Warfarin is a drug which can prevent life threatening conditions. However, it can be dangerous if people taking it are not monitored regularly and advised which dose to take. Recent changes have been made to the way we prescribe it.

When a patient requests a prescription for warfarin, the doctor must check that the necessary monitoring has been carried out. We can no longer prescribe warfarin “as directed” and the specific dose must be stated on the prescription.

Nurse led Warfarin clinics

We run Nurse led warfarin clinics for patients who are already classed as being stable on the drug.

Hypertension relates to High Blood Pressure.

High blood pressure often causes no symptoms, or immediate problems, but it is a major risk factor for developing a serious cardiovascular disease (conditions that affect the functioning of the heart and the circulation of blood around the body), such as a stroke or heart disease.

External Sites

High Blood Pressure Explained – NHS Choices

Blood Pressure Association

British Heart Foundation

British Hypertention Society

Videos from NHS Choices

High blood pressure has no symptoms, but if it’s not treated it can damage the kidneys, heart and brain.

Our respiratory clinics are primarily intended for patients with Asthma and COPD.

Asthma is caused by inflammation of the airways. These are the small tubes, called bronchi, which carry air in and out of the lungs. If you have asthma, the bronchi will be inflamed and more sensitive than normal. Our practice nurses have specialist asthma qualifications. During their clinics they monitor your overall condition, offer advice, answer any queries and ensure your treatment is effective.

Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have trouble breathing in and out. This is referred to as airflow obstruction. Breathing difficulties are caused by long-term damage to the lungs, usually because of smoking.

Asthma and COPD Clinics

We hold clinics to diagnose and to help patients to manage their asthma or COPD.

We like to see all our patients who have been diagnosed with these conditions at least once a year, depending on the severity of your condition, we may invite you to come to the clinic more often in order to ensure we give you the care you require.

External Links

• NHS Choices – Asthma in adults, the symptoms, diagnosis and treatment.
• The British Lung Foundation
• Asthma UK
• Action Asthma
• NHS Choices COPD

The most common symptoms of coronary heart disease (CHD) are chest pains (angina) and a heart attack.

You can also experience other symptoms, such as palpitations and unusual breathlessness. In some cases, people may not show any symptoms before they are diagnosed.

Angina

If your coronary arteries become partially blocked, it can cause chest pain (angina). This can be a mild, uncomfortable feeling similar to indigestion. However, a severe angina attack can cause a painful feeling of heaviness or tightness, usually within the centre of the chest, which may then spread to the arms, neck, jaw, back or stomach.

Angina attacks are often triggered by physical activity or stressful situations. Although symptoms of Angina usually pass within 10 minutes, you can alleviate the symptoms by resting or using a nitrate tablet or spray.

Heart attacks

If your arteries become completely blocked, it can cause a heart attack (myocardial infarction).

Heart attacks can cause permanent damage to the heart muscle and, if not treated straight away, can be fatal.

If you think you are having a heart attack, dial 999 for immediate medical assistance.

Although symptoms can vary, the discomfort or pain of a heart attack is usually similar to that of angina but often more severe. During a heart attack you may also experience the following symptoms:

• sweating
• lightheadedness
• nausea
• breathlessness

The symptoms of a heart attack can be similar to indigestion. For example, they may include a feeling of heaviness in your chest, a stomach ache or heartburn. However, these symptoms can also be accompanied by a pain that affects the arms (particularly the left arm), the neck and the jaw.

A heart attack can happen at any time, including while you are resting. If heart pains last longer than 15 minutes, it may be the start of a heart attack.

Unlike angina, the symptoms of a heart attack are not usually relieved using a nitrate tablet or spray.

In some cases, you may have a heart attack without any symptoms, called a silent myocardial infarction. This is more common in people with diabetes.

Heart failure

Heart failure can also occur in people with CHD when the heart becomes too weak to pump blood around the body, which can cause fluid to build up in the lungs that makes it increasingly difficult to breathe.

Heart failure can happen suddenly (acute heart failure) or gradually over time (chronic heart failure).

Want to know more?

• British Heart Foundation:angina
• British Heart Foundation:cardiovascular disease
• British Heart Foundation:heart attack

Diabetes is a long-term condition caused by too much glucose, a type of sugar, in the blood. It is also known as diabetes mellitus.

There are two main types of diabetes, which are explained below:

• Type I diabetes
• Type II diabetes

Normally, the amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas. The pancreas is a gland behind the stomach. When food is digested and enters your bloodstream, insulin moves any glucose out of the blood and into cells, where it is broken down to produce energy.

However, in people with diabetes, the body is unable to break down glucose into energy. This is because there is either not enough insulin to move the glucose, or because the insulin that is there does not work properly.

Our specialist diabetes team will provide you with support, regular reviews and the day-to-day care of your needs.

All Diabetic patients are entitled to an annual review. The Practice will normally contact you if yours is due. The review takes place in two parts – a data collection appointment and where appropriate, a follow up care plan appointment. If you feel you have been missed, or require a more urgent review, then please contact the Practice to arrange an appointment.

At the initial data collection appointment, your blood pressure, weight, urine, feet and well-being will be checked. It is necessary for you to bring an early morning urine sample with you. Following your initial appointment, a care plan booklet will be sent to you and if necessary, an appointment with your GP or one of our specialist nurses will be arranged.

For more information please visit the websites below:

External Websites

• Diabetes UK

Please find below information and links to various resources that are offered through the Knowdiabetes.org website.  

The Know Diabetes Service

The Know Diabetes Service is helping people in North West London with diabetes and those at risk of developing type 2 diabetes to live their lives to the full. It provides tips, advice, videos, resources, online education, helpful emails and information on programmes and courses to help you better manage your condition. It also lets you view your online health record with your latest test results. Register for your account here today.

The Healthier You: NHS Diabetes Prevention Programme

If you are at risk of developing type 2 diabetes, the NHS Diabetes Prevention Programme will give you the tools and information you need to make small lifestyle changes to reduce your risk. Learn more about the programme and type 2 diabetes prevention here

Diabetes Remission: The REWIND programme

If you’re living with type 2 diabetes, the REWIND programme can help you to lose weight, reduce medication and even achieve remission (reverse your diabetes). Find out more about the programme here.