NHS - Northwest Merton Primary Care Network


Contents Your PCN 2 Cancer 6 Your Health 10 Musculoskeletal 13 Childhood Immunisations 17 Diabetes 18 Cardiovascular Health 19 Social Prescribing – Mental Health 23 Home Visiting Service – Paramedics 24 Directory Of Services For Self-Referral 25 Your PCN Primary Care Networks (PCN) are groups of GP surgeries, located within close proximity to each other, who work together to better meet the needs of their local population. As well as working together, they form close working relationships with community, pharmacy, hospital, social care, mental health and voluntary services enabling a more tailored and coordinated approach to your care. Your local Primary Care Network is called Northwest Merton PCN. Led by our 2 jointly appointed clinical directors, we are made up of the following surgeries serving a population of just over 35,000 people: Alexandra Surgery Vineyard Hill Road Surgery Wimbledon Medical Practice Wimbledon Village Surgery Dr Tim Hodgson Dr Pete Brown

PARAMEDICS We have collaborated with our GP Federation and the London Ambulance Service to create an environmentally sustainable bicycle-powered home visiting service provided by paramedics on behalf of our GPs. DEDICATED CLINICAL PHARMACIST We have sourced a clinical pharmacist who works across our practices to review patients on multiple medicines as a result of complex medical needs. SOCIAL PRESCRIBING Our social prescribing link workers help promote health and wellbeing, enable access to holistic services and facilitate people to prioritise their own wellbeing. ACCESS We have provided additional appointment capacity across the PCN and outside of core surgery hours, in the form of face-to-face, telephone and online consultations. Impact Being part of a local network in this way means practices can remain small enough to provide individualised care whilst proactively offering larger economies of scale, through pooling together services or resources. For example, we share staff and can provide you with greater access to GP services by offering you appointments across multiple sites and times. Some of our Initiatives So Far Include… 3 Northwest Merton PCN: The Green Pages

COVID-19 VACCINATION CLINICS Our clinical directors have led teams of vaccination centre staff across Merton Hubs to ensure the swift roll out of essential vaccines at a large scale and our staff have worked tirelessly for the protection of local communities. So What’s Next…? COLLABORATION We are developing a joint Patient Participation Group (PPG) across our member surgeries to enable inclusive and consistent feedback. STAFF We continue to explore how to creatively engage periphery roles to support us with our work. PROJECTS We continue to explore innovative projects to ensure inclusive access to GP services and to promote the health and wellbeing of all community groups within our PCN patch. 4

Information about this booklet Communication The aim of this booklet is to raise awareness of how your PCN is working for you. As a network we are committed to helping our cohort of patients live healthier lives. This booklet is full of useful and easy to digest information relating to: • primary care, social and community services that are available to you • local treatment pathways • medical hot topics & self-help guides It is our intention for these to collectively enable and empower you to seek the right help when or should you need it. This brochure is available in a range of languages from our practice websites. It can also be made available in Braille upon request. With best wishes, Your PCN Team Please note that the information in this publication was correct at February 1st 2023. The websites shown throughout, direct you to their main landing pages. In some instances you will need to navigate to find the information specific to your local area. KEY Website Telephone Email 5 Northwest Merton PCN: The Green Pages

STATS: In the UK, around 360,000 people are diagnosed with cancer every year and it is estimated that 1 in 2 people will develop some form of cancer during their lifetime. There are over 200 types of cancer, each with its own treatment. HEALTH PROMOTION: A number of factors can affect the risk of developing cancer such as; genetics, poor immunity, lifestyle and the environment. Whilst it is not possible to control all risk factors, it is important to lower the risk of exposure to cancer by adopting a healthy lifestyle: Cancer: INTRO: Cancer is a disease caused by the uncontrollable growth and division of cells, which are the building blocks of the body’s tissues and organs. As cancerous cells spread, they can impact surrounding healthy tissue and form a tumour. Not all tumours are cancerous but some cancerous cells can be transported through blood or the lymphatic system to affect healthy tissue in other parts of the body. Giving up smoking Adopting a balanced diet Using sun protection Keeping to a healthy weight Increasing physical activity Limiting alcohol consumption 6

SCREENING PROMOTION: Cancer screening is a test that looks for early signs of cancer in people without symptoms. It can help spot cancers at an early stage, when treatment is more likely to be successful. For example, cervical screening can even prevent cancer from developing. In the UK, there are 3 screening programmes, bowel cancer screening, breast cancer screening and cervical cancer screening. Bowel cancer screening: A kit called a ‘FIT test’ (faecal immunochemical test) checks for hidden blood in stools. Anyone aged 60 to 74, living in England and registered with a GP is sent this simple home screening kit every 2 years until they reach 75. Thereafter, there is a freephone to order kits: 0800 707 6060. The current bowel cancer screening programme is being extended in phases to those under 60. Breast cancer screening: A mammogram is an X-ray that looks for any cancerous masses in the breast tissue which may be too small to notice. Anyone aged 50 to 71 and registered with a GP as female, is invited by letter every 3 years until they reach 71. Thereafter, local screening units can be contacted for appointments every 3 years. Cervical Cancer screening: A smear test checks the health of the cervix which is the opening to the womb. All women and people with a cervix and registered with a GP, are invited by letter every 3 years if they are aged 25 to 49 and every 5 years if they are aged 50-64. Thereafter the risk of cervical cancer is very low. 7 Northwest Merton PCN: The Green Pages

CANCER SCREENING IS FOR PEOPLE WITH NO SYMPTOMS AT ALL. If you have symptoms, don’t wait for a screening invitation – tell your doctor as soon as possible. See below for key signs and symptoms: Croaky voice, hoarseness or a cough that won’t go away Mouth or tongue ulcer that lasts longer than three weeks Coughing up blood Breathlessness Difficulty swallowing Persistent heartburn or indigestion Appetite loss Persistent bloating Very heavy night sweats Appetite loss Fatigue Unexplained weight loss An unexplained pain or ache An unusual lump or swelling anywhere on your body A new mole or changes to a mole A sore that won’t heal Unusual changes to the size, shape or feel of a breast, including nipple or skin changes A change in bowel habit, such as constipation, looser poo or pooing more often Blood in your poo Unexplained vaginal bleeding, including after sex, between periods or after the menopause Blood in your pee Problems peeing These are some of the key signs and symptoms of cancer. But if something’s unusual for you, it’s best to tell your doctor – even if it’s not on this list. Image from the Cancer Research UK website: earth-europe cancerresearchuk.org/about-cancer/cancer-symptoms 8

NHS information: earth-europe nhs.uk/conditions/cancer MacMillan Cancer Support: earth-europe macmillan.org.uk Support line: 0808 808 00 00 MacMillan Butterfly Centre at Epsom Hospital: Opening Hours: Tuesday – Friday 9.30 am – 4.30 pm 01372 735 456 earth-europe epsom-sthelier.nhs.uk/cancer-information-and-support-centres Cancer Research UK (CRUK): earth-europe cancerresearchuk.org 0808 800 4040 Bowel Cancer Screening: Useful website: earth-europe nhs.uk/conditions/bowel-cancer-screening Helpline: 0800 707 6060 (and to order FIT tests if aged over 75) Breast Cancer Screening: Useful website: earth-europe london-breastscreening.org.uk – click on appointments L ocal Screening Unit: The Rose Centre, St George’s Hospital Local Screening 0203 758 2024 (Mon – Fri 8 am – 7 pm, Sat & Sun 8 am – 4 pm (excluding bank holidays) Cervical Cancer Screening: Useful website: earth-europe nhs.uk/conditions/cervical-screening Prostate Cancer Screening: Useful website: earth-europe prostatecanceruk.org Useful Links: Below is a list of some organisations where you can get further information or seek help 9 Northwest Merton PCN: The Green Pages

Your Health Introduction: Comorbidities exist when a person has more than one long term disease and condition they are trying to manage. Comorbidities that exist in the population are heart diseases, high blood pressure, diabetes, respiratory diseases, mental health including dementia, joint disease and cerebrovascular disease. These are often managed by many medicines (often more than 4 or 5) and this is an example of polypharmacy. Comorbidities and polypharmacy coexist due to a rise in aging population or where patients are living with several long term conditions that can be compounded by disability and/or frailty. It is essential for polypharmacy patients to receive a medicines review which is recommended to be carried out at least once or twice per year. The purpose of a medicines review is to check whether the medicines prescribed are taken correctly and at the right intervals. It also reviews their optimisation for each patient to evaluate effectiveness on quality of life and mortality. HEALTH PROMOTION: Health promotion and disease prevention within an aging population early on is not only beneficial for the individual but also for the growing population and the NHS. The main focus of programmes like these is to keep people healthy and to provide opportunities to empower individuals to choose healthy behaviours and to make informed changes to reduce the risks of developing chronic long term diseases. 10

LOCAL SERVICES: There are many providers and easily accessible sources of information for the prevention and management of comorbidities. One example within the South West London region, is a structured educational programme called The Prevention Decathlon aimed at helping people avoid being diagnosed with preventable long-term conditions such as diabetes and cardiovascular disease. Specifically, the Diabetes Prevention Decathlon (DPD), is a ten week self-referral programme which provides a holistic approach and physical activity sessions for participants via either face to face or virtual offerings. There are many similar programmes offered throughout South West London, many of which are accessible via selfreferral, provide interactive supportive groups and available in multiple languages. Please see earth-europe tinyurl.com/222c94v8 for more information. Mental health has been a rising concern especially during Covid-19 pandemic and after. For adult residents of Kingston, Merton, Richmond, Sutton and Wandsworth who are experiencing difficulties with their mental health and feel unable to cope, there are 2 local mental health recovery cafés in South West London offering safe, inclusive, free and welcoming spaces. Both cafés offer a walk in service with no need for an appointment. You will be met by friendly people who will provide not only a listening ear but also companionship and an opportunity to attend therapeutic support groups and sessions – more detailed information is available online at earth-europe tiny.cc/klt2vz Sunshine Recovery Café 296a Kingston Road, SW20 8LX 07908 436 617 [email protected] Opposite Wimbledon Chase Train station and accessible by a range of bus routes Some other helpful resources include Merton Uplift (self-referral), Merton CAMHS (for young people and adolescents) and NHS-Go Wellbeing app (16 – 25 year olds). The following page outlines a list of other helpful resources / services throughout South West London: 11 Northwest Merton PCN: The Green Pages

Think Action – Offers a wide range of treatments and talking therapies that will support you to understand and manage your mental health problem. [email protected] 020 3823 9063 Getting It On – Information and services for 13-19-year-olds on sexual and mental health issues, drugs and alcohol and relationship problems. earth-europe gettingiton.org.uk Talking Therapies – Merton offers a range of psychological therapies including cognitive behavioural therapy and mindfulness. You can self-refer online or speak to your GP for a referral earth-europe mertonuplift.nhs.uk/ psychological-therapies 020 3513 5888 Address: Generator Business Centre, Miles Road, Mitcham, CR4 3DA One You Merton – Friendly local support to help you eat well, move more, stop smoking or drink less. earth-europe oneyoumerton.org 020 8973 3545 YMCA – An Exercise Referral programme is a structured 12-week exercise programme that offers a series of one-to-one sessions with a qualified exercise specialist. Criteria – 16+, live or work in Merton, exercise less than 30mins per week, have a health condition (physical or mental) or health is at risk due to your weight. earth-europe ymcastpaulsgroup.org/exercisereferral-programme YMCA Wimbledon 200 The Broadway Wimbledon SW19 1RY 020 8542 9055 [email protected] YMCA John Innes Youth Centre 61 Kingston Road Wimbledon SW19 1JN 020 8542 9055 [email protected] Y:Cube Mitcham George William Court Clay Avenue Mitcham CR4 1BB 07826 944272 [email protected] Health Watch Merton – Provide support and information to patients via support groups – who have Diabetes or in the Pre – Diabetes stage 020 8685 2282 Address: Healthwatch Merton, Vestry Hall, London Road, Mitcham CR4 3UD [email protected] LiveWell – Healthy lifestyles services in Merton They provide the majority of services for cardiovascular disease primary prevention, with services including smoking cessation, weight loss, physical activity and others. Interested individuals can self-refer to see a health advisor who can give general advice on becoming healthier and set personal health-related goals. They can give advice on a healthier diet, cutting down on alcohol, mental well-being and stress reduction techniques, increasing physical activity and weight loss. earth-europe nhs.uk/live-well 12

WHAT IS A FIRST CONTACT PRACTITIONER? FCPs are specialised physiotherapists with advanced clinical practice skills who are able to assess, diagnose, treat and discharge patients without medical input for a wide variety of MSK problems. The idea of the FCP service within our PCN, is that patients with MSK problems get access to quality care within days of contacting the GP surgery that improves their recovery and that the wait times to see our GPs are reduced as a result. WHAT DOES THE FCP SERVICE INVOLVE? An FCP session firstly involves assessing and diagnosing the patient’s presenting problem. From this the FCP will be able to provide self-management advice (including a home exercise program) and referral onto the NHS physio team if additional physiotherapy services or follow up appointments are required. An FCP can also refer to secondary care (specialist) services and send for further diagnostics (including MRIs and blood tests) if indicated. WHAT DOES THE FCP SERVICE NOT INVOLVE? The FCP service does not involve hands on treatment (massage/manipulation), however our FCPs have knowledge of private services and companies within the local community and this allows them to provide expert recommendations if they feel this form of treatment will facilitate recovery. BACKGROUND (MSK PROBLEMS WITHIN GENERAL PRACTICE) In the UK, musculoskeletal (MSK) problems are predominately managed in primary care, accounting for approximately 14% of General Practitioner (GP) Consultations. The First Contact Practitioner (FCP) role has been introduced to enhance care for patients with MSK problems, to increase capacity within GP surgeries and to improve access to primary care services. Musculoskeletal 13 Northwest Merton PCN: The Green Pages

An FCP also cannot prescribe medication, however because of their excellent relationship with GPs and knowledge of pharmacology, patients can gain faster access to medication following an FCP session if indicated. WHY SEE AN FCP INSTEAD OF A GP? Around 20% of people see a doctor presenting with neck, back, joint or muscle problems and they will often have to wait for a GP referral to get access to community physiotherapy services to manage their condition. By booking in within days and having early input from an FCP, the patient avoids these long waits and is statistically given the best possible chance of recovery and a smoother journey through the NHS MSK Pathway. HOW DO I BOOK IN TO SEE AN FCP? To book an appointment with an FCP, the patient simply needs to speak to reception at their respective GP surgery. The adjoining diagram can assist the patient when deciding whether they should be seeing an FCP or GP. GPs are also able to refer patients to an FCP, and work hand in hand with the FCP for many MSK cases. The option to see a doctor for MSK problems is always an option still given to the patient. HOW DO FCPS INTEGRATE WITH THE REGULAR NHS MERTON PHYSIOTHERAPY SERVICE? Our FCPs have an excellent relationship with the NHS physiotherapy service ‘Connect Health’ who are usually based at the Nelson Health Centre. They offer telephone, video and face to face appointments. Many patients will often begin with FCP management, and continue with the NHS physio team if additional treatment is needed. They have a self-referral system, which can either be used via telephone or manually through their website and our FCPs or GPs are able to contact them if needed. The patient journey Do you have a problem that affects your neck, back, bones, joints or muscles? YES NO Book with GP NO YES Book with GP NO Book with GP YES Book with FCP Are you feeling unwell at the moment? Would you be happy to see a physiotherapist rather than the GP? 14

REDUCTION IN MSK FOLLOWING FCP CARE Follow-up response rates at 1, 2 and 3 months were 63%, 62% and 54% respectively Global change in MSK symptoms (defined as better/much better) since patients first saw the FCP increased slightly from 58% at month 1 to 64% at month 3 There was a 2.8 mean reduction in pain intensity from baseline PATIENT’S EXPERIENCE Patient acceptability of FCP was very high; 98% of responding patients reported having confidence in the FCPs competency to assess their problem 95% reported receiving sufficient information about self-care 93% reported receiving sufficient information about their MSK condition Patients reported feeling valued as individuals with regards to ‘care and respect’ from general practice staff and ‘understanding and engagement’ of their problem by the FCP. The link to their website is earth-europe connecthealth.co.uk/services/merton 15 Northwest Merton PCN: The Green Pages

NORTHWEST MERTON FCP BIO – LACHLAN KERN Lachlan is an Australian trained Musculoskeletal Physiotherapist at Surrey Physio, who has been working as our PCN’s First Contact Practitioner since September 2020. Lachlan currently works across Northwest Merton PCN at Wimbledon Village Surgery, Wimbledon Medical Practice, Alexandra Surgery and Vineyard Hill Road Surgery. He is also the Clinical Lead for all FCPs in the Merton Integrated Care Board. This involves educating and mentoring other physiotherapists and networking with an array of other health care professionals and NHS services to optimise FCP care across Merton. Outside of physiotherapy… Lachlan is a keen tennis player, a Liverpool FC/Aussie sports fanatic and is passionate about world travel. 16

Immunisation is the safest way of protecting children against serious diseases. Some diseases can kill children or cause lasting damage to their health. Immunisation prepares children’s bodies to fight off diseases if they come into contact with them. Vaccines stimulate the body to produce antibodies that fight infection. Immunisation is also known as ”vaccination”, “jab” or “injection”. The Routine UK Immunisation programme starts at eight weeks old and continues into school until the age of around thirteen. The BCG can however be given from birth in the hospital or a local clinic if your baby is eligible. The Practice Nurse at your GP surgery will administer most immunisations and then the School Immunisation team take over when your child starts school. Your Practice Nurse, GP, Midwife, Health Visitor and School Immunisation Nurse are there to answer any questions you may have regarding any childhood immunisation. Unless vaccine uptake remains high, many of the serious infections diseases we no longer have, will return from parts of the world where they still occur. If this happens, then children living locally that are not vaccinated will be at risk if these infections, their complications and even death. There are vaccines to protect children against: Meningitis, whopping cough, measles and flu to name a few. The full UK Childhood schedule can be accessed here: earth-europe tiny.cc/ult2vz Childhood Immunisations LOVE THEM, PROTECT THEM, IMMUNISE THEM! 17 Northwest Merton PCN: The Green Pages

The job of insulin is to allow the glucose (sugar) in our blood to enter our cells and fuel our bodies. Because the insulin isn’t working properly the sugar levels keep rising when we eat carbohydrate foods and sugary drinks. Continuous high glucose levels in your blood can cause complications for your heart, kidneys, eyes and feet. The main two types of diabetes are type 1 & 2. It is type 2 that is on the increase and accounts for about 90% of all diabetes cases. It also costs the NHS £25,000 per minute in treating the complications caused by it. Your age, ethnicity, family history, medical conditions and weight may increase your risk. The good news is that you can help yourself to manage your blood glucose levels and lower your risk of heart disease and maybe the need to take medication. Your GP, Practice Nurse, and Local Diabetes Specialists are all here to help. Treatments include eating healthy food, being active by increasing exercise and maintaining a healthy weight and of course not smoking. Medications can be taken by tablet and if needed insulin injections. Structured education is also recommended and Diabetes UK state that “Evidence shows that people who access education and support are more likely to achieve their goals and stick with them”. Diabetes UK is a fantastic long-standing charity for people living with diabetes. Here you will find lots of information with short videos, educational resources, healthy eating tips and interactive tools. On their website is information about two courses DESMOND and X-PERT specifically for people with Type 2 diabetes. Merton has local DESMOND courses which you can attend virtually or face to face. DIABETES INFORMATION Diabetes is a very serious condition when the sugar levels in the blood are too high. This happens because the insulin made by your pancreas can’t work properly or it’s not making enough. Diabetes Do it for life! 18

Your Pharmacy and how they can help improve your Cardiovascular Health There are a variety of ways you can gain support from your local pharmacy or from a pharmacy close by. As qualified healthcare professionals, they can offer clinical advice and over-the-counter medicines for a range of minor illnesses, such as coughs, colds, sore throats, tummy trouble and aches and pains. If symptoms suggest it’s something more serious, pharmacists have the right training to make sure you get the help you need. For example they will tell you if you need to see a GP, nurse or other healthcare professional. All pharmacists train for 5 years in the use of medicines. They are also trained in managing minor illnesses and providing health and wellbeing advice. Hypertension is the main risk factor for stroke and a major risk factor for heart attack, heart failure and kidney disease. People with hypertension are three times more likely to develop heart disease and stroke, and twice as likely to die from these as people with a normal blood pressure. Cardiovascular Health Cardiovascular disease (CVD) is one of the leading causes of premature death in England Affects 7 million people and accounts for 1.6 million disability adjusted life years Hypertension is the biggest risk factor for CVD Top five risk factors for all premature death and disability in England 5.5 million people have undiagnosed hypertension in England CVD is a key driver of health inequalities and accounts for around 25% of the life expectance gap 19 Northwest Merton PCN: The Green Pages

What else can your pharmacy support you with? Many pharmacies are open until late and at weekends. You do not need an appointment. Most pharmacies have a private consultation room where you can discuss issues with pharmacy staff without being overheard. Essential services These are the services that all community pharmacies provide: Disposal of Unwanted Medicines Promoting Healthy Lifestyles S ignposting to other Healthcare Providers Supporting you with self care Dispensing R epeat dispensing (with agreement from your GP) R epeat prescriptions can be issued in 2 different ways: You order the prescription to be approved by a GP each time you need a refill. You order the prescription once and a GP approves a series of refills for you. They are sent to the pharmacy automatically, so you do not need to order them each time. This is called electronic repeat dispensing. The GP surgery or pharmacy will let you know when you need to re-order your prescription. How can community pharmacies help? Pharmacy teams can offer blood pressure testing to a wide range of patient and demographic groups. Community pharmacy-based interventions to prevent, detect and manage hypertension are recommended in national guidance from Public Health England (PHE) and NHS England. Who can have a hypertension check in their local pharmacy? Inclusion criteria Adults aged 40 years and over with no diagnosis of hypertension By exception, younger than 40 years with family history of hypertension (pharmacist’s discretion) Approached or self requested 35-39 years old (pharmacist’s discretion) Adults referred by a general practice Fact: Approximately one third of people with hypertension do not know they have it 20

In both cases, you can: Choose a specific pharmacy (nominated pharmacy) to collect your prescriptions from each time Call or contact the pharmacy online a few days before you run out of medicine to check your prescription is ready to collect Decide each time you’re given a prescription where to collect it You’ll be given a paper copy with a barcode to take to any pharmacy in England, or the pharmacy can find your prescription using your NHS number Advanced services These are the services that most community pharmacies provide: Appliance Use Reviews Community Pharmacy Consultation Service (CPCS) for minor illnesses where you can be sent to see a pharmacist for a consultation either by your practice or via NHS111 Community Pharmacy Consultation Service (CPCS) for an urgent supply of repeat medications via NHS111 Flu Vaccinations Hepatitis C Testing Hypertension Case Finding (as above) New Medicines service (NMS) ask your pharmacist how they can help when you are prescribed new medications for the following conditions – asthma – chronic obstructive pulmonary disease (COPD) – t ype 2 diabetes – h igh blood pressure – p eople who have been given a new blood-thinning medicine Discharge Medicines Service (DMS) providing support to complex patients with their medication post hospital discharge Stoma Appliance Customisation (SAC) Smoking Cessation Sexual health advice and Emergency Hormonal Contraception As part of the repeat prescription service, the pharmacist will ask if you’re having any problems or side effects with your medicines and, where appropriate, they can discuss this with you and your GP. 21 Northwest Merton PCN: The Green Pages

Other services you may get from pharmacies Travel Vaccinations (from those who run travel clinics) Private Vaccinations Holistic health support Wellbeing checks P harmacies can give treatment advice about a range of common conditions and minor injuries, such as: – aches and pains – sore throat – coughs – colds – flu – earache – cystitis – skin rashes – teething – red eye If you want to buy an over-the-counter medicine, the pharmacist and their team can help you choose. Asthma inhaler use and advice Chlamydia screening and treatment Substance misuse service, including needle and syringe exchange schemes Weight management service And a range of other support specific to each pharmacy 22

The Merton Social Prescribing Service celebrated its 5th anniversary in October 2022. We are one of the UK’s longest established SP service and our team of Link Workers supports patients from the 6 Merton PCNs (made up of 22 practices) with non-medical needs. Our colleagues have professional backgrounds in either Psychology, Counselling, Health, Education or Social Care. You can request up to 6 appointments of 60 mins per session with a Link Worker. The Link Worker will provide support and guidance and they can sign post you to hundreds of activities in the community. We are using a person centered & strength-based approach, which means that the service is entirely about your needs and about your preferences. Between April 2021 and March 2022, we have received 2892 new Social Prescribing referrals. The top reasons for referrals have been Mental Health referrals with 1007 referrals and 538 referrals for Social Isolation. We would like to introduce 3 ideas to prevent social isolation, to improve Mental Health and to strengthen community ties. First, spend at least 15 minutes each day talking with or writing to a loved one. 15 minutes doesn’t seem like a lot of time, but when done consistently that small amount of time can make a big difference in how connected we feel. Second, dial down distractions and give undivided attention to people. Refreshing your social media feed or scrolling through emails is obvious to the person you’re speaking with. The quality of our relationships is important. Third, find ways to serve others. We can call a neighbour and check on them to make sure they’re doing okay. We can drop food off to somebody. We can write to people to let them know that we know that they’re going through a tough time and that we’re thinking of them. These are small but powerful ways in which we can seek to serve others. If you need to talk to a Link Worker about any non-medical issues or problems that you may have, please book an appointment today at your Practice. Social Prescribing – Mental Health 23 Northwest Merton PCN: The Green Pages

Aimed to help alleviate some of the pressures GP surgeries are often exposed to, a collaboration with our Federation Merton Health and the London Ambulance Service saw the start of the paramedic home visiting service, currently in its 2nd year of running. Working on rotation and equipped with their medical bags, you may have spotted our paramedics; Ben and Luke, on their e-bikes, travelling door to door up and down the streets of Merton visiting patients within our PCN patch. Here is what Luke had to say about paramedics and the PCN home visiting service: ‘Paramedics are often experienced in acute (conditions that have a sudden onset which are generally managed for a short time) medical care. They are able to perform a complete set of observations, as well as blood tests, to identify red flags that may suggest the need for escalation or further treatment. They have access to referral pathways such as social prescribing, physiotherapy and pharmacists. They are able to collaborate with your General Practitioner (GP) following your assessment to send prescriptions to your nominated pharmacy, however some paramedics are able to independently prescribe. Home Visiting Service – Paramedics If you have an appointment or home visit with a paramedic for an undiagnosed medical issue, you can expect detailed history taking, investigation / assessment and a discussion on your diagnosis and management.’ Our paramedics have been on hand to help assess and treat a range of patients in the community, including; those suffering from long term conditions, vulnerable patients such as elderly / frail patients or those who have recently been discharged from hospital. Once a patient is assessed, they then work with our GPs for appropriate follow up care, onward referral or to assist with existing care plans. Below are some example Age UK Merton activities our paramedics have previously referred to: Mid week lunches earth-europe tiny.cc/7mt2vz Social club (Mondays & Wednesdays) + Craft Club (Tuesdays) earth-europe tiny.cc/8mt2vz Chair based exercise (over zoom Tuesday & Wednesday in person) earth-europe tiny.cc/9mt2vz 24

Directory of Services for Self-Referral Active Signposting Useful Links Merton Directories earth-europe directories.merton.gov.uk MVSC Find a group Online database of information predominantly of local services/activities offered by the voluntary and community sector earth-europe mertonconnected.co.uk Care4me Online database of information predominantly of services/ activities offered by the voluntary and community sector earth-europe care4me.org.uk CarePlace London’s centralised source for care and community services, information and guidance (commissioned by West London Alliance) earth-europe careplace.org.uk HELPLINES Find a local or national approved helpline earth-europe helplines.org/helplines Surrey Info Point Find services across Surrey earth-europe surreyinformationpoint.org.uk Advice Local Find help with benefits, work, money, housing problems and more earth-europe advicelocal.uk Advice Services Citizens Advice Lambeth and Merton earth-europe caml.org.uk Citizens Advice Help to Claim Universal Credit Line Help to Claim service can support you in the early stages of your Universal Credit claim, from the application, through to your first payment. 0800 144 8 444. The information in this publication was correct at February 1st 2023. The websites shown throughout, direct you to their main landing pages. In some instances you will need to navigate to find the information specific to your local area. KEY Website Telephone Email PLEASE NOTE This is only a list of some of the available services in Merton or nationwide. Other services do exist and we recommend that you carry out your own research and choose a service you feel is most appropriate to you. 25 Northwest Merton PCN: The Green Pages

Civil Legal Aid Advice Line To check if eligible for legal aid call: 0345 345 4 345. Open Monday – Friday 9am – 8pm, Saturday 9am – 12:30pm. Calls cost from 4p a minute – or you can ask them to call you back. earth-europe gov.uk/civil-legal-advice South West London Law Centres Offer FREE Legal advice drop in clinics and legal aid to those who qualify. earth-europe swllc.org Find Legal Aid/Family Mediator Find a legal aid adviser or family mediator. earth-europe find-legal-advice.justice.gov.uk Grief Support Grief Support Wimbledon Guild – offers a one-toone service that can help you with advice, information and support pre and post bereavement. earth-europe wimbledonguild.co.uk Cap Debt Advice Debt assistance, money courses, life skills, job club. earth-europe capuk.org/get-help Springfield Law Centre An independent charity providing specialist advice on housing, community care, debt and welfare benefit matters. For benefit advice/ appeals/tribunals contact legal advisor Dennis 0203 513 3931. earth-europe springfieldlawcentre.org.uk MCIL Offer services and opportunities for adults with disabilities and advise and advocacy. earth-europe mertoncil.org.uk Carers Support Merton Support for informal carers. earth-europe csmerton.org SSAFA Provide support with experienced, non-judgemental and friendly advice, as well as a variety of practical services which cover a range of social, family and financial issues. earth-europe ssafa.org.uk/london-south-west Bluecross Vet care and operations offered for FREE (voluntary contributions invited) to people on means tested benefits living in certain postcode areas across Merton. earth-europe bluecross.org.uk/merton SAILINE Seafarers’ Advice & Information Line is the Citizens Advice service just for seafarers. Free advice on benefits, debt, housing and much more. earth-europe sailine.org.uk Advice4renters Advice4Renters (A4R) is the only advice organisation in London for private renters, legal aid and low cost assistance available. earth-europe advice4renters.org.uk Independent Health Complaints Advocacy for people who wish to make a complaint about treatment provided under the NHS. earth-europe nhs.uk – search for advocate. Rights Of Women Our free telephone advice lines have provide advice for women on a range of legal issues including domestic violence, child contact, sexual violence and the criminal justice process and immigration and asylum as well as other legal issues arising from relationship breakdown. earth-europe rightsofwomen.org.uk/get-advice Taxaid Free confidential advice on tax to people on low incomes about issues such as tax debt or self-employment. earth-europe taxaid.org.uk 26

Transport For All Accessible Transport advice line for disabled and elderly, advice and application form for Freedom Pass, Blue Badge or Dial-a-Ride. Making Appeals if an applications is turned down, Making a complaint about problems you are facing while travelling, Help with planning your journey around London. earth-europe transportforall.org.uk Fosterline Fosterline is free, confidential, impartial and supportive for Foster Carers and anyone thinking of becoming one. earth-europe fosterline.info TFL Sarah Hope Line Offer comprehensive help and support to anyone who has been bereaved or sustained life changing injury through an incident involving Transport for London services. earth-europe tfl.gov.uk – and search for ‘Incident support service’ Elder Abuse Freephone helpline, which provides information, advice and support to victims and others who are concerned about or have witnessed abuse, neglect or financial exploitation. 080 8808 8141. earth-europe wearehourglass.org Disability Law Service Provide free legal advice to people with disabilities & MS and their carers to ensure that they have access to their rights and justice. They advise on community care, employment, housing and welfare benefits. earth-europe dls.org.uk ESOL & Immigration Learn English Together Information about all the free and paid-for English classes in Merton. Helping to assess level of English and identifying the right class. earth-europe learnenglishinmerton.org Migrant Families Network Tool to find out if a person can use social service, apply for benefits and seek legal advice. earth-europe migrantfamilies.nrpfnetwork. org.uk Migrant Help Asylum seekers helpline and Home Office funding to support vulnerable EU citizens to apply for settled or pre-settled status. earth-europe migranthelpuk.org CARAS CARAS is a community outreach charity based in Tooting. We support people of refugee and asylum-seeking background who live in South-West London. Mainly women. earth-europe caras.org.uk South London Refugee Association (SLRA) Provide expert advice, specialist services and effective support to refugees, asylum seekers and vulnerable migrants in South London. Also provide free ESOL classes and activities for asylum seekers. earth-europe slr-a.org.uk 27 Northwest Merton PCN: The Green Pages

Migrant Women’s Rights Service This is a confidential advice service for those working with vulnerable migrant women they are unable to provide advice to individual women. Provide advice on the housing and support options for all migrants, refugees and asylum seekers, including women who have overstayed their visas – ONLY FOR PREGNANT WOMEN AND NEW MOTHERS. earth-europe maternityaction.org.uk/ migrant-womens-rights-service Find Immigration Adviser immigration advice if you need help with getting permission to stay in the UK. earth-europe gov.uk/find-an-immigrationadviser Visa and Immigration info to work study and live in the UK. earth-europe gov.uk/browse/visasimmigration Employability and Volunteering Better Working Futures Reed in Partnership Health & Work Programme, Social Prescribing Coordinators can directly refer to this programme as referral partners – Merton, Sutton, Kingston, Richmond & Croydon areas. earth-europe betterworkingfutures.co.uk Find Your Job Centre Search for your local job centre. earth-europe find-your-nearest-jobcentre. dwp.gov.uk National Career Service Information, advice and guidance to help you make decisions on learning, training and work. earth-europe nationalcareers.service.gov.uk Job Centre – Job Match Use the ‘Find a job’ service to search and apply for jobs. earth-europe gov.uk/find-a-job Love London Working Employability project for residents for anyone over 16 who is unemployed. earth-europe lovelondonworking.com Working For Carers Working for Carers is a London-wide project that supports unpaid carers, aged 25 or over, to move closer to employment. earth-europe camdencs.org.uk AIM4WORK A FREE specialist employability programme for people with common mental health conditions living in South London, North London and East London. Website needs to be updated, Aim4work has been extended for an additional 2 years from March 19. earth-europe shaw-trust.org.uk ACAS Acas (Advisory, Conciliation and Arbitration Service) provides free and impartial information and advice to employers and employees on all aspects of workplace relations and employment law. earth-europe acas.org.uk Access To Work Provides advice and support to overcome employmentrelated obstacles. It can award funding approval towards additional barriers to employment due to disability or long term health condition. earth-europe generate-uk.org/service-2/ access-to-work 28

Peer Circles Offers practical and emotional help to reduce social isolation, build skills and confidence, and work towards employment, Social Prescribing Coordinators can refer to this programme. earth-europe stgilestrust.org.uk/page/peercircles DO-IT Find a volunteering opportunity near you. earth-europe doit.life/volunteer Activities / Practical Support Merton Vision A range of support services and activities for people in Merton who are partially sighted or blind. earth-europe mertonvision.org.uk Wimbledon Guild Host and offer a wide range of services from counselling, to activities and befriending. earth-europe wimbledonguild.co.uk AGE UK Merton A range of services and activities for older people. earth-europe ageuk.org.uk/merton Merton And Morden Guild Activities for older people. earth-europe en-gb.facebook.com/ mandmguild Volunteer Merton Volunteering Opportunities in Merton and beyond. earth-europe mertoncommunityhub.org.uk Merton Mencap Providing support and services for children, young people and adults with a learning disability and their family carers in the London Borough of Merton. earth-europe mertonmencap.org.uk Merton Library Activities Events and activities across Merton Libraries. earth-europe libraries.merton.gov.uk Cycling Instructor – Bikeability FREE Cycle lessons or courses for adults & children in Merton & Croydon. Cycling Instructor provides a range of cycling services in London for all levels and bicycles, cannot ride a bicycle to experienced cyclists. earth-europe cyclinginstructor.com NEMCA North East Mitcham Community Association – Activities for all ages from babies to senior citizens and everyone in between. earth-europe nemca.org.uk Merton Home Tutoring Offer free English lessons in and around Merton for people who are not able to get to formal college classes, because of cost, family situation or disability. earth-europe mhts.org.uk MUSHKIL AASAAN Mushkil Aasaan is a care agency that offers care services to people at home as well as counselling in a range of languages including Urdu, Gujarati and Somali just to name a few. earth-europe mushkilaasaan.com South Wimbledon Community Association Activities, toddler and children groups, Martial arts, senior citizens, faith groups and Weightwatchers. earth-europe southwimbledoncommunity.com South London Cares Social activities and befriending, matching elderly and young people together in Southwark & Lambeth. earth-europe southlondoncares.org.uk/activities 29 Northwest Merton PCN: The Green Pages

Vision Housing (Forward Trust) To provide housing and on-going support to ex-offenders on release from prison. Vision Housing helps ex-offenders find homes in the private rented sector. earth-europe forwardtrust.org.uk Muslim Women in Merton Social group – Provides a platform for Muslim women to be heard, represented and contribute their skills, experience and knowledge for the benefit of the community. earth-europe muslimwomenmerton.com Families Merton Family Services Directory For information on services for children, young people, parents, carers, professionals and practitioners. earth-europe directories.merton.gov.uk Merton Council Needs Assessment Getting the help and support for people with medical and care needs and their carers. earth-europe directories.merton.gov.uk – click ‘Adult Support Services Directory’ then ‘Adult Social Care Support’. Merton Grow Baby Merton Growbaby provides new and secondhand, baby clothes and equipment (up to 5 years), free of charge to anyone who needs it, regardless of income, background, or faith. earth-europe mertongrowbaby.co.uk Local Mums Local Mums Online is packed with information and support for local mums in Surrey and SW London. earth-europe localmumsonline.com Homestart Merton Parent volunteers offer regular support, friendship and practical help to families with at least 1 child under the age of 8, in their own homes, helping to prevent family crisis. earth-europe homestartmerton.co.uk Healthy Start Healthy Start is a UKwide government scheme to improve the health of low-income pregnant women and families on benefits and tax credits. earth-europe healthystart.nhs.uk JIGSAW 4U Children’s charity with links in schools across Merton and Sutton and post/pre-bereavement support for children. earth-europe jigsaw4u.org.uk Young Minds Support for children, adolescents up to 25 and their parents. earth-europe youngminds.org.uk ACCA Free ESOL classes, women’s support groups, homework club, volunteer placement, advice support and many more. earth-europe acaa.org.uk National Autistic Society Directory Support and resources for parents of autistic children. earth-europe autism.org.uk AL-ANON UK Al-Anon Family Groups UK is there for anyone whose life is or has been affected by someone else’s drinking. earth-europe al-anonuk.org.uk Grandparents Plus Advice and support for grandparents and kinship carers, also peer support/ listening ear service available: 0300 123 7015. earth-europe grandparentsplus.org.uk 30

MIND THE DAD Provide free online support either with your baby or in virtual groups, where you can meet other dads in similar situations, at flexible hours (including evenings and weekends). earth-europe annafreud.org – search for ‘mind the dad’ FOSTERLINE Fosterline is free, confidential, impartial and supportive for Foster Carers and anyone thinking of becoming one. earth-europe fosterline.info SIBS Brothers and sisters of disabled children and adults. earth-europe sibs.org.uk LGBTQ free2b-alliance Free2B Alliance is a London based Community Interest Company, supporting LGBTQ+ young people and parents. earth-europe free2b.lgbt Mental Health WDP Merton Integrated, recoveryfocused service: free and confidential treatment and support for individuals and their families affected by drug and alcohol problems. earth-europe wdp.org.uk/merton Merton Uplift – Wellbeing Workshops Wellbeing workshops open to anyone registered with a Merton GP – booking via Eventbrite. earth-europe eventbrite.co.uk – search for Merton Uplift. Sunshine Recovery Cafe Open to adults in South West London (18+) who perceive themselves, or are at risk of moving into mental health crisis. It offers a constructive and non-clinical alternative to A&E or admission to hospital. earth-europe cdars.org.uk Raynes Park Bereavement Listening service for people affected by bereavement (not counselling). earth-europe mertonconnected.co.uk/rpbs Cruse Bereavement Support, advice and information when someone dies. earth-europe cruse.org.uk OASIS OASIS is an NHS mental health service for young people in South London. Accepting referrals for people who: Live in the boroughs of Southwark, Lambeth, Croydon, Lewisham 14 – 35 years old. earth-europe meandmymind.nhs.uk Lambeth And Southwark Mind Lambeth Southwark Mind. earth-europe lambethandsouthwarkmind. org.uk Victim Support Help people feel safer and find the strength to move beyond crime. The support is free, confidential and tailored to your needs. earth-europe victimsupport.org.uk Young Minds Support for children, adolescents up to 25 and their parents. earth-europe youngminds.org.uk Focus 4 1 MH support group meeting every Tuesday for BAME at Vestry Hall and other projects. earth-europe focus-4-1.co.uk 31 Northwest Merton PCN: The Green Pages

Recovery College MH workshops and courses at Vestry Hall – Anyone with an SM4/ SM5 postcode in primary care can access RC (part of Sutton Uplift), other patients in Merton will need to be in secondary care. earth-europe swlstg.nhs.uk Counselling Merton Uplift – IAPT Free integrated Primary Care Mental Health service for anyone living in Merton or registered with a Merton GP (+18) earth-europe mertonuplift.nhs.uk Relate Services include counselling for couples, families, young people and individuals, sex therapy, mediation and training courses. earth-europe relate.org.uk The Spark The Relationship Helpline is for those in relationships, parents, families call free on 0808 802 2088 from 11am until 2pm, Tuesdays and Wednesdays, confidential advice on your relationships. (based in Scotland). earth-europe thespark.org.uk Marriage Care Relationship support services including couples counselling, relationship and marriage preparation. No fixed charge, contribution-based. earth-europe marriagecare.org.uk Off The Record Free and confidential counselling to young people aged 11 – 18 in the Borough of Merton and online counselling for young people aged 14 – 18. earth-europe talkofftherecord.org/merton SPECTRA Spectra trans counselling service offers a safe, trans-inclusive space to discuss and explore your thoughts and feelings and find a way forward. earth-europe spectra-london.org.uk MS UK counselling 6 sessions of telephone counselling (50 mins). earth-europe ms-uk.org/counselling Options Wimbledon Options Wimbledon Pregnancy Resource Centre provides free confidential counselling for all issues related to pregnancy. earth-europe pregnancychoicesdirectory.com/ centres/london-wimbledon IESOHEALTH On-line Computerised CBT (Referral via Merton Uplift). earth-europe iesohealth.com Freedom from Torture Counselling for torture and war survivors. earth-europe freedomfromtorture.org PTSD resolution Providing counselling for former armed forces, reservists & families. For free, immediate, local help ring: 0300 302 0551. earth-europe ptsdresolution.org Petals Baby loss counselling charity. earth-europe petalscharity.org BAATN Black, African and Asian Therapy Network. earth-europe baatn.org.uk Big White Wall NO LONGER FREE VIA NHS Available 7am – 11pm, 7 days a week, Accessible quickly without long waiting lists, CBT and counselling available, Delivered by typing, online audio and secure webcam. earth-europe togetherall.com 32