At The Valleys Medical Partnership we take patient safety very seriously. We follow the latest advances in medical research and continually update and review our clinical practice to ensure patient care is of the highest standard.
Mirena (IUS) for HRT
The IUS or Mirena is a small plastic T-shaped device. It is placed inside the womb and slowly releases progesterone.
There are two threads attached to the mirena which pass through the entrance of your womb into your vagina. These allow you to check that the coil is in place and allow easy removal. Your partner doesn’t usually feel them during intercourse, and they don’t hang outside your body.
What is the Mirena Used for?
The Mirena is a very reliable and common form of contraception.
It is the most effective treatment to reduce heavy periods – reducing bleeding by approximately 90%.
It can be used to provide the progesterone component of HRT which protects the lining of your womb. Side effects of progesterone given by the Mirena are much less than those experienced by patients taking oral progesterone.
It is the most effective treatment to reduce heavy periods – reducing bleeding by approximately 90%.
It can be used to provide the progesterone component of HRT which protects the lining of your womb. Side effects of progesterone given by the Mirena are much less than those experienced by patients taking oral progesterone.
How is it fitted?
The Mirena coil is easily fitted in our practice. The process is very much like having a smear but takes a little longer.
We advise that you take paracetamol an hour before the procedure to reduce any period type pains that you might experience on insertion.
We must ensure that you are not pregnant before fitting the Mirena so you must not have unprotected sex between your last period and your fitting appointment.
Once fitted the Mirena can be left in place for 5 years. If you wish to have a coil fitted you need to book a phone consultation with a coil fitter who will discuss the process and then book you a face to face appointment for the fitting.
We advise that you take paracetamol an hour before the procedure to reduce any period type pains that you might experience on insertion.
We must ensure that you are not pregnant before fitting the Mirena so you must not have unprotected sex between your last period and your fitting appointment.
Once fitted the Mirena can be left in place for 5 years. If you wish to have a coil fitted you need to book a phone consultation with a coil fitter who will discuss the process and then book you a face to face appointment for the fitting.
What are the risks?
There are a few very small risks associated with fitting the coil:
– Occasionally we are unable to fit the coil in the clinic. We would then discuss alternative options with you.
– Rarely, (approx. 1 in 1000) on insertion, the coil might pass through the womb wall and then we would need to refer you to hospital for an operation to remove the coil.
– Sometimes the coil falls out of your womb (expulsion). This happens in about 1 in 20 women and we ask you to check that your coil is in place each month by feeling for the threads.
– There is a slight increased risk of infection, so where necessary we will ask you to do a vaginal swab to reduce that risk.
– The Mirena is a very effective method of contraception but if you did get pregnant, there is a chance that the pregnancy would implant outside your uterus. This is known as an ectopic pregnancy and would require referral to the hospital for management.
– Occasionally we are unable to fit the coil in the clinic. We would then discuss alternative options with you.
– Rarely, (approx. 1 in 1000) on insertion, the coil might pass through the womb wall and then we would need to refer you to hospital for an operation to remove the coil.
– Sometimes the coil falls out of your womb (expulsion). This happens in about 1 in 20 women and we ask you to check that your coil is in place each month by feeling for the threads.
– There is a slight increased risk of infection, so where necessary we will ask you to do a vaginal swab to reduce that risk.
– The Mirena is a very effective method of contraception but if you did get pregnant, there is a chance that the pregnancy would implant outside your uterus. This is known as an ectopic pregnancy and would require referral to the hospital for management.
Are there any side effects?
The Mirena can cause some irregular bleeding during the first six months after fitting. This usually settles and most people don’t have any further bleeding.
You might experience some progesterone side effects such as breast tenderness, headaches, and symptoms similar to premenstrual syndrome, but these normally settle within the first few months.
You might experience some progesterone side effects such as breast tenderness, headaches, and symptoms similar to premenstrual syndrome, but these normally settle within the first few months.
What about follow-up?
When you leave the clinic you can return to your normal activity. If you are using the Mirena for contraception it will be effective after seven days and you will need to use extra protection to prevent pregnancy in that time. You may experience slight bleeding and period like pains for which you can take paracetamol or ibuprofen.
Most people don’t need any follow up but if you experience any problems or would like a follow up you can book through the reception team.
Most people don’t need any follow up but if you experience any problems or would like a follow up you can book through the reception team.
Administration of Multiple Vaccines
There have been a number of studies on the safety of administration of multiple vaccines at the same time, especially since the COVID-19 pandemic.
Based on the evidence above, where patients in an eligible group present having recently received one or more vaccine, COVID-19 vaccination should still be given. The same applies for other vaccines where COVID-19 vaccination has been received first or where a patient presents requiring two or more vaccines.
It is generally better for vaccination to proceed to avoid any further delay in protection and to avoid the risk of the patient not returning for a later appointment.
- This includes but is not limited to vaccines commonly administered around the same time such as pneumonia vaccines, shingles and flu.
Blood Pressure
Patients with blood pressure conditions may be asked to attend review.
If you would like to monitor your own blood pressure you can find a list of validated home blood pressure machines here – local pharmacies usually have the Omron M2 in stock.
Weight Management Referrals
The NHS is having a big push this year to try to encourage adults classified as either overweight (BMI >25) or obese (BMI >30) to try to lose weight as it has been shown that weight loss can have a significant impact on reducing your risk of future disease such as heart disease or cancer.
We are currently able to refer our patients to two FREE NHS Weight Management programmes. If your BMI is >30, you can be referred to either, or if your BMI is >25 you can access the Live Life Better Derbyshire service. Please see your text message to see which group you fall into.
If you would like to be referred, please reply to the message stating your preference of the service you would like referral to. We will then arrange this and you should hear back directly from your chosen service.
Non-NHS Services
The government’s contract with GPs covers medical services to NHS patients. However, in recent years more and more organisations have been involving doctors in a wide range of non NHS work.
This work is not funded by the government, so GPs have to charge a fee to cover their time and other expenses.
Do GPs have to do non-NHS work for their patients?
With certain limited exceptions, GPs do not have to carry our non-NHS work. Many GPs however will always attempt to assist their patients and carry out this work.
Why does it sometimes take my GP a long time to complete my form/letter?
Time spent completing forms & preparing reports takes the GP away from the medical care of patients. GPs have an ever increasing workload of forms which must be prioritised against offering appointments and other urgent administration.
I only need the GP’s signature – what’s the problem?
When a GP signs a certificate, completes a report or writes a letter it is a condition of remaining on the medical register (which allows them to practice as a doctor), that they only sign what they know to be true. In order to complete even the simplest of forms, the doctor may have to check a patient’s entire medical record.
Who sets the fees and why do different doctors charge different fees?
The BMA suggest fees that may be charged in certain circumstances however these are intended for guidance only. Doctors are not obliged to charge the rates suggested by the BMA and the fee levels will generally reflect the amount of work and time involved.
Why do GPs charge for the completion of cremation forms?
A deceased person cannot be cremated until the cause of death is definitely known and properly recorded.
Before cremation takes place, two certificates must be signed, one by the GP and one by another doctor. The completion of these forms is not part of a doctor’s NHS duties and the fees are normally charged to the funeral director who generally passes on the cost to the family.
These fees are agreed with the relevant national associations applicable to funeral directors. Death certificates are a separate form and are completed free of charge.
Before cremation takes place, two certificates must be signed, one by the GP and one by another doctor. The completion of these forms is not part of a doctor’s NHS duties and the fees are normally charged to the funeral director who generally passes on the cost to the family.
These fees are agreed with the relevant national associations applicable to funeral directors. Death certificates are a separate form and are completed free of charge.
What notice is required for the completion of reports & letters?
We ask for 4 weeks’ notice although many are completed more quickly.
Where a patient has an urgent request this should be explained to the receptionist who will note the request. However, it is not always possible for other more clinically urgent work to be delayed.
Where a patient has an urgent request this should be explained to the receptionist who will note the request. However, it is not always possible for other more clinically urgent work to be delayed.
Fees List
All charges are inclusive of VAT (*), where applicable.
Copies of Records
| Type of record | Charge | Who normally pays? |
| Computerised records added more than 40 days ago * | First copy: No Charge (if subject to GDPR) Otherwise, £1 per sheet (min £5; max £10) | Patient |
| Computerised Records added within the last 40 days | No charge | n/a |
| Copy of individual letter from the record | No charge | n/a |
| Manual records or a combination of manual & computerised records * | First copy: No Charge (if subject to GDPR) Otherwise, £50 | Patient / employer / insurance company / solicitor |
Certificates, Letters & Forms
| Type of certificate , letter or form | Charge (where there is a range, the doctor will specify the charge) | Who normally pays? |
| Freedom from infection certificate * | £36 (single page) £54 (multiple pages) | Patient |
| Fitness to exercise / travel letter * | £36 (single page) £54 (multiple pages) | Patient |
| Vaccination record | no charge | Patient |
| Holiday cancellation insurance claim form * | £36 (single page) £54 (multiple pages) | Patient |
| Fitness for education / sport * | £36 (single page) £54 (multiple pages) | Patient |
| Private sick note (any sick note within 7 days is private) * | £36 | Patient |
| Claim form (e.g. BUPA, Westfield) * | £36 (single page) £54 (multiple pages) | Patient |
| School fees insurance claim form * | £36 (single page) £54 (multiple pages) | Patient |
| Letter for firearms application or renewal* | £54 | Patient |
| Mental Capacity Assessment | £145 | Patient |
| Completion of Power of Attorney or Court of Protection form * | £200 | Patient / Solicitor |
| Form requiring attendance and/or medical with a GP* | £95 to £145 subject to requirements | Patient |
Travel Vaccinations
Some travel vaccinations are provided free of charge (from your registered GP practice) on the NHS. The following vaccinations are not provided on the NHS, but can be provided on a private basis.
This practice is also able to provide a travel vaccine advice & immunisation service to patients not registered at this practice. Please see the “Fees for patients not registered at this practice” section below.
| Vaccination | Number of injections | Cost of vaccination course |
| Hepatitis B * | 3 injections per course | £90 |
| Japanese B Encephalitis * | 2 injections per course | £160 |
| Meningitis A & C * | 1 injection | £40 |
| Rabies * | 3 injections per course | Private prescription or £135 |
| Tick Borne Encephalitis * | 3 injections per course | £115 |
| Yellow Fever | Not available |
Driving
| Type of report / form | Charge | Who normally pays? |
| Full medical & report (HGV, PSV, PCV, LGV) * | £145 | Patient or employer |
| Local Authority PCV / LGV report * | £90.50 | Local Authority |
| Report (no examination) * | £95 | Patient or employer |
| Report to DVLA (with examination) * | To be determined by the DVLA | DVLA |
| Report to DVLA (no examination) * | To be determined by the DVLA | DVLA |
Employment
| Type of report / form | Charge | Who normally pays? |
| Form (no examination)* | £95 | Employer |
| Form (including examination)* | £145 | Employer |
| Short Report (single sided) * | £120 | Employer |
| Longer Report (2 or more pages) * | £150 | Employer |
| Patients should ask their employer to write to the surgery with specific questions. Employers will need to gain written consent from the patient. In the unlikely event that patients need to seek their own report at their own cost for employment purposes, then the charge will be £95* | ||
Adoption & Fostering
Adoption fees are normally paid by the parent(s); fostering fees are normally paid by the NHS, but sometimes paid by the adoption / fostering agency.
| Type of report / form | Charge |
| Form IHA (Initial Health Assessment) | £58.12 |
| Forms M, B – Obstetric Neonatal Reports | £44.95 |
| Forms C, D, YP, AME – Full examination of child | £97.91 |
| Form AH – Health Assessment for a prospective carer | £73.86 |
| Form AH2 – Update report | £24.36 |
| Childminder OFSTED health declaration form | £84.50 |
| Examination of child in care: First examination Subsequent examination | £37.99 £24.36 |
| Freedom from infection for children in care | £24.36 |
Attendance Allowance & Disability Living Allowance
Normally paid by the Department for Work & Pensions (DWP)
| GP factual report * | £40.20 |
| Form DS1500 * | £21.00 |
Insurance Company Reports
Normally paid for by the insurance company, but occasionally by the patient (check individual policy).
| iGPR report | £95 / £125 (Depending on size) |
| Paper based report / eGPR | £120 |
| Follow up information request | £56 to £120 depending on nature of request |
| Charitable organisation / ATOS etc | Charge determined by requesting organisation |
Fees for patients not registered at this Practice
Travel vaccines
Patients are able to attend their registered GP practice for most travel vaccines and the majority of these are offered free of charge on the NHS.
Please see the “Travel & Occupational Health Vaccinations” section above for more details.
If you are unable to source travel vaccinations from your local registered practice, we are able to offer the following vaccinations on a private basis:
| Travel vaccinations (some vaccinations require a course of 3 injections). Please note we do not provide yellow fever vaccinations * | Cost of the vaccine plus an administration charge of £15 per injection |
Operations & Procedures
These are applicable to clients who are NOT registered patients of The Valleys Medical Partnership.
No private consultations or private operations are offered to registered patients.
The costs exclude the costs of medicines, laboratory / histology.
| Cryotherapy of warts, verruca etc. * | £60 per 10-minute session |
First Contact Physiotherapy Services
Have a musculoskeletal problem and want to speak to someone at the surgery?
Initially you are likely to be directed to one of our First Contact Physios (FCPs) who are experts at diagnosing and treating these problems and have the ability to refer you on for further tests if necessary.
We’d encourage all of our patients to engage with them as outcomes have been shown to be better than speaking to a doctor first!
Musculoskeletal First Contact Practitioners (FCPs) work alongside your GP and Nurse Practitioner as part of the General Practice team.
They are Physiotherapists with advanced skills that provide expert assessment for people with injuries to bones, muscles and joints, or longer-term conditions like low back pain, neck pain and arthritis.
The FCPs will diagnose what is happening and give expert advice on how to best manage your condition. They may also refer you on for a course of Physiotherapy treatment, to other specialist services or for investigations such as X-rays, MRI scans and blood tests if necessary.
- You can book to speak to our FCPs directly, without the need to see a GP, by contacting your practice’s reception.
Citizens Advice Bureau
The Citizens Advice Bureau offers a service to patients of our practice.
This service is available on Wednesday mornings for patients registered at both practices and appointments are usually at the Gosforth Valley site.
Citizens Advice also offers appointments at other venues in Dronfield and Eckington please see the website for more information.
Minor operations
The surgery runs a comprehensive minor surgery service.
We perform:
- Injections for a wide range of musculoskeletal conditions.
- Aspirations for certain cysts.
- Cryo-cautery (freezing) for suitable skin lesions.
- Incisions for drainage of abscesses, haematomas and some cysts.
- Excisions for certain skin and subcutaneous conditions (“lumps & bumps”).
Please note: We are no longer funded for cosmetic procedures, in line with the East Midlands Adult Cosmetic Procedures Policy. This applies to both cryotherapy (freezing) and minor operations. If we are unable to provide the service, we are able to provide contact details for local private providers.
Travel Vaccinations
Please contact the practice to book an appointment with our practice nurse for advice about immunisation and avoiding tropical illnesses.
Please get advice as soon as you have booked your holiday.
If you require any vaccinations relating to foreign travel you need to make an appointment with the practice nurse to discuss your travel arrangements. This will include which countries and areas within countries that you are visiting to determine what vaccinations are required.
Further information about countries and vaccinations required:
It is important to make this initial appointment as early as possible – at least 6 weeks before you travel – as a second appointment will be required with the practice nurse to actually receive the vaccinations. These vaccines have to be ordered as they are not a stock vaccine. Your second appointment needs to be at least 2 weeks before you travel to allow the vaccines to work.
Some travel vaccines are ordered on a private prescription and these incur a charge over and above the normal prescription charge. This is because not all travel vaccinations are included in the services provided by the NHS.
- If you are travelling to Europe the EU has published useful information for travellers on the European website.