Ormiston Medical Practice
Tynemount Road
Ormiston
East Lothian
EH35 5AB
Tel: 01875 610248
Fax: 01875 615045
Out of Hours: 111
Ormiston Medical Practice
Drs Stevens, Hughes, Bolton and Huggett

Practice Services

We are pleased to offer a wide variety of general primary care services at Ormiston Medical Practice, including specialised clinics that are outlined here in detail:

Asthma

Asthma is a common inflammatory condition that affects the lungs causing narrowing of the airways. This results in patients experiencing the symptoms of breathlessness, cough (often worse at night-time), wheeze and chest tightness. The symptoms can vary from mild to severe, and can be kept under control with inhalers. Asthma is very common with 5.1 million people in the United Kingdom (UK) suffering from this. If you are concerned that you have Asthma, please book an appointment with a GP on 01875 610248.

If you have confirmed Asthma, you will be invited for a review with our trained Practice Nurse once a year. At this check, the Practice Nurse will:

  • Discuss your symptoms, triggers and the impact your symptoms are having on you
  • Review your inhaler technique, so please bring your inhalers to your appointment
  • Measure the capacity of your lungs called Peak Flow (if aged over 5)
  • Provide help with stopping smoking if applicable
  • Provide you with a detailed personal self-management plan for your Asthma
  • Give you advice about your inhalers, and make changes to these if appropriate
  • Offer you the annual Flu vaccine if you own a preventer inhaler

 

Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a term that includes the conditions chronic bronchitis and emphysema. With COPD, the airflow to the lungs is restricted (obstructed), and this is usually caused by smoking. Symptoms of COPD include a productive cough, breathlessness, wheeze, chest tightness and frequent chest infections. If you have any of these symptoms, please make an appointment with your GP for review on 01875 610248.

The most important treatment for COPD is to stop smoking that we can help you achieve. If you wish to stop smoking, please contact the surgery or click here for further information. Inhalers are commonly used to ease symptoms in COPD by improving the function of the lungs. There are other treatments available such as steroids, antibiotics, oxygen, and mucus-thinning medicines (mucolytics). These medicines are usually used in more severe cases, or during an exacerbation (flare-up) of the symptoms. About 3 million people in the UK have COPD, and it is more common with increasing age.

If you have COPD, you will be invited for a yearly check-up by our trained Practice Nurse by letter. At this check, the Practice Nurse will:

  • Discuss your symptoms and the impact of your symptoms are having on you
  • Review your inhaler technique, so please bring your inhalers to your appointment
  • Perform breathing tests called Spirometry to access your lung function
  • Provide help with stopping smoking if applicable
  • Give advice about your inhalers, and make changes to these if appropriate
  • Offer you the annual Flu vaccine
  • Provide you with a personal self-management plan
  • Advise you about signs to monitor for that suggest an infection (e.g. green sputum)
  • Refer you for Physiotherapy known as Pulmonary Rehabilitation for exercises if appropriate

 

Coronary Heart Disease

Coronary Heart Disease (CHD) is the biggest killer in the UK accounting for 4 out of every 10 deaths. In CHD, the blood vessels called arteries that supply the heart with oxygen and nutrients become narrowed by fatty deposits by a process called atherosclerosis. This causes a restriction in the supply of blood and oxygen to the heart, and causes the symptom of chest pain. If you have a feeling of heaviness, tightness or pain in the middle of your chest that may extend to your arms, neck, jaw, face, back or abdomen, you require urgent medical assessment. If this discomfort does not settle after 5-10 minutes, you should call 999.

There are several things that put you at higher risk of having CHD, but there are also lots of things that you can do to reduce your risk. These include:

  • Stopping smoking - If you would like help with this, please let us know as we can help you do this.
  • Eating a healthy low fat diet and taking regular exercise at least three times a week.
  • Keeping your weight within a normal level.
  • Drinking alcohol within the recommended limits that is a maximum of 21 units of alcohol per week for men, and no more than 14 units of alcohol per week for women. Please note that 1 unit of alcohol is equivalent to 1 small spirit, half a pint of beer or a small glass of wine.

If you have confirmed CHD, you will be invited by letter for annual review with the Practice Nurse. At this check, the practice Nurse will:

  • Discuss your symptoms and the impact your symptoms are having on you
  • Review your medications, and any side effects that you have
  • Check your weight, height and blood pressure
  • Take blood samples to check for your kidney function, blood count, cholesterol level and sugar level
  • Address any risk factors for CHD outlined above, and help you reduce these
  • Provide help with stopping smoking if applicable
  • Offer you the annual Flu vaccine
  • Perform a screening test for depression as some patients with CHD develop low mood

 

Stroke

Stroke is the largest cause of disability in the UK, and third most common cause of death (after heart disease and cancer). Each year 110,000 people in the UK have a first stroke, and about 30,000 have a recurrent stroke. A stroke causes damage to the brain and is due to either a blood clot in the brain (called an ischaemic stroke) or bleeding in the brain (called haemorrhagic stroke). Outcome following a stroke depends on several factors such as the part of the brain affected, the extent of brain damage and how quickly treatment is given. Both a stroke and a mini-stroke (called a TIA) are medical emergencies and need immediate medical attention. If you develop any of the following, you should dial 999 immediately (remember FAST):

F - Facial weakness. Can the person smile? Has their mouth or eye drooped?

A - Arm weakness. Can the person raise both arms?

S - Speech distrurbance. Can the person speak clearly? Can they understand you?

T - Time to call 999 immediately if you or a person have any of the above symptoms.

There are several things that put you at higher risk of having a stroke, but there are also lots of things that you can do to reduce your risk. These include:

  • Stopping smoking - If you would like help with this, please let us know as we can help you do this.
  • Eating a healthy low fat diet and taking regular exercise at least three times a week.
  • Keeping your weight within a normal level.
  • Drinking alcohol within the recommended limits (21 units of alcohol per week for men, and 14 units of alcohol per week for women).

If you have had a TIA or stroke in the past, you will be invited by letter for an annual review with the Practice Nurse. At this check, the Practice Nurse will:

  • Discuss your symptoms and the impact your symptoms are having on you
  • Review your medications, and any side effects that you have
  • Check your weight, height and blood pressure
  • Take blood samples to check your kidney function, blood count, cholesterol level and sugar level
  • Address any risk factors for strokes outlined above, and help you reduce these
  • Provide help with stopping smoking if applicable
  • Offer you the annual Flu vaccine
  • Perform a screening test for depression as someone patients after a stroke develop low mood

 

Diabetes Mellitus

If your body does not make any hormone called insulin or does not make enough of this, your body cannot convert blood sugar (called glucose) into fuel for your body's cells. This condition is Diabetes Mellitus, and it is a growing problem with more than 2 million people in the UK having this condition.

There are 2 types of Diabetes Mellitus: Type 1 and Type 2. In Type 1 Diabetes, the body is unable to produce any insulin. It usually starts in childhood or young adulthood, and is treated with diet control and insulin injections. Type 2 Diabetes is when not enough insulin is produced by the pancreas gland, or the insulin that is made by the body does not work properly. It tends to affect people as they get older and usually appears after the age of 40, and often occurs in overweight people.

Common symptoms of Diabetes include:

  • Frequent urination (polyuria)
  • Increased thirst and fluid intake (polydipsia)
  • Increased appetite (polyphagia)
  • Unexplained weight loss
  • Sudden vision changes
  • Tingling or numbness in the hands or feet
  • Feeling very tired much of the time
  • Very dry skin
  • Sores that are slow to heal
  • More infections than usual

If you have any of these symptoms you should book and appointment with a GP on 01875 610248. If you have confirmed Diabetes, you will be invited by letter for a review by the trained Practice Nurse. At this check, the Practice Nurse will:

  • Discuss your symptoms and the impact your symptoms are having on you
  • Review your medications, and any side effects that have
  • Check your weight, height and blood pressure
  • Take blood samples to check your kidney function, blood count, cholesterol level, HbA1C, thyroid function, liver function and sugar level. Your HbA1C is a measure of how well controlled your Diabetes is.
  • Check your urine for protein, so please bring a fresh urine specimen to your appointment. Please note that white-capped urine bottles are available for Reception.
  • Discuss your diet, lifestyle and alcohol intake
  • Check your feet and circulation
  • Provide help with stopping smoking if applicable
  • Offer you the annual Flu vaccine

Research shows that the better your Diabetes is controlled, the less likely you are to develop complication of Diabetes, such as kidney problems, nerve problems, blindness, foot ulcers, and heart disease. Attending for regular check-ups is therefore a very important part of your Diabetic care. If you have any questions about Diabetes, please contact the Practice.

 

Chronic Kidney Disease (CKD)

Chronic Kidney Disease (CKD) is a long-term abnormality of the kidneys that means that your kidneys are not working as well as they once did. The severity of the disease is classified into five stages 1-5 with most people in the mild stage. If you have mild or moderate kidney disease, you are unlikely to have any symptoms and it is unlikely to progress to kidney failure.

CKD is important to identify at any stage as it increases the risk of developing heart disease or a stroke. By identifying this condition, we can give you medications to reduce this risk. If you have confirmed CKD, you will be invited by letter for a review by a Practice Nurse each year. At this check, the Practice Nurse will:

  • Discuss any symptoms that you may have
  • Check your weight, height and blood pressure
  • Take blood samples to check your kidney function, blood count, cholesterol level and sugar level
  • Check your urine for protein, so please bring a fresh urine specimen to your appointment
  • Discuss your diet, lifestyle and alcohol intake
  • Provide help with stopping smoking if applicable
  • Offer you the annual Flu vaccine

 

Epilepsy

Epilepsy is defined as a tendency to have recurrent seizures (sometimes called fits). A seizure is caused by a sudden burst of excessive electrical activity in the brain, causing a temporary disruption in the normal message passing between brain cells. This disruption results in the brain's messages becoming halted or mixed up. If you have confirmed Epilepsy, you will be invited by letter for review by a GP each year. At this check, the GP will:

  • Discuss your symptoms and the impact your symptoms are having on you
  • Review how often you are having seizures
  • Review your medications, and any side effects that you have
  • Provide advice and answer any questions that you may have

 

Mental Health

Mental health problems cover a wide spectrum of illnesses, and can interfere with the ability to cope on a daily basis. We offer patients with chronic mental health problems an annual check up of their physical health, such as blood pressure check, weight and blood tests. If applicable, you will be sent a letter inviting you for this to be done by the GP once a year.

 

 

 

 

 

Carer Reviews

All staff at Ormiston Medical Practice recognise the important and valuable contribution made by carers. A carer is defined as a person irrespective of age who, without payment, provides help and support on a regular basis to a relative, partner, friend or neighbour of any age affected by physical or mental illness (often long-term), disability, frailty or substance misuse.

Carers play a crucial role in the delivery of health and social care provision in Scotland. There are approximately 657,300 identified carers in Scotland that equates to 1 in 8 of the population. We actively strive to identify and support carers and those being cared for in the local community. If you are a carer, please advise our Reception team of this on 01875 610248.

As a carer, our Practice Nurse will invite you for an annual review to see if there is any additional support that we could offer you, and to review your own physical and mental health. The Practice Nurse will also offer you the seasonal Flu vaccination that you are entitled to receive for free as a registered carer.

Carers of East Lothian supports all adults in a caring situation in East Lothian to get information and services to help their individual caring role, enhance their own wellbeing, and strengthen their collective voice to improve services.
You can contact them on 0131 665 0135 or visit their website by clicking here.

 

Wart Clinics

Warts and verrucae are very common, and are caused by a wart virus. They are slow growing and may gradually spread, but are not dangerous to your health. Left alone, warts and verrucae will eventually disappear of their own accord.

Recent research has shown that regular daily treatment with salicylic acid is the best way to treat warts and is more effect than cryotherapy. We therefore recommend using Salctol or Salactac every day on warts and verrucae. Please note that this treatment may have to be continued for up to 3 months.

 

Childhood Immunisations

Babies generally have their first vaccines at their 6-8 week baby check appointment with a Staff Nurse or Health Visitor. If you have questions about any aspect of the immunisation programme, please speak to your GP, Health Visitor or Practice Nurse. For further information about the UK Immunisation schedule, please visit their website at http://immunisation.dh.gov.uk/

 

 

 

 

Travel Advice and Immunisations

When travelling abroad, it is important to prevent illness by ensuring that you are immunised appropriately and are taking anti-malarial medications if applicable. In order to do this, we ask that you complete a pre-travel questionnaire that you can obtain from Reception or download here at least 2 months before travel.

The Practice Nurse will check the up-to-date recommendations for your destination(s), and contact you with what immunisations or medications are required. Please note that a fee may be applicable for some private vaccinations to cover for a private prescription and for administration of the vaccination by the Practice Nurse. The Nurse will inform you regarding this if applicable. Please click here for Government up-to-date travel advice and warnings.

 

 

 

Private Medicals and Reports

The Practice offers appointments for private medicals, such as for insurance policies and HGV licences. Please inform the Receptionist when you telephone for an appointment for this, as this usually requires a 30-minute appointment, and ask for the up-to-date charge for this. Details of these charges are available from Reception, and are made in line with the British Medical Association (BMA) recommendations.

GPs complete many forms covering a wide range of things, such as insurance reports, DVLA reports, occupational health reports, critical illness insurance, life insurance and cancellation of holidays. Before we can complete these requests, we need your signed consent. As completion of these reports is out with our NHS responsibility, we charge a fee for this work and details of this can be obtained from Reception.

 

 

 

Cervical Screening

A cervical smear test is a method of detecting abnormal (pre-cancerous) cells in the neck of the womb called the cervix. These tests are performed in order to prevent cervical cancer in women. The vast majority of women have normal smear test results, but for 1 in 20 women, the test will show some abnormal changes in the cells in the cervix. A very few of these cases will require treatment to prevent them from becoming cancerous.

In Scotland all women aged between 25 and 49 are invited for cervical screening every three years. All women aged between 50 and 64 are invited every five years. It is estimated that early detection and treatment can prevent up to 8 out of 10 cervical cancers. For further information about the cervical smear programme in Scotland, please click here.

If you would like to arrange your smear test, please phone Reception to book an appointment with our experienced Practice Nurse on 01875 610248.

 

Contraception

There are many different methods of contraception available that are outlined in detail below. Contraception is important to prevent unwanted pregnancies, and should be used until the menopause. Choosing a method of contraception that is right for you is a very important decision.

1) Contraceptive Implant (Nexplanon)

Nexplanon is a small flexible single rod that is inserted just under the skin on the inside of the upper arm. It is the size of a matchstick, and releases low daily dose of a hormone called etonogestrel for up to 3 years. It is a very effective (over 99%) contraceptive that does not affect your fertility. If you wish to conceive in the future, your fertility returns as soon as the implant is removed.

What are the advantages of using a contraceptive implant?

  • You do not have to remember to take a pill every day.
  • It lasts for three years and does not interfere with sex.
  • It can be used when breast-feeding.
  • Period pain is usually less.
  • It can used by some women who are unable to use contraception containing oestrogen.

What are the disadvantages of using a contraceptive implant?

  • Often causes changes to the pattern of your periods, and some patients have irregular bleeding.
  • Periods can sometimes be heavier and last longer with the implant.
  • It does not protect against sexually transmitted infections (STI’s), so you also need to use condoms.

If you wish to have Nexplanon inserted or removed, you should book an appointment with Dr Hughes. Nexplanon is best fitted during the first 5 days of your period. Please note that you will need to book an appointment for counselling about the procedure before your Nexplanon can be inserted. 

2) Intra-uterine Device (IUD or Copper Coil)

An IUD is a small plastic and copper device with threads on the end that is put into your womb (also called uterus). The thin threads hang through the opening at the entrance of your uterus called your cervix into the top of your vagina. An IUD can stay in for 5–10 years, depending on the type. If you are aged 40 or older when the IUD is fitted, it can be left in until the menopause.

What are the advantages of using an IUD?

  • It is effective as soon as it is inserted.
  • It works for 5–10 years depending on the type of coil.
  • It does not affect sex.
  • It can be used if you are breast-feeding.
  • Your fertility returns to normal as soon as the IUD is taken out.
  • It can be used as a form of emergency contraception.

What are the disadvantages of an IUD?

  • Periods can sometimes become heavier, longer or more painful with the coil.
  • It does not protect you from sexually transmitted infections, so you also need to use condoms.
  • Perforation (puncture of the wall of the womb) may rarely occur at the time of insertion.
  • Rarely infection and bleeding at the time of insertion can occur.
  • Expulsion of the coil from the womb can occur, often in the first month after insertion.
  • If you do become pregnant while you are using an IUD there is a small increased risk of you having an ectopic pregnancy (fetus growing outside of the womb).

If you wish to have an IUD inserted or removed, you should book an appointment at Chalmers Hospital on 0131 536 1070.

3) Intra-uterine System (IUS or Mirena Coil)

The IUS is a small, soft, flexible plastic system that is placed in the womb to prevent pregnancy. It can be used up to 5 years.

What are the advantages of using an IUS?

  • You do not have to remember to take a pill every day.
  • It lasts for up to five years and does not interfere with sex.
  • It can be used when breast-feeding.
  • Period pain is usually less, and the IUS is a recommended treatment for heavy painful periods.
  • It can used by some women who are unable to use contraception containing oestrogen.
  • If you wish to conceive in the future, your fertility returns to normal after removal of the IUS.

What are the disadvantages of using a contraceptive implant?

  • Often causes changes to the pattern of your periods, and some patients have irregular bleeding.
  • Perforation of the womb, bleeding and infection may rarely occur at the time of insertion.
  • Expulsion of the coil from the womb can occur, often in the first month after insertion.
  • Pelvic or abdominal pain.
  • Headache.
  • Breast tenderness.
  • Skin changes (acne).
  • It does not protect against STI’s, so you also need to use condoms.

If you wish to have an IUS inserted or removed, you should book an appointment at Chalmers Hospital on 0131 536 1070.

4) Combined Oral Contraceptive Pill (COCP)

The combined pill contains two hormones (oestrogen and progestogen) that are similar to the natural hormones women produce in their ovaries. If the pill is taken according to instructions it is over 99 per cent effective. There are a wide variety of pills available, but generally you take the pill for 21 days then have 7 days when you have a pill free week. During this pill free week, you will have a withdrawal bleed like a period.

What are the advantages of the pill?

  • Does not interrupt sex.
  • Your periods usually become regular, lighter and less painful.
  • It can reduce premenstrual symptoms.
  • Reduces the risk of cancer of the ovary, uterus and colon.
  • Reduces acne in some women.
  • Reduces the risk of fibroids, ovarian cysts and non-cancerous breast disease.

What are the disadvantages of the pill?

  • There are several side effects including headaches, nausea, breast tenderness and mood changes.
  • May increase your blood pressure.
  • Does not protect you against sexually transmitted infections.
  • You often experience break-through bleeding or spotting.
  • Cannot be used in breast-feeding women and some women with certain health problems.
  • Increases the risk of blood clots (venous thrombosis), heart disease and stroke.
  • Small increase in the risk of being diagnosed with breast cancer.
  • Small increase in the risk of developing cervical cancer with longer use of the COCP.

5) Progestogen-Only Pill (Mini-Pill or POP)

The progestogen-only pill (POP) contains a progestogen hormone that is similar to the natural progesterone women produce in their ovaries. Progestogen-only pills are different to combined pills because they do not contain any oestrogen. This pill needs to be taken at the same time every day, and unlike the COCP there is no break with this pill.


What are the advantages of the POP?

  • Does not interrupt sex.
  • Your periods usually become regular, lighter and less painful.
  • It can be used if you are breast-feeding.
  • It can be taken by women who are unable to take oestrogens.
  • You are able to use it at any age regardless if you smoke.
  • It can reduce pre-menstrual symptoms.

What are the disadvantages of the POP?

  • Your periods may become irregular or more frequent while you are taking the POP.
  • Does not protect you against sexually transmitted infections.
  • You have to remember to take the pill at the same time every day with no break.
  • Common temporary side effects include acne, breast tenderness, weight change and headaches.

6) Contraceptive injection (also known as Depot or Depo-Provera)

The contraceptive injection contains a progestogen hormone that is similar to the natural progesterone that women produce in their ovaries, and is given in your buttock. Depo-Provera protects you from pregnancy for 12 weeks and is over 99 per cent effective.

What are the advantages of a contraceptive injection?

  • It lasts for 3 months and does not interrupt sex.
  • It can be used when breast-feeding.
  • It is not affected by other medications.
  • Reduces heavy painful periods and it can help with premenstrual symptoms for some women.
  • It can be used by women who are unable to use contraception containing the hormone oestrogen.

What are the disadvantages of a contraceptive injection?

  • Irregular bleeding is common, and may continue for some months after you stop the injections.
  • Weight gain is a common side effect of the depot.
  • Delay of up to a year before the return of your periods and fertility after stopping the depot.
  • Does not protect you against sexually transmitted infections.
  • Risk of infection at the site of the injection.
  • May affect your bones by causing thinning of your bones.

7) Emergency Contraception

If you have had unprotected sex, that is, sex without using contraception, or think your contraception might have failed, you can use emergency contraception. There are two different types of emergency contraception:

1) Emergency contraceptive pill called Levonelle (also known as the Morning After Pill):

  • This pill can be taken up to 72 hours after sex.
  • It is more effective the sooner that the pill is taken after sex.

2) Emergency intra-uterine device (IUD):

  • This can be inserted up to 5 days after sex.
  • It can remain in the womb to provide long-term contraception if desired.

Emergency contraception can be very effective especially if you have an IUD fitted or if the emergency contraceptive pill is taken soon after sex. You should see your GP, Practice Nurse or Pharmacist as soon as possible if you are worried about unprotected sex. We are unable to offer the fitting of the IUD at the Surgery. Should you wish this form of contraception, please urgently contact Chalmers Hospital direct on 0131 536 1070.