Monthly Archives: May 2015


Since I started this blog each year I have had the chance to make and record some fascinating observations. The first year it was a family of ducklings that hatched and were led by their mother to the river and the challenges of surviving nature and its dangers Alas this year the mother reappeared but she didn’t  establish a nest and I have not spotted any ducklings.

Last year I obseved a family of bluetits which nested in a jug and all fledglings hatched and happily flew into the outside World. This year the tits have nested in the nesting box fixed to a tree and the parents have been happily flitting back and forth and seem very contented  with their new home.

This year after watching a pair of busy redstarts it became apparent that they had decided to build a nest in the eaves of the covered terrace. Redstarts are immediately identifiable by their bright orange-red tails, which they often quiver. Breeding males look smart, with slate grey upper parts, black faces and wings, and an orange rump and chest. Females, like the one I photographed on her nest and young are duller. Redstarts ‘bob’ in a very robin-like manner, but spend little time at ground level. They are commonly seen in Wales, but usually around London but if you are in Europe or travelling outside London  look out for them  as they are charming little birds with a sweet song. They were thought to be in the thrush family but are now thought to be part of the old world flycatcher family and are cousins to robins and nightingales. Infact  name start comes from the Old English word fot tail, steort. According to the RSPB  The redstart is included on the Amber List as a species with unfavourable conservation status in Europe where it is declining, which made me feel happy to be providing a home for this family.


Then to my delight while the the mother had briefly left the nest I took a sneaky peep in the nest and discovered that the fledglings were beginning to hatch and I was able to take a short video to share:-


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As a follow up of the blog posted recently which explains this scheme we can now give more details:-

Long Term Conditions – Self Management Programme for Ealing!
This programme is available to Ealing residents living with a long-­term condition such as:
Heart Disease
Pain conditions
Neurological condition
Pulmonary Rehab
High blood pressure


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I have made it quite apparent that not only do I enjoy gardening but I am advocating it as an important health benefit both physically and mentally. Many people are not fortunate to have a garden and don’t even have a balcony or chance to grow plants. However, during these summer months there is a chance to be able to not only visit public gardens but also private gardens which open for public viewing and at the same time raise money for a selection of important charities.

I have been aware of The National Gardens Scheme in Britain for many years and enjoyed visiting many private gardens with the  help of ‘The Yellow Book’ which has made its appearance in my home from time to time and contains when and where these gardens are open and is available to purchase from ‘Smiths’ bookshop of you can refer to the website


You may be wondering what this all has to do with District nurses now often named community nurses. Before I reveal that, I must digress to declare my admiration for these nurses who have to be resourceful, broadminded, diplomatic and adaptable to any situation.  They have certainly made a significant  impact on my career as a GP.  It was district nurses in my early career as a GP who enlightened me into the necessity  of holistic care of an ill person at home.

To give just one example, I remember not long after I started at the practice in Ealing being called to see a patient, Tom who was a middle aged man, formerly a ballet dancer. When I arrived the door was ajar and as I tentatively opened the door I was greeted by a swarm of flies and an intense stench of faeces. I called out to give me an idea of where I was to go and Tom summoned me to a large room at the end of the hallway. He was lying semi-naked propped up in a bed covered in newspapers  to absorb his double incontinence and was struggling to eat his meals on wheels accompanied by a can of Lager and joined by a couple of friends . He was in good spirits, somewhat confused as he was suffering Korsakov Syndrome an infliction secondary to long term alcohol abuse and although he did not warrant an acute hospital  admission, clearly he needed sorting out. Following my visit I contacted the district nurses and within 24hrs when I revisited Tom, I arrived at a flat now smelling sweet and a clean,tidy, almost unrecognisable patient sitting in a chair by the bed eating his dinner, listening to some music. The ‘fairies’ had visited and had transformed the scene in a most remarkable way – the district nurses had managed the situation.

It was the National Garden Scheme, which was founded  in 1927 in order to raise money for a national voluntary organisation which would recruit, train, and support  ‘District’ nurses, who would nurse patients in their  homes in deprived areas throughout the country.

The idea of District  nurses had originated in 1859 when William Rathbone, a Liverpool merchant, employed a nurse to care for his wife at home. After his wife’s death, Rathbone kept the nurse on to help poor people in the neighbourhood. Later, Rathbone raised funds for the recruitment, training and employment of nurses to go into the deprived areas of the city. Based on this idea in the latter half of the 19th century ‘District’ nursing spread throughout the country and became  a national voluntary organisation supported by Queen Victoria and Florence Nightingale.

In 1926 the organisation decided to raise a special fund in memory of their patron, Queen Alexandra, who had recently died. For much of the 20th Century, district nurses were usually unmarried women who lived in nurses’ homes provided by local nursing associations all over the country.The fund would pay for training and would also support nurses who were retiring. The Institute became known as ‘The Queen’s Institute of District Nursing and  trained district nurses until the 1960s, in a model that was copied across the world. This model of care was instrumental in developing a comprehensive, highly-skilled service in the UK that meets the needs of millions of people every year.


In 1926 a council member, Miss Elsie Wagg, came up with the idea of raising money for charity through the nation’s obsession with gardening, by asking people to open their gardens to visitors and charging a modest entry fee that would be donated. The following year The National Gardens Scheme was founded. Individuals were asked to open up their gardens for ‘a shilling a head’. In the first year 609 gardens raised over £8,000. A year later, the district nursing organisation became officially named  The Queen’s Nursing Institute.

Subsequently, a few years later Countrylife produced the ‘ Yellow Book’ and there were 1,000 gardens listed.

After the Second World War, the National Health Service took on the District Nursing Service, but money was still needed to care for retired nurses and invest in training. The National Gardens Scheme offered to donate funding to the National Trust to restore and preserve important gardens. In return, the National Trust opened many of its most prestigious gardens for the NGS.

The NGS , although it no longer funds District Nurses per se it now acts as a beneficiary for Macmillan Cancer Support, Marie Curie Cancer Care, Help the Hospices and (now Carers Trust) and also benefits a different annual ‘guest’ charity chosen from recommendations from NGS volunteers.

Since its foundation, the National Gardens Scheme has donated over £45 million to its beneficiary charities, of which nearly £23 million has been donated within the last ten years. The National Gardens Scheme’s commitment to nursing and caring remains constant, and the charity continues to grow and flourish.

Jardins Ouverts 

When I arrived this year in France I was intrigued to hear that the scheme had arrived in this Country starting with 4 gardens in one Departement 3 years ago and is expanding fast by 100 gardens each year. Some enterprising English migrants had decided to start the Jardins Ouverts scheme along similar lines to the NGS. An ex-nurse friend and another friend as well as other people in the area had decided to open their gardens this year and introduce the French in the Perigord to the idea of opening your own garden to raise money for charity.

The chosen charity for Jardins Ouverts for 2015 is:-

À Chacun son Everest is a French charity, founded by Dr Christine Janin, the first French woman to summit Everest.


  • It recognises the similarity between the supreme test of climbing the world’s highest mountain and the challenge facing young people with cancer or leukaemia:
  • the sense of achievement when the goal has been reached;
  • the confidence that this brings;
  • the opportunity to share their hopes and fears with children in a similar situation
  • the realisation of innate personal qualities such as courage, will-power, hope and determination.

They decided to support A Chacun son Everest for several reasons: there can be few things worse for a child and his/her family than to be told that s/he has cancer or leukaemia. They were also impressed by their very personal responses to their enquiries and ware now building a very positive relationship with this organisation.

We set off on one of those days which looked totally unpredictable – the sort of day that you wear a sun hat with a raincoat . I used to be amused by one of my patients who would come to surgery dressed like this – I now understand why. The blue sky made a  perfect back cloth  to the  soft white fluffy cotton wool clouds creeping high above with the occasional ones showing a tinge grey potentially threatening to open up to rain. In good determined British style,  whatever the weather we were to proceed not to let our friends down and with grim resolve to enjoy the day. We drove through the beautiful Dordogne countryside past woodland glades causing  the sunlight to dazzle and dance and fields bursting with seedlings teasing the eye  by not revealing whether they would become sunflowers or maize; the fields frequently punctuated with majestic walnut trees either in rows or alone registering their supremecy in this countryside. Moreover, along the roadside there was a plethora of wild flowers, Queen Ann’s lace, wild sage, Ox-eye daisies,  greater and lesser stitch work, campions and  outcrops of wild orchids just to name a few. We didn’t need to go to a Jardins Ouverts we were admiring the country garden just by venturing into this wide open space.

We arrived at the entrance of the first garden labelled accordingly by a sign showing the way and drove up a track for almost 1 km through a wooded area until the house and garden were revealed. The man at the desk took our money 5€ for both gardens  and a plant stall selling donated plants and then pointed us in the right direction. By now the sun was shining brilliantly enough to make us feel happy enough to leave our wet weather attire in the car. We strolled around the garden admiring the clematis concealing old sheds and aged trees, hostas, roses, foxgloves, violas, budding peonies and countless familiar shrubs and perennials all had been tended carefully and prepared for this event.


It would not be complete without the inevitable chat with fellow visitors over a cup of tea and cake served by the fascinated French children, who had come along to witness this interesting event.

We then left and after a short drive appeared at our next destination, an old presbytery where the garden had been revived including the nurturing of a herb garden,


There was an aged Medlar tree, which bears the fruit that is eaten just before it  becomes rotten, bletted and is frequently mentioned by Shakespeare and Chaucer when they write about unfaithful women.
The house was in the shadow of the Church and there was an ancient well which was adorned by roses and irises in full bloom.


Moreover,  hidden away an array of various chickens and bantams all individually named strutting around there territory clearly dominated by the new arrival ‘Lady Gaga’

In the ponds, more recently created goldfish  darted” under the Lily pads and the perfect water lily flowers were resplendent as the water sparkled  in the sun as the water glistened as the surrounding shrubs and flowers swayed gently in the soft warm breeze.



My friend had jested the night before that she had sent her husband around with a pair of scissors to deadhead some of the flowers and trim any unwanted buttercups which were found peeping amongst the perennials – he had certainly done a good job. Chelsea Flower Show had arrived in the Dordogne! After another chat with visitors French and English, a cup of tea  under the lime tree and a purchase at the pop up jams and chutney stall  we drove back with a clearer blue sky along twisting country roads past the tapestry of the glorious Dordogne countryside.

We arrived home refreshed, inspired with fresh eggs and homemade spicy mango chutney and having had a delightful day out . These gardens had been revived and  nurtured by people who had seen adversity in their lives but had pluckily exercised their energies into something,  which not only can they be proud of but have shown the generosity of spirit to share with others and raise money for a worthy cause.

I wanted to share this experience  As may be someone reading this might be inspired to share their garden and raise money for these worthwhile caring charities  as well as share their garden or allotment  with others who don’t have one of their own.

If you are in France this summer there may be a ‘Jardins Ouverts’ near where you are going : to find out view

The website

When I referred to the NGS website( there is a garden open in Hanwell this weekend so perhaps you can visit this newly joined garden to be inspired and support Tony and Eddy. Details below:-



Posted by on May 18, 2015 in Training and Advice


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Every year a group of 4th phase medical students are attached to the practice to follow a pregnant lady through the last few weeks of her ptregnancy and see her after the birth. This is always a valuable experience for the students as many of these young people have not had the experience of talking to a pregnant woman and understanding the process and what is entailed in ante-natal care, the delivery and post-natal care. Also, just as importantly how it affects the life of the pregnant woman and her life. I am always grateful to the pregnant women who kindly partipate in this project.

Alongside this assignment they are required to carry out a Health Promotion study. This involves looking at an aspect of medicine which they research and often find a way of producing data eg by written questionnaire or patient and/or health professional interviews. This is a compulsory part of their studies and they are then required to formally present their findings and usually produce a result in the form of an education leaflet or a recommendation for increased patient awareness.

This year all the studies were of a high standard and gave us important insights into particular aspects of health care. I am publishing one example by permission of the students involved. One student was concerned that her younger 15 year old brother had not been vaccinated with the MMR vaccine. With her colleagues she researched the topic and then was able to send out a questionnaire out to parents of that age group to find out how many of these teenagers were affected. Following this they devised a leaflet explaining the importance of the MMR vaccine and distributed it to the relevant parents. We will be distributing their leaflet to our teenagers in the practice where there is no record of vaccination so that they can be seen to receive the appropriate vaccine.

They created the poster below to illustrate their study



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Cough is the commonest reason for preschool children to see a GP. Isolated coughing has been reported by parents in almost a third of children at any one time; the symptom can have an impact on sleep, school and activities for the child and can be anxiety provoking for parents.


An average preschool and primary school child has 3-8 coughs or colds per year. Sometimes several coughs or colds occur one after the other. A child who lives with smokers has an increased risk of developing coughs and colds.

A cough is a reflex action to clear your airways of mucus and irritants such as dust or smoke.
Coughs may be dry or chesty and most coughs clear up within three weeks.

Cough may be broadly split in to three categories:

Acute cough = < 3 weeks

Prolonged acute cough = 3-8 weeks, slowly resolving, e.g. post-viral pertussis

Chronic cough   = Variably defined from 3-12+ weeks

Needless to say that constantly hearing your child cough especially at night is bound to cause concern. Even if the mother is happy her child is otherwise well someone else will make a comment. It may be a well meaning grandparent, a dad returning from work or a teacher who will ask whether the child has seen a doctor. I have to say when I see a child  with a cough I examine the child step by step explaining as I go along what symptoms and signs which would cause me as a doctor to be concerned. This not only makes me rule out significant causes of cough but it also reassures and educates the mother as to what important signs she should be looking for.

  • has the child lost their appetite?

  • are they playing or responding as normal?

These symptoms are most important when you are deciding if your child is unwell in that if the child is showing both of the above symptoms you must  keep a closer eye on your child so that if they go on to develop any signs listed below you can visit your GP  On many occasions I have seen a child in surgery racing around, playing happily and having eaten a good breakfast.  Be reassured a child with a cough in this situation is not needing to see a doctor.

However, If you notice any of the following associated with a cough you must bring the child to the doctor

  • has trouble breathing or is working hard to breathe

  • is breathing faster than usual

  • has a blue or dusky colour to the lips, face, or tongue

  • has a high fever (especially if your child is coughing but does NOT have a runny or stuffy nose)

  • has any fever and is younger than 3 months old

  • is an infant (3 months old or younger) who has been coughing for more than a few hours

  • makes a “whooping” sound when breathing in after coughing

  • is coughing up blood

  • has stridor (a noisy or musical sound) when breathing in

  • has wheezing when breathing out (unless your doctor already gave you an asthma action plan)

  • is weak, wingy, or irritable

  • is dehydrated; signs include dizziness, drowsiness, a dry or sticky mouth, sunken eyes, crying with little or no tears, or passing urine less often (or having fewer wet nappies)

Because most coughs are caused by viruses, doctors usually do not give antibiotics for a cough. A cough caused by a virus just needs to run its course. A viral infection can last for as long as 2 weeks. We very rarely send a child for a chest X-ray. 

Unless a cough won’t let your child sleep, cough medicines are not needed. They might help a child stop coughing, but do not treat the cause of the cough. If you do choose to use an over-the-counter (OTC) cough medicine, discuss with the pharmacist to be sure of the correct dose and to make sure it’s safe for your child.

Do not use OTC combination medicines  they have more than one medicine in them, and children can have more side effects than adults and are more likely to get an overdose of the medicine. Some cough medicines have the effect of making a child hyperactive which most parents would agree is not a desired side effect!

Cough medicines are not recommended for children under 6 years old. Meanwhile, you may want to try this homemade remedy my mother gave to us as children and remains a good remedy.



Honey, lemon and glycerine (a liquid I use in Christmas cake Royal icing to make the icing softer) is a homemade remedy for coughs provided the person  is not allergic to any of the ingredients. It is not adviseable to give to a child < 12 months. Honey is a natural antibiotic and lemon is full of cold-fighting vitamin C and glycerine is good for soothing sore throats.

It can also be bought ready mixed over the counter.

Store in the refrigerator for up to a year. For sore throats and chest congestion take one teaspoonful every few hours. (If it starts to taste so good you want to pour it over ice cream – you are probably getting better and don’t need it any more.)

¼ cup (60ml) freshly squeezed lemon juice
¼ cup (60ml) liquid honey
¼ cup (60ml) food grade glycerine

Strain the lemon juice through a fine meshed strainer. Whisk together with the honey and glycerine and pour into a glass bottle with a tight-fitting lid.

Store in the refrigerator for up to a year. For sore throats and chest congestion take one teaspoonful every few hours.

Remember to train your child to cover their cough in order to help protect  those who are vulnerable from catching an infection. 



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Are re you a carer?

If you look after your partner, or a relative or friend who is ill or disabled, you are a carer, even if you don’t think of yourself that way.

There are many ways that you might care for someone.

For instance you might:

  • be on hand 24 hours a day to provide care
  • arrange hospital appointments for someone
  • drop round each day to keep someone company or cook their dinner
  • visit a relative who lives far away once a month to see how they’re doing.
  • Whether you’ve cared for the person for a long time, are temporarily helping them (for example, while they recuperate from an operation), or have just become a carer, take time to review your options and find out what support is available to you.

To establish your rights as a carer refer to  Age UK on the following link

The Care Act comes into force in May 2015. It changes the way the social care system will work in the future.

You’ve probably heard about the biggest change: a care cap that means no-one will spend more than £72,000 of their own money on their care needs.

If you need care, or look after someone who does, you’ll need to know how care is changing.


Ways it may affect you from April 2015:

  • You will have a right to a free needs assessment from your council, even if it thinks your finances are too high or your needs are too low to qualify for help.
  • All councils will use a new national eligibility criteria to decide whether someone can get help from them.
  • If you get social care support, you will now have a right to request a personal budget if you’re not offered one. This is a summary of how much the council thinks your care should cost. This might be useful if you want to pay for your own care. This will become more important when you have a care account from April 2016 (see below).
  • If your needs assessment shows you don’t qualify for help from the council, they must advise you how the care system works and how to pay for your own care. So if you just need a hand with housework, for example, the council should assist you in finding this.
  • You can defer selling your home to pay your care fees until after your death.
  • If you’re paying for your own care, you can ask the council to arrange your services for you. It can only charge you as much as someone whose care they are funding.
  • If you’re a carer, you have a legal right to a care assessment from the local council. You can also get support services if you qualify for them.
  • If you find it difficult to communicate or to understand the issues being discussed, the council must provide an advocate to help you when discussing your care. They will represent your interests if you don’t have a friend or relative who can help
  • The council must provide preventative services that could reduce or delay your need for care. For example, intermediate care at home after a hospital stay could help keep you independent for longer.

Ways it may affect you from April 2016:

  • It becomes even more important to get a needs assessment, as the council will then set you up with a care account. This tracks the amount of money spent on your eligible care needs. The word ‘eligible’ is important as it only includes the needs covered by your assessment. So if you decide to hire a cleaner but the needs assessment doesn’t say you need this help, the cost of that won’t be included.
  • There will be a cap on how much you have to spend on your care needs. Anything you or the council spend on your eligible needs will be added up in your care account. Once it reaches £72,000, the council will pay for all your eligible needs. This excludes your daily living costs, which include things like your food and accommodation in a care home.
  • The council can reassess your care needs, even if you pay for your own care. This is because the council works out how much your care should cost to meet your eligible needs, and adds this up in your care account. It needs to check every so often that the amount it thinks you should be spending is still right.
  • New rules about top-up fees in care homes mean you may be able to pay them yourself. Top-up fees may apply if you move into a care home that costs more than the council can pay.
  • If you’re not happy about a decision, you have a new right to complain and appeal it, and for this to be independently investigated.


                         For more information:
Call Age UK Advice: 0800 169 6565

To all carers

You  can obtain local support at the Ealing Carers – details on a previous blog

When you’re caring for someone it’s easy to overlook your own needs. But looking after your health and making time for yourself can help you feel better and manage better with your caring role.

Your health

Tell your GP you’re a carer, and discuss the impact this is having on your own health. They will be able to offer you advice and support, and you may be entitled to additional health services such as a free annual flu jab if the person you care for has a serious or ongoing health problem.
Although it can be difficult, try to make sure that you eat healthily, stay active and get enough sleep.

Don’t feel like you need to do everything yourself. If you have relatives who live nearby, try to be honest with them if you need a hand or want to share the responsibility.

I’m Emotional health

Don’t overlook your emotional health. Family and friends, carers’ groups , your GP or counsellor, or organisations like Samaritans can all provide you with space to talk about how you’re feeling.


If you care for someone with dementia, it can be hard to share any feelings of guilt, sadness, confusion or anger with them, leaving you feeling isolated. It’s important to acknowledge your feelings, and remember there’s no right or wrong way to feel.


Your social life

It’s a good idea to take up a hobby or activity, such as going to an exercise group or an evening class, if you can. Taking part in an activity you enjoy will give you the opportunity to do something for yourself – it’s important that you have your own interests and make time to pursue them where you can.

Your local library can provide information about social activities, events, education and courses. The University of the Third Age (U3A) can also tell you about courses in your area.

Please refer to a previous blog


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imageRecently I had an email from a patient asking if I would  support them in attending a course with MindFood. I had to admit I didn’t know what this was about and emailed Ed Harkness from MindFood to let me know what this was all about. After reading about it on the website I asked if I could blog about as not only was I interested in this venture but I would like to promote it.​

MindFood has a vision to see people with mental health issues recover, find healing and go on to achieve their potential through growing and selling food.

They run a sensory market garden in Ealing West London
They offer people with a wide range of mental health issues a therapeutic environment where those attending can learn to sow, plant and grow a variety of fruit and vegetables.
They then go on to sell ‘food that’s good for your mood’ into local communities.

I have to say I am a keen gardener and have been all my life- I have never been  far from a garden and if is no coincidence that the consulting room looks out on a garden. I remember as a small child having a patch to grow vegetables and there was nothing more thrilling than watching things grow and even  more exciting tasting the crops . I always enjoyed growing kale, spinach and sprouting purple broccoli as they all guarantee a good productive harvest from a small packet of seeds. It amuses me now to hear my children telling me now to buy them because they are today’s superfoods! Kale chips are a strong favourite- simply bake prepared kale with olive oil or even better coconut oil at 180F  for about 15 minutes and sprinkle some chilli and paprika and sea salt on them –  delicious family favourite.

My dear uncle was a gardener for the Council and had been brain damaged after a very traumatic birth but he had a major influence on my love for gardening. He could barely read or write but he knew how to garden. He could make frozen peas grow – nothing better than his homegrown Birds Eye peas! He could tell you the colour of a tulip by the bulb and prune a tree skillfully. I loved being with him in the garden and learnt so much from him but most of all I loved the peaceful atmosphere that I felt as we chatted and worked together.

When I was in Wales as a GP it was not unusual for me to be summoned from the garden, toss of my wellies to visit a patient when I was on all each weekend. Patients knew of my interest and when they came with their various complaints would also be asking about the state of the garden or pass on tips to get rid of blight, slugs or the like.

It has been my greatest joy since I have partially retired to do more gardening. I am aware of the hours of pleasure gardening has  given me over many years,  a chance to unwind, get rid of inner frustrations by digging and a sense of achievement after weeding an overrun flowerbed or harvesting crops. I am writing this after a day in the garden – trimming the conservation hedge I planted a 3 years ago and now well established providing food and homes for several families of birds. I planted my spinach and purple sprouting broccoli along with other vegetables and will look forward again to gathering the crops later this year and weeded my herb garden.

My garden last year – summer 2014. I have created this over the past 3 years since my partial retirement and it has become my Paradise.


I was delighted when my half Danish grandson decided to call me ‘Drangma’  which is the Danish for ‘ big digger’. He obviously felt it was appropriate as one of our main activities together has been digging in the garden.

It is not surprising that I was so pleased to hear about this project which supports all that I would say about gardening.


I strongly commend this course to anyone who has had moderate or severe depression and for anyone else to either look at the website or visit the site to consider volunteering to help support ythisworthwhile project.

MindFood CIC
Cleveley Crescent,
W5 1DZ

MindFood is launching a new ‘Growing Wellbeing’ 6 week course that focuses on the 5 ways to wellbeing in a food growing environment. The course is designed to be a fun balance of learning how to grow a wide range of fruit and vegetables whilst becoming more mindful of ways to improve our wellbeing.

The course is action orientated so each week we’ll discuss and commit to a specific action that will help improve our wellbeing between each session and ongoing after the course.

The five ways to wellbeing are 5 simple and practical steps that we can all take to improve our levels of wellbeing. The graphic below is an outline of the 5 ways to wellbeing and an indication of how this course will help you to engage with each one. s the course right for me?

Do you feel that poor mental health is having a negative impact on your quality of life? This course is aimed at people who experience mild to moderate depression, anxiety and other common mental health problems. The course is also for people who want to help prevent the onset of mental ill health e.g. an episode of depression.

When does the course run?

Our courses runs on Monday mornings and Friday afternoons. The next course starts on the 12th June. (Please note lunch is not provided)

Where is the course based?

We are based in Ealing, West London on a group of allotments which are a 5 minute walk from Hanger Lane Tube station or on bus routes 83, 112, 226, 95, 487. A map of our location can be found here.

What is the cost of the course?

The 6-week course costs £30 (£5 per session). The course is subsidised through the support of MindFood’s funders.

How do I sign up?

Please register your interest or direct any queries by emailing
Alternatively you can complete the referral form and send to Ed so that we can assess whether this course would be suitable for your needs.

How many people will be on the course?

The course is limited to 6 places.

Are there other courses or opportunities that MindFood offers?

Upon completion of the 6-week course you will have the opportunity to join MindFood’s Plot to Plate programme that offers longer-term opportunities to be part of our ecotherapy social enterprise.


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The Expert Patients Programme (EPP) is a self-management programme for people living with a chronic (long-term) condition. The aim is to support people by:

  • increasing their confidence
  • improving their quality of life
  • helping them manage their condition more effectively

What is an expert patient?

Many GPs who care for people with chronic condtions say that the patient often understands the condition better than they do. This is not surprising – many patients become experts as they learn to cope with their chronic conditions.

There is evidence that, with proper support, people with a chronic condition can take the lead in managing their condition. This helps improve their health and quality of life, and reduces their incapacity.

An expert patient is someone who:

  • feels confident and in control of their life
  • aims to manage their condition and its treatment in partnership with healthcare professionals
  • communicates effectively with professionals and is willing to share responsibility for treatment
  • is realistic about how their condition affects them and their family
  • uses their skills and knowledge to lead a full life

This week we had an email informing us that this programme is due to start this month


Our first Expert Patient Programme has now been booked:

Dates:      19th May to 23rd June ( 6 consecutive Tuesday evenings)

Time:        6pm – 8.30pm

Location:  Hanwell Community Centre, Small Meeting Room, Westcott Crescent, Hanwell,

London W7 1PD

Interested participants contact the course provider directly to register interest either calling or emailing as shown above



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Effectiveness, Efficiency and Efficacy

As I reflect upon my student days at The Welsh School of Medicine, Cardiff (now known as Cardiff University School of Medicine)  I realise how I was oblivious to the great opportunity of listening attentively to the lectures of Archie Cochrane , an epidemiologist who has dictated how Western Medicine is practised today. I have to say I was not enthralled by his lectures, which were largely composed of quoting various statistics, tables and numbers and certainly not my idea of studying medicine so it was not unheard of to dodge going to his lectures along with many of my peers. I vividly remember him strolling along the corridors usually smoking a pipe and I am afraid many of us were more interested in watching him roll up in his top of the range Jaguar than attending the lectures!

Archie joined the scientific staff of the recently formed Medical Research Council’s Pneumoconiosis Research Unit in Llandough Hospital, Penarth, near Cardiff (South Wales), in 1948 and initially conducted groundbreaking comparative studies of dust levels in the coal mines of South Wales.

Around one in twenty miners suffered some sort of disability from working in the pits. It was these men he recruited for the study. They were the key to its success, ensuring an astonishing response – more than 90 per cent of the population agreed to take part. Initially, he conducted groundbreaking comparative studies of dust levels in the coal mines of South Wales. Two years later, he launched the Rhondda Fach – Aberdare Valley (‘two valleys’) scheme to investigate the aetiology of progressive massive fibrosis.

Its main aim was to see if the common miners’ disease progressive massive fibrosis (PMF) was due to an interaction between pneumoconiosis and tuberculosis. In the end, it concluded that tuberculosis had relatively little or no impact.

Another of his main interests were the X ray classification of coal workers’ pneumoconiosis and the relationship he demonstrated between X ray categories, dust exposure and disability. His interest in this field continued for the rest of his life, as reflected in the completion during 1974-1986 of 20- and 30-year follow-up studies of the population of the Rhondda Fach.

Its real impact was to demonstrate that epidemiology – looking at the pattern of disease – could be carried out effectively in large-scale field studies as well as the laboratory. If Tredegar, the birthplace of Aneurin Bevan was the cradle of the NHS, the Rhondda Fach was its nursery.

Under Archie’s direction, the MRC Epidemiology Unit quickly established an international reputation for the quality of its surveys and studies of the natural history and aetiology of a wide range of common diseases, including anaemia, glaucoma, asthma and gallbladder disease. Indeed, the Vale of Glamorgan became the epidemiologically most well-defined area of the UK. These studies led naturally to Archie’s interest in the validation of screening strategies within the National Health Service. Indeed, he became a leading critic of the introduction of screening for cancer of the cervix on what he regarded as seriously inadequate evidence of its effects.

I  clearly remember this controversy and it made me understand the relevance of randomised controlled trials. An RCT, at its most elementary level, involves assigning patients to either the experimental group or the control group by using some method independent of human influence. This is the only way of proving a treatment is effective and it is the practice of carrying out RCT that has formed the backbone of Evidence Based Medicine.

It was assumed that an abnormal smear if left untreated would develop into a Cervical cancer but this had not been shown by carrying out a randomised trial but as screening was now well established at that time it would have been unethical to carry out such a trial. Otherwise, it had not been shown categorically that screening was beneficial in reducing the incidence of cervical cancer. Since that time trials have been carried out in other parts of the World comparing the death rate in a screened population and an unscreened population and proved the efficacy of cervical cancer screening.

I also remember at this time a trial was carried out comparing the death rate of those having heart attacks being hospitalised or staying at home. Those staying at home had a better survival rate. As a result of this publication  there was a policy that  patients were to be kept at home unless they developed complications or  needed to be hospitalised for other reasons. Subsequent trials around the country came up with different outcomes  as well as significant advances in cardiology so that the policy was reversed and Coronary Care Units evolved.

The uncomfortable truth which he highlighted in his 1971 Rock Carling lecture Effectiveness and Efficiency: Random reflections on health services,  was there was no good evidence for many medical intervention and treatments. Too often it was based on subjective ignorance (from fellow doctors, which didn’t endear Archie to many colleagues) rather than objective evidence from randomised controlled trials. The conclusions of the lecture given 44 years ago makes fascinating reading and bear a striking resemblance to how our Health Service is evolving today.

Since this time countless randomised controlled  trials of medical interventions and treatments have been carried out and now form the basis of evidence medicine which dictates how we practise medicine today. As I reflect on this I feel amazed that those lectures that I dodged along with many fellow students more than 40 years ago would be so significant. But somehow it has always been engrained in my thinking as a doctor simply because we had to remember the basics from the lectures in order to pass an examination. When I had a recent chest X-ray it showed that I must have had sub – clinical tuberculosis – so that I along with many others also proudly carry the scars of working with miners in South Wales. . Hence without realising it I was experiencing the influence of one of the most important pioneers of scientific method in medicine, Archie Cochrane.

Moreover, it is a sobering thought to think that it took nearly 30 years of Archie Cochrane’s extensive work with miners in demonstrating the association of mining  with disabling pneumoconiosis, the management of which played a major part in my early medical career, to be recognised as a disease warranting compensation.



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