complete-registration-pack-with-new-footers-jan-2021

 New Patient Health Questionnaire – Please bring this with your completed registration form.. When returning the completed forms to reception, please arrange a New Patient appointment w

Registration Pack: Welcome Letter

Dear New Patient,

Please find enclosed everything you should need for registering at our practice.

 Registration Form – You MUST have your NHS number to enable us to register you.

 My Health Online Registration – This will allow you to order repeat medications online.

 New Patient Health Questionnaire – Please bring this with your completed registration form.

 A list of acceptable Identification & Address Verification – We need these as confirmation of your details.

 Practice Leaflet – An introduction to our practice This should tell you everything you need

to know about our practice.

When returning the completed forms to reception, please arrange a New Patient appointment with the

Health Care Assistant If you are on repeat medication you MUST provide a patient summary for us to add

your medication

Please note: We ask all new patients to supply a patient summary from your previous surgery detailing medication, allergies & past medical history We kindly ask that you are supplied with 1 months supply of your medication from your previous surgery before registering.

Many Thanks.

Acceptable Identification Documents for Registration at the Practice

Please provide two forms of ID one with your name and one showing your permanent address Please provide a copy of your repeat medication.

 Current signed full passport

 Current UK driving licence

 Blue disabled drivers pass

 Current benefits or State Pension

notification letter confirming rights to

benefits for the current period.

 Current HMRC tax notification eg

PAYE coding, statement of account

(P45’s & P60’s are not official HMRC

documents)

 Shotgun or Firearms Certificate

 Travel documents issued to foreign

nationals granted permission to

remain in the UK

 Current EU/EEA driving licence

 Residence permit issued by the Home

Office to EU nationals

 EU/EEA member state identity card

 Recent utility bill

 Local Authority tax bill for current year

 Credit/Store card statement (but if

produced/ printed from internet requires letter from account manager

If you are unable to provide any of the above documents please speak to a member of the

reception team who will be able to discuss alternative documents.

New Patient Registration

To ensure the process of registering with us goes as smoothly as possible, could we please ask that you get

at least 1 month’s supply of your repeat medication & a patient leavers report from your current surgery.

A patient leavers report MUST be provided as part of the registration process This can either be handed in

with your registration form or emailed to Natasha.Dimonaco@wales.nhs.uk.

It is your right under the access to records to request this information, but if your current surgery requires written confirmation from us before they can release this information, please ask them to email

Natasha.Dimonaco@wales.nhs.uk.

Please complete the below to inform us how you have provided the patient leavers report & return this

with your registration forms.

Many thanks

Name:……… Handed in with registration forms

Emailed by current surgery

Current surgery Email address:………

Staff use only

Received by:……… Date:………

Tywyn Health Centre Request for a My Health Online Account

My Health Online is a new online service for repeat prescription ordering, brought to you from NHS Wales My Health Online offers patients the convenience of ordering repeat prescriptions using the internet If you wish to register to use My Health Online please fill in the boxes below You may send the completed form back to us by email, post, or drop into the Health Centre To protect patient confidentiality when you next visit us please provide identification, preferably photo ID (e.g driving licence or passport) You will only have to do this once

Please Note: Each patient will need a different email address You cannot use the same email address as your partner or another member of your family.

Request for a My Health Online Account

Please set up a My Health Online Account and issue me with a letter containing my account details

The following checks should be completed before a patient can receive access to My Health Online.

1 Patient’s identity verified by document

Details of documents checked and added to the GP system

………

2 Patient’s name and date of birth checked on this form and updated on the clinical system (if necessary)

3 Registration process and next steps to registration explained

4 Patient Guide and Frequently Asked Questions provided to patient

5 Advise patients to register their online account over the next 24 – 48 hours

NEW PATIENT HEALTH QUESTIONNAIRE

To the patient

Please complete this questionnaire as fully as possible This information will help the nurse to make an initial assessment of your health which will help in your future treatment.

Have you been registered with the practice before?

NAME: DATE OF BIRTH

ADDRESS:

HOME TELEPHONE NO:

MOBILE PHONE:

OCCUPATION:

PREFERED LANGUAGE :

ARMY VETERAN :

Tetanus jab in the last 10 years ? Yes / No Have you had any major operation?

Are you on repeat medication? Yes / No MEDICATION – If you are on any repeat medication please ensure you provide us with a patient summary ALLERGIES Please list any allergies:

SMOKING Do you smoke? Yes / No If yes, how many per day?

If you smoke, how old were you when you started?

EX SMOKERS If you used to smoke, how old were you when you stopped?

If you used to smoke, how many did you smoke per day?

PASSIVE SMOKING Are you exposed to smoke at work? Yes / No At home? Yes / No ALCOHOL How many units of alcohol do you drink each week?

(1 unit = half a pint of beer, 1 glass of wine, or a pub measure of spirits) DIET Do you have a special diet? Yes / No If so, please detail

EXERCISE How many minutes do you exercise for at a time?

How many times per week?

FAMILY HISTORY Do you have or is there any of the following in your family (father, mother, brother, sister) before the age of 65? Heart disease (heart attacks, angina) Yes / No Which family member

Stroke? Yes / No Which family member

Cancer? Yes / No Which family member

Site of cancer

Asthma? Yes / No Which family member

Diabetes? Yes / No Which family member

High BP? Yes / No Which family member

Glaucoma? Yes / No Which family member

Other? Yes / No Which family member

CARERS Are you a carer? (Are you responsible for the care of another person?) Yes / No If yes please give details

PATIENTS WITH DISABILITIES

Do you have any disabilities?

If you need help when accessing the building please let us know before your arrival and we will assist in anyway we can

Nurse only

BP Height

Weight

Date:

PATIENT ETHNIC ORIGIN QUESTIONNIARE

This questionnaire follows the recommendations of the Commission for Racial Equality and complies with the Race Relations Act

some health problems are more common in specific communities, and knowing your origins may help with the early identification of some of these conditions

Choose ONE section from A to E, and then tick one box to indicate your background

Name: Date of birth:

A White

British Irish Any other white background please write below:

B Mixed

White and black Caribbean White and Black African White and Asian

Any other Mixed background please write below:

C Asian or Asian British

Indian Pakistani Bangladeshi Any other Asian background please write below:

D Black or Black British

Caribbean African Any other white background please write below:

E Chinese or other ethnic group

Chinese Any other please write below:

Patient Rights and Responsibilities Undertaking

The Practice and its employees owe to me as a patient a

duty of care and will aim at all times to provide services

to meet my needs for primary healthcare and treatment.

The Practice and its employees aim to provide health

services that are sympathetic and responsive to my

individual needs within the resources that are available.

The Practice and its employees want to deliver

appropriate and effective health care and treatment to

me.

The Practice expects all its employees to treat me with

courtesy and respect.

The practice will only restrict or withdraw my rights to

care in exceptional circumstances when I have failed to

comply with any of my responsibilities in a manner,

which is deemed unacceptable.

Please note that patients are seen by appointment only;

further information is contained in the practice leaflet.

I will treat NHS staff, fellow patients, carers and visitors politely and with respect at all times.

I will not consume alcohol, smoke or take any form of prescribed medication or drugs whilst on the surgery premises.

non-I accept and understand that the practice is obliged to provide a safe and secure environment for its staff and to care for their health and safety

I understand that if I display any aggressive, threatening or violent behaviour towards any member of staff employed at this surgery

or put any of the staff or members of public in fear of their own safety, I will be removed from the practice list with the matter referred to the police.

I understand that I need to engage with services I am referred to by the Practice and, if I am unable to engage, I will contact the Practice in advance to let them know.

Dr M Flannery & Dr T Windsor-Lewis

Website: www.tywynhealthcentre.org

Telephone: 03000 843200

Health Centre Opening Times

Monday – Friday 08:00 to 18:30

Please be aware from 12:30 – 13:45pm a telephone message is left giving details of

how to get hold of a Doctor or Receptionist, urgent enquiries

Disabled Access: Tywyn Health Centre is accessible to all patients You are able to get to us

by either using the lift which is located on ground floor car park entrance, or by using the entrance at Tywyn Cottage Hospital

The Doctors

MRCGP, DFSRH trained at the University of Oxford Dr Flannery is a GP

trainer and his special interests include respiratory medicine and palliative care Dr Flannery performs minor cryotherapy and joint injections

Dr Faye Stockton MBChB (Hons) (Manchester 2009), MRCGP, trained

in North Staffordshire and Liverpool before moving to Wales to train as a General Practitioner She works as a GP trainer and Programme Director for the Aberystwyth Vocational Training Scheme

Dr Tom Windsor-Lewis MBChB BSc (hons) PGCMedEd Dr (Tom)

Windsor-Lewis studied medicine at Warwick Medical School and spent his early junior doctor years working mainly in the acute sector at University Hospital Coventry & Warwickshire and South Warwick General Hospital Hetrained as a general practitioner in Aberystwyth, joining the practice as a partner in February 2018

He was awarded a postgraduate certificate in medical education in 2014 and hasexamined medical students at finals and intermediate levels since 2013

His interests lay in pre-hospital care (BASICS), motorsport medicine, remote

& rural general practice and undergraduate education He acts as the practice cluster lead and joint undergraduate lead tutor alongside Dr Taylor

The Nurses

Sr Gwawr Flannery, Senior Nurse Practitioner – RGN/RM DIP, BSc (Hons), SPA

Sister Gwawr specialises in Triage, Minor Illness, Respiratory diseases Sister Gwawr can assist with many conditions in her minor illness clinic and is qualified to issue prescriptions When consulting with Gwawr she is able to liaise with the Doctor if she feels it is necessary

Sr Carole Carroll, Practice Nurse, RGN, Dip BSc Hons

Sister Carole specialises in treating general treatment room aliments including wound care, smoking cessation, and contraceptive review She now offers advice on the management of diabetes

Nurse Bethan James, RGN

Bethan specialises in Triage and Minor Illness, and helps assist the GPs with home

visits When consulting with Bethan she is able to liaise with the Doctor if she feels it is necessary She is currently studying to become a prescriber

Sr Susie Davies, RGN, BSc (Hons)

Sister Davies specialises in Triage, Minor Illness and general treatment room ailments Susiealso offers advice on the management of diabetes

Brenda Jones, Health Care Assistant

Brenda has a special interest in BP monitoring, ECG and general medication review to update your prescription

Susan Wright, Phlebotomist Susan takes blood samples and blood pressures

Management

Beverley Williams - Practice Manager, BA (Hons), Chartered MCIPD

Administration

Annie French-Shaw - Operational Manager

Lauren Dunn - Practice Administrator & Trainer, Cert RBCB

Mandy Owen - Administrator

Lisa Gardner - Research & Development Officer, BSc (Hons)

Natasha Dimonaco - Records Clerk

Dispensary Team

Rebekah Hickman - Dispensary Supervisor, BSc (Hons)

Gaynor Weir - Dispensing Assistant

Jo Lloyd - Dispensary delivery driver

Reception

Sarah Roberts - Reception Manager

Sian Jones - Receptionist

Delyth Jones - Receptionist

Sarah Williams - Receptionist

Other Health Centre Users & Primary Health Care Team

Gaynor Jarvis - Clinical Specialist Physiotherapist MCSP SRP MSc

Gaynor manages mostmusculo-skeletal problems with advice,

exercises, investigations, steroid injections, medication and onwards specialist referral

Counsellor

Geoffrey M Hooper - MBE, MA, MBACP (Accred.) UKRCP Reg Ind Counsellor /

Psychotherapist

Hope Marshall - Primary Care Mental Health Worker

Eryl Gilliland - Chiropodist BSc (Hons) DPodM MChS Cert HSM

Nia Ellis-Brown - Health Visitor RGN Paeds BSc Hons

Fiona Jones - RGN, DN BSc (Hons) Community Sister,

Tracey Hammond - HCA Community Health Care Assistant

Liz Kinsman - Hospice at Home Nurse

Jackie Horton - Hospice at Home Nurse

Nasima Valli - Prescribing Pharmacist

Appointment System

We have up to 9 different types of appointments each day

1 Triage Appointments: All requests for appointments are to be triaged by the

nurses, you will receive a telephone call from the Triage nurse to assess the patient’ssymptomsfurther If our triage nurse decides you require an appointment or home visit you will be provided with details of your appointment during the telephone call

2 On the day appointments are for urgent must-be-seen conditions Each doctor has a

certain amount of these appointments each day These appointments are allocated

by our Triage nurses from 8.30am onwards on the day Please telephone for these appointments

3 Emergency appointments with the Doctor on-call that day These will be arranged via

the Triage Nurse

4 Daily GP routine appointments These appointments allow you to see the doctor of

your choice for routine conditions, or if your doctor has recommended that you see him/her Routine appointments may be made from two to up to four weeks in

advance We recommend you arrange a routine appointment if you are over the age

of 75 or haven’t seen a doctor in over 3 years

5 Daily minor illness appointments with Sr Gwawr, Sr Susie or nurse Bethan who treat minor illness

6 Daily appointments are also available with our practice nurses.

7 Daily appointments with our Health Care Assistant for BP and ECG monitoring, and

your general medication review These can be booked via the contact form on our website www.tywynhealthcentre.org

8 Daily appointments with our Phlebotomist, for blood tests and monitoring INR’s

These can be booked via the contact form on our website

www.tywynhealthcentre.org

9 Home visits are available on request These will be arranged via our Triage Nurse and

are only available for house bound patients The Practice is unable to assist in

transport arrangements If you think you need a home visit please telephone before 10am

The doctors have asked our receptions to gather from patients a brief description of the medical issue to ensure that they are triaged quickly and effectively and are seen by the most appropriate clinician