Dear Patients,
All the below information is there to help and guide you with any questions you may have in regards to practice procedures. This includes reviews and questionnaire or just simple instructions to follow.

Registered Patients
Please note the below document is very important and required for all registered patients to fill in as consent for your own line of care. Please read the document carefully, sign and send or bring into the practice so we can update your records. We thank you for your co-operation on this.
Patient Consent
Ear Drop Procedures
Please note, of late we have had numerous patients who have been requesting Ear syringing without following the below procedures first. This is a waste of both your and our nurses time and we would appreciate if you could do the below first before booking an appointment.
Ear Drop Instructions
Spirometry Test - Only to be performed with clinician permission.
Spirometry Testing.
Zero Tolerance Policy
Church Elm Lane Medical Practice takes it very seriously if a member of staff or one of the doctors or nursing team is treated in an abusive or violent way. The Practice supports the government's 'Zero Tolerance' campaign for Health Service Staff.
This states that GPs and their staff have a right to care for others without fear of being attacked or abused. To successfully provide these services a mutual respect between all the staff and patients has to be in place. All our staff aim to be polite, helpful, and sensitive to all patients’ individual needs and circumstances. They would respectfully remind patients that very often staff could be confronted with a multitude of varying and sometimes difficult tasks and situations, all at the same time. The staff understand that ill patients do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint. However, aggressive behaviour, be it violent or abusive, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police being contacted.
Alcohol Questionnaire:
Please answer the questions in the short questionnaire to enable us to assess your alcohol consumption rate and offer advice if necessary.
Alcohol Consumption Questionnaire
For patients who are due an annual asthma review.
Please would you answer the questions on the form below and submit it to us.
If your symptoms are deteriorating or you have any concerns, please make an appointment to the respiratory nurse or a doctor as well.
Open the Asthma Annual Review Form
Depression Questionnaire
This easy to use patient questionnaire has been validated for use in Primary Care.
It is used by your doctor to monitor the severity of depression and response to treatment.
It can also be used to make a tentative diagnosis of depression.
PHQ-9 Depression Assessment Questionnaire
Bowel Screening
In England, bowel screening currently uses FOBt (Faecal Occult Blood Testing). The FOBt looks for hidden traces of blood in poo. Bowel cancer screening aims to detect bowel cancer at an early stage before symptoms have a chance to develop.
The FOBt programme invites all men and women between the ages of 60-74 years. Those aged 75 and over can request a kit by ringing 0800 707 6060.
People are invited by letter to their home address every 2 years and are asked to complete a FOBt by providing 6 samples (from 3 stools) and post it back to the national programme for analysis in a sealed envelope. You wil receive your result by letter free post and your GP will be informed.
If you would like more information and advice, please visit www.cancerscreening.nhs.uk/bowel/
Information about cancer prevention - http://www.nhs.uk/LiveWell/preventing-cancer/Pages/Preventing-cancer-home.aspx
Interactive tool to support healthly living choices related to cancer prevention - http://www.cancerresearchuk.org/about-cancer/causes-of-cancer
Interactive tool to aid risk assessment of bowel cancer - http://www.nhs.uk/Tools/Pages/Bowel-cancer-self-assessment.aspx?Tag=Screening%2Band%2Btests
National Bowel Cancer Screening FREEPHONE 0800 707 6060; email: lnwh-tr.bcsp@nhs.net ; Address: Level 5V 013 St Marks Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ.
Bereavement
If Death Occurs At Home
- Telephone the doctor who will visit to confirm that death has taken place.
- Contact a funeral director.
- Arrange to collect the doctor's Medical Certificate of Death (usually from the surgery).
- Take this to the Registrars Office, (together with the deceased's Medical Card and Birth Certificate, if available) for the area in which the death took place. Alternatively you can register by declaration at any convenient Registrars Office but certificates will not be available as these will have to be posted to you a few days later.
- The Registrar will normally issue a Green coloured certificate for you to give to your funeral director who will look after necessary arrangements for the funeral. The Registrar will also issue a white notification certificate for the DSS. They will also enquire as to the number of Certified Copies you require for dealing with the deceased finances (a fee is payable for each copy).
If The Death Occurs In Hospital
- Contact a funeral director to inform him his services are required.
- Collect the certificate from the hospital then follow 4 - 5 as above
Note For Cremation
Your funeral director will usually liaise directly with the surgery regarding the additional certification required.
Please book an appointment with one of our Doctors if you require any further support. HOPE Counselling in also available via West & Co Funeral Services.
Breast Screening
Women aged 50-70 are invited for breast screening mammography every three years. Women aged over 70 can refer themselves by telephoning their local screening centre.
Women in Barking & Dagenham will be offered screening either at a mobile unit in Barking Town Centre or at King George Hospital. Women can phone the administration centre and ask to go to a different site if they wish.
Screening sites:
Westland Medical Centre, Hornchurch
King George Hospital
Barking (Axe Street) - mobile unit
Harold Wood Polyclinic
Are you a Carer?
Carers of Barking & Dagenham are striving to make a difference for over 30 years. They offer:
Information, Advocacy and Emotional Support
Peer Support Groups
Training for carers
Carers Centres are on 334 Heathway, Dagenham, RM10 8NJ and Memory Lane Resource Centre, 243 Porters Avenue, RM8 2AQ.
You can contact them on 0208 593 4422; email: carers@carerscentre.org.uk
Web: www.carerscentre.org.uk
Food Bank Services
If you feel you are in need of an emergency food supply or any support in regards to general day to day living. Please use the below link to visit our nearest The Trussell Trust Campaign - Stop UK hunger. If you feel you are able to donate to this trust then please also click on the link to find out how.
http://dagenham.foodbank.org.uk/
DOMESTIC VIOLENCE/ABUSE
There is a new app made to look like a weather app called brightsky. This contains a UK wide directory of specialist domestic abuse support services with contact details. It includes a secure journal tool, safety questionnaires and myth busting on domestic and sexual abuse. It also includes links to further resources.
Once you have installed it you just click to convert mode and it is disguised on your phone.
https://play.google.com/store/apps/details?id=com.newtonmobile.hestia&hl=en_GB
Band Together
If you or your family are in need of any advice and information in regards to Barking And Dagenham Money related matters or Employment Seeking. Please click on the below website link for support.
www.bandtogether.co.uk
Mental health resources
General information https://www.lbbd.gov.uk/mental-health
https://www.nhs.uk/conditions/suicide/
https://www.mind.org.uk/
Adults: http://www.barkingdagenhamccg.nhs.uk/Local-services/mental-health-services.htm
psychiatry services https://www.nelft.nhs.uk/services-barking-access-assessment-team
older peoples mental health https://www.nelft.nhs.uk/services-barking-older-adult-mental-health-service
mental Health advocacy services http://careandsupport.lbbd.gov.uk/kb5/barkingdagenham/asch/service.page?id=JnraaIDuoGY
psychology services Barking & Dagenham https://www.nelft.nhs.uk/services-barking-psychological-services
Mental health for Children - resources.
https://www.nicolamorgan.com/
https://www.nspcc.org.uk/preventing-abuse/keeping-children-safe/mental-health-suicidal-thoughts-children/