Dear all,
We held a ‘Winter Chinwag’ on the 10 November 2025 that was well received and attended by the retired although there was some representation from working people too. This was a socially orientated event aimed at giving the opportunity to combat isolation. The event was open until 5.30pm to allow for age-friendly attendance. A representative from Gaddum, Salford Carers, along with two members of our PPG, kindly gave short introductions to their caring work and the Mosley Common Walking Group (initially established 10 years ago through PPG intervention and now organised by Be Well, Wigan) and other local social orientated groups, respectively.
Our Winter Chinwag had a convivial atmosphere but we also discussed the links between vulnerable patients to our practice groups and considered workable ideas that would benefit the health and well-being of these patients and the practice.
The idea of a Winter Chinwag, with a very visual focus, originated out of a member’s concern for the vulnerability of our elderly patients. However, we soon realised that this was a much wider concept that should be applied to all our patients to help mitigate and navigate exposure to physical and emotional harm etc that we can ‘bump’ into from time to time.
We acknowledge that every patient is vulnerable to some extent and for a variety of reasons throughout their lives. Some are highly individual reasons whilst others may be brought on through the way we arrange our society. Nevertheless, many return to periods of vulnerability, possibly on repeated occasions and for varying reasons, following times of stability and good health. Additionally and sadly, there are some patients who remain in a vulnerable position for continuous and extended periods of their lives with no respite, such as those who are very ill or homeless.
Looking at our practice population as a whole, therefore, we realised that there is a continuous shifting of patients who are vulnerable and those enjoying good health.
In times of extreme circumstances, for example, during the pandemic, the vulnerability demographics were heavily biased towards those patients who were most susceptible because of factors, such as, their age, level of immunity and general health at the time.
With this in mind, and as lay people, the PPG, were curious to understand more about the dynamics of vulnerability (involving non-clinical issues) and what can be achieved. Subsequently, our aim is to help improve the health and wellbeing of the patients at Boothstown Medical Centre by supporting the clinicians.
Firstly, all patient populations can be categorised into a number of patient groups according to the age related, social, mental and physical health needs etc of patients within each practice. However, the PPG doesn’t recognise vulnerable patients as a separate group but instead sees every group as having vulnerable patients. Many of these patient groups overlap, as patients could belong to several groups at any period of time. Furthermore, this arrangement is evolving constantly as patients age and their situations change so any set of patient groups that an individual belongs to changes accordingly, as patients go through life.
Already, we are beginning to appreciate the complexity of what we are attempting to achieve, in both understanding and identifying appropriate action, that is within our means.
So, we needed to work out what comes under the giant umbrella of ‘Vulnerability’ and how it impacts each patient group. We opted for each member of the PPG, thinking of single words or three word phrases that would accurately describe how vulnerable patients in each patient group could be impacted.
As patients may be in several groups at once, as explained above, the words or phrases were often duplicated for those groups or sometimes a different word or phrase was identified as relevant.
We wanted to see if any patterns were emerging and crucially if there were underlying themes or any overarching issues that could be identified and used as starting points to aid our understanding.
As we looked at and began to discuss the results, we found that many issues were indeed replicated and therefore, affected a number of patient groups. We considered that perhaps these could be a starting point.
In order to gain further understanding we organised our Winter Chinwag and asked the attendees to do the same exercise. Our conversations around the tables with our guests, provided valuable first hand insight and support from Health Professionals was very useful too.
It was helpful that many of our PPG members and Chinwag attendees had direct access to family and friends who were members of other patient groups. This was particularly useful for including mental health and disability issues as these patients are often hard to reach. The reasons why these patients often feel vulnerable, for example, may be deep rooted including societal stigma that can have a grave effect, combining with an individual’s lack of resilience. These are wide issues and beyond our scope without professional intervention so that other more accessible vulnerability issues that we can help to address, can surface.
Other attendees had had the opportunity to make informal observations of other patient groups within their community settings. This information significantly increased the breadth of our findings. At this stage we had obtained an inkling of the most salient vulnerability issues that were affecting the patient groups.
The above is an ongoing process and communication issues clearly play a part at different levels. We continue to add to our knowledge through an increasing number of patients accessing our Facebook, website and other social media outlets, thus increasing their interest and awareness over time. This, together with possible future invites to patients attending the surgery, to join in this dialogue and actively partake in what they can achieve themselves is promising.
The PPG are interested to lend a listening ear to encourage further ‘layman’ conversations with patients. However, every patient’s vulnerability levels are different and we can only be involved in general awareness and non-medical issues and not provide any form of medical advice. Hopefully, though, general issues will be opened up to create and aid greater patient awareness and understanding and have the potential to ultimately benefit to some extent, all members of the Practice.
We recognise that it often takes time for patients to develop confidence to join in our conversations but by promoting an inclusive, age friendly ethos, we hope to break down barriers and increase communications.
The above focused on the negative aspects of the links between vulnerabilities and patient groups. However, a further dimension to holding the Winter Chinwag was the positive principles of Hygge (a Danish way of life that encourages wellbeing and a cosy lifestyle resulting in the Danes purportedly being branded the happiest people in the world!). The aim in considering both Vulnerability (Negative) and Hygge (positive) aspects, was for attendees to think of realistic, balanced, well rounded ideas that when put into practice would benefit both Patients and the Practice.
All ideas were anonymous because we didn’t want want to highlight individuals. Instead we preferred the (Hygge ‘We not I’) community spirit option and would like to emphasise that we value everyone’s contributions, however small. We know that we wouldn’t be able to action all ideas submitted but we would like to be able to choose the most relevant aspects of everyone’s contributions and combine them together into workable suggestions, ensuring a truly communal effort.
This is why we used the analogy of making a nutritious soup or stew – your individual ideas resembling the ingredients (Hygge comfort and good food) that combine to release the flavour and nutrients (just like your combined good, well balanced ideas!). Furthermore, is it possible that your homegrown, heirloom (just means old varieties more than 50 years old!), Winter Greens can be added to the pot too? 🥬 😂
Kind regards, The Patient Participation Group
