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THE OVER SIXTIES CLINIC—OXLOW LANE
A number of attempts have been or are being made to further the ideals of preventive
medicine as it affects the elderly. Each effort produces a variation of the
principal theme and lays emphasis on one aspect or another, but as yet, no established
pattern has emerged which would be universally applicable and it may well be that no
such pattern ever will appear.
As far as the scheme operating in Dagenham is concerned, although it is as yet
early days a certain pattern appears to be emerging which may give some clue about
the future of this service.
In September 1957 this centre opened up at the Essex County Council Clinic at
Oxlow Lane. I agreed to operate this on an experimental basis, though with some very
hazy ideas about how it could be done. Preconceived ideas suggested (a) that there
would be a high incidence of nutritional deficiency and (b) anaemia would be a common
finding. The suggested scheme was first discussed at one of our occasional meetings
with general practitioners. The clinic, staffed by a health visitor and myself began to
operate with one patient, referred by the health visitor and by agreement with her own
doctor.
Since then the centre has gradually become established and cases are referred by
general practitioners and health visitors, or attend because their next door neighbour
attended and felt that she received something there she could not get elsewhere. Patients
are not seen without the knowledge of their own doctors, but some of those doctors who
practise near the centre have very kindly agreed that their prior consent in each case is
not necessary.
The premises we use are waiting hall, minor ailments room, consulting room, office
and a room normally used for ante-natal relaxation classes. The patients are seen by
appointment only and transport is arranged on their first visit and thereafter if it is
considered necessary. Three patients can be seen in a 2½ hour session, one first attender
and two subsequent attenders or vice-versa.
At the first attendance the patient is interviewed and is encouraged to talk about her
problems, both medical and social; this interview may take three quarters of an hour.
On the first visit the blood is taken for routine haemoglobin, arrangements are made for
X-ray of the chest, vision and hearing are tested and urine is routine tested. Spirometry
is also carried out. On the second visit, normally two weeks later, all the investigation
results are available, together with any medical details from the general practitioner which
are thought to be of value (and here the general practitioners have been most helpful).
A routine physical examination is carried out and any disability noted. If it is felt that
further specialist investigations are necessary, the patient is referred to the appropriate
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