Southern Independent Medical Pratice
Southern Independent Medical Practice
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Patient Area

There are many benefits of becoming a registered patient with S.I.M.P.

Benefits of registration:
Your own personal 'Online Account' where you can:

Change your contact details
View your vaccination records
View your allergies list
View your last "Healthcheck"
Discounted fees
Click to see more benefits

Click here to apply fornew patient membership with the doctors at Southern Independent Medical Practice in Salisbury, Wiltshire.

Southern Independent Medical Practice - We care about our patients, call us on 01722 415444


Rectal Bleeding

Rectal bleeding is common, however, only about a third of patients who are affected seek advice or treatment. Although the cause is usually of no great medical significance, it is important to recognise that it is an abnormal symptom and can be due to more significant or very serious medical conditions like inflammatory bowel disease or bowel cancer.

Because of the potential seriousness, we would encourage any patient who notices bleeding to come and have this checked.

Bleeding may be bright red and only on the toilet paper or discolouring the lavatory pan, or it may be on the surface or mixed in the stool. Bright red blood usually indicates bleeding from the lower part of the colon, the rectum or the anus. Darker red or maroon blood usually indicates bleeding higher in the colon or the small bowel and malaena, very dark stools, ranging in colour from very dark red to black, indicates bleeding from the stomach wall, the upper part of the small bowel.

As part of the annual health check, fecal occult (hidden, non-visible bleeding) is tested for. This also forms part of the NHS bowel cancer screening programme offered to all 60-74 year olds.

Particularly in younger patients, the cause is likely to be something simple like haemorrhoids (small vulnerable veins in the rectum or the anus) or an anal fissure (a small tear in the lining of the anus), but we encourage all patients who notice any rectal bleeding to have this checked, as serious conditions, although more common in patients over 55, can occur in much younger patients.

Better to be safe than sorry.

December 2017


Prescription supply issues

An increasing number of prescription medications are becoming out of stock without explanation and suppliers are experiencing difficulty replenishing supply from the manufacturers due to national shortages. Some items considered to be routine medication have ceased, only to return after an extended period at significantly increased cost.

This trend has been covered in the media recently, however, whilst answers are awaited, this has resulted in increased prescription handling times, delays and disappointment sourcing medications.

In order to manage prescription requests effectively, Southern Independent Medical Practice has increased the minimum prescription notice period to 72 hours (3 working days) before collecting prescriptions from us.

Please do keep track of any prescription medication you are taking and contact the Practice in good time to source your next prescription. Our patients can email requests or call 01722 415444 and leave a request on our Prescription Message service.

December 2017


Improved Flu vaccines available here

Southern Independent Medical Practice are pleased to offer an improved selection of seasonal flu vaccinations this year which are available to all.

Appointments are available from 22 September, speak to a member of the team on 01722 415444 to book or ask the doctor during your next visit. Details of the vaccines are below:

The Quadrivalent Influenza vaccine provides improved protection against 4 common types of influenza virus rather than the 3 types included in the standard flu vaccines. This vaccination is suitable for adults and children from 3 years of age. The cost for our subscription members this year is £7.00 and for non-member patients is £11.50. All are welcome.

The children's nasal spray vaccine will also be available this season. This is suitable for children from 24 months of age and also provides protection against the 4 common types of flu virus. The cost for children with subscription membership is £26.80 and for non-members is £29.99.

An alternative injectable vaccine is also available for children from 6 to 35 months of age. This provides protection against 3 common types of influenza virus and costs £7.00 for subscription members and £11.50 for non member patients.

NB: Children under 9 years of age who have not been previously vaccinated should be given a second dose after 4 weeks to complete their protection.

September 2017


Health Check Tips

No time like the present for booking a health check. Our subscribing patients benefit from an annual health check with a written report as part of their membership. If this is something you have been considering, contact us for more details.

Here are a few tips to get the most out of your appointments:

  • Remember to fast for 12 hours before your blood test, but drink plenty of water to remain hydrated (black tea / coffee is also acceptable).
  • Bring in a urine specimen in a sterile container (to avoid contaminating your test results). Specimen pots can be purchased from pharmacies or collected from Reception.
  • Arrive in plenty of time so you feel relaxed before your blood pressure reading is taken.
  • Refrain from using body lotions, creams or moisturisers in case the doctor recommends an ECG test during your appointment.

September 2017


Vitamin B Helps Prevent Insect Bites

Some people seem prone to being bitten by insects, particularly mosquitoes and when abroad.

Many dermatologists now recommend that the skin can be made much less attractive to biting insects by taking Vitamin B supplements whilst at risk. So we recommend that Vitamin B complex, 2 tablets twice a day, or Vitamin B-1, 100 mg daily, is a good way of helping to reduce the risk of being bitten.

This advice is recommended in addition to taking usual precautions. We should all safeguard against being bitten particularly in countries where insects carry specific disease, such as malaria or the recently publicised Zika virus. Protect your skin with appropriate insect repellents and where necessary sleep inside an insect proof net. Insects tend to be most active at night, particularly in foreign countries.

September 2017


Meningitis B for Adolescents

The majority of students heading off to university qualify for Meningitis ACWY vaccination under the NHS immunisation programme, however, Meningitis B, a significant element of meningitis protection is absent from this vaccine.

According to a European surveillance report in 2012, the UK currently has the highest proportion of reported cases of Meningitis B in the EU each year. The proportion of cases is shown to decrease with increasing age, however, there is a noted rise in adolescents and young adults aged between 15 to 24 years. In 2012, Meningitis B was responsible for 68% of confirmed meningococcal infections followed by Meningitis C (17%) and Meningitis Y (8%).

We recommend students benefit from Meningitis B vaccination to ensure they are protected from all common strains of the virus during their studies . Vaccines are held in stock and we are generally able to book appointments within a few days of receiving a request. See our Vaccinations page or contact us for more details.

September 2017


Parking at SIMP

Please be aware that the on road parking arrangements in the immediate vicinity of the Practice have changed. Many of our patients are aware of the various previous parking proposals, which have since been finalised and are now in place. Please be aware the new arrangements are currently being enforced by the council.

The parking bays immediately outside the Practice on the same side of the road (up to 5 spaces) are limited to one hour parking for non-residents. There are a number of other bays provided nearby to support other businesses in the area. A map is available at Reception. The remainder of the area is now Residents Parking only, however, Blue Badge holders may continue to park wherever there is a space and there are 2 car parks nearby (Central and College Street).

We appreciate this change will disappoint many patients, yet we understand that residents experience considerable difficulty finding parking in some of the roads locally and hope the new arrangement will at least offer a parking option for some patients.

Whilst we adjust to the change in parking availability, we recommend allowing extra travel time to avoid unnecessary stress and ensure you are able to attend your appointments as scheduled.

September 2017


Vaccine Shortage

A number of key vaccines are currently subject to long term supply issues.

  • Hepatitis A - a global shortage of the vaccine continues and is expected to continue until Spring 2018
  • Hepatitis B - a current shortage of vaccines is due to problems in the manufacturing process. Supply is expected to resume early 2018 and current UK stock is only available to those deemed to be at high risk under Public Health England guidelines. If you qualify under Priority Groups 1 to 3 and require this vaccination, please contact us to source this protection.
  • Shingles - supplies are not currently available to private health providers. The vaccines have a lengthy manufacturing process and it may well be that the current supply has been used to fulfil the latest NHS contract obligations. In the meantime, if you are aged 70, 78 or 79, or born after 1 September 1942, contact your NHS GP to claim your shingles vaccination.

Once the supply situation changes we will post an update.

September 2017


Travel Service Temporarily Suspended

Due to a severe shortage of some travel vaccines, combined with limited clinical availability over the remainder of the summer period we have regretfully taken the decision to temporarily suspend our Travel Service for non practice members until January 2018, in order to effectively balance the current demand on our resources with the needs of our practice members during this time.

However, please note this does not apply to Yellow Fever vaccination which we will continue to provide to anybody needing this protection. Other vaccinations that remain available are Pertussis (Whooping Cough) and BCG (Tuberculosis) vaccinations, which are not routinely subject to our Travel Health Consultation procedure. Please do contact us if you are in need of these immunisations.

We are sorry for the inconvenience this may cause and will review vaccine availability in the new year with a view to resuming our normal service at this point. Unfortunately we are unable to take any further travel enquiries before then.

September 2017


HPV Vaccination

Whilst the national immunisation programme offers important protection against cervical cancer for girls in the UK, it is also recommended that this vaccine is given to boys as they too can get cancers and other serious conditions caused by the human papilloma virus (HPV).

Rates of mouth cancers have risen by 68% in the last 20 years according to a recent report from Cancer UK and many of these cases are related to previous exposure to HPV. Mouth cancer is now the 8th most common cancer in the UK.

There are over 100 different types of HPV, 13 of which are linked to cervical cancer, 2 are known to cause genital warts and 2 are linked to cancers of the anus, penis, mouth, throat, vagina and vulva. HPV related cancers are on the rise and other than cervical cancer there are no screening tests to identify them early. This often leads to them being caught at a later stage and difficult to treat.

Gardasil vaccine offers protection against 4 of the HPV strains commonly linked to cancers. A new version of the vaccine is now available in the UK which offers increased protection against the 9 types of HPV responsible for most of HPV related cancers and diseases.

Patients that have already started a Gardasil vaccination schedule should complete the course on the same vaccine. Boys, girls or adults due to start a course of Gardasil are advised to have Gardasil 9, although both remain currently available.

For more information on this subject call 01722 415444 or email us for more details.

December 2016


Doctor Update

SIMP are pleased to welcome Dr Jeremy Meadows to the Practice.
Dr Meadows joined us in April and is proving to be a popular member of our expanding team.

We will also be pleased to welcome Dr Claudia Morley back to the Practice in the New Year.

December 2016


Flu Clinics

Flu vaccinations are available to all at SIMP.

Suitable for all ages, vaccination offers some inexpensive protection from the misery of flu this winter.
Call us now on 01722 415444 to book your appointment. .

December 2016


Travel Service

Travel vaccination enquiries have been very popular this year as many patients plan international trips. Please contact us well in advance of travel dates to ensure there is sufficient time to commence any vaccination schedules required. Our services are available to all and we hold many vaccines in stock, including Hepatitis A and BCG which are currently in short supply in the UK.

Pertussis vaccination is now a standard travel requirement if you are visiting friends or relatives with infants in Australia or the USA.

Malaria and altitude medication can also be prescribed and/or dispensed from the Practice and we can screen patients who frequently fly, especially to long haul destinations for thrombophilia (a condition that predisposes to the development of deep vein thrombosis).

Call 01722 415444 with vaccination enquiries or to arrange a Travel Health Assessment.

December 2016


Meningitis B Vaccine - Appointments Now Available

We are pleased to announce the Meningitis B vaccine supply situation is improving and we are able to start taking new bookings again.

The manufacturer will continue to manage allocations to private practices until the end of the year due to the unexpectedly high demand; however, we are now able to begin new vaccination courses with the assurance of being able to complete them.

We are holding special clinics over the next few weeks to provide an opportunity for those interested in the vaccine to start their schedules. These appointments will be allocated on a first come first served basis.

Details of the Meningitis B vaccination schedule are on our Vaccinations page for your information.

We feel this is an important vaccination and do not wish to exploit the opportunity of charging excessively. Each dose of the vaccination is currently charged at 118 and the total cost for the full course will vary depending on the age of the child and the number of doses required.

Please contact us on 01722 415444 for more details or to book an appointment.

June 2016


Health Checks

An integral part of our ethos since inception is that our patients should undergo annual health checks. A Well Man / Well Woman health check is therefore included as a benefit of our annual subscription patient membership.)

The value of health checks is often debated in the medical press and elsewhere and many will say they are an unnecessary waste of resources and have no value. This is certainly not the view we take here. We see them as a very important part of providing effective and preventative healthcare.

Health checks provide an opportunity not only to have a full and thorough check up (in particular to look for any signs of cardiovascular disease or noted skin problems) but also to review any health concerns that might not merit a separate consultation. This also allows us to review family history of illness which can be very important in assessing an individuals risk of disease and review lifestyle, which is increasingly recognised to play a significant part in our risk of illness, including cancer and cardiovascular disease.

Well Man and Well Woman Health Checks, and Executive Health Screening services are accessible to all at Southern Independent Medical Practice. These include a physical examination, a variety of tests and a detailed report. More information can be found on our Medical Services page. Call 01722 415444 or contact us for details or to book an appointment.

December 2015


The Importance of Vitamin D

It has long been appreciated that Vitamin D is important in the prevention of osteoporosis (thinning of the bones), rickets in children and also osteomalacia in adults. It has only recently been recognised that Vitamin D deficiency may be linked to many diseases, including heart disease and strokes, autoimmune diseases (such as rheumatoid arthritis and multiple sclerosis), high blood pressure, inflammatory bowel disease, Alzheimers disease, Parkinsons disease and depression.

Research has suggested that Vitamin D supplementation in childhood can significantly reduce the risk of developing Type I diabetes. Vitamin D also regulates production of antimicrobial peptides and deficiency can result in an increased tendency to infections.p>

There is some evidence that high levels of Vitamin D both help the body recover from cancer and also play a major part in cancer prevention. It is considered that optimising your Vitamin D levels could help to prevent as many as 16 different types of cancer including pancreatic, lung, breast, ovarian, prostate, and colon cancers. Furthermore, there are now oncologists in the UK using Vitamin D as part of cancer treatment.

It is recognised that many adults and possibly a third of all children may be Vitamin D deficient. This deficiency is related to our lack of sunlight exposure and the use of sun blocking creams. It is also known that some people need more Vitamin D than others, in particular the elderly, pregnant and breastfeeding women, children under five, those with darker skin and the housebound. In February 2012 the Chief Medical Officer for England and Wales recommended vitamin D supplementation for this group in particular.

Since studies have shown that possibly 70-80% of the UK population may have low levels of Vitamin D, it is now being recommended that we should all consider taking a daily supplement. The best food sources of Vitamin D3 are oily fish (such as mackerel, sardines, herrings, salmon and trout). However even a daily helping of one of these could only provide about 300 IU of vitamin D. There continues to be uncertainty regarding the most effective dose but it is undoubtedly the case that previously recommended doses of 400 IU a day is not sufficient to provide effective blood levels.

Southern Independent Medical Practice recommend that patients should consider taking 1000 IU daily throughout the year. Vitamin D supplements are best taken as Vitamin D3. These can be purchased over-the-counter at many outlets and patients are welcome to order supplies directly through the practice.

December 2015


Reticence and Remedies in Erectile Dysfunction

Erectile dysfunction (ED) is common yet can be a difficult topic for men to broach. This is partly because men have a reputation for not seeking necessary medical help and for concealing intimate problems in particular. It is, however, important that men (particularly those aged under 50) do discuss this with their doctor as it is well established that it can be linked to pre existing but silent (and therefore undiagnosed)cardiovascular disease, which can lead on to a heart attack or stroke.

Causes of Erectile Dysfunction

ED can be either physical or psychological.Usually men with physical erectile dysfunction have a gradual onset so it is difficult for them to date exactly when it happened. Men who suddenly experience ED usually have an underlying psychological cause.

The most common physical problem in ED is reduced circulation to the penile artery due to the build-up of atheroma. The risk factors here include, lack of exercise, obesity, smoking, high cholesterol, high blood pressure, hypertension and diabetes mellitus. Other physical causes of ED include medication side effects, testosterone deficiency, renal failure, brain, spinal or peripheral nerve problems, alcoholism and pelvic surgery. Testosterone deficiency is more likely if there is a loss of facial or body hair or loss of morning erections. A decrease in libido may also suggest a decrease in testosterone levels as the cause of ED.

Treatments for Erectile Dysfunction
  • In physical ED, tablets such as the PDE-5 inhibitors Viagra, Levitra or Cialis can be useful though caution is needed in ischaemic heart disease and men cannot take them if they are on regular nitrates for angina. The underlying physical cause also needs to be treated appropriately. There are also injections, devices, topical remedies and surgical solutions for selected men with ED.
  • For ED with testosterone deficiency, testosterone replacement is beneficial. There are testosterone gels, patches, and injections available. We can advise you about these also.
  • Marriage guidance, counselling and psychosexual counselling can be useful where there are psychological issues leading to ED. Occasionally, the PDE-5 inhibitor medications can assist short term performance anxiety or as an adjunct to psychological therapies.

This is only a brief summary of key points in ED, to encourage men that this is an important subject for which there is good remedies.

Dont suffer in silence

It is very important to seek medical advice. Please dont die of embarrassment contact your GP.

Southern Independent Medical Practice offer confidential medical consultations, advice and treatments. For men with possible physical ED we check the history and smoking status, blood pressure, testicles, body hair, pulses and heart sounds. More physical tests are appropriate in diabetes and men aged over 50 years. We also check if any medication could be causing ED as a side-effect. Blood tests include fasting cholesterol, fasting blood glucose or HbA1c, thyroid hormone, kidney function, 9am testosterone and sometimes PSA. Sometimes other hormones such as prolactin, LH and FSH are checked in order to see whether there is a testicular or a pituitary problem.

We have male doctors available where is too challenging to talk such problems over with a female doctor. Call 01722 415444 or contact us to book an appointment.

December 2015


Meningitis ACWY Vaccination Programme

There has been a rapid and accelerating increase in cases of a highly aggressive form of meningococcal group W disease (Meningitis W).Meningitis causes inflammation of the brain and septicaemia (blood poisoning) that can kill in hours, and those who recover may be left severely disabled.

Meningitis W has been increasing year-on-year since 2009, with 23 cases confirmed in 2009,119 confirmed cases in 2014 and the incidences are accelerating further this year.
Provisional figures show that since July 2014, there have been more than 150 cases in England to the end of April 2015, compared to 80 cases in the same period the previous year.
The government has introduced a programme of vaccination for children aged 13 and also first time university entrants, however this leaves many teenagers and young adults without protection.
We would recommend that all adolescents from the age of 13 are vaccinated and any young adults up to the age of 25 who have not been vaccinated should consider having this protection.A single vaccination is all that is required and it will help to prevent this very serious and sometimes deadly disease.
SIMP are pleased to offer this vaccination to member and non-member patients. Please contact us for details or view more information on our vaccination page.

October 2015


Driving and Diabetes

A statutory requirement was introduced last year for insulin dependent diabetic drivers.

Do please remember if you are an insulin dependent diabetic that you are now required to test your blood sugar no more than 2 hours before the start of a car journey and then every 2 hours while driving.
More frequent testing may be required if for any reason there is a greater risk of low blood sugar (hypoglycaemia), for example after physical exercise or an altered meal routine.
If you have noticed a change in the symptoms or management of your diabetes, please do contact your doctor to arrange a review.



Hot Flushes and HRT (Hormone Replacement Therapy)

Most doctors and many women were very happy with the benefits of HRT until about 10 years ago when the Women's Health Initiative study emphasized the risks of HRT. Then the UK use of HRT fell to under half of what it was before. There has been reassurance in studies in recent years, so the pendulum is moving in a more positive way towards HRT though there now needs to be a little more caution in decision making. This article summarises current thinking on Hot Flushes and HRT (Hormone Replacement Therapy)

Although there are many symptoms of menopause,the main 2 are hot flushes and vaginal dryness/soreness. For vaginal symptoms,lubricants (such as Replens) and topical HRT creams (such as Ovestin) or pessaries can be used. With hot flushes, sometimes benefit is found from antidepressants, weight loss, exercise and herbal remedies such as Black Cohosh and Red Clover. But the controversy is whether women with hot flushes should take HRT the only powerful remedy.
Benefits of HRT. The main benefit of HRT is the reduction of hot flushes and this is clear for most women within a few days. There is also a reduced risk of bone fractures with HRT if used for 4 years or more.
Risks of HRT.As the benefits are so clear, the risks of HRT are the key to decision making for hot flushes and these risks are increasingly well understood. Long term use of combined HRT (oestrogen with progestagen) slightly increases the risk of stroke, heart attacks and leg clots. After 5 years of use there is also an increased risk in breast cancer. In women over 65 there is also a small increase in dementia risk.
Reduced Risks in Oestrogen-only HRT. For women who have had a hysterectomy and therefore only need oestrogen in their HRT, leg clots and strokes are still increased,but not heart attack risk or breast cancer risk.
Reduced Risks for Younger Women on HRT.However, for younger women on combined HRT in their 50s, when hot flushes are most common anyway, only leg clot risk was increased even by combined HRT. Better still for younger women, a study on women up to age 58 who started combined HRT around the menopause and had taken HRT for 10 years were shown to have a REDUCED risk ofdeath from all causes and reduced risk of strokes and heart attacks in particular. There was also no significant increase in breast cancer in this group.
In Conclusion. As most women who have troublesome hot flushes are younger in their 50s the outlook is better than we had thought. The concerns about HRT are much more with regard to long term use in older women.
You need an individual solution for your menopausal symptoms, as every woman is different and these differences can make HRT a good or a bad choice for you. There are also a great variety of HRT products with their own benefits and disadvantages.
At SIMP, we can help you to make sense of the menopause and the options in HRT. Contact us on 01722 415444 to arrange an appointment if you would like to discuss this with a member of our medical team.



BCG Vaccine back in stock

We are pleased to announce the BCG (tuberculosis) vaccine is now back in stock.

Tuberculosis or TB is a common and potentially fatal infectious disease which most commonly attacks the lungs as pulmonary TB, but can also affect the central nervous system, the lymphatic,circulatory and genitourinarysystems, bones, joints and even the skin.

BCG vaccination is available from infants to adults. Itis routinely given to adolescentsfrom age 12 to 16 years, consisting of an initial skin test to check for immunity, followed by a vaccination as required 48 - 72 hours later, however, the method given will depend on age.This vaccination ceased under the regular NHS vaccination schedule and isnow only given to those considered to be at risk of the disease.

For more information or to book an appointment, call us on 01722 415444.

June 2015


Acupuncture returns to SIMP

We are pleased to announce Caiti Buck is now offering acupuncture at Southern Independent Medical Practice.

Caiti says "Traditional acupuncture can be effective for a wide range of health complaints. It's focus on treating the whole person rather than symptoms in isolation can also help improve general wellbeing."

Caiti trained at the College of Integrated Chinese Medicine in Reading and is a member of the British Acupuncture Council, the largest body of traditional acupuncturists in the UK, with a guarantee of excellence in training, practice and conduct.

To welcome clients new to acupuncture, Caiti has a half price offer on an Introductory Treatment Package. This includes a consultation and the first 5 treatments and is valid for initial consultations booked by 31 July 2015.

To find out how acupuncture can help you, contact Caiti or call 07955 236015 for more information.

May 2015


Confidential Counselling

Ian Burton BSc(Hons) FRGS MBPsS MBACP is an experienced and qualified counsellor, providing open ended and short term counselling for adults of all ages and young people aged 16+.

Ian holds one-to-one counselling sessions in a quiet, safe and confidential environment at Southern Independent Medical Practice

His counselling sessions aim to help clients come to a better understanding of their personal situations and support them in the changes they may wish to take.

For more information or to arrange a free, no obligation initial meeting, call Ian on 07951 509606.

May 2015


Facial Aesthetics Practitioner

Many of our patients will already know Dr Claudia Morley as one of our highly qualified GPs at the Practice.

Claudia has also been trained by some of London's leading aesthetics practitioners and provides a facial aesthetics service at Southern Independent.

The most popular treatments are anti-wrinkle injections (botox) and dermal fillers.

Claudia offers aesthetic treatments with the reassurance of being provided by a medically trained, experienced doctor, and an approach aimed at enhancing the natural you.

Subscription paying members of Southern Independent Medical Practice receive a 10% discount on all treatments. Contact Morley Aesthetics to book a free consultation.

May 2015


Miscarriage: Help and Hope

Miscarriage occurs in 20% of recognized pregnancies and can be very distressing for many reasons.

Following 3 consecutive miscarriages, (known as recurrent miscarriage,) the risk of yet a further miscarriage is about 40%.

It can be particularly difficult to cope with simply not having a reason for the occurrence and if you dont know why it has happened, you may begin to wonder if it could have been avoided.

A better understanding of both causes and prevention of miscarriage provides reassurance of misplaced guilt as well as reducing recurrence.

The list of potential causes of miscarriage is long. Many early miscarriages are caused by one-off genetic faults and occasionally due to a parental genetic fault. However, there are various potentially remediable causes of miscarriage, including:

  • Progesterone hormone deficiency. A Cochrance review found evidence of the benefit for progestogen therapy in women with a history of recurrent miscarriage. Luteal phase defectwhich underlies progesterone deficiency is present in up to 35% of cases of recent miscarriage.
  • Antiphospholipid syndrome (APS) is an important treatable cause of recurrent miscarriage. Antiphospholipid antibodies are present in 15% of women with recurrent miscarriage. In primary APS, aspirin, sometimes combined with heparin improves live birth rate to 70%.
  • Inherited thrombophilia, (clotting disorder) such as protein C and S deficiency and MTHFR variants may have a role in recurrent miscarriage, because of an increased risk of thrombosis (clots) in the placental circulation. Women with a second-trimester miscarriage (beyond 14 weeks) should be screened for inherited thrombophilia. (Inherited thrombophilia also increases the risk of the mother having blood clots and pulmonary embolism in her pregnancy.) If one of these inherited clotting disorders is found, then heparin and aspirin therapy should be discussed with a specialist.
  • Uterine anomalies are seen in between 10-25% of cases of recurrent miscarriage and may be remedied surgically.
  • Bacterial vaginosis in the first trimester is a risk factor both for second-trimester miscarriage and for preterm delivery. A vaginal swab will reveal such infections.
  • Cervical incompetence may cause mid-trimester recurrent miscarriage and is treated by cervical support known as cerclage.
  • Women with polycystic ovarian syndrome are at higher risk of miscarriage and there is ongoing research regarding the use of metformin (a diabetic medication), during pregnancy to reduce this risk.
  • Natural Killer cells are increased in the uterine lining of women with high rates of miscarriage and there are encouraging ongoing UK studies using steroids to reduce recurrent miscarriage in these women. Hopefully these treatments will become mainstream. (Natural killer cells in the bloodstream do not appear to be a marker for treatable recurrent miscarriage).

Traditionally, testing has not been offered until after 3 early miscarriages (up to 14 weeks). With better investigation and treatments as well as the increasing age of expectant mothers, there are good reasons to consider whether it is necessary to wait for 3 early miscarriages Southern Independent Medical Practice will sympathetically discuss your case and arrange appropriate investigations, treatments and specialist referrals according to the best evidence.

If you would like to discuss this sensitive matter with a doctor at our practice, contact us or call 01722 415444 to book an appointment.

May 2015


Flu Advice

Although influenza is around all year, it is particularly common at this time of year. It is an infectious viral illness spread by coughs and sneezes, and the germs can easily be spread now that we are spending more time indoors either at work or at home with guests, friends and family.

Flu is not the same as the common cold. Although many symptoms are the same, flu can result in a high fever and make you feel so exhausted and unwell that you have to stay in bed and rest until you feel better. It can also lead to serious chest problems and hospitalisation.

Generally flu symptoms are at their worst for 2-3 days and it can take 2-3 weeks to fully recover. Following a good hygiene routine can help to prevent spreading the germs. eg: cough and sneeze into a tissue, regularly wash hands, avoid touching your nose and eyes, promptly dispose of tissue waste and disinfect surfaces in common use.

If you are otherwise fit and well, the best advice is to rest at home, keep warm and drink plenty of fluids. Paracetamol or ibuprofen should help to reduce a high temperature and relieve aches and pains.

If you are pregnant, over 65 or have an existing medical condition, please contact your GP for further advice.

Southern Independent Medical Practice offer an accessible flu vaccination service available to anyone interested in immunisation, including an alternative vaccine suitable for those with an egg allergy. Flu vaccination is 6.50 for our subscription paying members and 11.50 for all others.

Call us on 01722 415444 to book your appointment today.

December 2014


Radiation doses in X-Ray and CT Scan Examinations

As we all know, doctors request x-ray and other imaging investigations as part of the diagnostic process or for screening purposes. X-ray examinations and computed tomography (CT) scanning both involve some radiation exposure; however, MRI scanning and ultrasound do not.

Different types of examination require different imaging to provide the information required and X-rays and CT scanning are often the most effective way of imaging specific organs or tissues, both for diagnostic purposes or screening.

We are all exposed to background, naturally occurring, radiation all the time and the dose of radiation used in medical procedures is measured against this background exposure.

Radiation is expressed in milliSieverts (mSv). We are all exposed to between about 2.5 3.0 mSv a year from this background radiation.

It is important to recognise that radiation from these procedures is cumulative over our lifetime and doctors are very conscious that we should not expose patients to unnecessary radiation. However, it is reassuring to note that with modern imaging equipment, radiation is kept to a minimum.

We thought it would be helpful to provide some information about the amount of radiation that common procedures involve and whether these procedures carry any additional lifetime risk.

Other than for mammography and bone density assessments, we prefer not to use X-rays or CT scanning for screening because of the radiation doses that patients would be exposed to.

For this procedure:
* Your approximate effective radiation dose is:
Comparable to natural background radiation for:
** Additional lifetime risk of fatal cancer from examination:
Computed Tomography (CT) - Abdomen and Pelvis
10 mSv
3 years
Computed Tomography (CT) - Colonography
10 mSv
3 years
X-ray - Spine
1.5 mSv
6 months
Very Low
X-ray - Extremity
0.001 mSv
3 hours
Bone Density Scanning (DEXA)
0.001 mSv
3 hours
Computed Tomography (CT) - Head
2 mSv
8 months
Very Low
Computed Tomography (CT) - Spine
6 mSv
2 years
X-ray - Chest
0.1 mSv
10 days
Coronary Computed Tomography Angiography (CTA)
12 mSv
4 years
Cardiac CT for Calcium Scoring
3 mSv
1 year
0.4 mSv
7 weeks
Very Low

December 2014


Meningitis B Vaccine Latest

The most common cause of meningitis is meningitis B, with around 2000 cases in the UK each year. Of these 10% die of the infection and many others are left with disabilities.

Typically this affects young children under the age of 5 and teenagers aged between 15 and 20.

Southern Independent Medical Practice has been pleased to offer this important vaccination since 2013.

We routinely re

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