity that offers support to families when a baby or child of any age is dying, and also when a child is facing bereavement.  https://childbereavement.uk.org/

Use the form here to record your weekly blood pressure readings. A guide to taking your own blood pressure at home can be found here.

Information about what your blood pressue readings mean and what action you should take can be found here. 

Chest, Heart and Stroke can provide information and support  for people and their families across Scotland with chest, heart and stroke conditions. 

Womens' Heart Health:  BHF studies  show that women underestimate their risk of heart disease and are less likley to recognize the symptoms of a heart attack. 

Informaton about symptoms of heart disease and how women can lower their risk can be found here

Carers living in Edinburgh can get  information and support through the Local Carer Support Team.

This service can provide information and advice to help carers in their caring role. It also offers short term interventions to help carers to consider their own health and lifestyle needs and to link them to appropriate sources of support.

The Edinburgh Carers Support Team can be contacted on: 0131 536 3371

VOCAL can also offer telephone support and face-to-face video chats on things like benefits advice, breaks from caring and counselling.  Information about VOCAL can be found here or can be contacted on: 

Tel:  0131 622 6666 

Carers can self-refer for support, or be referred with their consent by any Heath and Social Care professional using the form on the VOCAL website at vocal.org.uk/referrals

Support from VOCAL for carers during COVID-19  can be found here. 

Cholesterol is a fatty substance which is produced by the liver and is important for the cells in the body. Cholesterol is also present in foods that we eat and too much cholesterol can be harmful. 

Cholesterol comes in two types – LDL (“bad”) cholesterol and HDL (“good”) cholesterol. The reason we worry about cholesterol is because if you have high levels of cholesterol in your blood it can build up in the walls of blood vessels and can increase your risk of having a heart attack or a stroke. Therefore it is important to monitor your cholesterol and treat it if it is too high.

High cholesterol is caused by a combination of factors. Some of these can be modified including eating too much saturated fat and doing too little exercise. Others are “un-modifiable” such as your age, gender and other medical problems you may have.

We use your cholesterol results and your medical history to calculate something called your ASSIGN score. This is an estimate of your risk of having a heart attack or stroke over the next 10 years assuming we did nothing to improve your health.  This takes into account your age, recent blood pressure results and any significant family history of heart disease. Your GP can arrange a blood test for  this to be checked.  

If your cholesterol level puts you at high risk of having complications we usually start a medication called a statin. The decision to start this medication is usually a joint one between a patient and their medical team, and often we would try other measures (e.g. diet and lifestyle) before initiating drug treatment.  Statins are usually safe and well-tolerated. However, a small number of people develop side effects to statins. There is a very useful patient decision aid published by NICE which is aimed at helping patients making informed decisions about statins. 

What does your ASSIGN Score mean ? 

If your ASSIGN score is less than 10%: Your risk is low. You should concentrate on looking at your diet for any areas you could change to reduce your cholesterol intake and increasing your exercise. There is lots of helpful information about this on the British Heart Foundation website and others (see below) and our practice nurse would be able to discuss this with you further. We would not normally prescribe medication for someone in this situation but we are happy to discuss this with you. It would be reasonable to repeat your blood test in a year’s time. 

If your ASSIGN score is between 10 and 20%: You have an intermediate risk. At this level we would always recommend looking at diet and lifestyle changes but if we are not able to reduce your cholesterol or if there were other factors (such as other medical conditions or risk factors) we would consider the need to start you on medication (usually a statin). Please have a look at the information in the websites below and then arrange to discuss with our practice pharmacist regarding your results and whether you would benefit from a statin.

If your ASSIGN score is greater than 20%: Your risk is high. Whilst it is very important to make changes to your diet and lifestyle we would recommend that you make an appointment with our practice pharmacist to discuss whether you should start on medication to treat your high cholesterol.

If you have diabetes the recommendations above may differ – it would be sensible to discuss this in more depth with your GP.

Useful websites/sources of information are: 

British Heart Foundation:  www.bhf.org.uk 

NHS inform:  https://www.nhsinform.scot/healthy-living

Patient.co.uk:  https://patient.info/heart-health/high-cholesterol

NHS information on statins:  https://www.nhs.uk/conditions/statins/

Patient decision aid on statins: https://www.nice.org.uk/guidance/cg181/resources/patient-decision-aid-pdf-243780159

ERIC - provids support and care for children and teenager with a bowel or bladder condition 

NHS Squeezy is an App that helps women to remember to do their pelvic floor muscle (kegel) exercises and to do them in the right way.

Continence Nurses:  Patients requiring support with continence care can self refer to the continence care service. The number for self referral is:  0131 446 4307

The Edinburgh Counselling Agencies list can be found here and helps people find counselling appropriate to their needs, their locality as well as what they can afford. 

The list also highlights the likely time that someone might be expected to wait until they can be seen and a  contact name at each respective agency.

What is CKD?

CKD stands for Chronic Kidney Disease. 

CKD is actually a very common condition that affects about 1 in 10 people in the UK. Having CKD means that your kidneys do not work quite as efficiently as they should. Chronic just means that this is a long-term condition, but it does not mean that the condition is severe. Most people with CKD don’t even know they have it, they have no symptoms or only very mild symptoms, and it never causes them any long-term problems. Sometimes CKD is related to a pre-existing medical condition, it may be due to medication you use, or there may be a genetic or age-related reason. 

Why does it matter?

Identifying that you have CKD is important as it allows us to offer regular monitoring and enables us to offer risk reducing medication if this is appropriate for you. Often the only impact the diagnosis has on you is to encourage you to make a few lifestyle changes, such as:

• Keep well hydrated.

• Avoid medications, where possible, that can irritate the kidneys like anti-inflammatory tablets.

• Attend annual monitoring at the practice. 

Where do I get more information?

Kidney Care UK has an excellent set of online resources to give you more detailed information. You can find them here.

NHS Inform is another reliable source of information about CKD and can be found here.

If you have more questions after this, you are welcome to follow up with your usual GP.

What do I do now?

We would like to encourage you to attend every year for:

• a blood test (Kidney function test or C&E’s)

• blood pressure check

• a urine protein test (Urinary ACR)

You do this by making an appointment with a practice phlebotomist once a year, your birthday month is often a good time to do this.

Please bring a urine sample along with you in a white topped sample bottle, you can get one of these from reception. 

You can have your Blood pressure checked at the same time as your blood test.

A GP will see all the results a few days later.

Please phone for your results a week after your visit and you will be informed of the Doctor’s advice and any follow up that is needed. 

The Alzheimer’s Society provides support and advice for everyone affected by dementia.

Information, support and advice with dementia is available on the dementia support line by calling 0333 150 3456.

The Herbert Protocol is a national scheme introduced by the police in partnership with other agencies to encourage carers to compile useful information which could be used to help locate a vulnerable person if they go missing.

More information can be found at scotland.police.uk/herbertprotocol, where the form can be downloaded . 

You can learn more about the Herbert Protocol from PC Yocksan Bell (Missing Persons Co-ordinator, Police Scotland) in the following video

The Herbert Protocol form can also be used together with  Alzheimer Scotland Purple Alert, a free app designed to help find missing people with dementia. If someone is missing, users will get notified via the app so they can help with local searches.

Diabetes UK  - provides information for newly diagnosed diabetes and the ongoing care of diabetes. You can also call them on 0345 123 2399

My Diabetes My Way - NHS Scotland interactive diabetes website with advice and access to your own records

Type 2 Diabetes – Health Information is an NHS Lothian website that provides valuable information about what to expect following a diagnosis of Type 2 Diabetes and what you can do. 

Diabetes Managed Clinical Network - a variety of Patient Information Leaflets, support and advice for managing your diabetes can be found on the Lothian Health Board website here. 

NHS Lothian Weight Management - various healthy lifestyle support and resources are available to manage pre diabetes, type 2 diabetes and weight loss on the NHS Lothian website, including the 12 Week Weight Management Programme. You can self refer to this programme. Further information and self referral form can be found here. 

Medicines and Dehydration Leafet :  provides information for patients with type 2 Diabetes about  what actions to take if you develop an illness that causes dehydration.  It also contains advice as to what action you should take if you think you may be developing COVID-19.

Gestational Diabetes:  Studies show that having gestational diabetes, even if your blood sugars returned to normal after pregnancy, increases your risk of developing type 2 diabetes later in life.

In fact, up to 50% of women who have had gestational diabetes go on to develop type 2 diabetes within 5 to 10 years. However, the good news is that with the right lifestyle changes and regular monitoring, this risk can be significantly reduced.

We therefore recommend that women with a history of gestational diabetes have an annual HbA1c blood test – around your birthday month - to check average blood sugar levels. This helps monitor your health and provide support if any changes are needed.

You can learn more about gestational diabetes and how to reduce your risk at the following links:

NHS information on gestational diabetes:

https://www.nhs.uk/conditions/gestational-diabetes/

Diabetes UK – reducing your risk after gestational diabetes:

https://www.diabetes.org.uk/about-diabetes/gestational-diabetes

Local support via the ‘Let’s Prevent Diabetes’ programme:

https://services.nhslothian.scot/awmt2d/lets-prevent-diabetes/

In Scotland there are three national screening programmes to test for early signs of bowel, breast and cervical cancers. 

The earlier cancer gets detected the earlier it can be treated. More information can be found HERE.

All cancer screening services have now been resumed in Scotland.

Cervical Screening is routinely offered to women and anyone with a cervix in Scotland between the ages of 25 and 64. It can  stop cervical cancer before it starts.  

Although  the cervical screening programme has been resumed  it will take sometime to fully restore the service. 

If you have unusual discharge, or bleeding after sex, between periods or after the menopause, arrange a GP appointment. 

Breast Screening is  a test for breast cancers that are too small to see or feel. In Scotland, women between the ages of 50 and 70 are offered breast screening every 3 years.

FAQ and a video explaining what happens at a breast screening appointment can be found here 

Bowel Screening  is offered to men and women aged 50 to 74 across Scotland to help find bowel cancer early when it can often be cured. 

National Domestic Abuse helpline:

Tel: 0808 200 246 (free to call, open 24/7) 

https://www.nationaldahelpline.org.uk/

Scottish Woman’s Aid: 

Tel:  0800 027 1234

https://womensaid.scot/

Abused Men In Scotland (AMIS)

Tel:  0808 800 0024 

(free to call, open Mon-Fri 9am-4pm) 

https://amis.org.uk/

Ear wax can be uncomfortable and troublesome but with some simple self care measures can be treated effectively at home. 

Information about how to do this can be found here

Appointments for ear care services, including ear syringing and checks prior to audiology appointments are now provided from the Community Treatment and Care Service (CTAC) at Sighthill Medical Practice. 

An appointment can be arranged by calling: 

0300  790  6296

This is an automated service and you will be asked to leave your details when you call. Information on what details are required will be provided. 

A letter will then be sent to you for the next available appointment. 

Anyone can have a fall, but it's more likely if you're older or have mobility problems. 

Making changes to prevent falls can help you avoid injuries and keep your confidence and independence. 

Information and advice on  how to avoid trips and falls can be found here. 

Public Health Scotland have produced the  Up and About leaflet that provides lots of useful advice on how to avoid  trips and falls

NHS Inform also has information on how to reduce your risk of falling at home

Many people develop a fungal nail infection at some point in their life. It's not usually serious, but can be unpleasant and difficult to treat.

The infection develops slowly and causes the nail to become discoloured, thickened and distorted.

It can  affect one or more toenails and fingernails and most often involves the great toe nail or the little toe nail.

Information about the treatment for  fungal nail infections can be found here. 

Some patient may be treated with  terbinafine and important information about direction when taking this medication can be found here. 

Chronic or persistent pain is pain that lasts longer than 12 weeks, or beyond the natural healing time. NHS Inform contains lots of useful information and resources to support people living with chronic pain and can be found here. 

Learn more about your pain and what you can do to manage it yourself by booking a 2-hour pain education session provide by Pain Concern. 

Further information and booking details can be found here 

Ten Footsteps to Living Well with Pain is a step-by-step online guide to living well despite your persistent pain

Information about using the tool kit can be found here. 

Action for Pain is a local free six week group programme to support people in chronic pain.

The Charity Health All Round in conjunction with Lothian NHS  provides a  programme that will help you understand your pain, and highlight effective ways to manage and improve your pain.

More information can be found here. 

To register contact  actionfor pain@healthallround.org.uk or phone 07707916177 or 0131 337 1376.

The Wellbeing after Miscarriage programme is a 6-part online programme designed to support your physical and mental health after miscarriage. 

This free online programme includes: 

• mental health support from specialist counsellor – addressing topics such as grief, bereavement, sleep and self-care strategies

• physiotherapist-led sessions to rebuild core strength and reconnect with your body after a loss

• exercise sessions specially developed for those who’ve been through a miscarriage, for all fitness levels.

Information about it can be found here. 

NHS Inform also provides lots of useful information and links to various support , including giving you someone to talk to, providing information about what happens next and  online resources. 

Further information can be found here. 

Information about Community Podiatry Services in Lothian can be found here.

You can now  self refer to the Community Podiatry Service. 

Download the form here and return it to the address on the form. You will be contacted with a suitable appointment.

Understanding PSA Testing: What Patients Should Know

We are aware that there is an increased interested in prostate cancer and PSA testing. If you are 45 years or over you can book an appointment for a PSA test with one of our phlebotomist without speaking to the doctor first, however we recommend that you read the following information in advance of your appointment.  

What is a PSA Test?

The Prostate-Specific Antigen (PSA) test measures the level of PSA, a protein produced by the prostate gland, in the blood. Elevated PSA levels can indicate prostate problems, but it doesn’t necessarily mean you have prostate cancer.

Why is the PSA Test Done?

The PSA test is commonly used to:

• Screen for prostate cancer in men over 50 or those at higher risk (e.g., family history).
• Monitor prostate cancer in patients who have already been diagnosed and treated.
• Help investigate symptoms such as difficulty urinating, pain, or blood in urine.

What Can PSA Levels Indicate?

High PSA Levels: Elevated levels can suggest prostate cancer, but they can also be caused by non-cancerous conditions like benign prostatic hyperplasia (BPH) or prostatitis (inflammation of the prostate).

• Low or Normal PSA Levels: A low PSA level typically indicates a lower likelihood of prostate cancer, though it's not a guarantee. Some men with normal PSA levels may still have prostate cancer, especially in its early stages.

Factors That Can Affect PSA Levels

PSA levels can be influenced by several factors, including:

• Age: PSA levels naturally increase with age.
• Prostate size: Larger prostates can produce more PSA.
• Recent activities: Recent sexual activity, prostate infection, or a digital rectal exam (DRE) can temporarily raise PSA levels.
• Certain medications: Drugs like finasteride (often used for BPH) can lower PSA levels.

PSA Test Limitations

• False positives: A high PSA level doesn’t always mean cancer. Many men with elevated PSA levels do not have prostate cancer.
• False negatives: Some men with prostate cancer may have normal or low PSA levels.
• PSA testing is not perfect and should be combined with other tests (like biopsy or imaging) for a more accurate diagnosis.

Screening Guidelines

There is ongoing debate about the benefits of routine PSA screening:

• For average-risk men: The Prostate Cancer Society suggests discussing PSA testing with your healthcare provider starting at age 50, or earlier (around age 40-45) for those at higher risk (e.g., African American men or those with a family history of prostate cancer).
• For older men: Men over 70 or with a life expectancy of less than 10 years may not benefit from routine PSA testing.

Risks of PSA Testing

While PSA testing can detect early prostate cancer, it can lead to overdiagnosis and overtreatment. Some prostate cancers grow very slowly and may never cause symptoms, so treatment may not always be necessary.

What Happens After a PSA Test?

If your PSA level is elevated, further tests such as a biopsy or imaging may be recommended to check for cancer.

• If the test shows normal or low levels, your doctor may recommend periodic testing to monitor any changes over time.

In Summary

PSA testing is a useful tool for detecting prostate issues, but it is not definitive for diagnosing prostate cancer.    

Prostate Cancer UK  also provide useful information and support about prostate cancer and testing. 

STIs & STI Testing

Routine check-ups for sexually transmitted infections are now usually done using a Self Sampling Kit that can be posted to your address. 

You can order a kit online here.  You can also request a  kit by calling  0131 536 1070.

Alternatively you can also attend the  ‘No-Talk’ Testing clinic at Chalmers Centre.

You only need to book an appointment at the Practice if you have symptoms. 

Further information about Lothian Sexual Health Services can be found here. 

Contraception  

Appointments for  coils, implants and STI testing can be made directly either  online at 

www.lothiansexualhealth.scot/book-an-appointment/  or calling : 0131 536 1070

Young People and Sexual Health 

If you are aged between 13 and 18 years you can access the Edinburgh Young Persons Sexual Health Service.  You can get help with: 

• STI testing and treatment
• Pregnancy testing
• Emergency contraception (sometimes called the morning after pill)
• Contraception – this includes the pill, injection, coil, implant and other options
• Accessing our Choices service if you are pregnant and want to chat about your options

Drop-in clinics run at various sites and further information can be found here. 

Smoking is one of the single largest preventable causes of premature

death and ill health in Scotland

Information on the benefits of quitting smoking and support to help you quit can be found on NHS Inform here. 

Quit Your Way Scotland provides free  advice and support services for anyone trying to stop smoking in Scotland. 

Your local community pharmacy  also provides free stop smoking services. Find your local pharmacy  that can provide this service here 

You can also call the local Smoking Cessation Nurse on 0131 286 5113

Warts and verrucas are small lumps that often develop on the skin of the hands and feet  and  are  caused by an infection with the human papilloma virus (HPV).

NHS Inform provides useful information about the treatment and prevention of warts and verrucas and this can be found here. 

Most warts are harmless and clear up without treatment however you can get advice  and treatment directly from a pharmacy if required. 

Self care advice for warts and verrucas can also be found here. 

If you are concerned about a growth on your skin however, please arrange to see the GP. 

Travel Vaccinations 

Travel vaccinations are now  no longer provided by  General Practice.

NHS Lothian provides travel vaccinations at designated travel clinics and information about this service can be found here.  

NHS Lothian Travel Clinic  can be contacted on 0131 537 2823.

Booking lines are open Mon-Fri 9.00am-5.00pm and there is an answering machine service available.

Please be aware that  advice can not be given over the phone and clinics are by appointment only. 

Travel Advice 

Useful travel  advice and vaccination information and can be found at NHS Inform.  

You can also get lots of useful up-to-date travel advice, including what vaccinations you may require from:

www.travelhealthpro.org.uk

Tablets for fear of flying: why we don’t prescribe them any more

People sometimes ask for diazepam, or similar such drugs, to be prescribed for fear of flying or to help sleep during flights.

Prescribing these drugs for this purpose is now not recommended for a variety of reasons. More information about why this is and  aviation industry recommended flight anxiety courses as an alternative can be found here.

INFORMATION ABOUT THE MENOPAUSE

World Menopause Day is on the  18th October each year. 

The theme for World Menopause Day this year is Menopause Hormone Therapy.

As part of this the Health and Social Care Alliance Scotland are hosting a free online webinar on 17th October from 1-2pm. 

To register please click the link to complete the short booking form:

https://us02web.zoom.us/webinar/register/WN_rnNxIHWjTXCXSjJ-8x7uUA#/registration 

Further Information about the Menopause can be found can be found on the International Menopause Society website here 

The British Menopause Society comments on the Channel 4 programme: Davina McCall: Sex, Myths and the Menopause can be found here. 

Further information from the Alzheimer's Society about hormones and dementia can be found here. 

Menopause Matters is a UK website providing up-to-date, accurate information about the menopause, menopausal symptoms , remedies, and advice. 

A guide to HRT and the menopause can be found here. This booklet has been  wriiten by staff at the Edinburgh Menopause Clinic to help women reach a decision on whether or not they wish to start, or continue, taking hormone replacement therapy (HRT).

Guidance from Lothian Health and the Scottish Medicines Consortium on the  use of  Utrogestan® (micronised progesterone) as the progestogen component of HRT can be found here 

Information to help you understand the breast cancer risks of HRT can be found  here.

ALISS  (A Local Information System for Scotland) will help you find services, groups and activities for health and wellbeing across Scotland. Using AI you can text or speak to search for groups, activities and services. 

NHS Inform  Health and care information for the people of Scotland

NHS24 - information about help and services 

NHS Scotland  - lots of useful self help guides, local services and  health resources

NHS Lothian - information about primary and secondary care medical services in Lothian

Patient - a useful website with lots of self help information and advice for various ailments

This booklet is packed with practical tips on how to keep you, your family and your community safe – from protecting your home and possessions to helping your children enjoy the benefits of the internet in safety.