Health Matters - Autumn 2012 by NHS Medway

Medway

Autumn 2012

Kent and Medway

Win family passes to The Historic Dockyard Chatham page 15

Your Guide to Local Health Services page 19

Diabetes left Georgia within days of death page 7

How I got to be like everyone else at the gym. Page 4

I chose feeding my baby over smoking. Page 5

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Inside Contacts

Welcome

Editor Laura Patrick

Welcome to this, the fifth edition of Health Matters, containing the 2012/13 guide to local health services for Medway residents.

Contributors Emma Burns Emily Turner Julia Rogers For the latest news, stories and information, visit www.medwaypct.nhs.uk Follow us on Twitter @NHSMedway or visit our Facebook page www.facebook.com/nhshealthmatters NHS Kent and Medway Fifty Pembroke Court Chatham Maritime Chatham Kent, ME4 4EL Tel: 01634 335020 While every effort has been made to ensure the accuracy of the contents, the publisher cannot accept responsibility for errors or omissions. If you have an idea, story or query, want to know about alternative formats or would like to order a copy in large print, contact: itsyourhealth@nhs.net or phone 01634 335210

Dr Pete r Green

Since the last edition, Medway Clinical Commissioning Group has been making important changes to the way health care is delivered, which you can read about in Health Matters. We’ve been internationally recognised for our innovative work to develop technology which will help you to make lifestyle changes to improve your health. Read more on page 14. Early signs of changes to our health may mean the start of something serious. Our cover girl, Georgia Horsley, didn’t know her extreme weight loss and thirst were signs that she had diabetes. Doctors told the teenager that if left untreated, she would have died. Read her courageous story on page 7. Jacquie Brown knew that her tickly cough may have been an early sign of something more serious. Read about her battle with lung cancer on page 6. People who have the most life-threatening injuries, such as head injuries or stab wounds, can now be treated in a new state-of-the art trauma centre in Medway. Read more on page 10. Please let us know your comments or suggestions about Health Matters by emailing itsyournhsmedway@nhs.net or phoning 01634 335210. Dr Peter Green Accountable Officer Designate Medway Clinical Commissioning Group.

Competition winner

Design and print by Cherry www.cherrycommunications.co.uk

In the spring edition, The Roffen generously donated a six month gym membership and a meal for four people at its private-members’ club in Rochester. The winner of the six month gym membership was Anne Ward of Chatham and the meal for four was won by Keith Judges from High Halstow

Photography by Praxis Design www.praxisdesign.co.uk

New times for blood testing service

NHS Kent and Medway represents the three primary care trusts; NHS Medway, NHS Eastern and Coastal Kent and NHS West Kent.

People who need to have their blood tested can now visit Medway Maritime Hospital in Windmill Road, Gillingham, from 7am to 4.30pm, Monday to Friday. The Elms branch surgery session time at Grain village hall in Chapel Road has also changed to 9am to noon every Friday. Full details of the locations and opening times of all blood-taking clinics in Medway are available at www.medwaypct.nhs.uk/bloodtest

Kent and Medway

Matthew achieves his excercise dream Do you want to lose weight or become more active, but don’t know where to start? Why not become one of the growing number of people like Matthew Burley who have been supported by Medway’s public health team. Visit www.abettermedway.co.uk to find out more or follow @abettermedway on Twitter and www.facebook.com/bettermedway Matthew Burley feels like a new man since joining A Better Medway’s exercise referral programme. Since completing the 12-week programme, the 24-year-old’s strength and muscle control is the best it has ever been. “Matthew had a stroke before his first birthday, which had left him blind and weak down the left side of his body,” his mum Pat recalls. “His sight returned after three months, but doctors told us he had been born with only Type 1 muscle fibres – most people are born with both Type 1 and 2. This affected his mobility, causing him to be unstable on his feet and the need to walk with a frame. It also affected his ability to build muscle.“ When Matthew, who lives with his family in Rainham, was told he could take gentle exercise, he joined the exercise referral programme. The programme, which is available in all of Medway Council’s leisure centres, gave Matthew the chance to get regular hands-on experience using gym equipment, with help from an exercise instructor.

“Matthew’s goal was to improve his balance and walk unaided, as well as to build some muscle,” Pat explains. “His instructor made sure the exercises suited his needs and ability.” Matthew attended gym sessions once a week at Echoes at Splashes Leisure Centre and since completing the programme he has continued to visit Echoes and a private gym three times a week. His weight has increased from six to nearly eight stone and his diet and confidence have also improved. “Matthew just wanted to be like every other young person who goes to the gym,” Pat says. “Now he has his regular days where he knows he will be going to the gym and working out and he really looks forward to them. He feels so much better in himself, he is eating well and friends and family comment on how much stronger and more grown-up he looks. The course has helped his self-esteem and confidence tremendously. It is really supportive and tailor-made for young people like Matthew who have complex needs. I’m so pleased.” Speak to your GP or practice nurse about the exercise referral programme, or phone the A Better Medway team on 01634 333720 or email medwayexercisereferral@nhs.net for details.

I quit smoking to save my baby “The thought of not being able to hold my new born baby was the kick I needed to stop smoking during my pregnancy,” Lorine Cowdry remembers. The 31-year-old mother of three from e in r Rainham cradles her o L ily: Happy famith her youngest child, Cowdry whildren Caitlyn, who is one, three c and says she regrets the day she started smoking when she was 13. “It was the usual story of wanting to fit in with my friends and look cool in front of boys, but to be honest I didn’t smoke properly and I hated it.” After trying to quit several times, Lorine always said she’d stop when she became pregnant. However, she found quitting more difficult than she imagined. “I thought that I wouldn’t smoke as soon as I saw the positive result, but I found it really hard. I cut down from about 30 to 20 a day and finally down to 10.“

“I was about three-and-a-half months pregnant with my first son when I finally quit. I replaced my daily cigarettes with fruit and the odd chocolate bar. My husband also gave up at the same time as me, which was a big help.” Babies born to women who smoke may become distressed during labour and, like Robert, may need to be delivered by Caesarean section. “Robert, who is now five, has also had croup every winter since he was born and now has seasonal asthma. We are not sure if this is linked to my smoking, but I am sure it hasn’t helped.” Lorine, who didn’t smoke during her other two pregnancies, is now encouraging other smoking mums-to-be to contact Medway’s Stop Smoking Service to get the help they need to quit. The service offers specialist one-to-one support for pregnant women who want to stop smoking, whatever stage of their pregnancy. For more information phone 0800 234 6805 or 07990 583195 and ask for Fareeda Williams, email medwaystopsmokingservice@nhs.net and/or visit www.abettermedway.co.uk/smokinginpregnancy

Lorine knew that women who smoke during pregnancy are putting their unborn child at risk of being born stillborn, prematurely or underdeveloped; at increased risk of cot death and being born addicted to nicotine. Unborn babies are also forced to float in more than 4,000 harmful chemicals while in the womb, including arsenic, tar, polonium, carbon monoxide and formaldehyde. A meeting with a smoking counsellor during one of her antenatal appointments at Medway Maritime Hospital was the wake-up call she needed. “I was told you shouldn’t hold a new born baby for at least half hour after having a cigarette as the nicotine residue on your hair, skin and clothing would be absorbed by the baby. I planned to breastfeed Robert and this meant I had to choose between smoking or feeding my child; feeding my child won.” With the help of Medway’s Stop Smoking Team and her husband James, Lorine managed to quit.

A Better Medway’s hard-hitting campaign to encourage pregnant women to stop smoking

Lung cancer

When a tickle isn’t funny Jacquie Brown’s cough was driving her – and everyone around her – mad. “It was a really irritating tickly, but hoarse-sounding cough,” the 63-year-old grandmother of six says. “I bought some over-the-counter remedies, such as cough mixture, sweets and inhalers, but nothing seemed to help. “It went on for about a month and was driving me mad.” Her GP prescribed a course of antibiotics but, after three weeks, the cough hadn’t cleared up, so she was referred to the hospital for a chest x-ray. The results were inconclusive. “My GP had a gut feeling that something wasn’t right and sent me for a second chest x-ray. During the next five months I had a CT scan and a biopsy. I have never smoked, but I still had this hacking cough; nothing seemed to clear it up and no-one knew what was causing it.” Nearly seven months after her cough began Jacquie, who lives in Rainham, was told that she had lung cancer and that her persistent cough was a tell-tale sign of the potentially deadly disease. Other signs include a cough that has changed over time; coughing up blood; tiredness or lack of energy;

unexplained weight loss; chest or shoulder pain and being short of breath; having a chest infection that does not go away with treatment or a hoarse voice. “It was a very strange emotion when the doctor told me I had cancer; I started laughing and crying and then broke down. I don’t know if it was relief that they had found the reason for the cough.” Within a couple of weeks Jacquie had the cancer removed from her right lung at Guy’s Hospital in London. She also underwent a month-long course of radiotherapy at Maidstone Hospital. More than 140 people are diagnosed with lung cancer in Medway each year, making it one of the most common types of cancer in the area. Jacquie is now urging anyone who has any of the symptoms to contact their GP. While it’s unlikely to be lung cancer, the sooner it’s checked out, the quicker and easier the cancer, if diagnosed, can be treated. “It’s not going to beat me and I’m not going to put my life on hold just because I have cancer,” an upbeat Jacquie says. “I’m glad my cancer was picked up and I would encourage anyone with any of the signs and symptoms to visit their GP.” Visit www.nhs.uk/lung-cancer for more details.

Every night I fear Georgia won’t wake up

Diabetes

It was the early hours of the morning and Georgia Horsley had gone to the toilet for the third time that night. The sound of a running tap woke her mum, Jacqui.

high. If it’s too low I’ll have a sugary drink to bring it back up. I also have to count the carbohydrates in my food to work out how much insulin I need to inject for every meal.”

“Georgia kept going to the toilet and would have a drink immediately after,” the mum of two says. “She’d also lost about a stone in a fortnight – her clothes were hanging off her.”

There is also an emergency injection of Glucagon in the Horsleys’ fridge, which would be used if Georgia became unconscious. Thankfully, they have never had to use it.

Doctors diagnosed Type 1 diabetes, a potentially life-threatening condition which is caused by the body no longer being able to produce insulin, which turns food into energy. If left untreated, it can cause dangerously high blood sugar levels which could lead to blindness, kidney failure and, in rare cases, death.

“There is a strong risk that her glucose levels could drop while she’s asleep and she would not wake up,” Jacqui says. “I feel a sense of relief every morning when I hear Georgia get up.

The main symptoms of diabetes are feeling very thirsty; going to the toilet often, especially at night, extreme tiredness and weight loss.

“Diabetes is very stressful. I worry she won’t notice her blood sugar level dropping until it’s dangerously low, meaning she becomes confused and is unable to ask for help.”

“Two more days and she’d have been dead.”

Jacqui says: “We were told she’d have been dead if we had left it for two more days.” The bubbly 15-year-old now has to test her blood sugar levels at least eight times a day and inject insulin into her body more than four times a day. Georgia says: “I thought I’d have about three injections and would be okay; I didn’t know I’d have to inject insulin every day for the rest of my life. “I need extra insulin if my blood sugar levels are too

Warning signs that Georgia’s sugar levelsmay be low are feeling light-headed, having shaky hands, mixing up her words and having very pale-coloured skin. The pair have set up three Facebook groups to support other families – Diabetic Mums UK; Type One Teens and Parents of Type 1 Teens. Georgia says: “The groups are a place where they can talk openly about how they’re feeling or to share advice. I’ll always have diabetes, but I still do things like a normal teenager – I’m not going to let it take over my life.”

Online support: Georgia and Jacqui have set up Facebook support groups

Mental health consultation

Improving mental health crisis care – have your say A consultation is underway on plans to improve care for people of working age in Medway who are suddenly and seriously mentally ill. The plans are needed because of big changes to the way people in a mental health crisis are cared for. They also offer a solution to real problems with A Block, the inpatient unit for people from Medway, Sittingbourne and Sheppey. Around 700 people of working age who live in Medway experienced a mental health crisis last year. In the past, they would all have been taken to hospital. But dramatic improvements to round-the-clock crisis care over the last few years means that most people can now be looked after in their own home. Last year, 432 people were treated at home by the crisis team. Treatment at home is what most people prefer and it is also proven to help people recover more quickly. However, 320 people were so unwell, they could not stay at home. They were admitted to an inpatient unit, most of them to A Block which is run by the mental health trust, Kent and Medway NHS and Social Care Partnership Trust (KMPT), on the Medway Maritime Hospital site. Some people had both kinds of care in the 12 month period. Dr Rosarii Harte, Assistant Medical Director for KMPT, said: "When people are treated as inpatients now, it is because there is a real risk they would hurt themselves or others, or because their family or those around them are no longer able to look after them. “This means smaller numbers of people are being admitted and they are more ill than in the past. They need highly specialist care which keeps them safe and does everything possible to promote their recovery.”

There are a number of problems with the way services in Kent and Medway are organised at the moment. One is that A Block is not up to 21st century standards. There are also not enough beds in east Kent and too many for west Kent. A psychiatric intensive care service which supports staff on the wards in west Kent and Medway, is not available in east Kent.

Problems with A Block In Maidstone, Dartford and, from November in Canterbury, people have single rooms with en-suite bathrooms, and easy access to the outside which is proven to help recovery. At Medway’s A Block however, there are only two single rooms. Most people sleep in dormitory bays with four or five beds. People who may be very distressed or very delusional have only curtains around their beds to provide privacy. Sixteen people share two bathrooms in each of the wards. People in wards on the first floor who want fresh air have to wait to be escorted downstairs. This inevitably builds up frustration. Medway’s A Block has 34.5 per cent of the beds in west Kent and Medway – but in 2011-12 it had: • 43 per cent of the reported violent incidents to staff and other patients • 38 per cent of the referrals from acute wards to the psychiatric intensive care units, and • 53 per cent of reported serious incidents, all five of which resulted in injury. Louise Clack, the modern matron who manages Medway’s Acute Service for KMPT, said: “I’m really proud of what the staff in A Block do but they are frustrated by the facilities, which simply are not the kind of environment conducive to patients’ recovery.”

Mental health consultation KMPT, supported by NHS Kent and Medway, is now proposing that: • inpatients are treated in future at its centres in Dartford, Maidstone and Canterbury which will become centres of excellence. These will offer state-of-the art accommodation, with en-suite rooms and better access to psychiatric consultants and therapies • A Block is no longer a mental health inpatient unit. Instead, people from Medway, Sittingbourne and Sheppey who need to be admitted are treated in one of the three centres of excellence so they can get their own bedroom, en-suite bathroom and easy access to outdoor space like everyone else in Kent. • the psychiatric intensive care outreach service is expanded to cover all of Kent and Medway; and more beds are made available for people from east Kent, by converting the current Psychiatric Intensive Care Unit in Canterbury to provide inpatient beds • £297,000 a year is invested in additional Crisis Resolution Home Treatment (CRHT) staff from April 2013 to further strengthen crisis care for people in their own homes. The proposal means that people living in Medway would use the centre of excellence at Dartford. Lauretta Kavanagh, Director of Mental Health Commissioning for NHS Kent and Medway, said: “Since 2000, the NHS in Medway has made many attempts to find alternatives to A Block in more suitable buildings nearby. None was successful. With the changes to mental health crisis care, we know that we need to focus inpatient care in fewer centres providing the best possible service for the most acutely mentally ill people. “This is similar to changes in other specialist NHS services, such as for heart attack.

"We have drawn up the plans after speaking to service users, carers, mental health professionals, GPs and others. They take into account people’s natural worries about transport for friends and family visiting inpatients. "I would like to ask you to read our information and respond to the consultation. This will help us take the right decisions."

Have your say Both the full consultation document and a summary, including a survey, can be read at www.kmpt.nhs.uk/acute-mental-health-review or for a copy, please email pals@kmpt.nhs.uk or call 0800 587 6757 or 01227 791281. You can also visit one of the road shows in Kent and Medway: Maidstone: 18 September, 2-5pm at Maidstone Community Centre, 39-48 Marsham Street, Maidstone, Kent, ME14 1HH Swanley: 28 September, 1-4pm at Swanley Banqueting, Alexandra Suite, St Mary’s Road, Swanley, Kent, BR8 7 BU Medway: 2 October, 6-9pm at The King Charles Hotel, Brompton Road, Gillingham, Kent, ME7 5QT Ashford: 4 October, 10am to 1pm at Norman House, Beaver Business Park, Beaver Road, Ashford, Kent, TN23 7SH The closing date for responses is 26 October 2012.

Trauma network

Trauma network saves lives Medway residents who suffer the most serious, life-threatening injuries will soon be treated at a dedicated 24-hour specialist trauma centre in London. The major trauma centre at King’s College Hospital in London is presently supported by a network of trauma units across south east London. From November, the Kent and Medway trauma units, including one at Medway Maritime Hospital, will also be in place, forming a new South East London, Kent and Medway major trauma network (SELKaM). The new trauma network will provide round-the-clock, life-saving treatment for seriously injured patients, such as those who have head injuries, stab wounds or have been in a car accident. In some cases, patients will need to be transferred to King’s College Hospital as the quality of care they receive will be improved, increasing their chances of survival. King’s College Hospital’s Major Trauma Centre, which will operate 24-hours a day, is staffed by consultant-led specialist teams which have access to the best state-of-the-art diagnostic and treatment facilities. The local trauma units will have access to round-the-clock care from their own consultants, an on-call surgeon, a senior trainer surgeon and CT scanning. The units will also work directly with a trauma consultant at King’s to ensure patients receive the very best care. This trauma network will be supported by South East Coast Ambulance Service NHS Foundation Trust (SECAmb) and the Kent, Surrey and Sussex air ambulances, so that severely injured patients can be taken to the right place for their care quickly and safely. For the first time the ambulance service and helicopter emergency service will work directly with the major trauma network to ensure the most urgent patients are sent to the most appropriate place. This could be straight to the major trauma centre in London, to a local trauma unit for stabilisation first or to a local trauma unit for treatment. There will be 22 major trauma networks across the country, which will improve the care and treatment of patients. They are predicted to

save around 600 lives across the country each year and have been proven to reduce deaths by up to 40 per cent. Dr Robert Stewart, Co-Medical Director at NHS Kent and Medway, said: “The number of patients who suffer this type injury is thankfully small but their complexity and seriousness means that patients are best treated in specialist centres which have the necessary resources and skills to treat complex and sometimes multiple injuries. “This new system is a great example of the difference that can be made to patients’ lives by having all the expertise, experience and equipment in one place. It will improve the quality of care patients receive, as well as saving lives.” Accident and emergency departments will not be affected by the networks as 90 per cent of emergency departments see less than one major trauma case a week, and 75 per cent have fewer than one a fortnight. People will continue to go to their local A&E for most injuries. However, the new networks will mean that those most seriously injured will get the specialist care they urgently need, improving outcomes for patients and, ultimately, saving lives.

Electronic prescribing

Prescriptions at the touch of a button A simple click of a mouse button has saved Eric Hartup countless trips to his GP to request repeat prescriptions. Since he began using the NHS Electronic Prescription Service (EPS) last year, Eric has been able to spend more time with his wife, Gillian, rather than driving in his car across Medway to drop off and collect their prescriptions. Eric now emails his repeat prescription request to his preferred pharmacy – Boots at Hempstead Valley Shopping Centre – where a pharmacist contacts his GP to confirm the request. Once the pharmacist has processed the order, Eric collects his prescriptions directly from Boots. “I think it’s out of this world,” the 79-year-old enthuses. “I have 11 medicines that I regularly use and this service has saved me hundreds of trips driving to my doctor in Rainham and then to my chemist; it’s a really clever idea.” More than 20 GP practices and 40 pharmacies in Medway are using the EPS, which has helped reduce pharmacy waiting times as prescriptions can be made up in advance. Eventually all GP practices and pharmacies will offer this service. But you don’t need to be like Eric and use the system at home to send your request. If you choose to sign up to EPS you can request a repeat prescription from your GP, who will then use the online service to send their patients’ prescriptions direct to a participating pharmacy of the patient’s choice.

Eric and Gillian Hartup, who use the electronic prescribing service.

This means there is no need to visit your GP, simply collect your prescription from the pharmacy. More than 7,000 people have so far signed up to the service in Medway, which is completely safe, with only approved NHS staff being able to use the secure, online system. The service means that patients can collect their prescriptions closer to home or work, or from a participating pharmacy with longer opening hours.

“It’s out of this world” Pharmacist Helen Morley has been providing EPS at her Boots pharmacy at Hempstead Valley for nearly six months. “We love it,” she says. “The system is a lot quicker and easier. The GP can now electronically send us a prescription if any items have been missed off, or an item is out of stock and the prescription needs changing, rather than the patient having to go back to their surgery to collect a new form or waiting for us to go to the surgery the next day. It also gives us time to prepare the medication or get it ordered, which means the prescription is ready and the patient doesn’t have to wait around. “We have found the new service very easy to use and the customers love it as it makes the process much quicker.” You can find out more about EPS and if your GP or preferred pharmacy is offering EPS by visiting www.nhs.uk or www.connecting forhealth.nhs.uk

Dementia

We’ve got a glimmer A wide smile spreads across Christine Walker-Richmond’s face when she remembers the day her mum, Barbara, stopped taking powerful drugs used to treat her Alzheimer’s. “It was very moving,” she remembers. “Mum was sitting on a chair with her arms reached out and she recognised me. She was so animated and joyful, it was like a glimmer of her had come back.” Barbara, 78, is one of 160 people in Medway whose dementia was being treated with antipsychotics, which can help manage some of the symptoms of dementia, including wandering, shouting, physical and verbal aggression and the loss of sexual inhibitions. While low doses of antipsychotics help some patients, they can cause dizziness and unsteadiness, leading to falls and injuries in some people. They can also increase the risk of strokes. Barbara, who was diagnosed with Alzheimer’s in 2005, was put on antipsychotics when she went into care three years ago. Christine says. “She became much quieter and subdued when she was on them; it wasn’t my mum at all.” During the past seven years, the family has rallied together to support Barbara. “We knew that she probably had Alzheimer’s about four years before she was diagnosed. We used to laugh at her funny ways, silly things like not letting people come into the house through the back door and repeating herself, but we just put it down to forgetfulness.”

Barbara Walker-Richmond and her husband Tony at their Golden Wedding anniversary in 2004, a year before she was diagnosed with Alzheimer’s.

Dementia

of mum back But it was during a family holiday in Dymchurch in 2004 that Christine decided to test her mum’s ‘forgetfulness’. “We knew that something wasn’t right with mum. I’d read about some of the ways to check if someone has dementia, like asking them to name the Prime Minister or being unable to sign their name. I gave mum a piece of paper and a pen when everyone went out to get fish and chips and I asked her to write her name, but she couldn’t – she kept drawing a line down the piece of paper.” After their holiday, Christine persuaded her mum to get tested for dementia. “Mum being diagnosed was horrendous. We didn’t know what to expect. It’s the most soul destroying thing you can go through and watch. We have seen my mum disappear and go from being an active person to wasting away.” A glimmer of light came when Barbara was moved to one of Avante Care and Support’s care homes, Amherst Court, a residential home in Chatham which provides specialist care for people with dementia. The home took part in a pilot to see whether some residents could be weaned off antipsychotics. This followed a review by NHS Kent and Medway which identified 160 patients in Medway who were taking low doses of antipsychotics. Avante Care and Support strongly supported Barbara being taken off this medication. Anne Child, Head of Pharmaceutical Care and Clinical Standards at Avante Care and Support says: “There was such a great outcome for the project for many reasons, but the main one is the difference it made to our residents at Amherst Court. The project was extremely rewarding and we will be reviewing all our residents’ medication with their GPs and other healthcare professionals to deliver high quality care.”

For more information on Amherst Court or any of Avante Care and Support Care homes or services, please call 01795 597431, email enquiries@avantecaresupport.org.uk or visit www.avantecaresupport.org.uk

Dementia cafés Get the support and advice you need for either your dementia, or that of someone close to you, at one of Medway’s dementia cafés. The cafés are a place for people with the condition and their carers to meet and share their experiences, find out about support services and and listen to guest speakers talk about living with dementia. Dementia cafés are held on the second Friday of each month at Amherst Court care home in Palmerston Road, Chatham from 1 to 3pm and at St Paul’s Church in Long Catlis Road, Parkwood from 1 to 3pm on the first Tuesday of the month. The cafés are run by the Alzheimer’s Society on behalf of NHS Kent and Medway, and Medway Council. There is no need to book, but the café cannot offer personal care or one-to-one counselling. Contact Sylvia Wolfson on 07557 111060 or email sylvia.wolfson@alzheimers.org.uk to find out more.

Christine says: “We know that we are never going to get mum back completely, but we feel as if we have got a little bit of her back since she has come off the drugs.”

Medway Clinical Commissioning Group

Technical Revolution By Dr Peter Green, Accountable Officer Designate ‘Skyping’ your GP, tracking and monitoring your blood pressure on an app, or taking part in a teleconference with your healthcare team may sound a little futuristic, but they are just some of the cutting-edge examples being explored to improve the NHS. Medway has been at the forefront of research and the use of technology in supporting patients. A pioneering piece of software called Audit+ is helping Medway GPs to improve the health of their 275,000 patients. The software allows GPs to quickly see their patients’ health and lifestyle factors, including their family history, so they can provide the most appropriate treatment. Audit+, which was nominated for a prestigious award and has gained international interest, can help manage conditions such as irregular heartbeats, heart failure and chronic bronchitis, raised cholesterol and kidney disease. It is also useful to support people to stop smoking, lose weight and drink sensibly. Patients with skin conditions are also benefitting from technological advances. A dedicated team of dermatology nurses take photographs of an affected area, which are then uploaded to dedicated telemedicine software. The images are reviewed by a consultant dermatologist, who decides on the most appropriate treatment for the patient. The service, which is run from Medway Maritime Hospital, has helped reduce waiting times and ensured that patients are seen in the right place, at the right time. Teenagers can get details of where to get free condoms, emergency contraception and treatment for sexually transmitted infections by using the award-winning Kent and Medway C Card app. The NHS smartphone app, which was designed to help reduce unplanned teenage pregnancy and prevent sexually-transmitted infections, is available on iPhone, Blackberry and Android. Visit www.medwaysexualhealth.co.uk for details. Apps have also been developed by Diabetes UK and Asthma UK to help patients in the early stages of these diseases share medical information with their community nurses. We are looking at developing clever IT solutions to help health and social care teams to share information more easily. It will involve working with telecommunications companies and using smartphones, apps and the internet more widely to improve care.

The award-winning C Card app

Telehealth uses electronic equipment to monitor a patient’s daily health, like their pulse, blood pressure and sugar levels, from the comfort of their own home before sending it to a community matron or specialist nurse. Being able to track a patient’s condition so closely not only helps people to manage their own condition, but prevents crises and fewer emergency admissions to hospital. The Department of Health is so impressed it is now championing its use nationwide. One thing is for sure, if the NHS locally is to embrace the challenges of the 21st century, we must now embrace the opportunities that technologies bring. The techno revolution is here.

Three of the best free health apps 1 The Diabetes UK app gives people reminders on checking blood sugar levels and taking medication. Information can then be sent electronically to the patient's surgery or clinic. www.diabetes.org.uk 2 iBreastCheck from Breakthrough Breast Cancer, provides women (and men too) with a guide to checking their breasts for abnormalities. www.ibreastcheck.com 3 The NHS Drink Tracker helps you follow how much you drink over time, analysing your habits to provide tailored feedback. www.nhs.uk/tools

Win family passes

Competition

The Historic Dockyard Chatham The award-winning Historic Dockyard Chatham is the world’s most complete dockyard of the age of sail and is one of Britain’s leading maritime heritage destinations, with a remarkable range of galleries, iconic buildings and historic warships to explore, together with events, family activities and outstanding temporary exhibitions throughout the year. Make your own piece of Chatham Hemp rope on the Victorian Ropery Tour; be gripped by the stories of life aboard the huge historic warships; absorb the sights, sounds and smells of the dockyard of 1758; celebrate a time of power and strength of the ships built and of the people behind the dockyard, without which Britain may not have achieved such global power, and hear heroic stories in the RNLI Historic Lifeboat Collection. Children can also let off steam in indoor soft play and outdoor adventure play areas. Buy a ticket once a year and return as many times as you want. Visit www.thedockyard.co.uk or phone 01634 823807 for details.

The Historic Dockyard has generously donated three annual family tickets worth £45 each to three lucky Health Matters readers, which allow two adults and two children – or one adult and three children – entry to The Historic Dockyard for 12 months. Terms and conditions apply*. To be in with a chance of winning, simply answer the following questions: On which tour can you make Chatham Hemp rope?

What do you think of this magazine?

What would you improve?

Return this coupon, including your answer, name, age, address and telephone number to Health Matters, NHS Kent and Medway, Fifty Pembroke Court, Chatham Maritime, Chatham, Kent. ME4 4EL. The first three people to be drawn from the entries will each win a year-long family pass. Answers will be picked at random and must arrive by noon on Monday, 22 October. Entries received after that date will not be valid.

You must be 18 or older to enter this competition. Competitions are not open to employees (or members of their immediate families) of NHS Kent and Medway. By entering the competition the winner agrees to participate in such promotional material as NHS Kent and Medway may require. We will only process your data in accordance with the Data Protection Act 1998. NHS Kent and Medway will analyse the information you provide to see what is most effective about this publication and to help us identify ways to improve it. As a public body we do not share data with other organisations unless the law permits us to do so. We do not sell individual information. We will share it only with our authorised Data Processors who must act at all times on our instructions as the Data Controller under the Data Prote ction Act 1988. *www.medwaypct.nhs.uk/termsandconditions/

Health advice

Ask the doctor

Dr Sha riq Lan ker

by Dr Shariq Lanker Q

I have just found out that I am pregnant with my first child. Is it safe to exercise during pregnancy?

Being healthy and exercising is important at any time, but particularly if you are having a baby. It’s good for your physical and mental health, will help reduce the risk of excess weight gain, help you have a faster recovery post-baby and will also give you an easier and shorter labour. Women who exercise are also less likely to experience lower back pain and pelvic discomfort and it keeps your muscles and joints mobile. You should avoid strenuous exercise, particularly contact sports where there is a risk of being hit in the stomach, or any high impact exercise that puts a strain on your joints or ligaments. Brisk walking, swimming and gentle toning and stretching classes are ideal during pregnancy. It is important that you don’t overheat, so drink plenty of fluids. If you go to an exercise class, make sure your teacher is properly qualified and knows that you’re pregnant.

Q A

How can I keep warm and healthy this winter?

Being cold isn’t just uncomfortable, cold weather can be a risk to your health. Very cold temperatures can raise your blood pressure and thicken the blood which can increase the risk of a heart attack or stroke. It can also make lung conditions worse and make it harder for you to fight common infections. Use an indoor thermometer to keep an eye on the temperature – the ideal indoor temperature is 18°c 21°c. Wear plenty of layers of clothes and make sure hats, gloves, scarves and appropriate footwear are easily accessible. Only go outside during cold temperatures if it is absolutely necessary – anybody with a heart condition should avoid sudden physical activity during cold weather, such as shoveling snow.

If you are over 65, ask your GP to have the free seasonal flu jab. Make sure you have enough food and medicine at home so you don’t have to go out during very cold temperatures and order repeat prescriptions in plenty of time, particularly if bad weather is forecast. Phone the Energy Saving Trust on 0300 123 1234 and ask if you can get any help with insulating or heating your home and advice about methods to reduce draughts.

I like to unwind with a couple of glasses of wine in the evening, but I have read that this may be bad for my health. How can I reduce the amount I drink?

Having a drink may feel like an easy way to unwind at the end of the day but one glass can often lead to two or three, which can lead to a pattern of harmful drinking. There is a wide range of illnesses associated with increased drinking levels, including mouth cancer, liver disease and stroke. Reducing the amount you drink is not only good for your health, but also good for your waistband and purse; you will find you will have more money, energy and a slimmer waist. Try and have at least two alcohol-free days a week and watch what you’re drinking at home – it can be easy to drink more than you would if you were out as home measures can be tripled, compared to the single measures you’d get in pubs. Always try and drink at least one glass of water in between each alcoholic drink. There is more advice about safer drinking and where to get support if you think you need it at www.abettermedway.co.uk Dr Shariq Lanker works at Rainham Healthy Living Centre and at the Woodlands Family Practice in Gillingham. He is on the Medway Clinical Commissioning Group Board, which will take responsibility for buying and planning health services for people in Medway from next April.

News

Changing lives Anyone who’s ever had a child will know how important health visitors are in the crucial first few months of a baby’s life, offering advice including immunisation, nutrition and child development. It’s a complex role requiring professional judgment and expert clinical knowledge as well as a friendly face. The NHS in Kent and Medway is Health visitors play a crucial role in babies lives recruiting an extra 200 health visitors by 2015. If you’re a qualified nurse, midwife or a student nurse expecting to gain NMC registration by September 2012, you can apply to join a free one-year full-time or two-year part-time degree course while receiving a salary during your training. Visit www.southofengland.nhs.uk/what-we-do/campaigns/ health-visitors for more information.

Deadline for Continuing Healthcare claims People who think they or a relative may be eligible for NHS continuing health funding are urged to apply before 30 September. This is care which is arranged and paid for by the NHS for people not in hospital but whose primary need, as a result of disability, accident or illness, is for healthcare (rather than social care). The deadlines are a result of the NHS reorganisation. Applications must be in by 30 September for claims from 1 April 2004 to 31 March 2011. People whose care was received from 1 April, 2011 to 31 March, 2012 need to apply by 31 March 2013. People who received care across both time periods must submit before the first deadline - 30 September 2012 - for the entire period of care to be assessed. Applications received after the deadline will not be considered unless there are exceptional circumstances. Medway residents should phone Janet Manuel, Head of NHS Continuing Healthcare Assessment North, on 01634 335045.

Mary (centre) pictured outside number 10 with Judith Marsh (left) and Jane Boreham (right)

Medway nurse visits Downing Street Medway nurse Mary Kirk shared her knowledge and insight with the Prime Minster to help improve health services. Mary was one of three nurses from Kent and Medway who were invited to Number 10 to celebrate leaders in nursing. Mary, who is a nurse representative on Medway Clinical Commissioning Group’s Board, said: “It was really exciting and a great privilege to be invited to Number 10. Nurses play an important role in informing and guiding where we should focus developments, keeping in mind what patients really want and need and making sure the care we do provide is of a high standard."

How’s your GP doing? Find out how well your GP practice is performing with the click of a button. The GP scorecards give an indication of how practices are performing and how they compare with national targets and local achievement. GP surgeries are marked on a range of issues and services they provide. This includes the management of conditions such as diabetes and asthma and indicators relating to screening and prevention. There is also a measure of patient satisfaction. Dr James Thallon, NHS Kent and Medway’s Co-Medical Director says: “Scorecards give practices and patients the opportunity to see how GP practices in the area are working. They allows patients to access practice information and give practices target areas in which to improve and develop. We hope that everyone will find the scorecards useful.” You can read your GP’s scorecard and leave comments at www.medwaypct.nhs.uk/GPScorecards2010-11

Heart attack

Changing lifestyles after a heart attack Patricia Allenby’s heart attack was the push she needed to stub out her cigarettes. Patricia, 53, from Chatham says: “I was at work when my jaw started to ache. It was uncomfortable and a weird sensation. After ’s y b n e about an hour, I began ll A Patricia fit after to feel a burning pain g fightin rt attack a e h in the middle of my her chest. I joked to a friend that I had a lock jaw and heartburn. I really began to feel very unwell and my colleague called 999 even though I kept saying it was just heartburn.”

The treatment was the same given to Prince Philip last Christmas. Patricia was discharged from hospital three days later. “The nurses were fantastic. One of the first questions I was asked was if I smoked. I did and I was advised to give up, which I have.” With willpower and the help of her cardiac rehabilitation team Patricia, who smoked 20 cigarettes a day for the past 40 years has now managed to kick her habit. Thanks to a combination of improvements in people’s lifestyles - such as quitting smoking, better medication for people with high blood pressure and improved treatment like Patricia received - the number of people dying of a heart attack in Medway has dramatically fallen by more than 77 per cent during the past 20 years.

When the ambulance arrived, she was connected to an Electrocardiography (ECG) which measured the rate and regularity of her heartbeats, as well as being able to identify if her heart had been damaged.

Dr Alison Barnett, Director of Public Health for Medway says: "This is saving so many people from early death and families from the grief and distress of losing their loved ones.

The image was sent down the line to a cardiologist – a specialist heart doctor – at the William Harvey Hospital in Ashford, who examined the image and told the ambulance crew to bring Patricia to the hospital.

"The gold-standard treatment provided at the William Harvey Hospital, which unblocks the artery while the heart attack is still ongoing, opens up the oxygen supply to the heart muscle, reducing damage and saving lives.

“I was rushed straight into theatre and the consultant showed me the blockage. A small balloon was guided to the clogged artery and inflated to relieve pressure. A stent was put in place, which can keep the artery inflated and prevent further attacks.”

"Patients spend only a few days in hospital and in many cases they leave hospital with little or no long-lasting damage to their heart.”

Would you know the signs? Ring 999 if you suspect that you or someone you know is having a heart attack. The symptoms of a heart attack include: • Chest pain: the pain is usually located in the centre of your chest and can feel like a sensation of pressure, tightness or squeezing • Pain in other parts of the body: it can feel as if the pain is travelling from your chest to your arms (usually the left arm is affected but it can affect both arms), jaw, neck, back and abdomen

• Shortness of breath • Nausea • An overwhelming sense of anxiety (similar to having a panic attack) • Feeling light headed • Coughing • Vomiting • Wheezing. For healthy heart tips visit www.bhf.org.uk, call 0300 3300 3311 or visit your GP.

Walk-in centre, 01634 575232 Medway NHS Healthcare Centre 547-553 Canterbury Street, Gillingham, ME7 5LF

Your local NHS NHS Kent and Medway Fifty Pembroke Court, Chatham Maritime, Chatham, Kent ME4 4EL Patient Advice and Liaison Service Complaints

01634 335020

0800 014 1641 0800 014 1634

Medway Community Healthcare, 01634 382777 Units 7/8 Ambley Green, Bailey Drive, Gillingham Business Park, Gillingham, ME8 0NJ Customer Care: 01634 382266 Email medwaycustomercare@nhs.net www.medwaycommunityhealthcare.nhs.uk (provides the vast majority of community health services in Medway, such as community nurses, health visitors, speech and language therapists, out-of-hours GP and nurse care). Medway NHS Foundation Trust, Medway Maritime Hospital, Windmill Road, Gillingham, ME7 5NY 01634 830000 Patient Advice and Liaison Service 01634 825004 Complaints 01634 825216 Patient Contact Centre (about appointments) 01634 838938 Kent and Medway NHS and Social Care Partnership Trust (KMPT – provides mental health and learning disabilities services) 01732 520400 Patient Advice and Liaison Service 0800 587 6757 Complaints 01622 722133 Medway Community Healthcare Centres: Darland House, 01634 852323 29 Darland Avenue, Gillingham, ME7 3AL St Bartholomew’s Hospital, New Road, Rochester, ME1 1DS

01634 810900

Wisdom Hospice, High Bank, Rochester, ME1 2NU

01634 830456

Walter Brice Centre, 01634 253611 Tilley Close, Hoo St. Werburgh, Rochester, ME3 9AE Rainham Community Healthy Living Centre, 103-7 High Street, Rainham, ME8 8AA 01634 337600 Rochester Community Healthy Living Centre Delce Road, Rochester, ME1 2EL 01634 334200

Parkwood Health Centre, 01634 234400 Long Catlis Road, Parkwood, Rainham, ME8 9PR Twydall Clinic, Twydall Green, Gillingham, ME8 6JY

01634 232007

Elizabeth House, Holding Street, Rainham, ME8 7JP

01634 382091

Canada House, Barnsole Road, Gillingham, ME7 4JL

01634 583000

Will Adams NHS Treatment Centre, 0333 200 1730 Beechings Way, Gillingham, ME8 6AD Medway Council, 01634 306000 Gun Wharf, Dock Road, Chatham ME4 4TR Customer First Social care (children and adults)

01634 333333 01634 334466

Living Well in Medway Friendly advice and guidance for people who want to know about care and support services in Medway and who live in: Chatham, Rochester, Strood or Hoo Peninsula – contact: Medway Citizens’ Advice Bureau 01634 383760 Kingsley House, 37-39 Balmoral Road, Gillingham ME4 6BG Gillingham or Rainham – contact: Carers First and Medway Carers Centre 01634 577340 3 Canterbury Street, Gillingham, ME7 5TP Medway Local Involvement Network (LiNk) The local independent network of local people and community groups working together to influence and improve Medway’s health and social care services. www.themedwaylink.co.uk or phone: 0800 980 3956 Five ways to wellbeing These are actions which, research shows, can help improve the way we feel and help us get the most out of life. The websites have information about local groups, activities and courses.

Lordswood Community Healthy Living Centre, Sultan Road, Lordswood, Chatham, ME5 8TJ 01634 337444

1: Connect with the people around you: www.medway.gov.uk/leisure

Balmoral Gardens Healthy Living Centre Balmoral Gardens, Gillingham, ME7 4PN 01634 334900

3: Take notice – be aware of the world around you

Keystone Centre, Gun Lane, Strood, ME2 4UL

01634 717755

2: Be active: www.medwaygetsactive.co.uk 4: Keep learning: www.medway.gov.uk/adultlearning 5: Give – do something nice for someone: www.medway.gov.uk/volunteer

Useful contacts

Carers Medway Carers’ Line: 0800 197 4517 www.care-first.co.uk Crossroads Care Medway: 01634 868885; www.medwaycrossroads.org

While every effort has been made to ensure the accuracy of the contents, the publisher cannot accept responsibility for errors, omissions, or details that may Princess Royal Trust Medway Carers Centre: have changed since going to press. 01634 577340, www.medwaycarerscentre.org.uk Alcohol Alcoholics Anonymous: 01622 751842 www.alcoholics-anonymous.org.uk Medway Alcohol Services: 01634 829025 Young people’s drug and alcohol services: KCA 01634 338640; Kenward Trust 01622 814187

Arthritis Arthritis Care Helpline: 0808 8004050 Arthritis Research Campaign: 01634 309973 Asthma Medway Asthma Self Help (MASH): 01634 855844, www.medwayasthmaselfhelp.co.uk Autism MAGIC (Medway Autism Group and Information Centre): 01634 292015 www.medway-magic.org Kent Autistic Trust: 01634 405168 www.kentautistic.com Bereavement Rainham Bereavement Friendship Group: 01634 364309 Cruse Bereavement Care (Maidstone and Medway branch): 01622 671011 or 0844 477 9400, email: helpline@cruse.org.uk or maidstone@cruse.org.uk Cruse young people’s helpline: 0808 8081677 Bereaved Parents’ Support Group (Medway) Carole: 01634 684031 Blind Kent Association for the Blind: Rehabilitation services, volunteering, clubs and leisure: 01634 332929

Cerebral Patient Advice and Liaison Service Cerebral Patient Advice and Liaison Service Care: 01634 851454 Continence Care Medway Community Healthcare continence care: 01634 382809 COPD Breathe Easy Medway 01634 234561 Counselling (see also mental health) For information on self-help, visit www.liveitwell.org.uk or ask at your local library. Medway Psychological Therapies: 01634 841524 (8.30am to 6pm Mondays, Tuesdays 8am to 8pm, Wednesdays/Thursdays 8.30am to 5pm, Friday 8.30am to 4.30pm) RELATE North Kent: 01634 846914 Support is also available for children and young people. Speak to your GP. Dementia 24 hour Dementia Helpline: 0800 500 3014 email: helpline@alz-dem.org DementiaWeb for Kent and Medway: www.dementiawebkentandmedway.org.uk Alzheimer’s and Dementia Family Support: 01634 338630 Dementia Carers’ Friendship Group: 01634 377254 Admiral Nurses: 01634 382091

Deaf Services For equipment and support for deaf or deaf blind people, contact Medway Council Deaf Services: Blood testing Blood tests are available at many GP practices and other tel/text: 01634 331727, fax: 01634 331199, SMS: 07795 951465, email: deafservices clinics in Medway. For more details, please ask at your @medway.gov.uk or drop in Wednesdays 9am-1pm practice or visit www.medwaypct.nhs.uk/bloodtest at Riverside One. Medway Community Healthcare Anticoagulation For demonstration, loan, or purchase of equipment Service monitors people taking long-term contact Medway Hi Kent: Audiology Department, anticoagulation medication (such as warfarin): Medway Maritime Hospital, 01634 825043, 01634 810910 or email: medch.mas@nhs.net www.hikent.org.uk Cancer Dentistry Kent and Medway Cancer Guide: NHS Medway dental helpline (for help finding a www.kentmedwaycancerguide.nhs.uk dentist): 0800 0141 538 Macmillan Cancer Support: 0808 808 0000, Community dental service, Medway Community www.macmillan.org.uk Healthcare: for patients with physical, mental, social or Kent and Medway Cancer Network: 01634 335127, dental special needs. Ask your dentist for a referral if www.kentmedwaycancernetwork.nhs.uk you need one. Medway and Swale (West) Association for Breast DentaLine (for emergencies at night or weekends): Cancer. Meets first Tuesday of the month. Area 7, 01634 890300 Medway Maritime Hospital, 7pm to 9pm. Contact Angela Blackwell: 01634 861802 or angela@blackwell2.plus.com

Diabetes Medway Community Healthcare specialist diabetes service: 01634 238657 Medway Kids; for families of children with Type 1 diabetes in Medway: www.medwaykidsdiabetes.org.uk Diabetes UK Medway and Swale group: for more information; contact Karen Wheatland: 01634 841489 Disability Medway Community Healthcare Children’s Therapy Team: 01634 334280 Disability Information Service: 01634 838947 Cleft Lip and Palate Association, Kent: 01227 452131 /0207 833 4883 Contact a Family: 0808 808 3555 www.cafamily.org.uk Isle of Grain Carers and Disabled Group: 01634 270425 Domestic Violence (services for women) Ravi Refuge - Asian Project: 0808 2000 247 Medway Domestic Abuse Forum email: medwaydaf@aol.com 24Hour National Domestic Violence Freephone Helpline: 0808 2000 247 K-DASH (Women’s Support Service): 01622 761146 Domestic Violence (services for men) Men’s Advice Line: 0808 801 0327, www.mensadviceline.org.uk Drugs KCA (Prescribing and Counselling): 01634 571658 Needle exchange scheme visit www.nhs.uk to find your local drop in Narcotics Anonymous: 0300 999 1212 www.ukna.org Young people’s drug and alcohol services: KCA: 01634 338640; Kenward Trust: 01622 814187 Talk to Frank/National Drugs Helpline: 0800 776 600 Eating Disorders Early diagnosis is important. Speak to your GP. End of life care Palliative careline (urgent health advice or help, 24/7): 01634 792098 The Wisdom Hospice, Medway Community Healthcare: 01634 830456 has 15 inpatient beds. Teams also provide specialist palliative care at home and at Medway Maritime Hospital; a day hospice Monday – Friday; psychosocial and family support to patients and friends; and bereavement support. Epilepsy Epilepsy Action helpline: 0808 800 5050, www.epilepsy.org.uk Equipment Medway Community Healthcare Community Equipment Loan Store: 01634 334860.

Eyes For a list of opticians in Medway, see www.nhs.uk Sudden eye problem – six local opticians offer fast expert care to anyone aged two plus with eye pain, blurred vision or other problems. www.medwaypct.nhs.uk/eyecare Healthcall Optical – free home eye test service for housebound elderly people: 0800 030 4083, www.healthcalloptical.co.uk Falls prevention Medway Community Healthcare falls prevention service: 01634 810900 or fallsservice@nhs.net Families Medway Families Information Service: 01634 335566, www.medwayfisd.com Parentline Plus (part of Family Lives): 0808 800 2222 www.familylives.org.uk email: parentsupport@familylivesorg.uk ChildLine: 0800 1111 Feet The Podiatry Appointment Centre: 01634 718113 Footcare services for older people – Age Concern, Chatham: 01634 811938 Medway Age Concern (Footcare clinic): 01634 572616 Fibromyalgia Fibromyalgia Support Group Medway: 07974 606280, www.fibrosupportmedway.btck.co.uk GPs It is always best to see your own GP. For practice details, see www.nhs.uk or Health Matters Spring 2012 edition at www.medwaypct.nhs.uk Your GP practice will try to fit you in if you need an urgent appointment during the day. If they cannot, they will be able to refer you to MedOCC. Medway Community Healthcare’s Health Visitors are based at: All Saints Children’s Centre, Chatham: 01634 338833 Balmoral Gardens Community Healthy Living Centre: 01634 334900 Keystone Centre, Strood: 01634 717755 Lordswood Community Healthy Living Centre: 01634 337444 Parkwood Community Health Centre, Rainham: 01634 234400 Rainham Community Healthy Living Centre: 01634 337600 Rochester Community Healthy Living Centre: 01634 334200 Sunlight Centre, Gillingham: 01634 338892 Walter Brice Centre, Hoo: 01634 253611 Woodlands Children’s Centre, Gillingham: 01634 338370 Healthy Living Medway Health and Lifestyle Team offers one to one advice and support to help people achieve healthier lifestyles: 01634 338892, email: halt@sunlighttrust.org.uk For advice and guidance, see www.abettermedway.co.uk or www.nhs.uk/livewell

Healthy Weight MEND 2-4 offers support for families with children aged two to four: 01634 333103 MEND 7-13 offers support to families with children aged seven to 13: 01634 333741 www.mendprogramme.org or email: mend@medway.gov.uk Tipping the Balance offers support for adults: 01634 333101, email: tippingthebalance@nhs.net Exercise Referral: 01634 333720 email: medwayexercisereferral@nhs.net

MedOCC From 6.30pm to 8am, Monday-Friday, and at weekends, phone: 01634 891855 if you need an urgent appointment which cannot wait until your GP practice opens. You must ring first – you cannot be seen if you just turn up.

Mental health Information about local services and ideas for staying well at: www.liveitwell.org.uk Mental Health Matters, 24/7 hrs emotional support and advice: 0800 107 0160 Heart conditions Depression/anxiety self-help group for women: British Heart Foundation heart helpline: 0300 330 01634 718471 3311 (local rate, 9am to 5pm Monday-Friday) Mental Health Service User Engagement Project www.bhf.org.uk/heartmatters (for people who use mental health services): 01634 812850, www.mhsuep.org.uk Help with health costs Rethink Hope (recovery-focused local support group) Find out how to claim back money for NHS health and Rethink Hope in Caring (local support group for costs: 08456 101112 carers), both of which are inclusive of black and minority ethnic communities: 01823 365327, Infant feeding groups@rethink.org For support with breastfeeding: 01634 331054, email: Rethink 0845 456 0455 (open 9am to 5.30pm ifp@medway.gov.uk Monday - Friday), email: advice@rethink.org Young Minds, the voice for young people’s mental Interpreters Interpreters are available if you need them to speak to health and wellbeing. Parents’ helpline: 0808 802 5544, your GP or other health professional. Access will be www.youngminds.org.uk arranged by the practice or clinic. PAPYRUS young suicide prevention society. HOPElineUK: 0800 068 4141, www.papyrus-uk.org Learning disabilities Samaritans: 01634 730981 or 08457 909090 or Medway Learning Disabilities Team: 01634 337433 face-to-face 9am to 10pm seven days a week at Shout Out: 01634 338600 Valuing People Learning Disabilities Partnership Board: Priory Road, Strood ME2 2EG 01634 333333 www.valuingmedwaypeople.org.uk Minor injuries The Challenging Behaviour Foundation: There are specialist minor injuries units in 01634 838739, www.challengingbehaviour.org.uk Sittingbourne and Sheppey, for minor injuries that Carers’ Relief Service: 01634 715995 DGSM yourChoice (local Mencap group): 01322 281833 might need cleaning, stitching or dressing. Kent Wide Down Syndrome Group: 07787 947142, email: info@kentds.org Lymphodema service Rainham clinic (8am to 5pm Monday-Friday): 01634 337592/337602 Email: eck-pct.LymphoedemaReferral@nhs.net Maternity Midwifery phoneline: 01634 825188 (for newly expectant mothers who want to book their first midwife appointment direct) Maternity Services Liaison Committee: 07984 120783 ME/Chronic Fatigue Syndrome Sussex & Kent ME/CFS Society: 01273 674828 www.measussex.org.uk Kent and Sussex Alternative ME group (KASME)/ The Young ME Sufferers Trust: 01634 270425 Mediation Medway Mediation: 01634 832285 – free, impartial and confidential service to resolve neighbour disputes.

Sheppey Community Hospital, Plover Road, Minster on Sea, ME12 3LT, 01795 879104 Sittingbourne Memorial Hospital, Bell Road, ME10 4DT, 01795 418300. Motor Neurone Disease Motor Neurone Disease Association : 01634 846330 Multiple Sclerosis Society (Medway) 01634 238502 NHS Continuing Care NHS Medway Continuing and Funded Nursing Care Team: 01634 335045 NHS Direct For health advice and reassurance, symptom checker, and details of local services, 24 hours a day, 365 days a year, NHS Direct: 0845 4647, www.nhs.uk/nhsdirect. If you use an Android or iPhone smartphone you can download a free NHS Direct app from www.nhsdirect.nhs.uk/About/MobileApps

Older people Age Concern, Chatham: 01634 811938 Medway Age Concern: 01634 812850 Medway Pensioners’ Forum: 01634 842333 Welcome Day Centre: 01634 844639 WRVS Information Centre for people over 55, 95-97 High Street, Chatham ME4 4DL: 01634 844390 Osteoporosis Referral is by GPs or consultant. Osteoporosis Unit, Medway Maritime Hospital (open 8am to 5pm Mon-Fri) helpline: 01634 833892 National Osteoporosis Society Medway Support Group: 01634 719266, www.nos.org.uk Occupational Health Referral is by GPs, care managers or other professionals. Acute inpatient service: 01634 830000 x 3425 Community brain injury team: 01634 833937 Environmental control service: 01634 833923 Outpatient and hand therapy: 01634 830000 x 3425 Palliative care: 01634 830456 Prosthetic service: 01634 833948 Wheelchair and specialist seating: 01634 833935 Parkinson’s Disease Parkinson’s UK: 0808 800 0303, www.parkinsons.org.uk Medway Parkinson’s Disease support group: 01634 831407 Patient Transport Patient Transport Booking Service: 01634 825192 Eligibility criteria apply. British Red Cross Transport Service: 0800 0280831 (Minimum of 48 hours’ notice, charges apply) HANDS (9.30am to 12.30pm Monday-Friday): 01634 362119 Pharmacists In Medway, some pharmacies can provide free medicine for minor conditions, if you do not normally pay a prescription charge. Many also offer free emergency hormonal contraception. For details of opening times, see www.nhs.uk Physiotherapy Medway Community Healthcare adult physiotherapy service: 01634 821560, see the service’s page at www.medwaycommunityhealthcare.nhs.uk for self-referral form.

Postnatal depression Speak to your GP or health visitor if you are finding it hard to cope. Rapid response Medway Community Healthcare rapid response team: 01634 382900 (short-term care for people recovering from illness or injury).

Sexual assault Crisis line (women and girls only): crisis line: 0800 458 2818, support line: 01227 450400, both open Monday-Friday 6.30 to 9.30pm Family Matters (counselling for survivors of sexual abuse/assault): 01474 537392, www.familymattersuk.org Sexual Health Medway Maritime Hospital GUM clinic (genito-urinary medicine), green zone on level 3, walk-in service, 9am to 3.45pm, Monday to Friday: 01634 838948. For a full list of clinics in Medway, see www.medwaypct.nhs.uk/A-Z For information for young people on sexual health, relationships, contraception, STIs, pregnancy, advice for parents, and where to go in Medway for free, confidential advice and support, see www.medwaysexualhealth.co.uk Smoking Stop Smoking Service: 0800 2346805 or 01634 823563, www.smokefreemedway.co.uk Speech and language therapy Medway Community Healthcare speech and language therapy: 01634 833711 For adults with acquired communication disorders and/or swallowing problems. Medway Community Healthcare children’s speech therapists are based at: Lordswood Community Healthy Living Centre: 01634 337444 St Bartholomew’s Hospital, Rochester: 01634 810968 Parkwood Community Health Centre, Rainham: 01634 234400 Rainham Community Healthy Living Centre: 01634 337630 Rochester Community Healthy Living Centre: 01634 334280 Cleft Lip and Palate Association (Kent): 01227 452131/0207 833 4883 Spina Bifida Kent Association for Spina Bifida and Hydrocephalus: 01474 536501 Stroke Stroke Association (Medway Stroke Club and Working Age Club):01634 382868, www.medwaystrokeclub.org.uk Stroke Association family support service and Dysphasia-Communication Support service: 01634 575232 Walk-in centre Medway NHS Healthcare Centre offers GP and nurse care 8am to 8pm, 7 days a week: 01634 575232 Wounds service Medway Community Healthcare wounds service: 01634 810925 Medway Community Healthcare tissue viability and dermatology service: 01634 810919