Little Bushey Surgery

Useful Resources

BBC Health News

Measles cases hit record high in Europe20 Aug 2018 12:43More than 41,000 people have been infected with measles in the first six months of 2018.
'I broke every bone in my face - and survived'20 Aug 2018 01:14Tom Locke is one of 1,600 people alive today thanks to a change in the way the NHS works, a study suggests.
Child passive smoking 'increases chronic lung risk'19 Aug 2018 01:39A study shows higher risk of fatal lung disease in adults exposed to cigarette smoke in childhood.
Rise in type 2 diabetes in young people in England and Wales18 Aug 2018 01:21Child health experts say the rise is "alarming" and more should be done to reduce obesity.
E-cigarettes can be key weapon against smoking, say MPs17 Aug 2018 13:20E-cigarettes are much less harmful than tobacco and shouldn't be treated the same way, MPs warn.
Low-carb diets could shorten life, study suggests17 Aug 2018 02:28Moderate carbohydrate consumption is best for health and longevity, researchers say.

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.

Submit Form

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Need care but want to stay in your own home?

Little Bushey Surgery, California Lane, Bushey, Herts, WD23 1EZ

Telephone 020 8386 8888

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