Little Bushey Surgery

Useful Resources

BBC Health News

'Miracle' six-day-old baby survives Ebola14 Dec 2018 16:12It took five weeks of round-the-clock treatment to keep Benedicte alive after her mother died.
Obamacare: Texas court rules key health law is unconstitutional15 Dec 2018 10:01The challenge from a coalition of 20 US states is now likely to go to the US Supreme Court.
Why did Rachel Johnston die after having all her teeth removed?14 Dec 2018 00:02The families of three people with learning difficulties tell the BBC all their teeth were taken out.
Breast cancer screening error 'overstated'14 Dec 2018 12:24There was no major incident, just confusion, and the scale of the problem was overstated, a report finds.
Meat or two veg? Find out your food’s climate footprint13 Dec 2018 16:47Check the environmental impact of what you eat and drink.
Overweight patient denied NHS operation by York CCG14 Dec 2018 14:21Roland Crooke took a loan to pay for private treatment after being told to lose weight for hip surgery

Hertfordshire Active Living

This form enables health professionals working with you to find out how you are managing at home, and whether you need any extra help to reduce your risk of falling and getting hurt in future.

Anyone who is aged over 75, can fill in this form. A carer, family member or a health professional - such as a doctor or nurse - can fill in the form with you if you need help.

If the answers you give show that you are at a higher risk of falling, the people involved in your care will be able to signpost you to further advice and support.

1Hertfordshire Active Living

Name

Date of Birth

2Section A

Do you have difficulty getting to the loo in time at home?

Are you unsteady or have you had a fall in the past year?

Are you finding it more difficult to remember things?

3Section B

Are you aged over 85?

Are you male?

Do you have any health problems that limit your activities?

Do you need someone to help you on a regular basis?

Do you have any health problems that require you to stay at home?

Can you count on someone in time of need?

Do you often use a stick, frame or wheelchair to get around?

Please add up all of your scores, what is your total?

4What next?

If you have answered ‘YES’ to any of the questions in Section A or if your total score in Section B is 4 or more, with your consent we may refer you to HertsHelp.

Please tick the box if you agree to be referred to HertsHelp.

5If you answered the questions in this form and:

• you haven’t had any falls in the past year

• you don’t have any problems with getting to the toilet

• you are not experiencing memory problems,

• your total score added up to three or less

Then you are not currently considered to be at a high risk of losing your independence or falling.

See the Health in Herts website - www.hertsdirect.org/healthinherts for advice and tips on staying healthy and active at home or out and about, or visit your local library for information on clubs and healthy activities. If you want to speak to someone about any support needs that you have, call the county-wide advice line ‘HertsHelp’ on 0300 123 4044.

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to
Little Bushey Surgery • Little Bushey Surgery, California Lane, Bushey, Herts, WD23 1EZ.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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