PPG Annual Report 2018/2019

Thank you for taking some time to read our annual report. The report describes the role of the Patient Participation Group (PPG) at Evergreen Surgery and it’s work over the last year.

The Patient Participation Group was formed in 2011 and meets on a quarterly basis. It is a mutually supportive group of patients who;

  • Work with the surgery to ensure the views of patients are heard
  • Support the surgery to make positive changes and improvements
  • Support the surgery’s work in helping patients play a greater role in their own health

The doctors and staff at the surgery are very supportive of the PPG’s work and value the insights and support the group provide.

The PPG consists of patients who regularly use the surgery’s services. The surgery welcomes new contributors and there is no barrier to membership. The group would like to represent the diverse range of patients the surgery serves and reflect both their views and the assistance they can offer their NHS.


The last year has been very significant for the NHS and the surgery. The surgery and it’s staff have worked very hard to manage the pressures felt within general practice, particularly during the autumn and winter. The PPG understands that the demand for appointments remains high and appreciates the work undertaken to manage this.

At the start of the year, the group had a number of priorities. A significant issue was to introduce additional seating and improve the environment in the waiting area. The PPG was pleased to see the improvements made with the introduction of new seating, both in the waiting area and consulting rooms, and an increase in the seating capacity available to patients. A proportion of the new seating includes handles which are of particular importance to elderly patients and those with disabilities. The surgery has also introduced additional signage which is appreciated.

Another major priority was to reinstate access to blood tests at the surgery. The service provided by the North Middlesex had been suspended due to concerns about the safety of service staff. Evergreen and other surgeries in the centre worked together to offer the reassurances required. The service has now resumed and patients can once again access tests without having to travel.

The PPG also recognises the additional changes the surgery has made to improve the service patients receive and the response to issues the group raised during the year.


The group raised the issue of how the surgery supports carers. The surgery actively seeks to record those who identify themselves as carers and has established a link with the Enfield Carers Centre (ECC) based in west Enfield. Marc Warwick from the Centre was invited to meet the PPG and volunteers have set up stalls in the waiting area promoting the work of the Centre.

Diabetes Service

The Surgery has large numbers of diabetic patients and the PPG is aware of the importance of detecting the condition early. The Evergreen Centre hosts the Diabetes Prevention Service which offers support to patients with prediabetes. The support is aimed at reducing the risk of patients developing diabetes in the future. We noted during the year that the waiting list for new patients was growing and that access to the service was being cut. The surgery informed the group of a change in the referral process which had reduced the numbers being referred. The group felt that this was not a positive step but were reassured when the number of places allocated to Enfield was increased. While the surgery itself offers advice and support to patients with prediabetes, the group felt the prevention service remains a valuable resource.

Blood Pressure Monitoring

Patients have been able to check their blood pressure and weight on a self-check machine for several years. The group felt that patients with disabilities, the elderly and those with English as a second language may have difficulty using the machine. The surgery has taken several measures to address this concern. A multi-lingual screen has been installed linking the machine to the surgery computer system so patients can identify themselves and have their readings entered into the computer automatically. Staff are also available to assist those with difficulties. For disabled patients or those in wheelchairs, a second blood pressure machine on a low level stand is available.

Text Messaging

In addition to texts reminding patients about appointments and other general messages, the surgery has introduced personal messaging. doctors, nurses and staff are now contacting patients directly by text with information, test results and advice. This often saves patients having to call the surgery. It is particularly helpful for those patients with carers, where the messages received can be shared with family and others, and for those patients with English as a second language.

Multi-lingual staff at the surgery are sending messages in Turkish and other languages which is a great help given the diverse nature of the surgery’s patients.


The surgery has piloted a new physiotherapy service. The role of the First Contact Practitioners (FCP) was discussed with the group. The PPG was interested in the success that such services have enjoyed elsewhere and were pleased the surgery had been selected to pilot the service. The pilot has two Royal Free Hospital physiotherapists working with the surgery to see patients with back problems. Patients are given a half hour appointment providing time for patients to be examined and their care discussed. The service has been well received by patients and the group was impressed by feedback on the benefits. The success of the pilot has led to its’ extension across Enfield allowing patients throughout the Borough to benefit.

Extra Daytime Appointments

The access service has been provided since 2017 and runs alongside the walk in centre. Patients value both services and the PPG was pleased to see the surgery adding weekday daytime appointments to those already available in the evenings and at weekends. The group felt the additional appointments would be welcomed by all patients particularly those with urgent problems.

Primary Care Networks

At the last PPG meeting, Dr Patel advised the group of the NHS’s vision for general practice over the next five years. The PPG learned about the major changes which the new contract will bring. With patients everywhere, the group is concerned about the national shortage of GPs. The new contract will see surgeries working more closely together to provide services. The NHS will also invest to bring more staff into general practice. The staff will include physiotherapists, which we have now seen at first hand, pharmacists, paramedics and physicians assistants. While GPs will always play a central role in care, the group welcomed the introduction of additional staff and hope they will contribute to improving the service provided by the surgery.

The group found the discussion very helpful. The PPG members understand the changes may take some time to materialise but were informed the surgery is taking active steps to establish a network locally and begin the recruitment of new staff.

Plans for 2019/20

The group plans to remain fully engaged with the work of the surgery and will continue to represent the surgery at wider PPG and other health related meetings locally. The group looks forward to seeing the new primary care network take shape and the first new staff join the surgery.