Davenport House Surgery, Harpenden
Bowers Way

Nursing Services

Nursing Staff

There are five registered practice nurses working in the surgery.

  • Heather Warwick
  • Mary Ibbotson
  • Rosemary Fairhurst
  • Sharon Catlin
  • Christina Harrison

All the registered nurses have individual areas of expertise.

  • Heather Warwick and Mary Ibbotson share overall clinical responsibility for training and supervising nursing care.
  • Heather Warwick is the Clinical Nurse lead for Diabetes. 
  • Mary Ibbotson is the Clinical Nurse lead for Cancer Care.
  • Christina Harrison is the Respiratory Nurse Lead.

All nurses help run appointments for both general nursing services and for specialised clinics. Appointments are made via the receptionists.

Patients can make an appointment with the nurse without seeing their doctor for minor injuries, general or holiday immunisation or vaccination advice and for ear-syringing.

However, patients must see their doctor first before blood tests or special tests or investigations can be arranged. Patients may be asked by their doctor, or invited by letter, to attend special clinics run by the Practice nurses that monitor chronic conditions such as Heart disease, Asthma, Diabetes and Hypertension - or for monitoring medication such as Contraception or Hormonal Replacement therapy or support screening services such as cytology.  

Advanced Nurse Practitioner

Helen Cruickshanks works alongside our GPs offering a minor illness clinic for advice and treatment of fever, urinary tract infections, sickness and diarrhoea and other minor ailments. She also supports the nursing team in surgery looking after leg ulcer patients.

Health Care Assistant

Karen Donovan our Health Care Assistant, is able to carry out ECG’s, audiograms, new patient checks, blood pressure checks, suture removal and basic dressing. Karen also has a special interest in supporting patients to stop smoking and also offers NHS Health checks to eligible patients. 

Childhood Immunisations

At the surgery you can book your child in for immunisations at a time that suits you with a practice nurse, we do not offer set clinics for vaccinations so we can be as flexible as possible.

The current routine vaccination schedule is:

  • 8 weeks
    • Diptheria, tetanus, pertussis, polio, Hib and Hep B (Infanrix hexa - thigh)
    • Pneumococcal (PCV Prevenar13 - thigh)
    • Rotavirus (Rotarix - oral)
    • Meningococcal B (MenB- Bexsero- thigh)
  • 12 weeks
    • Diptheria, tetanus, pertussis, polio, Hib and Hep B (Infanrix hexa - thigh)
    • Rotavirus (Rotarix - oral)
  • 16 weeks
    • Diptheria, tetanus, pertussis, polio, Hib and Hep B (Infanrix hexa - thigh)
    • Pneumococcal (PCV Prevenar - thigh)
    • Meningococcal B (MenB- Bexsero- thigh)
  • 12-13 months
    • Hib/Men C (Mentorix - upper arm/thigh)
    • Pneumococcal (PCV Prevenar 13 - upper arm/thigh)
    • MMR (Priorix / MMR VaxPro - upper arm/ thigh)
    • Meningococcal B booster (MenB- Bexsero- thigh)
  • From 3 years 4 months
    • Diptheria, tetanus, pertussis and polio (Repevax / Infanrix IPV - upper arm)
    • MMR (Priorix / MMR VaxPro - upper arm)

Download a poster detailing the childhood immunisations schedule.

For more information, including a full explanation of the vaccines and potential side effects please visit NHS Choices

Travel Vaccinations and Advice

The Practice nurses are happy to advise you on recommended health precautions for your foreign travel.

Fill out a Travel Vaccinations Request form via our Online Services

This may require vaccination according to the country or countries you are visiting and the time of year you are travelling.

The nurse has regularly updated information about the recommended vaccinations required for each part of the world and will be able to advise you if new or booster vaccinations are necessary after looking at your immunisation records. 

You should make sure you book an appointment at least a month in advance of your travel in case more than one vaccination has to planned after an interval to provide full protection.

Patients are warned that some specialised vaccinations are not provided as part of NHS services and maybe relatively expensive, requiring a private prescription to be paid by the patient.

Prescriptions to prevent malaria where necessary are also not provided under the NHS terms of service though in general are quite cheap and again these will be provided on a private prescription.

See a full list of our Travel Vaccination Charges.

Travel Advice

Before you Travel

  • Book in with the practice nurse for a travel consultation – preferably a minimum of 6 weeks before travel.
  • Rabies and Hepatitis B vaccination courses take a minimum of 3-4 weeks to complete (6 months for full course of Hepatitis B for those under 16 years old). 
  • Read up about the country or countries you are visiting regarding local customs / visas / health risks www.fitfortravel.nhs.uk or www.nathnac.org 
  • Get an EHIC card and sufficient travel insurance ensuring it fully covers any current health problems and any activities.
  • Ensure you have sufficient medication for the time you are away with some extra encase of flight delays or lost medication. Carry some in your checked luggage and hand luggage.

Travel Consultation

  • Ensure you know the following before you attend for your consultation to ensure you get the most accurate advice and information:
  • When and where you are going, how are you travelling there, urban / rural areas ? Give your specific regions and itinerary. Bring any maps / information from travel company you have
    • Will you be going to a high altitude?
    • Activities during trip ?
    • Medical history and current medication?  
    • Accommodation? 
    • Allergies and previous travel vaccines (if vaccinations have not given at surgery you are attending please bring in vaccination records, we don’t always have them)?
    • Women – Pregnant ? Planning a pregnancy ?

Risks to Travellers

  • Accidents – The most serious life threatening risk is a road traffic accident, travellers are 4 times more likely to be injured on a road abroad.  This is due to travellers changing their routine safety procedures when they are travelling.  All travellers should be advised:
    • Wear a seat belt.
    • Don’t drive if you are suffering from jet lag. 
    • Don’t drink and drive.
    • Don’t travel overnight. 
    • Great caution when crossing or walking on roads.
  • Exacerbation/ complications of chronic disease (as a traveller ensure you carry plenty of medication with you in your hand luggage and checked luggage).
  • Infectious diseases.

Food and Water Precautions

  • Diarrhoea is one of the most common health problems experienced by travellers, affecting 20% to 60% of overseas travellers.  Illnesses, including: Cholera, Hepatitis A and Typhoid are also spread by food and water contaminated with human waste.
  • Don’t add ice to your drinks or brush your teeth with tap water in countries where water is not considered safe to drink. Use boiled or bottled water from a safe source or chemically purified/filtered water. 
  • Wash your hands frequently. 
  • Raw fruit and vegetables, including salad unless you wash and peel them yourself.
  • Food left exposed to flies.
  • Food shared with lots of people, such as buffets. Particularly reheated foods. 
  • Any unpasteurised products, including dairy products and fruit juices.
  • Undercooked or raw fish, meat or shellfish.
  • Do not assume food served in expensive hotels or restaurants is safe - if staff do not take care with food handling or personal hygiene, ingredients can be contaminated.  Try to eat freshly prepared, thoroughly cooked piping hot food.
  • Boil it, cook it, peel it, or forget it’!

Bite Avoidance

Day biting mosquitoes can carry serious illness like dengue fever and yellow fever. Night biting mosquitoes can carry Japanese Encephalitis and malaria.  Mosquitoes are attracted but carbon dioxide exhaled when we breathe as well as heat and movement.

Bed Nets

If where you are staying does not have window and door screens you must sleep under an intact bed net. Pre treated nets with an insecticide are a must and carry a  sewing kit / tape with you to repair as needed.

Insect Repellents

The best available are those that contain DEET (N – diethyl-m-toulamide) they come in various forms such as sprays, creams and come in different percentages. 50 % is as strong  s you will need. Check http://www.nathnac.org/travel/misc/travellers_mos.htm  for latest guidance.

Blood Pressure Checks

Patients are welcome to ask for the Practice Nurse to take their blood pressure. They are able to make an appointment through the receptionist.

The normal levels for most ages is 140/90. If it is found to be normal then a repeat blood pressure is normally not necessary for another 3 - 5 years unless your health or weight changes appreciably.

If it raised then several more readings will need to be taken to assess whether the first reading is raised because of anxiety.

Persistent levels more than 160/100 usually require long term medication to reduce future risks of damage to the heart or brain. Patients with other medical conditions such as heart disease or Diabetes will need treatment at lower levels.

The Practice Nurse will be able to refer you on to the doctor appropriately but may conduct other tests to help the doctor make a decision about the treatment or measures necessary to try and bring your blood pressure down to normal levels.

Dressings & Minor Surgery

Patients may require attention and treatment for minor injuries, burns, animal bites or skin problems such as leg ulcers.

These can be seen and assessed by the practice nurse who can ask for a doctors opinion if necessary.

She will also be able to advise you about the need for a tetanus booster or course. There is a special dressing surgery run by the nurse each week.

Please the receptionist about this if you require care for a leg ulcer. The nurse is not qualified to assess injuries that might involve a fracture.

If an injury may involve a fracture, patients should explain this to the receptionist and arrange an appointment with a doctor that day.

Heart Tracings Investigations & Tests

Your doctor may ask you to have blood tests, other investigations at the surgery or hospital x-rays or tests after a consultation or as part of a regular review of your medical condition. These should be booked through the receptionist after seeing the doctor.

Blood tests
If you require blood tests the doctor will give you a blood request form for you to take with you to the phlebotomist or person who takes the blood sample. This is by appointment at the nearby Harpenden Memorial hospital.

There is free parking at the hospital or it is within easy walking distance from the surgery. Please ask the receptionist for directions and ask for appointment slip to remind you if necessary.

At other times the doctor may ask you have tests at the surgery such as urine and stool tests or swabs taken for infection, an ECG or heart tracing, or other special blood pressure, circulation, breathing or hearing tests. 

Samples of urine or stool
These must be placed in sterile containers provided by the doctor or nurse with the patient's name clearly written on the outside label. These should be brought to the surgery and immediately placed in a special container provided for transport that is available at the reception desk. Please ask the receptionist before leaving samples there. 

ECG's and special tests performed by the practice nurse should be booked through the receptionist after seeing the doctor. The doctor will indicate how urgently and which tests need to be performed.

Tissue specimens taken from minor operations will normally be available two weeks after your operation.

Ear Syringing

The practice nurse is happy for patients to book an appointment to assess the need for removal of ear wax by gentle syringing.

The practice uses a electronic ear syringing device that is more comfortable for patients. Patients with sudden hearing loss or a history of ear discharge or a previous perforated eardrum should see their doctor first. 

It is often necessary to soften ear wax by first using ear drops a day or two beforehand. Chemists will be happy to advise you of the sort to buy though a small amount of warmed olive oil is usually sufficient. 

Children do not normally require ear syringing.

Cystitis & Urinary Tract Infections

Infection of the urine often known as "Cystitis" is very common especially in women. It can be uncomfortable but simple to treat by a short course of antibiotics if drinking increased amounts of fluids to 'flush' out the germ doesn't improve symptoms after 24 hours or so.

The practice therefore has devised a system to check the urine of patients with symptoms of cystitis and provide a prescription within a few hours to avoid unnecessary suffering.

Patients with symptoms should therefore bring a fresh early morning specimen of urine in a sterile container or pass a sample at the surgery after it has been provided at the reception desk.

You will be asked to fill in a form indicating your symptoms as well as a few other details before the nurse tests the sample. Urine samples left without details being properly filled in ill be discarded. Depending on the result - you may then be able to collect a prescription shortly afterwards once it has been checked by your doctor.

Patients should not use this system if they are ill or passing blood in their urine. It is not designed to treat children or men who nearly always require further assessment and possible investigations.

Women with more than three infections a year, incompletely resolving or a return of symptoms within a month should also see their doctor for further assessment.

Women with vaginal symptoms or who are or maybe possibly pregnant should also discuss this with their doctor before a prescription is issued.

Hospital 'After-Care'

Patients may leave hospital after an operation and require further dressings or wound attention and later removal of stitches. 

If too unwell or weak these can be dealt with by the District Nurse at home who is normally contacted by the hospital beforehand.

The District nurse can also be contacted through the surgery receptionists who will contact them for you.

Otherwise you should make an appointment for the practice nurse to redress wounds or remove sutures through your doctors receptionist.