Cervical Smears
Chronic Disease Management Clinics
Including Ischaemic Heart Disease, Diabetes, Asthma, COPD etc.
Mental Health
Diabetes
What is Diabetes?
There are two types of diabetes (type 1 and type 2). People with type 1 diabetes do not produce enough of a hormone called insulin, this is produced in the pancreas. Insulin controls the level of glucose (sugar) in your body. This means the level of glucose in your blood becomes too high. It is often diagnosed in childhood and is a life long condition. They must take insulin daily to control their blood glucose levels.
Unlike type 1 diabetes, type 2 diabetes is largely preventable through lifestyle. People with type 2 diabetes have ‘insulin resistance’. This means that their body does not respond normally to insulin. Type 2 diabetes is more common with approx. 1 in 17 people having a diagnosis. It is likely to develop as you become older or are overweight.
Symptoms of Type 1 Diabetes include:
- feeling very thirsty
- peeing more than usual, particularly at night
- feeling very tired
- losing weight without trying
- thrush that keeps coming back
- blurred vision
- cuts and grazes that are not healing.
- fruity smelling breath
Symptoms of Type 2 Diabetes include:
- feeling thirsty all the time
- peeing more than usual, particularly at night
- feeling very tired
- losing weight without trying
- itching around your penis or vagina, or repeatedly getting thrush
- blurred vision
- cuts and grazes taking longer to heal
If you are experiencing any of the of the above symptoms or are worried that you may have diabetes, contact the practice to arrange an appointment.
What is Pre-Diabetes?
Pre diabetes is when blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes to be made. People with pre-diabetes have an increased risk of developing type 2 diabetes and a higher risk of heart disease.
Making simple lifestyle changes is the most effective way of reducing the risk of pre-diabetes progressing to type 2 diabetes and heart disease.
Weight
Keep Active
Stop Smoking
Healthy Eating
Reduce Alcohol
Managing your weight
Managing and losing weight will help reduce your blood glucose level. Try to lose weight by cutting down on fatty foods and keeping as active as possible.
- Reduce your intake of sugar and sugary foods
- Increase your intake of high fibre foods and wholegrain
- Reduced your fat intake, especially saturated fat
- Reduce salt intake
- Drink alcohol in moderation
- eat regular well portioned meals
- try to include five portions of fruit and vegetables a day
- avoid skipping meals
- try to evenly space out your meals throughout the day – this will help control your appetite and blood glucose levels
Regular physical activity will help manage your weight, lower your cholesterol and reduce your blood glucose levels. Aim for 30 minutes of exercise 5 days a week, this should be moderate intensity and something that makes you slightly breathless.
Useful links:
https://livewirewarrington.co.uk/lifestyle/get-back-into-exercise
You need to seek professional support and make a clear plan before you stop smoking. Ask one of our patient care advisors to refer you to the local smoking cessation service.
Include starchy carbohydrates with meals
Carbohydrates are an important part of our diet as they provide us with a main source of energy as well as being a source of vitamins and fibre. Most carbohydrates are digested and absorbed as glucose into our bloodstream resulting in a rise in our blood glucose levels. Try to include starchy carbohydrates with your meals as these do not effect blood glucose levels as much as they are absorbed slowly. Sugary foods are absorbed very quickly.
Types of starchy carbohydrates:
- Pasta
- New potatoes or sweet potatoes
- Pulses e.g. kidney beans, lentils, baked beans
- Porridge oats, natural muesli and all-bran cereals
- Grainy breads e.g. granary, rye
- Basmati or easy cook rice
To help maintain the health of your digestive system and prevent other problems such as constipation, You should try to include high fibre varieties of starchy food. All the different types of carbohydrates will be digested into sugar so it is also important to limit your portion sizes.
Cut down the fat you eat
Fat is the greatest source of calories so cutting down the amount of fat, especially saturated fats, you eat will help you lose weight. Choosing unsaturated fats and oils are better for your health and your heart.
- choose low fat dairy products
- grill, steam or oven bake your food rather than frying or roasting in oil
- use low fat margarines and cooking oils
- choose leaner cuts of meat or trim off excess fat/skin
- avoid hidden food with hidden fats, such as pastries, biscuits, cakes and pies
Many foods that are labelled as low fat often contain high amounts of sugar, and foods labelled low in sugar can he higher in fat. It is best to try and keep a healthy balance so using the food labels can help you make appropriate choices.
It is recommended both men and women do not consume more that 14 units of alcohol per week and allow at least two alcohol free days a week. It is advised that women drink no more than 2-3 units a day and men drink 3-4 units a day.
Alcoholic drinks are higher in calories so it is best to choose low calorie/sugar-free/diet mixers.
Diabetes Management
If you are diagnosed with diabetes the GP will arrange to speak with you about your test results and your diagnosis. You will then be asked to come in to see one of our primary care practice nurses to make your diabetes care management plan.
Once you are affectively managing your condition the practice will continue to offer annual diabetes reviews, this may be sooner for some patients depending on their agreed diabetes care management plan.
Gestational Diabetes
Gestational diabetes is high blood sugar(glucose) that develops during pregnancy and usually disappears after giving birth. It happens when your body cannot produce enough insulin to meet your extra needs in pregnancy. It can happen at any stage of pregnancy but is more common in the second or third trimester.
Gestational diabetes does not usually cause any symptoms. Most cases are only discovered when your blood sugar levels are tested during screening for gestational diabetes.
Some women may develop symptoms if their blood sugar levels get too high, such as:
- increased thirst
- needing to pee more often than usual.
- a dry mouth
- tiredness
- blurred eyesight
- genital itching or thrush
Some of these symptoms are common during pregnancy and are not necessarily a sign of gestational diabetes. Speak to your midwife or doctor if you’re worried about any symptoms you’re experiencing.
Any woman can develop gestational diabetes during pregnancy, but you’re at an increased risk if:
- you are over 40.
- your body mass index (BMI) is above 30 – use the BMI healthy weight calculator to work out your BMI.
- you previously had a baby who weighed 4.5kg (10lb) or more at birth.
- you had gestational diabetes in a previous pregnancy.
- 1 of your parents or siblings has diabetes.
- you are of south Asian, Black, African-Caribbean, or Middle Eastern origin (even if you were born in the UK)
- you have had a gastric bypass or other weight-loss surgery.
If any of these apply to you, you should be offered screening for gestational diabetes during your pregnancy.
Patients diagnosed with Diabetes are urged to contact the Podiatry department for diabetic foot screening or expert assistance regarding foot issues like ulcers, blisters, open sores, and numbness. Kindly reach out to the podiatry department on 01925 946682 to book an appointment.
Forums, Blogs and Apps
- Diabetes.co.uk forum – discussions about living with and managing diabetes.
- Diabetes UK blogs – a collection of blogs on work and diabetes, food, eyes and more
- Diabetes Chat – scheduled chats with healthcare professionals or just the chance to talk to others
- NHS Apps Library – find apps and tools to help you manage your diabetes, including some that link you to a lifestyle coach.
Support
Diabetes UK hold regular meetups.
Find a Diabetes UK support group near you
It’s also worth asking your diabetes team if they know of any local groups.
Diabetes helpline
Diabetes UK has a confidential helpline for questions about day-to-day management.
Call: 0345 123 2399 Monday to Friday, 9am to 6pm
Email: helpline@diabetes.org.uk
Medicines Management
Contraception services
Joint injections
Safeguarding Services
Safeguarding at Eric Moore Partnership Medical Practice
What is safeguarding?
Safeguarding simply means keeping people safe from harm. It is about protecting children and adults from abuse or neglect. There are many different types of abuse.
Types of abuse that children can suffer include:
- physical abuse
- sexual abuse
- neglect
- emotional abuse
- domestic abuse
- bullying and cyberbullying
- child sexual exploitation
- child trafficking
- criminal exploitation and gangs
- female genital mutilation
- grooming
For more information on these types of abuse and how you can spot them, visit:
- Warrington Safeguarding Partnership: https://www.warrington.gov.uk/warrington-safeguarding-partnership
- NSPCC: https://www.nspcc.org.uk/what-is-child-abuse/types-of-abuse/
Types of abuse/neglect that adults can experience include:
- Physical abuse
- Sexual abuse
- Domestic abuse
- Psychological or emotional abuse
- Financial or material abuse
- Modern slavery
- Discriminatory abuse
- Organisational or institutional abuse
- Neglect
- Self-neglect
For more information on these types of abuse, you can visit:
- Warrington Safeguarding Adults Board: https://www.warrington.gov.uk/warrington-safeguarding-adults-board-wsab
- Social Care Institute of Excellence: https://www.scie.org.uk/safeguarding/adults/introduction/types-and-indicators-of-abuse
Who is responsible for safeguarding?
Safeguarding is everyone’s responsibility. Here at Eric Moore Partnership Medical Practice all staff members play a role in safeguarding. Safeguarding is not just something we choose to do, it is also something we are required by law to do.
At Eric Moore Partnership Medical Practice, the Safeguarding Lead is Dr T Hudson and the Deputy Safeguarding Lead is Dr AS Rajkumar.
How does Eric Moore Partnership Medical Practice safeguard children and adults who are, or who might be, experiencing abuse or neglect?
Keeping children and adults safe from abuse and neglect cannot be done by one person or one agency. At the heart of any safeguarding process is the child or adult who may be suffering abuse. We work in partnership with our patients who are, or who are at risk of, experiencing abuse as well as their families and advocates as appropriate.
We work closely with our health colleagues such as health visitors, the school nursing team, midwives, paediatricians, mental health teams and other hospital colleagues. We also work with our partner agencies locally such as child and adult social care, education and the police to ensure any child or adult suffering abuse can be supported and protected and any concerns about abuse can be properly investigated.
To find out more about how agencies work together in Cheshire to keep children and adults safe visit:
- Warrington Safeguarding Partnership: https://www.warrington.gov.uk/warrington-safeguarding-partnership
- Warrington Safeguarding Adults Board: https://www.warrington.gov.uk/warrington-safeguarding-adults-board-wsab
Safeguarding Training
All staff at Eric Moore Partnership Medical Practice have the appropriate levels of safeguarding training for their job role. Safeguarding training standards are set nationally for all healthcare professionals and we follow this national guidance.
Safeguarding training is essential to ensure all staff are able to spot signs of abuse or neglect and take action. We work hard to make safeguarding a key priority for our practice and our patients.
What will happen if a GP or any member of staff at the practice is worried that a child or adult is being abused or neglected?
All staff in the practice have a duty and responsibility to speak up and say something if they are worried a child or adult might be being abused or neglected. If any staff member has concerns they will discuss this with the practice Safeguarding Lead or with one of the other GPs who will decide what needs to happen next.
If a doctor is concerned that a child or young person is at risk of abuse or neglect, they must take steps to make sure the child or young person is protected. It can be very upsetting and stressful for families when this happens and parents often have questions about what their doctor may or may not do.
This leaflet from the General Medical Council (GMC) helps to answer those questions:
If a doctor is concerned that an adult is at risk of abuse or neglect, they will:
- Ask the person if they require any immediate support to keep themselves safe
- Explain how safeguarding works
- Ask the person what they would like to happen (Making Safeguarding Personal)
- Support the person in a way to give them choice and control to improve their quality of life, wellbeing, and safety
To do this the doctor will:
- Listen to the person
- Understand their views and wishes
- Take them seriously
- Treat them with respect
- Support them to feel as safe as they want
- Support them to make their own decisions
- Keep them informed and involved
- Tell the person what will happen next
Capacity
When making decisions about what action is necessary to safeguard an adult, healthcare professionals have to consider whether the person has capacity to understand their situation and make decisions about what should happen to them.
What is capacity?
- Capacity means the ability to use and understand information to make a decision, and communicate any decision made.
- A person lacks capacity if their mind is impaired or disturbed in some way, which means they are unable to make a decision at that time.
For more information on capacity visit:
All professionals have to follow The Mental Capacity Act which empowers and protects people who are not able to make their own decisions. This covers decisions about property and financial affairs, health, welfare and where they live.
For more information on The Mental Capacity Act visit:
Information Sharing
Sharing information with other relevant professionals is an important part of safeguarding. Sadly, reviews of cases where a child or adult has been killed or seriously harmed due to abuse or neglect, have often found that professionals have not shared the right information with the right person at the right time to keep the child or adult safe.
All staff at the practice must comply with the law and national guidance when making decisions about information sharing. The General Medical Council (GMC) provide guidance for doctors making decisions about information sharing.
The practice also follows the Caldicott Principles:
- Justify the purpose(s) for using confidential information
- Do not use personal confidential data unless it is absolutely necessary
- Use the minimum necessary personal confidential data
- Access to personal confidential data should be on a strict need-to-know basis
- Everyone with access to personal confidential data should be aware of their responsibilities
- Comply with the law
- The duty to share information can be as important as the duty to protect patient confidentiality
As a general rule we will ask for the person’s (or relevant parent/guardian, advocate, Power of Attorney) permission before sharing information for safeguarding purposes.
However, there are circumstances where we will need to share information even without the person’s permission (consent).
Examples of these circumstances include:
- Other people are, or may be, at risk, including children
- Sharing the information could prevent a serious crime
- A serious crime has been committed
- Someone in a position of trust is implicated in causing abuse/neglect
- The risk of serious harm or death is very high in a domestic abuse situation
- A court order has requested the information
Again as a general rule, we will inform the person that we will need to share information about them in order to keep them or others safe from serious harm,
as long as this does not increase risk of harm to the person or others.
Where can you get help if you are worried you or someone else is suffering abuse or neglect?
Remember:
- Abuse is always wrong
- No one should have to live with abuse
- By reporting abuse you can help bring it to an end
Worried about a child?
Where there are significant immediate concerns about the safety of a child, you should contact the police on 999.
If you are worried about any child and think they may be a victim of neglect or abuse, you can make a referral to:
- Children’s Social Care Multi-Agency Safeguarding Hub (MASH) – Tel: 01925 443322 (select option 2, then option 1)
- Children’s Social Care Out of Hours: 01925 444400 https://www.warrington.gov.uk/mars
You can also contact the NSPCC helpline on 0808 800 5000, email them or submit an online form. Further details are on the NSPCC website: https://www.nspcc.org.uk/
Worried about an adult?
Many adults may need help. This is not always safeguarding, (i.e, there is no one abusing them or neglecting them). They may need help because they can no longer cope for various reasons. They may require support to manage their needs or because they can no longer cope being a carer, or they may need a number of referrals for services who can assess and support them.
Whether it is Safeguarding or care and support the number is the same.
If you or the person you are concerned about is in danger and immediate action is required, you should ring the emergency services on 999.
If you or the person you are concerned about is not in immediate danger, you should ring:
- Adults Social Care – Tel: 01925 443322 (select option 2, then option 2)
- Adults Social Care Out of Hour – Tel: 01925 444400
You can also speak in confidence to any member of staff at Eric Moore Partnership Medical Practice.