Practice News

Advice for patients and GPs for requests to prescribe sedatives prior to dental procedures, anxiety from flying and claustrophobia before an MRI

GPs will not issue prescriptions for sedating medications (such as diazepam) prior to dental procedures.

Dentists should not direct patients to GPs requesting they prescribes sedating medications, such as diazepam.  

If a dentist wishes to prescribe sedating medications for anxious patients that dentist should be responsible for issuing the prescription. The dental practitioner’s formulary, which is the list of drugs a dentist can prescribe is found on the BNF dental practitioners formulary, includes Diazepam Tablets and Oral Solution.  

If the dentist is treating a patient within their practice NHS contract, then the prescription should be on a FP14D form. 

If the dentist is treating a patient privately, they should issue a private prescription.   Dentists can access a patient’s summary care record via the DERs/Rego electronic referral system for NHS England Southeast dental referrals.  

Dentists may contact a GP for information or advice, if, for example the patient has a complex medical history. 

Claustrophobia and refusal to have MRI scans

GPs will not issue prescriptions for sedating medications (such as diazepam) prior to MRI scans.

It’s estimated that every year, approximately two million MRI scans worldwide are not performed because of patients refusing to be scanned or terminating the scan early due to claustrophobia. 

There are many resources online that can help prepare patients on what to expect during a scan including step by step explanations and videos of MRIs being performed.  In more severe cases, the NHS website suggests that mild sedatives are an option for people with severe MRI anxiety. However, the MDU would recommend members to carefully consider the 2018 Royal College of Radiologists’ guidance, Sedation, analgesia and anesthesia in the radiology department, which states that a ‘trained and credentialed team should administer sedation and analgesia.’ 

There is also an emphasis on thorough pre-procedure assessment, planning and monitoring. 

This means that the GP is not the right person to prescribe these medications. If they are needed, then this needs to be discussed with the radiology team. 

Flight anxiety and prescribing of medications for flying

For the following reasons we will no longer be providing Diazepam or similar drugs for flight anxiety, and instead suggest the link to aviation industry recommended flight anxiety courses at the end of the page. 

Flight anxiety does not come under the remit of General Medical Services as defined in the GP contract and so we are not obliged to prescribe for this. Patients who still wish to take benzodiazepines for flight anxiety are advised to consult with a private GP or travel clinic. 

Initial use of benzodiazepines, including the well-known Diazepam also known as ‘Valium’, was enthusiastic and they were hailed as a wonder drug. However, it became increasingly clear that, as well as having short term deleterious effects on memory, co-ordination, concentration and reaction times, they were also addictive if used for a moderate time, with withdrawal leading to fits, hallucinations, agitation and confusion, and further had long-term effects on cognition and balance. Unfortunately, benzodiazepines have also become a widely used drug of abuse since they first came on the market. 

Because of these reasons the use of benzodiazepines has been a lot more controlled around the world since the 1980-90s, especially in the UK. Diazepam in the UK is a Class C/Schedule IV controlled drug. 

The following short guide outlines the issues surrounding its use with regards to flying and why the surgery no longer prescribes such medications for this purpose. People often come to us requesting the doctor or nurse to prescribe diazepam for fear of flying or assist with sleep during flights. Diazepam is a sedative, which means it makes you sleepy and more relaxed. There are several very good reasons why prescribing this drug is not recommended.  

According to the prescribing guidelines doctors follow (British National Formulary) diazepam is contraindicated (not allowed) in treating phobic states. It also states that “the use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate.” Your doctor would be taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalized anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.  

NICE guidelines suggest that medication should not be used for mild and self-limiting mental health disorders. In more significant anxiety related states, benzodiazepines, sedating antihistamines or antipsychotics should not be prescribed. Benzodiazepines are only advised for the short-term use for a crisis in generalised anxiety disorder in which case they are not fit to fly. Fear of flying in isolation is not a generalized anxiety disorder. 

Although plane emergencies are a rare occurrence there are concerns about reduced awareness and reaction times for patients taking Diazepam which could pose a significant risk of not being able to react in a manner which could save their life in the event of an emergency on board necessitating evacuation.  

The use of such sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at an increased risk of developing a blood clot (Deep Vein Thrombosis – DVT) in the leg or even the lungs. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours, the amount of time which has been shown to increase the risk of developing DVT whether in an airplane or elsewhere.

• Whilst most people find Diazepam sedating, a small number have paradoxical agitation and aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally which can pose a risk on the plane. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law. A similar effect can be seen with alcohol, which has led to people being removed from flights.  
• A study published in 1997 from the Stanford University School of Medicine showed that there is evidence use of Benzodiazepines stops the normal adjustment response that would gradually lessen anxiety over time and therefore perpetuates and may increase anxiety in the long term, especially if used repeatedly.  
• Diazepam and similar controlled drugs are illegal in several countries. They may be confiscated, or you may find yourself in trouble with the police. The passenger may also need to use a different strategy for the homeward bound journey and/or other legs of the journey.  
• Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing, you may fail this having taken diazepam.  Your driving may be impaired after your flight.
• It is important to declare all medical conditions and medications you take to your travel insurer. If not, there is a risk of nullifying any insurance policy you may have.  

For further information, please click on the link below:

• EasyJet Fearless

Changes to hayfever prescriptions

Mild to moderate hayfever preparation will no longer be available on NHS Prescription.

Following a review of the latest NHS Guidance, we are no longer able to prescribe the following hayfever medication:

• antihistamine tablets and liquids (including cetirizine, loratadine, fexofenadine)
• steroid nasal sprays (including beclometasone)
• sodium cromoglicate eye drops.

These products are available to buy from pharmacies and most supermarkets, therefore you will still have access to these products should you wish to continue using them.

Below are some FAQs about the changes and how you can treat it yourself using over the counter (OTC) medicines:

How do I get hayfever medication now?

Most hayfever treatments are available to buy from pharmacies and most supermarkets.

How should I treat general hayfever symptoms (sneezing, itchy throat, coughing)?

Use simple antihistamine* tablets, capsules or liquid.

*Antihistamines may cause drowsiness.

What should I take for nasal symptoms (runny nose, sneezing and congestion)?

If you are 18 years old and over, you can use a steroid nasal spray. This works by reducing inflammation in the nose and helps control allergic symptoms associated with hayfever. This will not produce immediate relief and can take 2-3 weeks of regular use before the full benefit is seen. For best results start using 2-3 weeks before the likely onset of symptoms and make sure you use it every day.

A pharmacist can check your technique to help make sure you are using it correctly.

A steroid nasal spray can also ease eye symptoms.

Saltwater nasal sprays may also help. The aim of saltwater sprays is to wash pollen out of the nostrils. This can sometimes help to reduce the need for steroid nasal sprays.

What should I take for eye symptoms (red watery itchy eyes)?

Use eye drops.

Eye drops containing sodium cromoglycate can stop the release of histamine from cells to stop the watering and provide relief from itchiness. They need to be used regularly in both eyes to prevent symptoms. Sometimes they can make the vision blurry when first put in the eye(s) but this will clear. Sodium cromoglycate eye drops can be used throughout the hayfever season if needed. All eye drops should be discarded one month after opening to reduce risk of infection.

What if my symptoms don’t improve?

If your hayfever symptoms are not controlled after 2-4 weeks, you may need to try a different treatment or need to add in another treatment. Some trial and error may be required to find the best combination of tablet/nasal spray and eye drop for you.

How long do I need to take hayfever medication for?

If you are taking hayfever medication regularly and your hayfever is well controlled on your current treatment, continue this treatment until the end of the pollen season.

When should I seek further advice from my doctor’s surgery?

• If symptoms cannot be controlled with medications you have purchased or there are troublesome side effects caused by the medication.
• Any wheezing or any shortness of breath or worsening of asthma.
• If your child is under 2 years old.
• If the pattern of your symptoms is unusual, such as occurring during the winter or only at your workplace. It is likely that a substance other than pollen is responsible and further testing may be required to confirm this.
• If you are pregnant or breastfeeding.

What medications are available over the counter?

The following table shows some common OTC hayfever products that can be bought from a pharmacy and their suitability for children. Some are also available in smaller pack sizes from a supermarket or convenience store.

For all medicines, please make sure you read the information leaflet to make sure it is suitable for you and that you know how to use it correctly. If in any doubt, please speak to your local pharmacist – always mention any other medical conditions or if any medication being taken.

For further information please visit Hayfever – NHS (www.nhs.uk)

Practice Policy on Period Delay Medication (Norethisterone)

Important Update: Nexplanon Contraceptive Implant Now Licensed for 5 Years

We would like to let patients know that the Nexplanon contraceptive implant is now licensed for 5 years of use, instead of the previous 3-year licence.

What This Means for Patients

If you currently have a Nexplanon implant in place, it will continue to provide effective contraception for up to 5 years from the date it was inserted.

This means that many patients who were expecting to have their implant replaced at 3 years no longer need an appointment at this time.

Our Waiting List

We are currently reviewing our implant replacement waiting list and contacting affected patients. If your implant has not yet reached 5 years since insertion, you may be removed from the waiting list as replacement is not currently required.

When to Contact Us

Please contact the practice if:

• Your implant is approaching 5 years since insertion
• You are experiencing side effects or problems with your implant
• You would like the implant removed sooner
• You have any questions or concerns

Further Information

This licensing update is based on national guidance from the Faculty of Sexual and Reproductive Healthcare and the updated product licence for Nexplanon.

Thank you for your understanding.

Relocation of PAH Phlebotomy

From Monday 27th April 2026, most phlebotomy services at Princess Alexandra Hospital will be relocating to the Harvey Centre. Please CLICK HERE for more information.

Blood Tests at John Tasker House & Felsted Surgeries

Due to staffing pressures, we will no longer be offering blood tests on site, either at John Tasker House (Dunmow) or Felsted Surgery.

We apologise for the inconvenience this may cause, however this decision has not been made without thorough consideration. Blood tests can be arranged at local hospitals, such as Princess Alexandra Hospital (Harlow), Herts & Essex Hospital (Bishops Stortford) or Broomfield Hospital (Chelmsford).

DigiGo Bus

If you are unable to travel by car, you can use the DigiGo Bus.

Cost - £3 per single fare, with some even cheaper

Areas covered - South Braintree, Great Dunmow, Broomfield, Great Leighs, High Roding, Great Canfield, Stebbing, Great Sailing, Great Bardfield, Finchingfield, Panfield, White Notley, Terling and many more!

To book - Call the booking line on 0345 603 7633 (Monday to Friday, 9am till 5pm)

DigiGo - Digital DRT | Travel Essex

If you have any further concerns or queries, please don't hesitate to contact us.

Changes to the appointment system from 1st October 2025 - No More 8AM Rush!

The practice is open from 8.00am to 6.30pm, Monday to Friday.

Throughout these hours you, or your carer on your behalf, can:

·         Go online using the practice’s website www.jth.org.uk or the NHS App - including for urgent appointments

·         Visit the practice

·         Call us

You can choose the way you contact the practice based on what is best for you.

What if the practice is closed?

If you need urgent help for your physical or mental health when the practice is closed, and you cannot wait until we open, go online to 111.nhs.uk or call 111. They will tell you what to do next.

What if it’s an emergency?

If it’s a serious or life-threatening emergency, go straight to A&E (Accident and Emergency) or call 999.

What happens when you contact the practice to request an appointment?

Whether you make your request by phone, on-line or visiting the practice, you may be asked to give the practice some details so that we can assess what is best for you based on your clinical need. The practice team will consider your request for an appointment or medical advice and tell you within one working day what will happen next.

This could be:

An urgent appointment or phone call that day

A priority appointment or phone call in the next few days

A routine appointment or phone call in the next few weeks that can be booked yourself via a link

A text message responding to your query

Advice to go to a pharmacy or another NHS service.

The practice will decide what is best for you based on your clinical need.

If the practice does not have any more urgent appointments left you may be asked to contact 111 or attend an urgent treatment centre for further assessment.

Who might help you?

You might be offered a face-to-face appointment or a phone call with a GP or other member of the practice staff, like a Physician Assistant, Emergency Care Practitioner, First Contact Physiotherapist or Pharmacist.

If you have a carer, they can speak for you with your consent.

You can ask to see a preferred healthcare professional, and the practice will try to meet your request, although you might have to wait longer for that person to be available.

It can be helpful to see the same healthcare professional, particularly if you have a long-term health condition.

How can you help us?

Be prepared: Before an appointment, think about writing down your symptoms, what you are worried about and what you want to talk about.

Be on time: Being late for an appointment or being unavailable for a timed call-back can affect other patients.

Cancel if needed: If you can’t go to your appointment, tell the practice as soon as you can, so that they can offer it to someone else.

Use the NHS App or website: If you’re confident using smart phones or computers, you can book or cancel appointments, order repeat prescriptions, and see your test results online.

Turn on notifications: If you use the NHS App, turn on notifications so the practice can contact you more easily.  Please keep an eye out for messages.

Order repeat medicines on time: Make sure you ask for repeat prescriptions on time, so you don’t run out, and only order what you need.

Treat staff with respect: The practice aims to treat everyone fairly, kindly and respectfully.  Likewise, you should also treat staff with respect.  The practice can remove patients from our list if they are violent or abusive to staff.

Join the Patient Participation Group: The practice has both an in-person and virtual group of patients who can offer feedback on the services we deliver. The practice website explains how you can join.

Thank you for your understanding.

Partners, Management and Staff – John Tasker House & Felsted Surgeries

NHS App

NHS App

Patients were granted full access to their medical records from October 2023, however this was only access going forward from that date, it did not include historical data. Some patients will have previously had access to their historical data which has been temporarily suspended. We are hoping that we can give full access to patients in the near future.

All your data is still on your record, it is just currently not visible via the App, if you need access for whatever reason please get in touch via Contact Us button.