Travel Information

The following websites will give you some travel advice:

Travel Health for information of vaccinations available on NHS

MASTA for private vaccination clinics

Gov.uk for specific country travel advice

EHIC to apply for your free European Health Insurance Card

https://www.fitfortravel.nhs.uk/home.aspx

Travel Vaccines

Although our practice will no longer provide you with travel vaccines, you can visit local pharmacies which are providing travel vaccines on behalf of the NHS:

https://www.nhshighland.scot.nhs.uk/health-and-wellbeing/immunisation-and-vaccines/travel-vaccines/

Medicines for travel

GPs Will No Longer Be Prescribing Diazepam For Flying

Our concerns around using diazepam ( Class C/ Schedule IV controlled drug) in patients who are nervous about flying are as follows:

• Diazepam is a sedative, which means it makes you sleepy, more relaxed and can significantly delay your reaction times. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation. This could endanger you, or passengers around you, in the event of a safety critical incident on board.
• 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. There is concern this can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung which can be dangerous. This risk is greater if your flight is greater than four hours.
• Whilst most people find sedative medications like diazepam have a relaxing effect, a small number of people can actually feel more agitated or even aggressive after taking it. Diazepam can also cause disinhibition and lead you to behave in a way that you would not normally.
• Prescribing guidelines doctors follow (known as the BNF), don’t recommend using benzodiazepines like diazepam in phobias. We would be acting against these guidelines if we prescribe.
• Diazepam and similar drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police if you are carrying any on arrival.
• 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.

We appreciate that fear of flying is very real and very frightening. A lower risk approach is to tackle this properly and hopefully permanently, with a Fear of Flying course (run by a number of the airlines). We have listed a number of these below or there are also some free online courses:

• Easy Jet www.fearlessflyer.easyjet.com Tel: 0203 8131644
• British Airways www.flyingwithconfidence.com Tel: 01252 793250
• Virgin Tel: 01423 714900

Good advice and techniques on how to manage flight anxiety can be found here:

https://patient.info/news-and-features/how-to-manage-flight-anxiety

Malaria prophylaxis

National decisions on prescription status are based on the balance of personal risk versus population risk. Antimalarials should not be prescribed for prophylaxis on the NHS; a private prescription must be issued. Community pharmacies can advise on and sell non-prescription antimalarial medicines over the counter. Community pharmacies can also advise on other issues related to travel medicine. In addition to Travax, additional information is available at Home – Fit for Travel

Taking medicines out of the UK

Patients requiring regular repeat medication for a stable pre-existing illness may be supplied with an NHS prescription for a maximum of three months treatment, to provide treatment for the journey and until further supplies can be secured at the destination.

If patients are to be out of the UK for longer than this then they may require on-going medical review and it would be more appropriate to provide a letter detailing the patient’s medicines until they can make arrangements to get further supplies of medicines at their destination.

Advice for patients requesting medicines for taking on extended holidays and for taking prescribed controlled drugs outside the UK is available at NHS Choices: Can I take my medicine abroad?

Prophylactic medication

A person is not entitled to NHS provision of drugs where there is no existing condition. Any requests for items to be prescribed in case of illnesses contracted whilst travelling abroad (eg ciprofloxacin or oral rehydration sachets for diarrhoea) are a private transaction.