Tag Archives: 999


When Mary O’Brien came the surgery last week and said she had difficulties getting her words out, was confused for a short period of time and couldn’t give someone basic directions this was:-image


Every year at least 46,000 people in the UK have a TIA or Transient ischaemic attack (also known as mini-stroke) for the first time and although the symptoms may not last long, a TIA is still very serious.

It’s a sign that a person is at risk of going on to have a stroke. That is why a TIA is often called a warning stroke yet too many people are unaware of the link between TIA and stroke and are not getting the services and support they need.

Every three and a half minutes, someone in the UK has a stroke. It is the killer disease that’s been ignored for too long.

There is no way to tell whether a person is having a TIA or a stroke when the symptoms first start. Stroke is a medical emergency. The quicker the person gets access to specialist assessment, investigation and treatment, the more likely they are to make a better recovery.
Our message to the public

If you, or someone else, show any of the signs of stroke you must call 999.

The ambulance staff in London are aware of the 4 specialist units in London and will automatically take a patient to the nearest specialist stroke unit.

Ambulance blue light

The symptoms of TIA often pass very quickly so the public – and some health and care staff – may mistake them for a ‘funny turn’. Rapid access to specialist assessment, investigation and treatment is still important even if the symptoms have stopped.

If you think you have had a TIA and have not sought medical attention, see your GP urgently. Urgently investigating and treating people who have a TIA or minor stroke could reduce their risk of having another stroke.




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Outside normal surgery hours you can still phone your GP surgery, but you’ll usually be directed to an out-of-hours service. The out-of-hours period is from 6.30pm to 8.00am on weekdays and all day at weekends and on bank holidays.

If it is not an immediate emergency then call NHS Direct on 111.
I appreciate that when this when this was launched there were many problems but it has improved during the last few months and when I asked those that attended the Patient Participation Group there was good positive feedback.

imageNHS 111 is available 24 hours a day, seven days a week.
When you call 111 a receptionist will ask you various questions to assess the urgency of the problem and your needs.

  • If it is advise you need the receptionist will transfer you to a doctor or nurse practitioner.
  • If you wish to see a doctor they will make an appointment for you to see a doctor or nurse at the Urgent Care Centre(UCC).
    The nearest UCC in W13 & W5 is Ealing Hospital. This open 24 hours every day of the year.
    imageDetails of this or other local UCC can be obtained on the following website:- Search/Urgent%20Care/LocationSearch/0If you are given an appointment it is important to turn up or cancel the appointment as the the receptionist has the responsibly to chase you up to find out to find out what has happened before removing a patient off the screen. Having been alongside a receptionist making enquiries as to why the patient has not turned up to hear answers such as ‘the child went to sleep’ or ‘the patient is better and they have gone out’ or ‘we called an ambulance because we can’t afford a taxi’ is not helpful in making a service efficient.
    If you turn up in A&E it is possible that you may be directed to this service but may have to wait longer to be seen. Hence it is in your own interest to phone 111 to make an appointment.

If the doctor seeing you feels you need further investigation or a specialist opinion they will consult their specialist colleagues at the same hospital or another local hospital and arrange for you to be seen. You will not have to queue again in A&E.

  • If for some reason you are unable to leave your home for medical reasons ( bed-bound or terminally ill) the receptionist will refer you to a doctor working alongside them to arrange for one of the mobile doctors to visit. Although the doctor does NOT have access to your medical records the details of the telephone conversation, consultation or visit including any treatment given is recorded and then faxed to your usual doctor for them to receive the following morning. Dr Livingston and myself read these before a morning surgery and if we either need to see you will telephone or write to you but you may be told to see your GP next day. The record is then scanned on to your computer record.
    By doing this we are attempting get good continuity of care.
    I occasionally work in one of the local centres( much to patient’s surprise when faced with me) as do many of our local GP’s and it gives me a chance to appreciate how the system works.
  • If it is a serious injury or illness then call 999 but if you are unsure call 111 first and they can arrange an ambulance or for you to be seen urgently.


A&E departments assess and treat patients with serious injuries or illnesses. Generally, you should visit A&E or call 999 for life-threatening emergencies, such as:

  • loss of consciousness
  • acute confused state and fits that are not stopping
  • persistent, severe chest pain
  • breathing difficulties
  • severe bleeding that cannot be stopped

I viewed this on the NHS Choices ( website and thought it would be good for all to view:-

If an ambulance is needed, call 999, the emergency phone number in the UK.

You can also dial 112, which is the ambulance number throughout the European Union.

Major A&E departments offer access 24 hours a day, 365 days a year, although not all hospitals have an A&E department. At A&E a doctor or nurse will assess your condition and decide on further action.

Dental Problems
Emergency dental service is available Monday to Friday 6pm – 10pm, Saturday, Sunday and Bank Holidays 9am – 10pm.
Tel: 020 3402 1312
Otherwise phone 111 to ask advise.

Mental health emergencies

If a person’s mental or emotional state quickly worsens, this can be treated as a mental health emergency or mental health crisis.
24 hour support line: 0300 1234 244
SANELINE on 0845 767 8000 – open 1pm – 11pm every day
If you use the services of the Gender Identity Clinic and have an urgent issue, please contact your GP.

If it is a medical emergency, please call 999. If you are in acute emotional distress and your GP is unavailable, please contact the Samaritan support group on 08457 90 90 90 or visit

If you are worried about a family member or someone you care for whose health has suddenly gone downhill, you can also call the Samaritans or our 24 hour support line for help and advice.
In this situation, it’s important to get help as soon as possible. Contact NHS 111 to find out where help is available. If you feel the person is in immediate danger then call 999.

Emergency contraception can stop you becoming pregnant after having unprotected sex. Two methods are available, the ‘morning after’ pill and the copper intrauterine device (IUD). The pill can be taken up to 72 hours after sex and is available free from your GP and most family planning clinics. It is also available from some pharmacies. The IUD is a plastic and copper device that is fitted into the woman’s womb by a doctor or nurse within five days of having unprotected sex.
If you need to find a pharmacy who may supply ‘morning after pill’ the following link will be helpful
Also refer to our website to find out where the nearest Family planning clinics are located.

Walk in clinic
If for any reason you are not able to attend your GP surgery or need medical attention you can either walk in to the Urgent Vare Centre at Ealing Hospital open 24hours.
Our local clinic is at:-
Featherstone Road Clinic, Southall UB2 4BQ

Tel. 020 3313 9880

Mondays to Sundays

8:00am – 8.00pm


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Posted by on October 19, 2013 in Training and Advice


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Yesterday a patient came into surgery and said “I am a bit worried about my mum , when I came home from work she seemed a bit confused and she was getting her words wrong she kept saying to my dad  to come and get his ice- cream when she meant to say dinner and called the cat a car. She was otherwise OK and before I went to work she wasn’t like that”
I  knew this patient had high risk factors for a stroke and infact had seen her earlier in the week so I knew this was something to act on and

Although her speech was not slurred she had a sudden change in being able to speak normally and it is the SUDDEN onset of change that is important.
Medical students posted this poster in the surgery and then after a week asked attending patients if they had seen a poster or new how to recognise a stroke and very few knew!
By recognising the signs and getting them to hospital as soon as possible can be extremely beneficial to the patients.When you call an ambulance in West London and tell them what you have witnessed or it is happening to you they know that they must take you to either Northwick Park Hospital or Charing Cross Hospital as these are the designated hospitals with a specialised Stroke unit and are equipped to act fast and administer specialised intensive aftercare.

However if the symptoms are transient and there is a recovery within 24hrs then it is still important to get an urgent appointment or in the case of 102theavenue surgery there is walk in surgery each morning or the receptionist would fit a patient in to a later appointment surgery. If surgery is closed there are walk in clinics or phone 111 for an urgent appointment in the nearest Urgent Care Clinic.
If you want to know more about stroke and what happens physiologically use the links or watch the video below:-


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