Cervical Screening (“Smears”)
It is recommended that all women have regular cervical screening – even those who have never been sexually active can very rarely develop cervical cancer.
The national screening intervals:
- 25 – 49 yrs every 3 years
- 50 – 64yrs every 5 years
- Those aged 65+ should have a screen only if not having been screened since age 50 or have had recent abnormal tests.
Cervical screening under 25 years is not reliable and cancer is very rare in that younger age group. If you are worried, however, please talk to your GP or practice nurse. Your first call-up will be when your reach 24.5 yrs.
Trans men (assigned female at birth) do not receive invitations if registered as male with their GP, but are still entitled to screening if they have a cervix. Please ask your GP and we’ll sort you out or, alternatively visit a sexual health clinic.
Book your appointment with a Practice Nurse. The national computer recall system will call you up every 3-5 years as a reminder but if your are due, you don’t need to wait if you are called (but please don’t book if your are not due!). You should avoid a time during your period – best to wait a few days after – or if your are having treatment for a vaginal discharge. Avoid using any vaginal medications, lubricants or creams in the 2 days before you have your test as they can affect the results.
Your results are sent to you by letter from the screening service around 14 days after your test.
Early detection and treatment can prevent up to 75% of cervical cancers and relies now on testing for HPV, the virus that is responsible. The test for HPV is positive, a second test to look at the cells is performed (cytology) on the same sample and if any abnormality is detected a referral is made for colposcopy
For information about the National Cervical Screening Programme and the test itself click here.
Symptoms which could suggest cervical cancer can include:
- bleeding between periods, during or after sex, or after you have been through the menopause
- unusual vaginal discharge
If you are worried, contact us via PATCHS or book an appointment with one of the female doctors – do not wait for your next cervical screening appointment.
Breast Cancer Screening
All women between the ages of 50 to 71 yrs, are entitled to attend free screening for breast cancer every three years. (trial are going on to see if extending the range at both ends will be worthwhile). Though invitations stop at 71yrs, you may still book screening tests after if you wish.
Your first automatic invitation will take place any time between the ages of 50 and 53. Screening takes place at the North London Breast Screening Service, Edgware Community Hospital HA8 9BA (Tel: 0202 758 2024) or in a mobile unit at Northwick Park Hospital or Wembley Centre for Health & Care HA0 4UZ.
Screening is carried out by mammography (a low dose Xray). You will receive your results by letter within 2 weeks. If an abnormality is found, you will be contacted for an outpatient examination and further testing which may include another mammogram, ultrasound scan and / or a fine needle biopsy. 75% of women with an abnormality do not have breast cancer.
For full details about the Breast Cancer Screening click here.
Here’s a useful leaflet explaining more details (available in 10 languages)
Sexual Health
Sexual health services comprise both sexually transmitted infection (STI) testing and treatment and contraception services. Our surgery provides the full range of contraceptive services.
Sexual Health services for Brent – including STI and HIV testing and care – are available locally:
- The Patrick Clements Clinic, Central Middlesex Hospital (Tel 0208 453 2221) or book online.
- The Caryl Thomas Clinic, Wealdstone HA1 4UQ (Tel 0203 893 8575)
There is also a limited range of contraceptive services only available from Chalkhill Clinic, Wembley Park and Edgware Community Hospital.
You can also use the new online testing for STIs – register online and a kit will be sent for you to post samples back to the lab and receive a result within a few days.
Contraception
We provide the full range of advice and contraception and can help you choose the best methods from a range including all the various combined pills, the progesterone only pill, the coil (IUD or intra-uterine device and IUS, the intrauterine system), implants, diaphragms, condoms and natural methods.
The nurses are able to provide all these except the IUCD / IUS and implants which will need a special appointment with a doctor. The female GPs can insert IUCDs and IUSs and Dr Dodhia is trained to perform implants. It is best to discuss this with a doctor in advance – please leave message with reception and you will be contacted to arrange. For all other contraception just make a normal appointment with the nurse.
All contraception is free of prescription charges under the NHS.
Here is a good guide to the various forms of contraception. Also the Family Planning Association is no longer a charity and was bought by a publisher but has some useful
Emergency Post-Coital Contraception
Emergency contraception is available for up to 5 days after unprotected intercourse, though the earlier the better. The most effective form is to fit an IUCD (a coil) which can be inserted up to 5 days after the accident. We can provide this at the surgery (ask to speak to a doctor as soon as possible to arrange this). An advantage with this method is, the IUCD can be left in place for good contraception. In the first 3 days (72 hours) the Post-coital Pill or ‘morning after pill’ is available, though it is more effective in the first 24 hours.
If you have need of emergency contraception, please contact us for an appointment as soon as possible- we will always fit you in. If the surgery is closed many pharmacies can also provide the Post-Coital Pill.
Unwanted Pregnancy
If you find yourself accidentally pregnant and wish to consider a termination of pregnancy (TOP) free of charge under the NHS, you can self-refer to BPAS – British Pregnancy Advisory Service (Tel 0845 730 40 30), which has a clinic at Willesden Centre for Health & Care NW10 3RY and provides counselling and all forms of termination under the NHS.
You can also get information and refer yourself to Marie Stopes for private terminations (Tel 0333 253 1271).
You may also book to discuss with a GP as soon as possible.
Medical abortions (2 stage pills) are the safest method for most women up to 10 weeks of pregnancy, though it can be painful and unpleasant. From 10 weeks onwards surgical abortions are necessary.
All termination services offer post-abortion counselling and it is strongly recommended – even if you do not feel the need at the time – to book a session.
Preconceptual Advice
When you wish to start a family, it is a good idea to start preparing 3 – 6 months before if possible. This applies to men as well as women, so if you want advice, you may like to come and see one of our nurses or doctors together or check this Emma’s Diary guidance (beware – adverts!)
You should both give up smoking of course and any other illicit drugs, ideally stop alcohol, reduce caffeine, get fit and eat a healthy diet and reduce stress. Avoid taking any over-the-counter medication including ‘natural remedies’ and supplements. Men should avoid hot baths and tight underpants and women need to start taking Folic Acid 0.4mg and maybe vitamin D and reduce weight if overweight.
Working out the most fertile time for sex is also helpful! There are lots of ovulation calculators and aids available which may help such as this from the NHS
Women should ensure they are immune to Rubella (German Measles). It is worth having a blood test even if you are sure you had the immunisation. It is a good idea to make sure you are up to date with your cervical smear.
It can takes up to 18 months to get pregnant but if it has been 12 months, or earlier if you are approaching 40yrs or have had previous gynaecological problems, then come and see your doctor.
Maternity
Antenatal Care
Congratulations!
Check here to find your Due Date.
Once you have become pregnant it is a good idea to ‘book’ your pregnancy, usually from week 6-10. You can refer yourself directly to the hospital of your choice. This link is for Northwick Park, which is used by the majority of our patients. Other local antenatal services include Royal Free and Barnet which includes the Edgware Birth Centre for low risk births , St Mary’s and Queen Charlotte’s ,
To help decide where to have your baby and what services are offered, check out the masses of information at:
- London North West University Healthcare (Northwick Park) and download their very useful Your Pregnancy Handbook
- Royal Free Foundation Trust
- Imperial Trust (St Mary’s and Queen Charlotte’s)
Provided you have confirmed your pregnancy with a pregnancy test (obtainable from the chemist or supermarket), there is no need to do another.
We have not had community midwife services at the surgery for some years so all the antenatal care is now delivered by midwives in the community clinics. You will be seen by a midwife at the hospital for booking and have an examination and blood tests and an ultrasound scan arranged (you have this between 16-20 weeks). You will be given an antenatal folder containing all the information pertaining to your pregnancy. Please remember to take it to any appointments you attend. Typically you might have an antenatal appointment every four weeks after 12 weeks, and then every two weeks from about 32 weeks, and for the last three or four weeks have weekly appointments. This is variable depending on circumstances.
At most appointments you will have your blood pressure checked, your urine tested, an examination of your abdomen including listening to your baby’s heartbeat and a check for swelling of your legs. Screening tests in pregnancy
For further details of pregnancy and antenatal care try this excellent NHS guide written for women in NW London:
Also: NHS.UK pregnancy pages , The NCT (National Childbirth Trust) ,and Emma’s Diary if you can stand the advertising.
Maternity Certificates
These qualify you for Statutory Maternity Pay (SMP) from your employer or the state Maternity Allowance and are obtained from your Midwife (or Doctor if they do not give it) any time from the 20th week of your pregnancy. There is an online application process also if your Midwife or GP has registered for this (but it is new and not easy to get set up!).
The certificate also entitles you to free dental treatment and free prescriptions and it lasts until your baby is 12 months old. More details about Maternity Certificates here .
Please ask when you attend an antenatal appointment with your Midwife or fill in a request form at reception.
Bowel Cancer Screening
Around 1 in 20 people get bowel cancer. The screening programme has been shown to pick up cancers at an earlier stage leading to more effective treatments.
Bowel Screening is a two stage process in the NHS:
- Age 55 yrs (or over) there is a one-off flexible bowel scope test to detect and remove polyps which could be pre-cancerous.
- Aged 60 – 74 yrs you’ll be sent a FIT home test kit every 2 years – you take a small sample of poo and post it back to the lab to detect invisible traces of blood.
If you are 75 or over , or miss your test, you can ask for one to be sent (Tel: 0800 707 60 60)