Atrial fibrillation explained

Your heart is controlled by a conduction system which sends out electrical signals. This causes a heartbeat. Atrial fibrillation is a type of arrhythmia, which is a problem in the conduction system that can make your heart beat too slowly, too quickly and in an irregular way.

Atrial fibrillation happens when the electrical signals in the top chambers (atria) of your heart do not get sent out properly. They should be steady and regular, but instead they quiver or twitch (fibrillation). This causes your heart to beat randomly, which means it does not pump blood as well as it should.

There are different types of atrial fibrillation:

Paroxysmal atrial fibrillation. This is when the symptoms start and end without treatment.

Persistent atrial fibrillation. This is when the symptoms last for longer than seven days (or when it’s treated).

Permanent atrial fibrillation. This is when you always feel the symptoms and are usually getting treatment.

Long-standing atrial fibrillation. This is when you’ve had the symptoms usually for over one year.

Atrial fibrillation is not life-threatening but it can create blood clots in the heart that may cause a stroke. If you have atrial fibrillation, it makes you five times more likely to have a stroke.

Symptoms of atrial fibrillation

The symptoms of atrial fibrillation can include:

palpitations (the feeling that your heart is racing, pounding, fluttering or like you have missed heartbeats)

chest pain

finding it harder to exercise

tiredness

shortness of breath

dizziness or feeling faint.

We will be receiving Atrial Fibrillation (AF) detection devices called MyDiagnostick in each practice and patients will be asked to use it if suspected of AF.  MyDiagnostick is a screening tool that detects patients with Atrial Fibrillation (AF). It is very quick and easy to use. The patient holds the metal handles at either end of the device which automatically switches it on, starting the recording of an ECG whilst analysing the heart rhythm. After one minute, the device displays either a green tick for a normal ECG, or a red cross if AF is detected. ECG traces can be downloaded to the MyDiagnostick Management Studio software and PDF ECG reports created if required.

About Blood Pressure @ Home

Blood Pressure @Home aims to increase availability and access to home blood pressure monitoring for patients with poorly controlled hypertension. Patients are either supported to use a blood pressure machine they own or can gain access to, or if this is not possible, can be loaned a machine in agreement with the PCN providing the project. They are provided with a remote pathway to share their readings with the practice.

BP @Home is part of the project to scale up PCN remote monitoring Hub’s being developed in Bromley to:

Enable personalised clinical support to be delivered remotely and help people to better manage their health and care.

Reduce inequalities in health care CVD events due to uncontrolled hypertension.

Provide more convenient, high quality and timely alternatives to face-to-face care, where this works for the individual, and when clinically appropriate.

Provide a sustainable model/approach at PCN level to the management of Long-Term Conditions

How BP@Home works

“You will take your blood pressure at home X times day/week and send the results back to us”. We explore how patient would like to send results back: accuRx text, email, telephone appointment, face to face appointment (if appropriate).

“If your results are within the target range we will text you back/call you and ask you to send results again in X weeks”

“If your results are outside the target range they will be reviewed by a qualified health care professional, who will decide whether or not you need to come in for a review and we will text/call you to arrange this”.

“We may ask you to send in your result more or less often depending on the readings you send us”.

“If you have any questions at any time you will be able to contact me by emailing or calling the practice to request a support call”.

We will send you a message with a question “Would you like to take part in this?”

We have found that a lot of our patients do not have NHS App for whatever reason and therefore are digitally excluded from various faster routes for example to order a repeat prescription, access their records, book various appointments. The reasons may be that they don’t understand how to use the technology, don’t have means to access the technology or simply they don’t feel like that they need the technology. In this modern technology-led world, when people access their bank accounts through their app, order shopping through the app and many other things that can be done digitally, we would like our patients to be included as much as they would like to be. And therefore, we will be running FREE Digital Inclusion workshops with help with our local resident volunteers, where we will be helping our patients with understanding the digital healthcare tools amongst our adult patients and reduce the disparity of uptake and thereby improve access to primary care through digital routes. Digital healthcare tools in primary care include:

NHS App for repeat prescriptions, records access, booking appointments, organ donor preference, with more functionality planned in the year ahead

Online consultations

Use of practice website, including to access services through self-referral

Automated registrations and updating personal details

‘We can provide free data SIM cards for our patients if these are needed for you to access digital services.

Please see our flyer for more details and we hope to see you soon!

Effective from Saturday 1st October 2022, General Practice is required to deliver a range a primary care services between 18:30 – 20:00 on weekdays and 09:00 – 17:00 on Saturdays with some local discretion allowed.

This is a compulsory change to the national primary care contract. MDC PCN and Bromley General Practice Alliance (BGPA) work together to deliver these services under MDC PCN.

Clinicians will have access to your electronic patient records and will be able to see you in one of our registered practices. Standard data protection and confidentiality policies are in place.

Our practices will remain open during our core opening times 08:00 – 18:30 and will continue to provide appointments to their registered patients.

An out-of-hours appointment might not be at your regular GP surgery. Out of hours appointments are not available as walk-in appointments. You will need to complete eConsult on your practice’s website, which will get triaged by an experienced clinical professional and an out of hours on-the-day appointment will be offered to you as necessary. You might be offered a telephone or face to face appointment, depending on your presenting complaint and the clinician’s decision. Your GP practice will call you and advise you on the appointments which are available, and which healthcare professional is the right person to help you.

If you need medical help now but it’s not an emergency, you can also go to 111 online or call 111.

Our new and modern way of seeing patients.

It has been successfully used in many GP practices across the country.

We will have our group clinics for our patients PCN wide, once a month starting at the end of April.

We have decided to first organise the group clinics for patients with Type 2 diabetes whose annual review is due. We hope, after a successful start, we will be able to offer group clinics to patients with other conditions (e.g. menopause, high blood pressure, HRT etc).

During the group clinics, there will always be a clinician (most times a specialised nurse) present who’ll go through the patients’ results individually and will be answering patients’ questions.

Data protection is paramount, and patients will be asked to sign confidential forms prior to the clinics to comply with the GDPR. Everything that will be discussed during the group clinics must stay between those taking part.

The sessions will provide opportunity for patients to meet other patients with the same health challenges, share experiences and advice on how to manage their conditions.

The clinics initially will be run online using MS Teams, prior to the clinics, all logins and technical requirements will be communicated to patients through a dedicated group clinics e-mail address.

Personal contact details will not be shared with participants.

Below are some videos explaining what group clinics are, how they run and the positive changes the clinics are making in people’s life.

Introduction of Video Group Clinics:

Information on your rights and what you share:

Clinicians explaining group clinics and people’s testimonials:

Short patients’ testimonials:

We, and our healthcare partners, have listened to our patients’ feedback to offer the respiratory services closer to home as well as at the hospital. This project is now run at various sites across Bromley borough. We have run specific searches on our clinical systems and identified patients across our PCN that can be referred to this service.

These patients will be contacted and referred to the service once they agree. We will offer the patients to be seen at the community bases as well as the hospital.

The MDC Neighbourhood’s “Young Mums’ Hub” is designed to be an integrated service across primary, community and third sector providers, delivering proactive care to vulnerable young families in the MDC Neighbourhood.  

Where is it? 

Its location is in a large church hall at St Edward’s Church in Mottingham. It was chosen for its relatively central location and ease of access within the PCN and availability of creche facilities. 

When is it?

The first YMH was held in June 2023.  Occurring every second Wednesday of the month between 10 am to 2 pm. Refreshments and lunch are provided. We engage the attendees by holding a free raffle. It’s a small prize, usually something useful for the baby. 

Who comes?

We have mums attending between 18 and 42 years of age with babies and toddlers under 2 years of age.

Who is present and what we do during the sessions:

Social Prescribers – they engage with the mums, making sure they are listened to and helping with any queries they may have. 

Care Co-ordinator – Helping and engaging in conversations with mums, making sure their health and wellbeing questions are answered.

Nurse / HCA – Recording baby weights directly into EMIS, checking immunisation / screening status, promoting and booking vaccination appointments. Speaking with the mums and health / screening status.

PCN Administrator – Helping with any IT issues and  liaising with mums.

At least one guest speaker each month.

Occasionally a health care professional (trainee doctor) may attend.

Our previous guest speakers:  

Bromley Children’s Project. Local authority organisation, that supports families living in Bromley to create a safe, secure and happy environment for all children by reaching out to parents and young people up to 18 years especially those who are struggling and need additional help. Advice offered and support on parenting, gaining employment, debt, managing a child’s behaviour at home or school, those experiencing domestic abuse, family members affected by drugs, alcohol, crime or anti-social behaviour. Offer targeted parenting courses and one-to-one family support. 

Mindful Mums. Give learning tips and techniques to manage the changes related to the life-changing and often hugely challenging period of pregnancy and the early months after childbirth. They also offer attendees the opportunity to connect with other pregnant women and new parents with similar experiences.

Successful Mums. They provide online, flexible and interactive training to help mums find work, start or develop a business. offer training courses specifically for mums on Successful Mums learning platform. Their programmes include weekly group webinars and one-to-one career or business coaching. They aim to provide direction, clarity and the confidence to make it happen. They also offer links to a network of flexible friendly employers.

Hestia(housing support). They recently attended the group. Some young mums were already linked to the organisation. Provided a good opportunity for them to ask any questions and provide updates. Also gave an opportunity for other attendees to learn more about the organisation. Offered free practical support to maintain a more successful tenancy. Also gave expert advice to find better work or training. ​

Talk Together Bromley. Attend once a month. They offer talking therapies for people experiencing low mood, stress, anxiety and depression, panic attacks, social anxiety, OCD, employment related issues and people living with a long -term health condition. Options for counselling discussed such as CBT, group sessions.

One of our trainee doctors

Our aim:

For the mums to feel included and supported.

Mums and babies to socialise and make new social circles to enable them to support each other. 

To promote healthy lifestyle and support wellbeing during the sessions.

For the mums to share mutual experiences.

Advice on getting back to work when the mums feel ready.

Ensuring vaccinations and screenings are up to date for both mums and babies and provide appropriate advice.

Keep mums up to date with latest health advice for their children. We recently sent them a link to One Bromley’s “Keep your child well this winter” leaflet, which can be found on our PCN’s website.

Future plans:

We hope to engage someone to hold activities e.g. mum/baby yoga, music sessions etc.

To develop a social media platform to keep the mums connected and updated

Bigger events advertising the Young Mums’ Hub, e.g. pop-up soft play, mini fete, picnics (encouraging attendance and an opportunity to promote health initiatives).