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Latest News

Notice - Practice Merger

On Monday 1st July 2019; The Forge Surgery, Gateway Medical Practice and Whitehorse Surgery will be merging as one practice under the title of 'Springhead Health'.


For the immediate period there will be no changes in how we work. We will continue to use the same telephone number, the same staff will be on reception, Dr Karunaharan will still see you and prescriptions will still be dealt with in the same way. Obviously things will change but you will be informed of each stage as it happens.


Dr Karunaharan and her team would like to thank you for your loyalty, co-operation and goodwill shown over the past. We are fortunate to have you as our patients and we look forward to caring for you under Springhead Health 






Patients can have a free shingles vaccination once they have turned 70 and before their 80th birthday.  You can ask for this at any time but you need an appointment with the nurse.  


We said good bye to our nurse Rosemary recently but we have managed to cover her shifts by using nurses from the neighbouring White Horse Surgery - so cover our needs.


The Forge Surgery Patient Participation Group

What we are and what we do

A growing number of GP surgeries now encourage Patient Participation Groups, or PPGs, that work with the doctors to improve services and promote health and quality of care.

The Forge Surgerys PPG started in 2013. Its objectives are to foster the highest possible standard of primary care through the medium of patient participation and promote cooperation between patients and The Forge Surgery. The PPG meetings are held every two months.

 AIM of the Group:

Acting as a communication channel between patients and practice;

Helping to assess community needs;

Advising and educating on Mental health programs and promoting preventative medicine and choice of healthy lifestyle;

Expressing patient opinions on changes relating to the wider structure of health care in DGS Kent.

Membership is open to all patients Partners and the staff of the Practice.

The Group comprises of a committee  including two partners of Forge and the Practice Manager.


Meetings are held approximately 6 times a year and normally all patients are welcome to attend and participate in discussion.


Those interested to participate could contact Practice Manager by Email: the or phone 01474564758 between 10am to 4pm on Mon Tue Wed & Fridays. 

Currently there are vacancies on the committee and volunteers would be also welcome. The committee is particularly keen to recruit members from among The Forge Surgerys younger and ethnic minority patients as well.

(It should be noted that it is possible that e-mail addresses of those on the contacts list could become known to others on that list.  Addresses will under no circumstances be disclosed to neither other members nor organisations.)


The PPG organizes speakers from various faculties to give a brief talk on relevant topics.

We are proud to own a defibrillator purchased in January 2016. This would certainly help our patients in time of necessity.

 Keep up with current rapid changes occurring on NHS Services. Usually the PPG meetings are held once in two months.





It is an asset to the surgery in time of need.


We are abiding by the requests made and in the process of changes as required in terms of the staff and working pattern.


We need to get this operative. today the turnout of members is just two hence will should be able to take a decision at the forthcoming meetings.

Next meeting will be notified later as Dember is the festive season as many of the members would not come.

Close of meeting at 2.15pm.

 The next PPG Meeting will be held on Wednesday 18th January 2017.

 PPG MEETING HELD ON 26th October 2016

 Present: Alan Sheehan(AS),Leslie Uden(LU), Anne Bealses(AB), Philip Scrivenger(PS),Dr. V. Karunaharan(VMK), Dr. N. Puvi (NP), Rizvi Rawoof(RR) Practice Manager

Apologies: Raj Gill(RG), Gertrude Brewer(GB), Alison Duffert(AD), Hazel Sheehan(HS).


NP said that we have already purchased a Defibrillator. As this equipment will become very useful at the time of need to patients hence the best option is to own one said VMK.

Currently PPG money is dormant in the Barclays Account. Once the account would become operational then transfers could be affected  appropriately.


Dr. VMK said that as we have performed satisfactorily hence we have not had a visit yet, nevertheless we are preparing for it . CQC gives two weeks notice prior to their visit to any Surgery.


AB is appointed Executive Director Sussex Partnership Trust. AB will set up to help the young people who have mental issues. LU suggested to have workshops in this respect. VMK said from the surgerys’ point of view we could support to display posters leaflets etc. and coordinate with AB. LU We have to update the website and keep informed as much as possible. AB will plan to target individuals who are silent, isolated and lonely.


VMK Online booking are very few. We do have but not a lot. Younger generation are happy to book online. Patients are comfortable on F2F and telephone bookings. AB said that she likes this surgery as the staff are very friendly and efficient.


E-mail-the elderly patients would not read hence phoning is the best option to invite for eg: Health check up, Diabetes etc.


AS-Medway CCG has new ambulance contract. Gravesham and Dartford are excluded from this contract. They have a different policy to Kent. Gravesham has limited time factor . They have the ambulance to take patients to Medway /DV.

VMK-Appointment letters have a contact telephone number for transport.


Next meeting – Wednesday 20th April 2016

 The PPG meeting was last held on 14th April 2015.

Minutes will be uploaded soon.

Minutes of the P.P.G. Meeting held on 9th December 2014


Present:       Mrs. Hazel Sheehan – PPG Chair, Mr. Alan Sheehan,

                     Mrs. Louise Fisher, Dr Ragbir Gill, Miss Joan Handley,

                     Mrs. Belinda Jackson-Knowles (Practice manager).

Apologies:Dr. V Karunaharan, Dr. N. Puvi, Mrs. Alison Duffort.

The Meeting started with introductions and welcoming everyone.

Apologies were given from the representatives from Rethink/Sahayak, who were to have given a talk about their charity and the services that they supply to the community. It is hoped that they will be able come to the next meeting in February 2015.

The minutes of the last PPG meeting were checked and agreed as a true and accurate account of the meeting held on October 14th 2014.

Matter Arising and Feedback

The outcome of how to raise the last monies required to purchase a defibrillator for the Practice was discussed, and the idea of holding a raffle was dismissed as putting pressure on patients.

At this point, Miss Joan Handley produced a cheque for £200.00 from her sister (

Patricia Handley), which she said had been donated towards the purchase. This amount, when added to the funds held in a PPG account known to Dr. Karunaharan, should make it possible for the purchase of a defibrillator to go ahead.

Many thanks were expressed for the generosity of J. Handley’s sister, and the B.J-K said that she would inform the doctors, and send a letter of gratitude to Miss Pat Handley forthwith.

A.S. Raised the matter of staff training on the use of a defibrillator, and said that he had previously given details of a local company who could provide this if needed. B.J-K said that all the staff had undergone defibrillator training in the last year, but that if a new machine was purchased and it was significantly different to the one that they had trained on, that she would look into having the staff re-trained.

A.S. Then asked whether the doctors had given any more thought to holding drop-in sessions, to screen patients for diabetes?

B.J-K answered that this hadn’t gone ahead; as patients are offered health checks once they reach forty years plus, on a rolling programme, and that the doctors or Practice nurse would also send a patient for a blood test if they felt that they were at risk, during a consultation.

H.S. then reported that she had been unable to attend the last DGS meeting, and that she would forward the minutes to the PPG, once she had received them. She said that unfortunately, she would not be able to attend the next meeting either, that is to be held in Swanley. Apologies would be sent, and minutes obtained.

H.S. also mentioned that should we have a CQC inspection, the PPG would be expected to have a Constitution, and this would also mean that an AGM would have to be held. The CCG website would be accessed to find resources for compiling a Constitution.

The CQC inspectors would also want to see evidence of how the PPG had had a positive influence on the practice.

The recruitment of new PPG members was discussed, and a name put forward of a possible new member.

New Items for the Agenda

B.J-K apologised again that there would be no talk by the Rethink/ Sahayak charity, and that instead she would update the members on the surgery’s progress.

Copies of the feedback and reviews of the surgery taken from the NHS Choices website, were handed out for discussion. It was noted that two very favourable comments had recently been added, that had boosted the surgery’s rating back up to four and a half stars out of a possible five.

B.J-K then explained to the members, the implementation of the new Friends and Family questionnaire that all GP surgeries as well as hospitals, were now required to undertake. A copy of the questionnaire to be handed out in the surgery was handed out, with the explanation that there was also access to it via the surgery website. From 2015, monthly feedback figures from the practice are to be passed to NHS England for publishing, using the CQRS system.

BJ-K went on to say that the surgery had now compiled a Chaperone Policy, and that that two members of the reception/admin staff had undertaken Chaperone and Infection Control training. Now that this training had been completed, posters are displayed offering a chaperone for intimate examinations.

It was also explained that the practice now prominently displayed for the patients, information on how to make a complaint; this now being a requirement that would be checked during a CQC visit.

Any Other Matters

L.F. Asked about the new system of booking appointments with the doctors. She asked whether if she rang up she could book an appointment for a day later in the week. She stated that she had joined our practice specifically because it had always been easy to book an appointment, and that she was unable to understand why the opportunity to book for any day, was no longer easily available?

B.J-K answered that all patients who contact the surgery on any one day, are always offered either an appointment or a telephone consultation with a GP. If during a telephone consultation , the GP decides that the patient needs a face-to-face consultation, they would ask them to come in.

Should a patient wish to book an appointment for another day, they would be added to the GP’s telephone consultation list, for this to be discussed.

It was explained further, that due to increased pressure for appointments, the doctors felt that this was the best system to ensure that patients would have access to the care that they needed.

The meeting then conclude with thanks for the participation of all involved.

Date for the next meeting was set for February 10th 2015, at 1pm.


The date for the next PPG meeting is to be rearranged for Tuesday 17th February 2015 at 1pm( due to a double booking for the 10th February).




MEETING 14th October 2014


Present       Mrs. Hazel Sheehan, Mr. Alan Sheehan, Mr. R. Gill, Dr. V Karunaharan,

                     and Belinda Jackson-Knowles as Practice Manager

Apologies     Mrs. Joan Handley


The meeting started with introductions and welcoming everyone.

 Minutes of the previous P.P.G. meeting on 12th August 2014 were distributed and agreed upon, and matters arising from the minutes were then discussed.

 Belinda fed back to the group that she had accessed the patient survey on the Practice website, and that appeared to be working. She suggested that someone from the group may like to now go onto the website in order to test it out.

 The matter of fund-raising in order to raise the extra money needed to buy a defibrillator for the Forge Practice was again discussed. The possibility of asking the Gateway practice to jointly purchase a defibrillator was discussed. Dr. Karunaharan said that there could be practical difficulties in storing one in such a place that staff from either surgery would have unobstructed access to it in an emergency.

Dr. Karunaharan favours raising funds to purchase one for the Forge Surgery to keep on our site.

 Possible means of fund-raising for this purpose discussed were either holding a raffle, or keeping a secure collection box in the surgery for voluntary donations.

 The next matter discussed was the printing of new appointment cards, including useful patient information.

This had been bought up in a previous meeting, and Dr. Puvi had offered to look into it. As yet there is no decision on having this done.

 Mrs. Sheehan informed the group that due to personal commitments she had not been able to attend the last DGS CCG meeting. The next one is to be held in Gravesend on 30th October 2014, and Mr. Gill said that he may be able to attend, if his commitments allow.

Following on from an idea raised by Joan Handley at the last meeting, the possibility was discussed of inviting a guest speaker to give a talk to both the members and maybe a selected patient group, regarding Living Wills, DNR requests, allocating the Power of attorney, etc.

 Dr. Karunaharan thought that any talk given of this nature would have to be handled very sensitively, and it may be better to have someone give a more general talk on issues faced by the over 75yr age group and their carers.

 Belinda Jackson-Knowles was asked to explore whether someone with relevant qualifications and experience from Social services or Age Concern, would be willing to give such a talk at a future meeting in 2015.

At this point Mr. Ragbir Gill said that he worked as a volunteer for ReThink, a charity with a local base in The High Street, Gravesend, that was both a ‘Drop-in Centre’, and that also provided outreach to vulnerable groups within society. This was also linked with Sahayak, which offered help and support to members of the Asian population. These charities provide volunteers to help with a wide range of issues, and there is also access to trained counselors if required.

 Mr. Gill was asked if he would be able to ask someone from this organization to come along to the next meeting, in order to give a short talk. He said that he would look into it.

 Another matter brought up was whether there could be a patient information sheet in order to explain what an Urgent Referral meant, as it could sometimes give alarm. Dr. Karunaharan explained that an urgent referral meant that a patient had to be seen by a consultant within 2 weeks, in order that any possibility of cancer could be ruled out. Patients would have this explained to them at the time of referral, if they asked.

 Mr. Sheehan asked whether there was any more news regarding GP surgeries staying open 7 days a week?

Dr. Karunaharan replied that this was just being discussed at Government level, and that the implications would be far reaching for both G.P.s and other services, such as pathology laboratories, pharmacies, etc.

It would require far more G.P.s in order to implement this, and investment in the other services that would be involved. As yet, there is no solid proposal to put this into practice.

 Mr. Sheehan also asked whether there had been any increased demand from patients for Metformin to be prescribed, following media coverage that it could play a part in delaying the aging process?

 Dr. Karunaharan replied that she hadn’t seen any increased demand, and that this drug was not licenced for such purposes.

 The meeting was concluded by thanking all members for attending and the date for the next PPG meeting was decided to be on Tuesday 9th December 2014 at 1pm.








Present: Dr. Puvi, Mrs. Hazel Sheehan – PPG Chair, Mr. Alan Sheehan, Mrs. Joan Handley and Mrs. Manjit Chana - practice manager

 Apologies: Dr. Karunaharan, Mrs. Louise Fisher, Dr. Raghbir Gill, Ms. Janet Hare, Mrs. Brewer, Mr. Burridge  and Mr. P. Manu

 The meeting started with introductions and welcoming everyone.

 Mrs. Sheehan recently attended the District PPG chairs’ meeting and shared some information with the group.   She informed that the results of practice survey should be discussed with the PPG group and an action plan agreed.  Any changes to be made to the action plan should be discussed and agreed by the group.  She also mentioned that she was unable to open the survey on the practice website.  PM to action.

 Mrs. Sheehan also informed that from the district chairs’ meeting, it aspired that there will be a “One stop Dermatology clinic”, however the practice has had no information on this as yet.  Mrs. Sheehan said she will bring in more information on this.

 She informed the group that CCG have confirmed that PPG chairs can now claim travelling expenses if they travel out of their area to attend the meetings.  We understand that the chairs meeting for DGS locality are rotated around Dartford, Gravesend and Swanley.

 Defibrillator – We discussed different ways of raising money to buy the defibrillator.  There has been no follow up regarding the charity walk.  Alternative ways of raising money were mentioned – e.g. raffle tickets.

 PM informed the group that we have now updated the practice leaflets with the website address and additional services.

 PM has also put up notices to raise PPG awareness (including how to join PPG) in the waiting rooms.  Mr. Sheehan also brought in some sample posters that could be used.

Mrs. Handley discussed about “Living Wills”.  She informed the group that most elderly people don’t know how to go about making a Living Will.  She suggested we should have more information about this to help older people.  Dr. Puvi suggested that Age Concern may have a speaker who can give us more information.

 PM mentioned that we have been informed by patients who have registered with vision on line services, that they receive appointment reminders via their email.  We have had patients coming in when they have booked for a telephone consultation.  PM has now changed the way we book telephone consultations so hopefully that problem has been solved.

 The meeting was concluded by thanking all members for attending and the date for the next PPG meeting was decided to be on Tuesday 14th October 2014 at 1pm.










Present: Dr. Puvi, Mrs. Hazel Sheehan, Mr. Arshi, Mrs. Joan Handley and Mrs. Manjit Chana practice manager

Apologies: Dr. Karunaharan, Mr. Alan Sheehan, Mrs. Louise Fisher, Dr. Raghbir Gill, Ms. Janet Hare and Mr. P. Manu


The meeting started with introductions and welcoming everyone.

As discussed in the previous meeting that we need to have surgery signs with more information for patients for easy access. Dr. Puvi informed the group that we now have new and improved signs for the surgery to reflect the website, opening times and online services.  We also have a leaflet box at the bottom of the stairs where we stock surgery leaflets with up to date information.  Dr. suggested that we add the website address to our letterhead and surgery leaflets – PM to action.


PM informed the group that our website is updated with additional services that we offer – minor surgery and women’s contraception.


We discussed having new appointment cards which would have surgery information and website address. This has not been started yet.


Dr. Puvi explained the new service – those patients 75 years of age and over will have a named GP.  We are in the process of sending patients letters and information about this service.  Mrs. Handley was happy about this service and said that since she registered with the surgery she has been seeing Dr. Karunaharan.


Defibrillator – discussion about having a defibrillator on the site was carried forward from the previous meeting.  It was agreed that we would organize a charity walk and raise money to buy one.  Dr. Karunaharan has been on leave and will be back early July. Mr. Arshi suggested we could get some sponsorship forms done to raise money before the walk.  Patients could take the forms and collect the money for the surgery.


Mrs. Sheehan mentioned that there was some information on PPG awareness which she will bring in at the next meeting.  She also suggested that we should have a poster to advertise PPG group on the notice board so that more patients can read and join the group.  PM said she will put something on the notice board temporarily until the poster is available. Mrs. Sheehan also suggested that the results of the patient survey carried out annually should be discussed in the PPG meetings.  


Mr. Arshi suggested that we put up a notice in the patient’s waiting room for the upcoming PPG meeting, that way patients will be better informed.


The meeting was concluded by thanking all members for attending and the date for the next PPG meeting was decided to be on Tuesday 12th August 2014 at 1pm.


Putting Patients at the Centre of Care

Your Pharmacy Services




Thursday 5 June, 2014

12.30pm – 4.00pm


Learn how the Clinical Commissioning Group make decisions on what drugs to fund and what services are available from pharmacists within the community


What is important to you from your local pharmacy?

Come and talk to commissioners and pharmacists and




The afternoon is open to patients, public, voluntary organisations and community pharmacists.


light refreshments available

To register your place, please contact Rebecca McClymont


07768 421350







Present: Mrs. Hazel Sheehan, Mr. Alan Sheehan, Mrs. G. Brewer, Ms. Janet Hare, Mr. Steven Burridge, Dr. V Karunaharan, and Mrs. Manjit Chana practice manager


Apologies: Dr. N. Puvi, Mrs. Louise Fisher, Dr. Raghbir Gill, Mr. Narinderjit Arshi and Mr. P. Manu


The meeting started with introductions and welcoming a new member (Mrs. Hares) on board.


Members were reminded that the surgery website is updated  regularly and we have to encourage patients to visit the website for the latest news.  The question – How are patients made aware of the surgery website? Was raised and some suggestions to improve this were discussed:-



  • More notices should be put to point patients to the website.
  • A message could be added on the prescription slips.
  • The signage leading up to The Forge Surgery could be improved to include website.


Mr. Burridge offered to help with the signage.  We could also add a message, e.g. we are registering new patients now.  The signs can have a QR code (quick reader code) which can be scanned with mobile phones and it will take you to the surgery website.  Dr. Karunaharan enquired about making the website more dynamic e.g. with regular news flashes, monthly updates on different issues like hay fever, flu season, holiday season etc.


Mr. Sheehan mentioned that we could also have appointment cards designed for our surgery with more information about the services and the website details.


Mr. Burridge enquired whether we could audit the vision on line services to see if it is being actively used.  Dr. karunaharan explained that we have recently started this service and there has been a slow gradual uptake.  Manjit informed that we have about 75 patients signed up to the service. It was suggested that reception staff to offer the service to patients more actively. We have been receiving a few repeat prescription requests on line and there are daily appointments available for patients to book.


Mrs. Sheehan enquired whether the “APP” mentioned in the previous meetings had now been put into action.  We confirmed that there has been no update on this.  Mrs. Sheehan also updated the group on the newsletter from “Health Watch Kent”.


Mr. Sheehan reminded us that at the last meeting we had discussions about access to a public defibrillator.  He has doing some research and brought some quotations with him from an Irish company.  He said that we could make it cost effective if we liaised with other surgeries, or could also avoid vat if a VAT registered practice bought them for us and sold them on.


Dr. Karunaharan mentioned that they used to have PPG group before and a charitable bank account, however sadly a couple of members passed away and it came to a stop.  We could reactivate the bank account and use the money for a useful cause e.g. a defibrillator.  Dr. also mentioned that we could organize another charity walk, possibly in June.


MR. Burridge suggested the walk route could be back to the old Forge and meet up with other doctors and it can be done in the memory of the expired members.  Dr. Karunaharan said we will decide a date for the walk and tie it in with the newsletter.



The meeting was concluded by thanking all members for attending and the date for the next PPG meeting was decided to be on Tuesday 10th June 2014.











·  Vision On-Line update


·  Health Help Now


·  PPG meeting minutes on the website


·  New member


·  E-mail addresses update via VOS


·  Website


·  Any other matter





Requirement 1  Provide a description of the profile of the members of the PRG

PPG consists of people from varied ethnic backgrounds and wide range of age group (18-82 yrs).


Requirement 2  The steps taken by the Contractor to ensure that the PRG is representative of its registered patients and where a category of patients is not represented, the steps the contractor took in an attempt to engage that category

All patients have been encouraged to join PPG by leaflet left at reception.  We also publish a newsletter.  Patients who have shown an interest have been contacted and encouraged to join PPG.


Requirement 3  Details of the steps taken to determine and reach agreement on the issues which had priority and were included in the local practice survey

We discussed issues that are more important to the practice population in the PPG meeting and following this one of the PPG members has volunteered to draft a questionnaire which has been amended and approved and has been distributed to patients.


Requirement 4  The manner in which the contractor sought to obtain the views of its registered patients

The questionnaire was anonymous and patients were free to express their views.


Requirement 5  Details of the steps taken by the Contractor to provide an opportunity for the PRG to discuss the contents of the action plan

The questionnaires were collected in a box and the results were plotted in a graph which have been discussed in a PPG meeting.


Requirement 6  Details of the action plan setting out how the findings or proposals arising out of the local practice survey can be implemented and if appropriate, reasons why any such findings or proposals should not be implemented

One of the key findings from the questionnaire was that some patients were unaware of how to contact the out of hours.  We have set out plans to publish this in the newsletter and also on the website regarding the out of hours use outside practice hours.


Requirement 7  A summary of the evidence including any statistical evidence relating to the findings or basis of proposals arising out of the local practice survey

The findings of the survey have been published on the website.


Requirement 8  Details of the action which the Contractor

· And, if relevant, NHS England (or other appropriate organisation where such functions may have been delegated), intend to take as a consequence of discussions with the PRG in respect of the results, findings and proposals arising out of the local practice survey; and

· Where it has participated in the DES for a year (1st April – 31st March), or any part thereof, ending 31st March 2013, has taken on issues and priorities as set out in the Local Patient Participation Report

We have discussed the findings of the survey in the PPG meetings which are also on the website.


Requirement 9  The opening hours of the practice premises and the method of obtaining access to services throughout core hours

The opening hours of the practice are published in both practice leaflet and practice website.


Requirement 10  Where the contractor has entered into arrangements under an extended hours scheme, the times at which individual healthcare professionals are accessible to registered patients

Our extended opening hours on Mondays are indicated on our website and on the leaflets and are on the notice board.


  Name of person completing this form: Manjit Chana

  Surgery Name: The Forge Surgery

 G Number of Surgery: G82096

 Date: 26th February 2014







Present: Mrs Hazel Sheehan, Mr Alan Sheehan, Dr V Karunaharan, Dr N Puvi and Mrs Manjit Chana practice manager


Apologies: Mrs. Louise Fisher, Dr Raghbir Gill, Mr. Narinderjit Arshi, Mrs Gertrude Brewer.


The PPG thanked Patricia Lewing for all the work she has done up to now.


The committee discussed at length the outcome of the PPG chair meeting held on 6th Feb 2014.  At that meeting it was discussed about texting patients to prevent DNAs.  It was pointed out that texting can cause problems for the elderly.


Issues around AGM (Annual General Meeting) were raised as well.  For future activity the following were suggested:

  1. Getting email addresses of patients.

  2. Regular PPG newsletter.

  3. Updating the website.


PPG also discussed at length about Summary Care Records and it was felt that it will be appropriate at the moment to inform patients again about summary care records via repeat prescriptions, newsletter and notices at the surgery.


The DNAs survey done with the practice nurse was discussed at the end of the meeting.  Out of 848 booked appointments during a 3 month period, 67 did not attend.  The practice will look into this to minimize future DNAs.


The meeting was concluded with this and the date for the next PPG meeting has been set on 8th April 2014 at 1pm at the Forge Surgery.







14th JANUARY 2014


Present: Mrs Hazel Sheehan, Mr Alan Sheehan, Dr Raghbir Gill, Mrs Louise Fisher, Mr Narinderjit Arshi, Mrs Gertrude brewer, Dr V Karunaharan, Dr N Puvi and Mrs Patricia Stokes practice manager


The meeting of the PPG today was a short half hour preliminary meeting, before a speaker from Carers First came to speak to who that had been invited to attend from the surgery.


Mrs Sheehan (Chair of PPG) informed the meeting of her attendance at the meeting of Chairs held on 9th January 2014.  There were only 5 surgeries that attended the meeting out of a possible 34 practices.  The topics / points that arose or were discussed included:

Survey through ‘Survey monkey’ sent out by the CCG, gathering/recording e-mail addresses of patients, vision on-line services e.g. requests for repeat prescriptions and booking appointments on line direct by patients, DNAs to appointments, minor injuries and the ‘Health Help Now’ including the app which was launched on 13th January 2014.  It was stated that there are 200 visits to A&E Department daily, of which 50% are 18-64 yrs old.  31% of attendees needed admitting.  It was brought up about patients attending A&E for dressings.  The next Chair’s meeting would be held on Thursday 6th February and it would cover the subject of IT.


There was short discussions following the reports on the above subjects and it was suggested that a survey be done to see how many DNA’s there are at The Forge Surgery, perhaps starting with the diary of the practice nurse Sessions.  It was also requested that the minutes of the PPG should be included on the surgery website and the next Newsletter.


At this point the PPG discussions concluded as the speaker from Carers first and patients started to arrive.


The speaker gave a general introduction to the Charity and stated that 11% of the population is unpaid carers.  The state recognized the need to support carers in order for them to continue their care during the early 1990s.  A conclusion was reached that there was a need to transform what had been done previously e.g. residential care by 4 ways: Social isolation, Falls prevention, Continence support and supporting care.


It was revealed that 41% of carers breakdown and cannot do it anymore if they do not have support.  Previously support was given by the provision of places/locations for patients to attend but now this situation is being reversed by supporting staff going to the patients.  This remote working also reduces back office costs.  Carers First have 13 carer support staff to make visits.


Every carer is entitled to a statutory assessment.  The categories of older people and Dementia, mental health and substance misuse, young carers and young adult carers  and learning and physical disabilities were mentioned.  The organization can offersuch things as: employment support, respite, signposting to the right places, training, administrative help e.g. with the pharmacy.  Carers first is just one of 3 organisations that operate within Kent.


The meeting then concluded with questions from the attending carers and also members of the PPG and the doctors.  Mrs Sheehan then thanked everyone for attending and for what had been shared.


The next meeting of the PPG was confirmed that it would be held on Tuesday 11th February 2014 at 1pm.







26 NOVEMBER 2013


Present: Mrs Hazel Sheehan, Dr Raghbir Gill, Mrs Louise Fisher, Mr Narinderjit Arshi, Dr V Karunaharan, Dr N Puvi and Mrs Patricia Stokes practice manager


Apologies: Mr Alan Sheehan, Pavraj Manu


The Minutes of the last meeting held on 22 October were accepted by all parties present.


Nomination of a ‘Chair’ person : the group was quite pleased for Mrs Hazel Sheehan to be nominated as the Chair for the group and to attend the PPG Chair meetings, of which the next meeting was to be held on 5 December 2013. (Update – this meeting has now been postponed to 9 January 2014).


The In House patient Survey (50 patients) in the format of bar charts was studied by the group and the following points were discussed:


1.   Only 54% of patients were ‘agreed that there is sufficient parking space upon arrival’. 22% ‘disagreed’ and 24 % were ‘undecided’. It was suggested that the Theatre could be contacted to see if it was a possibility to use their car park and that the next Newsletter should contain information clarifying the parking arrangements and highlighting the availability of the car park in front of the White Horse Surgery. It was also mentioned that patients do park in marked places for staff. The signage was discussed and it was shared that The Forge had 3 signs made: one for the perimeter entrance, one by the entrance door and lastly one on the first floor on the outside of the building.


2. It was noted that 100% ‘agree’ that the ‘physical environment is calm and suitable for that of a Surgery’. Discussion took place re: ‘technical calling systems’ for patients and it was felt that for a small surgery, it was good to have the personal touch of the doctors and practice nurse coming to the waiting room and calling the patients directly for their consultations.


3. The NHS 111 Service:  further discussion took place of how to make more patients more aware of this Service and so to ease the  misuse of the Accident and Emergency Department.  Mr Arshi volunteered to photocopy the recently received Clinical Commissioning Group poster ‘Health Help Now’ which will be displayed in reception and the Waiting Room. Following on from this Pat would make enquiries about 2 Notice Boards being placed in both these areas. Mrs Sheehan suggested that perhaps members of the PPG on the day of meetings would check the Notice Boards to make sure notices displayed are up to date etc.


The Group were informed that the Surgery now had a website to be found at: and that the Surgery is also looking towards becoming ‘live’ for Vision online services e.g. requesting repeat prescriptions and appointments online.


Discussion arose re the service provided by Chemists of ordering and delivering repeat prescriptions. Dr Karunaharan explained some of the problems that can arise eg. when medications are altered and the Chemist is not informed of the change and patient’s find it difficult to keep astride of their medications and doses.


It was proposed that at the next meeting a representative should be invited to speak on the subject of  ‘Carers’, from one of the following organizations: Social Services Department, Carer UK, Association of Carers, Age UK.


The recent media coverage of the proposal (from April 2014) that the ‘over 70’s’should have a nominated GP who would know all the patient history and ongoing problems was raised and it was felt that this would be a good system to be implemented in the interest of patient care.


The next meeting was decided to be held on Tuesday 14th January at 1.30pm, with the first half hour as a PPG meeting and from 2pm, a speaker on the subject of ‘Carers’ and invited Carers, hopefully would be attending.













Present: Dr V Karunaharan, Pavraj Manu, Mrs G Brewer, Mrs H Sheehan, Mr A Sheehan and Patricia Lewing practice manager


Apologies: Mrs L Fisher, Mr N Arshi, Mr R Gill and Mr S Burridge, Dr N Puvi


Welcome to new members, and then discussion followed the minutes of the last meeting held on 17th September 2013.


The Lift had broken down again on 2 more occasions in October 2013.


Many thanks were given again to Pavraj for creating the patient survey which had now been given to 50 patients as they attended the Surgery. Pavraj would now create a graph of the Survey results.


Mr Sheehan raised the point that ‘31%’ did not know how to contact an out-of-hours GP Service in the KMCS GP Patient Survey (Jan – Sep 2012) from the previous minutes and discussion of this followed. From our own patient survey recently carried out this figure had now reduced to 20%. The reasons for these percentages were talked about and it was agreed that in the next survey there should be questions as to age group, ethnicity, gender and language and to introduce open questions.


The 16% difference on waiting times for appointments from the national survey mentioned in the previous minutes was clarified, it was only 4% of patients who had waited more than 15 minutes as 12% had answered ‘don’t know’.


Following on from this, the appointment protocol was explained that all Surgeries are to have emergency appointments available within 24 hours, normal appointments within 48 hours and that patients are able to book appointments 2 weeks in advance.

The Forge has a late night surgery on a Monday evening and it was estimated that 30% of the patients booked in at that surgery could be dealt with over the telephone.


The subject of ‘Health Tourism’ was discussed as mentioned in the national media on the day of the meeting. The Local Medical Committee had previously been sought for advice on this and new registrations.


Lastly, it was shared that there are PPG Chairs Group Meetings.  Mrs Sheehan volunteered to be a representative to attend the next meeting to be held on 5th December 2013 at the Training Room, OldTown Hall, Gravesend from 5.30pm – 7.30pm. The group understood that these meetings would provide an opportunity to raise questions on patients behalf re Services, budgets, etc with other attending parties including the Clinical Commissioning Group and to share and communicate with other PPG representatives.


The next meeting of The Forge PPG would be held on Tuesday 26th November 2013 at 1pm at the Surgery.


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