Patient Participation Group

The surgery strives to provide excellent healthcare. We welcome constructive feedback and suggestions to help shape our services to serve the needs of all of our patients. Our Patient Participation Group (PPG) meets at the surgery periodically to provide a forum for discussion about the surgery. View the outcomes of previous PPG meetings and Patient Surveys here.

The PPG has contributed towards improvements in the surgery, this includes:

  • Waiting area refurbishment
  • Notice board policy
  • Updated website
  • Increased appointments available to book online

If you are a patient registered at the surgery, with a positive contribution to make, please complete the below application form to apply to join the group. Places are limited and applicants will be selected with the aim that the group will consist of a representative cross-section of our patients.

PPG Meeting Minutes

PPG Minutes 07.10.21 

Summercroft Surgery Patient Participation Group Meeting


Thursday 7th October 2021 1730 – 1900 (via zoom)


Patient Attendees:

Surgery Attendees:  Dr Rak Balendran, Carla Michalska, Kay Williams


Chair:                     Rak Balendran/Carla Michalska

Minutes:                 Janet Carlo


 1. Matters Arising – as below. Action
 2. Patient Data  
  This was discussed at the June meeting at which stage more information was awaited. Nothing further had been heard although CM was following this up. There is a link on the website providing the latest guidance.  


 3. Covid Vaccination Programme  
  CM reported that initial guidance was to provide both the flu and covid vaccinations at the same time. Summercroft would be providing the flu vaccination only although CM confirmed that patients were able to have both at the same time if offered. A new age group had been included this year for the flu vaccination, i.e. 50-65 year olds. The covid booster programme would be run by the BGPA and also at national sites. Patients having their second vaccination 6 months or longer ago would be invited first. The booster programme for Housebound patients was currently under discussion and guidance was awaited from the CCG on how this would be delivered. Flu vaccinations for the housebound would be given by the District Nurses.

RB confirmed that the vaccines could now be mixed (e.g. Pfizer and Astra Zenica). HH reported that 99% of the boosters were Pfizer.

Update – late October it was agreed that the Surgery would be providing covid boosters for the Housebound and this is planned for week commencing 22nd November.

 4. Face to Face (F2F) Appointments/Zoom Meetings  
  CM confirmed that for every 20 GP appointments 2 – 4 would be F2F although GPs were squeezing extras in. Minor Surgery and Sexual Health are all always F2F. It was further confirmed that the Surgery was fully open and had been for some time with patients able to come in without having to ring the bell and speak to Reception first.

EK queried why other European countries GP Surgeries had remained fully open throughout the pandemic. HH commented that she thought there were probably less patients per GP than in the UK and also the service was not free in other countries.

RB stated that contrary to reports in the media etc. it was a misconception that GPs preferred digital appointments to F2F and they much prefer F2F.

The types of appointments offered had to be balanced with patient and staff safety paramount; a further Covid outbreak in the Surgery would result in diminished services and it was anticipated that Covid cases would increase. It was also confirmed that the Surgery was continuing to follow national guidance on the way they operated and would continue to do so.

It was acknowledged that patients telephone consultations were not always as explicit as they could be.

HH likes F2F appointments but has found phone/zoom communication saves time. JMcC feels zoom meetings are more focussed although some patients may be put off, EK is happy with both as is PY.

Regarding future PPG meetings and whether they should be F2F or via zoom it was agreed to continue with zoom for the time being which was the recommended route but to keep the position under review.


















5. eConsults  
  It was reported that the number of these had increased considerably and were now proving difficult to manage. CM has contacted the CCG regarding managing the appointments system and the type of appointments to be offered. Access to eConsults can be controlled by reducing the times they are available to patients e.g. making them unavailable at weekends – JMcC in favours of this. KW stated that eConsults were particularly popular with the younger patients. HH happy with this form of contact.  
6. Initiatives/Projects  
  CM informed the PPG of the following initiatives:

1)   Time for Care (discussed at the last meeting) – being run by NHS England and Summercroft have signed up. This will give the Surgery protected time to look at systems and see how improvements can be made. The Chair of the CCG is to visit the Surgery and discuss with staff additional support systems which will come with funding. The PPG are fully supportive of the Surgery and don’t see how they can do more at the current time. They can also see things from the Surgery’s point of view rather than just as a patient and don’t see social media as being helpful.

2)   Salaried GP – this post has currently been advertised and 2 candidates have applied with interviews scheduled. CM stated that she felt the Surgery were lucky in this respect as there’s a national shortage of GPs and 14 Surgeries within Bromley are currently advertising. The vacant sessions are currently being covered by regular locums such as Dr Stuart Robertson. Locums don’t have the associated administrative work which deters some from applying for regular posts.

3)   Training Practice – the Surgery is now accredited as a training practice for GPs. Our first trainee will be starting in January.

4)   Pharmacists – employed and funded via the PCN. Raghad Taha has now rotated from Summercroft to the Biggin Hill Practices. A newly appointed Pharmacist (Sarah) has joined Summercroft and Krina currently at Bromley Common & Southborough Surgeries is rotating to Summercroft increasing Pharmacist input at Summercroft from 3 days to 5. The Surgery also benefits from a Social Prescriber employed by the PCN and other new staff such as Physiotherapists are planned.

5)   CM drew everyone’s attention to a poem she had added to the website; JC to send a link along with the Minutes.
















7. Thank You  
  CM thanked everyone for their input and stated that she felt it had been a very productive meeting.  
8. Next Meeting – early January via zoom – date to be confirmed. RB/CM


Summercroft Surgery Patient Participation Group Meeting


Thursday 24th June 1730 – 1915 (via zoom)


Patient Attendees:

Surgery Attendees:  Dr Rak Balendran, Carla Michalska


Chair:                     Rak Balendran/Carla Michalska

Minutes:                 Janet Carlo


 1. Matters Arising Action
 2. Patient Data  
  This had been raised by JM and concerned the sharing of patient data. CM stated that there had been no consultation and the first the Surgery knew of the proposed changes was when patients started calling the Surgery having been made aware by the media. RB confirmed this. He also added that the Government used the extracted information in order to plan for the future e.g. virus such as covid.

Originally the deadline to opt out was June but this has been extended to the end of September in order to give Surgeries and patients time to consider the implications.

CM explained that information had always been extracted from NHS Digital but the changes affected the way it was going to take place. Information has now been uploaded onto the website by way of a series of links. There are basically 2 choices –

1)   Can opt out entirely so information is not shared with anyone

2)   Can opt out of NHS Digital sharing information.

CM explained that Summercroft has no control or say in what is extracted by NHS Digital; patients have a choice about what is shared but Surgeries don’t.

RH recalled a previous digital extraction which had ended in disaster and had cost a huge amount of money; SI remembered this. CM commented that she thought that was slightly different and related to the complete digitalisation of patient records thereby eliminating all paper completely.

MK commented that data was now more valuable than gold. He had recently been contacted by Track and Trace on a daily basis and had been told that his information would be shared; on querying who with no-one could give him an answer.

RH agreed and added that since going to Guys for his covid vaccinations he has been receiving marketing information aimed at the elderly e.g. retirement homes, hearing aids etc.

BB stated that she felt the latest development would have an impact on patient trust for GP Surgeries but that if it was under the control of the Surgeries there would be less patient concern. CM agreed and mentioned that in the first week patients were angry with the Surgery about the proposal and also that the Surgery could not provide further information.


 3. Covid Vaccination Programme  
  CM confirmed that once a patient has a covid vaccination it is automatically notified to the patient’s Surgery and uploaded into their record.

CM reported that there was a national initiative to get as many people vaccinated as possible due to the Delta variant but only had a week to implement this. She asked for the views of the PPG on patients to target and mentioned that the Housebound and Learning Disability patients had been vaccinated by the Surgery. Reasons for patients not taking up the vaccine ranged from those not wanting it at all with some undecided and some having problems in arranging it. The vulnerable and those with health conditions were a concern and the Surgery has not managed to arrange for all of these to be vaccinated. Although CM did not have the exact figures to hand she estimated that approx. 270 of eligible patients had not been vaccinated and of these approx. 50 had declined the vaccination. Approx. 300 were due a second dose. RB asked for suggestions in encouraging unvaccinated patients to take the vaccine up. RH felt that some patients were now so used to not being able to attend GP Surgeries/Hospitals that they now didn’t want to. PY thought the younger patients would be keen to take the vaccination up as without it they would be limited e.g. travelling.

 4. Appointments/Opening the Surgery  
  It was noted that patients were increasingly frustrated at not having Face to Face (F2F) appointments. CM commented that initially the patients had been understanding and supportive but that had changed recently. RB stated that to keep staff and patients safe they could only have so many patients in the Surgery at a time and they didn’t have the staff to police the waiting room. The Surgery also recognised that with the current system patients needs might not be completely met. RB again commented that the GPs do not like the current system, they miss the F2F contact with patients and find the present system more stressful. He further added that the telephone triage system removed the risk of spreading the virus and said that he also had to consider the effects of any change could impact on the staff and result in the Surgery being an unpalatable place to work with the possibility of staff losses.

MK asked who made the ultimate decision on the type of appointments offered. RB responded that the Surgery was following BMA guidelines on how to proceed.

RB requested that the PPG pass the word on why the restraints are still in place.

It was agreed that communicating the above to the patients was important and both SI and MK considered that the website was the most appropriate way of doing this.





















5. Hospital Referrals  
  In response to a query from BB regarding delays to referrals RB said that 2WW referrals were still being met but that the Surgery had no influence on other referrals unless they were cancer related.  
6. Initiatives/Projects  
  CM informed the PPG of two initiatives.

1)   Time for Care – being run by NHS England and Summercroft have signed up. This will give the Surgery protected time to look at systems and see how improvements can be made.

2)   PCN Project – aimed at patients recognising early signs of cancer to improve diagnosis rates. Previously patients would have been made aware by posters in the Surgery but with limited patients attending the Surgery this was not considered effective. RH suggested a page on the website; MK suggested asking patients having been treated for cancer to give their experiences and thought this would carry most weight. MK also suggested the local radio, especially the BBC and also proposed this could be undertaken for the CCG as a whole. WhatsApp was not considered feasible but texts could be sent via AccurX.

CM agreed to feedback to the cancer lead with a view to a local campaign and also to seek funding from the CCG.
















7. Website  
  CM confirmed that all websites within the Bromley area had been standardised. Photos of the Surgery were suggested and it was agreed these would be uploaded. Individual photos of all clinicians was also proposed as was a group staff photo.  




8. Next Meeting – September – date to be confirmed. RB/CM


Summercroft Surgery Patient Participation Group Meeting


Thursday 25th March 1730 – 1900 (via zoom)


Patient Attendees:

Surgery Attendees:  Dr Rak Balendran, Carla Michalska, Kay Williams


Chair:                     Rak Balendran/Carla Michalska

Minutes:                 Janet Carlo


 1. Matters Arising Action
 2. Covid Update/Vaccination Programme  
  i)             Invitations – RB reported that the Bromley GP Alliance (BGPA) had undertaken the delivery of vaccinations for Summercroft and had been provided with details of patients in the various priority groups. RB stated that there were some initial teething problems but that since Christmas delivery of the vaccine had been straightforward. Some patients had received 3 invitations from different sources e.g. NHS national booking system and Hospitals. It was noted that on the NHS site both the first and second vaccination had to be booked and it was not possible to book the second vaccination separately. The second vaccination will be provided at the same site as delivery of the first vaccine and the second vaccine will be the same as the first, e.g. Pfizer. RB also added that Summercroft patients had been amongst the first to be vaccinated. Also, that Bromley overall had performed well culminating with a visit from the Prime Minister at OHWBC.

ii)            Sites – BGPA had organised delivery of the vaccine from 3 sites including Community House in Bromley. Three Bromley GP Surgeries did not renew their contract with the BGPA following which Community House was no longer being used by the BGPA for the programme. The Mosque in Keston is being used for the delivery of the Astra Zenica vaccination and this satellite clinic had been set up by Dr Omar Taha (locum at SC covering Dr Jiskoot’s maternity leave and Dr Taraq Waheed, Partner at Southborough Lane and Clinical Director of Five Elms PCN of which SC is a member practice). Although both are Muslims the clinic is open to all patients. CM reported that the CCG had found it to be very successful in targeting ethnic minorities.

Vaccination delivery was automatically uploaded into patient’s records irrespective of where it was provided.

iii)           Housebound – Summercroft had undertaken to vaccinate their own housebound patients and this had been completed. They would be providing second vaccinations to these patients. Payment for delivery of the vaccine is reliant on the same provider administering both so it was in all providers interests to deliver the second vaccination. It was noted that Summercroft are currently receiving many queries regarding the second vaccination.

iv)          Statistics  – CM reported that Bromley overall had done very well with vaccinating the 4 priority groups by 15th February. SC had achieved the following:

80 years +                    95.1%

70 – 79 years                97.6%

60 – 69 years                89.3%

Clinically vulnerable       97.8%

v)            Long Covid – in response to a query from JM regarding the support to be provided to these patients CM stated that a service may be introduced locally; further details are awaited. RB added that  Hospitals are currently holding Long Covid Clinics and it is expected that the number of patients will increase. JMcC and EK are both participating in a Covid Symptom Study (Zoe).

 3. Staff Changes  
  It was noted that Dr Rachel White would be retiring on 31st March and it was recognised that she would be missed by patients and staff alike. From 1st April the Practice would have 3 Partners – Rak (Senior Partner), Dr Vicky O’Brien and Dr Annika Jiskoot. RB reported that he and the other 2 Partners communicated well and worked well together as a team. In addition there would be 3 Salaried GPs – Dr Rajiv Samarasinghe who has been in post for several years, Dr Nehul Patel who has been employed as a regular locum by SC for a number of years and Dr Beena Ashok who has experience of working in the Bromley area. CM stated that all GPs were being encouraged to share their expertise rather than having specialisms.

It was noted that many GPs are not interested in becoming Partners due to the additional workload involved in managing the business as well as patient services.

The PPG Members all wanted to wish Rachel well on her retirement.

 4. Appointments/Opening the Surgery  
  CM stated that the GPs were continuing to triage patients by phone, video consultation or e-consult in line with NHS guidance. The system was reviewed at each stage of the pandemic. The GP is able to book a F2F (face to face) appointment for the patient if he/she decides a physical examination is required. RB reiterated that the GPs miss the F2F contact but the overriding factor is patient and staff safety.

RB further added that if staff were required to work from home a remote service could still be provided.

It was anticipated that e-consults and telephone triage would continue and this model of working had been introduced/increased due to the pandemic.

Although it is possible to request a consultation with a named GP via an e-consult these are normally allocated to the Duty Doctor. RB said that the most important factor was to deal with these in a timely fashion. Patients can still telephone the Surgery if they have a serious issue to discuss.

It was also noted that some Surgeries in the Bromley area require all contact to be via e-consult. CM commented that the younger patients preferred this method of contact.

















5. Training Practice  
  Summercroft had been a recognised Training Practice until Dr Jonathan Palin who was an accredited Trainer left. Dr Rajiv Samarasinghe had always expressed an interest in training future GPs and had started the process of becoming a Trainer about a year ago. In recent weeks both Dr Samarasinghe and SC had been approved which raised the profile of the Surgery. Trainee GPs would be allocated to the Surgery for training.  
6. Prescriptions  
  BS commented that these were being turned around much more quickly. This was thought to be due to them being sent electronically.  
7. Telephones  
  Noted there had been problems with the phone system on 2 consecutive days (not related to SC) which had led to delays in patients being able to contact the Surgery and a subsequent increase in e-consults.  
8. Next Meeting – June – date to be confirmed, either 3rd or 24th RB/CM


Summercroft Surgery Patient Participation Group Meeting


Thursday 3rd December 1730 – 1915

Patient Attendees:

Surgery Attendees:  Dr Rak Balendran, Carla Michalska


Chair:                     Rak Balendran/Carla Michalska

Minutes:                 Janet Carlo


 1. Matters Arising Action
 2. Covid Outbreak  
  CM reported that there had been a covid outbreak in the Surgery over a 2 week period in October. This had resulted in reduced staffing levels and other staff working from home and the Surgery had reverted to the system in place during the first lockdown. A message had been added to the phones re the unavailability of routine GP appointments. The CCG and Public Health England had been involved and were both supportive. Subsequently the CCG had agreed to fund additional locum GP sessions in order to offer extra appointments and catch up with administrative work. It was recognised that patient care had been reactive rather than proactive.  
 3. Covid Vaccination Programme  
  CM said that NHS England had asked GP Surgeries to start discussion with their PCNs on how to deliver this service. It was noted that it was a complicated vaccine and could not be provided in the same way as a flu vaccine. The BGPA were likely to deliver this service for all Bromley CCG patients. The site suggested for Summercroft patients was the Orpington Health & Wellbeing Centre although this was subject to confirmation. A site in Biggin Hill was also a possibility but OHWC was considered more convenient. Summercroft would not be a site.

EK asked if there would be a choice of vaccine; it was not thought so at this stage, only whether to receive it or not. In response to a query from JM re shielding patients CM was unaware of what arrangements would be made but felt sure they would be made and agreed to feedback to the CCG/BGPA on this.

A message had been added to the phone greeting regarding the vaccination programme.

CM expected to be given criteria for the first patients to be notified about the vaccine (e.g. age or medical conditions) but this would not be decided by Summercroft. Realistically it was predicted this would be rolled out in January/February.

 4. Appointments  
  CM stated that the GPs were still triaging patients by phone, video consultation or econsult. The GP is able to book a F2F (face to face) appointment for the patient if he/she decides a physical examination is required. The Surgery recognises that the reduction in F2F appointments is a disadvantage for the patients and that similarly the GPs miss this contact and find the consultation more difficult. CM added that Summercroft has a large elderly population and it’s been recognised that many patients over the age of 70 have a hearing problem.

It was noted that the Surgery are aiming to increase/improve the video consultations.

JM commented that she had a F2F appointment in the Surgery and felt she had been kept safe; entering via one door and exiting through another.

RH mentioned that he had a telephone appointment which had worked well and felt congratulations to the Surgery were in order. HH and BB also agreed and felt for some people they were beneficial. Similarly PY had been referred urgently by RB; she received a letter 8 days later with an appointment 5 days after this.

JM queried the need to upload a photo when completing an e-consult; CM stated this was not normal procedure.



















5. Hospital Access  
  Access to hospital appointments had improved since the first lockdown. EK commented that blood test results were coming through quickly.

CM reported that the Surgery were undertaking quality improvement work to audit how urgent referrals were processed and safety netted.

RB stated that urgent referrals were normally dealt with on the day and that the Hospitals were still catching up with delayed referrals but the situation was improving. Information from the Hospitals was coming through quite quickly. As with GP Surgeries the Hospitals are governed by guidance from NHS England/DOH.

6. Flu Clinics  
  CM reported there is a shortage of vaccines for the 50 – 65 age group and the Surgery are attempting to obtain more. On receipt the Surgery will notify patients accordingly and aim to hold some clinics for patients within the Surgery, hopefully during December.

The national target for take up of the over 65 age group was 75% and for the PCN was 77%; Summercroft had achieved 81%.

It was not compulsory for shielding patients to have the vaccine but it was recommended in order to reduce the risk of contracting flu. Household members of shielding patients are entitled to the flu vaccine but are difficult to identify.

7. Telephones  
  BB asked about access to the Surgery via the phone. CM ran a report and it was noted that during November the average wait was 3 minutes 56 seconds. A total of 6,835 calls had been made of which 5,025 were answered. The remaining calls were either made when the Surgery was closed or the patient did not wait to be connected.  
 8. DNR/DNAR  
  It was noted that GP practices normally document and code these in a patient’s record and that the patient would have a copy. Generally speaking GPs would speak to patients and their relatives. At Hospital level a decision can be made without this involvement.

The Surgery had been asked to contact patients considered to be frail to determine their wishes.

9. House on Corner of Starts Hill Road & Crofton Road  
  RH asked if the Surgery were aware of plans to develop this site and queried whether the land could be made available for car parking. It was noted that the site was locally listed and it was not certain if it had been sold. CM agreed to inform members if the Surgery were made aware of development plans.  
10. Reception Interpretation of Results  
  EK asked what training was provided to Reception staff re the above. She had been informed her blood test result was normal when in fact it was a urine result that was abnormal. CM stated that Receptionists do not interpret results but pass on the comments made by GPs on the results. CM to email EK with a request for further information in order to look into this and if necessary would discuss with the Team Leads at a Significant Events meeting due to be held next week.  
11. Next Meeting – February/March 2021 RB/CM