The E4 Primary Care Network Enhanced Access Service is offered from one location centrally within the E4 PCN geography.

The service is intended to supplement your standard GP hours offering appointments in the evening and weekends which may be particularly beneficial to patients who work full time or have other commitments during regular GP hours. 

In addition to GP’s the service includes other healthcare professionals such as Nurse Practitioners, First Contact Physiotherapists, Pharmacists, Health Care Assistants, Vaccinators and Phlebotomists.

Appointments are offered at Chingford Medical Practice, Chingford Health Centre, 109 York Road, Chingford, E4 8LF at the following times:

• Monday 18:30-20:00hrs
• Tuesday 18:30-20:00hrs
• Wednesday 18:30-20:00hrs
• Thursday 18:30-20:00hrs
• Friday 18:30-20:00hrs
• Saturday 09:00-17:00hrs

Appointments may take place by telephone, video or face to face depending on your clinical needs.

To book an appointment with the E4 Enhanced Access Service, contact your GP surgery today!

Chaperones

You may request a suitably trained chaperone for any appointment, procedure, test or examination. Friends and family are not permitted to act as chaperones.

Both male and female clinical team members work within the service, if you have a preference, please ensure you discuss this when you book your appointment

Your General Practice Pharmacist: Supporting Your Health & Wellbeing

At the E4 Primary Care Network (PCN) we have 6 General Practice Pharmacist’s, working within our GP Practices, who are highly trained healthcare professional to help you manage your medications and long-term conditions. They are experts in medicines and prescribing, working alongside GPs, nurses, and other healthcare staff to ensure you receive the very best care.

How Can the Pharmacist Help You?

Our pharmacist can support you with:

• Medication Reviews – Checking your medicines are safe, effective, and right for you.
• Managing Long-Term Conditions – Helping with diabetes, asthma, high blood pressure, and more.
• Repeat Prescriptions – Making sure you get the right medication when you need it.
• Reducing Side Effects – Reviewing any unwanted effects of your medicines.
• Advice & Support – Helping you understand how to take your medication correctly.
• Stopping Unnecessary Medications – Ensuring you only take what is needed.

Why See the Pharmacist Instead of the GP?

🏥 Expert in Medicines – Pharmacists are specialists in medication management.

⏳ Faster Appointments – You may be able to see the pharmacist sooner than a GP.

💊 Comprehensive Care – The pharmacist works closely with your doctor to ensure you receive the best treatment.

Book an Appointment with the Pharmacist If You:

• Have questions about your medication.
• Need help managing a long-term condition.
• Experience side effects from your medicine.
• Want advice on stopping or changing a medication.

To book an appointment with our practice pharmacist, contact your GP surgery today!

E4 Primary Care Network (PCN) holds a Multi-Disciplinary Team (MDT) meeting every month to discuss clinically vulnerable patient cohorts. This collaborative approach ensures that patients receive comprehensive, high-quality care by leveraging expertise from both primary and secondary care services.

Purpose of the MDT Meeting

The MDT meeting provides an opportunity for healthcare professionals to:

1. Review complex patient cases and develop personalised care plans.
2. Address physical, psychological, and social needs while respecting patient preferences.
3. Enhance collaboration between different healthcare and social care professionals.
4. Improve patient outcomes and reduce unnecessary hospital admissions.

MDT Members (not limited to)

The team includes a wide range of professionals with diverse skills and expertise:

• General Practitioners (GPs) – Oversee medical care and coordinate treatment plans.
• Practice Nurses – Support ongoing care, including chronic disease management.
• PCN Clinical Pharmacist – Optimises medication use and safety.
• PCN First Contact Physiotherapist – Assesses and manages musculoskeletal conditions.
• PCN Social Prescribers – Connect patients with community resources for social and emotional well-being.
• PCN Care Coordinators – Ensure seamless communication and care transitions.
• Adult Social Care Representatives – Provide support for patients requiring social services.
• Geriatrician – Specializes in elderly care and complex medical needs.
• Mental Health Practitioners – Offer mental health support and interventions.
• Community Matrons – Experienced senior nurse whose role is to prevent hospital admissions.

Benefits of the MDT Approach

• Holistic patient care considering medical, mental health, and social factors.
• Better coordination between primary and secondary care services.
• Improved patient experience with tailored care plans.
• Reduced hospital admissions through proactive management.

By working together, the E4 PCN MDT ensures that vulnerable patients receive the best possible care and support tailored to their individual needs.

First Contact Physiotherapist (FCP) Service – E4 Primary Care Network

The E4 Primary Care Network (PCN) has employed four First Contact Physiotherapists (FCPs) to work directly in five GP practices, as well as our Enhanced Access, providing expert care for Musculoskeletal (MSK) health issues. MSK problems account for 1 in 5 GP appointments, and many can be effectively managed by an FCP without needing to see a GP, reducing waiting times for diagnosis and treatment.

Why See an FCP?

Research shows that physiotherapists are the most expert professionals in MSK conditions, second only to Orthopaedic Consultants.

What Happens in an FCP Appointment?

• Assessment – Evaluating symptoms and physical function.
• Diagnosis – Identifying the MSK condition.
• First-line Treatment – Providing exercises, advice, and pain management strategies.

Additional Services Provided by FCPs

• Referral for Physiotherapy – If ongoing treatment is needed.
• Ordering Investigations – Such as X-rays and MRI or other scans when necessary.
• Referrals to Secondary Care – Direct referrals to Orthopaedics, Rheumatology, or Pain Management teams using the same pathways as GPs.
• Self-Management Advice – Encouraging lifestyle changes, physical activity, and fitness for work.
• Social Prescribing – Linking patients to community-based support services.

This patient-centred approach ensures timely, specialist MSK care, reducing GP workload and improving patient outcomes.

The E4 Primary Care Network Phlebotomy Service is a convenient way for you to have blood tests done at your local GP practice, our PCN Hub, or even at home (for those who are housebound). These tests help your doctor diagnose, monitor, and manage various health conditions.

What is Phlebotomy?

Phlebotomy is the process of taking a small sample of blood from a vein, usually in your arm, using a needle. This blood sample is then sent to a laboratory for testing.

Why Might You Need a Blood Test?

Your doctor may request a blood test to:

• Check for health conditions like diabetes, anaemia, or infection.
• Monitor long-term conditions such as kidney disease or high cholesterol.
• Measure medication levels (e.g., blood thinners like warfarin).
• Assess overall health as part of a routine check-up

How to Access the Service

• GP Referral: Your doctor or nurse will request a blood test for you.
• Booking an Appointment: You will need to book a phlebotomy appointment via your GP Practice.  Appointments are available at your local GP Practice throughout usual operating hours and in the evenings and Saturdays at the E4 PCN Hub site.
• Home Visits: If you are unable to leave your home due to medical reasons, a phlebotomist may visit you at home to collect the sample

What to Expect During a Blood Test

1. Preparation: Some tests may require fasting (e.g., cholesterol or blood sugar tests). Your doctor will inform you if needed.  Being hydrated is essential for collection of blood so please ensure you drink sufficient water prior to your appointment
2. Collection Process: A trained phlebotomist will clean your arm, insert a small needle to draw blood, and remove the sample. This usually takes just a few minutes.
3. Aftercare: You might have a small bruise, but this usually fades within a few days. Drinking water and keeping your arm moving can help.
4. Results: Your doctor will review your results and contact you if further action is needed

Our Social Prescribing Link Worker is here to help you!!

Social Prescribing is a free, personalised support service that helps you improve your health and well-being by connecting you with local activities, groups, and services. It’s designed to support you with non-medical issues that may be affecting your overall health, such as stress, loneliness, financial worries, or lifestyle changes.

How Can Social Prescribing Help?

Our Social Prescribing Link Workers can support you with:

• Carer Support – Helping those caring for family or friends to access resources.
• Mental Well-being – Helping with stress, anxiety, or low mood.
• Loneliness & Isolation – Connecting you with social groups and activities.
• Lifestyle Changes – Supporting healthier eating, physical activity, and stopping smoking.
• Housing & Financial Advice – Signposting to support for benefits, debt, and housing issues.

Who is Social Prescribing for?

Social Prescribing is available to anyone who may need extra support beyond medical care. If you feel that social, emotional, or practical issues are affecting your well-being, Rasna could help.

How Does It Work?

1. Referral – Your GP, nurse, or other healthcare professional can refer you, or you can self-refer via your GP receptionist (asking to be booked an appointment with the Social Prescribing Link Worker).
2. Chat with Rasna– Our E4 PCN friendly Social Prescribing Link Worker, Rasna,  will contact you to discuss your needs.
3. Personalised Support Plan – Together, you’ll create a plan and be connected to suitable local services.
4. Ongoing Support – Your Link Worker will check in with you and provide further guidance if needed.

Contact your GP surgery to ask about Social Prescribing and get the support you need to improve your well-being.

The E4 Network Social Prescribing Link Workers

Rasna Begum
My name is Rasna Begum and I have been working as a Social Prescribing Link Worker for the E4 Primary Care Network since November 2021.

I started my career working with young children with Autism and learning disabilities until I moved into adult mental health care. This is when I first came across the term ‘Social Prescribing’ and began to understand its value.

I became a Social Prescribing Link Worker to provide well rounded support to the wider community and ‘link’ individuals with local provisions in order to improve health and wellbeing.

As a Waltham Forest resident, I am still discovering new and existing services that have been beneficial not just to my patients, but to myself, and I am keen to discover more.

Patient Testimonials

Patient of The Old Church Surgery
Rosin recommended to me by my doctor. I was unsure of the job of this profession until she was introduced into my daughter and I’s life. This beautiful human being was not just fantasticshe was caring, understanding, empathetic and a wonderful listener on top all of that she did her job professionally giving advice and links for help I didn’t even know were out there.

She never missed a phone appointment and she guided and helped me through all we talked about.

I highly recommend a social subscriber to anyone in need.

Patient of Handsworth Medical Practice
I was referred to Social Prescribing by my GP. At the time I was very unwell and found it difficult to do things for myself.

Based on a previous experience of the service I did not think they would be much help.

I needed practical help to contact relevant agencies, services and to be linked into these. I did not want to be sign posted to these services as I did not have the energy or motivation to do this myself.

After explaining this to the social prescriber (Roisin Reilly) she was great. She referred me to the relevant services and made sure they had made contact with me, chased them up when they didn’t.

She kept in touch with me and when she was unable to keep our appointments or was running late for them she always made contact to let me know which was very much appreciated.

I found her to be caring and compassionate. She listened to me and was highly competent. I value the support she gave me.

Her support at a time in my life when I most needed it has made a real difference to my health and functioning.

You have been referred to the E4 Spirometry Service by your GP for a lung function test (spirometry). To ensure the most accurate results, please review the following information.

What is Spirometry?

Spirometry helps diagnose and monitor lung conditions such as Chronic Obstructive Pulmonary Disease (COPD) and other respiratory illnesses. You may also have a FENO test during your appointment.

A normal spirometry test does not always rule out lung disease, as some conditions (e.g., asthma) may show normal results at certain times.

How is the Test Performed?

1. Your height and weight may be measured.
2. You will breathe into a spirometer:
   • Take a full breath in, seal your lips around the mouthpiece, and blow out as fast and hard as possible until your lungs are empty.
   • You may also be asked to breathe out slowly.
3. Depending on the results, you may take four puffs of an inhaler, and the test will be repeated.

This test requires maximum effort, so please inform staff if you have experienced any of the following in the past 2–3 months:

• Chest pain, unstable angina, heart attack, stroke
• Collapsed lung, aneurysm, pulmonary embolism
• Recent surgery (eye, hernia, abdominal)
• Ear infection or perforation
• Uncontrolled high/low blood pressure
• Pregnancy
• Recent chest infection requiring antibiotics or steroids (within 6 weeks)
• Dementia

If you are recovering from a chest infection, please reschedule your test at least 6 weeks after recovery.

Preparation for Your Test

• Wear loose, comfortable clothing.
• Arrive 10 minutes before your appointment.
• Avoid a large meal within 2 hours of the test.
• Do not smoke or drink alcohol on the day of the test.
• Do not exercise for 1 hour before the test.
• Inhaler Use Before Test:
  • Avoid using your blue salbutamol inhaler for 6 hours before your appointment.
  • Bring all your inhalers with you.

Appointment Duration & Results

Your appointment may take 45–60 minutes. After the test, the clinician will send your results and treatment plan to your GP.