Lander Medical PracticeTel: 01872 243700
Threemilestone Branch SurgeryTel: 01872 243723
These are run by the Community Midwives. If you are pregnant and have not yet been seen by a Midwife, please inform the Reception Staff. We now run daily postnatal clinics at Truro Health Park where the Midwives see the majority of new mums and babies. On the first day after discharge a Midwife will contact the family to ascertain if a home visit or an appointment at Truro Health Park is needed.
The midwifery team run antenatal preparation classes to prepare you for your birthing experience.
We also have maternity support workers in the midwifery team who can visit at home or see you at the Health Park.They provide breast feeding advice and newborn baby care support.
To book an appointment please call: 01872 243700
Midwives Office: 01872 221 420
If you are on medication for heart disease, thyroid problems or have had a history of stroke, your blood pressure and cholesterol levels should be checked annually. If you are on medication for hypertension, your blood pressure should be checked at least once every six months. Our Practice Nurses run special screening clinics. If you suffer from Asthma or Diabetes, there are dedicated nurse clinics to review your condition at least annually. A new government initiative suggests that patients with Rheumatoid Arthritis should be reviewed annually at the surgery.
Routine physical checks (blood pressure, urinalysis etc) are available with the Practice Nurse. For more detailed advice on health matters, ask for a Lifestyle Clinic appointment. Click on the picture above to be directed to Health Promotion Cornwall.
Exercise poster - click here >>Exercise Leaflet
For children at 2,3 and 4 months, MMR at 13 months and pre-school boosters are available in twice weekly nurse clinics. Adult vaccinations for tetanus are done by the practice nurse.
Please consult your doctor first for an assessment. If your doctor feels that you need minor surgery you will be placed on a short waiting list and this will be performed at the practice. Some minor surgery procedures require referral to the hospital due the size or location of the problem.
Our Practice Nurses run a general session every day by appointment at Lander Medical Practice, and Monday mornings and Thursday mornings at Threemilestone, to deal with managing minor illnesses, wounds, injuries, dressings, removal of stitches and ear syringing.
They are supported by two Health Care Assistants who have clinics (Mon-Friday mornings and Wednesday and Friday afternoons at Lander Medical Practice, Monday and Wednesday mornings at Threemilestone) to take bloods, perform routine ECGs and blood pressure monitoring.
If you are travelling, we will ask that you check with your travel agent or look on an appropriate website to find out what travel vaccinations you will require. If you require Typhoid, Hepatitis A & B (Twinrix) or a tetanus booster, you can book in with the Nurse for these immunisations. For all other travel vaccinations you are advised to visit a Travel Clinic Centre or visit your nearest Pharmacy.
Information about countries and vaccinations required can be found on the links below:
It is important to make the initial appointment as early as possible, even if you think it is too early - we suggest at least six weeks before departure.
Hepatitis B: GPs are not obliged to provide the hepatitis B vaccine on the NHS if you're not thought to be at risk (source: NHS Choices Website)
This Practice has a policy to make a charge for the vaccine if you want it as a travel vaccine, or we may refer you to a travel clinic so you can get vaccinated privately. The current cost of the vaccine given at this practice is £25 per vaccine.
Warts are usually harmless, but may be unsightly. Warts on the feet are called verrucas and are sometimes painful. Warts and verrucas usually clear in time without treatment. If required, they can often be cleared more quickly with treatment. For example, by applying salicylic acid, or by freezing with liquid nitrogen or a cold spray, or by covering with tape
What are warts and verrucas?
Warts are small rough lumps on the skin. They are caused by a virus (human papilloma virus) which causes a reaction in the skin. Warts can occur anywhere on the body but occur most commonly on hands and feet. They range in size from 1mm to over 1cm. Sometimes only one or two warts develop. Sometimes several occur in the same area of skin. The shape and size of warts vary, and they are sometimes classed by how they look. For example: 'common warts', 'plane (flat) warts', 'filiform (finger-like) warts', 'mosaic warts', etc.
Verrucas are warts that occur on the soles of the feet. They are the same as warts on any other part of the body. However, they may look flatter as they tend to get 'trodden in'.
Note: anal and genital warts are different and are dealt with in a separate leaflet. Please enquire regarding this.
Who gets warts and verrucas and are they harmful?
Most people develop one or more warts at some time in their life, usually before the age of 20. About 1 in 10 people in the UK have warts at any one time. They are not usually harmful. Sometimes verrucas are painful if they press on a sensitive part of the foot. Some people find their warts unsightly. Warts at the end of fingers may interfere with fine tasks.
Are warts contagious?
Yes, but the risk of passing them on to others is low. You need close skin-to-skin contact. You are more at risk of being infected if your skin is damaged, or if it is wet and macerated, and in contact with roughened surfaces ie in swimming pools and communal washing areas. You can also spread the wart virus to other areas of your body. For example, warts may spread round the nails, lips, and surrounding skin if you bite warts on your fingers, or nearby nails, or if you suck fingers with warts on. If you have a poor immune system you may develop lots of warts which are difficult to clear. (For example, if you have AIDS, if you are on chemotherapy, etc.)
To reduce the chance of passing on warts to others:
Don't share towels.
When swimming, cover any wart or verruca with a waterproof plaster.
If you have a verruca, wear flip flops in communal shower rooms and don't share shoes or socks.
To reduce the chance of warts spreading to other areas of your body:
Don't scratch warts.
Don't bite nails or suck fingers that have warts.
If you have a verruca, change your socks daily
To treat or not to treat?
There is no need to treat warts if they are not causing you any problems. Without treatment, about 3 in 10 warts have gone within 10 weeks, and most warts will have gone within 1-2 years, and leave no scar. The chance that a wart will go is greatest in children and young people. Sometimes warts last longer. In particular, warts in older people are sometimes more persistent and may last for several years.
Treatment can often clear warts more quickly. However, treatments are time consuming and some can be painful. Parents often want treatment for their children, but children are often not bothered by warts. In most cases, simply waiting for them to go is usually the best thing to do.
What are the treatment options?
The three most commonly used treatments are:
Covering with duct tape.
Each of these is now discussed further
There are various lotions, paints, and special plasters that contain salicylic acid. You can buy these at pharmacies, or your doctor may prescribe one. Read the instructions in the packet on how to use the brand you buy or are prescribed, or ask your pharmacist for advice. Usually:
You need to apply each day for up to three months. This 'acid burns' off the top layer.
Every few days rub off the dead tissue from the top of the wart with emery paper (or similar). Gradually the wart is 'burnt off' and 'rubbed away'.
It is best if you soak the wart in water for 5-10 minutes before applying acid. You should not apply acid to the face because of the risk of skin irritation which may cause scarring.
If you have diabetes or poor circulation, you should use salicylic acid only on the advice of a doctor.
If you put the acid on correctly each day you have a good chance of clearing the warts within three months. Studies report that about 7-8 in 10 warts are cleared within three months with daily use of salicylic acid.
Tips for success include:
Try not to get the acid on the skin next to the wart as it may become irritated. You can protect the nearby skin by putting some Vaseline on the normal skin beforehand, or by putting on a plaster with a hole in it which just exposes the wart for treatment.
If the surrounding skin does become sore, stop the treatment for a few days until it settles. Then re-start treatment. There is also a small risk that you may get a skin allergy to the treatment. If this occurs, the surrounding skin becomes red and itchy.
It may take two weeks or more before you notice any improvement. It can take up to three months of daily applications for warts to go completely.
Treatment may work better if you put a plaster on the wart after applying the acid.
Acid lotions and paints are flammable. Keep them away from open fires and flames.
A recent study found that covering a wart with strong adhesive tape is likely to clear the wart within a month or two. (Duct tape was used in the study.) In this study, about 7 in 10 warts had cleared within two months with using duct tape. It may be worth a try as it is painless. However, further studies are needed to clarify the role of this treatment. The method described in the study was:
The wart was covered with duct tape for six days. If the tape fell off during this time a fresh piece of tape was put on.
After six days, the tape was removed and the wart soaked in warm water for five minutes. After drying it was then gently rubbed with an emery board or pumice stone to get rid of dead tissue from the top of the
The wart was then left uncovered overnight and duct tape put on again the next day.
Treatment was continued for up to two months. (Note: most warts that cleared with duct tape did so within 28 days.)
Some experts advise that you should not use duct tape on the face as in some people it can irritate the skin.
Other treatment options
A podiatrist or chiropodist can pare or rub down a verruca. This is often enough to ease any pain, even though part of the verruca may still remain.
If the above treatment options do not clear warts then other methods may be tried. There are various ways that can 'cut out' or 'burn' warts, but they are usually only done by specialists if other treatments have failed. Some treatments (such as laser treatment) are not available on the NHS to treat warts and verrucas.
What about swimming?
A child with warts or verrucas should go swimming as normal. Warts can be covered with waterproof plasters. A verruca can also be covered with a waterproof plaster but some people prefer to wear a special sock which you can buy from pharmacies. It is also a good idea to wear flip-flops when using communal showers as this may reduce the chance of catching or passing on virus particles from verrucas.
Updated April 2018
Six month repeat prescriptions of the Pill can be obtained in the same way as a repeat prescription. Once a year you should be checked in the Practice Nurse’s Well Woman Clinic, or in your own doctor’s normal surgery. Depo-provera injections can be done in the General nurse Clinic. Please make sure you make an appointment to have your blood pressure checked regularly if you are receiving any kind of hormonal contraception.
For cervical smears, breast and blood pressure checks ask for an appointment in the Well Woman Clinic. If you do not wish to be called for a smear test you must complete the appropriate 'opt out' form. Please discuss your wishes with your GP who will be able to advise you further.
The Lander Medical practice is registered with the C-Card scheme as a distribution centre.
Please note: certain types of epilepsy medication may prevent you being able to use a certain type of contraceptive. Please check with your GP in the first instance. Thank you.
This leaflet gives a brief summary of the methods of contraception. A more detailed leaflet is available for each of the methods.
How effective is contraception?
All the methods of contraception listed below are effective. However, no method is absolutely 100% reliable. The reliability for each method is given in percentages. For example, the contraceptive injection is more than 99% effective. This means that less than 1 woman in 100 will become pregnant each year using this method of contraception. When no contraception is used, more than 80 in 100 sexually active women become pregnant within one year.
The effectiveness of some methods depends on how you use them.
You have to use them properly or they may lose their effect. For example, the 'pill' is more than 99% effective if taken correctly. If it is not taken correctly (for example, if you miss a pill or have vomiting) then it becomes less effective. Other 'user dependent' methods include barrier methods, the progestogen only pill and natural family planning.
Some methods are not so 'user dependent' and need to be renewed only infrequently or never. These methods include the contraceptive injection, implant, intrauterine devices (coils) and sterilisation.
What are the different methods of contraception?
Choosing a method of contraception involves a balance between:
** how effective it is
** possible risks and side-effects
** plans for future pregnancies
** personal preference
** if you have a medical condition that needs to be considered.
This is often just called the 'pill'. It is more than 99% effective if used properly. Contains oestrogen and progestogen and works mainly by stopping ovulation. It is very popular. Different brands suit different people.
Some advantages - Very effective. Side-effects uncommon. Helps ease painful and heavy periods. Reduces the chance of some cancers.
Some disadvantages - Small risk of serious problems (eg thrombosis). Some women get side-effects. Have to remember to take it. Can't be used by women with certain medical conditions.
PROGESTERON-ONLY PILL (POP)
Used to be called the 'mini-pill'. Contains just a progestogen hormone. More than 99% effective if used properly. Is commonly taken if the combined pill is not suitable. For example: breastfeeding women, smokers over the age of 35 and some women with migraine. Works mainly by causing a plug of mucus in the cervix that blocks sperm and also by thinning the lining of the uterus. May also stop ovulation. Some advantages - Less risk of serious problems than the combined pill. Some disadvantages - Periods often become irregular. Some women have side-effects. Not quite as reliable as the combined pill.
A combined hormone form of contraception, containing oestrogen and progestogen hormones. It is essentially the same type of contraception as the combined oral contraceptive pill but it is used in a patch form. The contraceptive patch is stuck onto the skin so that the two hormones are continuously delivered to the body. There is one combined contraceptive patch available in the UK called Evra®.
Some advantages - It is very effective and easy to use. You do not have to remember to take a pill every day. Your periods are often lighter, less painful and more regular. If you have vomiting or diarrhoea, the contraceptive patch is still effective.
Some disadvantages - Some women have skin irritation. Despite its discreet design, some women still feel that the contraceptive patch can be seen.
These include male condoms, the female condom, diaphragms and caps. Prevents sperm entering the uterus. Male condoms are about 98% effective if used properly. Other barrier methods are slightly less effective than this.
Some advantages - No serious medical risks or side-effects. Condoms help protect from sexually transmitted infections. Condoms are widely available.
Some disadvantages - Not quite as reliable as other methods. Needs to be used properly every time you have sex. Male condoms occasionally split or come off.
CONTRACEPTIVE INJECTIONS (eg Depo-provera® and Noristerat®)
Contain a progestogen hormone which slowly releases into the body. More than 99% effective. Works by preventing ovulation and also has similar actions as the POP. An injection is needed every 8-12 weeks.
Some advantages - Very effective. Do not have to remember to take pills. Some disadvantages - Periods may become irregular (but often lighter or stop all together). Some women have side-effects. Normal fertility after stopping may be delayed by several months. Cannot undo the injection, so if side-effects occur they may persist for longer than 8-12 weeks.
CONTRACEPTIVE IMPLANTS (eg Implanon®)
An implant is a small device placed under the skin. Contains a progestogen hormone which slowly releases into the body. Is more than 99% effective. Works in a similar way to the contraceptive injection. Involves a small minor operation using local anaesthetic. Each one lasts three years.
Some advantages - Very effective. Do not have to remember to take pills.
Some disadvantages - Periods may become irregular (but often lighter or stop all together). Some women develop side-effects but these tend to settle after the first few months.
INTRAUTERINE DEVICE (IUD)
A plastic and copper device is put into the uterus. Lasts five or more years. It works mainly by stopping the egg and sperm from meeting. It may also prevent the fertilised egg from attaching to the lining of the uterus. The copper also has a spermicidal effect (kills sperm).
Some disadvantages - Periods may get heavier or more painful. Small risk of serious problems.
HORMONE RELEASING INTRAUTERINE SYSTEM (IUS)
A plastic device that contains a progestogen hormone is put into the uterus. The progestogen is released at a slow but constant rate. More than 99% effective. Works by making the lining of your uterus thinner so it is less likely to accept a fertilised egg. Also thickens the mucus from your cervix. Is also used to treat heavy periods (menorrhagia).
Some advantages - Very effective. Do not have to remember to take pills. Periods become light or stop altogether.
Some disadvantages - Side-effects may occur as with other progestogen methods such as the POP, implant and injection. However, they are much less likely as the hormone is mainly confined to the uterus (little gets into the bloodstream).
This involves fertility awareness. Effective if done correctly. Requires commitment and regular checking of fertility indicators such as body temperature and cervical secretions.
Some advantages - No side-effects or medical risks.
Some disadvantages - May not be as reliable as other methods. Fertility awareness needs proper instruction and takes 3-6 menstrual cycles to learn properly.
This involves having operation. Is more than 99% effective.
Vasectomy (male sterilisation) stops sperm travelling from the testes.
Female sterilisation prevents the egg from travelling along the fallopian tubes to meet a sperm.
Vasectomy is easier and more effective than female sterilisation. Popular when family is complete.
Some advantages - Very effective. Do not have to think further about contraception.
Some disadvantages - Very difficult to reverse. Female sterilisation usually needs a general anaesthetic.
Can be used if you had sex without using contraception. Also, if you had sex but there was a mistake with contraception. For example, a split condom or if you missed taking your usual contraceptive pills.
Emergency contraception pills - are usually effective if started within 72 hours of unprotected sex.
Can be bought at pharmacies or prescribed by a doctor. It works either by preventing or postponing ovulation or by preventing the fertilised egg from settling in the uterus (womb).
An IUD - inserted by a doctor or nurse can be used for emergency contraception up to five days after unprotected sex.
This is just a brief account of each method of contraception. Ask your practice nurse, doctor or pharmacist if you want more detailed information about any of these methods.
Under 25 and confused about cervical smears?
You may have seen some articles in the newspapers and online, about cases of cervical cancer in women who were too young to have been invited for NHS England cervical screening (a “smear” test).
Fortunately these sad cases are very rare, but are often accompanied by campaigns to lower the age at which women are called for smear tests, to 20.
Women under 25 are not routinely invited for smears because in younger women, normal developmental cell changes in the cervix can look very similar to abnormal changes, leading to unnecessary treatment and worry.
REMEMBER a cervical smear is a routine screening test, designed to pick up very early changes in the cells in the cervix in women who have NO SYMPTOMS.
If you have any worrying symptoms, such as an abnormal discharge or bleeding between your periods, especially after sex, then visit your GP or GUM clinic for an examination and advice, regardless of your age.
These symptoms are very unlikely to be caused by cancer, but should be checked.
A cervical smear is not the appropriate investigation for women who have symptoms, whatever age they are.
The PSA test is a blood test that measures the amount of prostate specific antigen (PSA) in your blood. PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells.
Please see the leaflet for for futher information: PSA
'Fit notes' replaced sick notes from 6 April 2010
If you’re off work sick for seven days or less, your employer should not ask for medical evidence that you’ve been ill.
If you’re off work sick for more than seven days, your employer will usually ask you to provide evidence or proof that you’ve been ill. They will normally ask for a fit note from your GP. Fit note is the informal name for the Statement of Fitness for Work. Fit notes replaced sick notes from 6 April 2010.
The seven days include days that you don’t normally work. So when you work out how long you’ve been off sick, you should include weekends and bank holidays.
Your employer can ask you to confirm that you’ve been ill. You can do this by filling in a form yourself when you return to work. This is called self-certification.
Self-certification forms usually include details such as:
These dates may be days that you don’t normally work. For example, your sickness could start or end on a Saturday, Sunday or bank holiday.
Many employers have their own self-certification forms. If your employer doesn’t have their own form, instead they may use an SC2 form from HM Revenue & Customs: Employee’s Statement of Sickness (PDF).
If you’re sick and off work for more than seven days, your employer will probably ask for proof of your illness. Most employers ask for a fit note from your GP.
However, this will also depend on your employer’s company policy on sick leave (or sickness absence). This policy should tell you how many days you can be off sick before you need to provide proof of illness or a fit note.
A fit note must be signed by a doctor, such as your GP. On the fit note, your GP can advise that:
For more information, including what ‘may be fit for work’ means, see What are fit notes?
If you need a fit note, you should contact your GP practice. They may advise you to make an appointment or book a telephone consultation.
If you’re under the care of a hospital, your fit note may be issued by the hospital, rather than by your GP.
There is never a charge from an NHS doctor for providing a fit note if you’re off work sick for more than seven days.
Some employers may request a fit note, for example, from employees who repeatedly take time off sick, even if, each time they’re off work, it’s for seven days or less.
For sickness of seven days or less, the GP practice may make a charge to provide a fit note.
Read the answers to more questions about workplace health.
LANDER MEDICAL PRACTICE - PHYSIOTHERAPY DEPARTMENT
We have a small team of highly experienced physiotherapists with a wide breadth of knowledge and experience across a variety of areas. They are supported by a member of administration support staff and a physiotherapy assistant.
Rebecca Davison - Physiotherapist - MSc BSc (Hons) MCSP HCPC
Paula Pender - Physiotherapist - PG Dip MCSP HCPC
Diana Wharton - Physiotherapist
Paula Bright - Physiotherapist
Elle Cathcart - Physiotherapy Assistant
Sue Ballard - Physiotherapy Admin
What we offer
We see a variety of generalised musculoskeletal conditions from acute to chronic problems.
We also are a recognised 'Any Qualified Provider' (AQP) for a Neck and Back Pain Service which we run jointly with the Three Spires Physiotherapy department. Patients with acute neck or back pain i.e. whiplash, stiffness, neck related headaches, mechanical low back pain, posture related back and neck pain, are seen through this pathway.
We have an excellent Physiotherapy unit within the Lander Medical Practice at the Truro Health Park consisting of a clinic room and gymnasium which is used for rehabilitation and some Physio led exercise classes.
Who can refer to us?
We only accept referrals to Physiotherapy from our own Lander GP's and do not take self referral from patients or from other sources.
However, we can accept referrals from outside of the practice for our AQP Neck and Back service if patients fulfil the criteria.
How to contact us
If you would like to speak to a member of the team please ring the Lander Medical Practice number on 01872 243700 between 08.00 and 13.30, Monday to Friday when a member of the admin team will be available to answer your call. If you are unable to ring between those hours then please leave a message with the reception team and we will get back to you as soon as possible.
If your concern relates to the AQP Neck and Back service then please call 01872 243712 between 08.00 and 12.00, Monday to Friday (outside of these hours please leave a message), or you can email Sue Ballard our admin support staff on: email@example.com
Truro Health Park Back and Neck Pain Service
(Lander and Three Spires Medical Practices)
We have a team of five highly experienced physiotherapists who are supported by two physiotherapy assistants and a clerical/administration support worker.
At the Back and Neck Pain service we treat patients with back and neck pain including:
Stiffness and restricted movement
Headaches caused by neck problems
Mechanical lower back ache
Back and neck pain caused by activities of everyday life
Posture related back and neck pain.
Contact details: 01872 243712
08:00 - 11.30 Mon-Fri (outside these hours please leave a message)
The KCC Group are the shadow commissioner for health services in this area. Further information about who they are and what they do can be found by clicking linking the link below:
Smoking is UK’s biggest killer, accounting for about 1000 premature deaths each year in Cornwall as well as a heavy toll of illness. We have made great strides in recent years in driving down the number of people smoking – it is now 20 per cent of adults.
The Cornwall and Isles of Scilly Stop Smoking Service works to NICE Guidance and has over 80 trained Stop Smoking Service advisors working across Cornwall, in a variety of settings including: surgeries, hospitals, pharmacies, schools, Children's Centres and other community venues.
The majority of smokers report that they want to stop. Almost nine out of ten (88%) smokers state that they want to quit because of health concerns.
Using the help and support of the Stop Smoking Service is the most cost effective way of quitting is nearly four times more effective than will power alone.
The ASH 'Reckoner' toolkit to help estimate the local health impact and cost of tobacco use estimates that:
* There are 88,564 smokers in Cornwall and Isles of Scilly
* Smoking costs Cornwall and Isles of Scilly approximately £175.7 million a year
Call Health Promotion now on (01209) 615600 or e-mail us at firstname.lastname@example.org and find out how they can help.
Go for it, you've got nothing to lose and so much to gain.
Smoking cessation is associated with the following health benefits:
Updated April 2018
Life assurance, permanent health insurance, driving and HGV require a special appointment outside normal surgery time. Please contact our secretary, Yvonne Lusty, who will arrange a time. 01872 243700. Please make sure you have the appropriate paperwork for your medical or check with Yvonne to see if the Practice has already received it.
Please note we are unable to to provide ENG1 seafarers medicals. These need to be undertaken by a GP registered to provide this information. Please click the photo below to find a list of Doctors in Cornwall who will be able to assist you with this service.
For fees please see tab on right hand side 'Fees for Private Work'.
Enter all or part of your postcode in the box below and click one of the buttons
to find those services that are local to you.
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