DMC sent out its patient survey erroneously under my name, for which no doubt it is very sorry. It did not come from me or the Patient Participation Group. As chair of the PPG I am busting a gut trying to help them provide a better service on diminishing resources, so I was happy to add an encouraging note which has, I see, been edited. I added some questions to the survey which have been formulated so badly that the answers will be almost useless. Practices are all supposed to send out an annual survey like this. Results are available nationally and are supposed to help service planning. Ha! DMC has demonstrated that this survey software is not foolproof! As my email address was included in the mailing, I am doing my best to answer all your replies. Yes, there are 12,000 patients. Practices are not allowed to close their lists. DMC CPR receives only 0.9 of the possible allowance per patient as East Dulwich is not seen as medically needy. We are assured that there is a full complement of both clinical and admin staff for 12,000 patients. Patient feedback indicates that the doctors are almost always excellent but it is hard to get an appointment, leading to frustration, anger and often real distress. There are some very good administrators. The pharmacists are excellent. The nurses are too busy. District Nurses now come from Guy's and St Thomas's and don't always fit our visits in. There will soon be a Community Psychiatric Nurse appointed. I hope the CPN will keep a few sessions available to overstretched staff.... The PPG is giving itself a year to September to see if we can do anything useful. If we can't we shall disband and allow DMC to carry on without us. It is possibly useful that we have averted the start of Telephone Triage, where GPs assess our needs on the phone, until practice telephone monitoring demonstrates conclusively that this is a reliable means of communication. GPs seem to feel that they are mostly likely, after phoning patients, to end up asking to see them anyway, so their workload could increase rather than lessening. If you read the attachment, you will see that we are trying. Some of us are very trying. Helen Chown.