North Worcestershire Emergency Planning

One of the best ways of keeping ourselves well during winter is to stay warm. Keeping warm over the winter months can help prevent colds, flu or more serious health conditions such as heart attacks, strokes, pneumonia and depression. The chances of these problems are higher if people are vulnerable to cold related illnesses because of one or more of the following:

• They are over 65
• They are on a low income (so can't afford heating)
• They have a long-term health condition, such as heart, lung or kidney disease
• They are disabled cold homes have a significant impact on people's health.

Make yourself warmer

• Wear several thin layers, rather than one thick layer. This is because they trap warm air close to the body
• Go for clothes made from wool, cotton or fleecy fabrics, if possible
• Draw your curtains, as soon as it gets dark to stop the heat escaping and the draughts coming in
• Keep any windows and internal doors closed when it’s cold – this will keep heat inside, where you most need it
• A lot of heat is lost through the head and neck, so if you’re chilly indoors, try wearing
• a hat and scarf
• Your body keeps warm by burning food you've eaten, so make sure you have regular hot meals that contain carbs, such as potatoes, pasta, bread and rice. Try porridge with hot milk for breakfast and soups and stews for lunch and dinner.
• If sitting down, a shawl or blanket will provide extra warmth and try to keep your feet up, because air is cooler at ground level.
• Wear warm clothes in bed. When it’s really cold, wear thermal underwear, bed socks and even a hat.
• Keep your feet warm. As with your hands and face, cold feet can trigger a potentially dangerous rise in blood pressure. Choose boots with non-slip soles and a warm lining, or wear thermal socks. These boots keep you safe if the ground is slippery and keep your feet warm.
• Check local news and weather forecasts for advice when bad weather is forecast.

The Electronic Prescription Service (EPS) is an NHS service. It gives you the chance to change how your GP sends your prescription to the place you choose to get your medicines or appliances from.

What does this mean for you?

If you collect your repeat prescriptions from your GP you will not have to visit your GP practice to pick up your paper prescription. Instead, your GP will send it electronically to the place you choose, saving you time. You will have more choice about where to get your medicines from because they can be collected from a pharmacy near to where you live, work or shop. You may not have to wait as long at the pharmacy as there will be time for your repeat prescriptions to be ready before you arrive.

Is this service right for you?

• Yes, if you have a stable condition and you:
• don’t want to go to your GP practice every time to collect your repeat prescription.
• collect your medicines from the same place most of the time or use a prescription collection service now.

It may not be if you:

• don’t get prescriptions very often.
• pick up your medicines from different places.

How can you use Electronic Prescription Service?

You need to choose a place for your GP practice to electronically send your prescription to. This is called nomination.

You can choose:

• a pharmacy.
• a dispensing appliance contractor (if you use one).
• your dispensing GP practice (if you are eligible)

Ask any pharmacy or dispensing appliance contractor that offers EPS or your GP practice to add your nomination for you. You don’t need a computer to do this.

Can I change my nomination or cancel it and get a paper prescription?

Yes you can. If you don’t want your prescription to be sent electronically tell your GP. If you want to change or cancel your nomination speak to any pharmacist or dispensing appliance contractor that offers EPS, or your GP practice. Tell them before your next prescription is due or your prescription may be sent to the wrong place.

Is EPS reliable, secure and confidential?

Yes. Your electronic prescription will be seen by the same people in GP practices, pharmacies and NHS prescription payment and fraud agencies that see your paper prescription now. Sometimes dispensers may see that you have nominated another dispenser. For example, if you forget who you have nominated and ask them to check or, if you have nominated more than one dispenser. Dispensers will also see all the items on your reorder slip if you are on repeat prescriptions.

If you are unhappy with your experience of nomination You can complain to the pharmacy, dispensing appliance contractor (DAC) or GP practice. You can also complain to NHS England or their local NHS Clinical Commissioning Group (CCG) if your complaint cannot be resolved www.england.nhs.uk/contact-us/complaint/ For more information visit www.hscic.gov.uk/epspatients, your pharmacy or GP practice. (Dec 2014)

When the cold weather sets in you can make a difference by looking in on a neighbour who is elderly or vulnerable.

• Introduce yourself first - On your first visit be polite, smile, say who you are and ask if it's alright to enter the house before you do so. Let them know that you'll be popping in now and again to see if they need anything.
• Speak clearly - If you think an older person may have trouble hearing or has memory problems, make sure to speak clearly (but don't shout!). Pause between sentences and questions to give them the chance to digest the information. And allow a little extra time for them to respond – don't hurry them.
• Put the kettle on - Hot drinks help to keep an older person warm, so offer to make a cup of tea or coffee or heat up a can of soup. If they can't get around easily, you could offer to make up a flask of tea, soup or Bovril to have close to hand to last them through the day.
• Help with shopping - If you're doing a supermarket run, it doesn't take much to ask if they need some shopping at the same time. This is especially helpful for heavy or bulky items such as cans, washing powder and pet provisions.
• Give them a lift - Offers of a lift are usually very welcome, especially when it's cold and icy and hard to get about. If you have a car, offer to drive them to appointments at the GP surgery or hospital, or simply to see their friends.
• Help with household tasks - Older people often really appreciate any offer of help with basic chores such as taking out the rubbish, changing light bulbs, fastening sash windows, clearing snow off the path, putting up pictures and so on.
• Take them a meal - Many older people need a hand cooking for themselves, so why not take round an extra plate of hot home-cooked food (or a frozen portion they can heat up or microwave).
• Get them moving - General movement will help fend off the cold. Invite them outside for a walk with you, but make sure they wrap up and wear shoes with a good grip. Chair exercises are also a good way to keep warm and active.
• Check they're warm enough - Ideally the home should be heated to 21ºC. Older people often can't tell how cold they are, so a room thermometer is more accurate. Heat is lost through the head and neck, so suggest they wear a hat and scarf, even indoors. And warm socks will help to keep the circulation in the lower legs moving.
• Watch for signs of illness - Older people are particularly vulnerable during the winter as cold weather increases the risk of illnesses such as colds, coughs, flu, heart attacks, strokes, breathing problems and hypothermia (a dangerous fall in body temperature). Check if they've had a free flu jab and, if not; offer to make an appointment at the GP surgery. Look out for signs of serious illness, such as drowsiness, slurred speech and the person not complaining of feeling cold even in a bitterly cold room. If you're worried, ask if there's a relative or close friend you can telephone, or call the doctor or NHS 111.

Five ways to stay healthy this winter. Even when the weather turns colder winter needn't be the unhealthiest time of year. Here are five ways to make sure that, even when our bodies tell us to hibernate, we can keep healthy and fit, no matter what the weather's like.

• Eliminate your sleep debt - On average we sleep six-and-a-half hours a night, much less than the seven to nine hours recommended. In winter, we naturally sleep more because of the longer nights. It is perfectly natural to adopt hibernating habits when the weather turns cold, use this time to catch up.
• Drink more milk – We are 80% more likely to get a cold in winter, so making sure your immune system is in tip-top condition is important. Milk and dairy products such as cheese, yoghurt and fromage frais are great sources of protein and vitamins A and B12. They're also an important source of calcium, which helps keep our bones strong. Try to go for semi skimmed or skimmed milk – rather than full-fat – and low-fat yoghurts.
• Eat more fruit and veg - When it's cold and dark outside, it can be tempting to fill up on unhealthy comfort food, but it's important to ensure we still have a healthy diet and include five portions of fruit and veg a day. Try a juicy clementine or satsuma instead, or even sweet dried fruits such as dates or raisins instead of reaching for a sugary treat. Winter vegetables such as carrots, parsnips, swede and turnips can be roasted, mashed or made into soup for a comforting winter meal.
• Try new activities - Don't use the cold winter months as an excuse to stay in and lounge around. Instead, get out and try a new activity or take a bracing winter walk on the beach or through the park. Regular exercise can help to control weight, boost your immune system, and is a good way to break the tension that can build if we are constantly cooped up inside the house.
• Have a hearty breakfast - Winter is the perfect season for porridge. Eating a warm bowlful on a cold morning isn't just a delicious way to start the day, it also helps boost your intake of starchy foods and fibre. These give you energy and help you feel fuller for longer, stopping the temptation to snack mid-morning. Oats also contain lots of vital vitamins and minerals. Make your porridge with semi-skimmed or skimmed milk or water, and don't add sugar or salt. Add a few dried apricots, some raisins, a sliced banana or other fruit for extra flavour.

It's thought the winter blues, or seasonal affective disorder (SAD), affects around 2 million people in the UK and more than 12 million people across northern Europe. It can affect people of any age, including children. The Seasonal Affective Disorder Association (SADA) recommends the following 10 tips to help you beat the winter blues.

Keep active - Research has shown that a daily one-hour walk in the middle of the day could be as helpful as light treatment for coping with the winter blues.

Get outside - Go outdoors in natural daylight as much as possible, especially at midday and on brighter days. Inside your home, choose pale colours that reflect light from outside, and sit near windows whenever you can.

Keep warm - Being cold makes you more depressed. It's also been shown that staying warm can reduce the winter blues by half.

Eat healthily - A healthy diet will boost your mood, give you more energy and stop you putting on weight over winter. Balance your craving for carbohydrates, such as pasta and potatoes, with plenty of fresh fruit and vegetables.

See the light - Some people find light therapy effective for seasonal depression. One way to get light therapy at home in winter is to sit in front of a light box for up to two hours a day. Light boxes give out very bright light at least 10 times stronger than ordinary home and office lighting. They're not available on the NHS and cost around £100 or more.

Take up a new hobby - Keeping your mind active with a new interest seems to ward off symptoms of SAD, such as singing, knitting, joining a gym, keeping a journal, or writing a blog. The important thing is that you have something to look forward to and concentrate on.

See your friends and family - It's been shown that socialising is good for your mental health and helps ward off the winter blues. Make an effort to keep in touch with people you care about and accept any invitations you get to social events, even if you only go for a little while.

Talk it through - Talking treatments such as counselling, psychotherapy or cognitive behavioural therapy (CBT) can help you cope with symptoms. See your GP for information on what's available locally on the NHS.

Join a support group - Think about joining a support group. Sharing your experience with others who know what it's like to have SAD is very therapeutic and can make your symptoms more bearable.

Seek help - If your symptoms are so bad that you can't live a normal life, see your GP for medical help.

Feeling lonely is a normal human emotion and can affect anyone of any age. People can become lonely for a variety of reasons such as getting older, less mobile, no longer being the hub of their family, leaving the workplace, isolated, disability or illness, and the deaths of spouses and friends.

Whatever the cause, it’s easy to be left feeling alone and vulnerable, which can lead to depression and a serious decline in physical health and well-being. If you have been feeling lonely for a while, a first step is to notice and identify this, even if just to yourself. This can help you can think about what you could do to help yourself, or how to ask for help from others.

Reconnections Worcestershire is a new service which aims to reduce feelings of loneliness for people over the age of 50. It is a one to one service offering support to:

• Build confidence with the support of a volunteer
• Connect with people and groups who have common interests and experiences
• Find activities and pastimes in local communities
• Help share skills and knowledge with others
• Offer opportunities to support other lonely people

To talk confidentially call 01905 740954 or email Age UK Herefordshire and Worcestershire.

If you are feeling lonely, you could try one of more of the following;

Connect - With the people around you family, friends, colleagues and neighbours. Invite friends for tea, keep in touch by phone, and learn to use computers. Computers are a great way to share emails and photos with family and friends, have free video chats using services such as Skype or Face Time to make new online ‘friends’ or reconnect with old friends with social media sites such as Facebook or Twitter.

Be active - Exercising makes you feel good. Most importantly, discover a physical activity you enjoy and that suits your level of mobility and fitness. For further information about local walking groups, cycling routes and parks and country parks visit www.worcestershire.gov.uk and search 'countryside and leisure'.

Take notice - Be curious. Catch sight of the beautiful. Remark on the unusual. Notice the changing seasons, savour the moment whether you are walking to work, eating lunch or talking to friends. Be aware of the world around you and what you are feeling. Reflecting on your experiences will help you appreciate what matters to you.

Keep learning- Try something new, meet new people and spend time with others. There are a variety of courses available for adults in Worcestershire including basic computer skills For more information visit: www.worcestershire.gov.uk and search 'adult learning'. Health & Well-being Living Well – Winter Health Campaign ylyc.worcestershire.gov.uk

Give - Do something nice for a friend, or a stranger. Thank someone. Join a community group get involved in local community activities. There are a huge number of social groups in Worcestershire from walking groups, singing groups, book clubs, bridge, bingo, quiz nights and faith groups. Find out more from the Finding Services page. Volunteer your time by helping others, use the knowledge and experience you’ve gained over a lifetime to give something back to your community. You’ll get lots back in return, such as new skills and confidence and, hopefully, new friends too.

Visit Act Local Worcestershire's website for volunteering opportunities in the community.

Further Information:

• Mind's 'How to Cope with Loneliness' booklet
• Royal Voluntary Service's Guide: Feeling Well and Overcoming Loneliness
• NHS Choices provides information on looking out for the signs of loneliness and what you can do to connect with other people.

Being active is one of the most important things you can do for your health and wellbeing whatever your age and it is never too late to start! You will start to feel better within weeks of being more active, you will meet new people, make new friends and it doesn’t even have to cost anything. Research suggests that many adults spend more than seven hours a day sitting down, at work, on transport or in their leisure time.

People aged over 65 spend 10 hours or more each day sitting or lying down, making them the most inactive age group. Being active can reduce your risk of major illnesses, such as heart disease, stroke, diabetes and cancer. Physical activity can also boost self-esteem, mood, sleep quality and energy, as well as reducing your risk of stress, depression, dementia and Alzheimer's disease.

To stay healthy all adults should:

• Aim to be active daily doing at least 150 minutes of moderate aerobic activity such as cycling or fast walking every week
• On two or more days a week do strength exercises that work all major muscles
• Older adults at risk of falling should also do activities to improve balance and coordination on at least two days a week.

For any type of activity to benefit your health, you need to be moving quick enough to raise your heart rate, breathe faster and feel warmer. This level of effort is called moderate intensity activity. One way to tell if you're working at a moderate intensity is if you can still talk but you can't sing the words to a song.

Being physically active is easier than you think, especially if you make activity part of your daily routine, simple things like using the stairs rather than the lift, to walking or cycling instead of using the car. However, the more you do, the better, and taking part in activities such as sports and exercise will make you even healthier.

Information about popular activities in Worcestershire

Walking

Walking is a good way to get started. Start by challenging yourself to count the number of steps you do. Most people take between 3000 and 4000 steps per day, could you do more than this?

In Worcestershire we have a number of Walking for Health groups which open are to everyone, and are helpful if you have a health condition. Find out more about joining your local walking group and the opportunities for volunteering.

Cycling

Cycling can be a good way to travel and build activity into daily routines. There are many cycle routes across Worcestershire. Why not discover if there is one on your doorstep!

Swimming

Swimming is a great form of all-round exercise, ideal if you want to be more active and stay healthy, whatever your age or ability. Find out more from your local leisure centre.

Bowls

Bowls provides exercise of a moderate intensity. It also offers a mental challenge for people of all ages through the development of skills and tactics. If you're looking for a chance to keep active and socialise with people in your community, then bowls is for you. Contact Sports Partnership Herefordshire and Worcestershire by calling them on 01905 855498,  alternatively you can email them.

Couch to 5K

Couch to 5K is a free nine-week running plan for people who want to be more active. It's perfect if you're new to running - the plan is all about starting slowly and building up gradually. Anyone can start Couch to 5K - you don’t need to be fit! You can do it on your own with the help of the podcasts (downloadable from NHS UK) or you can join a local group. Contact the Sports Partnership for more information.

Parkrun

Parkrun organise free, weekly, 5km timed runs around the world. They are open to everyone, free, and are safe and easy to take part in. You can find your nearest one at www.parkrun.org.uk

Disability

Disability Sport Worcester specialises in creating and running sporting events, clubs and activities for children and adults with disabilities across Worcester City. They aim to inspire and encourage our members and help them to achieve their potential.

Strength and balance classes

Strength and Balance exercise classes are aimed at people who feel unsteady on their feet or have had a fall. The classes aim to improve strength, balance and mobility and also to help people feel more confident when out and about. They run across Worcestershire in local community venues.

The Sports Partnership hold a list for a variety of exercise classes that are suitable for the older age group. Please contact them by calling 01905 855498 for more information.

Further sources of information and advice

• Sports Partnership Herefordshire and Worcestershire can provide information about local activities, sports clubs and facilities in your area.
• Change4Life Get Going has lots of ideas on being active
• NHS Choices Getting Active has lots of information on being physically active
• Age UK has lots of information about staying active

The risk of falling is a common problem which can often be avoided by following a few safety tips. Here's some key things you can do to prevent a fall. The important thing to remember is that preventing falls is not just about hazards around you, but it is also about what you wear on your feet, what you eat, how active you are and what steps you take to prevent falls happening.

Loss of confidence - if you have had a fall or are worried about a falling there are some important things to remember;

• anyone can have a fall – you are not alone
• falling is frightening and people feel less confident after a fall.

Do you find you:

• Are more careful with your walking, maybe slower or doing less?
• Are leaving the house less often, or not going as far?
• Are you worried about what might happen if you fall again?

Answering yes to one or all of these questions is common and may mean you have lost your confidence, but remember there are lots of things that you can do to reduce your risk of falling and improve your confidence.

The information below is full of ideas to help increase your confidence by taking control. If your concerns are affecting you a lot then speak to a Health Care Professional.

Safety in the home

Each year, thousands of older people falls at home. Falls at home are often due to tripping hazards that are easily overlooked but easy to fix. For more information please visit the Age UK website as they have produced a Home Safety Checker about staying safe around the home

Safe use of medicines

Some medicines can you make you more likely to fall e.g. antidepressants, sleeping tablets and other sedatives. Sometimes tablets for blood pressure can work a little too well and make you dizzy when you stand up. The key things to remember are

• follow the instructions for taking your medicines and regularly review your medication with your doctor or pharmacist
• do not stop taking a medicine without first asking your doctor
• do not change the amount you have been told to take or take it at a different time without first discussing it with your Doctor or Pharmacist
• do not share or give your medicines to anyone else, they were prescribed for you and maybe harmful to other people.

Postural hypotension/dizziness

Postural hypotension is a drop in blood pressure during a change in position. This reduced the amount of blood going to your brain and can cause symptoms of dizziness, falls and blackouts. The fall in blood pressure can occur at any time and may happen after getting up from either lying or sitting positions. The key things to remember are;

• see your GP to ensure there is no medical reason for your symptoms,
• don’t get up to quickly, especially in the mornings because this is when it is most likely to happen,
• don’t rush off when you have stood up, try standing for a short period to make sure you don’t feel dizzy and sit back down if you are feeling dizzy.

Vision and hearing loss

You can experience falls due to sight or hearing loss so please ensure you have both regularly checked by a professional.

Lead an active lifestyle

Regular exercise and movement can prevent the risk of falling. Regular physical activity, such as walking, helps to strengthen muscles and bones. The key things to remember when exercising is that you check with a Doctor or Nurse before starting a new activity, build up your activity levels slowly, remember to warm up and cool down with some gentle stretching and wear loose clothing and suitable footwear.

Don’t exercise if you are feeling tired, ill or just after eating, don’t overdo it and make sudden or jerky movements such as tipping or turning your head. Standing up quickly can cause dizziness.
For more information on local Strength and Balance Classes please contact the Sports Partnership by calling 01905 855498

Foot care and footwear

As we get older our feet often start to protest about the way we have treated them over the years, so it’s important to take good care of them. Good simple foot care is important, remember to wash you feet daily in warm soapy water and make sure you dry them properly, especially between the toes, remove and dry or hard skin and use moisturising cream and trim your toe nails at least once a month, always cutting hem straight across not down the sides. Often your local Age UK will provide a foot care service.

Don’t ignore minor foot troubles, if you are in any doubt see your Doctor or a registered Chiropodist or Podiatrist, especially if you have diabetes mellitus. Badly fitted shoes may contribute to falls and many people slip, trip or stumble because of a slippery sole. Remember to take care of your feet and choose the right footwear for support and comfort, make sure you get your feet measured regularly as the size and shape of your feet change throughout your life and choose footwear that has nonslip soles.

Osteoporosis

Osteoporosis is a common condition where are bones become very fragile and weak making them easy to break. There are many factors that may increase your risk, such as; family history, a broken bone after a fall, the menopause and certain medical conditions. If you are concerned consult with your Doctor or Nurse who will be able to advise you on some treatments that can strengthen your bones. To protect bones quit/stop smoking, keep your alcohol intake low, exercise, go outside as often as possible as daylight is an important source of vitamin D and eat a balanced diet.

It is important to eat a balanced diet to make sure you have all the necessary protein, vitamin, minerals and other nutrients your body requires to keep your bones and muscles healthy and in good working order. Having strong bones prevent falls. You need to base your meals on starchy foods, eat at least five fruit and veg a day, eat more fish (including a portion of oily fish each week). A good supply of calcium is essential for the prevention of brittle bones, milk and diary foods are a good supply of calcium. Vitamin D is needed by your body to absorb the calcium from your diet. The main source of vitamin D comes from sunlight, it can also be obtained from certain foods e.g. margarine, eggs, liver, oily fish and breakfast cereals.

What if I have a fall?

If you have a fall being prepared could be a life saver. Keep calm!, if you have a panic button or alarm call for help, check to see if you are near a phone if so phone for help, if in doubt call the emergency services, if your neighbours may hear call for help. Check for injuries, check the area for any item you may have dropped and broken (you don’t want to cause any more injuries). You may want to try and get up, do this in stages so your nearer a chair or settee first, then get onto your hand and needs first, finally try and keep warm, by using a blanket, coat or towel. When the weather is cold you can easily suffer from hypothermia, particularly if you are lying on the floor after a fall.

Some health problems, such as asthma, sore throat and cold sores, are triggered or worsened by cold weather.

Colds - You can help prevent colds by washing your hands regularly. This destroys bugs that may have been picked up from touching surfaces used by other people, such as light switches and door handles. It's also important to keep the house and any household items such as cups, glasses and towels clean, especially if someone in the house is ill.

Sore throats - are common in winter and are almost always caused by viral infections. There's some evidence that changes in temperature, such as going from a warm, centrally heated room to the icy outdoors, can also affect the throat.

Asthma - Cold air is a major trigger of asthma symptoms such as wheezing and shortness of breath. People with asthma should be especially careful in winter. They should stay indoors on very cold, windy days. If they need to go out, they should wear a scarf over their nose and mouth.

Norovirus - Also known as the winter vomiting bug, norovirus is an extremely infectious stomach bug. It can strike all year round, but is more common in winter and in places such as hotels and schools. The illness is unpleasant, but it's usually over within a couple of days. It is important to drink plenty of fluids to prevent dehydration. Young children and the elderly are especially at risk. By drinking oral rehydration fluids (available from pharmacies), you can reduce the risk of dehydration.

Painful joints - Many people with arthritis say their joints become more painful in winter, though it's not clear why this is the case. Only joint symptoms such as pain and stiffness are affected by the weather. There's no evidence that changes in the weather cause joint damage. Daily exercise can boost a person's mental and physical state. Swimming is ideal as it's easy on the joints.

Cold sores - Most of us recognise that cold sores are a sign that we're run down or under stress. While there's no cure for cold sores, you can reduce the chances of getting one by looking after yourself throughout winter.

Heart attacks - Heart attacks are more common in winter. This may be because cold snaps increase blood pressure and put more strain on the heart. Your heart also has to work harder to maintain body heat when it's cold.

Cold hands (Raynaud's phenomenon) - is a common condition that makes the fingers and toes change colour and become very painful in cold weather. Fingers can go white, then blue, then red, and throb and tingle. It's a sign of poor circulation in the small blood vessels of the hands and feet. In severe cases, medication can help, but most people live with their symptoms.

Dry skin - is a common condition and is often worse during the winter, when environmental humidity is low. Moisturising is essential during winter. Contrary to popular belief, moisturising lotions and creams aren't absorbed by the skin. Instead, they act as a sealant to stop the skin's natural moisture evaporating away. The best time to apply moisturiser is after a bath or shower while the skin is still moist, and again at bedtime.

Flu - is a major killer of vulnerable people. People aged 65 and over and people with long-term health conditions, including diabetes and kidney disease, are particularly at risk. The best way to prevent getting flu is to have the flu jab (or flu nasal spray for children aged 2 to 18). The flu vaccine gives good protection against flu and lasts for one year.

Flu is a highly infectious illness that spreads rapidly through the coughs and sneezes of people who are carrying the virus.

People, who are at risk of complications from flu, should make sure they have the annual flu vaccine available from September onwards. Flu symptoms can hit quite suddenly and severely. They usually include fever, chills, headaches and aching muscles and you can often get a cough and sore throat.

• Anyone can get flu, but it can be more serious for certain people, such as:
• people aged 65 or over
• people who have a serious medical condition
• people who are very overweight
• pregnant women

Anyone from the above group are more vulnerable to the effects of flu (even if they are fit and healthy) and could develop flu complications, which are more serious illnesses such as bronchitis and pneumonia, which could result in hospitalisation.

Flu can also make existing medical conditions worse. See a GP or pharmacist about the flu jab if 65 or over, or if they have any of the following problems (however old they are):

• a serious heart complaint
• they are very overweight with a BMI over 40
• has a chest complaint or breathing difficulties, including asthma, bronchitis and emphysema
• serious kidney disease
• diabetes
• lowered immunity due to disease or treatment such as steroid medication or cancer treatment
• if they have had a stroke or a transient ischaemic attack (TIA)
• if they have a problem with their spleen or they have had your spleen removed

Some may be advised to have a flu jab if they have serious liver disease, multiple sclerosis (MS) or some other diseases of the nervous system.

Can anyone have the flu jab?

Yes anyone can pay for the flu vaccination privately if they are unable to have it on the NHS. It is available from some pharmacies and GPs on a private patient basis. Carers may be entitled to the flu jab if they are deemed to be in the a risk group.

How effective is the flu jab?

No vaccine is 100% effective however; people who have had the flu jab are less likely to get flu. If they do get flu despite having the jab, it will probably be milder than if they haven't been vaccinated.

Alcohol can make you think that you’re warm. But the balmy glow and red cheeks that come with a drink are deceptive.

When you drink, it dilates the peripheral blood vessels near your skin, which means more blood – and heat – flows to these vessels. This takes blood and heat away from the core of your body. So while it feels like you’re warm because your skin is warm, your vital organs aren’t as warm as you might think they are. If you then go out in the cold after drinking, because you’ve got a lot of heat on the periphery of your body, you can lose heat very easily and quickly. And that can be dangerous.

When you’ve been drinking heavily and then venture out into arctic conditions, the faulty internal thermometer coupled with the dulling of senses and bravado that alcohol can create, can spell trouble. Drinking too much can lead to bad decisions. If for example, you drunkenly decide to walk home across a snowy field instead of getting a taxi, you’re putting yourself at risk. Hypothermia can take hold quickly and can even lead to death.

Drinking alcohol and cold temperatures are a lethal combination. Calculate your alcohol unit intake.