Services

The Respiratory Clinics are lead by Nurse Jo Bendell. In these clinics the specialist Asthma and COPD nurses monitor patients who have asthma, COPD or episodes of recurring wheeze. The aim is to provide the most appropriate treatment to relieve and prevent symptoms. We recommend that patients with asthma and COPD are seen at least once a year at the clinic, regardless of whether they attend the Chest Clinic at St Richards.

An excellent website for asthma sufferers is Asthma and Lung UK.

If appropriate, we will send written invitations to patients to attend an annual check-up. If, for any reason, you are unable to attend an appointment we would very much appreciate you contacting the surgery to cancel or re-arrange the appointment. Other patients may benefit from the released appointment.

Help us prepare in advance for your review by completing our online form on Accurx prior to your usual review with a Clinician.

This clinic is for anyone who has had a heart problem (e.g. has had a heart attack, test or has angina) or blood pressure problem. The aim is to prevent any further complications from the condition. Patients are invited to attend a six-monthly or annual checkup as appropriate. We monitor weight, cholesterol levels and blood pressure along with other factors such as exercise, smoking and alcohol intake.

The clinic is also an opportunity to assess people who have borderline blood pressures to help make the decision as to whether they should take any medication. Patients taking medication will usually have their blood pressure measured six-monthly along with the annual check. Ample opportunity is given to discuss medication.

If appropriate, we will send written invitations to patients to attend a six-monthly or annual checkup. If, for any reason, you are unable to attend an appointment we would very much appreciate you contacting the surgery to cancel or re-arrange the appointment. Other patients may benefit from the released appointment.

Help us prepare in advance for your review by completing our online form on Accurx prior to your usual review with a Clinician.

Cervical cancer is largely preventable by regular screening and smear tests every 3 years are recommended for all women aged 24 years and six months to 49 years, and every 5 years for women aged 50 to 64 years. Smears are generally performed by one of our Practice Nurses. In addition, routine health checks such as Blood Pressure Monitoring as well as general advice and guidance on health issues will be given. 

The purpose of a smear test is to take cells from the surface of the cervix. These are then examined under a microscope to detect changes to the cells before they become cancerous. In this way, any abnormal cells can be removed preventatively.

We strongly encourage all women who are aged 24 years and six months or over and who have been sexually active to get their first smear done  and then to re-attend for future routine smears as determined by their last smear results (typically at three year intervals).

Written invitations are sent directly to patients when appropriate. If, for any reason, you are unable to attend an appointment we would very much appreciate you contacting the surgery to cancel or re-arrange the appointment. Other patients may benefit from the released appointment. 

If you are pregnant or have recently had a baby it is recommended that you wait approximately three months after the birth before having your smear, this allows for your cervix to return to normal and alleviate the risk of incorrectly diagnosing abnormal cells.

You will receive the results of your smear in 4-6 weeks.

Childhood immunisations, also known as vaccinations, are a critically important way of protecting your child from the most serious diseases. Many illnesses, which used to kill children, have been virtually eradicated because of immunisation. However, that does not mean you should not get your children vaccinated to protect them too.

What is a vaccine?

Vaccines may consist of a preparation of any of the following:

• a killed virus or bacterium
• detoxified toxins from a virus or bacterium
• a weakened form of a live virus or bacterium

They all work by stimulating the immune system in the same way as the actual infection would, but without causing the full-blown disease. Your immune system is designed to “remember” so once exposed to a particular bacterium or virus, it retains immunity against it for years, decades or even a lifetime.

We provide the standard regime of childhood vaccinations for all of our young patients. For further information on childhood immunisations see the NHS immunisation scheme. A summary of what vaccinations are given and when can be found at Patient UK. Also see our Home Page for monthly child immunisation clinic dates.

By Dr Rhianydd McGlone, Langley House GP and College Registered Trainer for the College of Sexual and Reproductive Health 

Langley House Surgery provides a range of free and confidential contraceptive services. 

To access help with contraception, please contact our reception team on 01243 78266. You may be asked to complete a questionnaire via text message. This questionnaire enables us to gather information to assist with offering you the correct appointment. Once we receive your response, we will contact you to arrange your appointment. 

Contraception (including emergency contraception) can also be accessed via the local sexual health service or via your local pharmacy. 

• Sexual Health West Sussex - Sexual Health Services West Sussex
• Find emergency contraception - NHS

For further information about contraceptive options, including emergency contraception and long-acting reversible contraceptives, please click Contraception Options

For further advice about preventing or treating sexually transmitted infections, please click Sexually Transmitted Infections

 

Diabetic patients are seen by Sue Bardall, our Diabetic Lead or Mandy Clements, our visiting Diabetic Nurse Specialist.

It is important to note that hospital-based diabetic clinics have moved away from full annual checks to a problem-solving approach. Therefore, even if you have been to a hospital clinic for an annual review, they are unlikely to have performed the complete range of tests that are recommended for annual follow-up. We very strongly encourage you to come to the annual check regardless of whether you have been seen in hospital.

Our practice team are always at hand to help you manage your diabetes effectively.

If appropriate, we will send written invitations to patients to attend an annual or six-monthly checkup. If, for any reason, you are unable to attend an appointment we would very much appreciate you contacting the surgery to cancel or re-arrange the appointment. Other patients may benefit from the released appointment.

We frequently inject joints as part of a management plan for many musculoskeletal conditions including shoulders, tennis elbow, wrists, carpal tunnel, trigger finger, heels, ankles and feet. Just discuss this with your usual doctor who will arrange it for you.

See our Non NHS Services

By Dr Rhianydd McGlone, Langley House GP and British Menopause Society Menopause Specialist

What is the menopause?

Menopause is the cessation of a woman’s menstrual cycle. The typical age of menopause in the UK is 51 years, and most women become menopausal between the ages of 45–55 years. Menopause is defined as the cessation of periods for 1 year. Before periods come to a complete stop they often change, as the ovaries struggle to work as regularly and reliably as they did in the past. Hormone levels fluctuate during this transition, and in particular there is a reduction in the amount of circulating oestrogen (produced by the tiring ovaries). Periods themselves may become lighter, heavier, or variable in volume and occur at different intervals of time. Hormone levels fluctuate in a way that the body is not used to and this, in combination with a declining level of oestrogen, can cause a variety of symptoms.

The time interval in which women experience symptoms before their periods stop is called the perimenopause and can last months to years. On average, symptoms of the perimenopause and menopause resolve approximately 4 years after periods stop completely, as the body eventually adapts to the constant lower level of oestrogen. The term postmenopause is used to describe the time after the cessation of periods for over 1 year i.e. after the menopause takes place.

It is considered ‘early’ to enter the menopause (periods stopping completely) between the ages of 40-45years, and ‘premature’ to enter it before the age of 40 years. Some women enter the menopause early or prematurely due to the side effects of medication, or as a result of surgery.

Menopause isn’t just about symptoms

Becoming menopausal is associated with increased health risks, and this is much better understood now than it was in the past. Low oestrogen levels lead to an increase in cardiovascular (heart) disease, osteoporosis (weak bones) and urinary tract infections (UTIs).

But it’s not all bad news! The Chinese refer to the menopause as a woman’s ‘second spring’. Thanks to advances in nutrition, sanitation, medicine and other public health measures, the average life expectancy for women in the UK is now 83 years. Woman may spend over a 3rd of their lives in the menopause and it is an opportunity to re-evaluate, re-prioritize and nurture the things that are most important to us, including our health.

How to diagnose the menopause or perimenopause

For most women, the diagnosis of perimenopause or menopause is a clinical one. The diagram above highlights the fluctuating hormone levels women experience. Taking blood or urine samples in a bid to diagnose the perimenopause or menopause is unreliable and largely unhelpful. Furthermore, hormone levels do not correlate well with symptoms: two women with the same hormone level can have very different symptoms, and the decision to offer treatment should be based on the nature of the symptoms, rather than the blood hormone level. Although private providers of menopause care may advocate blood tests, the NHS does not routinely provide this as there is no evidence that it is helpful in coming to the right decisions about treatment.

Treatments of Menopause and Perimenopause

Symptoms of the menopause, and the increased risk of certain diseases, can be improved with lifestyle changes and medication.

Lifestyle

It is more important than ever to try to lead a healthy lifestyle in the perimenopause and menopause. Activities that we could ‘get away with’ in our 20s and 30s, catch up with us in our 40s and 50s. Women will struggle to tolerate late nights, excess alcohol, smoking, and a lack of exercise, and these are the first areas that need addressing if perimenopausal or menopausal symptoms are troublesome. Measures include a healthy diet, regular exercise, managing stress, avoiding alcohol, stopping smoking and trying to maintain a healthy weight. All these lifestyle improvements reduce the risk of heart disease, bone thinning and cancer.

Online help with lifestyle improvements can be found free of charge

• Menopause Wellness Hub

Local help with lifestyle improvements can be found free of charge

• Chichester Wellbeing

Hormone Replacement Therapy (HRT)

HRT involves topping up a woman’s supply of oestrogen with the intention of relieving symptoms. It is the most effective way to relieve symptoms, and has been proven to reduce the risk of heart disease and bone thinning (osteoporosis).

The principle hormone replaced is oestrogen. This is usually given as estradiol on the NHS, a chemical that is derived from plants, but which is molecularly identical to human oestrogen. This similarity is termed ‘body identical’. Women can receive oestrogen via mouth or via the skin (transdermal). There are advantages and disadvantages of each route which will be considered later.

If a woman still has a uterus (womb), it is necessary that she take a second hormone in her HRT called progesterone. Oestrogen and progesterone work in synergy in the womb during the normal menstrual cycle. Oestrogen encourages the lining of the womb to grow (thickening in anticipation of pregnancy), while progesterone organized that growth and keeps it uniform. A lowering of progesterone levels later in the menstrual cycle induces the lining of the womb to shed and bleed. It is helpful to think of progesterone like the ‘cement’ that binds the oestrogen ‘bricks’ together and ensures the lining does not overgrow. When the cement is removed in the later stages of the menstrual cycle, the wall crumbles and a period ensues. Giving oestrogen (bricks) without progesterone (cement) can lead to disorganized growth of the lining of the womb, with an increased risk of irregular bleeding and uterine cancer. Progesterone must always accompany oestrogen HRT.

Progesterone can also be given in a variety of ways (patch, oral or directly into the womb), and can be body-identical or synthetic. Synthetic progesterone is called progestogen. Body-identical or synthetic progestogens have different risks and benefits, and these are further considered below.

How is oestrogen (estradiol) best taken?

Taking oestrogen by mouth is associated with a small increased risk of blood clots and stroke, which is similar to the risks from taking the combined oral contraceptive pills. Taking oestrogen through the skin (transdermal) is not associated with these risks, and should be the first-line route of administration for women over the age of 60 years, or those with other health problems such as obesity, diabetes and high blood pressure. Transdermal oestrogen comes in gels, patches or a spray. The choice of product is mainly determined by convenience of application, or current availability. Some women find that their symptoms are better controlled by one transdermal product rather than another. This is likely due to differences in absorption and is impossible to predict. A small number of women find benefits from oral HRT only, seemingly unable to absorb estradiol through their skin.

• Patches are applied to the buttock, thigh of lower abdomen and come in a range of doses: 25mcg, 50mcg, 75mcg or 100mcg. They are designed to remain in place for 3-4 days at a time and should be changed twice weekly. They do not need to be removed for bathing or swimming. Patches are a very convenient option for a lot of women, and are particularly good for women with hormone sensitive migraines, as the drug delivery is very constant.
• Gels are similar in texture to alcohol hand gel, and a metered dose or ‘pump’ is rubbed in to the outer arms and inner thighs. Women can increase their dose by increasing the number of pumps, up to a maximum of 4 pumps daily. Some women prefer a daily application product such as a gel, but others find it sticky or time consuming to wait for it to dry before dressing.
• An estradiol spray is also a once daily application, and is similar to an odourless perfume. It is squirted on to the skin of the forearm or inner thigh (in the same area each day) and dries within a few minutes. The dose can be increased up to a maximum of 3 sprays daily.

Why choose one progesterone product over another?

Some synthetic progestogen products provide contraception and are also helpful in treating problematic periods. These advantages should be taken into consideration when choosing a HRT product.

For many women, particularly those who are still having regular or problematic periods, the Hormonal Intrauterine System (IUS) is a popular way to receive progestogen. An IUS provides contraception, bleed control, protects the lining of the womb, and results in low overall progestogen absorption. Most women can have this device fitted for free at the surgery and it lasts for 5 years. 

For women who do not wish to have an IUS fitted, there are 3 alternative options: body-identical progesterone by mouth, synthetic progestogen by mouth, or synthetic progestogen via a patch.

Why do some women take progesterone all the time, while others only take it for a proportion of the month?

In women who are still menstruating, or who have only recently stopped, progesterone is given in a cyclical manner in keeping with a woman’s natural cycle. This means taking the progesterone for 2 weeks out of every month. This regimen maintains a regular bleed. In women who are no longer bleeding, progesterone can be taken daily and should not induce bleeding. For women in-between (having some, but not frequent bleeds) a clinician will consider which regimen is preferred. If progestogen is delivered directly in to the womb it is given continuously regardless of whether a woman is still having periods or not.

Other than symptom control, what are the advantages of HRT?

HRT has been proven to reduce the risk of heart disease and the risk of bone thinning. There are likely to be many other benefits too. One study found that HRT reduced the risk of death from all causes by 45% in women who took HRT under the age of 65 years, compared to women who did not. It is also worth noting that the benefits of HRT depend on when it is initiated. Heart benefits of HRT are only apparent in women who commence HRT within the first 10 years of their menopause, and before they develop heart disease.

What if I have a family history of breast cancer?

HRT is not completely contraindicated in women with a family history of breast cancer. It is important to recognize that woman with a strong family history of breast cancer are already at increased baseline risk. Adding HRT will increase their risk a little more, but the proportion of additional risk is small and should be balanced against the potential benefits of HRT. Women with a strong family history should discuss their risk with a clinician. Some women are eligible for more frequent breast cancer screening if considered to be at moderate or high risk of breast cancer.

Are some types of HRT safer than others from a breast cancer point of view?

Oestrogen only HRT (without progesterone or progestogen) is not associated with an increased risk of breast cancer, but this is not an option for women with a uterus (womb) due to the increased risk of uterine cancer.

The combination of oestrogen and progestogen in HRT is responsible for the increased risk of breast cancer. Different progestogen preparations confer different levels of risk. A body identical progesterone appears to be the safest preparation, and may not increase the risk of breast cancer for the first 5 years of use. Body identical progesterone is only available as a tablet. This can be combined with oestrogen in the form of a tablet, gel, patch or spray. Body-identical progesterone is available on the NHS.

Women are encouraged to check their breasts monthly and take part in routine NHS breast cancer screening, whether they take HRT or not. No additional monitoring is required for women taking HRT. Although combined HRT (oestrogen and progestogen) may increase the risk of having breast cancer, there is no increased risk of dying from breast cancer in women who take HRT.

If body-identical progesterone is safest, why might some women choose a synthetic progestogen?

Synthetic progestogen can offer contraception and improved bleeding, and these advantages may be a higher priority for some women than the lower risk of breast cancer.

What are other considerations that might guide HRT regimen choice?

An increased risk of blood clots or stroke necessitates taking oestrogen through the skin (transdermal). Transdermal oestrogen is less likely to increase the risk of blood clots or stroke, and can still be considered for use in women who have a history of these conditions. Women over the age of 60 years, or with other chronic health conditions such as diabetes, obesity or high blood pressure, should also take oestrogen through the skin.

Women with hormonal migraines tend to find that transdermal oestrogen is less likely to precipitate headaches. Patches or a spray are generally considered best.

For women who have already been diagnosed with bone thinning, HRT can be an effective treatment. Any HRT regimen will provide bone benefits. The type of progestogen used does not have an impact on this.

What about vaginal or urinary symptoms?

For vaginal and urinary symptoms of the perimenopause and menopause, oestrogen can be administered directly into the vagina without the need for progesterone. Oestrogen is poorly absorbed into the rest of the body from the vagina, and so there are no associated risks of womb cancer when administered this way. Vaginal oestrogen can be used on its own, or can be combined with HRT taken to the whole body if vaginal or urinary symptoms are particularly troublesome and women could benefit from a ‘double dose’ of oestrogen in this area.

For how long should I take HRT?

Most symptoms of the menopause usually resolve with time, as the body adjusts to the low, constant level of oestrogen. Women may find that they do not need HRT for symptom control 5-10 years after the menopause, but decide to continue HRT for the bone and heart benefits it affords. The risk of breast cancer from HRT increases with age. The decision to continue HRT is an individual one and should be guided, but not dictated, by a clinician.

When I stop HRT, will my symptoms just return?

Taking HRT does not prevent the body from adjusting to lower levels of oestrogen. If symptoms do return on stopping, they will normally be less severe and last for a shorter duration. Gradually reducing the dose of HRT, before coming to a complete stop, can help.

What is ‘bio-identical HRT’ and is this available on the NHS?

‘Bio-identical HRT’ is a term used in the private sector to describe products which are advertised as being ‘tailor-made’ for individuals. They are combination hormone products, usually containing oestrogen, progesterone and sometimes testosterone. Products are made up with different quantities of hormones, and are advertised as meeting the individual needs of patients. An individual’s needs are reportedly determined by blood, saliva or urine tests.

The risks and benefits or products with varying quantities of hormones cannot be determined, and these products are unregulated, with limited safety information. As stated above, there is no evidence to suggest that products should be chosen based solely on blood, saliva or urine levels, as these levels vary greatly.

The term ‘bio-identical’ is sometimes confused with ‘body-identical’, but these term are not synonymous.

What about testosterone?

The female ovaries also produce testosterone, and the level of this hormone declines with age. The role of testosterone is less well understood but guidance does exist about its use in Hormone Replacement Therapy. Testosterone is principally use for the treatment of enduring low libido but is also thought to improve mood and cognition (thinking processes).

Oestrogen replacement also has an important role in improving libido, and for this reason it is recommended that oestrogen is replaced first, then the need for testosterone re-assessed.

Ensuring vaginal comfort with oestrogen replacement to the vagina, and the use of vaginal lubricants and/or moisturisers is also important. Sylk and YES are both trusted brands of intimate lubrication and moisturizers for women. These can be purchased online or are also available on prescription for some women.

We recommended that women also consider other factors that may be impacting on their libido and recommend the book Mind the Gap by Karen Gurney to further explore this.

I’ve heard there is a HRT shortage, why is that?

Recent increases in awareness of the benefits of HRT has resulted in an increase in demand. Other factors (such as the covid pandemic) also contribute to temporary supply issues. Pharmacies often don’t know when they will receive a delivery of HRT products if in short supply, and GP surgeries are not privy to the stock levels in individual pharmacies.

Patients can usually switch to an alternative product as a short term measure if their usual product is unavailable, and it is helpful if a patient has enquired with a number of pharmacies to source a supply, before asking the GP to redirect a prescription. The table below provides a rough estimate of the equivalent doses of products, allowing easy transitions from one to another if needed. Transitioning to an oral preparation from a transdermal one is associated with small additional risks, and this will usually require an appointment with a clinician to discuss a medication request.

Estradiol-approximate equivalent doses

Visit Women's Health Concern to view the factsheet on HRT: Types, doses and regimens

Other treatments

Antidepressants and other medication can have some benefits for hot flushes, and may be offered to women who have medical contraindications to taking HRT, or to women who do not wish to take HRT. These products do not provide any reduction in the risk of heart disease or bone thinning (osteoporosis).

Some women also find benefit from herbal remedies and increased dietary intake of oestrogen. These treatments are not well studied, their benefits are unclear, and the risks less well understood.

Visit Women's Health Concern to view the factsheet on Complementary and alternative therapies

Contraception and the menopause

For women whose periods stop before the age of 50 years, guidelines recommend continuing contraception for 2 years after the last period. In women who stop menstruating after the age of 50 years, contraception is required for 1 additional year.

In women who are not having regular bleeding due to the use of hormonal contraception, and who cannot determine when their natural cycle stops, it is recommended that contraception is continued until the age of 55 years. Sometimes a series of blood tests can be used sooner than this to determine whether the menopause has already occurred, and whether contraception can be stopped sooner.

Summary & Resources

Langley House is a menopause friendly practice with sufficient expertise amongst our staff to successfully manage symptoms or the perimenopause and menopause.

If you wish to have a consultation about the menopause or perimenopause, please contact the surgery. You may be asked to complete a questionnaire in the first instance to help us better meet your needs.

Whilst waiting for your appointment, please see below a list of trusted resources about the perimenopause and menopause. There is a wealth of information on the internet, but not all of it is evidence-based. The NHS provides treatment based on evidence, not opinion: some treatments recommended by private clinics or celebrities may not be available on the NHS.

• Rock My Menopause: Patient facing campaign of the Primary Care Women’s Health Forum
• Women's Health Concern: Patient facing campaign of the British Menopause Society
• Balance: Education resource from Dr Louise Newson, GP Menopause Specialist and Menopause Campaigner

The Practice is equipped to carry out a range of minor surgical procedures including:

• Cryotherapy – for warts
• Excision of skin lesions
• Cautery
• Joint Injections
• In-growing toe nail removal

Please see your Doctor for suitability. If, for any reason, you are unable to attend an appointment we would very much appreciate you contacting the surgery to cancel or re-arrange the appointment. Other patients may benefit from the released appointment.

In addition to the standard childhood vaccinations, we offer the following vaccinations as required.

If, for any reason, you are unable to attend an appointment we would very much appreciate you contacting the surgery to cancel or re-arrange the appointment. Other patients may benefit from the released appointment.

Influenza

Influenza is a viral disease that usually strikes between October and May. It lasts from three to five days and can be followed by fatigue for two or three weeks. It usually causes aching muscles and joints, headaches, cough and fever with a temperature of between 38oand 40oC. Although it can become a much more severe illness, leading to pneumonia, nerve and brain damage and even death, such complications are rare. Because it is a viral infection it cannot be treated with antibiotics. The best remedy is rest while drinking plenty of fluids. 

Every winter we offer flu vaccination to all our patients who meet the at risk criteria defined by the Department of Health. These are people who:

• Are aged over 65 years old
• Suffer from diabetes (both types 1 and 2)
• Suffer from a chronic respiratory disease including: some forms of asthma, chronic bronchitis, emphysema, COPD, cystic fibrosis, interstital lung fibrosis, pneumonicosis and BPD
• Suffer from a chronic heart disease including: congenital heart disease, hypertension with cardiac complications, chronic heart failure, angina, previous heart attack or other forms of IHD
• Suffer from a chronic renal disease including: nephrotic syndrome, chronic renal failure and renal transplantation
• Suffer from chronic liver disease including: cirrhosis of the liver
• Suffer from immunosupression including: those undergoing long term immunosupressant therapy, asplenia, splenic dysfunction, HIV and ongoing chemotherapy

The rules laid down by the Department of Health state that if you do not fall in to an at risk group, we are not permitted to provide vaccination under the NHS. However, you can obtain a private vaccination and many businesses now provide this facility for their staff.

If you fall within an at risk group you are entitled to come in for a flu vaccination. We strongly recommend that you attend.

Pneumococcal Vaccination

Pneumococcal disease is an infection caused by a type of bacteria called Streptococcus pneumoniae. When these bacteria invade the lungs, they cause the most common kind of bacterial pneumonia and can then invade the bloodstream and/or the tissues and fluids surrounding the brain and spinal cord causing meningitis. Another common complication is infection of the middle ear.

If you aged 65 or over you can now have the pneumococcal vaccination to protect against the most serious forms of pneumococcal infection. You won’t need it each year and for most it’s a one-off vaccination.

You can also have this vaccination if:

• you don’t have a spleen, or if your spleen doesn’t work properly
• your immune system doesn’t work properly (due to HIV, chemotherapy etc)
• you have chronic disease of the heart, lungs, liver or kidneys
• you have diabetes

Shingles

The shingles vaccination programme has been expanded in September 2023 to protect more people at an earlier age. Those newly eligible for a shingles vaccine include all those turning 65 and 70 from 1 September 2023 and those aged 50 and over who have a severely weakened immune system. Those aged 70-79 remain eligible for the vaccine.

One in 5 people will go on to develop shingles in their lifetime and symptoms of the disease can include blindness, hearing loss, nerve pain and in some cases, death. Shingles can occur at any age, but the risk and severity of shingles increases with age and complications are higher in individuals who have severely weakened immune systems and those who are older.

In the first five years after a shingles vaccine was introduced in England in 2013, there were 45,000 fewer GP consultations and 1,840 fewer hospitalisations for shingles and post-herpetic neuralgia, showing the overall impact of the programme in protecting the public while freeing up NHS capacity.

Please see the table to see when you will be eligible. 

The shingles vaccine is given as an injection into the upper arm. Unlike the flu vaccine, you'll only need to have the vaccination once and you can have it at any time of the year.

Most people will only need 1 dose, but some people who cannot have the routine vaccine for health reasons will need 2 doses.

The shingles vaccine is expected to reduce your risk of getting shingles. If you do go on to have the disease, your symptoms may be milder and the illness shorter.

It's fine to have the shingles vaccine if you've already had shingles. The shingles vaccine works very well in people who have had shingles before, and it will boost your immunity against further shingles attacks. Your GP will tell you how long to wait after you recover from shingles before having the shingles vaccine. This may be up to 1 year.

Covid Vaccination

We do not offer these at Langley House but please book an appointment at a nearby vaccination centre online

We all know that smoking is one of the most destructive things we can do to our health. However, it is never too late, or too early, to quit smoking.

Chichester Wellbeing are now providing a free stop smoking service. Their Wellbeing Advisors are fully trained smoking cessation practitioners and can give you the advice and support you need to successfully quit.

What they offer

• One-to-one support with a trained Wellbeing Advisor.
• Face-to-face support, as well as phone and text support for a total of up to 12 weeks.
• Access to free Nicotine Replacement Therapy if required.

Contact them

For more information on their stop smoking service, please visit the Chichester Wellbeing website.

See our Travel Vaccinations information

From menstruation and contraception to pregnancy, menopause, and mental wellbeing, the new Sussex Women’s Health website is packed full of expert guidance from NHS professionals.

The site is a safe, inclusive space designed to empower women on their journey to better wellbeing.

Find local services, self-referral options, and practical tools to help you make informed decisions about your health.

Visit the new Sussex Women’s Health website

Now you have reached 16, you are entering the adult world and starting to take more responsibility for all aspects of your life, including your health and wellbeing.  We have created this section on our website to help with any concerns you may have.

How do I book an appointment?

If you need to see a GP, please complete the Rapid Health questionnaire. The form will ask you for your name and date of birth and a drescrIption of your symptoms. You should be offered an appointment at the end of the questionnaire at the most appropriate time for the urgency of your appointment.

If you don’t feel able to go online and fill out the questionnaire, you can always ring reception on 01243 782266 and our receptionists will go through the form with you.

How do I get to the surgery?

We are nearly at the end of West Street, next to County Hall and on the opposite side of the road to the Cathedral. If you come into Chichester for shopping, we are 2 minutes from the Cross and the Cathedral.  We don’t have a car park but the bus stops opposite the Cathedral.

Can I bring someone else with me?

Yes, you can bring someone with you like a friend or relative.

Will you tell anyone else that I came?

None of the staff at the surgery will tell any information to your parents or anyone else, not even that you’ve been here, unless of course you give them permission to do so. We will respect your privacy. There are some cases where we might suggest that its best to get other people involved, like if there is significant risk to you or others, but even then we would discuss this with your first.

What do I do when I get to the surgery?

When you arrive, you can use our self check in screen in the waiting room or talk to one of our receptionists, so that we know that you are here and ready for your appointment.  Once you have checked in, just take a seat in the waiting room and wait for your name to be called. 

Useful links to other websites

• Find it Out is a West Sussex service that supports young people from aged 11 to 25 with a range of challenges from bullying, anxiety, young carers, grief, racism and gender identity, social media and starting work. 
• West Sussex Mind offer mental health support for young people with problems including anxiety, stress, depression, post traumatic stress disorder and schizophrenia. 
• The Mix offers free, confidential support, expert advice and a welcoming community, all designed with and for young people. Whether you need help with mental health, relationships, work, money or anything else, you’ll find it here, whenever you need it. 
• Young Minds the UK's leading charity fighting for a world where no young person feels alone with their mental health, providing young people with the tools to look after their mental health.
• Papyrus UK a charity dedicated to the prevention of suicide and the promotion of positive mental health and emotional wellbeing in young people. We believe that no young person should have to struggle alone with thoughts of suicide. 
• Beat Eating Disorders the UK’s eating disorder charity to end the pain and suffering caused by eating disorders.
• Sexual Health West Sussex can help with advice and services including screening and contraception or visit our own page regarding contraception 

24 hour crisis support

• Samaritans. Call: 116 123
• Shout 85258 a free confidential and 24/7 text messaging service for anyone in the UK who needs support. If you are struggling to cope and need to talk, trained Shout volunteers are here for you.
• Childline. Call: 0800 1111
• NHS 111 if you think you need medical help right now, 111 online can tell you what to do next 

Abuse at school

• NSPCC: The dedicated NSPCC Helpline; Report Abuse in Education, launched on Thursday 1 April can be contacted by phone on 0800 136 663, or by emailing help@nspcc.org.uk.
• National Bullying Helpline: Bullying Information and advice about all forms of bullying

Drinking, drugs, and alcohol

• Talk to Frank (all drugs)
• Re-Solv (solvents)
• Drink Aware (alcohol)

Smoking

• NHS stop smoking services help you quit

Bereavement

• Winston's Wish: Bereavement Support for Children
• Talk Grief

Staying safe online

• Childnet: 11 to 18 year olds 
• Childline: Taking control of your online safety 

LGBT support

• LGBT Foundation