Monday 19th to Friday 23rd December inclusive - 08:00 - 20:00
Saturday 24th December – 09:00 - 13:00
Sunday 25th to Tuesday 27th December inclusive – CLOSED
Wednesday 28th to Friday 30th December inclusive – 08:00 - 18:00 *
Saturday 31st December – 09:00 - 13:00
Sunday 1st to Monday 2nd January inclusive – CLOSED
3rd January onwards – normal opening hours

* Telephone lines will remain open until 8pm
VIP24 Member access to the On-Call Number available outside of these hours

Practice Staff Update
Some of you will have met Dr Andrew Jackson who has been working with us for the past few months. Towards the end of November Dr Jackson is heading off to a medical posting in Val D’Isere until April. We look forward to working with him again when he gets back.

Ellen Devine, our Saturday Administrator, left us in August to head off to University. Shaleeza Makhani, who is in her 4th year at Dentistry School, has joined the Reception Team on a part time basis.

Adriana returned to her Receptionist role in September following her maternity leave. Now Adriana is back, Natalie has joined the Admin Team until the end of December, when she will be back on Reception covering for Caroline, who is heading off to do some travelling for a couple of months.

New DOCTORnow Cars
In May we took delivery of 3 new Toyota IQ cars. The IQs have more space and have better handling in snow and ice which, if future winters are going to be like the last two, will help our Doctors and Nurses to keep on the move!

Running Late?
Please note that if you arrive late for an appointment, whilst we will endeavour to still see you, in order to not delay other patients who arrive on time, you may have to wait for the clinician to fit you in. We hope you can understand that this is to ensure timely access to clinicians for our patients.

DOCTORnow Brochure
Our latest brochure is now available at Reception. Please feel free to take a copy, either for yourself, for a friend or for a relative who may be interested in our services.

Waiting Room Screen Presentation
We now have a screen in the waiting room which shows a rolling presentation, providing information about our services. It is changed regularly to include up to date general health information. We hope you enjoy watching it. Please do not hesitate to let us know of any changes or additions you think would be useful.

Charity Events
On August Bank Holiday Monday we supported the Beaconsfield Country Fayre, sponsoring the St Johns Ambulance in partnership with Universal Care, and holding a fun skeleton competition, which raised £64 for the Ian Rennie Hospice at Home.

On October 7th we supported Jeans for Genes Day. The DOCTORnow team made donations in order to wear jeans for the day, sold badges and held a raffle. We were delighted to raise £148 to help children born with a genetic disorder.

We also donated a free Well Person Check as a prize for a local Charity Ball to raise money for cancer research charities.

Universal Care Dementia Awareness Evening
Universal Care are holding an informative evening on understanding dementia and Alzheimer’s Disease on 12th January 2012. Sally Blackden, an advocate for people with dementias, has a wealth of experience to share with those supporting loved ones with the diseases. Dr McGirr will also be present. To book a free place or to find out more about the evening please call Universal Care on 01494 678811.

VIP FEES (valid from 1st November 2011 - 31st October 2012)

Joining Fees: Please note, a joining fee applies for all new members or lapsed members who are re-joining after a break in their membership, except for VIPi membership as follows:

Membership Fees: Annual fees can be paid by cheque, debit/credit card or Direct Debit. Monthly fees are to be paid by Direct Debit only.

Other Membership Fees:
VIP12 Doctor home visit (surgery hours): £242.00

VIP24 Doctor home visit: £121.00

VIP12 out of hours Doctor consultation: £189.00

VIP24 out of hours Doctor consultation: £95.00

VIP24 Nurse home visit: £33.50
VIP12 Nurse home visit: £67.00
Missed Doctor appointment fee: £57.50
Missed Nurse appointment fee: £18.75

NON MEMBER FEES (valid from 1st November 2011 - 31st October 2012)

Clinical Administrative Support
Death Certification £74.50
Identity Verification £27.50
Insurance Forms (v) £33.00
Prescriptions £22.00
Referral Fee £27.50
Sick Notes £22.00

Doctor Consultation Fees
Surgery (30 mins) £115.00
Telephone (15 mins) £57.50
Missed Appointment Fee* £115.00
Home Visit# £260.00
Home Visit out of hours ^## £285.00
Out of Hours Surgery Consultation ^## £220.00

^# during surgery hours and at the Doctor’s discretion
^## booked during surgery hours and at the Doctor’s discretion

Nurse Consultation Fees
Surgery consultation £37.50
Missed Appointment Fee* £37.50
Home Visit (surgery hours) £74.00
Laser Skin Rejuvenation
Consultation Fee £37.00
Laser Hair Removal Consultation Fee £37.00
MASTA Consultation Fee (advice only)** £20.00
MASTA Missed Appointment Fee* £20.00

Fees may not include procedure fees or the cost of tests.
Home visit fees are applicable within 15 miles of the surgery; additional £10 for each 5 miles thereafter
* Missed appointment fees will apply if the appointment has not been cancelled at least 4 hours in advance
** Only charged if no vaccinations are given

A state-of-the-art CT scanner that has revolutionised non-invasive diagnosis of tumours, lung and heart diseases and blood flow problems has just been unveiled at The BMI Chiltern Hospital.

The 128 slice Toshiba Aquillion CT scanner will allow the Great Missenden hospital’s Diagnostic Imaging Department to carry out a comprehensive range of established and new procedures. It will also allow invasive procedures such as CT-guided biopsies and joint injections.

BMI Chiltern’s Diagnostic Imaging Manager Amelia Timmis said: “This is a flagship scanner that puts The Chiltern at the cutting edge of CT imaging. In the short time it has been here it has already allowed us to do procedures that would not previously have been possible. It really does mean we can further improve the standard of care we can offer our patients.”

Did you know that antibiotic resistance is one of the world’s most pressing health threats?

Antibiotics are the most important tool we have to combat life-threatening bacterial diseases, but increased antibiotic resistance is compromising their effectiveness.

Many bacteria have become resistant to more than one type or class of antibiotic, which means patients may not be able to be effectively treated, which in turn can lead to life threatening illness.

Antibiotics cannot cure viral infections, and indeeed may make it more likely that you will become ill with a resistant infection.

It is estimated that more than 50% of antibiotics are unnecessarily prescribed for upper respiratory infections such as coughs and colds, most of which are caused by viruses.

Please therefore understand if your Doctor decides that you do not need antibiotics for your illness.

Tens of thousands of newborn babies are to be vaccinated against tuberculosis (TB) in order to fight the resurgence of the disease in the UK.

Health Chiefs say that TB is now a “serious problem” in some urban areas, especially in London.

TB infection has surged by 50% in the last decade. Most cases are brought in from Asia and Africa, but can spread to others by prolonged close contact (about 8 hours in the same room) with those infected.

TB, fatal if left untreated, may be curable with a six month course of antibiotics, but drug-resistant varieties are on the rise.

The BCG vaccination which protects against TB was discontinued for schoolchildren in 1995, so anyone aged under 20 is unlikely to have had the vaccination. Yet these young adults are more likely than ever to travel to worldwide destinations where TB is common.

We hold regular BCG vaccination clinics - please ask us if you would like more information.

For the convenience of our patients, by the end of October we will be stocking and dispensing a range of the medications most commonly required. This includes items such as antibiotics, asthma inhalers and diabetes medication.

This means that for some conditions you will have the option of taking your medication with you following your consultation. You simply pay for it at Reception before you leave the practice.

We hope you will find this new service useful.

Butter Bean Soup with Pancetta

Ingredients (serves 4)
2 onions, roughly chopped
A small bunch of chives, snipped
Butter
4 sprigs of thyme, leaves only
2 x 400g tins of butter beans, drained and rinsed
750ml chicken stock, fresh, cube or concentrate
8 slices of pancetta, grilled until crisp
Crusty bread, to serve

Method
Cook the onions in a knob of butter until soft, about 10 minutes.

Add the thyme, butter beans and stock, and simmer for 10 mnutes. Season, liquidise and serve topped with crisp pancetta and chives.

Nutritional per serving
193 kcalories, protein 15.6g, carbohydrate 20.2g, fat 6.1 g, saturated fat 2.5g, fibre 6.2g, salt 3.88 g

Winter can be a miserable enough time for most of us, with colder weather forcing us to don our hats and scarves, and the festive season seeming to empty our wallets. However, for some people, winter can bring with it something more serious.

An estimated 7% of the population suffer from Seasonal Affective Disorder (SAD) - a debilitating illness that can cause depression, sleep problems, lethargy, anxiety, loss of libido and a change in appetite.

It is believed that up to 17% of people will experience a mild form of one or more of these symptoms during the winter months.

Most sufferers will experience these symptoms during the winter months, most commonly during December, January and February.

Despite the severe impact SAD can have on peoples’ lives, we are still unsure as to why some people are affected so much more than others.

The shorter daylight hours in winter can lead to a reduction in two of the body’s hormones - serotonin and melatonin.

Serotonin is a chemical in the brain which enhances mood. The lack of natural sunlight in winter can cause a drop in the levels of of serotonin, causing depression.

The second hormone, melatonin, is produced by the brain during periods of darkness, and regulates sleep, body temperature and the release of hormones. Most people produce more melatonin in winter, but people with SAD produce an excess of melatonin, leading to sleep problems and lethargy.

If you find yourself experiencing low mood, anxiety, feeling tense or often wake up during the night, you may be experiencing SAD. If you are worried, it is important to speak to your Doctor to discuss your concerns.

Reassuringly however, in most cases it is easily treated. Light therapy involves the use of a specially designed light box which produces a light imitating natural daylight. The light boxes are completely safe and should be used for half an hour each day. This can be done while reading, eating, working or doing almost anything.

Light therapy has been proven to be a highly effective treatment, however in some severe cases Doctors may also prescribe antidepressants.

by Lyn Williams, BSc (Hons), MSc, CBT Therapist

We all experience stress from time to time. It usually arises from a combination of circumstances; a particular situation mixed with how we appraise what is happening to us, our own individual personality and ways of coping.

Certain life events increase vulnerability to stress, such as bereavement, divorce and even ‘pleasurable’ events such as Christmas or family holidays.

Stress isn’t necessarily negative. In the short term it can be a positive force which increases our performance because it makes us more alert, vigilant and increases energy. However, excessive stress over time can seriously affect functioning and health. What we can definitely say is that stress occurs when the demand upon us outweighs our ability to cope.

Workplace issues are one of the most common causes of stress. Researchers have found that some people with ‘stress resistant personalities’ can cope with high levels of stress yet have low levels of illness. This type of person seems to have three personality characteristics - they all begin with ‘C’!

The characteristics are: a sense of Control - they have a feeling of purpose and direction in life; a sense of Commitment to interests such as hobbies, family and work; and a sense of Challenge, they view change as something normal and positive, rather than as a threat.

Of course, fostering a more helpful way of behaving and thinking is not easy when you are under stress, but here’s one little technique that can be helpful.

We all know that the Titanic sank because of an iceberg ripping a hole in her side; once the water went over the bulkheads and filled the compartments she sank to the ocean floor. So imagine your life as being like a ship. Use a diagram like the one below to fill in each compartment with different aspects of your life. For example in one compartment you might write ‘work’ and in another your hobby, in another ‘being with partner’ and so on.

Take a look at the ones where there are difficult or temporarily impossible problems to solve. Decide which ones you can work on. See what areas can be improved. For example, what can you do to make your relationship with your partner better? Try to plan good times together. By doing this you can focus on those areas of your life where you can make positive improvements. You are strengthening those ‘bulkheads’ so the ‘water’ (stress) can’t overflow into all the compartments and ‘sink’ you.

If you are facing stress, do try out the technique above, but if you need a little help to keep your life ‘seaworthy’, consider some cognitive behaviour therapy (CBT) sessions to help you learn other ways of doing this.