We have been advised that HHMP will have the new Covid Vaccine Pfizer (XBB.1.5) monovalent Omicron vaccine available to give to our patients as from Monday December 11^th.

This new vaccine is believed to provide modest improved protection against the COVID 19 strains currently circulating.

ATAGI have also provided the following recommendations in regards to this new vaccine:

• All adults aged 75 years and over should receive an additional 2023 Covid vaccine dose if 6 months have passed since their last dose.
• All adults aged 65 to 74 years should consider an additional 2023 Covid 19 vaccine dose if 6 months have passed since their last dose, after discussion with their GP.
• All adults aged 18 to 64 years who are  Severely  Immunocompromised should consider an additional 2023 Covid 19 vaccine dose if 6 months have passed since their last dose, after discussion with their GP.
• For younger people or older adults (18 – 64) without severe immunocompromise who have already had a dose in 2023, no further doses are currently recommended.

Antiviral Medications

Patients over 50 years of age or over, as well as those who are immunocompromised or those with serious chronic conditions may be eligible for antiviral medications after testing positive for COVID-19. While such antivirals can help with recovery from infection, they are not a replacement for vaccination. If you test positive, you need to contact your GP ASAP to see if you eligible for antivirals and try and start these medications as soon as possible.

Shingles vaccine update

Supplies for the Shingles vaccine for eligible patients have been limited. HHMP only receives 15 doses per month. We currently have a waiting list. If you would like to be added to this list please contact our nurses.

Making a booster booking

If you would like to make a booking please click the book now button above or use the AMS connect App.

For the latest information please see the Australian Immunisation Handbook. if you would like further information or to clarify a specific situation please call the clinic and select the option to “speak to a nurse”.

Endometriosis is a chronic medical condition that affects millions of women worldwide, causing pain, discomfort, and sometimes infertility. It is a condition in which the endometrial tissue, which is the tissue that lines the inside of the uterus, grows outside of the uterus, leading to inflammation and scarring. This tissue can grow on the ovaries, fallopian tubes, and other pelvic organs, causing severe pain during menstruation, sexual intercourse, or bowel movements.

One of the most common symptoms of endometriosis is pelvic pain. This pain can range from mild discomfort to severe, debilitating pain that can interfere with daily activities. Women with endometriosis may experience different types of pain, including:

1. Dysmenorrhea – painful periods: This is a common symptom of endometriosis, and women may experience severe cramps during their menstrual cycle, which may feel like a stabbing or burning sensation in the pelvic region.
2. Chronic pelvic pain: Women with endometriosis may experience chronic pelvic pain, which is pain that lasts for more than six months. This pain may be present throughout the month or only during specific times, such as during menstruation or sexual intercourse.
3. Pain during intercourse: Women with endometriosis may experience pain during sexual intercourse, which can make sexual activity uncomfortable or even impossible.
4. Pain during bowel movements or urination: Endometrial tissue growths can also affect the rectum and bladder, leading to pain during bowel movements or urination.

Diagnosis and Treatment:

Endometriosis is a challenging condition to diagnose, and it may take several years before a woman receives a proper diagnosis. A gynaecologist may be involved and will perform a physical exam and take a detailed medical history to evaluate the symptoms. An ultrasound, MRI, hysteroscopy (uterine camera) or laparoscopy (Intra-abdominal camera) may also be used to visualize the endometrial tissue and diagnose the condition.

There is no cure for endometriosis, but several treatment options are available to manage the symptoms. Pain relief medication such as non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal therapy may be prescribed to manage the pain. Hormonal therapy such as oral contraceptives or GnRH agonists can be used to regulate the menstrual cycle and reduce endometrial growth.

In severe cases, surgery may be necessary to remove the endometrial tissue growths. A hysterectomy, which is the removal of the uterus, may be recommended in cases where the patient does not wish to have children or has not responded to other treatments.

Australian Government Commitment

Endometriosis affects at least 1 in 9 Australian women and can have an extensive, devastating impact on the daily lives of sufferers. With those suffering waiting on average of seven years before diagnosis. The federal government has committed to the establishment of 20 endometriosis clinics in general practices Australia wide.

Working in existing general practice, the clinics will strengthen what is often the first point of contact in the health system to reduce diagnostic delays and promote early access to multi-disciplinary intervention, care and treatment.

As well as directly helping patients, the clinics will raise awareness of endometriosis and pelvic pain, build professional knowledge and skills in this area, and improve access to information and care pathways.

The Assistant minister for health and aged care, The Hon. Ged Kearney noted that: “Too many women suffer for years with what we know can be debilitating conditions. They deserve to have their concerns be taken seriously with better access to specialised care”. She went on to add that “These Clinics are about providing women with an accessible front door to the care that they need. Gathering expertise under one roof, fostering that knowledge to improve diagnosis and services, having referral pathways in place – these are all crucial elements to getting the support that women need right.

Hunters Hill Medical Practice is one of those clinics

The team at hunters Hill Medical Practice is very excited to announce that we are one of only 6 clinics in NSW and 20 clinics nationally that have been picked as one of these clinics. This is a great achievement for the team and a huge vote of confidence. Multiple highly qualified female and male GPs who run their private practices from Hunters Hill Medical Practice have extra skills in women’s health and will be involved in the clinic.

The GP team will be supported by specialists, Dr Cherynne Johansson (Gynaecologist and laproscopic and robotic surgeon),  Dr May Wong (Gastroenterologist), Dr Matt Kim (Gastroenterologist), Prof Matt Rickard (Colorectal Surgeon), Dr Henry Cheung (Colorectal Surgeon), Dr Thaw Dar Htet (endocrinologist) and Dr Jeff Ahn (endocrinologist). The allied health team working from Hunters Hill Medical Practice also has excellent skills to support this with physiotherapists, psychologists and dietitian. This is a comprehensive group of practitioners to have at your local general practice, that is able to address your endometriosis and pelvic pain at all levels, diagnosis, treatment, surgery, weight management, Bowel related issues etc.

What happens next

The announcement of the clinics was made on Wednesday 22^nd of March 2023. We are glad to have qualified people at HHMP. GPs, physios and Gynecologist are already seeing and treating women. This funding will allow us to expand services and acquire extra resources and equipment.

Endometriosis Australia website can be a good place for information.

If we can be of assistance please use the BOOK NOW button or call us on 02 9817 2080.

Hunters Hill Tri Club is a new local club encouraging fitness and healthy use of the outdoors. As a triathlon club the focus is on cardiovascular fitness and physical activity. When combined with a good diet and appropriate sun protection, it is a winning formulae!

Hunters Hill Medical Practice is one of the inaugural sponsors for the Hunters Hill Tri Club (HHTC). We are happy to have some of our patients as members of the club and encourage others to be active and exercise.

Exclusive offer to HHTC members

As part of our focus on prevention, HHTC members, have an exclusive discount offer when accessing our Molemap skin check service.

If you have any questions please call us on 9817 2080

It has been some time since a new COVID-19 dose has been announced. The Australian Technical Advisory Group on Immunisation (ATAGI) has updated their recommendation on the  COVID-19 booster program and recommended the 2023 dose.  This applies to patients 18 years and over as well as children with serious chronic conditions or those considered at risk. For people over the age of 65, this will  be their 5th shot.

Advice summary

• A 2023 COVID-19 vaccine booster dose for adults in the following groups, is recommended if their last COVID-19 vaccine dose or confirmed infection (whichever is the most recent) was 6 months ago or longer, and regardless of the number of prior doses received:
  • All adults aged 65 years and over
  • Adults aged 18-64 years who have medical comorbidities that increase their risk of severe COVID-19, or disability with significant or complex health needs.
• ATAGI advises the following groups should consider a 2023 booster dose if their last COVID-19 vaccine dose or confirmed infection (whichever is the most recent) was 6 months ago or longer, and regardless of the number of prior doses received, based on an individual risk benefit assessment with their immunisation provider.
  • All Adults aged 18-64 years without risk factors for severe COVID-19
  • Children and adolescents aged 5-17 years who have medical comorbidities that increase their risk of severe COVID-19, or disability with significant or complex health needs.
• ATAGI advises that a booster dose is not recommended at this time for children and adolescents aged under the age of 18 who do not have any risk factors for severe COVID-19.

Please discuss your suitability for the 2023 booster with your healthcare professional.

Vaccine options

• All currently available COVID-19 vaccines are anticipated to provide benefit as a booster dose
• Bivalent mRNA booster vaccines (Pfizer or Moderna) are preferred over other vaccines.
• COVID-19 vaccine can be co-administered with influenza and other vaccines.
• Administration of a 2023 COVID-19 booster dose should aim to occur prior to June 2023  and at a time of 6 months or greater following the most recent COVID-19 vaccine dose or confirmed infection.

Anticipated benefits of a 2023 COVID-19 vaccine booster dose

An additional COVID-19 booster dose is anticipated to address waning of protection against severe COVID-19 prior to winter. This will provide an increase in protection against severe illness and protect the healthcare system during a time of high demand.

It is recommended to defer vaccination for 6 months following a confirmed SARS-CoV-2 infection, as this, together with prior vaccine doses received, will boost protection against COVID-19.  There are no safety concerns for individuals receiving a COVID-19 vaccine who may have had undetected SARS-CoV-2 infection within the past 6 months.

The increase in protection against severe illness from COVID-19 following a booster dose is most beneficial for people at higher risk of severe illness, i.e., older adults (65 years +) and those with serious medical conditions, chronic conditions or immunocompromise.

ATAGI considers a booster dose is most beneficial for all adults aged 65 years and older. The risk of severe disease increases with each decade of age. W

For children and adolescents aged 5-17 years with risk factors for severe illness, a booster dose may be beneficial; decision-making around booster vaccination should be based on an individual risk-benefit assessment with your doctor.

ATAGI continues to recommend a primary course of vaccination against COVID-19, followed by a booster dose for those eligible, even in individuals who have had past infection. Adults who have already been infected with an Omicron subvariant and vaccinated with 3 doses of COVID-19 vaccine are at lower risk of reinfection and hospitalisation compared to those who have been infected but not vaccinated.

Any future doses will be based on the ongoing surveillance of COVID-19 infection rates and clinical outcomes, new variants, and vaccine effectiveness.

Making a booster booking

Making a booking is simple and can be done online using the BOOK NOW button on top of this page or by calling 02 9817 2080. There is no waiting list.

Please wear a mask when you attend the practice.

Recently the Royal Australian College of General Practitioners and the Australian Medical Association launched campaigns against the imposition of payroll tax on individual doctors who run their own businesses from practices where they share resources to keep costs down. While practices have always paid payroll tax on employees such as receptionists, nurses and administration staff, recent rulings may mean that doctors not on the payroll would be counted under the payroll tax umbrella. This will lead to increased costs to practices and to patients as well as a reduction in bulk billing and some practices closing or doctors retiring at a time of doctor shortage! below is an open letter to the premier from the GP leadership.

The AMA GP Payroll Tax Fact sheet is available here

Open letter to NSW Premier Dominic Perrottet for the Royal Australian College of General Practice Leadership 

Dear Premier,

DON’T KILL OFF GENERAL PRACTICE

In your efforts to make up the shortfall in NSW payroll tax receipts, you could inadvertently wipe out bulk billing in general practice.

Please don’t impose payroll tax on a sector that is so vital to the community and that is operating legitimately.

Not all GPs own clinics. GPs who do own clinics have paid payroll taxes on wages and payments to reception staff, nurses, practice managers and so on since payroll tax was introduced, because we believe businesses should pay their fair share of tax as part of a functioning society.

General practices have operated in good faith over that time to provide services to GPs who operate as independent small businesses and not as employees of the practice. Sharing resources between those small businesses helps practices keep costs down and bulk bill as many patients as possible.

We know that if patients can’t see a GP, they head to the emergency department instead. Nearly 40% of presentations to emergency departments are for non-urgent issues.

You’re on record as saying that the NSW public health system needs to work in support of the general practice network, that NSW needs more bulk-billing doctors to treat patients free of charge and prevent unnecessary emergency department visits clogging up hospitals. And that there is a real opportunity right now coming out of a 100-to-150-year pandemic to reform the NSW health system.

The RACGP agrees.

GPs and general practices have told the RACGP that if payroll tax is imposed on practice earnings:

• almost 20% of general practices will be forced to close
• nearly 80% of GPs would have to pass the payroll tax on to patients as gap payments and increased fees
• many of our GPs would leave general practice altogether.

Unnecessary taxes in healthcare lead to bad outcomes for the community. But you know that – after all, NSW already exempts public hospitals and public ambulance services from payroll tax.

So please, Premier, don’t impose payroll tax on general practice earnings, unless you want to see:

• a dramatic fall in the number of patients who are bulk billed by a GP
• a material increase in out-of-pocket expenses for people who see a GP
• a significant increase in ambulance ramping and wait times at emergency departments
• more rural and remote communities losing their doctors
• an irrevocable change to the way general practice services are delivered to patients and
• their communities
• a resulting blow-out in NSW health sector costs that voters will be forced to wear.

Urge your fellow Premiers in the National Cabinet to make the same commitment to GPs and to voters.

Let GPs get on with keeping people healthy.

RACGP President Dr Nicole Higgins

RACGP NSW&ACT Chair Associate Professor Charlotte Hespe

COVID-19 case numbers remain high as we approach the Christmas holiday season. This has already affected the wellbeing and holiday plans of many patients. Much of the infections have been due to Omicron subvariants.

ATAGI now recommends everyone aged 50 years and over receive a second COVID-19 booster dose (4^th shot), in addition to those for whom it was previously recommended. This is especially important to patients 70 years and older who are most at risk.

Recently bivalent vaccines (have strains covering the original strains and the Omicron strains) have been approved for use in Australia. The 2 approved vaccines are from Moderna and Pfizer.

The recommended interval between recent infection or the first booster dose and a second booster dose has reduced to three months.

Antiviral Medications

Patients over 70 years of age, as well as those who are immunocompromised or those with serious chronic conditions are eligible for antiviral medications after testing positive for COVID-19. While such antivirals can help with recovery from infection, they are not a replacement for vaccination. If you test positive, you need to contact your GP ASAP to see if you eligible for antivirals and try and start these medications as soon as possible.

Making a booster booking

Making a booking is simple and can be done online using the BOOK NOW button on top of this page or by calling 02 9817 2080. There is no waiting list.

Please wear a mask when you attend the practice.

As COVID-19 cases increase due to the BA.4 and BA.5 subvariants, The Australian Technical Advisory Group on Immunisation (ATAGI) has updated their recommendation on the use of a second COVID-19 booster dose for people aged 30 years and over.

ATAGI now recommends everyone aged 50 years and over receive a second COVID-19 booster dose (4^th shot), in addition to those for whom it was previously recommended.

From Monday the 11^th of July 2022, the COVID 19 vaccination program will be expanded and will recommend the inclusion of a 2^nd COVID-19 booster (or 4^th dose) for people over 50 years of age. While the benefits are less obvious for those between the age of 30 to 49 years, they are now also eligible for the program.

A second booster dose is not currently recommended for people under the age of 30 years. While those under 16 years of age and without a chronic condition are not eligible for a booster at all and can only have their primary course of 2 shots.

The recommended interval between recent infection or the first booster dose and a second booster dose has reduced to three months.

Those under 30 years are eligible for a booster if they have a chronic condition

Eligible chronic conditions can be reviewed below:

• Cancer, with examples as follows: Non-hematological cancer including those diagnosed within the past five years or on chemotherapy, radiotherapy, immunotherapy or targeted anti-cancer therapy (active treatment or recently completed) or with advanced disease regardless of treatment. Survivors of childhood cancer
• Chronic inflammatory conditions requiring medical treatment with disease modifying antirheumatic drugs (DMARDs) or immunesuppressive or immunomodulatory therapies with examples as follows: Systemic lupus erythematosus, rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and similar who are being treated
• Chronic lung disease with examples as follows: Chronic obstructive pulmonary disease, cystic fibrosis, interstitial lung disease and severe asthma (defined as requiring frequent hospital visits or the use of multiple medications).
• Chronic liver disease with examples as follows: Cirrhosis, autoimmune hepatitis, nonalcoholic fatty liver disease, alcoholic liver disease
• Severe chronic kidney disease (stage 4 or 5)
• Chronic neurological disease with examples as follows: Stroke, neurodegenerative disease (eg dementia, motor neurone disease, Parkinson’s disease), myasthenia gravis, multiple sclerosis, cerebral palsy, myopathies, paralytic syndromes, epilepsy
• Diabetes mellitus requiring medication
• Chronic cardiac disease with examples as follows: Ischaemic heart disease, valvular heart disease, congestive cardiac failure, cardiomyopathies, poorly controlled hypertension, pulmonary hypertension, complex congenital heart disease
• People with disability with significant or complex health needs or multiple comorbidities which increase the risk of poor outcome from COVID-19, particularly those with trisomy 21 (Down Syndrome) or complex multisystem disorders
• Severe obesity with BMI ≥ 40 kg/m2
• Severe underweight with BMI < 16.5 kg/m2

If you believe you have a chronic condition that is not listed above, ATAGI said the list is not exhaustive, and that ‘providers may include individuals with conditions similar to those listed below, based on clinical judgment’.

Other vaccine updates

Influenza has been particularly problematic this  year due to multiple years with very little infection levels and low uptake of the influenza vaccine most likely due to a population that has been “vaccinated out”. Influenza remains a serious medical condition and is particularly dangerous for the chronically ill and the elderly.  There is a lot of influenza circulating in the community and influenza vaccination is still recommended for those who have not had it yet.

Making a booster booking

Making a booking is simple and can be done online using the BOOK NOW button on top of this page or by calling 02 9817 2080. There is no waiting list.

Please wear a mask when you attend the practice.