Ridgeway Recorder - November 2025

A welcome from Dr Genevieve Small

Welcome to the second issue of the Ridgeway Recorder – the newsletter produced by the patients group to keep you up to date with events at the surgery. It also gives me the opportunity to thank the group for their support – they are always ready to help out when needed. This month their volunteers have helped us run our flu jab clinics as well as commenting on our services on your behalf. The introduction of the
Ridgeway Recorder has also been a great success and I am grateful to the Editor, Lesley Cramp for her efforts along with the whole RSPG.

Looking at the articles in this edition underlines for me the variety of challenges facing all of us.

Dr Clare Etherington is answering questions about how to stay healthy in the winter. While we may not want to follow her example and go cold water swimming on Hampstead Heath, she provides good advice on useful medicines to keep in the house as well as knowing the difference between cold and flu. No one who knows Dr Etherington will be surprised to find she recommends plenty of exercise in the fresh air and eating healthily.

While trying to keep healthy in the winter is something we do every year, some challenges are completely new. Many of you will have heard the initials AI mentioned but perhaps you may not have realised what radical changes it could produce. Dr David Lloyd is already using AI in his work and his article provides a fascinating insight into its potential for the future.

The future is something we all need to prepare for. One of our committee members writes in this issue about the need to care for her mother and the help and support she has received from Harrow Carers. Issues we need to think about in Later Life were also the focus of a session run at the North Harrow Community Library – read about the things you can do to prepare for the future and how you can make things easier for your family.

Every year the patients group take part in the national Macmillan coffee morning. We now hold this on a Saturday in the local St Alban’s church. This gives us more time and space for people to enjoy the food and coffee provided. As more people attend it is also becoming an important community event. Getting together with other people in a common cause is always good for us and this time we were able to raise £1228.75 – more than ever before.

The need to take cancer seriously and to take the opportunities offered to protect ourselves is outlined by one of our patients who was diagnosed with prostate cancer after checks recommended by the surgery. This is a lesson for us all.

Finally, I would like to highlight that this edition is coming out just before the end of 2025. I want to thank all of you for helping to support the practice in the new ways of working that we have introduced over the last 12 months. We do know that change is difficult and we don’t always get things right. We like to hear from you with any suggestions you have but also do let us know if you identify members of the team you want to thank. We always pass on your comments to the team and they endeavour to always work hard to help keep you healthy

With Best Wishes
Dr Genevieve Small

Ask a Ridgeway Doctor

  We all have questions that we would like answered but may not be able to ask a doctor. We asked Dr Clare Etherington some questions about how to stay healthy during the winter.

Q: As a doctor you must come into contact with people who could be infectious. How do you look after your own health in the winter?

A: I wash my hands every time I touch a patient - it helps reduce spread of infection between patients and, equally importantly, it protects me. When I was a younger GP, I had a flu vaccine every year to protect my patients and colleagues. I am now old enough to have one every year in my own right. My secret magic is swimming outdoors on Hampstead Heath all year around. It’s not for everyone so don’t worry; I don’t prescribe it. I do however believe that doing some exercise, ideally outdoors, every day is helpful. 

Q: What are the best ways to manage cold and flu symptoms?

A: Your mum or dad probably gave you good advice - for the first couple of days rest, take plenty of fluids and food if you fancy it. There is good evidence for the benefits of hot drinks containing honey but babies under one should not have honey and hot drinks need to be cooler for children so they do not get burned if they spill. Unless you have to, try to keep away from crowds of people so that you don’t affect them. The same applies to vulnerable relatives.

Learn more anout the common cold - NHS

Q: How do I know the difference between a cold and flu? When do I need to contact the surgery?

A: Mostly colds come on slowly, are mainly in your nose and throat and, although you don’t feel great, you can usually manage the activities of daily life. Flu comes on faster, makes your whole body feel ill and stops you doing normal things. For some of you who are vulnerable such as people with lung diseases, people who are immunosuppressed and with some other long-term conditions, planning for winter should involve a conversation with us about what to do if you get an infection. Anyone whose illness causes them to feel short of breath or have difficulty in breathing or get chest pain should contact us or ring 111.

Learn more anout the common cold - NHS

Q: What are the basic medicines I should keep in the house in case of illness.

A: The more medicines you keep in the house the more likely they are to be out of date, and the more risk there is of children finding them and being attracted by the packaging. Paracetamol and ibuprofen would be top of my list. Good planning for the winter is to make sure that these are suitable for your medical conditions and any medicines that you take regularly. Be careful not to take a variety of flu medicines all at the same time. This could mean you go over your daily limit.

Medicines to Keep at Home

Q: Is it a good idea to have a flu jab? Who is eligible?

A: Flu jabs do not offer 100% protection but they reduce the severity of your own illness, making you less likely to go into hospital. The vaccine is available to those most likely to be seriously ill-older adults and people with long term illnesses. Carers are some of the most valuable people in our community and they are eligible for a flu jab. Remember you are a carer if you look after someone, you do not need to get a carers allowance.

Pregnant women are particularly vulnerable - we are always happy to talk to any pregnant woman who is worried about being vaccinated.

Your guide to who’s eligible for the autumn 2025 flu vaccine

Q: What is the danger of catching Covid? What precautions should I take and can I have a jab?

A: Covid is not often in the news but is still present in the community, all year around. Last year, we found that people who had been vaccinated were much less likely to end up in hospital with Covid. I think that the pandemic taught us some lessons about not sharing our germs. Washing our hands protects us and others. If we are acutely unwell with any sort of infection we should try to keep away from people to avoid spreading it.

This autumn the vaccine committee has decided to target the Covid vaccine on the most vulnerable- people 75 or older, care home residents and people who are severely immunosuppressed.

Q: Is there anything I should eat in the winter to keep me healthy and should I take vitamins?

A: I am not a fan of vitamin tablets - I think we can get the best benefit from eating a rainbow of fruit and vegetables each week. I think that there is some evidence that we should take vitamin D in the winter. People who are totally vegan should also take an oral B12 supplement.

Q. When it’s cold all I really want to do is stay in the warm and wait for Spring. Is there anything wrong in doing this?

A: It is fine to stay at home and wait for better weather but it is important to stay active, even in the winter. With the increasing costs of fuel, people can get very cold in their homes. Age UK has good advice on their web site about keeping active and staying warm. It also highlights resources for financial help with energy bills.

How to Keep Warm in Winter

Q:. I often feel very low in the winter – is there anything I can do about it?

A: Many of us find the dark mornings and evenings difficult, and some people get a sort of depression called seasonal affective disorder. Getting outside in the middle of the day can be helpful. Some people use special light bulbs or lamps but there is not much convincing evidence about how well these work. Loneliness can be dangerous to your health and it can be much worse in the winter for people who stay indoors. There are many organisations in Harrow such as the North Harrow Community Library, the University of the Third Age and faith groups which can provide opportunities to meet other people. Many people volunteer to help others. Harrow Carers can also help you find opportunities.

Q: I worry about falling over when I go out, especially if the pavements are slippery. Is there anything I can do to feel safer on my feet?

A: There is lots of evidence that we should all be doing exercises that focus on flexibility, balance and strength to reduce our risk of falling as we get older. If you are scared of falling because you have had other falls you may want to book an appointment with us to see what we could do to help.

Walk your way to health

AI and Me: From Lloyd George Envelopes to Digital Scribes

We asked Dr Lloyd to answer the question ‘Is AI really that clever, and will it make things better?’ His answer is well worth reading.

I’ve been a GP long enough to have seen general practice evolve from ink pens and Lloyd George envelopes to talking computers that can type up what I say before I’ve finished saying it.

When I first joined The Ridgeway, our ‘IT system’ consisted of A5 cards stuffed into brown envelopes. Notes were brief - ‘better’ or ‘worse’ were perfectly acceptable entries - and my senior partner, Geoff Shackleton, ran the surgery from the side of his house. Letters were dictated (if we were feeling grand) or handwritten (if we weren’t). The only ‘cut and paste’ involved scissors and glue.

I introduced something revolutionary at the time - SOAP notes: Subjective, Objective, Assessment, Plan. It seemed terribly modern and gave our typist something legible to type up on our new golf-ball typewriter. Thursday afternoons were our ‘half-day,’ so naturally that’s when I started our first dedicated hypertension clinic.

Then came Ken Walton, our third partner = part clinician, part coder. Ken wrote a cervical smear recall program on a Sinclair computer and proudly installed our first practice computer: a BBC machine with two floppy disks, each holding a massive 400 kilobytes.

From there we graduated to black screens with green text, and eventually to Windows = which, despite the name, has probably caused more closed eyes than open ones. Ken was a stickler for coding. He tried to label every diagnosis, symptom, and sneeze with the correct ‘read code’. I sometimes imagine him in retirement, shuddering at the chaos of the free-text notes now being churned out by my younger colleagues.

Fast forward to today. I type a little - having once taken a typing course between school and university (the only boy in a room full of girls, which I considered a solid career decision at the time). My notes were never verbose, but I prided myself on writing a good referral letter - always with a question for the consultant to answer. A lost art, I think.

Now? The pendulum has swung too far. We’re drowning in digital detail. Today’s doctors, terrified of missing something that a lawyer or patient might later spot, write screen-lengths of text. And because patients can now see everything we write, gone are the days when you could note, ‘seems a bit anxious - perhaps about mother-in-law.’

So yes, we’ve come full circle. The computer - which once promised to save us time - has become our master. Until recently, that is.

Last year, I started using an AI scribe called Tortus. It listens silently during consultations, summarises everything we say, and produces a neat draft of my notes and a summary I can send to patients afterwards. Suddenly, my notes are long, detailed, and accurate - but the typing isn’t mine. For the first time in decades, I can give my full attention to the person in front of me. It’s rather like being a doctor again.

Every note is checked by me before it goes into the record. The recordings vanish after 24 hours. It’s all NHS-approved and rigorously tested. You can, of course, say no to the AI being on - though I’ll be a bit bereft if you do.

Meanwhile, there are quieter revolutions happening in the background. AI tools like ChatGPT, Copilot, Claude and Gemini can turn those dreaded ‘To Whom It May Concern’ letters into flowing, accurate, and even legally referenced prose in half the time. They can help decode tricky blood results, suggest differential diagnoses, or draft advice that’s actually written in plain English.

None of this replaces the doctor–patient relationship. If anything, it might rescue it. AI should do the clerical work so we can do the human work — listening, thinking, connecting.

So, to answer the question: Is AI really that clever, and will it make things better?

Yes — if we use it wisely. It’s not a cost-cutting trick, and it’s not about replacing people. It’s about giving us back the time to be people again. AI won’t forget your name, but it won’t remember your face either. That’s still my job.

What makes you a Carer?

It can take a while to realise that you are a carer. One of our members has written about how important it is to recognise that looking after a loved one can take over your life and the sort of help that is available when it does.

Becoming a carer creeps up on you. I didn’t realise I was a carer until somebody else pointed it out me. They asked ‘does your mum get a carers allowance?’ I replied that I didn’t think she would qualify, either because she had too much money or because I was not doing enough hours.

After a while I realised that I had got to a low point. Caring was affecting my health but also my relationship with my mum. That was the point when I contacted Harrow Carers (based in North Harrow), and they turned everything around for me.

They gave me the confidence to apply for financial support (which I discovered is not actually income related), and to admit that I didn’t find looking after my mum easy. They advised me how to manage her behaviour while giving her as much independence as possible. I went on a six-week course with other carers who, like me, had been slow to realise the impact that caring was having, not just on ourselves but on our families and the people we were looking after.

My mum has dementia but does not realise the effect it has on her life. She still thinks she should look after me but thankfully her short-term memory is so bad she does not realise how hard it is for us both. We had arranged carers to come in twice a week but Harrow Carers encouraged us to arrange a visit from carers every day, Mum found it easier to accept care from them than from me. They also manage some housework every day, so the house is now cleaner and easier to maintain.

A major step has been installing cameras in the living areas as mum refused to have the Lifeline phone that many elderly people rely on if they fall or feel ill. Now I can see mum is fine until she isn’t, and then I can respond.

Most importantly I now have help from my brother, my husband and my children who could all see that I was not coping. My usual halo was slipping and I did not enjoy being complimented on what I was doing. Rather I wanted my freedom to spend time with the grandchildren and not to have to consider mum all the time. Now I realise that mum and I are not alone and can ask for help when we need it.

My final advice to anyone with elderly parents or those in poor health, is to organise the paperwork. You need a lasting Power of Attorney for both Financial & Property and Health & Welfare to be able to take decisions for your loved one. This can only happen if the person is able to give their consent and understands what they are agreeing to. You may also want to come to one of the Later Life sessions that the surgery runs with North Harrow Community Library.

You also need to tell your GP if you are a carer as they can advise and help you as well. It will be recorded on your medical notes and you can have a carer’s health check or get priority for flu and COVID jabs. The surgery can also arrange a joint appointment for a patient and their carer if needed.

Harrow Carers made all the difference – they gave me the confidence, the knowledge and the support I needed to face the future. There are still many other issues that will arise with my mum, and I know Harrow Carers will always be able to give me the best advice.

Learn more about Harrow Carers

Latter Life Matters – Summer Talk Session

This was organised jointly by Ridgeway Surgery & North Harrow Community Library. Facilitators were Dr Clare Etherington (Ridgeway Surgery) and Kamal Shah (North Harrow Library & Member of the Society of Will Writers).

Purpose of the Session

The session encouraged patients and families to openly discuss and plan for the future as we age. By thinking ahead, participants can make their wishes clear, easing the burden on loved ones who may need to make difficult decisions during emotional times.

Key Topics Covered

• Advance Decisions – planning future care and treatment preferences.
• Life-Sustaining Treatment – understanding choices around medical interventions.
• Do Not Resuscitate (DNR) Decisions – clarifying personal wishes.
• Living Arrangements – considering downsizing or adapting current homes.
• Financial & Legal Planning
  • Creating Lasting Powers of Attorney for both Finance and Health.
  • Ensuring trusted attorneys can act if you are unable to manage your affairs.
• Writing a Will – ensuring your estate passes according to your wishes.

Format

• Designed as a conversation, not a lecture.
• Participants encouraged to share real-life experiences, helping others learn and reflect.

By fostering open dialogue, the sessions empower individuals and families to prepare thoughtfully for later life, reducing uncertainty and stress when decisions become urgent.

We hope to arrange more sessions in the coming year on a variety of subjects related to health and lifestyle subjects.

Macmillan Coffee Morning – most successful so far!

Macmillan yearly fund-raising coffee mornings are part of the DNA of the Ridgeway Surgery Patient Group. In the early days we would run it in the surgery, providing coffee, cake and chat while patients waited to see their doctor. However, it became increasingly difficult to run the event without disturbing the patients and we looked for a new location.

We were lucky to find a new home on Saturdays with St Alban’s church nearby, which has provided a warm welcome and a range of practical support. This year was no exception. Our day started early as we took over the church, ably assisted by the church warden and his team, setting up welcoming tables and chairs. an extensive raffle, a stall with a delicious array of cakes and samosas as well as the tea and coffee stall.

We were ready to open the doors on time at 10.00am, welcoming the Mayor of Harrow Cllr Anjana Patel, who some of you may know as a local resident. We were also supported by Harrow West MP Gareth Thomas and North Harrow councillors Janet Mote and Chris Baxter. We were also pleased to welcome surgery doctors Clare Etherington and David Lloyd as well as practice manager Andy Slater.

This year we were able to raise more than ever before - £1228.75. This included £535 raised from our Just Giving page on the internet. Money donated here is particularly welcome as Macmillan are able to claim Gift Aid so it is well worth considering this in the future.

Apart from raising funds the event had a lovely community feel as people sat and chatted and enjoyed the refreshments. None of this would have been possible without St Alban’s Church allowing us the use of their premises, and the generosity of so many. A big thank you to everyone involved.

We are planning to run the 2026 event on Saturday, 26 September. We are hoping to raise even more money next year so we hope you will be there.

Macmillan were also delighted with our success. 'Coffee mornings like this bring people together to raise the vital sums we need to provide services for people living with cancer. Nearly 300,000 people are living with and beyond cancer in London alone and fundraising like this makes all the difference’ said Macmillan fundraiser Luke Lewis.

Men’s Health

Knowing how to look after your own health is important to all of us. One of our patients writes here about how taking ownership of managing his own health by working with the surgery has paid dividends.

He writes: ‘I started to have regular prostate checks and PSA blood checks from the age of 58. It seemed like common sense at the time. When I was 63 I got a call from one of the doctors at the Ridgeway Surgery, who said that my PSA levels were gradually rising and that a referral to Northwick Park Hospital would be helpful. That was June 2021.

Following multiple checks, tests and a biopsy, within three weeks I was diagnosed with prostate cancer. It was Gleason score 7 which indicates a medium-grade prostate cancer. I had an operation date in September 2021 and my prostate was removed by way of a radical robotic prostatectomy. I was subsequently advised by my surgeon that the cancer had developed aggressively to Gleason score 9 in just two months. However, my cancer hadn’t breached my prostate gland and it had not spread. The surgery was successful, with a positive prognosis.

Four years later I am discharged from monitoring and now just take an annual PSA and blood test as a checkup.

Speaking to my male friends about this before and after my surgery, I encouraged them to check and test for prostate cancer. One friend had an almost identical situation to mine but had a less successful outcome.

Catching cancer early by checking yourself is critical to a longer, healthier life. Had it not been for my regular PSA tests, and particularly the foresight of the doctors at the Ridgeway Surgery, my outcome would not be so positive and I know how lucky I am that my cancer was caught in time. Thank you to the surgery and to the doctors at Northwick Park hospital, for prolonging my life.

Ridgeway partner Dr Amit Gohil commented ‘This highlights the importance of regular health checks, which can help detect diseases early, making them easier to treat and reducing the risk of complications.’

Prostate cancer is the most common cancer in men in the UK. An increasing number of men are having PSA blood tests, which can help detect prostate cancer earlier. However, the test is not perfect: sometimes PSA levels can be raised for reasons other than cancer, causing unnecessary worry or further tests, and in some cases, a normal result may miss a cancer. In November 2025, the UK National Screening Committee issued draft recommendations on prostate cancer screening.

They do not recommend screening all men, as the potential harms may outweigh the benefits. Some high-risk patient groups are being considered for regular screening. A public consultation is underway, and the final guidance on this is expected in 2026.

If you are concerned about prostate cancer or experience symptoms such as a weak urine flow, getting up at night to urinate, urgency, or difficulty emptying your bladder, it is important to speak with your GP. They can help assess your risk, discuss PSA testing, and arrange further tests if needed. 

Chair has the final words

Wow, what a great informative newsletter. We hope it helps many with new information and ideas as to how to look after our health and wellbeing. This newsletter no. 2 is in our new format which is easy to negotiate online on the Surgery website - this has lots of information and guidance other than purely accessing PATCHS. We will be printing both nos.1 & 2 newsletters by the New Year and copies will be placed in both the Ridgeway and Alexandra Avenue Surgeries.

A huge thanks must go to Lesley Cramp (reporter extraordinaire) for her time and expertise in producing this newsletter, supported by Marion Deacon on this edition. Thank you to those who have shared their own experiences, you know who you are!

We are planning a First Aid Responder course for Monday, 26 January 2026, 7pm for a 7.15 pm start, to be held at the Ridgeway Surgery. More info in the new year! 

Thank you to all the current committee and all new members and friends - we will keep on being your voice and working with our GPs and the staff team.

Finally, a Happy Healthy New Year to you and your families.

Sue Bush 2025

Published: Dec 19, 2025