If you’ve lost a loved one to suicide, the grief can feel isolating and overwhelming. But you don’t have to face it alone.

Our support groups offer a compassionate, judgment-free space where you can share your feelings and find understanding. Together, we can break the silence and navigate this painful journey side by side.

When you’re ready, reach out. Let’s find strength in our shared stories and support each other through the darkness. 💫

Buckinghamshire Council has been gathering feedback from unpaid carers and professionals to ensure the right support is in place. Your voices have helped shape the new ‘All-Age Carers Strategy’ – but we need your input to make sure we’ve got it right.

👉 If you’re an unpaid carer, professional, or resident in Buckinghamshire, share your thoughts and help us set the right priorities. Complete our survey now ➡ https://orlo.uk/7OXIJ

Your feedback matters! Let’s work together to improve support for all carers.

Post Operative Wound Care  

For some time, we have been providing an unfunded post-operative wound care service for the convenience of our patients, despite the funding to provide post operative care being received by the hospitals. This service has been especially valuable for those who need regular care but struggling to get to the Hospital.

We regret that due to increasing demands on our nursing team and financial pressures on NHS General Practice overall, we can no longer continue to provide this service for which the hospital receives payment, as continuing to do so compromises our ability to deliver our core General Practice Services.

What does this mean for you?

From 1st of December  2024 we will no longer offer post-operative wound care to any new patients. This includes post operative care from all private and NHS services, including dermatology, surgery and urgent care. Patients will be required to receive ongoing wound care from these services directly.

• Patients currently receiving wound care will continue to be offered a maximum of 2 dressing changes per week until they are healed and discharged.
• Patients who are housebound will be able to receive post-operative wound care from the local District Nursing service. This should be arranged by the hospital service directly at time of discharge.
• We will continue to offer post operative clip / suture removal as well as wound care for leg ulcers, as these are separately contracted services.

Thank you for your understanding and support

Our 2024 flu vaccination clinics are now available to book. 

Our clinics will be held on:-

• Saturday 5th October 2024 (all day) at Misbourne Surgery in Church Lane
• Sunday 13th October 2024 (all day) at St Giles Surgery in Townfield Lane

Who is eligible for a Flu Vaccination?

• those aged 65 years and over
• those aged 18 years to under 65 years in clinical risk groups
• those in long-stay residential care homes
• carers in receipt of carer’s allowance, or those who are the main carer of an elderly or disabled person
• close contacts of immunocompromised individuals
• frontline workers in a social care setting without an employer led occupational health scheme including those working for a registered residential care or nursing home, registered domiciliary care providers, voluntary managed hospice providers and those that are employed by those who receive direct payments (personal budgets) or Personal Health budgets, such as Personal Assistants

Why flu vaccination is important

Flu vaccination is important because, while flu is unpleasant for most people, it can be dangerous and even life threatening for some people, particularly those with certain health conditions.

The best time to have your flu vaccine is in the autumn or early winter before flu starts spreading. But you can get your vaccine later.

Who can have the flu vaccine?

The flu vaccine is given free on the NHS to adults who:

• are 65 and over
• have certain health conditions
• are pregnant
• are in long-stay residential care
• receive a carer’s allowance, or are the main carer for an older or disabled person who may be at risk if you get sick
• live with someone who is more likely to get a severe infection due to a weakened immune system, such as someone living with HIV, someone who has had a transplant, or is having certain treatments for cancer, lupus or rheumatoid arthritis

 Flu vaccine for people with long-term health conditions

The flu vaccine is offered free on the NHS to people with certain long-term health conditions, including:

• respiratory conditions, such as asthma (needing a steroid inhaler or tablets), chronic obstructive pulmonary disease (COPD), including emphysema and bronchitis
• diabetes
• heart conditions, such as coronary heart disease or heart failure
• being very overweight – a body mass index (BMI) of 40 or above
• chronic kidney disease
• liver disease, such as cirrhosis or hepatitis
• some neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), or cerebral palsy
• a learning disability
• problems with your spleen like sickle cell disease, or if you’ve had your spleen removed
• a weakened immune system as a result of conditions such as HIV and AIDS, or taking medicines such as steroid tablets or chemotherapy

Talk to your doctor if you have a long-term health condition that is not in one of these groups. They should offer you a flu vaccine if they think you’re at risk of serious health problems if you get flu.

Flu vaccine if you’re pregnant

You should have the flu vaccine if you’re pregnant to help protect you and your baby.

It’s safe to have a flu vaccine at any stage of pregnancy.

Find out more about flu vaccine in pregnancy

Who should not have the flu vaccine

Most adults can have the flu vaccine, but you should avoid it if you have had a serious allergic reaction to a flu vaccine in the past.

You may be at risk of an allergic reaction to the flu vaccine injection if you have an egg allergy. This is because some flu vaccines are made using eggs.

Ask a GP or pharmacist for a low-egg or egg-free vaccine.

If you’re ill with a high temperature, it’s best to wait until you’re better before having the flu vaccine.

RSV Vaccination 

The new RSV vaccination will be delivered separately and we are planning to offer clinic shorlty

Our Flu vaccine Programme will commence from 3^rd October at both of our sites alongside the weekend clinics planned for Saturday the 5^th October at St Peter site in church lane and Sunday the 13^th October at our St Giles site. This in addition to lots more appointments available weekdays throughout the month.

Patients eligible for a Flu Jab on the NHS are.

• Pregnant women
• Children aged 2 or 3 years on 31st August 2024
• Children under 18 years in clinical risk groups (as defined by the Green Book)
• Aged 65 years and over
• Aged 18 years to under 65 years in clinical risk groups (as defined by the Green Book)
• Care home residents (living in long-stay residential care homes)
• Carers 
• Close contact of immunocompromised individuals
• Frontline social care staff

🚨 Get Your Flu and Covid Vaccinations with Us! 🚨

By getting vaccinated at our practice, you're not just protecting yourself—you’re supporting vital services in our community! 💉💪 Choosing another provider may affect our funding and the additional care we can offer. Let’s work together for a healthier community. 🙏

📅 Vaccinations start from October 3rd, with special weekend clinics on:

• Saturday, October 5th at St. Peter
• Sunday, October 13th at St. Giles

If you're eligible, you’ll receive a booking notification soon. Thanks for your support! 

Respiratory Syncytial Virus (RSV) is a common respiratory infection. While symptoms are usually mild, the elderly are at higher risk of serious complications.

The UK is leading the way as the first country to develop a vaccine against RSV. This vaccine will be offered to adults aged over 75 to 79. Will update you on the clinic availability shorlty.

Approaching Your 75th Birthday? 🎂

If you’re turning 75 on or after September 1, 2024, you’re eligible for a single dose of the RSV vaccine! This year, as part of a special catch-up program, those aged 75 to 79 are also eligible. RSV can cause serious complications in older adults, so make sure you protect yourself by getting vaccinated before turning 80.

We’ll be reaching out to eligible patients soon

The Surgery will be closed for the Bank Holiday on Monday 26 August 2024.

We will be reopening as normal on Tuesday 27 August 2024.

Please call 111 for medical advice or 999 in an emergency.

The outcome of the BMA ballot on collective action by GP contractors was announced on Thursday 1 August 2024.

Seven in ten eligible members voted in the non-statutory ballot with 98.3% of members indicating that they were willing to take action to save and protect general practice.

We are aware of, and supportive of, the outcome of the ballot and would like to reassure our patients that the practice remains open and operating as usual.

The BMA have produced the following information video which helps to explain the reasons for the ballot and the importance of supporting general practice.

https://www.youtube.com/watch?v=Tds7ML2OfY8

Thank you for your continued support.

The Misbourne Practice

Dear All,

We are aware of a worldwide IT outage, which is also affecting our systems.

Please be assured that the IT team is diligently working to resolve the problem as quickly as possible.

Thank you

📢 Important Announcement for Patients: Prescription Pre-Payment Certificates (PPC) 📢

Dear patients,

As healthcare costs continue to rise, we want to ensure that you’re aware of an option that can save you money on prescription charges. If you don’t qualify for free prescriptions, consider the following Prescription Pre-Payment Certificates (PPCs):

1. 3-Month PPC: £32.05
• Ideal if you require more than 3 prescribed items within 3 months.
2. 12-Month PPC: £114.50
• Cost-effective if you need more than 11 prescribed items within 12 months.
3. HRT Annual PPC: £19.80
• A great choice if you require more than 2 prescribed HRT items in 12 months.

Spread the word! Share this information with friends and family who may benefit. For more details, visit Prescriptions - NHS (www.nhs.uk).

Stay well, The Misbourne Practice

We are moving away from SMS communication being our primary way to contact patients, due to a rise in messaging costs; text messages will only be used where deemed absolutely necessary. It is therefore imperative that we have your correct email address, as that will be our preferred means of communication. Please update using the change of details form on our website.

The Surgery will be closed for the Bank Holiday on Monday 6 May 2024.

We will be reopening as normal on Tuesday 7 May 2024.

Please call 111 for medical advice or 999 in an emergency.

Spring 2024 booster eligibility

COVID-19 is more serious in older people and in people with certain underlying health conditions. For these reasons, people aged 75 years and over, those in care homes, and those aged 6 months and over with a weakened immune system are being offered a spring dose of COVID-19 vaccine.

Timing of the spring booster

You should be offered an appointment between April and June, with those at highest risk being called in first. You will be invited to have your booster around 6 months after your last dose, but you can have it as soon as 3 months.

If you are turning 75 years of age between April and June, you do not have to wait until your birthday, you can attend when you are called for vaccination.

You will be invited for your booster, your GP may offer you the vaccine or you can book using the NHS app for Apple or Android. You can also find your nearest walk-in vaccination site from the NHS website.

Vaccines in use this spring

You will be given a booster dose of a vaccine made by Pfizer or Moderna and approved in the UK. These vaccines have been updated since the original vaccines and target a different COVID-19 variant. These updated vaccines boost protection well, and give slightly higher levels of antibody against the more recent strains of COVID-19 (Omicron).

As we cannot predict which variants of COVID-19 will be circulating this spring and summer, the Joint Committee on Vaccination and Immunisation (JCVI) have concluded that the vaccine used in the later weeks of the autumn 2023 programme should be used.

Please accept the vaccination that is offered to you as soon as you are able to – you will be offered the right vaccine for you at the right time.

Who cannot take up the offer of a spring booster

There are very few eligible people who should not have a dose this spring. If you have had a severe reaction to a previous dose of the vaccine you should discuss this with your doctor.

Side effects

Common side effects

As with your previous dose, the common side effects are the same for all COVID-19 vaccines, including the updated vaccines being used this spring and include:

·       having a painful, heavy feeling and tenderness in the arm where you had your injection – this tends to be worst around 1 to 2 days after the vaccine

·       feeling tired

·       headache

·       general aches or mild flu-like symptoms

You can rest and take paracetamol (follow the dose advice in the packaging) to help you feel better.

Side effects following vaccination normally last less than a week. If your symptoms seem to get worse or if you are concerned, you can call NHS 111 or for text/phone use 18001 111.

You can also report suspected side effects of vaccines and medicines through the Yellow Card scheme.

Serious side effects

Cases of inflammation of the heart (called myocarditis or pericarditis) have been reported very rarely after both the Pfizer and Moderna COVID-19 vaccines. These cases have been seen mostly in younger men and within several days of vaccination. Most of the people affected have felt better and recovered quickly following rest and simple treatments.

You should seek medical advice urgently if, after vaccination, you experience:

·       chest pain

·       shortness of breath

·       feelings of having a fast-beating, fluttering or pounding heart

If you had a serious side effect after a previous dose you may be advised to avoid or delay further vaccination. You should discuss this with your doctor or specialist.

Reporting side effects

You can report suspected side effects of vaccines and medicines through the Yellow Card Scheme:

·       online at Yellow Card Scheme

·       by downloading and using the Yellow Card app on Apple or Android

·       by calling the Yellow Card scheme on 0800 731 6789 (9am to 5pm)

If you are unwell on the day of your appointment

If you are unwell, wait until you have recovered to have your vaccine. You should not attend an appointment if you have a fever or think you might be infectious to others.

You may still catch COVID-19 after having the vaccine

The COVID-19 vaccine will reduce the chance of you becoming severely unwell from COVID-19 this spring and summer. It may take a few days for your body to build up some extra protection from the dose. Like all medicines, no vaccine is completely effective. Some people may still get COVID-19 despite having a vaccination, but any infection should be less severe.

If you have not had all your vaccinations

If you have not yet had either of your first 2 doses of the vaccine (or a third dose for those with a weakened immune system) you should have a dose during the seasonal campaign.

If you are eligible and you have missed an earlier booster, you should have a dose this spring to catch up. Most people do not need extra doses to make up for those you have missed.

If you have a severely weakened immune system your doctor may advise an extra dose 3 months after you have the spring vaccine.

Waiting after you have your vaccine

If you have a history of allergies, or if you had a reaction immediately after a previous dose, you may be advised to stay for 15 minutes after the vaccine. Please make sure you tell the vaccinator.

Adult ADHD services have extensive national wait times, and our local provider is no longer accepting new referrals. Your GP might not be able to establish shared care agreements with online or remote providers for Adult ADHD treatment, potentially leading to no NHS referral recommendation.

Alternatively, they could refer you to other providers solely for assessment, not for ongoing treatment. Private sector referral might be suggested by your GP without shared care arrangements like those in the NHS.

This disparity in services, known as a "commissioning gap," has been highlighted at local and national levels.

You could address this issue yourself by contacting your MP or reaching out to the ICB at bobicb.plannedcare@nhs.net.

NHS App help and support - NHS (www.nhs.uk)

If you are having a difficult time, below are details of people you can talk to.

Safe Haven: telephone support every night 6pm-midnght

01494 218098

White Leaf Crisis team: Evening support 01865 902000

Mind: helpline 0300 123 3393

Shout: 24/7 text service 85258

Samaritans: 24/7 helpline 116123

Papyrus: under 35’s helpline 0800 068 141

Calm: helpline for men 0800 585858

High blood pressure (hypertension) is the single biggest treatable risk factor for cardiovascular disease including heart attacks, strokes and dementia. However high blood pressure usually has no symptoms, which is why from 11 March, a TV campaign will encourage those aged 40 and over, to get a free blood pressure check at the nearest participating pharmacy.

Please find below the publication and translated versions of the sexual assault and sexual abuse booklet with information for people seeking asylum:

• Albanian
• Arabic
• English
• Farsi
• Kurdish
• Pashto

The publication is hosted by Migrant Help on their website.

Home Office Asylum Support are socialising this across their estate.

What is Pharmacy First?

The Pharmacy First scheme provides professional health care advice, treatments, and medicines for common illnesses from your local pharmacy, without the need for an appointment.

Community pharmacies can offer treatment for seven common conditions without patients needing to see a GP, as part of a major transformation in the way the NHS delivers care. 

Highly trained pharmacists at more than nine in ten pharmacies can now access and treat patients for conditions below without the need for a GP appointment.

• Earache
• Impetigo
• Infected
• Insect bites 
• Shingles
• Sinusitis
• Sore throat
• Urinary tract infections (UTIs) for women aged 16-64 

Available on the high-street, community pharmacy teams have the right clinical training to give people the health advice they need, with no appointment necessary and private consultations available. Community pharmacists will signpost patients to other local services where necessary. 

By expanding the services community pharmacies offer, the NHS is aiming to help free up GP appointments and give people more choice in how and where they access care. Don't wait for minor health concerns to get worse – think pharmacy first and get seen by your local pharmacy team. For more information, visit nhs.uk/thinkpharmacyfirst

Benefits:

• Pharmacists are highly qualified health care professionals who are experts in medicines. They can give the same advice and treatment for common illnesses as the GP.
• Pharmacies are open during normal business hours, and many are open late, on Saturdays and on Sundays.
• It may be quicker to see your pharmacist than wait for a GP appointment.
• You don’t need an appointment.
• Medicines offered are free of charge if you are normally exempt from prescription charges. If you usually pay for prescription charges, you can still receive advice and can pay the cost of any medicine issued or the standard prescription charge, whatever is cheaper.
• Anything you say to the pharmacist is treated with confidence.

Important information

If accessing the Pharmacy First Scheme you must tell your pharmacist if:

• You are pregnant and/or breastfeeding
• You think you might be pregnant
• Other medications you are taking
• Any allergies that you have

Please check with your local pharmacy to see if they are participating in the Pharmacy First scheme.

We will soon be holding our Spring Covid Booster programme shortly.  The vaccines will be provided from both of our sites, Chalfont St Peter and Chalfont St Giles.  As soon as we have further details we will let you know but below is some general information for you.

Eligibility cohort for the spring People boosters are 

aged 75 years and older

residents in care homes for older people

and

those aged 5 years and over with a weakened immune system 

We will be prioritising our care home residents and housebound patients as soon as we start delivering the boosters.

Spring booster eligibility

COVID-19 is more serious in older people and in people with certain underlying health conditions. For these reasons, people aged 75 years and over, those in care homes, and those aged 5 years and over with a weakened immune system are being offered a spring booster of COVID-19 vaccine.

Timing of the spring booster

You should be offered an appointment between April and June, with those at highest risk being called in first. You will be invited to have your booster around 6 months from your last dose but you can have it from 3 months.

If you are turning 75 years of age between April and June, you will be called for vaccination during the campaign; you do not have to wait for your birthday.

Vaccines in use this spring

You will be given a booster dose of a vaccine made by Pfizer, Moderna or Sanofi and approved in the UK. These vaccines have been updated since the original vaccines and target different COVID-19 variants. For a very small number of people another vaccine product may be advised by your doctor.

These updated vaccines boost protection well, and give slightly higher levels of antibody against the more recent strains of COVID-19 (Omicron) than the vaccines you would have received previously.

As we cannot predict which variants of COVID-19 will be circulating this spring and summer, the Joint Committee on Vaccination and Immunisation (JCVI) has concluded that all of these vaccines can be used and that no one should delay vaccination to receive a different vaccine.

The Sanofi vaccine contains an adjuvant (a chemical used to improve the immune response to the virus). This vaccine will only be offered to older people, who may respond less well to vaccines. The adjuvant in the COVID-19 vaccine is similar to the one used in the flu vaccine which is routinely given to over 65 year olds. The NHS website has more information about vaccine ingredients.

You will be invited for your booster, your GP may offer you the vaccine or you can book using the NHS app for Apple or Android. You can also find your nearest walk-in vaccination site from the NHS website.

Who cannot take up the offer of a spring booster

There are very few people who should not have this booster. If you have had a severe reaction to a previous dose of the vaccine you should discuss this with your doctor.

Side effects

Common side effects

As with your previous dose, the common side effects are the same for all COVID-19 vaccines, including the updated vaccines being used this spring and include:

• having a painful, heavy feeling and tenderness in the arm where you had your injection – this tends to be worst around 1 to 2 days after the vaccine
• feeling tired
• headache
• general aches or mild flu-like symptoms

You can rest and take paracetamol following the dose advice in the packaging, to help you feel better.

Symptoms following vaccination normally last less than a week. If your symptoms seem to get worse or if you are concerned, you can call NHS 111 or text or phone 18001 111.

Serious side effects

Cases of inflammation of the heart (called myocarditis or pericarditis) have been reported very rarely after both the Pfizer and Moderna COVID-19 vaccines. These cases have been seen mostly in younger men and within several days of vaccination. Most of the people affected have felt better and recovered quickly following rest and simple treatments.

You should seek medical advice urgently if, after vaccination, you experience:

• chest pain
• shortness of breath
• feelings of having a fast-beating, fluttering or pounding heart

If you had a serious side effect after a previous dose you may be advised to avoid or delay further vaccination. You should discuss this with your doctor or specialist.

Reporting side effects

You can report suspected side effects of vaccines and medicines through the Yellow Card Scheme:

• online at Yellow Card Scheme
• by downloading and using the Yellow Card app on Apple or Android
• by calling the Yellow Card scheme on 0800 731 6789 (9am to 5pm)

If you are unwell on the day of your booster vaccination

If you are unwell, wait until you have recovered to have your vaccine. You should not attend an appointment if you have a fever or think you might be infectious to others.

You may still catch COVID-19 after having the booster

The COVID-19 booster will reduce the chance of you becoming severely unwell from COVID-19 this spring and summer. It may take a few days for your body to build up some extra protection from the booster. Like all medicines, no vaccine is completely effective. Some people may still get COVID-19 despite having a vaccination, but any infection should be less severe.

Catching up with missed doses

If you have not yet had either of your first 2 doses of the vaccine (or a third dose for those with a weakened immune system) you should have them as soon as possible.

If you are eligible and you have missed an earlier booster, you should have a dose this spring to catch up. You will not need another dose during the summer.

Waiting after you have your vaccine

If you have a history of allergies, or if you had a reaction immediately after a previous dose, you may be advised to stay for 15 minutes after the vaccine. Please make sure you tell the vaccinator.

We are committed to giving our patients the best possible care and as part of this, all staff take part in a number of Protected Learning Time (PLT) sessions throughout the year.

This month, we are closed for our staff protected learning on Wednesday the 15th in the afternoon from 13:00. Should you require medical assistance during this time, please call 111 or go online at 111.nhs.uk. The practice will re-open as usual on Thursday the 16th of March.

Many thanks for your understanding.

Call 999 or go to A&E if:

• your child has difficulty breathing: you may notice grunting noises, or their tummy sucking under their ribs

• there are pauses when your child breathes

• your child’s skin, tongue or lips are blue

• your child is floppy and will not wake up or stay awake.

Signs of scarlet fever to look out for include:

• a sore throat

• headache

• fever, along with a fine, pinkish or red body rash with a ‘sandpapery’ feel.

As a parent, and you feel that your child seems seriously unwell, trust your own judgement