Coping with bereavement and grief.
NHS Talking Therapies (formerly IAPT) self referral
NHS talking therapies, for anxiety and depression is provided by West London NHS Trust and offer evidence-based therapies for people over 18 who have a GP or live in the London Borough of Hounslow.
They can help you with common problems like stress, anxiety and depression. It could be that you’re feeling low, having trouble sleeping, or feeling frightened. These are all things that they can help with.
They offer a range of treatments either online, over the telephone, web-based or in person. There are also a number of different formats such as groups, workshops, couples therapy or individual therapy. They aim to provide individuals with a choice of time, day and location suited to the needs of the individual in a timely manner.
How to access this service
You can ask for a referral from your GP or any other health or social care professional. They will fill in a form explaining how you are feeling.
You can also refer yourself online. You can find out how to refer yourself and more information about the service here https://www.westlondon.nhs.uk/our-services/adult/iapt/iapt-hounslow.
Chargeable Services
There is some work that will incur a fee and does not fall within under the NHS. Please review our list of non-NHS work that we offer at our GP surgery, which attract a fee. This includes certificates, forms, medical examinations and various travel vaccinations.
Why does my doctor charge fees?
When your doctor is asked to give medical information about you in the form of a report, letter or certificate, the request kick starts a series of processes.
This takes time and is not always straightforward or simple to complete. Some of the information is not available easily and will mean the doctor has to sort and select the right information for the request.
The doctor also must establish who is funding this work and if it is not part of their NHS work, agree a fee for this.
All private work including private insurance claim forms will take up to 21 working days. We cannot complete this work any quicker as we are focused on delivering NHS services. Please do not keep calling the practice as we cannot make this any quicker and it prevents people getting through on the phones who are unwell.
Surely the work is paid for by the NHS?
Many patients see their doctor as the embodiment of the NHS and all that it provides – free care at the point of delivery. However not all work doctors are asked to do is paid for by the NHS and many GPs are self-employed.
This means they must cover their time and costs – staff, buildings, heating, lighting, etc – in the same way as any small business. The NHS only pays for NHS work, any work outside of the NHS must be funded by other means and this is why fees are charged.
Why does it take so long?
Your doctor receives large amounts of request and which is often to do with whether your general health allows you to do something e.g. to work, receive benefits, drive, play sport, attend school, own a house, a firearm or it is for insurance, court or other medico-legal reasons.
All requests will vary in complexity, volume and consistency ranging from signing a certificate which can take minutes, to an in-depth report with an examination that can take hours.
What your doctor is signing
When your doctor signs a certificate or completes a report, it is a condition of remaining on the Medical Register that they only sign what they know to be true.
In order to complete even the simplest of forms, they may have to check your entire medical record (some of which may not be accessible on a computer or on site).
Carelessness or an inaccurate report can have serious consequences for the doctor with the General Medical Council (the doctors’ regulatory body) or even the Police.
Why does my doctor seem reluctant or say no to this request?
Your doctor is inundated with work. They have to balance their time with treating the sick, keeping their practice afloat and making sure they are doing all of this safely and within their professional duties as a doctor.
With certain exceptions written within their contract, doctors do not have to carry out non-NHS work. However, many choose to for the benefit of you and other families they treat.
Where a doctor chooses to undertake the work, we advise them to inform and always agree a fee in advance of undertaking work.
Should their volume of work prove to be greater or more complex than expected, the doctor will contact you to discuss how to proceed.
What can I do to help?
– Not all documents need a signature by a doctor and can be done by other professionals. Please check the form and accompanying guidance as you may get a quicker response that way.
– If you have several forms requiring completion, present them all at once and ask your doctor if he or she is prepared to complete them at the same time to speed up the process.
– Do not expect your GP to process forms overnight. Urgent requests may mean that a doctor has to make special arrangements to process the form quickly, and this will cost more.
– Don’t book an appointment with your doctor to complete forms without checking with your doctor’s administrative staff as to whether you need to or not.
Having tests and getting your results
Please note test results can take up to two weeks.
We will usually send a text if they are normal and will contact you by phone or text if the results are abnormal. The quickest and easiest way to check if your test results are back is to log in to your online account. Your results will appear once the results have been reviewed by your GP or clinician.
General Information about Test results
As part of the care we deliver to you, our team may ask that you have a blood test, swab, ultrasound, X ray or other test. Some tests such as blood tests for people over 16, we can do here at the surgery, some may need you to go to other places.
Once we receive your sample we will send the sample to the lab for processing. This can take up to two weeks for the results to come back and your doctor or clinician to review your case.
Once you receive your result and your symptoms persist or get worse then please complete a Klinik form and a member of our clinical team will be in touch.
Please note that we have a strict policy regarding confidentiality and data protection. We will only give test results to the person they relate to unless that person has given prior written permission for their release.
To access your results online please follow the instructions below
- You can use your Systmonline account (or the Airmid app) and access the results from there. Please note that results are only available once the doctor has reviewed them. If you don’t have access to your record online, please request this in your online account or ask our reception team for help, ideally after 2 pm.
- If you don’t have online access then please visit the online services page for information on how to get it set up.
Please note that the results of tests carried out during hospital visits are not sent to the practice and you will need to contact your hospital doctor.
Why have I been asked to have a repeat test?
If a doctor asks you to have a repeat test, it is usually because:
- The result was borderline or unclear, and the doctor wants another sample to monitor the situation or to re-check the results.
- The result is abnormal, and the doctor cannot interpret the result without further tests and has asked you to come in for more tests.
Please do not worry if the doctor has asked you for a repeat test. The doctor will speak to you or request to see you directly if they need to discuss the results.
Understanding your Blood Test Results
Your GP record is written to help medical staff look after you. This means that sometimes you may not understand everything you see. We have shared this information to help patients understand their test results, but if you have any further questions please speak to a member of our team.
It is important to learn what’s ‘normal for you’, this is particularly important if you have a long-term illness, as your results may be different to other people’s.
Significant things to consider about your results:
- A test result outside the range may not indicate a problem, these are just reference ranges.
- Equally, if all results are within the reference range, this does not completely guarantee there isn’t a concern.
- Not all results are returned to us at the same time, we may be waiting for further results before contacting you.
- Comments may have been added automatically by a laboratory computer or by a laboratory scientist or doctor. Generally, comments are written for the doctor requesting the test rather than the patient, and so they may not be very meaningful to you.
- It is important to follow the advice of your doctor or other healthcare professional. Always look out for our comments attached to results. Often these have critical information about the test and how to interpret the result. We have included below an explanation of some of the comments you may commonly see on your results.
FAQs
Where are the reference ranges (normal ranges) for tests?
The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results. These are standardised reference ranges, but they will not apply to everyone. They do not take into account things like your gender, age, ethnicity or health conditions. The reference ranges mean a computer may flag a result as out of range or abnormal, but for you this might be a normal result. Whilst the ranges are helpful, it is important to follow the advice of the doctor who interprets the result.
What does it mean if my result is outside the reference range?
Your test results are interpreted by your health care provider within the context of other tests that you have completed. These results are also measured against other factors like your medical history. The medical significance of a single result that is slightly high or slightly low may be difficult to determine. This is why a doctor may repeat a test, and why they may look at results from your previous tests. However, a result outside the reference range may indicate a problem and warrant further investigation. Your doctor will evaluate your test results in the context of other relevant factors, and determine whether a result that falls outside of the reference range presents a significant issue.
If my results are normal, does that mean I have nothing to worry about?
If your results are within normal limits, it’s certainly a good sign. But one set of tests offers a snapshot of certain aspects of your health rather than a guarantee. There is a lot of overlap among results from healthy people and those with diseases, so there is still a chance that there could be an undetected problem. If you’re trying to follow a healthy lifestyle, take test results that are within range as a good sign, and keep it up. However, normal results do not mean that unhealthy habits will not have consequences in the future. Your health care provider may want to monitor you with a series of tests to make sure you’re still on track and to document any trends. A rise or drop in results, even if they are still within normal limits, could provide meaningful information.
If my result is abnormal, does that mean I have a problem with my health?
Not necessarily. A test result outside the reference range signals to your doctor to further investigate your condition, but it may or may not indicate a specific problem. You can have a value outside the range and have nothing. It is possible that your result is within that 5% of healthy people who fall outside the statistical reference range. In addition, there are many things that could throw off a test without indicating a major problem, such as not preparing for the test properly. Your doctor may want to rerun the test. Some abnormal results may resolve on their own, especially if they are on the border of the reference range. Your doctor will also seek explanations for an abnormal result. Key points your doctor will consider include how far outside of the reference range the results are and whether repeated tests also produce abnormal results.
I have had a blood test or dropped a sample at the practice, but what happens now?
Blood tests and other samples have to be sent away to a hospital laboratory for analysis. An NHS courier collects samples from us each day in the early afternoon.
– If your result needs urgent action we will contact you by phone to discuss what action needs to be taken.
– If your result needs action, but not urgently, we will contact you within an appropriate timescale to explain what action needs to be taken.
– If your result is normal, or if the doctor has some information for you following your test we may send this by text message.
– We aim to inform you of all results, but due to the volume we receive, if no action is required the practice will not contact you but you are free to check your results on the NHS App or contact the practice to get your result.
– If you need to discuss your result with a doctor or nurse, please ask the receptionist to take a message for the doctor or nurse. They will either telephone you or you will be asked to make an appointment to see them.
– If your result needs urgent action we will contact you by phone to discuss what action needs to be taken.
– If your result needs action, but not urgently, we will contact you within an appropriate timescale to explain what action needs to be taken.
– If your result is normal, or if the doctor has some information for you following your test we may send this by text message.
– We aim to inform you of all results, but due to the volume we receive, if no action is required the practice will not contact you but you are free to check your results on the NHS App or contact the practice to get your result.
– If you need to discuss your result with a doctor or nurse, please ask the receptionist to take a message for the doctor or nurse. They will either telephone you or you will be asked to make an appointment to see them.
Why does the result take so long?
Ask patient to book appointment
The doctor would like to speak to you to explain the result(s). The doctor may ask for this to be in person or by telephone. They may recommend you see the nurse or our Physician Associate.
Ask patient to repeat test
Small fluctuations in test results are common and slightly abnormal results usually return to normal without the need for treatment. The GP would like to check your result has returned to normal or remained stable. We will tell you how long you should wait before rechecking your blood test.
Discussed with patient or Patient informed
The doctor has already discussed this result with you.
Seen and dealt with
The doctor has already seen you and has dealt with any issues that arose.
Has appointment to discuss
You already have an appointment booked with the doctor, during which they will discuss the results with you. There is no need to contact us before then as the result is not urgent.
Just out of range-OK
This means that the doctor has looked at the result and deemed it to be just outside of the normal range and the result is not concerning and is OK for you.
Normal- no action
This means that the doctor has looked at the result and deemed it to be within the normal and no further investigation or treatment is needed.
Satisfactory
This means that the doctor has looked at the result and deemed it to be just outside of the normal range and the result is not concerning. No further investigation or treatment is needed.
Stable
The doctor has looked at the result and deemed them stable and the result is not concerning. We will continue to monitor and the doctor will tell you if you need a repeat test in the future.
On correct treatment
The doctor started you on a medicine and the results of your test show this is the correct treatment. There is no reason to change current treatment according to test results.
Inadequate specimen
Unfortunately very occasionally samples are lost or damaged. Sometimes there is a delay in samples reaching the laboratory which can affect the quality of the specimen making it unusable. On other occasions an incorrect bottle or label may have been used. Occasionally an incorrect test is requested in which case a repeat may not be needed. The doctor will usually ask you to repeat the test.
Referred to practice pharmacist
Our practice pharmacist will contact you to discuss the result. This is usually because your result has indicated we should make changes to your medications or start a new medicine.
The doctor would like to speak to you to explain the result(s). The doctor may ask for this to be in person or by telephone. They may recommend you see the nurse or our Physician Associate.
Ask patient to repeat test
Small fluctuations in test results are common and slightly abnormal results usually return to normal without the need for treatment. The GP would like to check your result has returned to normal or remained stable. We will tell you how long you should wait before rechecking your blood test.
Discussed with patient or Patient informed
The doctor has already discussed this result with you.
Seen and dealt with
The doctor has already seen you and has dealt with any issues that arose.
Has appointment to discuss
You already have an appointment booked with the doctor, during which they will discuss the results with you. There is no need to contact us before then as the result is not urgent.
Just out of range-OK
This means that the doctor has looked at the result and deemed it to be just outside of the normal range and the result is not concerning and is OK for you.
Normal- no action
This means that the doctor has looked at the result and deemed it to be within the normal and no further investigation or treatment is needed.
Satisfactory
This means that the doctor has looked at the result and deemed it to be just outside of the normal range and the result is not concerning. No further investigation or treatment is needed.
Stable
The doctor has looked at the result and deemed them stable and the result is not concerning. We will continue to monitor and the doctor will tell you if you need a repeat test in the future.
On correct treatment
The doctor started you on a medicine and the results of your test show this is the correct treatment. There is no reason to change current treatment according to test results.
Inadequate specimen
Unfortunately very occasionally samples are lost or damaged. Sometimes there is a delay in samples reaching the laboratory which can affect the quality of the specimen making it unusable. On other occasions an incorrect bottle or label may have been used. Occasionally an incorrect test is requested in which case a repeat may not be needed. The doctor will usually ask you to repeat the test.
Referred to practice pharmacist
Our practice pharmacist will contact you to discuss the result. This is usually because your result has indicated we should make changes to your medications or start a new medicine.
Links to Patient Guides
Sites to help you understand specific test results:
Guides to use the NHS App:
Get a sick note for work
The NHS provides sickness certification only after seven continuous days of illness. If you need a sick note to cover this period of sickness you should complete a Self-Certification (SC2) form which is available from your employer or on the HMRC website.
Online Services
If you are registered with our GP surgery, you can access some health services online. This means you can do some tasks when it is better for you and avoid telephoning the practice.
You can do things like:
- Order repeat prescriptions
- See parts of your health record, including information about medicines, vaccinations and test results
- See communications between your GP surgery and other services, such as hospitals
- Book, check or cancel appointments with a GP, nurse or other healthcare professional
- Send us a query or request a sick note
Below are some of the main online services we use in our GP surgery:
Airmid
If you would like to benefit from online services and prefer to use an app, you can use the Airmid app. Airmid is the patient-facing app for the provider of our clinical system. If you don’t want to use an app you can still access SystmOne Online.
Want to be setup?
To sign up for online services you’ll need to visit us. You can visit any of our surgeries and ask to be registered for the service. You’ll need to provide some ID.
Through the Airmid app you can:
Access your complete medical record and contribute to it using information from medical devices and wearables, Apple Health and Google Fit.
This includes:
- Consultation notes
- Medication History
- Vaccination History
- Allergy/Drug Sensitivities
- Procedure History
- Correspondence e.g. Referral/Discharge letters
- Pathology/Radiology reports
- Health data from your personal device
Use it to book and manage your appointments:
- View all upcoming appointments
- Add appointment reminders to your calendar, so you don’t miss an appointment
- Airmid has video consultations built-in, so you can be consulted straight from the app
Use it to manage your medication better:
- Request medication and re-order your repeat medication directly through Airmid
- Airmid supports the Electronic Prescription Service and can produce barcodes directly in the app ready for scanning at the Pharmacy for medication collection
- Update your nominated pharmacy. Integrated maps show you how to get to there too
Get the App
Non-urgent advice: Please note
To use the Airmid app, you must set up your NHS log-in.
This is the same login as you would use for the NHS App. For help and guidance on how to do this, please visit the NHS website.
NHS App
You can find out more about the NHS App, how to download it and get support here (https://www.nhs.uk/nhs-app/).
You’ll need to provide extra proof of who you are to get full access to your NHS account.
Once you have full access, you can:
- order repeat prescriptions – see your available medicines, request a new repeat prescription and choose a pharmacy for your prescriptions to be sent to
- book appointments – search for, book and cancel appointments at your GP surgery, and see details of your upcoming and past appointments
- view your health record – securely access your GP health record, to see information like your allergies and your current and past medicines. If your GP has given you access to your detailed medical record, you can also see information like test results and details of your consultations
- get your NHS COVID Pass – view and download your COVID Pass for travel abroad. There are also other ways to get your NHS COVID Pass
- register your organ donation decision – choose to donate some or all of your organs and check your registered decision
- find out how the NHS uses your data – choose if data from your health records is shared for research and planning
- view your NHS number – find out what your NHS number is
Quote / Testimonial: For more information go to www.nhs.uk/nhsapp.
If you’re a patient at our practice you can use the new NHS App, a simple and secure way to access a range of NHS services on your smartphone or tablet.
Get the app
Non-urgent advice: Having Problems?
You can still contact the practice by phone or in person, this is just another option, which other patients have found is more convenient and saves them time. More information including “how to” leaflets and videos of patients and why they are using GP online services are available at www.nhs.uk/gponlineservices
Your NHS Login
Your NHS account allows you to access your services through the NHS App or website. It also allows you to access authorised apps such as Airmid and Klinik.
To have an NHS account, you must be aged 13 or over and registered with an NHS GP surgery in England or the Isle of Man.
You can find out more about how to set up your NHS login, you can visit the NHS website: How to set up NHS login
You may find it easier to have an app on your phone to access your account but you don’t have to. If you prefer, you can access your NHS account online: Log in – NHS App Online (service.nhs.uk)
Klinik
SystmOnline
SystmOnline allows patients or someone acting on behalf of the patient to proactively manage their care. The online services available include the ability to view an online Electronic Medical Record (EMR) as well as booking appointments and managing medication.
SystmOnline is available as an online service if you prefer to use a computer. If you prefer to use an App on your tablet or smartphone, you can find information on the Airmid app.
SystmOnline
Non-urgent advice: Having Problems?
You can get
support and find
some Frequently
Asked Questions
about SystmOnline
below.
Antenatal Self-referral
Antenatal care is the care you get from health professionals during your pregnancy. It’s sometimes called pregnancy care or maternity care. You’ll be offered appointments with a midwife, or sometimes a doctor who specialises in pregnancy and birth (an obstetrician).
You should start your antenatal care as soon as possible once you know you’re pregnant.
In London you can choose where you have your antenatal care, this will probably be your local hospital. You can self-refer directly, or if you prefer you can ask your GP.
If you already know the hospital you want your care from, you’ll find information on their website about how to self-refer. Otherwise, you can visit the My Health London website and search for hospitals in your chosen area of London.