As spring arrives and people are outdoors more, you may find yourself with more bites and stings. Most insect bites and stings are not serious and will get better within a few hours or days.

What to do if you’ve been bitten or stung:

To treat an insect bite or sting:

• Remove the sting or tick if it’s still in the skin
• Wash the affected area with soap and water
• Apply a cold compress (such as a flannel or cloth cooled with cold water) or an ice pack to any swelling for at least 10 minutes
• Raise or elevate the affected area if possible, as this can help reduce swelling
• Avoid scratching the area, to reduce the risk of infection
• Avoid traditional home remedies, such as vinegar and bicarbonate of soda, as they’re unlikely to help

The pain, swelling and itchiness can sometimes last a few days. Ask your pharmacist about medicines that can help, such as painkillers, creams for itching and antihistamines.

Read more about treating insect bites and stings.

Read more here for NICE Guidance on insect bites and stings: antimicrobial prescribing.

When to get medical advice

Contact us or call NHS 111 for advice if:

• You’re worried about a bite or sting
• Your symptoms do not start to improve within a few days or are getting worse
• You’ve been stung or bitten in your mouth or throat, or near your eyes
• A large area (around 10cm or more patch of skin) around the bites becomes red and swollen
• You have symptoms of a wound infection, such as pus or increasing pain, swelling or redness
• You have symptoms of a more widespread infection, such as a high temperature, swollen glands and other flu-like symptoms

Self-care Guidance

SWL CCGs (NHS Croydon, NHS Merton, NHS Richmond, NHS Sutton and NHS Wandsworth) are committed to delivering best value by ensuring that we use our resources well. To help us to support the implementation of the NHS England guidance ‘Conditions for which over the counter items should not routinely be prescribed in primary care’ (March 2018), SWL CCGs no longer support the routine prescribing of health supplements and medications that can be bought over the counter for minor conditions, self-limiting and short-term illnesses. For the SWL position statement please click here.

Why are we doing this?

• We want to help people lead longer, healthier lives and support them to take better care of their health. Self-care is about avoiding becoming ill and seeking help when needed. By managing minor health needs through self-care, it will help to ease the pressure on the NHS.
• SWL CCGs have a set amount of money to pay for the health services that are needed and have a duty to spend that money wisely.

What treatment and preparations are included?

• Pharmacy Only (P) and General Sales Lists (GSL) treatments that can be purchased over the counter from a pharmacy with or without advice
• GSL treatments (including a patient information leaflet) that can be purchased from other retail outlets such as supermarkets, petrol stations, convenience or discount stores
• Treatments that are used to treat a condition that is considered to be self-limiting and so does not need treatment as it will heal/resolve by itself; and/or
• Treatments that are used to treat a condition which lends itself to self-care, i.e. that the person suffering does not normally need to seek medical care and/or treatment for the condition.
• Treatments available OTC which should no longer be prescribed in SW London are listed below.

To read more on how prescribing of over the counter medicines is changing: click here to see NHS patient leaflets. These leaflets have been produced to help CCGs implement recommendations and support discussions between patients and their healthcare professionals .

The Merton physiotherapy app (powered by getUBetter) is provided free of charge by
Merton CCG for patients registered at Nelson Medical Practice. It can be accessed on
a Smartphone or on the Web and guides you day-by-day through a sequence of
exercises and tips to help you recover from a range of new or recurrent muscle and
joint conditions:

• Lower back pain
• Back and leg pain
• Neck pain
• Shoulder pain
• Ankle pain
• Knee pain
• Soft Tissue Lower Limb pain
• Hip pain

You will be referred to the app by one of our GPs or Physio, or you can self-register by
clicking on this link or the App image.

Please use an email address that is unique to you and select the condition you need
help to manage. You will then be sent an email with all the information you need to
get started.

You can download the getUBetter App to your Smartphone for easiest access or you
can use the Webapp.

If you develop another condition select your new condition from within the app and it
will be added to your account.

The app will also connect you to your local; treatment, healthcare providers or
support services, if needed, such as Physiotherapy.

With life getting back to what we hope is more normal rhythm we want to let you know that we are here to support you.  We are continuing to improve our service and have put substantial effort into redesigning our access model.  We still have the same dedicated on call team to manage you urgent medical needs and will triage routine medical requests into the most appropriate appointment types with the most appropriate clinicians either remotely or in person according to your request, this may involve having tests before an appointment. You still have access to phlebotomy (blood tests), ECG (heart tracing), and X-ray within the Nelson health centre.

Our new telephone system will help more appropriately navigate you to the correct pathway and allow an automated call back should you call waiting times be long.  Do be aware that lines tend to be very busy on a Monday and Tuesday morning and call waiting times are shorter later on in the week and in the afternoon.

Our reception is staffed by patient care navigators from 7am until 8pm Monday to Friday and is open.  We have always offered (and continue to offer) face-to-face appointments to those who want and need them.  Over recent months we have however seen a significant increase in demand and are currently handling over 1,000 calls on average each day.  We are providing over 1800 appointments per week – the majority in person.  We understand call waiting times can be frustrating but ask that you remain patient with our team. You can also you the online symptom checker ‘doctor link’ to access care directly, or use the ‘contact us button’. We would also suggest that for routine queries you call at times when lines are likely to be quieter for example midweek and afternoons.

Some medical care can also be accessed directly:

• Musculoskeletal appointments offered directly by Connect health – 020 3795 3430
• Mental health appointments can be accessed directly by Merton Uplift
• Same day Minor injury appointments are offered at Queen Mary’s Hospital and can be accessed by calling 020 8725 0120
• Specialist opticians are providing direct primary eye care services. A list of participating opticians can be found here and further details at www.primaryeyecare.co.uk
• Local pharmacies can also provide advice relating to simple conditions, and many treatments purchased directly from the pharmacy

Secondary care (hospitals)

Many hospital are still under significant pressure, this is impacting waiting times particularly for routine appointments but is also leading to increase A+E waiting time, please do call the practice or use the services listed above if you think these would be appropriate for your needs, and be aware that we cannot re-arrange hospital appointments (please call hospital administration teams directly for this).

Coronavirus

Although we hope that life is returning to a more normal rhythm it is important to remain cautious. This is particularly the case with potentially vulnerable people needing to attend the Nelson for healthcare. For this reason if you have symptoms that could be infectious then we will ask you to come to an ‘isolation’ appointment at the surgery or at a coronavirus ‘hub’ appointment at a local practice.

If you have symptoms that could indicate an infectious illness we will see you in our isolation room and will ask you to wait away from the main waiting area in order to keep other patients safe. Please ensure you follow these instructions clearly.

There are also things that you can do to help reduce the potential for transmission within the surgery.

• Please arrive on time (not early) for your appointment to reduce time in the waiting room.
• Please wear a mask at all times during the building.
• Wash or sanitise your hands before entering and when you leave.
• Consider taking a lateral flow test before attending the practice.

Coronavirus Vaccination

Vaccines are our most powerful defence again coronavirus and will help keep you and those around you safe, and to bring the pandemic to an end.  Vaccines are proving safe and effective.

Anyone who has not yet had a vaccination should have one now.  No appointment is needed, the clinics are listed here. Walk-in and pop up vaccination clinics – South West London CCG (swlondonccg.nhs.uk) or book using the national booking system.

If you feel worried about having a vaccination please discuss with clinic staff or one of our team who will be happy to talk this through with you.

Boosters

Booster vaccinations are our main defence against the Omicron variant – all patients over 18 who are more than 91 days from their second vaccination can book a booster now.

Additional clinics are taking place at the Nelson Health Centre and Wilson Hospital, as well as Centre Court Shopping centre and other sites in the borough. Appointments are often not necessary.

All details can be found here:  Walk-in and pop up vaccination clinics – South West London CCG (swlondonccg.nhs.uk) or use the national booking system to book coronavirus boosters.

Boosters: 4^th vaccinations are now being offered to eligible individuals and we are making arrangements to visit those in care homes and housebound to deliver them. Do I need a spring booster – and how do I get one? – South West London CCG (swlondonccg.nhs.uk)

Our reception staff are not able to prioritise people for booster vaccination nor arrange ‘Covid passports’ as the process is managed nationally.

Mental health

We know that the last two years have been a particularly challenging time for many of us.  If you have an urgent mental health concern please do call our practice team in hours.  There are also many service that you can access directly without needing to contact the practice:

Merton Uplift continues to offer access to psychological therapies and you can contact them directly by calling 020 3513 5888.  They also run workshops in various areas including “Alcohol, Mood and Emotions”, “Feeling Confident coming out of Lockdown” and “Managing Sleep”. These are arranged through Merton uplift visiting.

• Off the record offer talking therapy for 11 – 25 years olds
• Kooth offer online support 
• Mental health crisis care can be accessed via 0800 028 8000 
• The Samaritans are available throughout the winter period via 116 123 

Please visit our Health and Wellbeing Coaches page.

Please see www.swlondonccg.nhs.uk/news/meet-matt-paramedic-on-a-bike-in-primary-care/.

A safe and inclusive space for patients of the Social Prescribing service. Our friendly team will help to facilitate the group with fun activities.

Cafe La Lavella
63 London Road, Morden SM4 5HT

· Wednesday 2nd March 18:00-19:00

· Thursday 10th March 16:00-17:00

The Potting Shed Café
Morden Hall Park

12:00-13:00

· Monday 14th, 21st & 28th February

· Monday 7th March

For further information please visit the Merton Connected Website.

At the Nelson Medical Practice we are always seeking to improve the experience of our patients. That experience begins when you book an appointment. We want to ensure that when you contact the practice for an appointment the process is straight forward, fair and gets you to the right person, at the right time, first time.

Our exceptional team is now larger and more diverse than ever including exciting new professional roles such as a paramedic, clinical pharmacists, physician associates, health & well-being coaches and social prescriber. They work closely alongside our GPs and practice nurses, but we realise sometimes it can be hard to know who you should see for what problem.

The COVID-19 pandemic has changed the way GP practices up and down the country have been working. We currently see hundreds of patients face to face every week and consult hundreds more by telephone, video and online. We have learnt that some patients prefer to consult remotely, whilst others prefer to come to the surgery. We want to make sure that our patients can have the types of appointments that work best for them when they need them.

With all this in mind, we have been working to redesign our access system to ensure that all patients have an outstanding experience of accessing our care and see the right member of the team, best placed to help with their problem.

Thank you to everyone who completed our recent patient survey, we received 1,515 responses and really value your feedback.  We’re using this data, along with the insights of our Patient Participation Group, clinicians and navigation staff to help improve your experience.

Our survey results told us that most of our patients prefer to contact the surgery by telephone. We know that many patients have experienced technical issues with our current telephone system which can be extremely frustrating.

To resolve these issues, we have installed a brand-new telephone system! This will help to direct patients safely and speedily to the right member of our team. Importantly this system will never give an engaged tone, never cut a caller off and if a longer wait is anticipated the system can call you back when your call reaches the front of the queue. Our new telephone system will ‘go live’ on Monday 7^th February 2022. Please note that there will be no change to our mainline telephone number.

Our changes don’t stop there. To ensure that we have the information we need to get you the right appointment we have trained all our Patient Care Navigators in the use of a clinical triage template. Some appointments will be booked directly and urgent problems requiring same day attention will be directed to our Same Day Team.

Where the problem is not urgent details will be taken by the navigator and then reviewed by one of our GPs so that you can be booked a suitable appointment that suits you. Please be assured that everything you tell our patient care navigators is handled in the strictest confidence.

Our reception remains open for patients who want to speak to a member of the team directly and we continue to offer online consultations through our online symptoms checker and advice tool, Doctorlink.

Our doctors and managers have worked with our navigation team and patients to ensure that the system is easy to use and makes sense to patients, but we know we won’t get everything right first time. For the next 6 months we will be keeping our new system under constant review as well as conducting patient surveys to find out how it is working. If you have any feedback on our new system please contact us:

Telephone: 020 3826 0826
Email: swlccg.enquiriesnelson@nhs.net
Contact Us Form: www.nelsonmedicalpractice.co.uk/contact-us

Best Wishes,
The Nelson Medical Practice

‘Guy’s and St Thomas’ have launched the PANORAMIC Study. The Study is testing an antiviral treatment for COVID-19.

If you have tested positive in the last five days and are over 50 years, or over 18 with an underlying health condition, you may be able to join.

Further Infomration: Community COVID-19 antiviral trial opens at Guy’s and St Thomas’ – BRC (nihr.ac.uk).

Patients in Merton can access urgent appointments with a GP during weekends and bank holidays from 18th December 2021 to 16th January 2022.

Call 0333 332 6570 weekends and bank holidays 08:00 – 20:00. Call to this number are charged at your standard network rate.

For emergencies, please continue to call 999.

With the emergence of the Omicron variant the NHS is again being asked to support a national campaign to reduce the impact of coronavirus through delivering booster vaccinations at unprecedented pace.

The case rates in Merton are now very high and rising quickly. This may mean that some of our routine primary care appointments may need to be delayed as we focus on urgent care and the delivery of vaccinations.

We want to assure you that the practice is open as usual for all urgent health care needs and we will continue to provide care in the surgery, on the phone and online during our opening hours 08:00 – 18:30.

Additional urgent GP appointments are available at weekends and Bank Holidays from 8am to 8pm from the 18^th December to the 16^th January and can be arranged by calling 03333386570.

Outside of these times please call 111.

Coronavirus

The current population rates of coronavirus are currently very high and rising rapidly.

The practice is open to see you in person, online, or on the phone if needed. We are continuing to use telephone triage to keep our patients safe. Some conditions can be managed remotely and we know this is convenient for some patients, this makes it safer and easier for those who need to come to the surgery to do so.

If you have symptoms that could indicate an infectious illness we will see you in our isolation room and will ask you to wait away from the main waiting area in order to keep other patients safe. Please ensure you follow these instructions clearly.

There are also things that you can do to help reduce the potential for transmission within the surgery.

• Please arrive on time (not early) for your appointment to reduce time in the waiting room
• Please wear a mask at all times during the building
• Wash or sanitize your hands before entering and when you leave
• Consider taking a lateral flow test before attending the practice.

The symptoms of coronavirus infection are often mild to start with and are often similar to many other viral illnesses with symptoms including muscle aches, headache, sore throat and tiredness as well as the well-known cough, fever and loss of smell. If in any doubt about your symptoms please book a formal PCR viral swab via.

www.gov.uk/get-coronavirus-test

If you need support during this difficult time please contact the Merton Community hub Covid-19 Community Response Hub (mertonconnected.co.uk). You can call them on 0208 066 4086 or email help@mertoncommunityhub.org.uk.

More information about the covid situation in the borough is available on Merton Council’s website Coronavirus | Merton Council. We recommend signing up for email updates.

Coronavirus Vaccination

Vaccines are our most powerful defence again coronavirus and will help keep you and those around you safe, and to bring the pandemic to an end. Vaccines are proving safe and effective.

Anyone who has not yet had a vaccination should have one now. No appointment is needed, the clinics are listed here. Walk-in and pop up vaccination clinics – South West London CCG (swlondonccg.nhs.uk) or book using the national booking system.

If you feel worried about having a vaccination please discuss with clinic staff or one of our team who will be happy to talk this through with you.

Boosters

Booster vaccinations are our main defence against the Omicron variant – all patients over 18 who are more than 91 days from their second vaccination can book a booster now.

Additional clinics are taking place at the Nelson Health Centre and Wilson Hospital, as well as Centre Court Shopping centre and other sites in the borough. Appointments are often not necessary.

All details can be found here:  Walk-in and pop up vaccination clinics – South West London CCG (swlondonccg.nhs.uk)

Or use the national booking system to book coronavirus boosters.

Our reception staff are not able to prioritise people for booster vaccination nor arrange ‘Covid passports’ as the process is managed nationally.

Service update

Our reception is staffed by patient care navigators from 7am until 8pm Monday to Friday and is open. We have always offered (and continue to offer) face-to-face appointments to those who want and need them throughout the pandemic. Over recent months we have however seen a significant surge in demand and are currently handling over 1,000 calls on average each day. We are providing over 1800 appointments per week – the majority in person.

We have noted an intermittent problem with the telephone system in that occasionally people are on hold for extended periods of time. We have therefore taken the decision to replace our telephony provider, which we hope will significantly improve the service. We apologise for the inconvenience whilst we do this and appreciate your patience and understanding whilst we make these changes.

We understand call waiting times can be frustrating but ask that you remain patient with our team. You can also you the online symptom checker ‘doctor link’ to access care directly, or use the ‘contact us button’.

• Additional urgent bank holiday and weekend GP appointments 03333386570 
• Musculoskeletal appointments offered directly by Connect health – 02037953430
• Mental health appointments can be accessed directly by Merton Uplift
• Same day Minor injury appointments are offered at Queen Mary’s Hospital and can be accessed by calling 020 8725 0120
• Specialist opticians are providing direct primary eye care services. A list of participating opticians can be found here and further details at www.primaryeyecare.co.uk
• Local pharmacies can also provide advice relating to simple conditions, and many treatments purchased directly from the pharmacy

Mental health

We know that winter can be a particularly challenging time for all of us, particularly so in the current pandemic.  If you have an urgent mental health concern please do call our practice team in hours. There are also many service that you can access directly:

Merton Uplift continues to offer access to psychological therapies and you can contact them directly by calling 020 3513 5888. They also run workshops in various areas including “Alcohol, Mood and Emotions”, “Feeling Confident coming out of Lockdown” and “Managing Sleep”. These are arranged through Merton uplift visiting.

• Off the record offer talking therapy for 11 – 25 years olds
• Kooth offer online support 
• Mental health crisis care can be accessed via 0800 028 8000 
• The Samaritans are available throughout the winter period via 116 123