What Croydon can learn from Covid-19 – Zoom Meeting

Zoom Meeting – 25th November 2020

On the 25th of November we had our second virtual meeting of the autumn and once again our speaker was from Croydon. We were delighted to hear Dr Nnenna Osuji, Consultant Haematologist, Medical Director and Deputy CE of CHS talk about “What Croydon can learn from COVID”.

Nnenna gave us a fascinating insight into the challenges the Pandemic threw at not just Croydon University Hospital but the whole health system. It became clear why CUH was so successful in not being overrun by the virus in the first wave and since then how well they are dealing both with the catch-up work and the developing second wave. The commitment of all the staff, the leadership and learning day by day (WhatsApp groups providing evidence based advice) plus cooperation between trusts – all this was highlighted as were individual and heart-warming stories. Nnenna spoke passionately and highlighted the impact on individuals and the importance of support for all staff.

The lively Q&A session was co-ordinated by John Spicer and there was universal praise for the performance of the Trust, ably led by Nnenna and her team. Nnenna was thanked for giving us such an excellent educational, engaging and inspiring talk.

Peter Boffa
President

Epidemics, Archbishops and the East India Company – The Busy Life of a Victorian Croydon Doctor.

Zoom Meeting – 21st October 2020

Your President, Dr Peter Boffa, welcomed 23 members to our first Zoom meeting. He felt it important to continue the role of the society to provide informative talks to members and was hopeful that these will prove popular. A moment of thought was given to honour the passing of Dr John Manners who sadly died in July just a few weeks after being presented with a special commemorative tankard for his services to CMS and as Honorary Archivist. We also remembered Dr Krish Arora who succumbed to Covid-19 earlier in the year. He was not a member of CMS but was well known to many as a popular local GP.

A small technical hitch was initially encountered but this was quickly sorted and we were able to sit comfortably and enjoy the presentation by Dr Nick Cambridge on: Epidemics, Archbishops and the East India Company: The Busy Life of a Victorian Croydon Doctor.

The talk was enhanced with a PowerPoint presentation and it was clear that Nick had a great knowledge of and passion for his subject. Dr Alfred Carpenter was a Croydon doctor for 30yrs from 1852-83 and then became a consulting physician until his death in 1892, age 66. As a 15yr old boy he helped look after his father’s patients when his father was ill, and this catalysed his interest in medicine. He looked after the cadets of The East India Company at its Military Seminary based in Addiscombe from 1809 – 1861. It was built on 88 acres of land between Addiscombe Road and Lower Addiscombe Road – this is now protected from development as a conservation area since 2007. I have attached a pdf document which some of you may find interesting. At one time this private army had 260,000 officers serving in India. Alfred also looked after the Archbishops of Canterbury at their summer residence who have a long association with Croydon for over 500yrs. The Old Palace had visits from Henry VIII and Elizabeth 1. Later the episcopal Palace moved to Addington Palace from 1807-1896. St Mary’s Church in Addington Village is where five of them are buried. When Carpenter was in private company, he would mention that he ‘closed the eyes of three Archbishops’. He was well known in the public health arena both nationally and internationally and promoted sewage irrigation as the best way of disposing of sewage. He was a JP and an active member of the Croydon Medical Book Reading Society (later changed to the Croydon Medical Society).

The Q&A’s were successfully filtered by Dr John Spicer and then the President thanked Nick for a most enjoyable evening. He reminded members to invite at least one other person to share our next meeting, on Wednesday 25 November, when Dr Nnenna Osuji will present a very topical subject on ‘What can Croydon learn from Covid-19’. The invited doctors should be potential members i.e. eligible by living or working in Croydon.

Anne Pilkington

Honorary Secretary for Croydon Medical Society

In order to watch the Zoom Presentation please login to the Members’ Area.

Learning from History: Primary Care Reforms’, using Art to explain.

Our second meeting took place on Wednesday 13th November at the Cedars School. There was a short agenda prior to the Speaker’s talk.

• Dr Dev Malhotra was introduced as a new member
• Dr John Spicer and Dr Louise Newlands were welcomed as new Committee Members
• Reminder about getting teams together for the Christmas Quiz on 10 December
• Overdue subscriptions to be paid asap
• Nominations for the Lifetime Achievement Award – note the deadline of 30 November – details on the website
• Reminder to please use our new website as it is very user friendly

The President went on to introduce the speaker, Dr Nav Chana who is well known to many of us in Croydon. Nav has been a GP at the Cricket Green Practice in Mitcham for many years. He has always been heavily involved in Education and Primary Care development at local and national level. He was warmly congratulated by the Society for his recently awarded MBE.

Nav gave a very entertaining talk on lessons learnt from changes in the health service illustrated using art. Nav showed us his wide knowledge of art, for which he clearly has a passion. This was an eye-opener for those of us used to a more cursory viewing! The development of the NHS was examined up to the present day up to the aspirations for the new Primary Care Networks. We were reminded that 90% of determinants of health are social and also to beware the “cobra effect”! If you weren’t at the meeting you should look it up. The evening concluded with a lively discussion.

Peter Boffa

Making decisions about feeding tubes for vegetative & minimally conscious patients: law, ethics and professional guidance

Professor Jenny Kitzinger was our October Speaker and she talked about decision making in tube fed patients who have prolonged disorders of consciousness – law ethics and professional guidance. She highlighted the key principles of best interest decision making in these patients who lack capacity and the risks involved in treating these individuals without best interest being established. For example, signing a monthly prescription for tube feeding (established as a medical treatment in law by the Tony Bland case) could constitute an assault – a surprise to many of the GPs in the audience! The GPs were also somewhat surprised to find that in the community they are the clinically responsible decision-maker for their patient, with all the responsibility that entails. The new guidelines from the Royal College/BMA should be read by all prescribers/decision-makers. Changes in the law now mean that withdrawal of tube feeding no longer needs go to court – so long as all parties agree.

There was lively discussion about ‘best interest’ meetings, with some strong views expressed and this led to discussion about what preparations the audience had made to ensure that family/friends would be aware of their own wishes about how they would wish to be managed should brain injury occur. A show of hands demonstrated that very few members of the audience had prepared either an Advanced Care Directive or a Power of Attorney and even fewer had both.

A very pleasant and enjoyable evening was had by all at our first meeting at The Croydon Day Hospital where we were very well looked after in very conducive surroundings.

Peter Boffa

A copy of Professor Kitzinger’s slides are available from the Members’ Only Area.

Professor Kitzinger’s Biog.

Professor Jenny Kitzinger is co-director of Cardiff University’s ‘Coma and Disorders of Consciousness Research Centre’ which specialises in examining legal, social and ethical aspects of how we treat such patients (see www.cdoc.org.uk; Twitter). Jenny served on the Royal College of Physicians’ working party on prolonged disorders of consciousness and contributed to the BMA/RCP guidance on decision-making about Clinically Assisted Nutrition and Hydration. Her research, conducted with her colleague (and sister), Professor Celia Kitzinger, has been widely published in journals such as The Journal of Medical Ethics, the BMJ, and Sociology of Health and Illness. This research has also been translated into a multi-media resource for families (see www.healthtalk.org/peoples-experiences/nerves-brain) and online training for clinicians (see CDOCTraining.org.uk)