Services

Talk to your GP about your end-of-life wishes

It's important to talk with your GP about your end-of-life wishes. Make time to have a discussion about your end-of-life wishes with your General Practitioner. If your wishes are documented, then you can have some control over health care decisions, even at times when you may be too unwell to discuss your health care.

Advance Care Planning is a process to help you plan your medical care in advance. It is important because some time in the future you may become too unwell to make decisions for yourself. If you have no problems communicating and can make your own health decisions, your advance care plan will not need to be used. Your doctors will talk to you about your health care choices.

Doctors will refer to your advance care plan if you can no longer communicate or make decisions. For example, this might happen if you have a stroke or serious accident, or become unconscious, or if you develop dementia. In some cases illnesses, such as cancer, may mean the medication you take or the pain you have may make you unable to communicate.

Benefits of Advance Care Planning

If you were very sick, it may fall to your family or close friends to make decisions about your health care. That can be a very stressful time where family members or loved ones may not agree with approaches to your care. If they have a document where you talk about the type of care that you would want, this can help them make decisions on your behalf.

It can help you too. For example if you were very sick, you might know that you don’t want to be kept on life support if you were not likely to recover. You might know that you want all available treatment, even if that treatment might have side-effects that make you very sick. Writing down what is, and is not, okay for you can help doctors consider your wishes and individual preferences when planning your care.

When should I do it?

You never know when you might be in an accident, or face a serious health condition. It is never too early to plan ahead. This can be as simple as talking to your family and close friends about your health care wishes. Some people see the completion of an advance care plan being just like filling in a Will. In fact, many people complete both documents at the same time.

If you have a chronic disease, if you are elderly or if your health seems to be getting worse, it is even more important to have a plan in place. Talk to your family about your health care wishes and document your advance care plan.

To view and print the Tasmanian Advanced Care Planning forms, click on the link below...

Advanced Care Planning Forms - Tasmania

All of the General Practitioners practicing at GHFP provide Antenatal Shared Care.

GP Shared Care is one of the options of care during pregnancy in which your General Practitioner is the primary care provider, in consultation with hospital doctors and midwives. Some private obstetricians also do GP Shared Care.

Some situations may exclude you from GP Shared Care, including high BMI, twins, some medical health conditions or previous pregnancy problems. Talk to your GP about whether you are suitable for GP Shared Care.

Antenatal appointments can be booked online or by phoning the practice on 6169 0000.

Shared Care Guide

Congratulations on your pregnancy! Your GP and support team look forward to caring for you during your pregnancy and beyond. This guide will give you an idea of what check ups to expect over the coming months.

‘Shared care’ means that throughout your pregnancy your GP will be your primary point of contact. You will also have visits to the Royal Hobart Hospital (RHH) with the midwives and doctors, or to your private Obstetrician. You will have your regular GP for routine antenatal visits and pregnancy related problems. You may need to see an alternative GP at the practice in an emergency, depending on your regular GP's availability.

What is involved in a routine visit? 

We will do a few checks including your blood pressure, fundal height (uterus size), baby’s position and heart sounds. We can discuss any concerns and plan for the next step in your pregnancy.

What is a normal pregnancy timeline?

A normal pregnancy is between 38-42 weeks long. We calculate your due date either from the first day of your last period, or from an ultrasound scan. Your routine visits will be around every 4 weeks until you reach 32 weeks, thereafter you will be seen every 1-2 weeks until delivery.

Your first RHH visit (the 'Booking In' visit) will be at around 14-20 weeks. Other hospital visits will at be around 28 weeks, 36 weeks and 40 weeks. There will also be antenatal classes and tours available. 

Important check ups:

First Visit:

• Background health check and blood tests
• Confirm pregnancy and due date
• Discuss healthy diet in pregnancy, supplements and other things to keep you and baby healthy
• Offer influenza vaccination

Second Visit:

• Check blood results
• Optional: 1st trimester screening for Down Syndrome, Trisomy 18 and Neural Tube Defects between 10-13 weeks, Non-invasive prenatal testing (NIPT)
• Referral to the Hospital for your ‘booking in’

10-14 weeks:

• RHH Antenatal clinic booking in visit
• Review screening tests

20 weeks:

• Morphology ultrasound scan: checks on babies development (and gender if you wish)

26 weeks:

• Blood test for gestational diabetes (2 hours oral glucose tolerance test)
• Blood test for iron levels and blood group

28 weeks:

• Blood test results
• Anti D for Rhesus D negative women
• RHH visit with doctors and midwives for check-up and education
• 34 weeks:
• 2nd dose of Anti-D for rhesus D negative women
• Pertussis vaccination for mother offered

36 weeks:

• RHH check up with midwives and doctors and to plan for delivery

40 weeks:

• RHH visit to discuss induction of labour and delivery

6 weeks after birth:

• Discuss labour, delivery and any concerns
• Check up on emotional well being
• Discuss contraception and family planning
• Organise repeat blood tests or cervical screen if needed
• Baby check up 

Your GP can help you with all your pregnancy related concerns including:

• Blood tests and immunisations
• Advice on keeping health in pregnancy
• Dietary and supplement advice
• Assistance with common pregnancy problems (e.g. nausea, fatigue, musculoskeletal problems)
• Psychological support
• Education on labour and delivery
• Assessment of any complications if they arise
• Preparing for a new baby
• Feeding and settling support once baby arrives

Communication is important between the RHH and your GP, we will send each other letters. Please remember: if you have any tests done to have a copy sent to your GP and to the RHH.

Fees:

Private fees apply to antenatal care appointments. The Fee and Medicare Rebate is dependent on the length and complexity of your consultation.

Important contact details:

Glebe Hill Family Practice: 6169 0000

Health Direct: 1800 022 222 

• 24/7 GP Phone Helpline

Royal Hobart Hospital:. 6166 8308

• General enquiries

WACS (Women and Children’s Services) RHH Clinic: 6166 0000

• Appointments
• Birthing and parenting classes
• Lactation Consultants: 6166 7929
• Pregnancy Assessment Centre: 6166 8352 (all hours)
• Speak to a midwife at anytime (after 20 weeks)
• Assessment in early labour

Useful pregnancy resources:

• Information on pregnancy, labour and birth
• Information on common problems in pregnancy

Queensland Centre for Mothers & Babies: http://www.havingababy.org.au

• Information on labour and birth

The Baby Centre: http://www.babycenter.com.au 

• General pregnancy information

Useful child health resources:

Raising Children Network: http://raisingchildren.net.au

• For all manner of helpful parenting resources and tips

• Advice for parents with unsettled or colicky babies

Parent Line (Tasmanian Department of Health and Human Services): 1300 808 178

• The Parent Line is available at any time to assist parents, of children 0-5 years, with parenting issues or concerns.

Child Health & Parenting Services (CHaPS): http://www.dhhs.tas.gov.au/children/child_health

• Information on all available parenting services in Tasmania (including parenting drop in centres, bedwetting and child therapy services)

Royal Children’s Hospital Fact Sheets: http://www.rch.org.au/kidsinfo/

• For all medical problems in childhood

• A complete guide to development, milestones, feeding, sleep and common questions in the first year

Comprehensive multidisciplinary asthma care is available at our centres. It is recommended that people with asthma see their GP for an asthma review at least once every 6 months.

People with moderate asthma requiring preventative medication should also have a Care Plan in place, and may benefit from input from other Allied Health Professionals, such as a Physiotherapist or an Exercise Physiologist.

What is asthma?

Asthma is a disease of the airways – the breathing tubes that carry air into our lungs. Sometimes it is harder for a person with asthma to breathe in and out, but at other times their breathing is normal. Asthma is a long-term (chronic) disease. Although there is currently no cure, with the right knowledge and good management, most people with asthma can lead full and active lives.

Symptoms of asthma

The most common symptoms of asthma are:

• wheezing – a continuous, high-pitched sound coming from the chest while breathing
• shortness of breath – a feeling of not being able to get enough air
• a feeling of tightness in the chest
• coughing – alongside other symptoms.

You do not need to have all of these symptoms to be diagnosed with asthma. Noisy breathing, such as a rattling sound, is common in healthy babies and preschoolers. This is not the same as wheezing and does not mean the child has asthma.

What causes asthma symptoms?

Many people think they have asthma only when they have asthma symptoms. In fact, the airways are sensitive all the time and most people with asthma have permanently irritated (inflamed) airways when not taking regular preventer treatment. From time to time, the airways tighten or become constricted so there is less space to breathe through, leading to asthma symptoms.

Asthma causes three main changes to the airways inside the lungs, and all these can happen together:

• the thin layer of muscle within the wall of an airway can contract to make it tighter and narrower – reliever medicines work by relaxing these muscles in the airways
• the inside walls of the airways can become swollen, leaving less space inside – preventer medicines work by reducing the inflammation that causes the swelling
• mucus can block the inside of the airways – preventer medicines also reduce mucus.

Asthma symptoms can be triggered by different things for different people. Common triggers include colds and flu, allergies, and cigarette smoke.

Who develops asthma?

Over 2 million Australians have asthma – about 1 in 10 adults and about 1 in 9 or 10 children.

Asthma and allergies are closely linked. Asthma is more common in families with allergies or asthma, but not everyone with asthma has allergies.

Adults of any age can develop asthma, even if they did not have asthma as a child.

Some people have asthma during childhood, but later have very few or no symptoms as adults.

Many preschool children who wheeze do not have asthma by primary school age.

Indoor and outdoor pollution (including moulds, gases, chemicals, particles and cigarette smoke) can increase the risk of developing asthma.

Athletes can develop asthma after very intensive training over several years, especially while breathing air that is polluted, cold or dry

What is an asthma flare up?

An asthma flare-up is when asthma symptoms start up or get worse compared to usual. The symptoms won’t go away by themselves and need treatment. These flare-ups can happen quite quickly (e.g. if you are exposed to smoke) but they can also come on gradually over hours or days (e.g. if you get a cold). The term ‘asthma attack’ is confusing because it means different things to different people – from a bout of wheezing after running for the bus through to being admitted to hospital for asthma. An asthma flare-up can become serious if not treated properly, even in someone whose asthma is usually mild or well controlled. A severe flare-up needs urgent treatment by a doctor or hospital emergency department.

How is asthma diagnosed?

There is no single test for asthma. Doctors make the diagnosis of asthma when a person has breathing symptoms typical of asthma that come and go, and there is also evidence that sometimes air does not flow in and out of their lungs normally. Airflow can vary in healthy people too (e.g. when someone has a cold their lungs may not work as well as usual). But people with asthma have a much bigger difference than healthy people between how their lungs work at their best and at their worst. How well the lungs work (lung function) measured with spirometry. You blow into a tube as forcefully as you can for a few seconds. The spirometer measures the amount of air pushed through the tube, as well as lung capacity and other measurements. Most children over 6 years old can do this asthma test, but is not used for preschool children or adults with certain medical conditions.

If you or your child may have asthma, your doctor will:

• ask about the symptoms
• ask about general health, including whether you (or other family members) have allergies like eczema or hay fever
• do a physical examination (e.g. listen to the chest, check inside the nose)
• consider other possible causes of the symptoms
• arrange a spirometry test (for adults and children aged 6 years and over).

How is asthma managed?

Medicines are essential to manage asthma well. Good asthma care also involves treatment for other health conditions that can affect asthma.

A healthy lifestyle helps people with asthma stay in control of their symptoms and feel well.

Everyone with asthma should have their own written Asthma Action Plan to follow that includes instructions for when they are well and whenever symptoms worsen.

Most adults and adolescents can monitor and manage their own asthma between visits to the doctor using their action plan.

Parents of younger children can also learn how to manage their child’s asthma.

The main aims of asthma treatment are to:

• keep symptoms under control
• prevent flare-ups or ‘attacks’
• keep lungs as healthy as possible
• stop asthma from interfering with school or work
• help you or your child enjoy a full and active life.

What is good asthma control?

Doctors assess recent asthma control by asking about symptoms during the previous 4 weeks.

Adults and adolescents:

• activities are not limited at all by asthma
• no asthma symptoms during the night or on waking up
• daytime symptoms on no more than 2 days per week
• need to take the reliever on no more than 2 days per week (not counting reliever taken before exercise)
• any symptoms go away quickly after using the reliever puffer.

Children:

• fully active and can run, play and laugh without asthma symptoms
• no asthma symptoms during the night (including coughing during sleep) or on waking up
• daytime symptoms on no more than 2 days per week
• need to take the reliever on no more than 2 days per week (not counting reliever taken before exercise)
• any symptoms go away quickly after using the reliever puffer.

Asthma Action Plans

Every adult and child with asthma should have their own, personalised, written asthma action plan prepared with their doctor that includes:

• a list of the person’s usual asthma medicines, including doses
• instructions on what to do when asthma is getting worse (including when to take extra doses or extra medicines, and when to contact a doctor or go to the emergency department)
• what to do in an asthma emergency

Written asthma action plans should be checked and updated at least once a year for adults and once every 6 months for children.

Bring your action plan or your child’s action plan to every visit to your doctor.

Asthma emergencies

When asthma symptoms are not relieved straight away by taking reliever medicine, or symptoms come back within a short time, the person needs immediate help.

It is an emergency if an adult or child has any of these danger signs:

• severe breathing problems
• symptoms get worse very quickly
• reliever has little or no effect
• difficulty saying sentences
• blue lips drowsiness.

Call an ambulance (dial 000) and start asthma first aid.

Reference: Asthma Australia

For more information about Asthma, go to https://www.asthmaaustralia.org.au/tas/home

Glebe Hill Family Practice and GHFP Nurture now offer body composition measurement through bioimpedance analysis (BIA). This is performed through the use of Seca mBCA Alpha scales and the Seca Analytics 125 software. 

What is Body Composition Analysis?

Body composition analysis can support your chronic condition management by providing detailed measurements your body composition across a variety of parameters. These include:

• fat mass percentage
• visceral adipose tissue
• skeletal muscle mass, including segmental skeletal muscle mass for each limb and the torso

With this information GPs can tailor treatment and lifestyle modifications to your specific needs, provide tailored education, and monitor for any adverse effects to weight loss treatments such as muscle loss. 

See your GP to discuss your chronic condition management and whether body composition analysis could be helpful in your situation.

The BCA service is provided at GHFP Nurture and available to existing patients at Glebe Hill Family Practice and GHFP Nurture.

The General Practitioners practicing at Glebe Hill Family Practice provide cervical screening testing. Cervical cancer is preventable with regular Cervical Screening. By having your 5 yearly CST you are preventing cervical cancer.

If you are a person with a cervix aged 25 to 74 years of age and have ever been sexually active you should have a Cervical Screening Test every 5 years until the age of 74. Your first Cervical Screening Test is due at 25 years of age. If your results are normal you will be due to have your next tests in 5 years. All people who have a cervix aged 25 and over should have cervical screening regularly even if they have had the HPV vaccination.

You should get a Cervical Screening Test every five years if you:

• are aged between 25 and 74
• have had any type of sexual contact (with any person, even of the same gender)
• are a woman / person with a cervix.
• You should get a test even if you:
• have had the HPV vaccines
• are not currently sexually active
• have had the same partner for a long time or only had one partner
• are gay, lesbian, bisexual, or transgender
• are pregnant
• have been through menopause
• feel healthy and have no symptoms.

A five-yearly Cervical Screening Test is more effective than the old two-yearly Pap test

On December 1 2017, the Pap test was replaced with a new Cervical Screening Test (CST). The CST is a more accurate, effective and safe test to have every 5 years instead of the 2-yearly Pap test. The new CST is taken in the same way as a pap smear, with a speculum examination, so it will feel the same to you. The way the sample is stored and tested is different. The new CST detects infection with Human Papillomavirus (HPV), which causes over 90% of cervical cancers. Evidence shows that screening for HPV every 5 years is just as safe as, and more effective than, screening with a Pap smear every 2 years. Most women and men will become infected with HPV at some point in their lives. The virus is so common that it can be considered a normal part of ever being sexually active. In most cases the virus clears up by itself within 1-2 years.

Starting cervical screening at age 25 is safe

The International Agency for Research on Cancer recommends that cervical screening commence at the earliest at age 25 because “there is minimal benefit and substantial harm in screening below age 25” (IARC 2005). It is a fact that screening before the age of 25 does not prevent cervical cancer. Cervical cancer is rare in women under 25 years, and and rates in this age group have remained unchanged in Australia despite screening. Screening before the age of 25 can cause harm because it leads to many women receiving treatment for cell changes caused by HPV that would never have become cancers but were destined to resolve on their own.

The National Cancer Screening Register

The National Cancer Screening Register (NCSR) will invite and remind women to participate in the NCSP.

Self-collection

Recent evidence shows a Cervical Screening Test using a self-collected sample from your vagina is just as safe and as accurate at detecting HPV as a clinician-collected sample taken from the cervix during a speculum examination. If you are eligible and decide collecting your own sample is the best option for you, your healthcare provider will give you a swab and instructions on how to collect your sample. A self-collected sample is taken from the vagina (not the cervix). All you need to do is insert a swab a few centimetres into your vagina and rotate it for 20 to 30 seconds. You usually collect the sample in a private space at the medical centre, such as in the patient toilet.

However, because self-collection looks for HPV only – not cervical cell abnormalities – it is generally not appropriate for people who have symptoms of cervical cancer or if you are experiencing unusual bleeding, pain or discharge. Talk to your GP about whether self-collection is the best option for you.

More information can be found here: Cervical Screening Self-Collection.

GP's practicing at Glebe Hill Family Practice offer comprehensive health care for babies, children and adolescents.

General Practitioners and Allied Health Professionals are skilled and experienced in managing the health care needs of young people.:

• Growth and Development
• Immunisation
• Behavioural problems and ADHD
• Rashes and common childhood illnesses
• Nutrition, feeding, fussy eating
• Coughs, wheezing, and Asthma
• Diabetes
• Epilepsy
• Congenital abnormalities and conditions
• Mental health conditions
• Injuries: cuts, bruises, fractures, sprains
• and more...

Adolecent appointments with the GP can be conducted with or without a parent or guardian present - it's up to the patient and their doctor.

Strict confidentiality guidelines apply to consultations for people aged 14 years and over.

Living with a chronic condition can feel overwhelming—but you don’t have to manage along. The team at Glebe Hill Family Practice is here to support you with Chronic Condition Management planning and ongoing reviews.

What Are Chronic Conditions?

Chronic conditions are long-term health issues that last six months or more, such as:

• Diabetes
• Heart disease
• Lung conditions
• Arthritis
• Mental health conditions

These conditions often need ongoing care to keep you feeling your best and prevent complications.

How We Help

The GPs and nursing team at Glebe Hill Family Practice work with you to create a GP Chronic Condition Management Plan (GPCCMP).

This plan:

• Lists your health needs and goals
• Outlines treatments and lifestyle recommendations
• Connects you with allied health professionals like dietitians or physiotherapists
• Includes regular reviews to keep you on track

Why It Matters

Managing your condition well can:

• Improve your quality of life
• Reduce hospital visits
• Help you stay active and independent

What’s Included?

• Up to five Medicare-subsidised allied health visits per year
• Regular check-ins with your GP
• Support from our nurses and health practitioners

Am I Eligible?

You may qualify if:

• You have a chronic or terminal condition lasting at least six months
• You’re registered with MyMedicare and have nominated Glebe Hill Family Practice as your registered practice

Glebe Hill Family Practice is dedicated to playing a part in Closing The Gap (CTG) by improving access to health care for Aboriginal and Torres Strait Islander people.

We will ask all patients: "are you of Aboriginal or Torres Strait Islander origin?".

To register for the Closing The Gap scheme at Glebe Hill Family Practice, you will need to sign a form stating that you want us to be your usual care provider, and to look after your chronic disease and/or chronic disease risk factor. We will need you to sign a new form every year, and you can do this from the 1st November to cover you for the following year.

Discounted or Bulk-Billed Consultations

Patients registered at Glebe Hill Family Practice under the Closing The Gap scheme of any age will usually receive discounted consultations.

Patients at Glebe Hill Family Practice under the Closing The Gap scheme who have a current Concession Card will usually be bulk-billed.

Please see our Fees page for further information.

Aboriginal and Torres Strait Islander Health Checks (Medicare item 715)

Closing The Gap patients will be offered a bulk-billed annual Health Assessment (Aboriginal & Torres Strait Islander Health Check) with a Practice Nurse and their GP, every 9 to 12 months.

Each Health Assessment is tailored to the individual, taking into consideration age, gender, family history, risk factors, lifestyle, and existing medical conditions. A Health Assessment takes about one hour.

The Health Assessment is an excellent opportunity for us to provide a thorough check up including:

• taking a comprehensive history
• a thorough medical examination
• arranging important medical tests (such as blood tests, medical imaging, ECG, spirometry, and more).
• arranging appropriate referrals for medicare-funded multidisciplinary health care (eg. Physiotherapy, Dietitian, Exercise Physiology, Occupational Therapy, Podiatry, Psychology, or Diabetes Education)

PBS Co-Payment Measure

Registering with your practice under the CTG scheme also improves access to PBS medications for those living with, or at risk of chronic disease. Presciptions printed for Closing The Gap patients will display a CTG PBS Co-Payment code. The PBS Co-Payment Measure reduces the cost of PBS medications at the Pharmacy. Closing the Gap prescriptions attract a lower co-payment for PBS medicines. Concession Card Holders will be dispensed their PBS medications for FREE at the Pharmacy.

A number of GP's practicing at Glebe Hill Family Practice are trained in insertion and removal of Implanon.

What is Implanon?

Implanon is a contraceptive rod containing the hormone etonogestrel, which is similar to the naturally occurring hormone progesterone, made by a woman’s ovaries. It is about the size of a match – four centimeters long and two millimeters wide. It is inserted under the skin of the inner upper arm. Once inserted, it can be felt, but not easily seen.

How effective is it?

Implanon is the most effective reversible method of contraception available. It is more than 99.9% effective.

How does it work?

It stops the body from releasing an ovum (egg) each month.

It thickens the mucus in the cervix (the entrance to the womb), which blocks sperm.

How do I use Implanon?

Insertion

Implanon must be inserted by a specially trained doctor or nurse. Insertion takes a few minutes, with local anaesthetic used to prevent discomfort. There may be some soreness and bruising, which settles within a few days. Implanon can be left in for up to three years before it needs to be removed or replaced.

Removal

The doctor will inject local anaesthetic under the implant, make a tiny cut in the skin and remove the Implanon rod. This usually takes a few minutes. You will have a small scar, but won’t have any stitches. You can have a new rod inserted at the same site at the same appointment.

When does it start working?

If Implanon is inserted during the first five days of a normal period, the contraceptive effect starts immediately. It can be inserted at other times in your menstrual cycle, in which case it takes seven days to become effective.

What are the advantages of Implanon?

• Implanon is highly effective,
• It provides 3 years of contraception.
• Implanon is inexpensive - the cost of a normal PBS prescription.
• Implanon is usually easily reversible.
• You don’t have to remember to take a pill every day.
• Bleeding may be lighter and less painful or your periods may stop.
• When Implanon is removed, the contraceptive effect and any side effects are quickly reversed.
• It can usually be used if you are unable to use contraception containing oestrogen.
• Your contraception will not be affected if you have diarrhoea or vomiting.
• Implanon is safe to use if you are breastfeeding.

What are the disadvantages of Implanon?

• You may experience pain and bruising in the area where Implanon is inserted.
• Your bleeding pattern will change.
• Bleeding is unpredictable.
• Implanon will not protect you against sexually transmissible infections (STIs). Continue to use condoms.
• Occasionally, women need to be referred to a specialist for removal of the Implanon rod. This is very rare.

Who should not use Implanon?

Women who have had breast cancer within the last five years and women taking certain medications should not use Implanon.

What are the side effects?

• All women given Implanon will experience a change in their bleeding pattern.
• Some will stop having periods completely. This is not harmful.
• Some may have irregular bleeding, which may be frequent and is unpredictable. This often settles in the first three to four months of use.
• Some women will have persistent bleeding or spotting.
• Some experience acne, breast tenderness, moodiness, increased appetite and headaches.

Unless side effects are severe, you should try to keep Implanon in for at least three months, as any side effects will often settle in this time.

Is it for me?

Implanon may be right for you if you:

• want a method that’s ‘fit and forget’
• want the most effective method available (besides sterilisation)
• find it hard to remember to take a tablet every day
• don’t mind some irregular bleeding
• have painful periods

Other things you should know

What if I become pregnant?

• There is no evidence that Implanon can harm a pregnancy.

What if I don’t like Implanon or want to become pregnant?

• Implanon can be removed at any time.
• Unless side effects are severe, you should try to keep Implanon in for at least three months, as any side effects will often settle in this time.
• After removal, any side effects should be reversed within weeks and you should start to ovulate (release eggs) again.
• When you stop using Implanon, you have the same chance of becoming pregnant as you had before you started.

Can I use Implanon while I’m breastfeeding?

• Yes. Implanon is safe to use no matter what age your baby is.

Will I gain weight while using Implanon?

• While some women report weight gain, most women’s weight will not change.

What happens if I have Implanon in for more than three years?

• If you are unable to have your Implanon changed before its three years of use have passed, use condoms until seven days after you have had your Implanon replaced.

Arranging Implanon at Glebe Hill Family Practice

Please make a Standard Appointment with your GP to:

• Discuss Implanon, and make sure it's the right contraceptive option for you
• Arrange a prescription for Implanon
• Arrange your Insertion Appointment. (We'll try to arrange your Implanon Insertion Appointment to be within the first 5 days of your normal period so that your implanon is effective immediately).

Your Implanon Insertion, Replacement, or Removal Appointment:

• You will need to collect your new Implanon from the Pharmacy, and bring it with you to your appointment.
• Your General Practitioner will discuss the procedure with you.
• A Practice Nurse may assist your General Practitioner with the procedure.
• Your Implanon will be inserted under sterile conditions.
• Your General Practitioner will use local anaesthetic, making the procedure relatively painless.
• You will be provided with a dressing and a bandage, which will help to minimise bruising or bleeding after the procedure.

The full schedule of vaccines on the National Immunisation Program Schedule, Influenza Vaccine, vaccines suitable for overseas travel, and other private vaccines including Meningococcal vaccines are available at Glebe Hill Family Practice.

Bulk-billed Immunisation Clinics are run at each practice each week. Immunisation Clinic appointments can be booked online.

Why Immunise?

Immunisation is one of the best ways to protect yourself, your children and safeguard the health of future generations.

Immunisation remains the safest and most effective way to stop the spread of many of the world’s most infectious diseases. Before the major vaccination campaigns of the 1960s and ’70s, diseases like tetanus, diphtheria and whooping cough (pertussis) killed thousands of young children each year. Today, deaths from these diseases are extremely rare in Australia, and the rest of the developed world.

If enough people in the community are immunised, the infection can no longer be spread from person to person and the disease can die out altogether.

How Immunisation Works

Immunisation is a simple, safe and highly effective way of protecting children and adults from harmful diseases before they come into contact with them. It is estimated that vaccinations currently save up to three million lives worldwide each year.

Immunisation uses the body’s natural defence mechanism – the immune response – to build resistance to specific viral infections. When a person is vaccinated, their body produces an immune response in the same way their body would after exposure to a disease, but without the person suffering symptoms of the disease. When a person comes in contact with that disease in the future, their immune system will respond fast enough to prevent the person developing the disease.

Immunisation protects more than just one child’s health. Vaccinating a child will reduce the opportunity for that child to pass that disease on to another – especially young babies who have not yet been fully immunised.

When levels of immunisation in a community are sufficiently high, the risk of specific diseases can fall so low that even those who are too young or too sick to be given a vaccine will not be exposed to it. This communal or ‘herd immunity’ can save countless lives.

Putting Safety First

Rapid advances in the science of immunisation mean that modern vaccines are extremely safe, and serious reactions to them are rare.

Safety testing is a key component of vaccine development and use. All vaccines used in Australia are thoroughly tested for safety and effectiveness. In development they are rigorously tested on thousands of people in progressively larger clinical trials. They are not included in the National Immunisation Program until they have been approved for use by the Therapeutic Goods Administration (TGA) to ensure they meet strict safety guidelines and are evaluated to ensure they are effective, comply with strict manufacturing and production standards, and have a good safety record.

Vaccines remain subject to testing after their introduction into general use through a variety of mechanisms, such as further clinical trials and surveillance of disease and vaccine adverse events. Australia has a national surveillance system, which includes reports of adverse events following immunisation from state and territory systems as well as information sent directly from health professionals, consumers and vaccine companies. These reports are reviewed by the TGA and referred as required to expert committees, such as the Advisory Committee on the Safety of Vaccines (ACSOV), to ensure ongoing assessment of safety.

Although vaccines may occasionally produce undesirable side-effects, such as pain and redness at the injection site, the majority of these reactions are mild and are quickly resolved.

The possible adverse reactions to vaccination will be discussed with you at your immunisation appointment at Glebe Hill Family Practice.

Iron deficiency

Our bodies need iron. Iron is used to make haemoglobin – the part of our red blood cells that carries oxygen around our body. It is also important for muscle strength, energy and good mental function. If your iron levels are low this may make you feel tired, short of breath, and not able to do normal daily activities. As the amount of iron in the body falls even lower, the haemoglobin level drops below normal. This is known as Iron Deficiency Anaemia.

Treating Iron Deficiency

The most common way to treat iron deficiency is to take iron by mouth as a tablet or liquid. This works well for most people and is usually tried first. Sometimes there are problems with oral iron supplementation, such as constipation. Some people may need iron to be given straight into the body through a vein if you are not able to take, are not responding to, or are not absorbing Iron tablets/liquid. Other indications include needing to get your iron levels up quickly (eg. before major surgery, late in pregnancy or to avoid blood transfusion) or if you have chronic kidney disease or chronic heart failure.

Iron Infusion

At an Iron Infusion appointment the iron is given through a needle and dripped (‘infused’) into your vein. Sometimes 2 iron infusions (given at least 1 week apart) are needed to fully top-up iron stores.

The infusion is made up of iron, not blood.

If you have iron deficiency (either with or without anaemia) and think you might benefit from an Iron Infusion please make an appointment to discuss further with your GP.

IUD insertions and removals are available at Glebe Hill Family Practice with Dr Anna Kingshott and Dr Victoria Whelan.

IUDs are used for long-term contraception, and can be helpful for women with bleeding problems.

What is an IUD?

An Intrauterine Device (IUD) is a form of contraception that is placed in the uterus. There are two types of IUD’s available in Australia:

Mirena IUD's–  a hormonal IUD made of plastic and containing a synthetic form of progesterone (a female hormone) which is slowly released into the uterus;

Copper IUD’s – an IUD made of plastic and copper

How do IUD’s work?

Both copper and Mirena IUD’s:

• Work by the main action of prevention of fertilization by stopping sperm from moving up to the fallopian tubes and slowing the movement of eggs through the fallopian tubes.
• They also change the lining of the uterus to make it hostile to a fertilized egg and prevent implantation (it is very rare for an egg to be fertilized).

The Mirena also thickens cervical mucous preventing sperm from entering the uterus and sometimes prevents or delays ovulation (the release of an egg) each month – especially in the first 3 months of IUD use.

When does it start working?

• The copper IUD is effective immediately (as long as pregnancy is first excluded).
• The Mirena is effective immediately if inserted in the first 7 days of the menstrual cycle, otherwise it takes 7 days to become effective.

Benefits of IUD’s

• Highly effective, inexpensive, easily removed
• They work for 5-10 years, depending on the type
• Once inserted, you only need to remember to check the string each month (compared to remembering a pill every day…)
• Once removed fertility rapidly returns to your normal level
• They are safe during breast feeding
• Their effectiveness is not reduced by other medications or illness such as diarrhea and vomiting
• They are usually safe options if you are unable to take contraception containing oestrogen
• Copper IUD’s can be used by women who cannot use any hormonal contraception or prefer a non-hormonal method
• The Mirena usually reduces the amount of menstrual flow by 80-90% and is ideal for women with heavy periods. 20% of women stop getting periods completely.

Disadvantages of IUD’s

• They can only be inserted by a specially trained doctor.
• Insertion can be uncomfortable. This is helped by use of local anaesthetic. The insertion may be more uncomfortable if you haven’t had children.
• There may be complications at the time of insertion (see below).
• They do not protect you against sexually transmitted infections (STI’s), and are not recommended for women who are at very high risk of STI’s. Use condoms to protect yourself against STI’s, especially with new sexual partners.

Disadvantages of copper IUD’s

• Periods tend to be longer, heavier and more painful. On average bleeding is increased by 20-50% (roughly 1-2 tablespoons per month for most women). The bleeding may settle with time.
• Copper IUD’s are not on the PBS. The usual cost of the IUD is about $160. They must be ordered from specialist medical suppliers and there may be a delay in availability.

Disadvantages of hormonal IUD’s

• When first inserted there tends to be frequent light bleeding which usually settles within 3 months.
• There may be hormonal side effects – headache, acne, breast tenderness, mood change – these are uncommon and usually improve with time.
• Women who have had actice breast cancer within the last 5 years should not use the hormonal IUD.

Complications

• There is a very small risk (<1 in 1000) of puncturing the wall of the uterus during insertion (perforation). The IUD may then pass through the wall of the uterus and require surgical removal. This risk is greatest in women who are breast-feeding or have delivered recently.
• There is a very small risk of infection occurring in the first 3 weeks after insertion.  A pelvic infection can lead to damage to the fallopian tubes affecting fertility.
• The IUD may be expelled (fall out) from the uterus.  This is most common in the first 3 months and usually happens during a period. It may occur without the woman knowing. We recommend checking for the strings monthly.
• There may be an increase in vaginal discharge.
• Although the failure rate is very low, it is important to see a doctor as soon as possible if you think you may be pregnant as IUD’s can harm the outcome of a pregnancy.  About 1 in 20 IUD pregnancies form in the fallopian tubes (ectopic pregnancy). There is also increased risk of infection, late miscarriage and prematurity if the pregnancy continues and the IUD can’t be removed.

If you wish to have an IUD inserted at Glebe Hill Family Practice…

Advise our reception staff who will book you in for a half hour pre-insertion (assessment) appointment with Dr Marita Jones, Dr Anna Kingshott, Dr Victoria Whelan or Dr Isabel Pemble.

You will be given information and asked questions by the doctor to ensure the IUD is appropriate for you.  You will also be examined and offered any necessary investigations (sometimes, but not always involves a pap smear and swabs).

The procedure will be explained and insertion appointment arranged. Written pre-procedure information and a prescription for your IUD will be provided at the assessment appointment.

A follow-up appointment 6 weeks after the insertion is recommended.

IUD Fees

Long GP consultation fees apply for IUD Assessment or Removal appointments prior to scheduling the IUD Insertion procedure. Information about GP consultation fees can be found here: Fees.

At the IUD Insertion appointment the practitioner will charge a private fee for the procedure, and a Medicare Rebate is applicable. There is an additional IUD Procedure Fee on the day which covers the practice's costs (consumables including disposable instruments and local anaesthetic).

Payment is required on the day of each appointment.

The Tasmanian Lung Centre operates a lung function testing clinic at GHFP Nurture. 

Lung function tests are essential diagnostic tools used to assess how well your lungs are working by measuring airflow, lung volume, and gas exchange. They help diagnose and monitor respiratory conditions like asthma, COPD, and other pulmonary disorders, guiding effective treatment plans.

The Tasmanian Lung Centre clinic is held once a month on a Monday at GHFP Nurture and is bulk-billed.

See your GP for a referral to the Tasmanian Lung Centre, and then the Tasmanian Lung Centre will book your appointment at GHFP Nurture.

GP's practicing at Glebe Hill Family practice support provision of multidisciplinary mental health care.

GP's are experienced in managing common mental health problems for all age groups, including (but not limited to):

• Anxiety
• Depression
• Stress
• Grief
• Psychotic disorders
• Personality disorders
• Drug and alcohol problems
• Sleep problems
• Relationship problems
• Post traumatic stress

Better Access to Mental Health Care

Better Access to Mental Health Care is an Australian Government initiative that aims to improve outcomes for people with a clinically-diagnosed mental disorder through evidence-based treatment. Medicare rebates are available to patients for selected mental health services provided by General Practitioners, Psychiatrists, Psychologists, and eligible Social Workers and Occupational Therapists.

What Medicare services can be provided under the Better Access initiative?

Medicare rebates are available for up to ten individual and ten group allied mental health services per calendar year to patients with an assessed mental disorder who are referred by a General Practitioner (under a GP Mental Health Treatment Plan), or by Psychiatrist or a Paediatrician.

MBS telehealth services that were made available in response to the COVID-19 pandemic, are now permanent. This means that eligible Australians can access individual telehealth services, no matter their location, where it is safe and clinically appropriate to do so.

What does it cost?

Appointments for GP Mental Health Treatment Plans are privately billed. If you would like an appointment for a Mental Health Treatment Plan please make a standard appointment with your GP to discuss your eligibility. A long appointment (30 minutes) is required for completion of a Mental Health Treatment Plan.

Allied health professionals are free to determine their own fees for the professional services they provide.

How can I access these services under Medicare?

Step 1:

Visit your GP who will assess whether you have a mental disorder and whether the preparation of a GP Mental Health Treatment Plan is appropriate for you, given your health care needs and circumstances. If you are diagnosed as having a mental disorder, your GP may either prepare a GP Mental Health Treatment Plan, or refer you to a psychiatrist or paediatrician who, once an assessment and diagnosis is in place, can directly refer you to allied mental health services. Whether a patient is eligible to access allied mental health services is essentially a matter for your treating health practitioner to determine, using their clinical judgement and taking into account both the eligibility criterion and the general guidance.

Step 2:

You can be referred for certain Medicare rebateable allied mental health services once you have:

• a GP Mental Health Treatment Plan in place; or
• are being managed by a GP under a referred Psychiatrist Assessment and Management Plan; or
• been referred by a Psychiatrist or Paediatrician.

Your GP or psychiatrist/paediatrician can refer you for up to six individual or six group allied mental health services, which may comprise either psychological assessment and therapy by a clinical psychologist or focussed psychological strategies by an allied mental health professional. It is at the clinical discretion of your referring practitioner as to the number of allied mental health services you will be referred for (to a maximum of six in any one referral).

Step 3:

Depending on your health care needs, following the initial course of treatment (a maximum of six services, but may be less depending on your clinical need), you can return to your GP or Psychiatrist/Paediatrician and obtain a new referral to obtain an additional four sessions to a maximum of ten individual and ten group services per calendar year. Whether you have a clinical need to access the additional allied health services which attracts a rebate is a decision for your treating health practitioner, taking into account the written report received from the allied mental health professional at the completion of a course of treatment. At this time, a Review of your GP Mental Health Treatment Plan may also be undertaken.

Physiotherapists:  Jane Wilkinson, Michelle Shering, Michelle Garland and Dipali Patel

Appointments with Physiotherapists can be accessed:

• privately, without a GP referral
• privately by referral from your GP (any GP, not only GP's practicing at Glebe Hill Family Practice and GHFP Nurture)
• under Medicare, with a specific referral form from your GP (please note that this requires a GP Chronic Condition Management Plan, or an Aboriginal & Torres Strait Islander Health Assessment) to have been completed)
• NDIS funding may be available

Medicare is complicated! Talk to your GP as to whether you're eligible for a Medicare rebate for your allied health visits.

For private referrals, a rebate may be available from your Private Health Insurer.

Physiotherapy services are provided at Glebe Hill Family Practice and available to existing patients of Glebe Hill Family Practice, GHFP Nurture and members of the general public.

The GP's practicing at Glebe Hill Family Practice and our Practice Nurses are skilled and experienced in wound care.

Extensive wound care services are available for:

• Burns
• Ulcers
• Lacerations and other injuries
• Post-operative and surgical wounds

We stock a range of dressings suitable for all types of wound management. Please note that charges may apply for dressings and nurse time.

Please advise our friendly Reception staff that you require wound care when making your appointment.