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We’ve commenced two new community dermatology services in December, commissioned by Bassetlaw CCG and NHS South Warwickshire CCG. The services were commissioned earlier this year, and we’ve been working closely with the CCGs and local primary care providers throughout their mobilisation. We’d like to take this opportunity to thank those who have been involved in getting things off the ground, and we’re eager to continue to develop positive working relationships within these contractual areas. We’re now live on the NHS e-Referral Service (e-RS), and practices within Bassetlaw and South Warwickshire can refer suitable patients into our care via the Referral Assessment Service (RAS). Bassetlaw and South Warwickshire Community Dermatology We welcome you to contact us if you have any questions about the new service available within your local area.

We’re thrilled to have achieved a 4.5-star user rating on NHS.UK. Thank you to all who have taken the time to review our services and their experience of being within our care. Here at HealthHarmonie, patient safety and satisfaction is at the core of what we do, and we’re delighted to be regarded by our service users as a provider of exceptional patient care. We’re extremely grateful for our dedicated staff, who are essential in achieving our accomplishments. If we’ve had the pleasure of welcoming you within one of our clinics, we’d be delighted to hear what you thought of our service. Let us know via our patient survey or by visiting NHS.UK.

The fast-approaching winter months present unique challenges for our eyes, and the seasonal weather and lifestyle may affect our vision and worsen existing eye conditions. We’ve outlined these challenges, and made some suggestions that are easy to implement and will help you to protect your eyes during the colder months. Winter driving Come November, the clocks have gone back and the days are short. By the time we’re traveling home from the events of the day, the sun is often already low in the sky, causing glare on potentially cold and frosty roads. Glare can hinder our visibility, and it’s a good idea to keep a pair of sunglasses in the car. Just remember to remove them once dusk arrives or if you enter a tunnel. Also, make sure that the windscreen is clean inside and out as this will help you to see clearly. ​ Once the sun has dipped below the horizon, it’s not glare but a lack of light that restricts our vision. Our pupils dilate to let in more light, but our vision can become blurred as a consequence. If you wear glasses, this may cause you to become more reliant on them – so make sure you have them handy for those evening road trips. ​ Winter entertainment We’re less inclined to adventure outside during winter, and our activities are more confined. It’s common for people to spend more time reading and using screens at this time of year, and this can have a detrimental effect on our eyes. These activities require us to hold our focus for prolonged periods, and our eyes can become tired as a consequence. We also tend to blink less frequently, and this causes dryness. Try applying the 20:20:20 rule when reading or watching TV, spending 20 seconds looking at something 20 feet away every 20 minutes. ​ If you’re adventurous, a ski trip may be the height of winter excitement, but don’t neglect your eyes while you’re out enjoying yourself on the slopes. Snow and ice reflect both visible and UV light, and you’ll put yourself at risk of long term damage if you fail to protect your eyes. Remember to wear a pair of good quality sunglasses or goggles marked with the safety standard BS EN ISO 12312-1:2013 or a CE mark. This is particularly important in sunny conditions. In flat light, visibility may be poor, so be sure to select an appropriate colour sunglass or google lens to suit the conditions. Rose, yellow or blue lenses are typically best for low light. ​ Dry eyes As we crank up the heating in our homes, the air within them becomes drier. The heat and lack of moisture tend to make our eyes dry, and this can cause irritation and discomfort. If you’re prone to dry eyes, you’re likely to notice a worsening of the condition in the winter months, and you may wish to consider using a humidifier and lowering the temperature in rooms where possible. ​ As aforementioned, our wintertime activities may also further the dryness of our eyes, and it’s important to make a conscious effort to blink more frequently and take regular breaks from reading and using screens. If you’re still suffering, lubricating eye drops may be helpful, and your optometrist or pharmacist will be able to advise you further on the use of these. ​ Watery eyes Your eyes produce tears to protect them for the environment, so it’s not uncommon for the cold weather and winter wind to cause your eyes to water more than normal. In the great outdoors, colder air usually means dryer air, and the lack of humidity makes your eyes produce more tears. Glasses are your best defense, creating a barrier against the harsh winter conditions. But interesting, and if you’re still struggling, try dropping a few wetting eye drops into your eyes before venturing outside. They might just prevent the biological tear response going into overdrive. ​ Falls and the elderly The slippery, frozen ground in the dark of winter poses an injury risk for even the most agile of us, and the elderly are in particular danger of falling in these conditions. It’s important not to underestimate the role of sight in spotting icy patches and maintaining our balance on slippery surfaces. If you wear glasses to improve your distance vision, make sure you’re wearing them when walking outside and if you’re unsteady on your feet, consider consulting your optician or optometrist for further advice. ​ You can find further information about winter eye care via the website of The College of Optometrists: lookafteryoureyes.org

Your eczema Atopic eczema, or atopic dermatitis, is a complex and common, non-curable, non-infectious inflammatory skin condition that presents as red (erythema), dry and itchy skin (excoriation) that can sometimes become weeping, blistered, crusted, scaling and thickened (lichenification). This condition can affect any part of the skin, but most commonly affects the joint creases at the elbows, knees and sometimes the wrists and neck. It is hereditary and affects both males and females equally, with 1 in 5 children in the UK affected by eczema at some stage. Causes Atopic eczema emerges as a result of a combination of patient susceptibility and number of environmental factors. It is typically due to changes in the skin barrier, and overly reactive inflammatory and allergy responses. This change allows irritating substances/particles to enter the skin and cause infection and inflammation. Environmental factors such as exposure to heat, dust, woollen clothing, pets and irritants such as soaps, detergents and chemicals can aggravate your eczema. When you become unwell your eczema may also worsen (i.e. having a cold), along with dryness of skin, teething in babies, allergens in some foods, stress and bacterial and viral infections. ​ Symptoms The main symptom of Eczema is itching and the response to itch is scratch. This response can lead to the cause of many visible implications on the skin. The itch when severe may interfere with sleep and cause tiredness and irritability. The severity of your eczema may change in phases, from Mild – Moderate – severe. The changes may be due to periodical exposure to the above-mentioned environmental factors. ​ Treatment While eczema cannot be cured just like Psoriasis, there are several effective treatments that can help control the activities of your eczema and help live a good quality of life. These treatments include topical treatments (emollient, corticosteroid and phototherapy), and systemics and biologics therapy. The majority of children will see their condition improve by 60% by their teenage years with regular use of emollients and continuing to avoid irritants into adulthood. ​ Topical treatments are those that are applied to the surface of the skin. These form the basis of your treatment and are most important in the treatment of your eczema. The treatment involves the frequent application of emollients (moisturisers) and washing with an emollient soap substitute. This should be applied several times a day to support the outer barrier of your skin and prevent dryness. Emollients can come as a lotion (more water based), cream (equal oil and water based) or ointment (mostly oil-based). Ointment provides the best protection and it is best you choose your preferred ointment. If your eczema becomes infected, you may require emollient that contains antiseptic. ​ Topical steroid creams or ointments may be used to improve the redness (inflammation) and itch. Your doctor will prescribe the required strength for the severity and site of your condition. If your eczema is not responding to steroid treatment, or the site of the condition is unsuitable (i.e. face, eyelids, armpits, groin), other preparations such as calcineurin inhibitors - Tacrolimus ointment (Protopic) and Primecrolimus cream (Elidel) may be used. These may initially sting on application and should not be applied to infected skin. ​ If your eczema is infected; the sites become wet, weepy and crusted, antibiotics and antiseptics may be prescribed. Natural herbal preparations can be harmful, and it is advisable not to use them. Antihistamine tablets may be prescribed to help you sleep and can be taken at night. Cotton bodysuits (wet or dry) or silk vests and leggings can help to prevent moisturisers rubbing off and stop scratching. Medicated paste bandages may also be used, and your doctor or nurse will be able to provide guidance on the application of dressings. ​ Like many other conditions, you may benefit from phototherapy. Phototherapy is a form of treatment where fluorescent light bulbs are used to treat skin conditions because natural sunlight has been known to be beneficial in certain skin disorders for years. If your eczema is severe, oral treatments (systemics) and biologics (injections) are now used to treat severe and widespread atopic eczema not responding to topical treatment. These works by hindering the immune system and are therefore given under close supervision of a healthcare professional. Self-help Always follow the treatment instruction provided by your health provider and remember that ointments are highly flammable and exposure to naked flames should be avoided. Antiseptics should not be used for a prolonged period as they can cause excessive drying of the skin. Avoiding allergens such as airborne allergens from cats, dogs, pollen, grass or the house dust-mite can prevent flare of your eczema and it’s important to wash clothes in non-biological washing powders and rinse properly to remove detergent residue from clothing. Wearing loose, comfortable and cool clothing made of soft and non-irritable material (i.e. cotton) is recommended. ​ Food allergies may irritate the skin and dietary advice may be sought from a professional to establish which foods should be avoided. Latex allergy is also common in those who have atopic eczema and contact with rubber should be avoided if it causes irritation especially household items (i.e. gloves). Smooth moisturiser into itchy sites and avoid the urge to scratch as although it may give short relief, it can cause further damaged in the long term. Contact allergies are rare. Nevertheless, you should contact your doctor if you are experiencing a worsening of symptoms following application of creams and ointments. See British Association of Dermatologists via their website: http://www.bad.org.uk/ for more information about atopic eczema.

Urinary tract infections (water infections) are very common. They usually pass within a few days and are easily treated with antibiotics. These infections are often caused by bacteria that live in the digestive system (gut). Bacteria like Ecoli, lie around the back passage or anus after you have emptied your bowel, which can travel to your urethra (the tube through which you pee) and into your bladder where it multiplies and causes an infection. Bacteria from other sources can also cause a urinary tract infection. How common is urinary tract infections? It is more common in females than males because of the much shorter urethra (the tube through which you pee) and the closeness of the opening to the anus (back passage). If the infection travels up to the ureters (tubes that connect the bladder to the kidneys), it is described as an upper urinary tract infection and can be more serious because the infection can spread to the bloodstream and cause permanent damage to the kidneys if not treated quickly. Some women suffer from repeated UTI (more than three episodes in one year), and this can be related to sexual intercourse. Urinary tract infections in men can happen as a result of an infection of the prostate rather than the bladder. ​ What are the symptoms of a urinary tract infection? The symptoms of lower UTI include burning or stinging sensations when passing urine, passing urine more frequently than normal, being unable to hold your urine or experiencing a strong urge to pee, experiencing pain or tenderness in the lower abdomen or back, blood in the urine and a generally feeling unwell. ​ The symptoms of upper UTI include fever or high temperature of 38ᵒC (100ᵒF) or above, uncontrollable shivering, feeling sick (nausea), vomiting, diarrhea, and headache. Older people (over 65) and people who have indwelling catheters, may only have symptoms of confusion or feel generally unwell. Some people may behave differently; for example, they may be agitated or confused, lose their appetites, or their diabetes control may become poor. ​ How are urinary tract infections treated? Antibiotic treatment will be chosen on an individual basis depending on symptoms. Suitable painkillers like paracetamol or ibuprofen should be taken for pain relief with the advice of a pharmacist if you are taking any other medication. ​ Your doctor should discuss the risks and benefits of antibiotics with you. Antibiotics are useful in treating bacterial infections, but we must be careful how we use them. This is because bacteria can become resistant to antibiotics and antibiotic treatment will become, and in some cases are, ineffective in treating infections. This is known as antimicrobial resistance, a growing problem because antibiotics are often prescribed when they are not needed. Cranberry capsules may be more effective than juice due to the high-strength cranberry extract. Do avoid it if you take anti-clotting medication such as warfarin as this can interact with your medication preventing it from working effectively. ​ Always discuss with your doctor first before trying over the counter medication and remember to drink at least eight glasses of water per day to maintain your hydration and keep your bladder healthy. For more advise or information please visit www.kidney.org.uk/, www.cobfoundation.org, www.bladderandbowelfoundation.org/, www.theurologyfoundation.org. ​ ​ ​ ​ ​

Fancy joining us as a Healthcare Administrator (HCA)? We’ve got a number of positions available for those who are interested in embarking on an exciting and fulfilling career with us. Being a HCA is a varied role, presenting an array of experiences and opportunities for development. There’re so many perks of being a HCA, let’s take a look at a few of them: It’s a rewarding career As we’re a community healthcare provider, it’s unlikely that you’ll witness the traumas of a busy accident and emergency department within our clinics. Nevertheless, as a HCA, you’ll still be supporting our patients through potentially worrying times. A welcoming, smiley face is often all that’s needed to reduce a patient’s anxiety and as a HCA, you’ll be there to comfort them and provide much-needed support. HCAs are arguably the true clinic heroes, helping the clinician to get what’s necessary out of the way whilst ensuring the patient receives the highest quality of care possible. Take a bow. ​ There’s never a dull day Working behind a desk nine till five isn’t for you? Being a HCA is a stimulating and active role, and two days are never the same. Not only will your daily responsibilities be diverse, but each appointment will bring a new patient from a different walk of life, all with individual conditions and needs. You’ll be operating clinics at multiple locations within your local area, and your day-to-day work environment will likely change on a regular basis. Our wonderful host sites house the friendliest of teams, and you’ll be working alongside them as the face of our organisation, building positive working relationships that support the business. ​ You’ll be part of a friendly team Not that we’re biased, but we think we’re a pretty great company to work for. You’ll be part of a dedicated clinical team that work closely and support each other to deliver exceptional patient care. We have a lot of fun as an organisation and we reward our Patient Care Advocates for their hard work. Every month, we draw upon feedback from patients and other members of staff to ensure that HealthHarmonie’s heroes are being recognised for going the extra mile. There are lots to get involved with as a HealthHarmonie employee, and you may find yourself helping out at one of our CPD events, baking a cake to raise money for Macmillan Cancer Support or celebrating our success at the HealthInvestor Awards. Welcome aboard! Being a HCA is a varied role, presenting an array of experiences and opportunities for development. ​ It’s an increasingly expanding industry There’s an increasing demand for healthcare professionals in the UK and HCAs benefit from job security and ever-expanding opportunities. There are no specific entry requirements for becoming an HCA, and we provide the necessary training for staff to flourish and develop prosperous careers. You’ll be exposed to a variety of healthcare disciplines throughout your time with us, allowing you to experience an array of health scenarios, make decisions about your preferences and tailor your expertise accordingly. Our clinicians are pioneers within their respective fields and as an HCA, you’ll be able to expand your knowledge as you work alongside them. ​ There’ll be opportunities to travel Whilst you’ll be based within your local area, there’ll be opportunities for you to assist in clinics further afield. We’re commissioned to deliver health services as far south as Berkshire and as far north as Stoke on Trent, and as we’re consistently growing and expanding our service coverage, who knows where we’ll be operating next. For those that like to travel, we’ll look after you while you’re away and you’ll be provided with all the luxuries of home. Your travel, accommodation and meals will all be covered and you’ll get to explore new places alongside friendly colleagues. ​ Sound good? You can find out more about becoming a HCA or apply for a position via our Job Vacancies page.

When you hear or see the word ‘Urology’ you may think of your bladder, your prostate or your kidneys. For some it may be a reminder of episodes in their lives they would rather forget; bladder cancer, prostate cancer, urinary incontinence, bed-wetting, infections and pain. I am reminded of my childhood and this may sound familiar to you too: The voice of a parent, “go and have a wee before we leave the house”, “the road is long and there are no toilets on the way, so make sure you empty your bladder before you get in the car”. It brings a smile to my face as I too, when my kids were younger, fell into that parental role of asking my kids to have a ‘wee’ before we left the house. The Urology Foundation have dedicated September as Urology Awareness Month. They reported that an estimate of 1 in 2 people in the UK will be affected by a urological condition impacting the lives of men, women and children. That is a staggering amount of people! Here at HealthHarmonie, we are committed to doing our bit to get the message across, breaking down the stigmas and encouraging our community to take care of their bladders, prostates and kidneys. The myth still exists that problems with leaky bladders are just part of the ageing process; all old people smell. Over the years, I have had many women in my clinic expressing the fear of not wanting to smell like an old lady. Often, they are too embarrassed to talk about their bladder problems. The elderly can be afraid to visit their families because they fear wetting their beds and ruining the mattress. They don’t want their grandchildren seeing them in nappies. Relationships break down because of incontinence episodes. The list is long. ​ The function of our bladder and kidneys The kidneys are responsible for cleaning up our blood, removing waste and excess fluid via our bladders in the form of urine. It ultimately acts as a filter, balancing salts and other substances in the blood to maintain stable blood pressure. Our bladders act as storage balloons, holding the urine until we are ready to empty them. The lining of the bladder consists of a muscle that contains nerve receptors. When the bladder gets full, nerve signals are sent to the brain to instruct the sphincter (valve) at the base of the bladder to relax and the bladder wall to squeeze to push urine out. This action should be entirely voluntary, but for some of us this is not the case and ‘oops-moments’ happen as a consequence. What can we do to keep our bladders and kidneys healthy? It’s important that we drink at least 8 glasses or 3 pints of fluid per day and consult our GP If we have problems with renal failure and heart disease. This is so that we can ensure that we are drinking the right amount for us. Reducing caffeine and alcohol intake whilst avoiding fizzy, sugary and acidic drinks will help, along with trying not to eat too much spicy and acidic food which may irritate your bladder. If you notice blood in your urine, experience pain when passing urine or go to the bathroom excessively during the day or at night, see your doctor. Passing urine 7 to 8 times per day (24hrs) is normal depending on your fluid intake.

Psoriasis is a long-term, non-infectious inflammatory skin condition that affects men and women equally at an average of 1 in 50 people. The condition does not scar, but it can change skin colour over time. Psoriasis can be scaly, red, flaky and very itchy and affect any part of the body including the scalp, nails and joints. If you experience joint pain with psoriasis, please inform a doctor. Psoriasis ranges from Mild to moderate to severe. Moderate to severe psoriasis can increase the risk of anxiety and depression and is also associated with other medical conditions such as; diabetes, obesity, heart disease, high cholesterol, stroke and few others. Please see a doctor if you are concerned about any scaly skin rashes/lesions on your skin. ​ Psoriasis can be physically diagnosed, although a biopsy may be needed (a process whereby a small sample of your affected skin area is taken under local anaesthetics to confirm diagnosis in the lab). Psoriasis can be inherited (although ‘how’ is not fully understood) and can also be linked to stress, excessive alcohol, smoking, sunlight and medications and infection. ​ Although there is no cure for psoriasis, there are several effective treatments that can help control the activities of psoriasis and help sufferers to live a good quality of life. The treatments include topical treatments (emollient, corticosteroid and phototherapy), systemics and biologics therapies. ​ Role of topical treatments ​Topical treatments are anything applied directly to your skin to treat your psoriasis. These range from lotions, creams, ointments, gels and shampoos. More severe psoriasis might require more intensive treatments such as phototherapy and systemics (through mouth) therapy. The roles of topical psoriasis treatment are to remove excess scaly skin and calm the underlying inflammation. This will improve the appearance and help the skin feel more comfortable and less itchy. ​ Emollients are the first line of treatments in psoriasis, helping to moisturise the affected areas and provide relief from itching and scaling. Emollients can be leave-on, vary from lotions to creams and can be used as a soap substitute. They help in absorbing other topical treatments and can be applied as many times as needed to settle dryness. It’s advisable to apply emollients at least 30 – 60 minutes before other topical treatments (i.e. topical corticosteroids) in a downward stroke manner, following the pattern of hair growth. This will prevent folliculitis (inflammation of the hair follicle) and the dilution of the effects of the treatment by spreading it to other areas of the skin that don’t require it. Emollients that are paraffin-based can be highly flammable. Please read the information on the pack carefully. ​ Topical corticosteroids are frequently used to manage the inflammatory process of moderate psoriasis on the body and scalp. Strong (potent) and super strong (extra potent) steroids can be used short term or intermittently and are available as creams and ointment for the body and lotions, gels, foams and prescription shampoos for the scalp. These are more suitable than ointments and creams for hairy areas as they are less sticky. ​ How to apply your topical treatments Psoriasis is a long-term, non-infectious inflammatory skin condition. There is no standard rule to effective application of topical treatments. It’s advised to wash daily with the soap substitute and pat the skin gently to dry. Do not rub the towel on your skin as this may cause the skin to become too dry. Using a spoon/spatula, scoop the emollients and apply all over your body in downward stroke. Do not dip your hands in the tub and this may lead to contamination. Leave the emollients to soak into the skin for at least 30 minutes for creams and 60 minutes for ointments and remember that paraffin-based ointments are highly flammable. Following the fingertips unit in the box of corticosteroid prescribed and apply the steroid all over the affected areas as instructed. Follow the same instructions for the scalp treatments. You can apply your prescribed emollients as many times as required but at least 30 – 60 minutes before or after the application of prescribed corticosteroids. ​ Phototherapy ​Phototherapy is a form of treatment where fluorescent light bulbs are used to treat skin conditions. Natural sunlight has been known to be beneficial in the treatment of certain skin disorders for years and the ultraviolet part of the radiation produced by the sun (mainly UVA and UVB) is used in phototherapy as a consequence. There are three main types of phototherapy that can be used to treat psoriasis: Broadband UVB (BBUVB); Narrowband UVB (NBUVB) and PUVA (Psoralen + UVA). The type most suitable for you depends on your skin type. ​ Your phototherapy nurse will discuss the process with you before you commence the treatment. You will need to avoid the use of your creams, ointments and lotions on treatment days unless directed otherwise by the phototherapy staff. You may continue to use moisturisers. Things to remember ​It’s important to discuss your psoriasis and how it affects your life with your GP or dermatologist and identify treatment goals. Manage your risk factors for heart disease and stroke with your GP and adopt a healthy lifestyle by eating a balanced diet, exercising regularly and trying to lose weight if you are overweight. If you smoke, stop smoking and reduce your intake of alcohol if you drink excessively. Reduce stress where possible and take medications as recommended by your GP or dermatologist. If you have pain in your joints discuss with your GP or dermatologist. ​ If you require further information about psoriasis, please visit the British Association of Dermatologists (BAD) website: www.bad.org.uk. ​ ​ ​

Healthcare bosses and commissioners are facing an ever-increasing demand to provide high quality, safe healthcare services to a growing population that is living longer. Service users are more informed about their health conditions and needs and their expectations of what that service should be like. Women's healthcare is no different. One such need is that of dysfunctional uterine bleeding or abnormal menstrual bleeding. Outpatient hysteroscopy is a very common procedure within the hospital setting but options are now available in some areas where the same service is available within a non-hospital community setting that is patient orientated and cost effective. In a randomised controlled trail, Marsh, F. et al (2000), demonstrated that outpatient hysteroscopy has economic benefits for women, the NHS and society at large e.g. less time off work, reduced loss of income, reduced travel cost and reduced NHS cost. ​ Satisfaction among conscious women having an outpatient hysteroscopy were higher than those undergoing the same procedure under a general anaesthesia on a day-case list (Kremer et al, 2000). ​ Community-based out-patient hysteroscopy offers a safe, convenient and cost-effective means of diagnosing and treating abnormal uterine bleeding, aiding the management of other benign gynaecological conditions. Possible risks include pain, feeling faint or sick, bleeding, infection (1 in 400) and uterine perforation. The risk of uterine perforation is much lower than having the procedure done under a general anaesthetic (fewer than 1 in 1000). Patients are advised to take a non-steroidal anti-inflammatory (NSAID) like Ibuprofen, provided it is not contra-indicated, an hour before their appointment time to aid pain relieve post-procedure. Women can return to work the following day. ​ If you would like to know more about community-based out-patient hysteroscopy, please do not hesitate to contact us via our contact us page.

As a community healthcare provider, we work to bring services that would usually be delivered within hospitals, closer to home. The benefit of this for patients is that there is no need to travel into the hospital, pay for parking or take time off work as gynaecology, ultrasound, dermatology and other minor healthcare appointments can be provided more conveniently within local health centres and GP surgeries. The NHS has to cover the entire population of England and tends to a vast library of illnesses and health problems. In such a largescale process, it can sometimes seem that the sense of community is lost and that’s why here at HealthHarmonie, we assure that healthcare isn’t just generalised but is in fact highly individual. We understand that to deliver the best possible treatment we must strive to understand the individual circumstances of our patients and they’re always at the centre of our operation as a result. ​ Closer to you, closer to home It is our priority to have clinics that are local to you and therefore closer to home. During our research process, our business development team use strategies to ensure that our clinics cover the region effectively but are still only around the corner, meaning our facilities are always accessible to our patients when they need us. We make sure that all of our host sites are accessible via public transport and that free parking is available, so there’s no need for patients to worry about how they are to get to their appointment or the costs that attending will incur. ​ We aim to deliver a customisable service that coincides with the lifestyles of our patients. With us, patients will not only have a choice over their clinician to suit their personal preferences, but they will also be offered choice over the location of their treatment and the date and time that it takes place. After an appointment has been arranged, our booking team send patients friendly reminders so that they don’t forget the details of their appointment and any preparatory requirements. Of course, unexpected things can happen, and the appointment agreed upon may suddenly be unsuitable. This is not an issue and if something arises, our booking team will go above and beyond to make sure that their appointment process is as care-free as possible. We will quickly reschedule for a later date which you can comfortably attend without having to wait weeks to be seen by a consultant. ​ Your healthcare, your choice Our brilliant staff work out-of-hours so that we can provide our health services at times which are most convenient for you. Across the country, we run early morning, evening and weekend clinics because we understand that our patient’s schedules are hectic and daytime appointments may be inconvenient for many. By offering out-of-hours appointments we become more accessible, helping you keep your day-to-day life completely unhindered. ​ Our service is conducted in local GP surgeries. We are always striving for quality and safety, and who better to tell us how to improve our service than our patients? We want to hear about their experiences during the HealthHarmonie process so we can better ourselves to offer a more complete and ever-improving service. ​ You said, we listened, we did We conduct patient satisfaction surveys which are sent via text message to patients after their appointment, asking about their experience of our service. Here, we can find out opinions and suggestions on how we can better ourselves for them. For instance, HealthHarmonie patients said our clinics were sometimes hard to find. We listened and designed clinic location maps that are now on our patient letters, leaflets and also on our website. ​ If you have any questions about our services or would like to find out more about your care within the community setting, please do not hesitate to contact us via our contact us page.

I started my nursing career as a student nurse in 1981 and qualified as a Registered Nurse in 1985. For a year after qualifying, I worked on night duty as a staff nurse on a surgical ward. I didn’t enjoy this initial role, as full-time night duty was very unsociable and I was pleased when a staff nurse position came up on the dermatology ward. They were struggling to fill this post as working on the 'skin ward' didn’t seem to be a very popular choice for most nurses. Nevertheless, I jumped at the chance as it was a job on day duty. So, I ended up working within the field of dermatology purely by chance and not because it was a particular passion of mine. This being said, I soon grew to love it and I worked at Royal Stoke Hospital for seven years on the dermatology ward, followed by eight years within the dermatology outpatient department. In 2001, I was seconded into a project nurse role for two years, assisting in the development of a community dermatology service for Stoke and North Staffordshire. This was a joint venture between primary and secondary care, a successful project funded by the modernisation agency in London. I worked for Stoke on Trent and Staffordshire Partnership Trust from 2001 to 2015, developing and delivering community dermatology services. ​ "The management team are approachable, supportive and committed to the continued progression and development of their clinical team." In 2015 HealthHarmonie took over the community dermatology service in Stoke and North Staffordshire and in being keen to remain within the field, I was transferred into their employment. I have a varied role as a clinical nurse specialist in dermatology and working for HealthHarmonie has allowed me to continue to provide quality dermatological care within the community. My role includes triage, audit and assisting in staff recruitment and staff training. I also help with clinical governance issues and carry out nurse-led clinics for minor skin surgery, phototherapy and cryotherapy. ​ I provide leadership support and training to my nursing colleagues and in turn, I receive fantastic support from the management team at HealthHarmonie. The management team are approachable, supportive and committed to the continued progression and development of their clinical team. We are supported by a large team of patient care advisors, who work tirelessly in the office and out in clinic alongside the clinicians to help maintain high standards of care and ensure the greatest possible patient experience. ​ Working for HealthHarmonie has presented me with lots of new challenges and I have met many new friends. I still thoroughly enjoy my role as a Dermatology Nurse Specialist and even after 32 years I hope to see out the rest of my career working with such a fabulous team. ​ We're always on the lookout for like-minded people with a commitment to exceptional patient care to join our team. If you'd be interested in working with us, contact our recruitment team on 0121 454 7779 or visit our career page.

I first met Charlie in February 2019 when he was referred to me for Cryotherapy. Charlie is seven years old and hyperactive to say the least: a beautiful boy inside and out. He presented with warts on his knees, face and hands and he wanted them ‘to go’. Initially, Charlie had to gain confidence in myself and Vicky, the admin support I had with me. We decided that the ‘good cop, bad cop’ approach would be best for him and Dad agreed with this. I, of course, was the ‘bad cop’ with the cryo gun! "Charlie came to my clinic last week and he was more exuberant than ever. ‘Look they’ve all gone!’ he shouted as he danced into the clinic room, ‘my skin is all better!’ He was over the moon that his skin was clear of all the warts." After meeting Charlie, it soon became evident that he was into superheroes and Captain Underpants was his favourite. I had never heard of this superhero before, so treating Charlie was a lesson for me. We thought Charlie was a superhero himself and after gaining verbal and written consent from his Dad, I was able to spray Charlie’s knees and one of the warts on his hand for a few seconds. ​ I wanted to reward Charlie and arranged a timely meeting with my colleagues in the office. We created a Superhero certificate and a ‘goodie-bag’ to give to after his next session. I learnt all about Captain Underpants and his partner Super Dipper Baby and ordered colouring books to keep him busy. ​ Charlie had a course of four treatments. He made our day and was always delighted with his reward, usually expressing his happiness with a little dance or song. Charlie came to my clinic last week and he was more exuberant than ever. ‘Look they’ve all gone!’ he shouted as he danced into the clinic room, ‘my skin is all better!’ He was over the moon that his skin was clear of all the warts. ​ Mum said that they thought of cancelling the appointment but Charlie wanted to see us. He had made thank you cards for Vicki and myself. Inside he wrote, ‘Thank you for making my skin better.’ I had a wonderful drawing of Super Dipper Baby in my card and Vicki’s card featured Captain Underpants himself. Yes, a tear came to our eyes as we were so touched by what this wonderful little boy had done for us. Mum was just smiling from ear to ear. We were pleased that Charlie’s warts had cleared but of course, we were also sad we would not see him again. Fortunately, Charlie’s parting words were: ‘if my skin gets bad again, I will give you a call okay?’ And then he was gone. We all have learnt so much from Charlie and are thankful to him and his parents. We’re delighted that we were able to enter his fantasy world of Captain Underpants and help him. I also now have a supply of superhero certificates for our younger patients and a unicorn suitcase full of goodies to reward these true superheroes. ​ "Charlie’s parting words were: ‘if my skin gets bad again, I will give you a call okay?’ And then he was gone." I am incredibly grateful that my colleague Jess, who puts together the admin support rota, was able to ensure Vicki worked with me when Charlie was going to be seen. Charlie’s story is an excellent example of how teamwork and communication can lead with an excellent outcome, all due to the clinic staff, managers and of course the leader of us all Charlie. ​ For more stories like Charlie's, visit our blog page. ​ ​