Time for you to take control
We have a fully developed minor illness booklet designed to allow you to self manage. In most instances, this is the same advice our doctors will give you. If you would like a copy, please call us and we will send you a copy free through the post. Alternatively, you can pick up a copy from our practice at anytime.
Your guide to self management
This guide is designed to provide you with useful tools and resources in order to build your confidence in the treatment of minor illnesses for you and your family. It does not stop you from contacting us, but aims to ensure that if and when you do, you have tried all the normal routes for treatment that are available first, normally over the counter from a pharmacy.
Why have we provided this booklet
We believe that the way GP practices work has to change if we are to meet the challenges facing the healthcare system.
Current access
Currently, GP practices work primarily as an “acute” service. This means that if a patient falls ill or has health concerns, they make an appointment with the GP and the GP consults with the patient, diagnosis the problem (possibly referring the patient to hospital for an expert opinion), and prescribes medication where appropriate.
Long term conditions
The difficulty with this approach is that where the patient already has a long-term condition, by the time they report their developing health problem to the practice, it is already at a level that either requires hospital admission, an attendance at the Accident and Emergency Department, or a number of GP appointments to try and get the health condition back under control.
Long term conditions attendances
In analysing our medical records, the top 5% of patients visit their GP at least 15 times a year, visits the A&E department 14 times a year and has a number of hospital admissions. The top 0.5% of patients visit their GP at least 50 times per year and have a corresponding number of A&E attendances and admissions. Suffice to say, this impacts both on the appointments available within the practice, but more importantly, tells us that there may be a better way to look after those patients so that they benefit from real health improvements.
Minor illnesses and self help
Another interesting fact is that 1 in 5 patients who attend for a GP appointment, attend not because they have a long term condition or a health concern that needs diagnosis, but because they have a Minor Illness which could be treated without a visit to the GP practice. (Source: http://www.pagb.co.uk/information/PDFs/AndyTismanarticle.pdf).
Please note, “Minor Illness” is a clinical technical term and does not mean it is unimportant. From a patient’s point of view, having a child that is distressed due to having, for example, influenza will never feel “Minor” in any sense. But the term “Minor Illness is simply a medical classification for a number of clinical problems and conditions that can either be a) self treated, b) uncomplicated thus not requiring further investigations other than advice and direction from a pharmacist or NHS Direct, or c) seen in our “Express Surgery” if self treatment, pharmacy and NHS Direct has not worked.
Finding better ways to look after our patients
The reason for outlining some of these facts and figures is because we want to change the way we look after our patients. If we can encourage patients who have minor illnesses to follow the advice in this book, then we can begin to reinvest these resources in patients who have long term conditions that would benefit from being proactively managed. Proactively managed simply means making regular contact with patients who are “at risk” because of their health needs, providing them with a personalised care plan and ensuring that they understand what their long term conditions means for them and how they can improve their health through managing their long term condition.
Investing in you
Put simply, we want to invest as much time and resources as possible in patients with long term conditions so that we can stop many of the complications that occur resulting in hospital admissions and A&E attendances. This approach will mean, on average, patients live for longer and that the quality of their life is better too.
In other words, we want to be smarter with the clinical time we have available for the benefit of YOUR long term health
Further Information about Minor Illnesses
Colds and runny noses
Even today there is no magic cure for the common cold. There are more than 1,000 types of cold virus. There are no medicines against these viruses and antibiotics are not given as these are not effective against viruses. You can only treat cold symptoms by taking plenty of drinks and if you have a headache or are feverish take paracetamol or ibuprofen. A pharmacist will be able to help advise about decongestants and other useful medication.
Influenza
Influenza is also caused by a virus infection. The symptoms of flu are a high fever, muscle aches, dry cough, headache and congestion. Symptoms may take up to two weeks to resolve, although the fever should settle within 3 – 5 days. You need to take paracetamol, plenty of fluids and rest.
Cough
Most coughs are caused by viral infections, and often occur with colds and flu. Cough medicines may help, as well as taking paracetamol. Seek medical attention if the cough persists for longer than three weeks, or if you are feeling particularly unwell with a high fever or breathlessness.
Sore throat
These are usually due to viruses and generally do not require antibiotics. Take paracetamol or ibuprofen, plenty of fluids, throat pastilles or a throat spray may help. See a doctor only if the sore throat is severe or persists for a few days
Sinusitis
The sinuses are hollow spaces deep inside the nose, behind the cheek bones and in the forehead which are linked to the nose via narrow passages. When you have a cold the lining of the sinuses swell and can block these passageways, then mucus cannot drain. You will feel a pressing pain next to the nose or in the forehead. This congestion can be helped using decongestant nose spray or rinsing with salt water. Steam inhalation is a helpful treatment, do this by breathing steam from above a bowl of steaming water with a towel over your head, drops of menthol can be added to the water. Take paracetamol or ibuprofen for pain.
Earache
This can be caused by eczema in the ear or earwax. In children, earache is usually caused by a virus infection and paracetamol is usually all that is required, you will only need to see a GP if the problem persists for more than 12 hours.
Hayfever
This is caused by an allergy to pollen affecting people during the Spring and Summer. The symptoms are sneezing, runny nose and itchy watering eyes. Antihistamines are the main treatment, and can be bought from a pharmacy.
Nosebleeds
Nosebleeds are caused by small blood vessels in the nose bursting, usually caused by picking or with a cold (sneezing, blowing the nose). For a nose bleed, lean forward and pinch the soft part, just below the bridge of the nose, for about ten minutes. If the bleeding has not stopped then repeat the process for a further ten minutes. If the bleeding persists for longer than 30 minutes then you should attend the Accident and Emergency department.
Eyes
Small pieces of grit or dirt in the eye should be washed out with plenty of water. If the irritation persists then you will need to attend the Minor Injuries Unit.
Sticky eyes in children can be helped by removing any discharge with cotton wool soaked in warm water.
Mild eye infections can be treated by using Chloramphenicol eye drops bought over the counter, the pharmacist is able to advise on these as well as other eye drops for sore or irritated eyes.
Minor injuries
These can be seen at the local minor injuries unit.
Sprains
A sprain (such as a twisted ankle) is caused by over stretching ligaments and tissues of a joint. In serious cases the ligaments can partly or completely tear. Firstly, apply a cold compress, containing ice if possible, for 15 to 30 minutes to reduce the swelling. Elevate the foot and give the sprain plenty of rest until the discomfort has subsided. After 24 hours, use within limits of the pain and take pain relief as needed. Attend the minor injuries unit if you are unable to stand on the foot, there was a lot of swelling which came on within a few minutes or you are in great pain.
Back and neck pain
Back pain is very common and is usually caused by a spasm or cramping of muscles. Back pain can be treated with painkillers or anti-inflammatory medication which can be purchased over the counter from a pharmacy. Heat from a hot water bottle can help and it is best to keep mobile. You may wish to seek help by contacting a physiotherapist, chiropractor or osteopath. If the pain goes down your legs, lasts for more than a week or is associated with numbness, weakness or a bladder problem then see your doctor.
Diarrhoea and vomiting
Most episodes of diarrhoea and vomiting are caused by viruses. It is important to take plenty of clear fluids to avoid dehydration. It is usually better to avoid anti-diarrhoeal medicines. If vomiting persists for longer than 24 hours, if it seems that you may be dehydrated, or diarrhoea persists for more than a week, then see your doctor.
Stomach pain
Most stomach ache is not serious and is caused by indigestion or wind. A hot water bottle may help to relieve symptoms, and antacids will help relieve pain from indigestion. If the pain lasts for a few hours or increases in intensity, then consult your doctor.
Heartburn
Bringing up stomach acid can give a burning feeling in the upper part of the stomach and the gullet. This can be helped by eating small amounts more often and avoiding hot spicy food, coffee and alcohol. Antacid medicines can be bought from a pharmacy.
Irritable bowel syndrome
This causes a cramping, tight feeling in the bowel with irregular bowel movements (constipation) and diarrhoea. This can be caused by the wrong choice of food and lack of physical exercise. To help eat a low fat and high fibre diet, you may add extra fibre to your diet (ask for this at a pharmacy). Ensure you drink enough and take regular physical exercise.
Constipation
This is when you have bowel movements less often than is usual for you, often with hard stools and stomach pains. To help this you should eat more fibre in your diet (fruit, vegetables, wholemeal foods) and drink more fluids. Seek advice from a pharmacist about laxatives.
Threadworms
A common complaint usually starts with an itchy bottom. Small white worms can be seen at the back passage or in the motions. Treatment can be bought from a pharmacy. All family members should be treated, follow the directions on the box.
Haemorrhoids
These are swellings around the anus which can be sore, irritable and can bleed, often caused by being constipated. Constipation can be treated with laxatives, and you can buy creams which ease the irritation. If there is unexplained bleeding or a recent change in your bowel habit then you should consult your doctor for advice.
Thrush
This is a common infection affecting women, with an itchy discharge caused by a yeast infection. Treatment can be obtained from a pharmacy, but if this treatment fails to clear the itchy discharge you should see your doctor for further advice.
Emergency contraception
It is possible to prevent pregnancy by taking the morning after pill within 72 hours of unprotected intercourse. These are hormone tablets, and are most effective when taken as soon as possible. The morning after pill is available over the counter from a pharmacy.
Cystitis
This is a common problem which mostly affects women, caused by inflammation or infection in the bladder. The symptoms are a feeling of needing to pass urine frequently and urgently with pain or a burning sensation. Symptoms will often settle by maintaining a good fluid intake and taking paracetamol. You should see your doctor if you are pregnant, male or a child, or for women whose symptoms do not settle within two days.
Insect bites and stings
Antihistamines tablets and creams for bites and stings can be obtained from the pharmacy, and will usually relieve most symptoms.
Head lice
Chemical applications are not advised, just apply ordinary hair conditioner and comb the hair thoroughly with a special fine comb which can be obtained from a pharmacy. This should be carried out daily for two weeks
Dry skin
You should use a moisturising cream regularly on the dry area of skin. A pharmacist can advise you on non-scented and the most nourishing creams if needed.
Minor cuts and grazes
Wash the wound thoroughly with water and a little soap. To stop bleeding, apply a clean dressing firmly to the wound for about 5 minutes. Cover with a clean dry dressing.
Burns and scalds
Apply large quantities of cold water to the affected area as soon as possible and maintain this until the pain subsides, this may take as long as 15 minutes. If the skin is unbroken but blistered, apply a loose, clean dry dressing. If the burn covers a large area or the skin is broken, consult your GP or attend the Minor Injuries Unit as soon as possible.
Sunburn
We are all increasingly aware of the dangers of over exposure to the sun and the long-term effects of sunburn. Care should be taken to protect your skin using sun block and sun hats, particularly to children who are susceptible to sunburn. If someone is sunburned, treat as for other burns with cold water to reduce the heat. Calamine lotion will relieve the irritation, paracetamol will help, and drink plenty of clear fluids.
Warts and verrucas
Creams can be obtained over the counter from pharmacies, please follow the directions on the box.
Toothache
Paracetamol first, followed by stronger painkillers should the pain be severe. Contact your dentist, there are emergency slots to deal with toothache.
Headache
The most common causes of headache are tension or migraine. Headaches also occur with common illnesses like colds and influenza.
Tension headaches often feel like a tight band around the forehead. Migraines come in attacks usually with visual disturbance, bad headache on one side and sometimes nausea and vomiting, and can be treated with medicines which are taken at the start of an attack.
Simple pain killers, drinking plenty of water, getting enough rest and avoiding alcohol and smoking will help most headaches.