Patient Involvement Group
Church Street Practice, The Health Centre,
Mably Way, Grove, OX12 9BN

Memories from Patients

I remember

… annual carnivals processions, garden fetes dances, to raise money for our local hospital

… Nightingale wards heated by two coke burning stoves, stoked by the porter 2 – 3 times a day

… the almoner closely questioning ward patients to decide how much they must pay for their care

… medical students flying a black flag over Cardiff Royal Infirmary on July 1948 when the NHS was inaugurated.

… the doctor lived upstairs above his surgery. What would have been the dining room was the waiting room, with stiff upright chairs ranged round the walls of the room. One sat in this cold bleak room waiting one’s turn in the doctor’s surgery. It was no warmer in there and if you had to undress…!!!

… the doctor’s bill arrived at the end of each month

… some of the remedies my mum used for our illnesses: horrid spoonful of cascara and castor oil for constipation. UGH!

… borrowing my mother’s glasses when I went to the cinema so that I could see better.

Prior to 1948 and the institution of the NHS costs health care had to be paid by the individual directly to the GP or a hospital. For working-class families, like the one I was born into in 1935, illness could be a drain on very limited resources. My early life was lived in a street of terraced houses in an industrial town in a heavily-polluted atmosphere. Women worked incredibly hard and often would not go to the doctor on their own behalf, though they would always take their children. Men had to keep well to be able to work long hours to provide for their families.

Children often died of childhood illnesses, chills and chest infections could be fatal, the frail of all ages could even ‘die of winter’. We had aspirin (Aspro) for headaches and general aches and pains, infusion of senna pods for constipation, kaolin for diarrhoea and other upsets, cod-liver-oil and malt as a general tonic, salts for liverishness, hot plasters of mustard or kaolin for infections, cold compresses for sprains, gentian violet for rashes, and lots of herbal and traditional remedies and patent medicines. Tonics from the doctor were popular but no-one had any idea what they contained. Makeshift steam tents were used for long-term illnesses such as pneumonia. Hernias were treated with trusses. Bad backs and gynaecological conditions relied on incredible corsets. My maternal grandmother had a wonderful pair which stood up on their own. Midwives, Health Visitors, and District Nurses covered their rounds on bicycles whatever the weather.

Men paid a few pence a week into an insurance club against being ill or unemployed. These were often set up by Trades Unions as there was no sick-pay, unemployment benefit or holiday pay. The average weekly wage was £2 (40 shillings). Many Trades Unions also ran Convalescent Homes. Doctors’ practices were private, though many people registered with a local doctor. As I recall at one time it was 1 shilling to go to the surgery (no appointment systems then) and about 3 shillings for a home visit. My elder sister and I regularly walked to our local surgery with a shilling a week to pay off a bill. My sister still has the receipt for 5 shillings our parents paid for her tonsillectomy in 1937. She can recall Father carrying her home from hospital on his shoulders.

Hospitals were often run and funded by Town or Borough Councils from the General Rates. Almoners assessed the financial standing of patients and decided how much they could contribute towards their costs. On the wards a good deal of cleaning and polishing went on, and everything seemed to be very highly starched. Regimes were very strict. My sister caught diphtheria when she was about 4 and spent some time in isolation in the Fever Hospital. No visiting was allowed and no toys; all our parents could do was to look through a window at her. Diphtheria was a very potent disease then, and some parents watched their children die through such windows.

As for mental health, my Great-Uncle Thomas was shell-shocked in the First World War. He spent the rest of his life in Winwick Asylum. I used to go with my grandmother to visit him and he always thought I was my mother. Tea and slab cake were served to inmates and visitors around a huge kitchen table. All the doors were locked. Such places often had ‘Asylum’ or ‘Crippleage’ or ‘Incurables’ in their titles. For Thomas the Asylum provided a place of safety and a degree of recovery, though he was never able to live independently.

Now we all have access to first-class treatment and our lives are immeasurably enhanced because of it. I feel that the changes during 60 years of the NHS are a cause for celebration, and that we should both maintain and defend our health system.

Anne Whear, August 2008

The Hospital travel costs scheme is for patients on low incomes who are referred to hospital by a consultant.

More patients are now electing to be seen in a community setting. The Trust has received enquiries from patients who have encountered difficulties accessing payments from the Hospital Travel Cost Scheme attending ORH peripheral clinics at Community Hospitals.

Further investigation into this problem highlighted additional PALS issues:

• Eligible patients were unaware if they could access the system locally for refunds
• Hospital staff don't have the relevant information
• Some volunteer car drivers have historical arrangements for reimbursement
• Each community hospital had a different system
• Lack of publicity

Following these enquiries, a steering group with ORH and PCT staff has been set up to look at ways for the patient to access the scheme at the place of their appointment, and to promote the scheme to our staff and patients. A user was invited to be a member of this group as part of public involvement.

A pilot is being run at Witney Community hospital starting on 1st August, for a 2 month period, to enable patients to claim cash for their travel expenses from the hospital on the day of the appointment. It is hoped to get a representative sample of patients, address any teething problems during that time and roll the scheme across the county in the autumn.

Sue Atkinson
Patient Advice and Liaison Services Manager
Oxfordshire Primary Care Trust

If you are a smoker and are due to have surgery; NOW’S the time to quit!

If you stop 8 weeks before an op the proven benefits are HUGE!

These include:

• 10 times less likely to develop wound infections such as MRSA
• 6 times less likely to develop wound complications such as bad scarring
• 3 times less likely after general anaesthetic to have lung problems such as chest infections
• On average a 2 day shorter stay in hospital
• Having better bone healing after bone operations

To maximise these benefits and have similar surgical risks to people who have never smoked, research has shown you only have to stop 8 weeks before surgery. And we at Church Street are here to help you.

The increased problems that smokers have following surgery are due to the effect of smoke on lung tissue and how the chemicals absorbed from the smoke, like carbon monoxide, effect the body. When you stop smoking the harmful effects of carbon monoxide disappear in 24 to 48hrs. Amazingly it only takes the lung tissue around 6 weeks to recover from smoke damage. However, over this time the lungs do produce a lot more mucus, which can lead to some problems after a general anaesthetic. Therefore when you decide you want the benefits from stopping smoking it is important that you talk to us about your quit date in more detail.

We recognise that waiting for an operation is a stressful time but we want to help you minimise your problems following a procedure.

So what can you do now?

If you are being referred to hospital and might need an operation we will write and invite you to see one of our Stop Smoking Experts. Just phone the surgery to book an appointment.

If you are already on a waiting list for a procedure don’t worry we can still help. Just book in at reception to see one of our Stop Smoking Experts and we can talk through the best time to stop in relation to your operation. f you are a smoker not having surgery and would like help please come and see us! When you make that life changing decision to quit we are here to support and advise you!

Dr. Matthew Gaw

The number of people with diabetes is increasing. Currently there are nearly 500 patients with diabetes in the practice.

The illness is complicated; Carrying with it increased risks of damage to the blood vessels that can result in heart, brain, kidney, eye, nerve and circulatory disorders.

The good news is that it is possible to dramatically reduce the risks to health by careful management and the key to this is a clear understanding of the illness its treatment and, most importantly, attention to lifestyle factors such as diet and exercise.

Audits over several years in the practice have shown a steady improvement in clinical measures of the service we offer to patients with diabetes but, in this area particularly, getting the best outcomes requires a shared approach.

In other words the best care isn’t something professionals do to patients but with them.

Hearing that you have diabetes can be a frightening experience and trying to learn how to deal with it can seem an overwhelming and confusing task.

It was with these thoughts in mind that we decided to test the water and canvass opinion amongst patients in the practice with diabetes about their interest in setting up a patient or ‘user group’ The aim of this would be to offer interested patients an opportunity to meet, share experiences and learn about diabetes in a friendly non clinical setting.

We have had a good response to our initial enquiry with approximately 50% of those asked expressing interest and with generous support from Novo Nordisk we are now able to set up the first, inaugural meeting to be held at The Bear Hotel on 1st October 2008. at 1.30pm.

The agenda will include experts talking about diet and exercise, a brief overview of the practice’s diabetes service and what it can offer patients and a discussion about the proposal to set up a patient led group to run further activities.

Dr. Mark Drury

Q Are there any NHS dentists in our area?
A Yes. Most dental practices in Oxfordshire have a contract with the PCT to provide a varying amount of NHS dental treatment. Details of these practices can be found on the NHS Choices website www.nhs.uk or by phoning the Oxfordshire Primary Care Trust dental line 01865 337267. Alternatively you can contact NHS Direct.

Q In our area it was understood that there was no NHS provision available. We have heard that there is a local practice taking people on, but how do people know about it? There will be local people who currently see dentists privately who would welcome the opportunity to transfer to NHS care. Are there any plans to increase NHS dentistry in the Wantage/Grove area?
A There are four dental practices and one Dental Access Centre in the Wantage/Grove area providing NHS treatment. A list of practices who have indicated that they are taking on NHS patients is held by the PCT and patients can contact the dental line 01865 337267 for further information. Oxfordshire PCT is committed to increase NHS dental provision across the county by working with practices to encourage them to increase their NHS commitment within the overall dental budget available.

Q What is a Dental Access Centre?
A A Dental Access Centre (formally the Dental Community Clinics) provides dental treatment and advice to a wide range of patients. They provide specialist dental treatment for people with medical, physical and mental problems usually by referral from their dentist or doctor. They are also responsible for in and out-of-hours dental emergency advice and treatment for patients who are not registered with a dentist and in pain. Charges are the same as that charged in N.H.S. general dental practice.

Wantage Dental Clinic is located at the Wantage Health Centre and is open on Wednesdays and Fridays and operates on a referral basis. Contact telephone no. 01235 774554.

Q How do people access emergency dental care in the evenings or at weekends?
A Oxfordshire PCT is responsible for providing out-of-hours emergency dental services. This service is available to all Oxfordshire residents (including temporary residents and visitors). Callers will be phoned back for triage and provided with either advice or offered appointments for emergency treatment. This service is for people with urgent or emergency needs only and therefore does not provide routine care or repeat appointments. You will be charged at NHS rates £16.40. For emergency advice or treatment please call: 0845 345 8995 between 6.30pm - 10.00pm Monday to Friday and 9.00am - 9.00pm at weekends and bank holidays.

NHS Direct provides advice regarding dental issues and services. It is available 24 hours on telephone: 0845 4647.

For patients who are registered with a dentist, an answer phone message will provide details of the out-of-hours arrangements available. Some private dentists have their own arrangements to see weekend and evening emergencies.

Chris Evans
PCT Dental Adviser

On Sunday 6th July, a team of staff from Church Street Practice, Wantage, completed Cancer Research UK’s 5km Race for life. There were 24 of us, GPs, Practice Nurses, Health Care Assistants, Receptionists and Administrative Staff, and some of our family and friends. We were joined by Frances Balkwill, the daughter of Dr Celia Teare who was a much loved GP at our Practice but tragically died from cancer in 2005.

The event took place at Newbury showground in wet and windy conditions. Despite being completely soaked we all really enjoyed ourselves due to our great team spirit!

We all enjoyed the challenge of regular exercise in preparation and plan to keep it up. Much of our work is Health Promotion, including encouraging people to increase the amounts of activity/exercise that they do. We saw this as a great opportunity to practise what we preach as well as support this charity.

We would like to thank everyone who has supported us, both through sponsorship and kind words of encouragement. We would also like to thank Bretts Chemists in Grove who very kindly donated our team T-shirts. So far, we have raised over £3,600 for Cancer Research UK.

Mary Elliott

Following the success of last year’s flu clinic, the Practice is again issuing a general invitation to all at risk patients to attend the Flu Clinic on 11 October and will not be sending out individual appointment letters. Please put the above date in your diary if you are due to have a Flu injection and then all you need to do is come to the Health Centre at any time between 9.00 a.m. and 3.00 p.m. on Saturday, 11 October.

We will only have a limited capacity to offer Flu injections in other clinics, so we would be grateful if you could try to attend on 11 October, as it is important that as many patients in the at risk groups are covered and we would not want you to miss out. If you are unwell on that day or otherwise unable to attend, please telephone the Practice after 14 October between 10am and 5pm to arrange an alternative appointment.

The groups of patients entitled to have a Flu vaccination are:

1. All those aged 65 and over as at 31 March 2009, i.e. born on or before 31 March 1944;
2. All those aged 6 months or over in a clinical risk group which include:
   • Chronic respiratory disease and asthma that requires continuous or repeated use of inhaled or systemic steroids or with previous exacerbations requiring hospital admission
   • Chronic heart disease
   • Chronic renal failure
   • Chronic liver disease
   • Chronic neurological disease
   • Diabetes
   • Immunosuppression
3. Those in receipt of a carer’s allowance, or those who are the main carer for an elderly or disabled person who may be at risk if the carer falls ill.

If you are not sure if you fall within one of the above categories, please contact the Practice .We will be advertising this clinic widely in the weeks running up to October 11th , to ensure you do not forget.

Sheila Dearman

Dealing with gout

Gout is actually fairly common. It is by no means restricted to bad tempered Colonels back from India, though it is more likely if you are male, overweight and (how shall I put it?) familiar with alcohol. If you do have gout then try to lose weight and drink sensibly.

It affects me more often in the mornings. It can be excruciatingly painful. It usually affects the feet, particularly the big toe.

If you can manage it then the thing to do is to gently exercise the foot. Perhaps a short walk even though it will be painful at first. This (I think) gets the gout crystals to move and get redisolved in the blood.

The other thing is to drink huge amounts of water as this lets the kidneys clean the blood; particularly so in hot weather as you must keep the water flowing to the kidneys. There is a huge list of the foods that are said to affect gout, I find it helpful to keep a diary as the effects are long term rather than immediately evident.

Michael Eden

Let’s have lots more hints, please?

The small garden area to the right of the Health Centre is being developed in loving memory of Dr Celia Teare. Soon a simple commemorative stone will be installed bearing her name.

So far, the planning and planting of the garden has been carried out by the staff of the Practice. However, the Practice would be vey happy to welcome any patients willing to help maintain and care for Celia’s Garden.

If you would like to be involved please contact Sheila Dearman. or leave your name at the Reception Desk.

Thank You

... my Mum went to visit a friend in hospital in SE London, in 1931. You dressed in your best to go visiting – navy two-piece costume, hat and fur wrap. They used to polish the floors in the wards every day and she slipped over in her high-heeled shoes and made her way down the ward underneath all the beds. Not a hint of dust on her navy blue!

... there was no appointment system, you just went to the surgery and waited your turn. When you were called in, before being asked what was wrong you were expected to lay your shilling (half a crown by 1939) on the desk. Medicines were extra.

... a home visit was requested only in dire cases. It was paid for at every visit, was more expensive than a surgery visit, and the Doctor decided how often he should call.

... my mother had a rheumatic complaint that required daily treatment under an unltra violet lamp. My Dad worked several weeks overtime to pay for this.

… I started work in 1942 and paid into a savings association. This covered the costs of an operation for appendicitis and nursing-home fees when my daughter was born in 1947.

… children had their teeth checked regularly at school, but treatment had to be paid for.

When it started everyone thought the NHS was wonderful. People demanded the removal of all their teeth so they could have false ones and no more trouble! People who had struggled to see had eye tests and received glasses. Sick benefit meant people could take time off work to recover and still pay the rent although groceries often had to be bought ‘on tick’ if the shopkeeper was generous.

Joyce Wardingley

Congratulations to Dr Cheryl Fairley and her husband on the birth of Kirsty Dawn on 23rd July 2008.

Wednesday: 12th November at 7.30

Venue: The Butler Centre, Church Street, Wantage

“URGENT CARE SERVICES IN OXFORDSHIRE”

“The Urgent Primary Care Service is responsible for the Out of Hours (OOH) service, Minor Injury Units (MIU) and First Aid Units (FAU) across Oxfordshire”

The Out of Hours service provides urgent medical care for Oxfordshire patients between the hours of 1830 and 0830 Monday to Friday, and 24 hour cover over the weekend and at bank holidays. The medical care is provided primarily by local GP's supported by nurse practitioners and paramedics.

We would like to explain how the Out of Hours service works in Oxfordshire, and would welcome questions and suggestions from the group about the services.

We are keen to promote the service across the area and ensure that the public know how to access the service, what to expect and receive views on the service of the future.

Christine Hewitt

The Public Meeting is open to anyone no matter which practice they attend. Everyone is very welcome.

The PIG AGM will follow the Public Meeting. It is open to any members of the Church Street Practice as they are automatically members of PIG.