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Dry eyes are a common condition that can be aggravated during the winter. This is not unusual as the wind and low temperatures can dry up the skin in several areas throughout the body. Heaters are used heavily within the winter periods at the workplace and at home, which can strip the air of moisture which can have an impact on our eyes. We do not have control of the conditions in the outside world, however we do have control of how we combat these conditions. Symptoms of Dry Eyes Burning sensation Itchy Mucus build up Redness around eyelids Sensitive to light Prevention Use a humidifier in order to stop the air from drying out Minimise the use of heathers and air conditioners If you are someone who wears contact lenses, then swapping these out for glasses can help to rest your eyes Limiting your smoking and alcohol intake Taking a break from daily activities that require you to concentrate, such as reading, using the computer, and being on your phone, as these can all limit blinking Avoid using hairdryers Medication Inflammation Reducing Drugs: Antibiotics can be prescribed to you by your GP that can assist in reducing inflammation around your eyelids. This can be in the form of eyedrops, but also in medication that can be taken through the mouth or as an ointment to apply around the eyes. Eyedrops: Prescription eyedrops can be obtained from your GP that can not only help to lubricate the eyes, but also to assist in reducing inflammation around your eyelids as well. This will then help your Meibomian (Oil) Glands to secrete oil back into your eyes naturally. Common Types of Eyedrops Include: Artificial Tear Drops: Commonly used for less severe cases of Dry Eyes and typically used as the first step of treatment. Artificial tear drops can be used frequently throughout the day to lubricate the eyes. Restasis: This is a daily use eyedrop, requiring two applications per day. Used to both lubricate the eye and reduce inflammation to aid in producing natural tears back into the eye. However, this is not an immediate effect and is a process that can take between 3-6 months. Xiidra: Similar to Restasis, in that it aims to reduce inflammation and requires two applications daily. Xiidra however, has a faster treatment rate, providing eye care relief for patients between 2-12 weeks. There are more eyedrop options and all medications can pose side effects, so we recommend you book an appointment with your GP to explore which one is best suited for you. Other Treatments Scleral Lenses/Bandage Lenses: Contact lenses designed specifically for dry eye treatment, these help to lock in moisture to combat dryness. Eye Masks: An eye mask is used to clear blocked oil glands. If your dry eyes persist, then we recommend consulting with your optometrist or pharmacist as they will be able to advise you further on the severity of your condition and what steps to take next. Further eyecare during the winter information can be found here in one of our previous blogs: www.healthharmonie.com/post/winter-eyecare

Staying wrapped up in the cold weather is Important in order to take care your hands. Not only does the lower temperatures affect the nerves in your body but it can also intensify the pain that comes with carpal tunnel syndrome. Carpal tunnel syndrome is caused by pressure on this median nerve inside of the wrist. The carpal tunnel itself is a narrow passage and when the nerve is being compressed, it can start to cause discomfort in the hand. Cold temperatures restrict blood flow and cause muscle tissue to expand, putting added pressure on the median nerve which can exacerbate the condition. Flare ups of carpal tunnel can also be triggered by Atmospheric pressure that comes along with cold temperatures. Again, this can cause the muscle tissue to expand and compress the median nerve. This is why athletes will warm up before partaking in sports as this helps to soften the tissue and make the areas more flexible. To combat the cold conditions, we recommend: · Wearing gloves made of wool, leather or synthetic materials · Regularly moving your fingers to help to stimulate a healthy blood circulation · Avoid tight clothing and accessories. Good blood circulation is key in keeping warm but if you wear gloves that are too tight or watch bands that do not fit correctly then this will restrict blood flow · Keeping your hands dry. If you're having to head out into snow or rain then gloves that are waterproof will help to keep moisture off of your hands. If you are heading out specifically for an activity then it is important not to overheat your hands during these activities. If you are partaking in a high intensity activity outdoors then options like thick thermal gloves will not be suitable and you will want to opt for something more breathable · Visiting a medical professional to discuss the factors of your condition and how to treat it On the nights, wearing a wrist brace can help to keep your wrist straight which takes pressure off the median nerve, however speaking with your doctor to get the correct one for your symptoms is important. There are wrist braces available that are not designed for carpal tunnel syndrome ,some are intended for things like breakages and sprains. These wrist braces feature straps across the wrist or have a metal spine along the palm side of the brace and this will only put more pressure onto the median nerve. A wrist brace will also need to fit you comfortably so that it is not too tight to impede blood flow and also loose enough so that you are still able to move your wrist to ensure a good blood circulation. Washable lightweight fabrics are recommended as they help to combat against any perspiration build up, keeping the targeted area clean. Treatments Non-Surgical: If early signs of carpal tunnel syndrome are detected and reviewed before they escalate then your carpal tunnel can be relieved of the pressure without the need for surgery. This can be achieved through different forms such as splinting, medicines or therapies. Surgical: If non-surgical treatments are not successful or signs of carpal tunnel syndrome are not acted upon, then surgery may be the next step. The two types of surgical procedures that can be performed are: Open carpal tunnel release: Your surgeon will separate the transverse carpal ligament which in effect will relieve the pressure from the median nerve and create more room within the carpal tunnel to prevent any reoccurring pressure. Endoscopic carpal tunnel release: This is the same procedure as open carpal tunnel release, however your surgeon will use an endoscope (small camera) to see inside your hand/wrist. Our Clinics We currently perform Minor Surgery within Doncaster and Stoke & North Staffordshire. Our clinics are community based to allow you to be seen locally instead of having to visit a hospital. These clinics are easily accessible, offering free car parking for your convenience. To access our hand surgery services please contact your GP. If you have any questions regarding hand surgery appointments, please do not hesitate to get in touch via our ‘contact us’ page.

November is National Health Skin month, a campaign which aims to raise awareness in looking after our body’s largest organ, the skin. It is important that we examine our skin often to locate any abnormalities. Regularly checking your skin can help to identify early signs of skin cancer, at the stage when it is most treatable. Below are some factors that can cause complications to the skin: Food The food we consume can have an impact on our skin, certain foods such as dairy, nuts, citrus fruits, spices, and foods that contain nickel can cause flare-ups to certain individuals or trigger allergies that leaves the skin itchy which can develop into dermatitis symptoms. Foods that are high in fat, contain large quantities of sugar and dairy products can raise the risk of acne. Exposure to the sun Wearing Sunscreen that contains a Sun Protection Factor (SPF) of 30 or above is crucial in protecting your skin from the sun. Ensuring your sunscreen is waterproof is also something to look out for, even if you are not swimming this still helps to combat sweat when you are exposed to hot temperatures so that it does not come off easily as your day progresses. Seeking cover from the sun can give your skin a break from the heat, it only takes between 10 – 20 minutes for your skin to start burning. When shade is available to you it is always wise to take cover in it, especially between the peak radiation times of 9am – 3pm. Clothing Different materials can create irritation on the skin, and some people may even be allergic to certain types like denim or lycra. Nickel can not only be found in food but it is also used in clothing accessories like zips, studs, buttons, and buckles. This again will be a problem for those who suffer with allergies to nickel as it will aggravate the skin. New clothes can cause irritation as they will contain a chemical called formaldehyde to keep the clothes looking fresh when displayed in stores, this can lead to skin irritation so simply washing the item can aid in removing this from the fabrics. When it does come to washing your clothes, it is worth noting that the washing detergent you use will contain harsh toxins like fragrances and dyes. There are washing powders on the market specifically designed for sensitive skin that are fragrance free to consider using instead. Emollients Emollients are moisturising treatments that soothe and hydrate the skin to lock in moisture such as products like soaps, creams and lotions. However, if you experience a burning or stinging sensation then immediately wash the product off your skin with cold water. The reaction will be due to one of the ingredients in the product not agreeing with your skin. Talking to your GP can help identify these ingredients so you can find a more suitable product that suits you. More information on National Healthy Skin Month: https://www.aad.org/public/public-health/awareness-campaigns/national-healthy-skin-month https://nationaltoday.com/national-healthy-skin-month/ Information on our Dermatology Services: https://www.healthharmonie.com/dermatology References: https://www.dermeze.com.au/articles/4-foods-didnt-know-cause-skin-irritations/ https://www.healthline.com/health-news/adult-acne-foods-that-cause-it#:~:text=Researchers%20say%20foods%20high%20in,that%20can%20increase%20acne%20risk https://www.cottonique.com/blogs/blog/draft-clothing-allergy-5-reasons-7-symptoms-and-6-ways-to-control

Each year more than 1 million people suffer from eye injuries. 90% of these injuries are easily avoidable so it is important that we take the correct steps in looking after our eyes to prevent any injuries or internal damage occurring. With Halloween quickly approaching, it is important to highlight the dangers of cosmetic contact lenses, as the side effects can be damaging. We strongly advise that these contact lenses, as easily accessible as they are, should be avoided entirely. The cheap materials and poor construction of these Halloween accessories can be dangerous on something as delicate as our eyes, and without experience of using contact lenses can raise even more complications. Only prescription contacts should be trusted, which will bear the ‘CE’ symbol on the packaging, which ensures that the contacts conform to health and safety standards and that they are medical devices made to meet the requirements laid out by the Medical Devices Directive (MDD). An eye exam will be needed prior as well as a valid prescription from the eye doctor when purchasing a pair. This prescription will give the vendor a brand name, expiration date and eye measurements as we all have different sized eyes. Prescription coloured contacts can not only provide you with a cosmetic change for Halloween but also still aid in improving vision, whilst costume store lenses are purely cosmetic and are not designed to remain in the eyes for a long period of time. Any contact lenses that begin to feel uncomfortable in the eye should be taken out immediately. Cheap contact lenses bought from retail stores and costume stores etc may be too large for the eyes or contain paints which could then lead to things like: Infections Scarring Outer Layer Scratching Corneal Swelling Impaired Vision Eye Ulcers Vision Loss It is important to have knowledge on how to clean contact lenses, as failure to do so can lead to further complications. Contact lenses that have not been cleaned correctly will retain bacteria within them and not cleaning them will only submerge the eyes in this bacteria. As well as being clean, they should also only be worn by the individual they were prescribed to and not shared amongst others as this can lead to infections. They could also cause damage to another persons eyes as their size specifications will not be the same. For information on our ophthalmology services: www.healthharmonie.com/ophthalmology

On Thursday 30th September, we hosted a webinar via Microsoft Teams led by our Gynaecology Lead, Dr. Pallavi Latthe. Dr. Pallavi Latthe runs gynaecology clinics across south and central Birmingham and oversees a wide range of gynaecological issues. She is a research active clinician and leads the adolescent gynaecology and urogynaecology tertiary services at the Birmingham Women’s and Children’s Hospital. The main aims and objectives that were covered within the webinar was: Defining heavy menstrual bleeding Causes of Menorrhagia Familiarise with new NICE guidelines Real Life Case Scenarios Dr. Pallavi Latthe discussed what can be done as a primary care clinician to support patients and provided insight into appropriate management of menorrhagia, which affects up to 30% of women and can have a significant impact on their quality of life. The benefits of this event included the chance to speak to and gain information from a leading gynaecologist, who would provide a path to follow when it comes to diagnosing Menorrhagia. Specific Knowledge on Menorrhagia and PCOS would be covered through real life case scenarios to provide a clearer, systematic approach. The webinar was a huge success, and we’d like to say thank to everyone who participated, and of course to Dr. Pallavi Latthe for presenting this and providing such educational support to our attendees. We had a Q&A section at the end of the presentation which proved to be very useful for those seeking answers on Menorrhagia & PCOS, and we look forward to doing more events like this in the future! For more information on our Gynaecology services: www.healthharmonie.com/gynaecology

HealthHarmonie holds extensive experience in providing capacity and wait list support with the NHS. During the COVID-19 Pandemic, there has been an increased challenge in ensuring patients are accessing the care that they need within target wait times. In 2020, HealthHarmonie were awarded a place on the NHS England Increasing capacity framework, enabling us to offer support to NHS Trusts in recovery from the COVID-19 Pandemic. What The Challenge Was UHCW approached HealthHarmonie seeking capacity support for a backlog of patients requiring surgery procedures. Due to the COVID-19 Pandemic, the Trust had been unable to offer patients appointments. As part of the recovery process, there was a national focus on rapid reduction in wait lists. HealthHarmonie is part of the NHS England Increasing Capacity Framework and therefore has undergone vetting to ensure we are a compliant, suitable provider. How We Developed Our Solution We conducted an initial scoping meeting with the Trust, the aim of this was to determine what areas there were challenges, and how we could respond in the most efficient way. From the scoping meeting, we developed a proposal for support which detailed what capacity we could give, the staffing available, and how we could ensure the best access for patients. After providing a proposal, we then met with the Trust and the clinical teams to discuss pathways, patient criteria and how the service would meet local need. How We Mobilised We scoped out the service and sourced activity numbers, as well as the types of activities. We used the same approach when finding the suitable locations and staff against activity and locality to source sites and clinicians. We confirmed each of the pathways with the trust itself, including the transfer pathways. Then got patients booked in and received receipts for each one. The mobilisation timeframe itself took place over the course of 3 weeks. What The Results Were As a result of the operation, we were able to assist by achieving the following: 430 patients transferred into HealthHarmonie 400 patients accepted by HealthHarmonie 400 patients attended for a procedure within 6 weeks of mobilisation Through this work, we have been able to offer local appointments outside of the Trust for patients which has increased accessibility locally. Our highly experienced and skilled dermatology team worked with the Trust dermatology team, in line with their policies to deliver the same standard of care and ensure consistency for patients. Our work has allowed UHCW to allocate their resource in order to provide treatment of complex cases. If you would like to discuss how we could help your Trust or CCG with wait time challenges, then please go to our contact page to get in touch: www.healthharmonie.com/contactus

National Eczema Week is upon us, running from September 13th - September 19th. The purpose of this is to spread awareness and educate others about eczema and ensure the public know how to deal with it. Atopic Eczema is the most common form of eczema. This usually starts at an early age and although does usually calm down through age, can still be an issue for some if not treated correctly. Diagnosing: Diagnosing Eczema will always involve the patient experiencing itchy skin. If the skin is not itchy then it is very unlikely that the condition is related to eczema. As well as this, the symptoms will also include some of the following: Suffer with generally dry skin Irritated red skin, commonly located between the joints of arms and legs A History of asthma or hay fever, as eczema can commonly develop alongside these existing conditions A family history with eczema Causes: Skin products: Such as soap, shampoo or even washing up liquid. Weather conditions: Any type of weather condition whether it be hot, cold, dry or humid, can be a possible trigger for eczema. Diet: Certain foods can trigger eczema, these often being dairy products such as milk and eggs. However other types of food like nuts, wheat and fish can also be a culprit. Spices on foods like cinnamon, cloves and vanilla should also be removed from the patient’s diet to monitor if they are worsening the condition. Clothing Materials: Abrasive materials like wool and polyester can irritate the skin which leads to eczema, or more often, can aggravate existing eczema areas. Genes: It is possible that Atopic Eczema can be inherited from a family member. Identifying these triggers by asking the patient to do things like keeping a food diary, switching out their skin products and being weary of the materials they are putting on their skin can be extremely beneficial in reducing and eliminating Atopic Eczema. Treatments: Atopic Eczema can be treated to relive the severity of the condition and improve the skins condition. If self-care methods and regular moisturising is not successful then the following can be prescribed: Emollients (Moisturising Treatments): This should be implemented on daily basis, 3-4 times throughout the day to reduce dryness and repair the skin. These come in the form of creams, ointments, and lotions etc. These should be used sparingly as failure to do so can lead to thinning of the skin. Topical Corticosteroids: The potency levels in which this would be used would depend on the severity of the atopic eczema condition. This method would help to reduce redness and itching. Applied once or twice daily. For more information on our dermatology services: www.healthharmonie.com/dermatology For more information on National Eczema Week: www.nationaltoday.com/national-eczema-week/ Our contact info: www.healthharmonie.com/contactus TEL: 0121 454 7779 EMAIL: health.harmonie@nhs.net

We are pleased to announce the unveiling of our new dermatology site in Staffordshire, Dunston Village. Our dedicated team have been working hard to ensure everything was ready for the site launch and we are very pleased with the outcome. We are now all set up at the location, seeing patients and booking in appointments daily. This site has wheelchair access with multiple access points to the clinic via the ramps. There are 3 medical rooms within the clinic, these being: Consultant Room - To see patients and diagnose their condition. Phototherapy & Cryotherapy Room - Designed to be able to perform scans and hold therapy procedures. Surgical Suite – Where we perform procedures such as punch biopsy's and treating skin lesions. We run our dermatology services across numerous sites throughout the UK and are proud to add Dunston Village to our ever-growing list. Our dermatology services include diagnosing, monitoring and treating a wide range of skin conditions including eczema, psoriasis, chronic rashes, acne, and low risk BCC’s. Patients will need to be referred to our services through their GP. Their condition will then be triaged within 48 hours and one of our booking team will be in contact with the patient within 4 days of the referral. They will then be offered an appointment with a selection of dates and times. Patients are seen within 4-6 weeks where we aim to offer diagnosis and treatment within their initial visit. Post appointment we will will provide the patient and referring GP with a care plan tailored to the patients needs. All consultations and treatments are led by our specialist medical experts in dermatology. Our dermatology lead is Dr Mohammed Al Abadie: “Hello, I’m Mohammed and I’m the clinical lead for our Dermatology service. I have a special interest in skin rashes, eczema and acne conditions. As Dermatology Lead, I’m responsible for overseeing our dermatology service and for ensuring the highest dermatological standards across the organisation. I’m involved in the recruitment of highly skilled staff and provide supervision over the audit processes used to certify the quality and suitability of our services. I’m a Fellow of the Royal College of Physicians (FRCP), American Academy of Dermatology and the European Academy of Dermatology and hold a doctorate in Dermatology (PhD).” For location information, please see below: www.healthharmonie.com/location/dunston-village Our contact information: www.healthharmonie.com/contactus TEL: 0121 454 7779 EMAIL: health.harmonie@nhs.net Have you recently had an appointment with us at Dunston village? Let us know how we did by leaving a review on NHS Choices: www.nhs.uk/services/independent-provider/healthharmonie-limited/X90588/ratings-and-reviews

Once a patient has been diagnosed with carpal tunnel syndrome and surgery needs to be performed, there should be no delay to ensure that these symptoms do not develop further. Waiting too long for surgery can lead to permanent nerve damage and muscle atrophy. If the numbing sensation that the patient is experiencing begins to accelerate over time, the hand can become completely numb for a long duration of time which can then cause irreversible damage. Before surgery is performed to treat carpal tunnel syndrome, other non-surgical treatments can be attempted. These treatments can involve supplying the patient with a splint to wear which enables the pressure on the nerve to be relived. This is worn at night for up to 4 weeks and can often prove very effective being that symptoms of carpal tunnel syndrome can eradicate at night. This then leads to waking up and creating shaking motions to the hand, worsening the condition. There are other home remedies that can be advised to potentially solve the condition, such as doing hand exercises. However, if the condition fails to respond to these solutions, this is when surgery should be advised to the patient and actioned promptly. Often you will find that patients are unaware how swift the surgery process is, so educating them that the surgery itself is between 15 - 30 minutes can help if they are experiencing any worries regarding this. Patients will be able to return to work and perform light day-to-day tasks within 2 weeks, making sure to avoid any strenuous tasks so that the recovery process is not interrupted. Full function of the hand should return within 6 - 12 weeks after surgery. Surgery can be performed through two different methods: Open carpal tunnel release: Separating the transverse carpal ligament which will relieve the pressure from the median nerve and create more room within the carpal tunnel to prevent any reoccurring pressure. Endoscopic carpal tunnel release: This is the same procedure as open carpal tunnel release; however, this is performed through an endoscope (small camera) to see inside the hand/wrist. We perform minor surgery within Doncaster and Stoke & North Staffordshire. Our clinics are community based and are easily accessible. These procedures are performed by our two specialist’s Dr Srinivas, who is the leading consultant for Birmingham University Hospital and Mr Morgan, who has over 30 years of medical experience. More on our hand surgery services below: www.healthharmonie.com/minor-surgery

It is important that eye tests are performed regularly for early detection of symptoms of glaucoma. If early symptoms are discovered within routine eye tests, patients can be referred to an ophthalmologist to give confirmation on their diagnosis. An ophthalmologist can then provide information for case-by-case specifics, along with treatment advice. Diagnosing glaucoma is not always an easy task as there are a magnitude of factors that can go into having this eye condition. To combat this, there are a range of different ways it can be identified and tested for: Eye Pressure Check (Tonometry) One of the largest risks of glaucoma is an increase in eye pressure. This is commonly the biggest sign of glaucoma and is often conducted through Tonometry, the most popular method being ‘The Goldmann applanation tonometry test. During which, eyes drops are administered and then a flat-tipped probe is lightly pressed against the surface of the eye into the cornea. The cornea will then push back onto the tonometer and the pressure that is produced is measured, giving a number for the patient which can be compared each year to monitor potential glaucoma. “In England, about 480,000 people have chronic open-angle glaucoma.” Visual Field Test (Perimetry) This test is performed one eye at a time whilst the other is covered, so not to produce any errors within the results. The test involves a light that repeatedly focuses on different areas of the patient’s peripheral vision. It will then show the extent of their visual field that each eye can see. It can detect a lack of function within both central and peripheral vision, thus caused potentially by glaucoma or other neurological conditions. “Approximately 10% of UK blindness registrations are ascribed to glaucoma. It is estimated that in the UK about 2% of people older than 40 have chronic open angle glaucoma, and this rises to almost 10% in people older than 75.” Cornea Thickness Test (Pachymetry) If a patient is getting artificially low eye pressure readings, then the thickness of their cornea may be influencing these results. Pachymetry is performed by firstly administering eye drops and then gently placing a pachymeter (a small probe) onto the cornea, to correctly measure how thick it is. This is measured on both eyes and if a thick cornea is detected, then this information can help to understand eye readings on other tests, to ensure an accurate evaluation is achieved. Angle Test (Gonioscopy) An angle test inspects the space between the iris and the cornea. The eyes will initially be numbed with drops and then a gonioscopy lens is placed onto the eye. This then measures whether the space between the iris and cornea is narrow or broad. If the result is narrow, then this could be a symptom of acute glaucoma, whilst a wide result could be a symptom of chronic glaucoma. We regularly see and treat glaucoma patients and in the past 3 months have treated over 2,000 patients. For information on our ophthalmology services, please visit: www.healthharmonie.com/ophthalmology We also provide outsourcing to hospitals for glaucoma wait list support. We offer these through the NHS increasing capacity framework. More information on the subject: www.healthharmonie.com/nhs-partnership

Insourcing is crucial as it ensures that patients have a wider scope of appointments to be able to attend in order to be seen and treated. Insourcing offers evening and weekend appointments that can play an incredibly helpful role alongside the typical 9-5 clinic. This plays a huge part in working around different patients work schedules as those who are at work throughout the day will not have time to attend the normal appointment times. Insourcing we can accommodate for patients much easier and provide them with more options, creating an extension of our already existing services. The quality of patient care is our main priority, and through insourcing it allows us to track the development process within the clinic. In doing so we are able to create increased levels of productivity. Our RTT is able to stay at a high level due to the increase in appointment options and when referred, patients can be seen within locally, making it more convenient for them. It also means that patients records do not need to be transferred as it’ll all be contained within one clinic site. Insourcing not only means we can have this extra capacity of care, but we can also extend our use of medical professionals within the NHS. Our insourcing solutions is part of our hybrid model which is inclusive of both insourcing and outsourcing. We offer bespoke solutions tailored to each CCG or NHS Trust.

Yesterday kicked off the start of Cervical Screening Awareness Week and we wanted to get involved to spread awareness on the subject. Cervical screening (the smear test) is the term used for the process which tests the condition of your cervix. Unfortunately, within the past 10 years the number of smear tests attended has dropped, so we wanted to stress the importance of attending these appointments. As a GP, helping patients who are feeling anxious at the idea of smear tests can ultimately increase the number of screenings performed each year by demonstrating a friendly and reassuring environment, ensuring the best care for our patients. Cervical screenings start from the age of 25, if we can educate on the subject so that patients are attending at this age then they are likely to continue this care with every screening appointment that follows. Most are worried to attend smear tests as they are too embarrassed to have one performed, so it is important that patients are informed on how simple the process actually is in order to combat the risk of potential cervical cancer. “It is estimated by UK researchers that in England, cervical screening currently prevents 70% of cervical cancer deaths. However, if everyone attended screenings regularly, 83% could be prevented.” The national target for cervical screening coverage is 80%, however: “Screening figures collected by NHS Digital show that coverage amongst women aged 25 to 49 years was 70.2% at 31 March 2016. This compares to 71.2% at 31 March 2015 and 73.7% at 31 March 2011. For women aged 50 to 64 years, the coverage at 31 March 2016 was 78.0% which compares to 78.4% as at 31 March 2015 and 80.1% as at 31 March 2011.” Whilst attending the appointments are down to the patient, GP’s and practice nurses can also aid in educating others on the subject to increase the number of patients attending their screenings. The Public Health England have created an educational video on the matter which can be viewed here: https://www.youtube.com/watch?v=8VU4xXybsto Dr Pallavi Latthe is our gynaecology lead who runs gynaecology clinics across south and central Birmingham and oversees a wide range of gynaecological issues. She is a research active clinician and leads the adolescent gynaecology and urogynaecology tertiary services at the Birmingham Women’s and Children’s Hospital. For more information on our gynaecology services: www.healthharmonie.com/gynaecology Sources: https://publichealthmatters.blog.gov.uk/2017/08/30/health-matters-making-cervical-screening-more-accessible/