LORDSHILLH/C

Newsletter

July 2018

Edition11

Welcome to the summer edition of our Newsletter. We have some important information regarding the flu vaccines this year so please do read carefully, as there are different flu vaccines for different age groups. This is following guidance from NHS England.

Debbie Charman

Practice Manager

FLU 2018/19

IMPORTANT INFORMATION

PLEASE SUPPORT US AND HAVE YOUR FLU VACCINEAT THE SURGERY

For the 2018/19 flu season, NHS England has told GPs to ensure that they order the quadrivalent vaccine for people aged 18 to 65 who are at risk and the newly licensed (2017) adjuvanted trivalent vaccine, Fluad, for patients aged over 65.

The adjuvanted trivalent vaccine (aTIV) is the most effective vaccine currently available for this group. The surgery will be informed of their delivery dates in August (there is only one supplier for the whole country of the adjuvanted vaccine) and will start booking appointments as soon as notice of delivery has been given. Please do support the surgery by having your flu vaccine with us.

New GP Partner

We are delighted to inform you Doctor Li who did her GP Registrar training with us will be joining us as a GP Partner from 2nd July 2018. Dr Li will be working 4 sessions a week

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Contact Details

Please remember to update any details you may change such as address or telephone numbers. We would also like your e-mail address. If we do not have yours please speak to reception and we will update your details.

Evening and weekend appointments

You may have heard us talk about appointments at theHUB

What is this?

Southampton GPs introduced a new initiative in 2015 to give patient access to medical help from 8am to 8pm every weekday (including bank holidays) and 8am to 4pm on Saturday and 8am to 2pm on Sunday.

Southampton Primary Care Ltd (which is owned by all Southampton GP practices) has been set up to provide these appointments, known as'THE Hubs’andis an importantpart of the practices resource to help provide appointmentsto our patient population. You will be asked for permission to share your medical record with the person seeing you to ensure they canview your usual medication and possible allergies etc.

Who can use these appointments?

As a registered patient at Lordshill Health Centre,we canbook anappointment with a doctor or nurse for you. You may find it more convenient to ask for a HUBappointment especially if you work orcan only see a GP or nurse at the weekend.

Where are theseHUBS?

There are six HUBSthroughout the city who offer these appointments but we cannot guarantee which one will have free appointments on any particular day.Please be aware that you may have tovisit one which may be slightly further away from your local surgery.

  • Woolston Lodge Surgery,66 Portsmouth Road, Woolston, Southampton,SO19 9AL
  • Chessel Practice,4 Chessel Avenue, Bitterne, Southampton, SO19 4AA
  • St Mary's Surgery,1 Johnson Street, Southampton SO14 1LT
  • Portswood Solent Surgery,7 Belmont Road, Portswood, Southampton, SO17 2GD
  • Shirley Health Partnership,Shirley Health Centre, Grove Road, Southampton SO15 3UA
  • Aldermoor Surgery,Aldermoor Close, Southampton SO16 5ST

How do I book?

Our reception staff can book these for you, call the surgery on 023 80738144.Also if you phoneNHS 111 (whenwe are closed), then you could be offered aHUBappointment if you need to be seen by a GP or nurse on that day. Remember calling NHS 111 is free to phone and available 24 hours

a day, 365 days a year, so you may notneed to wait until 8am on Monday morning if you need medicalattention over the weekend.

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Lordshill Health Centreis extremely proud to be part of the NHS

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Giving someone power of attorney

Putting in place a power of attorney can give you peace of mind that someone you trust is in charge of your affairs.

If you're aged 18 or older and have the mental ability to make financial, property and medical decisions for yourself, you can arrange for someone else to make these decisions for you in the future. This legal authority is called "lasting power of attorney".

The person who is given power of attorney is known as the "attorney" and must be over 18 years old. You are known as the "donor".

Types of power of attorney

There are 2 different types of power of attorney: lasting power of attorney (LPA) and enduring power of attorney (EPA).LPAs came into force in October 2007. Before that, people made EPAs. It's no longer possible to make an EPA, but an EPA made before October 2007 remains valid.

Lasting Power of Attorney (LPA)

This includes:

  • personal welfare LPA
  • property and financial affairs LPA

Personal welfare LPA

Personal welfare LPA gives your attorney the power to make decisions about your daily routine (washing, dressing, eating), medical care, moving into a care home and life-sustaining medical treatment. It can only be used if you're unable to make your own decisions.

Property and financial LPA

Property and financial affairs LPA gives your attorney the power to make decisions about your money and property, including managing your bank or building society accounts, paying bills, collecting your pension or benefits and, if necessary, selling your home.

Once registered with the Office of the Public Guardian, it can be used immediately or held in readiness until required.

Applying for power of attorney

It's generally recommended that you set up both a personal welfare LPA and a property and financial affairs LPA at the same time. Many people do this while reviewing or revising their will, and you may be able to use the same solicitor. You can apply online for power of attorney on GOV.UK.

Alternatively, contact the Office of the Public Guardian for an application pack:

  • by post at the Office of the Public Guardian, PO Box 16185, Birmingham, B2 2WH
  • by phone on 0300 456 0300 – lines are open Monday to Friday, 9am to 5pm, and 10am to 5pm on Wednesdays

Talk to a lawyer if you have problems answering any of the questions or if you want them to check what you have done. You can call the Office of the Public Guardian or the Court of Protection first to see if they can help on 0300 456 0300. Legal aid may be available for personal welfare LPA issues, but not for property and financial LPAs. The Law Society will be able to tell you which solicitors offer legal aid. You'll only be eligible for legal aid if you pass a means test.

Contact the Law Society by writing to them at 100-113 Chancery Lane, London WC2A 1PL, or call 020 7242 1222. You can also search for solicitors who specialise in this area on the Law Society online directory.

Registering the power of attorney

A power of attorney has to be registered before it comes into force. You can register a power of attorney on GOV.UK. Either the person making the application for power of attorney (the donor) or the person who will have power of attorney (the attorney) can apply to register the application. There is a 6-week notice period for any objections to be raised.

Once the power of attorney has been registered, the original document is returned to the applicant. The Office of the Public Guardian also gives notice to the donor that the LPA has been registered.

Cancelling power of attorney

You can cancel your lasting power of attorney at any time, even if the application has been registered.

But you must have the mental capacity to make that decision, and you must tell your attorneys and the Office of the Public Guardian so they can remove the LPA from the register.

Power of attorney automatically ends if:

  • the attorney or donor dies
  • the attorney or donor becomes bankrupt (depending on circumstances outlined below)
  • a marriage or civil partnership between the donor and the attorney is dissolved or annulled
  • the attorneys lack the mental capacity to make decisions

The Court of Protection can cancel an LPA if an attorney isn't acting in a person's best interests and is making excessive "gifts" to themselves or others.

Cancelling enduring power of attorney (EPA)

To cancel an unregistered EPA, you'll need to sign a formal document called a Deed of Revocation. You may wish to seek legal advice first.

You can cancel an unregistered EPA at any time while you have the mental capacity to do so.

If the EPA has been registered, you can't cancel it except by permission of the Court of Protection.

Advice for attorneys: personal welfare

Having an LPA over someone's personal welfare may mean you need to make decisions about the healthcare and welfare of the person you're looking after. If you have this power, you may have to decide:

  • where the person is to live
  • whether a care home or a nursing home is best for them, and which one
  • whether the person can continue to live at home with help from social services

You'll be able to decide if the donor should:

  • receive healthcare treatment
  • not receive a particular healthcare treatment
  • stop receiving a particular healthcare treatment

Some people who have a progressive illness sometimes make a decision about whether they'd want a particular treatment in the future.

They write down or tell others these wishes while they're mentally well, or have "mental capacity".

If the donor made a decision to refuse future medical treatment (known as an advance decision) in advance of losing their mental capacity, you can't override their decision unless the LPA was made later and specifies that you have the power to do so.

What personal welfare power of attorney can't do

A health and welfare LPA doesn't come into force until the donor has lost the capacity to make decisions for themselves. There are some decisions you as an attorney can't make for another person.

You can't:

  • refuse any medication prescribed by a responsible clinician if the person has been sectioned or is on leave from hospital
  • make decisions about where they should live if the donor is under a guardianship order
  • make a decision about life-sustaining treatment without checking whether the person has made an advance decisions about this

Personal welfare power of attorney and restraint

If you have personal welfare LPA, you may sometimes consider "restraining" (stopping or hindering) the person you're looking after from doing something you think will harm them or others.Under the law, you're considered to be restraining someone if you:

  • physically force them to do, or stop doing, something
  • threaten to physically force them to do, or stop doing, something
  • prevent them going somewhere or doing something they want to
  • ask someone else to do any of the things listed above

You shouldn't restrain the person unless:

  • you believe they don't have the mental ability or capacity to make a decision about that particular issue
  • you believe it's necessary to use restraint to prevent them harming themselves
  • it's a reasonable action to take because you believe they may suffer serious harm – for example, you could physically stop someone crossing the road if they were walking into traffic, but not if it's safe for them to cross the road

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Depression in children and teenagers

Depression doesn't just affect adults. Children and teenagers can get depressed too. Some studies show that almost one in four young people will experience depression before they are 19 years old.

It's important to get help early if you think your child may be depressed. The longer it goes on, the more likely it is to disrupt your child's life and turn into a long-term problem.

Signs of depressionin children

Symptoms of depression in children often include:

  • sadness, or a low mood that doesn't go away
  • being irritable or grumpy all the time
  • not being interested in things they used to enjoy
  • feeling tired and exhausted a lot of the time

Your child may also:

  • have trouble sleeping or sleep more than usual
  • not be able to concentrate
  • interact less with friends and family
  • be indecisive
  • not have much confidence
  • eat less than usual or overeat
  • have big changes in weight
  • seem unable to relax or be more lethargic than usual
  • talk about feeling guilty or worthless
  • feel empty or unable to feel emotions (numb)
  • have thoughts about suicide or self-harming
  • actually self-harm, for example, cutting their skin or taking on overdose

Some children have problems with anxiety as well as depression. Somealso have physical symptoms, such as headaches and stomach aches.

Problems at school can be a sign of depression in children and teenagers and so can problem behaviour, especially in boys.

Older children who are depressed may misuse drugs or alcohol.

Why is my child depressed?

Things that increase the risk of depression in children include:

  • family difficulties
  • bullying
  • physical, emotional or sexual abuse
  • a family history of depression or other mental health problems

Sometimes depression is triggered by one difficult event, such as parents separating, a bereavement or problems with school or other children.

Often it's caused by a mixture of things. For example, your child may have inherited a tendency to depression and also have experienced some difficult life events.

If you think your child isdepressed

If you think your childmay bedepressed, it's important to talk to them. Try to find out what's troubling them and how they are feeling.

See some tips on talking to younger children and talking to teenagers.

Whatever is causing the problem, take it seriously. It may not seem a big deal to you, but it could be a major problem for your child.

If your child doesn't want to talk to you, let them know that you are concerned about them and that you're there if they need you.

Encourage them to talk to someone else they trust, such as another family member, a friend or someone at school.

It may be helpful for you to talk to other people who know your child, including their other parent.

You could also contact their school to see if they have any concerns.

When to get medical help

If you think your child is depressed, make an appointment with them to see your GP.

If necessary they can refer your child to their local child and adolescent mental health service (CAMHS) for specialist help.

See more about CAMHS.

If you are worried about any aspect of your child's mental health, you can call the charity YoungMinds' free parents' helpline on 0808 802 5544 for advice.

The YoungMinds website also has mental health support and advice for your child

Exercise as you get older

Physical activityand exercisecan help you stay healthy, energetic and independent as you get older.

Many adults aged 65and overspend, on average, 10 hours or more each day sitting or lying down, makingthem the most sedentary age group.

They're paying a high price for their inactivity, with higher rates of falls, obesity, heart disease and early death compared with the general population.

As you get older, it becomeseven more important to remain active if you want to stay healthy and maintain your independence.

If you do not stay active, all the things you've always enjoyed doing and taken for granted may start to become that little bit harder.

You may struggle to pursue simple pleasures, such as playing with the grandchildren, walking to the shops, leisure activities and meeting up with friends.

You might start to get aches and pains you never had before and have less energy to go out. You may also be more vulnerable to falling.

This can all lead to being less able to look after yourselfand do the things you enjoy.

Strong evidence

There's strong evidence that people who are active have a lower risk of heart disease, stroke, type 2 diabetes, some cancers, depression and dementia.

If you want to stay pain-free, reduce your risk of mental illness, and be able to go out and stay independent well into old age, you're advised to keep moving.

Recent evidence suggests that regular exercise can reduce the risk of falling in older adults.

It's that simple. There are lots of ways you can get active, and it's not just about exercising.

Most people as they get older want to stay in touch with society – their community, friends and neighbours – and being active can ensure they keep doing that.

What is physical activity?

Physical activity is anything that gets your body moving. It includes anything from walking and gardening to recreational sport.

Aim forat least 150 minutes of moderate activity every week.

Ideally, you should try to do something every day, preferably in bouts of 10 minutes of activity or more.

One way of achieving 150 minutes of activity is to do 30 minutes on at least5 days a week.

Examples of moderate-intensity aerobic activities include:

  • walking fast
  • water aerobics
  • riding a bike on level ground or with few hills
  • playing doubles tennis
  • pushing a lawn mower

Daily chores like shopping, cooking or housework do not count towards your 150 minutes because the effort is not hard enough to raise your heart rate, although they do help break up sedentary time.

In addition to your 150-minutes target, try to do some activities that work your muscles.